Benchmark - Evidence-Based Practice Project Proposal Final Paper (Research Paper Sample)

Implementing Telehealth Services to Manage Chronic Illness Among Rural Residents Name Institutional Affiliation Course Instructor July 28, 2024 Implementing Telehealth Services to Manage Chronic Illness Among Rural Residents Technological advancements have revolutionized the healthcare sector. Telehealth is one of the major technological advancements that have allowed healthcare professionals to offer care to patients remotely, especially in rural areas. Rural areas often encounter challenges in accessing quality care due to geographical barriers, shortage of healthcare professionals, and lack of transportation. The problem is exacerbated for patients suffering from chronic illnesses and requires regular care and monitoring. Lack of access to quality care leads to poor management of these patients causing deteriorated health and quality of life. This project aims to implement nursing telehealth services for patients suffering from chronic illnesses in rural areas. The project will address the gap in access to quality healthcare among rural patients. Implementing telehealth services will allow nurses to monitor the patients' health remotely, and offer necessary interventions and health education. The project will develop an implementation plan including a timeline to implement the intervention, budget, data collection methods, and instruments used to evaluate the effectiveness of the intervention. The project will set anticipated outcomes to assess the effectiveness of the implemented intervention within 12 months. A valid data collection tool will be used based on the set objectives to promote the validity and accuracy of the proposed intervention. The collected data will be analyzed and used to make improvements and appropriate adjustments on the proposed interventions. Therefore, the primary goal of the proposed evidence-based practice project is to determine the impact of implementing telehealth services to manage chronic illness among rural residents. Problem Statement In the United States, residents living in rural areas have a higher likelihood of premature death from chronic illnesses including heart disease, cancer, diabetes, unintentional injury, chronic lower respiratory disease, and stroke. Coughlin et al. (2020) assert that diabetes is one of the leading chronic illnesses resulting in deaths reported to be 17% higher in rural settings than urban ones. The research further claims that rural populations are likely to be obese (29%) compared to urban communities (24%). Rural populations also have an 8-15% increased risk to succumb from colon cancer where lung cancer mortality rates are 20% higher than in urban areas. However, one potential solution that can be implemented to address the problem is increased access to healthcare for these populations. Telehealth, which utilizes technologies such as mobile phones and computers to deliver healthcare services is a suitable solution. Telehealth will be crucial to eliminate barriers to care, such as distance, transportation, and time constraints. By using telecommunications technology and electronic data, telehealth will also improve the quality, safety, and effectiveness of rural healthcare. PICOT Question: In patients who reside in a rural area (P), how does implementing nursing telehealth services (I) compared to not using telehealth (C) affect their chronic conditions (O) over 12 months (T)? (see Appendix A). Organizational Culture and Readiness There is need to ensure organizational readiness when implementing evidence-based changes. Discussing the extent organizational culture will support and sustain the proposed changes will lead to successful change implementation. Of importance, communicating with relevant stakeholders and team members on the proposed changes ensures they provide insight into how the changed can align with the current healthcare processes and systems. The Management and Organizational Sustainability Tool (MOST) was selected to assess the application of Munson Healthcare System's culture and readiness for this evidence-based practice proposal project. As one of the largest and leading healthcare systems in Northern Michigan, the Munson organizational culture is founded on the need to “cultivate quiet, kind, and dignified manners and politeness” in all its activities. It emphasizes on patient care and community needs according to the recent announcement of a regional care transformation plan in response to changing healthcare needs and challenges (Werly, 2023). The plan focuses on improving healthcare access by ensuring that healthcare services are close to the locals. Additionally, Munson’s Healthcare leadership structure prioritizes on the patient needs to be supported by active listening and adapting to the changing healthcare demands. The MOST assessment conducted shows that the Munson Healthcare System has several strengths and areas for improvement in supporting readiness for change. The survey shows that the healthcare system's management team is committed to change. Commitment to change also motivates the employees through fostering a sense of ownership and collective responsibility toward change implementation. However, the MOST assessment portrayed various improvement areas including resource allocation, communication, monitoring, and evaluation. Creating effective communication strategies will ensure the Munson Healthcare system's readiness for change by ensuring that all the relevant stakeholders comprehend the change process. Secondly, creating a comprehensive plan or budget will ensure better resource allocation while robust mechanisms for monitoring and evaluation will track the progress and success of the proposed change. Subsequently, a Patient Safety Enhancement Program (PSEP) will be implemented through training staff on standardized protocols to ensure consistent and high-quality care delivery. The PSEP program will help the organization identify and mitigate potential safety issues, and support a culture of open reporting while a cost analysis framework, including data analytics will streamline processes and eliminate waste in healthcare delivery. Importantly, the proposed project will various stakeholders including researchers, nursing staff, telehealth healthcare coordinators, and healthcare providers. The researchers will oversee the study, create timelines, manage resources, and collect data, while the nursing staff will offer the telehealth services, and engage, and monitor the participants. The healthcare coordinators will schedule appointments, and troubleshoot technical issues, while healthcare providers will be offered medical consultancies via telehealth, prescribe treatment, and adjust care. The project will also require telehealth platforms such as Zoom for healthcare or doxy. me. The technologies will be installed on nursing staff and patients' devices to support remote care. The nursing staff and patients will be trained on how to navigate these technologies. The Electronic Health Records (EHR) System will be integrated with the telehealth platform to streamline data entry and retrieval for enhanced value and team-based care. This will ensure seamless updating of patient records during and after telehealth consultations (Zhang & Saltman, 2022). The participants will also be provided with remote monitoring devices, including blood pressure monitors and glucose meters, linked to the telehealth system. Data from these devices will be automatically uploaded to the EHR for continuous monitoring. Literature Review A literature search strategy was utilized to identify relevant research articles to answer the PICOT question. The databases used included the Cochrane Library, PubMed, and CINAHL. The search terms were "telehealth," "chronic condition," "rural health," and "nursing." Boolean operators such as ‘AND’ and ‘OR’ were used to combine the key terms into phrases such as ‘telehealth and chronic conditions.’ The inclusion criteria for studies that focused on rural populations, evaluated nursing telehealth interventions, assessed chronic disease outcomes, and had a minimum follow-up of 12 months. Studies were excluded if they were not published in English or had no comparison group. The search yielded 125 studies. Four studies were selected according to the inclusion and exclusion criteria. Research demonstrates the effectiveness of nursing telehealth services in managing chronic illnesses. Basu (2022) provided a conceptual framework for studying rural-urban disparities in primary care utilization. The foundation for this study is that various socioeconomic and political factors affect health within a population. The author highlighted the importance of evaluating supply-side factors (e.g., availability of clinics, distance to care) and demand-side factors (e.g., patient characteristics, health beliefs) that contribute to inequities in access to care. This model can be applied to telehealth interventions to understand the factors influencing their uptake and effectiveness in rural settings. Notably, the study emphasizes the need to investigate the rural population's lack of access to primary healthcare clinics on healthcare outcomes. Butzner and Cuffee (2021) investigated the present use, therapeutic domains, and effects of telehealth initiatives on rural residents in the United States. The study was founded on the hypothesis that gaps exist in describing the effectiveness and design of technological interventions for addressing health determinants and treating diseases among rural communities in the USA. A narrative review approach was adopted to identify studies to be included. The study highlighted the potential of telehealth to improve access to care and health outcomes in rural areas. The authors identified several successful telehealth interventions targeting chronic conditions like diabetes, heart failure, and mental health, demonstrating the feasibili...