ADAPTED FROM THE CORE CURRICULUM FOR AMBULATORY CARE NURSING, 3 RD ED. AMERICAN ACADEMY OF AMBULATORY CARE NURSES Objective Two: The learner will be able to adapt and apply the unique dimensions of telephone nursing to the nursing process

Telephone Nursing Practice Telephone nursing has its own unique dimensions. The most notable difference is not being in the physical presence of the patient. This results in an adaptation in the application of the nursing process with increased emphasis on assessment and communication

Dimensions of telephone nursing Systematic assessment of patient needs using critical thinking, clinical reasoning & judgment, and may include use of decision support tools Quick establishment of rapport and patient trust to assess needs and determine urgency Applies relevant communication techniques to interact with and education clients with an emphasis on plain language according to the health literacy of the caller

…continued Dimensions of Phone Nursing Coordinates care planning with patients, their support systems, and healthcare providers Documents the interactions Demonstrates knowledge of legal issues specific to telephone nursing Evaluates outcomes of practices using specific quality measurements Maintains confidentiality of telephone encounters

ASSESSMENT ASSESSMENT – DATA COLLECTION PLANNING IMPLEMENTATION EVALUATION The reason for the call or patient’s chief complaint Medical history – diagnosed health care problems, allergies, prescribed and over-the-counter medications, alternative therapies History of symptoms, associated symptoms Focused assessment of the patient’s actual or potential health needs

PLANNING ASSESSMENTPLANNING IMPLEMENTATION EVALUATION Continually analyze the data to develop a plan of care Prioritize the triage category (emergent, urgent, non-urgent) Reference other resources as appropriate, collaborate with other team members Determine the disposition based on acuity of symptoms (9-1-1, emergency department, walk-in clinic, self-care), and nursing diagnosis

IMPLEMENT ASSESSMENT PLANNINGIMPLEMENTATIONEVALUATION Implementation – put the plan into action Define patient-centered plan Carry out nursing interventions Facilitate follow-up and coordination of services Provide instruction/information Utilize nursing communication and counseling skills towards desired outcome Document nursing process

EVALUATION ASSESSMENT PLANNING IMPLEMENTATIONEVALUATION Evaluation – achievement of outcomes Patient understanding, acceptance, implementation of plan of care – include circumstances to call back or further intervention Follow-up actions/plan of nurse Analysis or re-evaluation of effectiveness of each step of nursing process

Reference Laughlin, C.B. (Ed.). (2013). Core curriculum for ambulatory care nursing (3 rd ed.). Pitman, NJ: American Academy of Ambulatory Care Nursing.