Primary Care Clinic Nurse Activities with a Telehealth Monitoring System.
Chelsea Howland, Laurel Despins, Jeri Sindt and 2 others
PMID 32443961WHAT IT FOUND
In-home glucose and blood pressure monitoring did not improve A1C or blood pressure.
It added nurse activities and communications in primary care, so plan for more nursing tasks without shown patient benefit.
Key findings
01The original trial found no significant differences in A1C or systolic blood pressure after 12 weeks between in-home monitoring and usual care.
02In-home monitoring patients averaged 14.1 nursing activities over 12 weeks, while usual care patients averaged 7.3 nursing activities.
03In-home monitoring patients averaged 4.6 communications over 12 weeks, while usual care patients averaged 2.6 communications, and nurse-initiated communications were significantly more frequent in the monitoring group.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a secondary analysis of an existing trial. It did not directly test nursing workload or workflow. No time spent on nursing activities was measured. The counts of activities and communications do not show the time nurses needed. The analysis was not designed to link nursing activities to patient outcomes. The original primary outcomes were null. Only 74 patient records from six clinics at one academic medical center were analyzed. The sample is small and single-site. Patients and physicians were not blinded. The intervention included device transmission, nurse review, provider communication, and treatment changes, so extra nurse activity cannot be attributed to any single component.
Declared interests
Research Support, N.I.H., Extramural is listed in the publication types, but the supplied text does not include a conflict-of-interest declaration.
The easy way to misread this
Do not conclude that home telemonitoring improves diabetes or blood pressure control. The original trial's primary outcomes showed no significant difference, and this paper only counted nurse activities and communications. It did not measure time or link activities to outcomes.