Prevalence of Telehealth in Nursing: Implications for Regulation and Education in the Era of Value-Based Care

Value-based care theoretically catalyzes the business case for telehealth. Hence, the purpose of this study was to define the proportion of a statewide nursing workforce who self-reported telehealth or telephonic nursing as their primary work setting in a U.S. state undergoing rapid transitions to value-based care. We conducted a secondary analysis of a 2017 statewide nurse relicensure survey ( n = 10,851), overall response rate 99%. The focus of the analysis was registered nurses who reported that they were currently working in Vermont or serving residents of the state ( n = 8,457). Analysis was limited to descriptive statistics. We found that 18.4% of respondents ( n = 1,556) reported their employment status as “telehealth/ working as a telephonic nurse.” Responding to a different question, 17.2% ( n = 1,458) defined “telehealth/telephonic” as their primary work setting. Thus, nearly one fifth of nurses practicing in the state were employed in telehealth, a role for which there is scant preparation in nursing education. The multistate practice of roughly one third of these nurses highlights the importance of the Enhanced Nurse Licensure Compact and raises questions about global telenurse practice. Taken as a whole, these findings have profound implications for health care policy development and implementation, ongoing workforce development and analyses, nursing regulation, education, and continuing education. New and renewed skills are needed to provide safe, effective, culturally relevant telehealth, and virtual care.

THE (RE/DE)CONSTRUCTION PROCESS OF THE PROFESSIONAL IDENTITY OF NURSING IN THE BRAZILIAN NEWS MEDIA: 1980-1986

ABSTRACT Objective: identify how the formulation process of the professional identity of nursing took place through news items related to the regulation of the profession between 1980 and 1986. Method: qualitative, historical, documentary research, guided by the socio-historical research process. Results: of the 2994 news items that were located, 122 were analyzed that had been published in the newspaper Folha de São Paulo. The importance of the movements and claims of the nursing category and its representative organs was highlighted, which culminated in the approval of the new law of professional nursing practice in 1986. The news items on care and research activities were also highlighted, including scientific events, particularly the Brazilian Nursing Congresses. Contributions to the development and evolution of nursing as a profession were also evidenced, which influenced the professional identity process. The professional identity during this period was marked by the empowerment of nursing and its categories, based on struggles and actions in search of better work conditions and a better quality of care. Conclusion: based on the actions of the nursing category and its representative organs, the update process of the professional nursing regulation could be legitimized and pushed forward. The regulation of professional practice resulted from the movements of categories and representative organs, besides daily nursing practice in care, education and research, being considered essential for the historical construction of the professional nursing identity.