[Kaley Haymond]

A telehealth session was conducted between a recently discharged stroke patient and me, as a clinical nurse specialist (CNS). The patient was experiencing weakness, difficulty speaking, and carrying out activities of daily living (ADLs). She expressed concerns about her safety, especially when her sister was not around. As the CNS, I opted to connect the patient with a case manager to arrange an in-home physical therapy consult to provide in home consultation and recommendations for navigating her home environment. An Apple Watch, or similar device, could be beneficial to this patient as it has the technology to recognize vital sign abnormality or if a fall or crash occurs. The device is able to notify emergency services, as well as emergency contacts. This would aid in the patient’s concern for being safe when alone.

C-Tier Final Virtual Telehealth Experience Link: https://youtu.be/-cmiVbVM9Cs?feature=shared

Peer Review:
Amy Meehan’s Telehealth Etiquette Score: 5
1. Orientation (5)
2. Verbal Clarity (5)
3. Active Listening (5)
4. Patient-Focused (5)
5. Tone of Voice (5)
6. Eye Contact (5)
7. Other Body Language (5)
8. Empathy (5)
9. Rapport (5)
10. Respect (5)
11. Therapeutic Alliance (5)
12. Environment (5)
Comments: Amy did a great job with making the virtual environment feel comfortable and secure. She was empathetic to the concerns and frustrations felt by the caregiver. Great work!

Amy Meehan’s Telehealth Exam/Education Rubric Score: 9/9
1. Amy identified the reason for the visit.
2. Amy confirmed consent with the patient and explained telehealth.
3. Amy obtained a history of the situation.
4. Amy asked about treatments used prior to the visit.
5. Amy provided telehealth education using an appropriate learning style.
6. Amy provided an overview of the education.
7. Amy developed an educational plan and follow-up care.
8. Amy determined that the patient understood the plan and education provided.
9. Amy discussed how the patient will get follow-up information from the appointment.
9. Amy discussed how the patient will get follow-up information from the appointment.

Karen Genzel’s Telehealth Etiquette Score: 5
1. Orientation (5)
2. Verbal Clarity (5)
3. Active Listening (5)
4. Patient-Focused (5)
5. Tone of Voice (5)
6. Eye Contact (5)
7. Other Body Language (5)
8. Empathy (5)
9. Rapport (5)
10. Respect (5)
11. Therapeutic Alliance (5)
12. Environment (5)
Comments: Karen did an excellent job. Her comfort in the role of CNS in this situation made the caregiver feel secure in the discussion. Karen did a great job identifying the root cause of concerns and identifying solutions. Excellent work!

Karen Genzel’s Telehealth Exam/Education Rubric Score: 9/9
1. Karen identified the reason for the visit.
2. Karen confirmed consent with the patient and explained telehealth.
3. Karen obtained a history of the situation.
4. Karen asked about treatments used prior to the visit.
5. Karen provided telehealth education using an appropriate learning style.
6. Karen provided an overview of the education.
7. Karen developed an educational plan and follow-up care.
8. Karen determined that the patient understood the plan and education provided.
9. Karen discussed how the patient will get follow-up information from the appointment.

[Kaley Haymond]

As a neonatal clinical nurse specialist (CNS), I could utilize telehealth capabilities to provide support to birth parents recovering from deliveries in a hospital separate from where their infant is in the neonatal intensive care unit.
– Telehealth Model: I would utilize a videoconferencing model to allow for face-to-face interaction with the birth parent, as well as give them an opportunity to see their child, giving a visual to the education I am providing. Videoconferencing also gives me the ability to visualize the breastfeeding parent’s pumping.
– Equipment: Videoconferencing
– Population: New birth parents recovering from delivery at an outside hospital with their infant in the NICU.
– Role: My role in this would be to provide education, emotional support, and counseling for early milk expression
– Evaluation: I can survey the parent at the end of each session for their perception of the interaction and identify areas of improvement. I can also assess rates of breastmilk and breastfeeding to see if it has been influenced by the implementation of this intervention.
– Legal: HIPPA would be addressed through confirmation of the infant’s name and date of birth.
– Other professions: Neonatology, as needed, and lactation consultants, as available
– Protocol: I would include this in the standard admission process to have the CNS consulted for each new admit from an outside hospital.
– Consent: I would obtain consent for consultation from the birth parent.

[Author]

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