**8.3 Improved bed allocation**

By reconstructing effect choose extreme-risk customers—to a degree never-ending ailment sufferers and recent surgical cases—healthcare providers have established that telenursing offers a form that reduces readmissions significantly. Some organizations have listened inmates in ship telehealth programs. They secondhand

questionnaires and given fitness-connected instruction all week, making inquiries straightforwardly only accompanying those partners the one were further of the help all the while the ending [7].

### **8.4 Patient comfort**

Three in four clients feel affluent accompanying telemedicine, accompanying comforting until the plan of telenursing continually. Clients exceptionally like the plan of freely achieve consultants that ability usually wait laboriously due accompanying additional cases. According to a study of Massachusetts General Hospital telehealth sufferers, written a piece American Journal of Managed Care, most sufferers sensed in essence fitness visits were more available than in-woman visits, in addition to 60% sensed in essence visits were no various in status from in-individual visits, and as well 80% would advise in essence visits to kin and companions. NPs use telehealth technology to determine customer comfort levels and react therefore. The electronics admits NPs to fix the individual touch that home doctor visits formerly supported. Care providers again use the science to give duties to cases' commissions, to subsidiary hospitals, or to some part that offers availability [22].

### **8.5 Increased opportunities of healthcare employment**

Insurers revere telehealth cost stockpiles as a habit to give first-rate help at intensely shortened costs. Consumers inquire consultations to acquire news from care providers fast and prevent the nearly \$100 billion in expenses produce by loss to comprehend care plans. Analysts forecast that experts will occurrence a sharp increase in the patient meetings they transfer done yearly over the next 5 years, someday transferring about 27 million yearlong consultations [23].

### **8.6 Remote areas accessibility by patients**

Nearby 100 of rural hospitals ceased operations among 2010–2019, with various hundred more services through the country facing probability of closure, based on the declarations of National Rural Health Association. These closures are on account of society shifts and reserve misallocations. As physicians refrain location to country extents, and as patient conveyance management evolve more complex, questions accompanying care character and inclusion shortages are increasing. However, many trust that telenursing aids can go at a great distance in solving this crisis. Within telehealth services, hospitals of rural areas can reduce costs, expand coverage, and eliminate the waiting time spent till deliver services. Incidentally, this alike rationale applies to giving duties to cases in cultivating countries with its own government. Although customers can immediately sustain telemedicine take care of as little as \$50, not all providers offer telehealth that authorizes cases to collect the cost stockpiles. With adequate support and functional unification though, inmates here and there can have the skill to approach telenursing aids free in the forthcoming future [24].

## **9. Telenursing in nursing education**

The universal pandemic of COVID-19 obliged the world on widespread ratification of telehealth in tending practice and nursing e-learning. While healthcare

### *Telenursing Future in Solving the Nursing Global Workforce Gap DOI: http://dx.doi.org/10.5772/intechopen.110745*

providers altered their method of care from straight forwardly to e-learning in nursing education, tending programs used telehealth to accomplish practical hours. Before the universal COVID-19 pandemic, most nurses received telehealth preparation through their task, nurse residence, or companies entertaining the science. This approving the declaration of American Academy of Ambulatory Care Nursing (AAACN) in 2018, which reported that most nursing preparation occurs during their clinical orientation for different jobs or residency program, instead of their academic training. As a result, when the global society was in need to embrace telehealth and telenursing to face COVID-19 consequences, healthcare professionals, especially nurses, obliged to apply them without needed training [25].

Nurses erect themselves poorly trained for complying their arrangements of be fond of telehealth. Nursing programs can determine nursing students needs which mainly concentrated on the importance of more training to support the standard of care while guiding along route, over the noticed changes through the fruitful telenursing environment. So the educational nursing organizations have to mandate telenursing to be incorporated into all nursing curriculum [26].

Nursing education can adopt the telenursing training both in care providing and in nursing education which will be a worldwide trend in nursing science and can definitely help in decrease the gap of nursing shortage. Telenursing as a scientific practical method can provide a care or health services within some aspects which are completely unique and different. Telenursing not only practical method for providing nursing care, but also is an art in communication through applying of social etiquette in the management of patients' care including evaluation of them. Applying of legal considerations starting with the nursing license to perform tasks and duties, as well as confidentiality of patients' data to protect their privacy. The core of any care is comforting the patients, but in telenursing the core extended to the family members with a cultural competence through a social appreciating for the financial considerations as the health insurance coverage. Technology skills using mainly in telenursing and telehealth are including the ways to troubleshoot most issues of connectivity [27].

According to the American Nurses Association identifications for achieving effective telenursing program for providing a healthcare, its necessary to follow up four systematic phases. Those phases are starting with planning as a *first phase* for providing the service through telenursing then the *second phase* of preparing for it with checking of all facilities. Both first and second phases are involving setting up in addition to implementing the telenursing program. The *third phase* is providing the service using any of the suitable telenursing types, and finally performance evaluation as the *fourth phase* is important to evaluate the quality of care, communication and client satisfaction [28].

Telenursing educational programs are slightly different from telenursing using in providing a healthcare mainly. Telenursing educational programs focus on the first and fourth phases, providing and performance evaluation. The difference in providing phase is involving telenursing conduction through care coordination, triage, client education and monitoring. While, performance evaluation phase is assessing the factors that affect quality of telenursing program such as types of gathering data, tools for data collection and clients' feedback and outcome [29].

United Kingdom started the evolution of applying the telehealth and telenursing in both practical and educational fields with big support and collaboration of a multidisciplinary system. Starting with conducting of educational programs and carrying out of other specialized training programs for nurses and other health team members on the effective use of technology and software use with related operation, since even the actual use of Computerized Decision Support Systems (CDSS) in Europe. Those systems were helping in decision-making and facilitating standardized protocols that each patient is unique with varied situations. In UK, the first target users of this systems were general practitioners (GPs), then the practitioner nurses involved in the patients' advice lines through the nurse-led telephone service. These lines were implemented in different districts in UK and around as NHS Direct (NHSD) which applied in England, following by NHS Direct Wales (NHSDW) conducted in Wales as well as NHS 24 in Scotland. All of those programs were based mainly on well-designed educational programs for the nurses [30].

Telenursing and telehealth simulations and clinicians on different clinical settings are using three stages of preparing, telenursing visit and debriefing. The preparation stage in telehealth allows nursing students to search in patient conditions, reviews the key nursing skills and plan for their needs to address during the call. Students should confirm the patient consent, ask all available questions and record all data during the visit. The debriefing phase evaluates the process of assessment, patient's general condition, communication skills and outcomes of the telenursing or telehealth visit [25].

The paper of National Organization of Nurse Practitioner Faculty (NONPF) published in 2018, supporting telenursing in the educational programs of nurse practitioner (NP). They provided general guidelines of strategies, competencies, and evaluation process for telenursing modalities incorporation within the NP curriculum. This paper recommended by the need for telenursing competencies in nursing schools and teaching nursing students the clinical skills and technology [31].
