Integration of information and communication technologies in the nursing process is supposed to contribute to more effective care delivery. Though not being considered as a revolutionary advancement, telenursing has all chances to become an indispensable part of nursing curricula due to expected positive outcomes (Reierson, Solli, & Bjørk, 2015). A number of studies have been conducted in order to investigate the effects of telephone and online connection with patients as an alternative to traditional personal visits. The purpose of the given paper is to discuss the implementation stages of the research project studying the outcomes of telenursing and online follow-up versus traditional personal visits.
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Steps of the Implementation Process
The proposed study will be launched to examine the overall impact of telenursing among a group of discharged patients of a single local hospital. Research project implementation will proceed following a collaboratively developed plan. The research implementation phase will consist of the following stages: enlisting participants, pre-discharge and post-discharge interventions, data collection, data assessment and interpretation, results discussion, and reporting the findings of the research.
Step 1: Enlisting Participants
Participants of the study will be discharged patients from several units of a local hospital. A sample size is expected to be approximately 150-200 patients, all of whom will be assessed for eligibility after giving voluntary informed consent. The chosen sample size will allow for obtaining credible findings. Since the sampling will be based on the non-probability model, there will be no inclusion criteria, such as gender, race, or age.
Step 2: Interventions
The intervention program will consist of a pre-discharge assessment and a 4-week post-discharge follow-up with regular weekly intervals. Initial participants’ assessment will be conducted by the nurse care manager (NCM) on the basis of patients’ needs in terms of physiological, psychological, and psycho-social health. The intervention period will be 4 weeks since this is an adequate duration for such a project (Harrison, Auerbach, Quinn, Kynoch, & Mourad, 2014).
Based on the patients’ needs assessed, telephone consultation with the nurse will be performed once a week (4 sessions in total). Calling time will be between 8 pm and 10 pm, though participants will be able to call anytime in case of emergency. All the necessary instructions regarding making and receiving calls, diet, and skin care will be provided to participants.
Step 3: Data Collection
Since the study uses the non-probability method, the baseline data will not be collected. The clinical data, including the length of stay and condition, will be collected from the medical documentation. Post-intervention data will be collected by the nurse who will make phone calls to ask participants to assess their levels of stress and anxiety. The readmission data will be collected after 4 weeks of discharge using hospital documentation systems. Data on secondary outcomes, such as quality of life and satisfaction, will be collected using the Short Form Health Survey and questionnaires with confirmed validity. Rates of anxiety and depression will be estimated using the Beck Depression Inventory and Beck Anxiety Inventory.
Step 4: Data Assessment and Interpretation
Readmission rates of participants will be compared using the logistic regression model with the consideration of variables that are associated with hospital readmission (level of significance is 0,05). ANCOVA will be conducted in order to investigate the differences in the secondary outcomes, such as self-efficacy, quality of life, and satisfaction level. The means and standard deviations of stress and anxiety before and after interventions will be presented.
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Steps 5 and 6: Results Discussion and Reporting
The evidence obtained from the study will be used to fill the knowledge gap in research on the effects of telenursing on patient care (Goudarzian, Fallahi-Khoshknab, Dalvandi, Delbari, & Biglarian, 2018). Improvements in self-efficacy, quality of life, and satisfaction will be interpreted given that there is no interaction between these variables. It is expected that systematic analysis will reveal the psychological and economic effects of the intervention. The analyzed results of the research project will be incorporated into the final paper.
Time and Economic Considerations in the Research Project
As have been mentioned above, an intervention stage with regular follow-up calls will take a period of 4 weeks. However, it should be mentioned that all the following steps of the research will also take some time. It can be seen that the project is expected to be completed in 41 days, provided that all of the stages are executed in time (see Table 1).
Table 1. Time Frame of the Project.
|Enlisting participants||5 days|
|Pre-discharge and post-discharge interventions||28 days|
|Data collection||4 days|
|Data assessment and interpretation||1 day|
|Results Discussion||1 day|
Speaking of the budget, it should be stated that the project will not require financial support, if the necessary tools, such as software and hardware, are available for researchers. The tools required for the research include a phone or a smartphone used by the nurse to contact participants and a computer for results documentation and assessment. Among software tools, the researcher will need a voice recorder application and statistical software (SPSS) to analyze quantitative data.
In summary, the project aimed at evaluating the effects of telenursing on discharged patients will consist of six stages, including identification of the research sample, data collection and assessment, and results interpretation. The research study will occur over 41 days comprising of regular follow-up calls made with weekly intervals. No financial costs are expected for the given project; the required tools include hardware and statistical software.
Goudarzian, M., Fallahi-Khoshknab, M., Dalvandi, A., Delbari, A., & Biglarian, A. (2018). Effect of telenursing on levels of depression and anxiety in caregivers of patients with stroke: A randomized clinical trial. Iranian Journal of Nursing and Midwifery Research, 23(4), 248-252.
Harrison, J. D., Auerbach, A. D., Quinn, K., Kynoch, E., & Mourad, M. (2014). Assessing the impact of nurse post-discharge telephone calls on 30-day hospital readmission rates. Journal of General Internal Medicine, 29(11), 1519-1525.
Reierson, I. Å, Solli, H., & Bjørk, I. T. (2015). Nursing students perspectives on telenursing in patient care after simulation. Clinical Simulation in Nursing, 11(4), 244-250. Web.