[Chezenne Lareau]

As a Nurse Executive, the telehealth program I would develop is a nurse-led early sepsis recognition and rapid-response initiative designed to identify subtle clinical deterioration in high-risk patients at home or in post-acute settings. Sepsis is both time-sensitive and preventable when caught early, making it an ideal focus for a telehealth innovation grounded in nursing assessment and clinical vigilance.

Telehealth Model
I would implement a combined model using remote patient monitoring (RPM), store-and-forward data review, and synchronous nurse telehealth assessments. RPM would provide real-time vital sign trends, while asynchronous symptom check-ins and nurse-led video evaluations would allow rapid intervention when concerning changes appear.

Equipment and Technology
Patients would receive a Bluetooth-enabled BP cuff, pulse oximeter, thermometer, and weight scale. The RPM platform would generate alerts based on evidence-based thresholds (e.g., rising HR, falling BP, fever, oxygen desaturation). A centralized nursing command center would review incoming data, triage alerts, and escalate care as needed.

Target Population
The program would focus on patients recently discharged from the hospital after infection, those with indwelling devices, immunocompromised adults, and high-risk older adults in home health or skilled nursing facilities.

My Role as Nurse Executive
I would oversee program design, secure funding, select technology vendors, and lead the development of clinical protocols. I would also coordinate staff education on virtual assessment, sepsis screening tools, and escalation workflows. A major part of my role would be ensuring that the program supports nursing autonomy while maintaining strong interprofessional communication.

Program Evaluation
Key metrics would include: time from alert to nurse response, rate of ED visits for suspected sepsis, 30-day readmissions, timeliness of antibiotic initiation after escalation, patient adherence to daily monitoring, and staff comfort with digital tools.

Legal and Regulatory Considerations
Important elements include HIPAA compliance, secure device data transfer, clear documentation standards, credentialing of nurses providing telehealth, and defined liability coverage within escalation protocols.

Interprofessional Collaboration
I would involve hospitalists, infectious disease specialists, pharmacists, IT, and home health teams to ensure seamless transitions and shared situational awareness.

Protocols and Consent
Protocols would include alert thresholds, sepsis screening steps, nurse-to-provider escalation timelines, and technology troubleshooting. Telehealth consent would be obtained electronically and verbally, outlining privacy protections, risks, benefits, and expectations for daily monitoring.

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