Nursing interventions in a telemonitoring program.
BACKGROUND
The use of telemonitoring of patients with chronic illness in their homes is growing. Current literature does not describe what types of patient problems are addressed by nurses in these programs and what actions are taken in response to identified problems. This study defined and analyzed patient problems and nursing actions delivered in a telemonitoring program focused on chronic disease management.


METHODS
Data were drawn from a clinical trial that evaluated telemonitoring in patients with comorbid diabetes and hypertension. Using study patient records, patient problems and nursing actions were coded using an inductive approach.


RESULTS
In total, 2,336 actions were coded for 68 and 65 participants in two intervention groups. The most frequent reasons for contact were reporting information to the primary care provider and lifestyle information related to diabetes and hypertension (e.g., diet, smoking cessation, foot care, and social contacts). The most frequent mode of contact was the study sending a letter to a participant.


CONCLUSIONS
Detailed descriptions of interventions delivered facilitate analysis of the unique contributions of nurses in the expanding market of telemonitoring, enable identification of the appropriate number and combination of interventions needed to improve outcomes, and make possible more systematic translation of findings to practice. Furthermore, this information can inform calculation of appropriate panel sizes for care managers and the competencies needed to provide this care.
VA Health Services Research and Development Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City VA Medical Center, Iowa City, Iowa 52246, USA. bonnie.wakefield@va.gov
Bonnie J
BJ
Wakefield
Melody
M
Scherubel
Annette
A
Ray
John E
JE
Holman
D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000628:therapy*; D015438:Health Behavior; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000628:therapy*; D008019:Life Style; D009726:Nurses / Q000706:statistics & numerical data*; D017216:Telemedicine / Q000458:organization & administration*