Telemedicine is here to stay. According to an article published in the American Journal of Critical Care (AJCC) earlier this year, telemedicine is changing the way patient care is provided in a growing number of intensive care units (ICUs) across the country. The article notes that “the U.S. has approximately 45 tele-ICUs with monitoring capacity for more than 6,000 patients at more than 200 hospitals, impacting care for an estimated 12 percent of ICU patients in the country.” The authors of the article surveyed 1,213 nurses who work with critical care patients, revealing that across the country, nurses feel telemedicine is a key element of improving patient access and quality of care.
According to an American Association of Critical Care Nursing (AACN) online CE course, “tele-ICU” refers to a remotely-based critical care team that works with a bedside ICU team and patient via state-of-the-art audio/visual communication and computer systems.
“Tele-ICUs contribute to the care of the sickest patients by providing enhanced monitoring capabilities – or a ‘second set of eyes’ - for patients in critical and progressive care units,” said Connie Barden RN, MSN, CCRN-E, CCNS, chief clinical officer of the American Association of Critical-Care Nurses. “Some of the benefits of working in tele-ICUs include that the work is interesting, varied, fast-paced and challenges the thinking of even the most seasoned nurse. It also offers a myriad of opportunities to coach and mentor newer nurses as they care for acute and critically ill patients. Most rewarding is the opportunity to directly impact the quality of the care being provided to patients.”
The AJCC study, funded with an Impact Research Grant from the AACN, showed that between 800 and 1,000 nurses currently practice in tele-ICUs, interfacing from remote monitoring sites with 16,000 other staff nurses who are at the bedside. One of those nurses is Lisa-Mae Williams MSN, RN, the operations director of the Telehealth & eICU at Baptist Health South Florida in Miami, Fla.
”The opportunity to leverage technology with clinical expertise to enhance patient care and outcomes is what drew me to telemedicine,” said Williams. “In my current role I get to see the full value of providing access to critical care expertise along the continuum of care.”
In order to be a successful tele-ICU nurse, participants of the AJCC study rated critical thinking skills, ICU experience, skillful communication, mutual respect and emergency patient care management as the most important priorities.
“I had to learn to navigate relationships with the bedside team from a distance,” said Williams. “Learning to build trust with a team that you hardly see in person can be challenging. I learned that constant communication coupled with finding opportunities to share in successful outcomes has helped to build a strong collaborative between the tele-ICU and bedside teams.”
The nurses in the AJCC survey noted that benefits of tele-ICUs include increased efficacy in monitoring trends of vital signs, detecting unstable physiological status, providing medical management, enhancing patient safety, detecting arrhythmias, preventing self-extubation and preventing falls. For Barden, a key benefit of telemedicine is expanding the availability of care. Tele-ICUs are especially advantageous for areas of the country where there is a shortage of healthcare workers, such as rural settings.
“In rural areas, it is possible for tele-ICUs and other forms of telehealth to help fill the void if an area lacks a specialist,” she said. “These remote consults by a specialist result in getting the right care to the patient in a timely manner. Besides being an efficient way of delivering care it may also help to keep the patient in their local area rather than needing a transfer for care hundreds of miles away. So, it can save money and keep the patient with their family – a win-win solution for everyone.”