[Melanie Brewster]

Evaluation of Kiki Sowell. Kiki was the provider and I was a mom of a child that was recently discharged with asthma. The encounter was to provide education on how to prevent an asthma attack. Kiki during this telehealth visit in making the mom feel confident in understanding how to manage asthma at home.
Critical Behavior:
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
1. Identifies reason for the visit-1
2. Confirms that patient agrees with the reason for the visit and accepts
that it is delivered by telehealth-1
3. Obtains history of symptoms or situation-1
4. Obtains approaches/treatments patient has taken to address the issue-1
5. Conducts an appropriate physical using equipment at home, and/or
other individuals to assist or provides telehealth education using
appropriate learning style 1
6. Discusses findings/Overview of education 1
7. Develop plan (follow-up, referral, medication, etc.) 1
8. Determines patient’s understanding of plan/education 1
9. Determines how patient will get information on the visit (email,
portal, secure text, etc.)1
9/9

[Melanie Brewster]

Evaluation:
Critical Behavior:
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

[Melanie Brewster]

CNS Group 33: Melanie Brewster and Courtney Covert:
Description of case:
Courtney was recently discharged from the hospital with new diagnosis of diabetes with an insulin pod. She was overwhelmed about the new diagnosis and lifestyle changes. A team meeting with a diabetic educator and nutritionist would have been helpful during this encounter. Technology that would be helpful would be an upload of her glucose monitor information and better camera to assess feet.
The following is the link to Melanie Brewster (Provider) and Courtney Covert (Frustrated diabetic patient recently discharged)
https://odu.zoom.us/rec/share/xaor6j69imXDJGVP__J1DgRU7Z_hFbwqq9t-ErTGEQZaZbavrpWRK6SNgr2FR-sv.TN9Vhylvz8fB-4U0
Passcode:PS$&tr#1
Evaluation of Courtney Covert by Melanie Brewster
Overall did a great job. Verbal and nonverbal communication was comforting, and she displayed empathy, good listening and resources achieving goals of the visit and follow up.
Etiquette:
Appearance-met
Distractors-met
Privacy-met
Nonverbal communication-met
Verbal communication-met
Empathy-met
Telehealth exam/education rubric:
Identifies reason for visit-met
Confirms that patient agrees with the reason for the visit and accepts it is delivered by telehealth-met
obtains history of symptoms-met
obtains approaches/treatments patient has taken to address the issue-met
obtains allergy history-met
conducts an appropriate physical exam using equipment at home or other individuals or provides learning styles-met
discusses findings-met
develop plan-met
determines patients understanding or plan/education-met
determines how patient will get information on the visit-met
10/10

[Melanie Brewster]

Establishing a clinical nurse specialist (CNS) led telehealth program in a pediatric intensive care unit (PICU) setting could be beneficial in many capacities as described in the training thus far. First, many of the PICU patients are discharged home directly from the unit and utilizing telehealth could be used as way to follow up with patients to ensure they are following discharge planning and to evaluate their health status. Secondly, it could be used as a nurse to CNS consult or physician to CNS consult. Without being physically in the unit, the CNS could provide consultant services via telehealth to provide coaching and support to nursing staff, monitor bundle compliance as well as best practice recommendations for a clinically complex patient population. Lastly, the CNS could use telehealth in a capacity to consult with other providers within or outside of the institution to provide optimal care to the patient. The overall goal of the telehealth program would be to improve outcomes by increasing access to a healthcare provider after discharge, improve adherence to the discharge plan, answer questions, support adherence to bundle compliance, have 24/7 access to expert consultations and reduce readmission rates. Evaluation of the program could be obtained via surveys and tracking of data related to readmission rates, hospital acquired conditions, staff and patient satisfaction scores.
The primary telehealth model would be videoconferencing, but it could also include RPM for technology dependent patients. Equipment needed would be videoconferencing, RPM that would integrate with the EMR as well as communication via MyChart. Legal considerations would be HIPAA, breach of data, billing and practicing within scope of practice. This program could potentially include all disciplines based on patient need. Protocols would need to be developed as to how to handle an emergency but could model the telehealth model that already exists in the ambulatory clinics at the institution that addresses the third-party vendor and equipment Prior to discharge, the patient and family could consent for the telehealth visit.

[Author]

Posts