Practice Standards set out requirements related to specific aspects of nurses' practice. They link with other standards, policies and bylaws of the BC College of Nurses and Midwives and all legislation relevant to nursing practice.
Telehealth is an important component in the delivery of health services.
Telehealth1 refers to the use of communications and information technology to deliver health and health care services and information over large and small distances.
Telehealth may include any or all of the following:
Telehealth technologies range from simple (e.g., telephone, email, personal digital assistant) to complex (e.g., live, two-way videoconferencing, remote control surgical instrumentation). Telehealth is rapidly changing to provide more information, faster communication and instant access within health care.
Nurses2 in all practice settings can use telehealth to deliver care, provide education, monitor client progress, access client records, obtain information, and foster communication and collaboration among themselves, their colleagues and their clients.
Clients and health care providers in all communities benefit from the increased accessibility that telehealth offers. Telehealth can replace or complement some components of face-to-face health care. However, because the client is in a different location, a nurse's ability to do a comprehensive assessment is reduced, and therefore telehealth may not be appropriate for all situations.
Nurses engaged in telehealth are accountable for practising in accordance with the BCCNM Standards of Practice, all relevant B.C. and federal legislation, and their organization's policies.
Nurses engaged in telehealth are considered to be practising nursing in British Columbia when they are registered in B.C., regardless of where the client is located.
Understand that as a nurse engaged in telehealth, you are responsible and accountable for developing and maintaining the necessary competencies to provide telehealth care.
Consider how you can apply BCCNM's Standards of Practice although you are using a different method to provide care/services.
Understand how all BCCNM Practice Standards apply to telehealth, in particular those related to consent, privacy, confidentiality, nurse-client relationships and documentation.
Know your organization's policies related to providing telehealth services.
Recognize that different policies and legislation may affect telehealth practice in different provinces, states or countries. Contact the appropriate nursing regulator if you are providing telehealth services to clients outside B.C.
Be aware that individuals who are registered nurses outside B.C., but who are providing telehealth to clients in B.C., are responsible and accountable to their own regulatory organization. They cannot represent themselves as a BCCNM registrant.
Consider ways you can use telehealth to enhance and improve care and services for clients.
Recognize when telehealth is not appropriate to meet a client's needs, e.g., when a physical exam is required. Be aware of any risks to clients associated with the use of telehealth services, and use your organization's policies to minimize risk and to provide safeguards.
Recognize that a nurse-client relationship and a duty to provide care are established from the moment you engage with the client by using telehealth technology. At the end of a telehealth encounter, be sure to provide the client with clear direction about any further care required.
Inform clients about any limitations of telehealth services, including the possibility of equipment failure or communication breakdown. Inform clients if voice and email messages are not closely monitored. Be explicit with clients about alternative ways of obtaining care, particularly in urgent or emergent situations.
Identify any potential breaches in client confidentiality associated with using telehealth, and take precautions to protect personal information. For example, be aware that fax, email and cell phone communications can be intercepted and that other people may view information on computer screens.
Participate in developing, implementing, evaluating and improving all aspects of telehealth related to nursing practice.
Identify ways you can use technology to improve access to information in journals, databases, formularies, electronic health records, etc. Take opportunities for professional development related to telehealth and apply the new learning to your practice.
Telehealth: the use of communications and information technology to deliver health and health care services and information over large and small distances3.
BCCNM's Standards of Practice (Professional Standards, Practice Standards, and Scope of Practice Standards) set out requirements for practice that nurses must meet.
Terms defined in the Glossary are highlighted in bold type the first time they appear.
"Nurse" refers to BCCNM practising registrants.
Canada Health Infoway definition (2004) derived from Picot, J. (1998).
Sector Competitiveness Frameworks Series: Telehealth Industry Part 1 –Overview and Prospects. Industry Canada: Industry Sector Health Industries
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