The Syllabus: A Commitment to Diversity, Equity, and Inclusion in Nursing Education.

BACKGROUND: Preparing a diverse nursing workforce skilled at caring for diverse populations is essential for achieving health equity in our society. Academic organizations, schools of nursing, and faculty are responsible for creating diverse, equitable, and inclusive (DEI) learning environments. The obligation for DEI initiatives in nursing education is guided by professional position statements and accreditation criteria. METHOD: The course syllabus is an inclusive strategy for setting the classroom tone at the start of the semester. Faculty can leverage the syllabus to provide explicit rhetoric for a diversity-centered educational climate. RESULTS: This article provides a sample DEI syllabus statement developed by the authors using existing organizational policy terminologies and which was reviewed by a DEI team including the nursing dean, DEI champions, and the university legal department. CONCLUSION: A carefully crafted syllabus statement is a purposeful acknowledgement of DEI as a core value in nursing education and may positively affect students' impression of a course. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Telehealth policy guide for nurse practitioners: A compliance checklist.

ABSTRACT: Telehealth expanded health care delivery since the start of the COVID-19 public health emergency (PHE). In early 2020, emergency declarations and subsequent policy changes resulted in telehealth flexibilities to support health care providers limit the spread of disease and maintain access to health services. Pandemic policies affected provider licensing requirements, cross-state practice, telemedicine modality, prescribing rules, privacy and security discretions, and reimbursement. On January 30, 2023, the Biden Administration announced it would end the PHE on May 11, 2023, which means some telehealth flexibilities in effect since 2020 will expire at various times through December 31, 2024, in the absence of permanent legislation. It can be challenging for nurse practitioners (NPs) to remain up to date on telehealth rules and regulations in a changing regulatory environment. The purpose of this article is to discuss telehealth policy and propose a checklist, developed specifically for NPs, to guide compliance with federal and state laws. Nurse practitioners using telehealth must work within their scope of practice and follow discipline-specific guidance to avoid potential malpractice.

An Infrastructure to Provide Safer, Higher-Quality, and More Equitable Telehealth.

The rapid expansion and prompt widescale adoption of telehealth during the COVID-19 pandemic resulted in telehealth practice variations across health care settings and has implications for patient safety, health equity, and quality of care. Telehealth is part of the public health infrastructure, and health care stakeholders have an opportunity to strategically plan for telehealth expansion and sustainability in organizations as the pandemic wanes. A framework to guide organizational telehealth integration is needed that can support safe, accessible, and high-quality telehealth to patients regardless of social and/or economic status. The purpose of this article is to propose an innovative telehealth model, supported by systems theory, to address the complexity of telehealth implementation in health care organizations. A Donabedian approach is used to address quality. The telehealth model is an organizational infrastructure that outlines how policy and authority requirements, organization factors, provider competencies, and patient determinants of health influence safer, more equitable, higher-quality telehealth. The framework can guide leaders in building, redesigning, and measuring the impact of telehealth programs as health care shifts into a revolutionary technology era to meet the needs of diverse organizations and populations.

A nurse practitioner-led telehealth protocol to improve diabetes outcomes in primary care.

BACKGROUND: Diabetes-related complications contribute to a costly health burden in the United States. Telehealth (TH) is a tool that can increase access to care and offer ongoing support for chronic disease self-management. LOCAL PROBLEM: A primary care practice in Texas needed a method to manage an influx of patients with uncontrolled diabetes and improve type 2 diabetes outcomes using nurse practitioner (NP) TH appointments. METHODS: Thirty patients meeting inclusion criteria participated in monthly TH check-ins and followed monthly for 3 months. Baseline and postintervention diabetes laboratory studies (hemoglobin A1c [HbA1c], estimated glomerular filtration rate, and microalbumin) were collected. INTERVENTIONS: During each monthly TH visit, an NP-led diabetes TH QI protocol was implemented. The Telehealth Usability Questionnaire was administered to patients after the 3-month intervention. RESULTS: The TH QI protocol resulted in an overall ∼1% reduction in HbA1c. Over 73% of participants experienced various reductions of HbA1c, of which 2.3% achieved a postintervention HbA1c <7%, indicating controlled diabetes. Kidney function indicated by eGFR improved by 7 ml/min/1.73 m2 in 83% of participating patients. At the end of the 3-month intervention, 84% of participants expressed overall satisfaction with TH appointments. CONCLUSIONS: Interventions using TH to improve chronic disease may be useful in diabetes outcomes and self-management. Monthly TH visits can improve patient outcomes, reduce complications, and enhance the patient-provider relationship. Preventive self-care activities and long-term use of TH visits for self-management are implications for future studies.

Remote patient triage: Shifting toward safer telehealth practice.

ABSTRACT: Telehealth is a tool used to diagnose and treat patients at a distance. Telehealth quickly became essential during the COVID-19 pandemic as a result of stay-at-home orders. Regulatory waivers encouraged the use of telehealth as an alternative to the in-person encounter to limit the spread of disease. The pandemic incited a rapid growth in telehealth, and new legislation, new technologies, and providers new to virtual care changed the delivery of traditional telehealth. Postpandemic planning is necessary to support the safe integration of telehealth in the health care system. The purpose of this article is to discuss the current issues affecting telehealth and offer recommendations for safer virtual care. Critical considerations, beginning with an assessment of remote patient acuity, are needed to ensure the standard of care for telehealth is equivalent to the in-person setting. A triage protocol to screen patients seeking virtual services is required to prevent underestimation of severity of illness, sort patients to place of service, and determine if a need exists to escalate to an in-person evaluation or higher level of care. A standard approach to triage may minimize the risks to patient safety and support the appropriate use of telehealth technologies.