An integrated nursing and telemedicine approach to vascular care

Bangs, Iris; Clarke, Malcolm; Hands, Linda; Jones, R.; Knott, Mary; Mahaffey, Wendy

doi:10.1258/135763302320302271

Cited by 4 publications

(3 citation statements)

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“…Most of these studies demonstrate high accordance for the diagnosis of inflammatory and neoplastic skin diseases [17, 18, 19, 20, 21], and particularly for the diagnosis of pigmented skin lesions (teledermoscopy) [22, 23, 24, 25, 26]. Up to now only a few reports have discussed the use of teledermatology in the diagnosis and care of patients with leg ulcers [27, 28, 29, 30]. …”

Section: Discussionmentioning

confidence: 99%

Wound Teleconsultation in Patients with Chronic Leg Ulcers

Salmhofer¹,

Hofmann‐Wellenhof²,

Gabler

et al. 2005

Dermatology

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Background: The treatment of chronic leg ulcers requires frequent assessments of local wound status and adjustment of therapy. The availability of reasonably priced photographic equipment and quick electronic transfer of high-quality digital images should make it possible that the assessment of wound status can be made by remote experts. Objective: This study examines the feasibility of using teledermatology for wound assessment and therapeutic suggestions for patients with chronic leg ulcers. Methods: One hundred ten chronic leg ulcers of different origins were examined in face-to-face consultations. The examining doctor assessed the wound, made therapeutic recommendations and took 1–4 photographs of the wound using a digital camera. The digital images and relevant clinical information were then transmitted via a web application to an expert in wound care, who provided an independent teledermatological assessment of wound status and therapeutic recommendations. Results: In our study, a high accordance between direct consultations and electronic consultations was found in the assessment of chronic leg ulcers, especially for important features like slough (concordance: 84.6%), necrosis (concordance: 98.2%) and granulation tissue formation (concordance: 76.4%). Furthermore, the teledermatologist generally felt confident in recommending further treatment strategies and in planning further wound assessments via the internet. Conclusions: Our results suggest that teledermatology offers great potential for the future in chronic wound care. By reducing the need to travel long distances to the hospital or to consult a physician with expertise in wound care, wound teleconsultation might lower health care costs and improve the quality of life for patients with chronic wounds, while still maintaining a high quality of wound care.

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Section: Discussionmentioning

confidence: 99%

Wound Teleconsultation in Patients with Chronic Leg Ulcers

Salmhofer¹,

Hofmann‐Wellenhof²,

Gabler

et al. 2005

Dermatology

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show abstract

“…36 In vascular surgery, initial reports on the utility of these technologies appeared in the literature 20 years ago. 32,33,37 Despite data that telemedicine could increase access to vascular surgical services, reduce in-person outpatient attendance, reduce non-attendance rates, reduce both patient and hospital costs, and ensure that those patients who did require in-person consultations had sufficient dedicated time, all while maintaining patient satisfaction, adoption rates for telemedicine was low overall, in part due to the absence of relevant legislative and reimbursement protocols. 32,33,37 Nonetheless, in the years immediately prior to the COVID-19 pandemic, the development and implementation of telemedicine clinics was increasingly reported.…”

Section: Discussionmentioning

confidence: 99%

“…32,33,37 Despite data that telemedicine could increase access to vascular surgical services, reduce in-person outpatient attendance, reduce non-attendance rates, reduce both patient and hospital costs, and ensure that those patients who did require in-person consultations had sufficient dedicated time, all while maintaining patient satisfaction, adoption rates for telemedicine was low overall, in part due to the absence of relevant legislative and reimbursement protocols. 32,33,37 Nonetheless, in the years immediately prior to the COVID-19 pandemic, the development and implementation of telemedicine clinics was increasingly reported. In vascular surgery, the use of telemedicine in the management of patients with chronic venous ulcers, diabetic ulcers, peripheral arterial disease and chronic venous insufficiency had been reported.…”

Section: Discussionmentioning

confidence: 99%

Establishment of a clinical nurse specialist-led, virtual aneurysm surveillance clinic

et al. 2022

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Background The COVID-19 pandemic has necessitated significant changes to the manner in which healthcare is delivered. Chief among these has been the need to rapidly adopt virtual, or telephone clinics as a means of reducing unnecessary patient exposure to hospitals and clinical care settings. We were greatly aided in our adoption of virtual clinics by our experience in the establishment and maintenance of a Clinical Nurse Specialist-led, virtual clinic for both abdominal aortic (AAA) and extra-aortic aneurysm (EAA) surveillance within our department since 2016. Patients undergoing surveillance for abdominal aortic aneurysm (AAA) require frequent and lifelong clinical review. Previous studies have shown that post-operative surveillance in particular is critical in prolonging survival in AAA patients and in the early detection of late complications particularly following endovascular repair (EVAR). Poor compliance with EVAR surveillance has been shown to result in worse outcomes Aim The aim of this study was to evaluate the success of a nurse-led virtual clinic programme in terms of the safe management of patients undergoing AAA surveillance in a nurse-led virtual clinic. Results Over the course of the 4-year period from 2016 to 2019, 1352 patients were enrolled in the virtual aneurysm surveillance clinic. The majority of patients each year were male, ranging from 78.2% in 2016 to 85.2% in 2017. The majority of patients encountered the service owing to pre-operative surveillance of an AAA, with this group comprising at least 65% of the total cohort of patients each year. Over the course of the 4-year period of the virtual clinic there were 1466 patient encounters. Each ambulatory day care centre (ADCC) attendance normally costs the hospital €149. Therefore, a total saving of €218,434 resulted from this initiative alone. No patient presented as an emergency with a ruptured aneurysm during the time period studied. Conclusion Patients with AAA can be safely kept under surveillance in a nurse-led virtual clinic. Our experience with this model of care proved to be particularly advantageous during the period of the early COVID-19 pandemic.

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Telemedicine for the Diabetic Foot: A Model for Improving Medical Care, Developing Decision Support Systems, and Reducing Medical Cost

Fodor

Karnieli

2010

Annals of Information Systems

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An integrated nursing and telemedicine approach to vascular care

Cited by 4 publications

References 0 publications

Wound Teleconsultation in Patients with Chronic Leg Ulcers

Wound Teleconsultation in Patients with Chronic Leg Ulcers

Establishment of a clinical nurse specialist-led, virtual aneurysm surveillance clinic

Telemedicine for the Diabetic Foot: A Model for Improving Medical Care, Developing Decision Support Systems, and Reducing Medical Cost

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