[Ciara Linnens]

My patient role was Diabetes. Other professions involved in the call should be PCP, dietician and diabetes educator if available. Another type of technology that could be used is store and forward where the patient sends pictures of their feet.

Julie was rated a 5 in all critical behavior competencies and overall.
She was rated a 9 for the telehealth education rubric.

[Ciara Linnens]

Telehealth to Enhance Stroke treatment and outcomes

Telehealth model: I would like to use the videoconferencing and store and forward to consult a neurologists or other specialist in rural areas. Videoconferencing will allow and ER provider to consult a tele neurologist at a larger hospital. The Neurologist could assess the patient over the camera in combination with data sent via store and forward to improve treatment and initiate quicker transfers for care.

Equipment: I would use store and forward for labs and CT scans. I would use videoconferencing to allow the provider to complete an NIHSS.

Population: This would be extremely beneficial to patients with stroke symptoms in rural areas. If a patient at a rural hospital is evaluated through video and deemed a candidate for TPA/TNK or a mechanical thrombectomy a quick transfer to a comprehensive stroke center can allow this therapy.

FNP role: As an FNP I could initiate a telehealth visit with the neurologist. Understanding and using the resources that are available can enhance outcomes.

Evaluation: I would hope to reduce the amount of stroke patients that miss the window of TNK/TPA due to being at a facility that doesn’t offer that.

Legal: HIPPA and a patients ability to make healthcare decisions based on their neurological deficits

Other professions: Neurology, ED or urgent care providers, Nurses, Transport services

Protocol: I would create opportunities to educate rural healthcare providers on stroke signs and symptoms and when to initiate a telehealth consult in an effort to not delay care.

Consent: I would obtain consent for this from the patient if they are neurological intact or through the next of kin if possible.

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