Implementing a Telehealth Training Module in a School-Based Health Program

Abstract

Problem Statement: Hawaii Keiki: Healthy and Ready to Learn (HK) developed a telehealth program called Virtual Keiki Care (VKC) in 2020. This innovative telehealth technology allows for expanded access to provider-level care for its public-school students throughout the Hawaiian Islands. Telehealth is an effective method of increasing access to care for pediatric patients, particularly in underserved communities. However, health providers that lack proper training and support in conducting telehealth visits may not utilize the technology as often as needed, creating a barrier to potential access to health services, which was noted by the HK program in the early years of the VKC program. As a result, a quality improvement project that included telehealth education for nurses was implemented to demonstrate the importance of telehealth education and to increase telehealth utilization in the VKC program. Purpose: This Doctor of Nursing Practice (DNP) project aims to enhance the existing HK telehealth training using an evidence-based telehealth module for HK health staff to improve telehealth utilization. The telehealth module seeks to increase nurse confidence, knowledge, and competency in identifying students that should be referred for a telehealth visit. Methods: A PowerPoint telehealth module was created for HK nurses. The telehealth module was focused on educating nurses in identifying students for telehealth referral by chief complaint. The module was presented to HK nurses via a Zoom video meeting with three surveys distributed to nurses over three months to assess whether the project objectives were met and for nurse-reported telehealth utilization changes. Results: Despite a small sample size, nurses reported increased confidence, knowledge, and competency in identifying students for a VKC telehealth referral. The lead telehealth APRN also reported improvements in telehealth utilization. Discussion: Improved nurse confidence, knowledge, and competency are not solely attributed to the telehealth module, as literature shows that school nurse confidence is often related to gained experiences. HK nurses receive support from the HK Virtual Health Lead (APRN). The telehealth module enhanced the telehealth training by contributing evidenced based reference material to HK’s telehealth education. Increased utilization of VKC provides evidence for continued stakeholder support and improves access to care for Hawaii’s communities.