MAN 202 COURSEWORK

In Partial Fulfillment of the Requirements for the course

GLOBAL CONTEXT AND GLOBAL INITIATIVES IN NURSING

for the degree Master of Science in Nursing – Adult Health

COURSEWORK # 4

Submitted by:

Tumambing, Princess E.
SPUP MSN Student

Submitted to:
Dr. Anunciacion Talosig
Dean, School of Nursing and Allied Health Sciences

2ND SEMESTER 2020

 Table of Contents
Title: TELEHEALTH NURSING TAGUIG (TNT): NEW NORMAL
DURING PANDEMIC ......................................................................... 2

The Current State of Global Health ............................................. 2

Who We Are ............................................................................... 3

What We Do ............................................................................... 3

Where Do We Work .................................................................... 5

Mission, Vision, Objectives ........................................................... 6

Program Targets………………………………………………………….……………… 6

Time Frame………………………………………………………………………………....7

Resources…………………………………………………………………………………… 7

Expected Outcome……………………………………………………………..…..... 7

Reference…………………………………………………………………………..………. 8

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 Title: TELEHEALTH NURSING TAGUIG (TNT): NEW
NORMAL DURING PANDEMIC

The Current State of Global Health

The precise concept of a pandemic has been diverged between scientific and medical scientific for years,
but one point that everyone acknowledges is the term defines the prevalence of the disease above what
should usually be predicted in a geographic area.

The most vicious murderers in modern history include cholera, bubonic plague, smallpox and flu. And these
diseases are well defined as pandemics across international frontiers, particularly small pox, which, in its
12,000 years of life, has killed 300-500 millions of people.

A new ("novel") coronavirus started to occur with humans in the area of Wuhan , China, from December
2019 onwards. It was dubbed Covid-19, a simplified version of "coronavirus disease of 2019." This new
virus spreads extremely rapidly among people because of its uniqueness – no one on earth has immunity to
Covid-19, because no one had Covid-19 until 2019. Although it was originally seen as an outbreak in China,
the infection spreads around the world in a matter of months. The WHO declared Covid-19 a pandemic in
March, and by the end of the month, more than half a million people had been contaminated and almost
30,000 had died. The rate of infection in the US and other countries was also increasing.

The COVID-19 pandemic has resulted in increased demand for hospitalization, which can, in turn, highlight
logistical deficiencies that place additional stress on the U.S. healthcare system. Hospitals and health
facilities require contingency measures for reacting to spikes in urban hospitalization and mitigating the
transmission of coronaviruses to healthcare workers.

The pandemic of COVID-19 has put the world in danger for most people but threats are far more severe for
people who have weakened immune systems, such as disabled people, and older adults. In the same way,
family caregivers who care for their loved ones must be particularly vigilant when venturing outside the
house, as exposing themselves to a dangerous virus like coronavirus often means exposing their caregivers.
Telehealth nursing is a critical service during this time of crisis, and in this article, we will explore the
concept of telehealth nursing, examples of how it helps seniors, people with disabilities of family caregivers
during the coronavirus pandemic and beyond.

Tele is a prefix that means "at distance" that is used as a telescope or telemetry, for example. In conjunction
with the word scope, the telephone prefix has the only specific meaning: an instrument for distant viewing
phenomena.1 But, as in other fields, the prefix telephone also takes on many meanings. For instance, the
term telemetry is referred to as a process, information and electronic device related to the task of remote
measurement and reporting. Tele-based nomenclatures are inconsistent and evolving in health care. The
inconsistent usage of the terminology associated with remote delivery and management

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of health care has made it much more difficult to discern the ontology of words and to describe their based
protection and quality concerns.

Specifically, previous literature has used the terms telehealth, telemedicine, and telenursing somewhat
interchangeably, and the few articles reporting safety concerns were difficult to cluster for further analysis.

” Telemedicine, the original term, is defined as the practice of health care delivery, diagnosis, consultation,
treatment, transfer of medical data, and education using interactive audio, visual, and data communications.
Telenursing was described by the American Nurses Association as a tele-health subset focused on a
particular occupation (e.g., nursing).

Telenursing is the use of "technology to provide healthcare and treatments." While the use of technology
affects the medium of care delivery and may involve expertise relating to its use to provide care, there
should be little distinction between the care process and the scope of experience of telenursing.
Telecommunications nurses continue to assess, prepare, intervene and evaluate the effects of nursing
treatment but use technology such as the Internet, laptops, telephones, automated measurement instruments
and telemonitoring devices. With the word telehealth used to capture the wide range of facilities, taking
into account how health services already supplied by tele technology have grown.

In the sense of post-discharge treatment, telehealth technology will allow healthcare providers to cross the
gap between hospital and home care, promoting early treatments and thereby reducing the need for re-
hospitalization (Wakefield, n.d.). This advanced degree of communication is required to resolve the
conventional "black hole" in treatment between the actual release of hospital and the first follow-up
appointment of a patient. During this time, the physician's transfers, drug adjustments, and other
adjustments in the hospital's treatment regimen frequently slip by the wayside and don't sufficiently alter
until the patient returns to his primary practitioner.

Even so, the improved standard of treatment delivered by telehealth systems means that healthcare
providers can act early when a shift of health is reported, thus increasing the continuity of care, decreasing
the risk of being readmitted and ensuring cost-effectiveness for both the hospital and the patient. By
extending their reach beyond the traditional confines of the hospital walls, clinicians can offer a
combination of care between the hospital and the home those results in better overall outcomes and lower
costs (Schlachta-Fairchild et al., 2008). With the next generation of remote health management (RHM)
services, doctors can connect with patients on a daily basis while at the same time providing access to
reliable and precise data from patients in their homes.

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 Who we are As the first group of nurses totally focused on accelerating the
implementation of telehealth, TNT is trying to transform the way
the world feels about healthcare. Through this website we shall be of service with all the patients and
individual that needs our service and specialty.

We remain committed to ensuring that everyone has access to secure, reliable and adequate services where
and when they need it, allowing the system to do better for more people. We serve a wide and inclusive
network of technology solution providers and the local government of Taguig, as well as partner
organizations and partnerships. Together, we are working to advance the industry’s acceptance of telehealth
and virtual care, encourage responsive regulation, push for government and business standardization, and
offer education and tools to further incorporate virtual care into new value-based delivery models.

Telehealth Nursing Taguig (TNT) services can

What We Do facilitate public health mitigation strategies during
this pandemic by increasing social distancing. These
services can be a safer option for HCP and patients by reducing potential infectious
exposures. They can reduce the strain on healthcare systems by minimizing the surge of
patient demand on facilities and reduce the use of PPE by healthcare providers.

Maintaining continuity of care to the extent possible can avoid additional negative
consequences from delayed preventive, chronic, or routine care. Remote access to
healthcare services may increase participation for those who are medically or socially
vulnerable or who do not have ready access to providers. Remote access can also help
preserve the patient-provider relationship at times when an in-person visit is not practical
or feasible. Telehealth services can be used to:

• Screen patients who may have symptoms of COVID-19 and refer as appropriate
• Provide low-risk urgent care for non-COVID-19 conditions, identify those persons
who may need additional medical consultation or assessment, and refer as
appropriate
• Access primary care providers and specialists, including mental and behavioral
health, for chronic health conditions and medication management
• Provide coaching and support for patients managing chronic health conditions,
including weight management and nutrition counseling
• Participate in physical therapy, occupational therapy, and other modalities as a
hybrid approach to in-person care for optimal health
• Monitor clinical signs of certain chronic medical conditions (e.g., blood pressure,
blood glucose, other remote assessments)

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 • Engage in case management for patients who have difficulty accessing care (e.g.,
those who live in very rural settings, older adults, those with limited mobility)
• Follow up with patients after hospitalization
• Deliver advance care planning and counseling to patients and caregivers to
document preferences if a life-threatening event or medical crisis occurs
• Provide non-emergent care to residents in long-term care facilities
• Provide education and training for HCP through peer-to-peer professional medical
consultations (inpatient or outpatient) that are not locally available, particularly in
rural areas

Patients should be advised to make sure their devices have adequate charge or can be easily
plugged to a power source. (Greenhalgh, 2020; Cleveland Clinic Digital Telehealth Playbook,
2020) Speakers or microphones may need to be placed closer to elderly patients for easy
adjustment. (Krupinski, 2014) The patient should also confirm through the website on what
software/platform will be used. Different platforms may have different set up steps. (Greenhalgh,
2020) Thus, we will develop (or source from the platform vendor) a wide variety of patients
educational materials to set up. Different patients will have different learning styles. (AMA
Telehealth Playbook, 2020) In order to attain clear audio and video for the teleconsultation, it is
recommended that a minimum bandwidth speed of at least 2Mbps be used. This would allow for
a resolution of HD720p and a frame rate of 30fps. For both Greenhalgh (2020) and Akerman
(2020), it could also be helpful to do a demo visit 24 hours prior to the actual teleconsultation.
Patients may be also advised to restart their devices before the scheduled visit. This will ensure
that the visit can go smoothly. Background processes that could be running or utilizing cameras or
microphones can slow devices. Institutions who provide patient portals should consider creating
an IT care team for sessions with patients who need IT assistance. (AMA Telehealth Playbook,
2020)

Telehealth nurses can work in a variety of settings.

Where Do We Work Generally, they work from home or in a telephone triage
center. Depending on the specialization, telehealth
nurses may also work in the following locations:

• Physician's offices
• Hospitals
• Crisis hotlines
• Outpatient care facilities

It is a collaborative effort of the hospital and the City health government of Taguig which can be
benchmark by other neighbouring city or municipality.

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 Mission, Vision, Objectives

Mission:

❖ Provide a platform for the sharing of information and expertise of nurses and those working
with or assisting nurses using eHealth apps.

Vision:

❖ Nurses are expanding their scope through technology and improving the quality of
healthcare delivery worldwide.

Purposes:

• Technology:

➢ Promoting the expanded utilization and assessment of telehealth facilities by nurses.

➢ Stimulate new innovations and encourage programs to help improve eHealth.

• Businesses:

➢ Support interdisciplinary cooperation on telehealth to improve patient access and

outcomes.

• Professional:

➢ promote the awareness and expertise of nurses in telehealth by dissemination of

research findings;

➢ Education services and instructions for practice.

➢ Promote the ethical use of telehealth facilities.

Programme Targets

This guidance is for:

● Filipino patients who are unfamiliar with the telehealth Nursing process, discharged patients who has
questions regarding discharge planning, patients who has chronic disease who are at risk to have a follow
up in the hospital

● Filipino nurses who desire to help their patients prepare for a teleconsultation; and who has the capacity
to help each patient their needs for nursing intervention

● Nursing specialty organizations supporting their members in transitioning to telenursing

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 Time Frame
This programme will run until we there are patients who needs our service in this time of Pandemic.No fear
of the virus, no restrictions to travel, no facemask should be worn at all times outside the comfort of our
home.

Resources

When the patient is at home, office, or school, the patient would be needing their own mobile devices (with
or without camera), landline and/or laptops. If the mode of consultation is video, a landline or cellular phone
should still be available in case of disconnection.

Expected Outcomes

Improved Access – Since its inception, TNT has been used to bring healthcare services to consumers in
distant locations. TNT not only improves consumer access, it extends the geographic reach and expertise
of nurses and health facilities. Given provider shortages around the philippines, it has a unique and
appealing value proposition. It can provide a lot of people in both rural and urban areas access to safe,
effective, and appropriate care when and where they need it.

Cost Efficiencies – Reducing or containing the cost of healthcare is one of the strongest motivators to fund
and adopt virtual care technologies. TNT reduces the cost of healthcare and increases efficiency with better
management of chronic diseases, shared health professional staffing, reduced travel times, and fewer or
shorter hospital stays.

Improved Quality – Studies have consistently shown that the quality of healthcare services delivered via
TNT is as good as those given in traditional in-person consultations. TNT delivers a superior product, with
greater outcomes and consumer satisfaction.

Consumer Demand – The greatest impact of TNT is on the consumer, their family, and their community.
Using TNT technologies reduces travel time and related stresses for the consumer. Over the past months,
multiple studies have documented consumer satisfaction and support for TNT services. Such services offer
consumers access to providers that might not be available otherwise, as well as medical services without
the need to travel long distances.

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 Reference:

A Patient’s Guide to Telemedicine: What to Do When Your Doctor Calls or Video-Chats

with You. (2020, March 25). Retrieved April 30, 2020, from

https://www.himss.org/news/patients-guide-telemedicine

Akerman, S (2020) A primer for those new to the world of Telemedicine. KevinMD.com

Accessed 5 October 2020 (https://www.kevinmd.com/blog/2020/03/a-primer-for-those-newto-the-

world-of-telemedicine.html)

American Academy of Neurology. Telemedicine and COVID-19 Implementation Guide.

10 October 2020. (Accessed 06 May 2020). https://www.aan.com/siteassets/homepage/tools-and-

resources/practicing-neurologist--administrators/telemedicine-andremote-care/20-telemedicine-
and-covid19-v103.pdf

American Medical Association; Telehealth Implementation Playbook; (March 2020).

Accessed 20 September 20

American Telemedicine Association. Let There be Light. A Quick Guide to Telemedicine

American Telemed. (2020, July 22). Policy. Retrieved October 12, 2020, from

https://www.americantelemed.org/policy/Lighting. (2017) Accessed 2 October 2020

(https://www.americantelemed.org/resources/letthere-be-light-a-quick-guide-to-

telemedicine-lighting/)

American Telemedicine Association. Telemedicine Glossary. Accessed 5 October

2020(https://thesource.americantelemed.org/resources/telemedicine-glossary)

Bartz, C. (2017). Telehealth Nursing in Care Settings and Specialties Worldwide. Journal of the
International Society for Telemedicine and EHealth, 5, (GKR);e5:(1-3). Retrieved from
https://journals.ukzn.ac.za/index.php/JISfTeH/article/view/224

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 CDC. (2020, February 11). Coronavirus Disease 2019 (COVID-19). Retrieved October 6,

2020, from https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html

Centers for Medicare and Medicaid Services. Physicians and Other Clinicians: CMS

Flexibilities to Fight COVID-19. 29 September 2020. (Accessed 06 Ocotber 2020).

https://www.cms.gov/files/document/covid-19-physicians-and-practitioners.pdf

Chaet, D., Clearfield, R., Sabin, J. E., Skimming, K., & Council on Ethical and Judicial

Affairs American Medical Association (2017). Ethical practice in Telehealth and

Telemedicine. Journal of general internal medicine, 32(10), 1136–1140.

https://doi.org/10.1007/s11606-017-4082-2

Cleveland Clinic; Cleveland Clinic COVID-19 Response: Digital Health Playbook; September

13, 2020 (Accessed 20, September 2020 at: https://my.clevelandclinic.org)

Doshi, A. et. al (2020) Keep Calm and Log On: Telemedicine for COVID-19 Pandemic

Response. Published online first DOI: 10.12788/jhm.3419

Gordon, M. How To Get The Most Out Of Your Virtual Medical Appointment. National

Public Radio. Accessed 7 May 2020.

https://www.npr.org/sections/healthshots/2020/04/15/828084250/how-to-get-the-most-out-of-your-
virtual-medicalappointment.

Mphonline.org.(2020). OUTBREAK: 10 OF THE WORST PANDEMICS IN HISTORY. Sam

MacArthur – Media Relations. Retrieved from https://www.mphonline.org/worst-

pandemics-in-history/

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Nurses. Org. (2020). What is Telehealth Nursing and How to Become a Telehealth Nurse in

2020. Retrieved October 8, 2020, from https://nurse.org/resources/telehealth-

nurse/#what-do-telehealth-nurses-do

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