Purpose: Since the capricious and unprecedented advent of COVID-19, normalcy has been altered in myriad ways for both patients and healthcare professionals (HCP). Bi-directional risks of contagion (provider-to-patient, and vice versa), preservation of personal protective equipment, and mitigating the impact created by patient surges have transformed how and where patients access care (Centers for Disease Control and Prevention [CDC], 2020). Identifying ways of communicating effectively and continuing care for clients during the global crisis has become imperative, including more reliance upon digital platforms (Blandford, Wesson, Amalberti, AlHazme, & Allwihan, 2020). Telehealth is not new, but many HCP and patients were reticent about widespread adoption prior to the pandemic (Orlando, Beard, & Kumar, 2019). Our healthcare system is affiliated with two medical schools with frequent rotations by different medical students/residents. As tenured care providers, a team of clinicians and nurse leaders implemented an evidence-based practice initiative to explore innovative pathways to promote interprofessional and patient-engaged communication and enhance delivery of safe patient care.
Description: A PICO question was developed to guide the retrieval of salient literature: “Among potentially disenfranchised patients who traditionally seek care in the ambulatory care services of a safety-net healthcare system (P), does the integration of innovative, nurse-driven educational modalities facilitate (I) or impede (C) interconnected approaches to assessment, proficiency enhancement, and care delivery (O)?” Literature (N=151) was retrieved from Nursing Reference Center Plus, PubMed, and CINAHL. After eliminating duplicates, 21 articles met the specific inclusion criteria and were independently appraised by at least two team members using the Johns Hopkins nursing evidence-based practice criteria. Scoring discrepancies were resolved by team consensus. Appraisal ratings included: (level 1 [3 experimental]; level 2 [1 quasi-experimental]; level 3 [3 non-experimental; 2 qualitative]; level 4 [6 systematic reviews; 1 clinical practice guidelines]; and level 5 [5 literature reviews]).
Outcome: Remote access to healthcare benefits the medically or socially vulnerable, facilitates monitoring of chronic conditions and medication management, and expedites screening of patients who have symptoms of COVID-19. Incorporating multidimensional (e.g., cognitive and motivational) aspects is imperative when educating patients (Pesare, Roselli, Corriero, & Rossano, 2016). They must feel empowered to acquire knowledge about their condition and assume responsibility for their choices. A qualitative study revealed that social media can be useful in building patient awareness of their medical condition (Chan, Kow, & Cheng, 2017). Study participants (adolescents) embraced gamification as a strategy to counter negative perceptions regarding health apps. Games can promote intrinsic motivation; critical components to promote patient self-engagement in their care. Limitations regarding telehealth can include comfort with technology; particularly among older clients (CDC, 2020). Sensory and motor changes (e.g., vision, hearing, mobility) may be more problematic for older adults. However, it is a common misconception that older patients have no interest in using technology platforms.