Pre-Course Activities
Before you begin the course, please read through the following continuing education instructions and disclosure information, and take a pre-test.
Activities Included:
Continuing Education Instructions and Disclosure Information
Pre-Test
Pre-test Contact Hours
Module 1 - Telephone Triage: What is it? Essentials of Safe Care
Description:
Telephone triage is complex, potentially high risk, and full scope practice. Organizational support, formalized training, practice standards, and most importantly, nurses who incorporate critical thinking and clinical judgement are necessary to deliver appropriate care advice. This module introduces telehealth concepts with a focus on telephone triage nursing practice and explains what it is and what it is not. The right mindset is essential to practice safely.
Learning Outcome:
Upon completion of this module, the learner will be able to explain telephone triage as it relates to professional nursing and telehealth.
Activities Included:
Pre-Assessment Questions, Handout, & References
Lesson 1: Telephone Triage - Essentials of Safe Care
Telephone Triage Readings
Test Your Knowledge: Telehealth Terms
Lesson 2: Triage vs. Non-Triage Telephone Encounters
4 Reasons Why Telephone Triage is Important
Test Your Knowledge: Triage vs. Non-Triage
Essential Elements of Telephone Triage
Test Your Knowledge: Critical Thinking and Clinical Judgment
Critical Thinking and Clinical Judgment
Collaboration and Continuity of Care
Organizational Necessities
Lesson 3: Misconceptions Part I
Shared Misconceptions
Misconceptions: Part II
Key Learning Points
Nursing Continuing Professional Development Contact Hour Evaluation
Module 2 - Telephone Triage as Nursing Practice: Basic Standards
Description:
In this module, you will learn about the basic standards of practice in – and how they relate to – telephone triage. Then you will learn to use the nursing process to convey the complexity, significance, and risk associated with telephone triage and prepare yourself to provide safe and effective care over the telephone. Additionally, you will review the Code of Ethics and ethical dilemmas relevant to your role as a telephone triage nurse.
Learning Outcome:
Upon completion of this module, the learner will be able to describe how practice standards apply to telephone triage.
Activities Included:
Pre-Assessment Questions, Handout, and References
Lesson 1: Standards
Test Your Knowledge: Nursing Process Definitions/Descriptions
Lesson 2: Assessment
Physical Exam/Assessment by Proxy: The Patient
Test Your Knowledge: Objective Assessment with Patient/Caregiver in Proxy Role
Test Your Knowledge: Assessment
Diagnosis, Outcome, Plan, Intervention, Evaluation
Lesson 3: Nursing Process Examples in Triage
Test Your Knowledge: Ensuring Definitive Care is Accessed
Key Learning Points
Nursing Continuing Professional Development Contact Hour Evaluation
Module 3 - Standards of Practice
Description:
This module covers federal, state, and institutional regulations and their impact on telephone triage nursing practice. Professional nursing practice is guided by a code of ethics, scope of practice, and practice standards, which lay out accountability, rules, and guidelines for practice. Telephone triage nurses answer to multiple authorities, and often these authorities have varying imperatives or competing priorities.
Learning Outcome:
Upon completion of this module, the learner will be able to describe how regulatory, professional, and accreditation standards apply to telephone triage practice.
Activities Included:
Pre-Assessment Questions, Handout, & References
Lesson 1: Regulatory Oversight
Test Your Knowledge: What Do You Know About Your State's Nurse Practice Act?
Review Your State’s Nurse Practice Acts and Regulations
Test Your Knowledge: Who Can Practice Telephone Triage?
Test Your Knowledge: Where are You Practicing Nursing?
Regulatory Oversight Part 2
Review the Nurse Licensure Compact
Test Your Knowledge: Confidentiality & HIPAA
Lesson 2: Professional Nursing Practice
Code of Ethics Review
Test Your Knowledge: Where Does the Code of Ethics Apply?
Scope and Standards of Practice for Professional Telehealth Nursing
Lesson 3: Accreditation
Key Learning Points
Nursing Continuing Professional Development Contact Hour Evaluation
Module 4 - Avoiding Risk in Telephone Triage
Description:
This module explores nursing malpractice in telephone triage, recognition of common pitfalls, and clinical risk management strategies. To assert nursing malpractice/negligence in telephone triage, the four legal elements of duty, breach of duty, causation, and damage must all be proven. Avoiding the pitfalls described in this module will go a long way in minimizing risk associated with the practice of telephone triage. The clinical risk management strategies in telephone triage described in this module will ensure safe and prudent assessment, while also guiding the learner to remain vigilant to red flags that may appear.
Learning Outcome:
Upon completion of this module, the learner will be able to discuss how to minimize risk associated with the practice of telephone triage.
Activities Included:
Pre-Assessment Questions, Handout, & References
Lesson 1: Legal Standards in Telephone Triage
Test Your Knowledge: Legal Standards Definitions
Meeting Legal Standards
Are You Liable for Telephone Advice?
Elements of Negligence
Lesson 2: Common Pitfalls in Telephone Triage
Test Your Knowledge: Pitfalls of Telephone Triage
Lesson 3: Risk Management Strategies
Risk Management Principles
Test Your Knowledge: Practice Imperatives Scenarios
Risk Management Red Flags
Key Learning Points
Suggested Reading: Legal Pitfalls with the Use of Case Studies
Nursing Continuing Professional Development Contact Hour Evaluation
Module 5 - Organizational Standards/Program Design & Implementation: Access, Call Flow, Staffing
Description:
This module will explore considerations for designing a telephone triage program, along with advantages and disadvantages of various telephone triage staffing models, how access affects the telephone triage process and decision making, and the significance of call flow and its potential impact on telephone triage outcomes.
Learning Outcome:
Upon completion of this module, the learner will be able to describe how program design and implementation can impact access, call flow and staffing.
Activities Included:
Pre-Assessment Questions, Handout, & References
Lesson 1: Access - Building a Successful Telephone Triage Program
Telephone Tally Sheet
Access
Second-Level Triage
Chain of Command
Lesson 2: Staffing
Test Your Knowledge: Centralized vs Decentralized Telephone
Triage RN Skills and Traits
Lesson 3: Call Flow
Test Your Knowledge: Live Calls or Messages?
Patient Satisfaction and Sustainability of Live Answer
Live Calls vs Call Backs
Test Your Knowledge: Call Backs for Triage Calls
Call Back Scenario
Key Learning Points
Nursing Continuing Professional Development Contact Hour Evaluation
Module 6 - Critical Thinking
Description:
This module explores critical thinking and nursing judgment, competency in nursing practice, and the model of care delivery in telephone nursing practice. As you view the content in this module, critically assess your own practice and work setting. Some changes can be immediate, while other process improvement activities may take longer. While knowledge, experience, clinical competence, and knowledge of standards of care are essential to effective critical thinking, the role of attitude cannot be underestimated in the provision of care over the telephone.
Learning Outcome:
Upon completion of this module, the learner will be able to describe the roles of critical thinking and nursing judgment in telephone triage practice.
Activities Included:
Pre-Assessment Questions, Handout, & References
Lesson 1: Critical Thinking and Nursing Judgment
Test Your Knowledge: Critical Thinking: Supporting or Interfering?
Test Your Knowledge: Critical Thinking Components
Critical Thinking
Lesson 2: Critical Thinking and Clinical Reasoning
Test Your Knowledge: Decision-Making Using the Nursing Process
Test Your Knowledge: Critical Thinking and Use of the Nursing Process
Lesson 3: Competency in Nursing Practice
Further Reading on Competency in Telephone Triage
Lesson 4: The Model of Care Delivery in Telephone Nursing
Model of Care Delivery in Telephone Nursing Practice Readings
Model of Care Delivery in Telephone Triage Nursing Practice
Interpreting Information & Identifying Factors that Influence the Telephone Nursing Process
Key Learning Points
Nursing Continuing Professional Development Contact Hour Evaluation
Module 7 - Decision-Making
Description:
This module will explore the various elements that impact decision-making in telephone triage. Specifically, it will describe the three triage categories as emergent, urgent, and non-urgent presentations, as well as the clinical implications associated with different types of decision-making in uncertain conditions.
Learning Outcome:
Upon completion of this module, you will be able to identify decision-making strategies used in conditions of uncertainty.
Activities Included:
Pre-Assessment Questions, Handout, & References
Lesson 1: Decision-Making in Telephone Triage: Seeing with Your Ears
First Impressions
Listen to Visualize
Decision-Making in Conditions of Uncertainty
Playing the Odds
Lesson 2: Triage Categories
Test Your Knowledge: Emergent Presentations
Lesson 3: Types of Decision-Making
Key Learning Points
Nursing Continuing Professional Development Contact Hour Evaluation
Module 8 - Communication in Telephone Triage
Description:
This module will explore characteristics of the call, interviewing techniques, call flow and communication skills, and factors impacting compliance, connection, and communication.
Learning Outcome:
Upon completion of this module, you will be able to describe how the elements of communication impact the telephone triage process.
Activities Included:
Pre-Assessment Questions, Handout, & References
Lesson 1: Communication Over the Telephone
Further Reading on Patient-Centered Care and Social Determinants of Health
Lesson 2: Interviewing Techniques
Test Your Knowledge: Communication Techniques in Telephone Triage
Further Reading: Interviewing Techniques
Lesson 3: Call Flow and the Necessary Communication Skills
Test Your Knowledge: Quality Self-Assessments
Lesson 4: Factors Impacting Compliance, Connection, and Communication
Further Reading: The Importance of Patient Compliance and How Communication Can Impact Outcomes
Test Your Knowledge: Communication Skills
Key Learning Points
Nursing Continuing Professional Development Contact Hour Evaluation
Module 9 - Systematic Assessment
Description:
This module reinforces the importance of a thorough, systematic patient assessment as an essential element of an effective telephone triage encounter and the appropriate use of decision support tools and diagnostic thinking.
Learning Outcome:
Upon completion of this module, the learner will be able to identify the value of systematic assessment.
Activities Included:
Pre-Assessment Questions, Handout, & References
Introduction to Systematic Patient Assessment
Lesson 1: Systematic Patient Assessment
Lesson 2: Recognition of Emergencies
Suicide Assessment and Nurses: What Does the Evidence Show?
Pause to Ponder
Test Your Knowledge: Handling a Life-Threatening Emergency
Lesson 3: Contextual Variables
Lesson 4: Assessing the Presenting Problem
Test Your Knowledge: Applying POSHPATE
Lesson 5: Thinking Diagnostically
Key Learning Points
Supplemental Reading
Nursing Continuing Professional Development Contact Hour Evaluation
Module 10 - Clinical Pearls
Description:
This module will discuss assessment considerations of high-risk clinical presentations, identify assessment imperatives for special populations, and recognize special circumstances and environmental factors.
Learning Outcome:
Upon completion of this module, the learner will be able to identify assessment clinical pearls to employ in telephone triage.
Activities Included:
Pre-Assessment Questions, Handout, & References
Lesson 1: High-Risk Clinical Presentations
Heart Attack Symptoms: Men vs Women
Stroke and OB/GYN Considerations
Test Your Knowledge: Post-Partum Depression vs Post-Partum Psychosis
Ophthalmology and Rashes
Lesson 2: Elderly and LGBTQIA+ Considerations
Lesson 3: Substance Use and Misuse - Alcohol Use and Misuse
Test Your Knowledge: Alcohol Withdrawal Symptoms
Opioid Use and Misuse
Test Your Knowledge: Opioid Use vs Opioid Withdrawal
Lesson 4: Mental Health Considerations
Lesson 5: Intimate Partner Violence
General Pediatric Considerations Part 1
Test Your Knowledge: Developmentally Appropriate Bruising vs Suspicious
General Pediatric Considerations Part 2
Seasonal Illness & Resources
Key Learning Points
Supplemental Sheet of External Links
Nursing Continuing Professional Development Contact Hour Evaluation
Module 11 - Decision Support Tools
Description:
This module will examine clinical decision support tools, also known as protocols or algorithms, and discuss their advantages and disadvantages.
Learning Outcome:
Upon completion of this module, the learner will be able to appropriately utilize decision support tools in telephone triage nursing.
Activities Included:
Pre-Assessment Questions, Handout, & References
Lesson 1: What is a Clinical Decision Support Tool?
Test Your Knowledge: Decision Support Tool Recommendations
Telephone Triage Protocols
Lesson 2: Advantages and Disadvantages of Clinical Decision Support Tools
Key Learning Points
Nursing Continuing Professional Development Contact Hour Evaluation
Module 12 - Documentation
Description:
This module will explore the importance of documentation and why it is critical to a telephone triage encounter. Documentation should paint the picture of the call and the outcome recommendations. It is crucial for the safety of the caller that care providers can access all necessary information for follow up as well as account for the nurse's standard of practice and standard of care.
Learning Outcome:
Upon completion of this module, the learner will be able to identify critical elements in successful documentation of telephone triage encounters.
Activities Included:
Pre-Assessment Questions, Handout, & References
Lesson 1: Documentation Essentials for Telephone Triage
Lesson 2: Enhance Documentation by Using the Nursing Process
Test Your Knowledge: Documentation in the Nursing Process
Lesson 3: Incorporation of Systematic Assessment in Documentation
Test Your Knowledge: The SOAPIE Method and the Nursing Process
Key Learning Points
Nursing Continuing Professional Development Contact Hour Evaluation
Module 13 - Sharing a Common Understanding: Telephone Triage as Professional Nursing Practice
Description:
This module will empower the nurse to recognize telephone triage as professional nursing practice, to communicate this understanding consistently and accurately to other members of the healthcare team, and to provide leadership in one’s own professional setting to facilitate safe and effective delivery of nursing care over the telephone.
Learning Outcome:
Upon completion of this module, the learner will be able to share a common understanding of telephone triage as professional nursing practice.
Activities Included:
Pre-Assessment Questions, Handout, & References
Thank you
Introduction
Lesson 1: Foundational Tenets of Telephone Triage
Lesson 2: Analysis of a Bad Outcome
Lesson 3: Critical Thinking & Cognitive Bias
Test Your Knowledge: Common Pitfalls to Avoid in Telephone Triage
Test Your Knowledge: Check Your Bias
Conclusion
Nursing Continuing Professional Development Contact Hour Evaluation
Final Post-test
Activities Included:
Posttest
Certificate of Completion
Complete this evaluation to print a transcript for the course.
Activities Included:
Certificate of Completion