New Study Highlights the Enormous Impact of Telemedicine for Intensive Care

Tele-ICU is the next big thing in the field of critical care nursing. It has been part of a model of care that has tremendous potential to positively affect patients and their families. However, the concept of tele-ICU still faces a few challenges, according to the national survey results published in the American Journal of Critical Care.

Lead author, Ruth Kleinpell, RN, PhD, APRN-BC, CCRN, and colleagues conducted a national survey of nurses specifically working in intensive care telemedicine facilities in the US to gather information on the impact of such care on nursing.

The researchers conducted a 2-phase study:

• To better evaluate the nurses’ perceptions and insights on intensive care telemedicine
• To identify the areas of nursing that require more attention and improvements

Phase 1 included an online survey where nurses working in intensive care units (ICUs) that interface with the tele-ICUs in US were asked descriptive questions that would provide clarification on the perceived usefulness, perceived ease of use, nurses’ attitudes toward telemedicine, intention to use, and knowledge and awareness of telemedicine. Phase 2 included the Delphi method, a systematic and interactive approach to gather input from the participants without face-to-face contact.

The United States has around 45 tele-ICUs that can monitor more than 6000 patients across 200 hospitals. This accounts for an estimated 12% of ICU patients in the country, according to the study. The number of nurses practicing in tele-ICUs is anywhere between 800 and 1000. These nurses work in collaboration with the 16,000 staff nurses that work on patients at the bedside, meaning physically being by their side. Hence, the 2-phased study brings out some important results.

In phase 1, out of the 1,213 respondents,

• 63% agreed telemedicine accomplishes tasks faster
• 65.9% agreed telemedicine improves teamwork
• 63.6% agreed it improves job performance and communication
• 60% agreed it is essential in nursing evaluations

While a clear majority agrees on the widespread accomplishments of telemedicine, phase 2 put a spotlight on the challenges faced by nurses. The top 15 priority areas of care, as pointed out by 60 respondents included critical thinking skills, intensive care experience, skillful communication, mutual respect, and management of emergency patient care. Other barriers to better telemedicine care were largely technical such as audio and video interruptions.

The benefits of tele-ICU are manifold. It helps tremendously in detecting trends in vital signs and unstable psychological statuses. It also provides superior medical management and enriches patient safety. But the study also focuses on addressing the limitations in better telemedicine care to form the foundation for developing competencies for tele-ICU nursing.