Document Type

Report

Publication Date

Spring 2024

Date of Final Presentation

4-4-2024

Committee Chair

Katherine Doyon, PhD, MEd, RN, CHPN

Committee Member

Kelley Connor, PhD, RN, CHSE

Coordinator/ Chair of DNP Program

April Howell, DNP, RN

Abstract/ Executive Summary

The use of telehealth to provide care management services has increased as healthcare continues to evolve. Seven million Americans were predicted to use telehealth in 2020, which increased to over 35 million through the pandemic. These services have been shown to decrease healthcare disparities and promote positive health outcomes. Education and training for nurses providing telehealth services have not kept up with the increased demand. Nurses providing care management telehealth services in a large tertiary health system have low perceived self-efficacy for technology. Leaders in the organization believe this is causing a lack of digital proficiency in their workforce. This lack of proficiency leads to a gap in telehealth patient care services as nurses cannot carry full telehealth caseloads. Educational interventions to enrich perceived self-efficacy and improve digital proficiency will be provided to close this care gap. Providing technology-based education to nurses delivering telehealth can increase their perceived self-efficacy, leading to improved digital proficiency. As digital proficiency increases, the care gap should close.

Nurse leaders have identified the significant gap in patient care as variations in telehealth caseloads contribute to poor patient health outcomes. Some patients cannot be enrolled in telehealth-based care management services as some nurses cannot maintain caseload benchmarks. This variation leads to the inability to enroll patients efficiently in care management services. Nursing leadership believes this caseload variation may be due to disparities in the digital proficiency of the care managers.

Evidence suggests that increasing perceived self-efficiency can promote increased workplace engagement and output. Recent literature suggests people who believe they can perform a skilled task and are provided with job-specific education have better job performance. Recent studies suggest that providing telehealth nurses with education and training specific to technology can increase perceived self-efficacy with technology. The specific aims of the project are to improve patient access to telehealth services by increasing the provider's ability to utilize telehealth effectively by improving perceived self-efficacy for working with technology.

Nurses in the telehealth care manager job code attended a 2-hour education session to provide technological strategies to promote efficiency. Participants were screened using the General Self-Efficacy Assessment tool prior to the education session and again after the education session. Scores showed that there was not an overall impact on general self-efficacy. The next step in data collection and assessment involved a Likert scale post-intervention to assess if the intervention was successful in increasing the ability to use computers to engage patients and increase technological skills. These scores showed that the educational interventions increased participants' ability to use technology and computers. Half of the participants felt the intervention was impactful enough to help them engage more patients.

70% of project outcome goals were met, demonstrating that education promoting digital proficiency shows a potential to improve participants' perception toward technology and implications for improving how they work. This indicates that ongoing support and engagement with telehealth nurses to provide relevant and timely education can enhance how they provide patient care. This support could also lead to better patient access to telehealth services that could translate into decreased healthcare disparities for telehealth patients.

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