The present and future role of nurses in the new digital health era

In a recent review published in JMIR Nursing, researchers reviewed nursing practices and additional skills required to be mastered by nurses in the digital health revolution, with the use of digital technologies exponentially increasing during the coronavirus disease 2019 (COVID-19) pandemic.

Background

Nursing roles have expanded digitally and evolved to improve clinical practice quality and provide remote health assistance to individuals residing in places where healthcare facilities may not be accessible. In recent times, nurses have been required to complete a three-year university degree course in most nations to be authorized to provide care and assistance to patients and healthcare professionals, respectively.

About the review

In the present review, researchers explored the roles of nurses and the skills they require to adapt to digital health practices and improve the quality of healthcare services in light of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.

English publications assessing the impact of telemedicine on nursing practices, published between 2011 and 2021, were retrieved from the Web of Science, Google Scholar, and PubMed databases. Initially, 250 papers were identified, of which eight duplicate papers were discarded, and 156 papers with inaccessible free full text or which did not meet the research purpose were excluded. Further, 26 papers with redundant topics and insufficient detail were excluded, and as a result, 60 relevant studies were analyzed, and the review was completed by July 2021.

The findings broadly denoted five major areas of improvement to upscale digital health (eHealth) nursing practices: leadership skills, soft skills, nurse training, COVID-19 management remotely, and managing interpersonal relations with professionals and patients by digital means. Good leadership skills are essential for high-quality clinical practice since nurses are mainly involved in coordination and collaboration between healthcare professionals, caregivers, and patients.

Soft skills are required for effective communication, problem-solving, and adaptiveness to digital approaches and equipment. Communicative, technological, and transversal skills need to be added to nurse education curriculums to improve eHealth literacy levels and make nurses more prepared, competent, and autonomous for the successful transformation of healthcare from the manual to the digital world.

Nurses need to hone their remote chronic illness management skills to provide Ehealth support and assistance to patients living in remote locations and enable service decentralization from hospital settings to remote areas. Nurses need to enhance their interpersonal skills to provide patient-centered telemedicine support with a sensitive and open for effective healthcare delivery in situations wherein face-to-face (FTF) sessions are not possible and, therefore, nonverbal indicators may go unnoticed.

Nurses are responsible for patient enrollment, explaining services to patients and their caregivers, and managing data from digital health-monitoring devices (such as pulse oximeters and blood pressure monitors) used. Nurses must receive adequate technical training to use data management software and troubleshoot telemedicine-related issues.

International organizations such as the International Medical Informatics Association and Commission on Accreditation for Health Informatics and Information Management Education have proposed mobile health (mHealth) training frameworks to improve the health professional preparedness for facilitating digital care.

The mHealth frameworks aim to improve digital communication skills, digital education, digital device, and software use skills, regulatory issues, compliance issues, deploying telemedicine services and products, and improving inter-professional health communications. The skills need to be mastered by nurses to conduct remote medical consultations, health monitoring, and diagnosis and management of patients.

Incorporating telemedicine in nursing practice would improve information and technology (IT) use in health domains for improving guidance, support, and assistance to patients in remote locations by improving communication and interpersonal relationships between nurses and patients and transforming nurses into efficient leaders to administer innovative and high-quality care to patients.

Conclusions

In the review based on literature published over 10 years, the team outlined the skills and attitudes nurses need to master in the digital health era, the emerging responsibilities of nurses in adopting telemedicine-based approaches, and the impact of the digital health revolution concerning nursing requirements.

The review findings showed that improving nurses’ readiness for adopting telehealth approaches needs an integrated method, combining technical equipment and device knowledge, remote management abilities, effective communication skills, soft skills, and interpersonal skills. Nurses need to undergo digital training; however, effective and precise nurse training methods are yet to be developed.

Existing nurse educational curriculums are based on conventional lectures and instructions that may be inadequate for proper digital health training, creating obstacles to incorporating digital technologies into routine clinical practice. In addition, quiet and disturbance-free environments are required to impart telemedicine education to nurses.