The rapidly growing aged population is challenging conventional methods of care provision. Global ageing, combined with other challenges, has compelled health systems to explore new methods for providing health care. Telenursing, providing nursing care at a distance using new technologies, is identified as one alternative. The lack of evidence for the effectiveness of telenursing in aged care is a drawback for its wider use. The aim of this chapter is to review the evidence of randomised controlled trials (RCT) in geriatric telenursing practices. We performed a systematic literature review using the Ovid Medline and Pubmed databases on telenursing. A total of 62 articles were retrieved and 18 studies were selected for comprehensive analysis. The review found that the RCTs were conducted in different areas of geriatric telenursing and various information and communication technologies (ICT) were used in the interventions. Although robust evidence, based on RCTs in aged care telenursing is yet to emerge, the majority of current studies suggest that telenursing is an effective tool.
TopBackground
Elderly people are more likely to suffer from conditions of disability, chronic disease, and multiple impairments, and are therefore more likely to require care. Research shows that almost 75% of elderly (aged 65 and over) have at least one chronic illness (Calkins, Boult, & Wagner, 1999). The cost associated with treating the elderly with chronic conditions is high and continuing to grow. The World Health Organization (WHO) predicts that chronic disease will be the leading cause of disability by 2020 and will be the most expensive problem facing health care systems (Belfield & Colin-Thome, 2004). For example, studies show that caring for people with chronic diseases consumes approximately 78% of all health care spending in the United States – more than $USD 1 trillion annually (ITAA e-Health Committee, 2004).
One serious obstacle to providing care to the growing number of aged people is the lack of health professionals. The difficulty of recruiting and retaining quality health care workers has been well documented (Cooper, Getzen, McKee & Laud, 2002; Blumenthal, 2004). Nurses traditionally play an important role in aged care. According to the projections of the Health Resources and Services Administration (HRSA), the shortage of nurses in the US could escalate to one million by 2020 (HRSA, 2006). Australia projects a shortage of 40,000 nurses by 2010 (International Council of Nurses, 2005). The lack of nurses is a critical issue in developing countries too. According to WHO statistics, Sub Saharan Africa is short of 60,000 nurses to meet Millennium Development Goals (World Health Report, 2006).
Governments and health systems around the world are in search of solutions to the problems posed by global ageing. Logic dictates that the optimal solution would be the producing of more doctors, nurses and other health professionals. However, this requires long-term policy changes, funding and infrastructure development. Therefore, among other alternative solutions, the role of telehealth to address some critical issues in aged care has been identified.