Best Practices for Telehealth in Nurse-Led Care Settings-A Qualitative Study.

The COVID-19 pandemic in the US prompted a sudden shift to telehealth in nurse-led care sites which provide services to diverse geolocations. Using a lens of intersectionality, this study characterizes provider and patient-perceived best and promising practices emerging from geographical variation. The aim of this study was to identify best practices of implementing telehealth in nurse-led care models in Colorado through patient and provider experiences of the sudden implementation of telehealth that can enhance health equity. In this exploratory/descriptive qualitative study, a purposive sample of 18 providers and 30 patients were interviewed using a guide informed by the RE-AIM implementation and evaluation framework to capture the contextual experiences related to the sudden shift to telehealth. Textual theme analysis and reflexive team strategies guided the interpretation. Four primary themes of perceived best practices were identified: using multiple modalities, tailoring triage and scheduling, cultivating safety through boundaries and expectations, and differentiating established versus new patient relationships. The findings suggest that telehealth is a flexible and powerful tool to enhance the delivery of equitable care through nurse-led care models within diverse communities such as the one represented in this study. Nurse leaders are positioned to participate in innovative research and create policies and protocols to ensure telehealth is a viable resource to deliver equitable, safe, and accessible high-quality healthcare.

Concept analysis of nursing activism.

Nursing history is firmly rooted in social and political activism; however, both the word activism and its defined actions have been minimized in modern nursing practice. This paper seeks to define activism, its uses, and importance to the nursing discipline. A concept analysis using the Walker and Avant (2019) method was conducted. Literature sources were identified through a search of PubMed, CINAHL, and PsycINFO along with hand searches of reference lists. Nursing activism is a concept that extends from within the discipline's ethical responsibilities and social contract with humanity. Activism differs from advocacy or engagement as it requires the expenditure of energy including personal, social, and/or political capital. Nursing activism is a necessary response to health inequities, social accountability, and advancement of the nursing profession.