Telenursing

Telenursing refers to the use of telecommunications and information technology for providing nursing services in health care whenever a large physical distance exists between patient and nurse, or between any number of nurses. As a field it is part of telehealth, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, telemonitoring, etc.

Telenursing is achieving a large rate of growth in many countries, due to several factors: the preoccupation in driving down the costs of health care, an increase in the number of aging and chronically ill population, and the increase in coverage of health care to distant, rural, small or sparsely populated regions. Among its many benefits, telenursing may help solve increasing shortages of nurses; to reduce distances and save travel time, and to keep patients out of hospital. A greater degree of job satisfaction has been registered among telenurses

Applications
One of the most distinctive telenursing applications is home care. For example, patients who are immobilized, or live in remote or difficult to reach places, citizens who have chronic ailments, such as chronic obstructive pulmonary disease, diabetes, congestive heart disease, or disabilitating diseases, such as neural degenerative diseases (Parkinson's disease, Alzheimer disease, amyothrophic lateral sclerosis), etc., may stay at home and be "visited" and assisted regularly by a nurse via videoconferencing, internet, videophone, etc. Still other applications of home care are the care of patients in immediate post-surgical situations, the care of wounds, ostomies, handicapped individuals, etc. In normal home health care, one nurse is able to visit up to 5-7 patients per day. Using telenursing, one nurse can “visit” 12-16 patients in the same amount of time.

A common application of telenursing is also used by call centers operated by managed care organizations, which are staffed by registered nurses who act as case managers or perform patient triage, information and counseling as a means of regulating patient access and flow and decrease the use of emergency rooms.

Telenursing can also involve other activities such as patient education, nursing teleconsultations, examination of results of medical tests and exams, and assistance to physicians in the implementation of medical treatment protocols.

Legal, ethical and regulatory issues
Telenursing is fraught with legal, ethical and regulatory issues, as it happens with telehealth as a whole. In many countries, interstate and intercountry practice of telenursing is forbidden (the attending nurse must have a license both in her state/country of residence and in the state/country where the patient receiving telecare is located). Legal issues such as accountability and malpractice, etc. are also still largely unsolved and difficult to address.

In addition, there are many considerations related to patient confidentiality and safety of clinical data.