Thursday, November 14, 2013

Week 9 eShift


      This week in class we were introduced to the eShift model of care. Before this class I was unaware what eShift was and what part it plays in health care. South-West LHIN describes eShift as “a technology-based initiative that connects an enhanced-skill Personal Support Worker (PSW) in the home with a registered nurse via a web-enabled iPhone” (p.1). The eShift allows for care to take place in the home of the client. If a certain issue or question arises, the PSW is able to contact a nurse and proceed using their feedback.

      This weeks class facilitation provided a case study regarding a PSW working in-home with the patient. From the perspective of the patient, her spouse, the PSW and the RN we were asked to reflect on the pros and cons that the eShift model would have on each member. There are many strengths that the eShift can potentially have on these people. The client will feel less as though they are a burden to others and there will be a decrease in stress put on spouses or family members who were originally caring for the patient. There will also be an increase in job opportunities for PSWs as well as nurses. Some further positives to using eShift are that the client is able to receive care in their home environment where they most likely feel comfortable. The client will also have a personalized relationship with the PSW, where their needs will be looked after at constant times. This model also aids in creating a learning experience where nurses are able to practice communication through technology with other health professionals. This concept relates to the CHNC’s fifth standards of practice: Capacity building, where nurses “actively share knowledge with other professionals and community partners and appreciates the importance of collaborative team work” (Community Health Nurses of Canada, 2011, p.19).

      With every advantage there are some disadvantages. When caring for patients, it is in the health care providers scope of practice to be knowledgeable of how to provide care. When a PSW is unsure of something and requires assistance from the nurse, they, as well as the client are in a vulnerable position as they wait for a response. Some  may also argue that this type of care takes away from a therapeutic relationship, as the PSW is focusing on their mobile device as well as the registered nurse never seeing their client that they are working with. Further potential issues may be the cost of this technology, privacy and security concerns as technology at times can be unreliable, as well the need to implement teaching programs. With health literacy, some people may not own mobile devices or know how to use them. This will make it difficult for those people to adjust to the use of technology. What are your thoughts on eShift? Do the benefits outweigh the costs?

      When our professor posed the question of whether a nurse needs to be physically present to undertake a nursing role, my initial response would be no. However, after further reflection I believe that this would impact the nurse’s care. In order to provide positive, efficient care, it would be beneficial to have that face-to-face interaction with patients. I believe that the eShift model is an advanced new form of health care that could have the potential to be integrated and built upon in the future. However, due to the many positives and negatives of this technology, I am still unsure whether it would truly benefit health care. This model has expanded my understanding and view of nursing. I have always viewed the nurses as providing first hand care to patients and not being the ones who were on the other end of the line communicating to clients via text.

Here is a video on YouTube I came across on eShift. It talks about what it is, who it involves and some of the benefits to this model.

References

 Community Health Nurses of Canada. (2011). Professional practice model & standards of practice.  
      Canadian Community Health Nursing. Retrieved from
     http://www.chnc.ca/documents/chnc-standards-eng-book.pdf 

SouthWestLHIN. (Producer) (2012 ). Quality award winner - eshift [Web]. Retrieved from

South-West Local Health Integration Network. (nd). eShift helps patients and the South West
      CCAC. Retrieved from http://www.southwestlhin.on.ca/newsletter.aspx?id=60

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