This document discusses enhancing telehealth education in nursing programs using King's conceptual framework and theory of goal attainment. It describes how one school of nursing infused telehealth content and resources into undergraduate and graduate curricula. The school created a telehealth education and research center in partnership with an engineering school and healthcare providers. This allows nursing students to gain hands-on experience with telehealth technologies through simulated patient encounters and virtual visits. The document emphasizes the importance of preparing nurses at all levels to use technologies like telehealth to facilitate the nursing process and help achieve patient care goals and outcomes.

1. King Nursing Theory Application & Essential Information in Telehealth
Essay
King Nursing Theory Application & Essential Information in Telehealth Essay ON King
Nursing Theory Application & Essential Information in Telehealth EssayTelehealth
technologies are increasingly used in the provision of nursing care to clients and
populations. The education of nurses must include content and practice with telehealth
technologies. Please read chapter 15 of your text: Imogene M. King: Conceptual Systems and
Middle-Range Theory of Goal Attainment and the following article before completing this
assignment Enhancing Telehealth Education in Nursing: Applying King’s Conceptual
Framework and Theory of Goal
Attainment(https://www.researchgate.net/publication/317787530…)In a 2-3-page
7th edition APA formatted paper describe your conversation/discharge planning
education with a patient being discharged from the hospital after having a stroke (CHF,
Asthma, COPD) who is going to be monitored using telehealth technology. Assume this
patient has never heard of telehealth before today and that the patient either is a member of
a vulnerable population or lives in a rural location lacking transportation and resources for
continued care. Identify how nurses can use telehealth to provide care. King Nursing Theory
Application & Essential Information in Telehealth Essay1. What information would be
important for this patient to know about telehealth?(King’s theory of goal attainment
focuses on perceptions, communications, interactions, and transactions between nurses and
clients as part of the process of mutual goal setting to achieve a state of health).2. Using
King’s model describe an aspect of patient care with telehealth that will address the specific
needs of this patient.3. Create a nursing telehealth strategy that could be implemented to
address this patient’s specific needs using the nursing process (ADPIE) format. (Assessment
Diagnosis Planning Interventions Evaluations)4. Include the principles of QSEN to address
safety concerns in your nursing process (Quality and Safety Education for Nurses)[Working
in the Surgical ICU, focus on CHF and post operative CABG patient discharged home for
follow up. Focus on problems such as pain management and use of Incentive spirometer.
Explain patient teaching/informing via telehealth of different modalities of pain
management as well as use and importance of incentive spirometer.]I will include the
article included to read prior to the assignment as well as the book cover and pages of
chapter 15. Other sources are welcomed to be used as references. Please let me know if this
is doable for you and any questions you may have. Thank you.King Nursing Theory

2. Application & Essential Information in Telehealth
Essayattachment_1attachment_2attachment_3attachment_4attachment_5Unformatted
Attachment PreviewSee discussions, stats, and author profiles for this publication at:
https://www.researchgate.net/publication/317787530 Enhancing Telehealth Education in
Nursing: Applying King’s Conceptual Framework and Theory of Goal Attainment Article in
Nursing Science Quarterly · July 2017 DOI: 10.1177/0894318417708418 CITATIONS
READS 4 1,940 3 authors: Ann Fronczek Nicole Rouhana Binghamton University
Binghamton University 9 PUBLICATIONS 21 CITATIONS 12 PUBLICATIONS 76 CITATIONS
SEE PROFILE Judy M. Kitchin Binghamton University 1 PUBLICATION 4 CITATIONS SEE
PROFILE Some of the authors of this publication are also working on these related projects:
Telehealth and Telenursing View project Midwifery Education View project All content
following this page was uploaded by Nicole Rouhana on 23 September 2017. The user has
requested enhancement of the downloaded file. SEE PROFILE 708418 research-article2017
NSQXXX10.1177/0894318417708418Nursing Science QuarterlyYancey / Teaching-
Learning Processes Teaching-Learning Processes Enhancing Telehealth Education in
Nursing: Applying King’s Conceptual Framework and Theory of Goal Attainment Nursing
Science Quarterly 2017, Vol. 30(3) 209-–213 © The Author(s) 2017 Reprints and
permissions: sagepub.com/journalsPermissions.nav
https://doi.org/10.1177/0894318417708418 DOI: 10.1177/0894318417708418
journals.sagepub.com/home/nsq Ann E. Fronczek, RN; PhD,1 Nicole A. Rouhana, RN; PhD,1
and Judy M. Kitchin, RN; MS1 Abstract Telehealth technologies are increasingly used in the
provision of nursing care to clients and populations. The education of nurses must include
content and practice with telehealth technologies. The authors of this article discuss how
one school of nursing has infused telehealth content and resources into undergraduate and
graduate curricula using King’s conceptual system and theory of goal attainment as a guide.
Keywords King, nursing, teaching-learning, telehealth Nurses are providing nursing care in
environments that are increasingly innovative and complex. There is a continuous evolution
in telecommunications and healthcare technologies that expand nursing practice and the
potential ways that nurses interact with their clients. One area of growth that continually
evolves and expands access to healthcare for clients, families, and systems is in the area of
telehealth. Telehealth is defined as “a collection of means or methods for enhancing
healthcare, public health, and health education delivery and using telecommunications
technology” King Nursing Theory Application & Essential Information in Telehealth
Essay(Telehealth Resource Centers, 2016). Telehealth technologies include live video
conferencing, store and forward, remote patient monitoring, and mobile health (mHealth)
devices. The main reason for the emergence of telehealth use is to provide equitable access
to healthcare and education for those who live and work in remote areas, where these
provisions have been clearly established to be insufficient. Therefore, nurse education
leaders play a critical role in incorporating technology into the curriculum along with an
increasing responsibility to prepare graduates to work with technologies surrounding
healthcare. Nurses “should have skills in assessing using telecommunications technology,
communicating with other healthcare providers, teaching clients and families, managing
data, and making appropriate decisions when the clients need to be examined by a

3. healthcare provider” (Ali, Carlton, & Ali, 2015, p. 266). The purpose of this article is to
discuss how a school of nursing has infused telehealth content and resources into both
undergraduate and graduate nursing curricula using King’s conceptual system and theory of
goal attainment as the underpinning. Overview of King’s Conceptual Framework and
Theory of Goal Attainment It is already well-known that King’s conceptual framework is a
systems framework consisting of personal, interpersonal, and social systems that interact to
meet health needs (Gulitz & King, 1988; King, 1981, 2007). The personal system focuses on
the individual, the interpersonal system focuses on groups of individuals and interactions,
and the social system focuses on systems with common goals and interests such as an
educational system or workplace. Nursing practice focuses on health needs and wants of the
social system through mutual goal-setting, planning of programs that address patient needs,
and evaluation of outcomes. King’s theory of goal attainment focuses on perceptions,
communications, interactions, and transactions between nurses and clients as part of the
process of mutual goal-setting to achieve a state of health (King, 2007). To reach a state of
mutual goal-setting, nurses must be proficient in the application of the nursing process
including skills in assessment, diagnosis, planning, implementation, and evaluation of
nursing care. Much of this proficiency lies in excellent listening and 1 Decker School of
Nursing, Binghamton University, NY, USA Contributing Editor: Nan Russell Yancey, RN, PhD,
Dean of Graduate, Professional, & Continuing Education, Professor of Nursing, Lewis
University, One University Parkway, Romeoville, IL 60446, USA. Email:
yanceyna@lewisu.edu 210 communication skills and having specialized nursing knowledge
and skills in providing care through education in order to maintain and restore health to an
individual or setting. These factors, when coupled with health promotion and disease
prevention efforts that are mutually agreeable and attainable, can positively influence
patient outcomes. One facet of healthcare that is becoming a more pervasive element that is
influencing all three of King’s systems and the process of goal attainment is technology. In
the increasingly technological world, nurses and clients are using healthcare technologies to
health outcomes. Nurses at all levels of practice need to have some educational foundation
in the use of technologies, including telehealth technologies, and how they can best be used
to facilitate nursing process, goal-setting, and patient care outcomes. King Nursing Theory
Application & Essential Information in Telehealth EssayNurses must also be educated in
how technologies are being used by the clients they serve to move to a state of well-being.
Interactions through the personal, interpersonal, and social systems, as described by King,
are increasingly being facilitated by technology. Internal and external systems, such as
accreditation bodies in healthcare with authority, decisionmaking, and power, are already
influencing nursing curricula. King’s systems are rapidly establishing competencies in the
area of technology at multiple levels of nursing practice. Faculties now recognize a specific
educational responsibility to prepare students for technological advancements and their
applications to practice via their respective undergraduate and graduate curriculum.
Although faculties have multiple goals for concepts related to technology, the authors in this
article specifically focus on telehealth technology related to nurse education. Background of
the Project There were two major purposes for enhancing content in telehealth and its
infrastructure within both undergraduate and graduate nursing programs. The first

4. purpose was to ensure compliance with the school’s accreditation and regulatory agencies
by creating opportunities for students to become competent in assessment through
multiple approaches as well as information management and patient care technologies.
Both the American Association Colleges of Nursing (AACN) and National Organization of
Nurse Practitioner Faculty (NONPF) require content related to new patient care
technologies, along with using data to influence evidenced-based changes in care. This
content is used to guide nurse educators, on both the baccalaureate and graduate level, to
ensure current competencies. Using King’s perspective, along with ensuring Commission on
Collegiate Nursing Education (CCNE) required standards are met, AACN and NONPF were
sources of power and authority that influenced a move forward in this area. Faculty in the
school had the authority to meet the accreditation goals in the manner in which they felt
was best for the both the undergraduate and graduate programs. Faculty recognized early
that telehealth technologies Nursing Science Quarterly 30(3) are specific areas that many
students may not have significant exposure to in the curriculum. Students and faculty must
be familiar with using telehealth and remote monitoring equipment to communication and
assessment skills for monitoring clients. The faculty recognized the importance of
acknowledging that technology, including telehealth, should be included as an essential
element of curricula at the undergraduate and graduate levels. The AACN (2008) Essentials
of Baccalaureate Nursing Practice Essential IV: Information Management & Application of
Patient Care Technology does address some of the technological competencies that are
needed. The technology competencies that students are expected to have at the time of
graduation include use of “applications of patient care technologies that are mainly
described as monitors, data gathering devices, or other s for patient care interventions”
(AACN, 2008, p. 17), as well as the following: 1. 2. 3. Demonstrate skills in using patient care
technology, information systems, and communication devices to safe nursing practice. Use
telecommunication technologies to assist in effective communication in a variety of
healthcare settings. Apply patient care technologies as appropriate to address needs of a
diverse patient population.(AACN, p. 18) These competencies are fairly broad and do not
include specific language related to telehealth and are aimed primarily at nurses working in
mostly traditional healthcare settings. Building on the foundation of baccalaureate
knowledge and competencies, the master’s-prepared nurse must develop skills for critical
analysis and increasing autonomy as the role continues to expand in complexity. King
Nursing Theory Application & Essential Information in Telehealth EssayThe AACN
Essentials of Master’s Education in Nursing Essential V: Informatics and Healthcare
Technologies provides clear direction and rationale for content and skills related to
technology and systems management (AACN, 2011). Essential V requires that the master’s-
prepared nurse will utilize patient-care technologies to both deliver and improve care while
simultaneously using communication technologies to integrate and coordinate care. These
skills are critical as they also improving healthcare outcomes as recommended by the
Institute of Medicine (2003). The master’s-prepared nurse must not only demonstrate
competencies in technology to ethically collect, manage, and analyze data but also to share
outcomes publicly in an effort to initiate program evaluation and revision. Specific examples
of master’s-level technology competencies include: 1. Analyze current and emerging

5. technologies to safe practice environments, and to optimize patient safety, cost-
effectiveness, and health outcomes. Yancey / Teaching-Learning Processes 2. 3. 4. Evaluate
outcome data using current communication technologies, information systems, and
statistical principles to develop strategies to reduce risks and improve health outcomes. . . .
Provide oversight and guidance in the integration of technologies to document patient care
and improve patient outcomes. . . . Use current and emerging technologies in the care
environment to lifelong learning for self and others. (AACN, 2011, p. 19) Optimally, the
master’s-prepared nurse will become a lifelong learner and maintain currency with
evolving technological advancements in the healthcare arena and act as a role model to
enhance other nurses’ technology skills. At the Doctor of Nursing Practice (DNP) level,
education specific to technology builds on individual competencies used in direct patient
care. This includes advanced data analysis and synthesis in addition to developing
leadership skills related to program evaluation that contribute to improving population
health outcomes. AACN (2006) DNP Essential IV: Information Systems/Technology and
Patient Care Technology for the Improvement and Transformation of Health Care states
that DNP graduates are expected to: 1. 2. 3. 4. 5. Design, select, use, and evaluate programs
that evaluate and monitor outcomes of care, care systems, and quality improvement.
Analyze and communicate critical elements necessary to the selection, use and evaluation of
healthcare information systems and patient care technology. Demonstrate the conceptual
ability and technical skills to develop and execute an evaluation plan involving data
extraction from practice information systems and databases. Provide leadership in the
evaluation and resolution of ethical and legal issues within healthcare systems relating to
the use of information, information technology, communication networks, and patient care
technology. Evaluate consumer health information sources for accuracy, timeliness, and
appropriateness. (AACN, 2006, p. 12) King’s conceptual framework can be used to
curriculum and curriculum decisions. In one school, the mission and philosophy stresses the
importance of the connections and interrelationships between personal, interpersonal, and
social systems and how to use them to fulfill the mission in caring for rural and vulnerable
populations (Decker School of Nursing, 2016). From this mission and philosophy, the
faculty set forth end-of-program outcomes for the baccalaureate, master’s, and doctoral
programs that were influenced by faculty’s values and the external influence of the
accreditation body. These end-of-program outcomes are fulfilled 211 through courses and
course objectives that provide direction for the key values and fundamental skills that
graduates must have to function in the diverse environments in which they will practice. In
this specific case, faculty can trace the major concept of telehealth and how it evolved and
how it is now threaded throughout the baccalaureate, master’s, and DNP programs.
However, to bring the school’s telehealth content to a higher level across all three levels of
program, a variety of infrastructure s were enhanced to provide nursing students
additional opportunities to function in environments where telehealth is being utilized. In
the process of assessing and strengthening content in telehealth, the school had the
opportunity to participate in a collaboration and grant-funding opportunity between the
Decker School of Nursing and the Thomas J. King Nursing Theory Application & Essential
Information in Telehealth EssayWatson School of Engineering and Applied Sciences at

6. Binghamton University to design a telehealth education and research center that would
meet telehealth service needs of the university community and surrounding clinical
agencies. Binghamton University, encompassing the schools of nursing and engineering, in
partnership with regional healthcare providers, took advantage of the significant regional
expertise in healthcare-related research, development, and education to develop the
Southern Tier Telemedicine and Mobile Health Research, Development and Training Center.
Consistent with King, this collaboration demonstrated how faculty and leaders from the
community worked closely in both interpersonal networks and interacting social systems to
create a ive environment to discuss possibilities for telehealth. The grant provided capital
funds to purchase equipment and infrastructure needs to create the center and provide
technological s and education spaces to enhance the curriculum. The center currently
houses two education spaces and a research collaboration space. The education spaces
include a classroom that has multiple educational technologies embedded to provide faculty
and students with the ability to participate in educational initiatives both live and virtually.
There is a second space that has a primary care set-up with telemedicine technology at the
bedside to provide students with an opportunity to have handson or simulated experiences
by participating in virtual visits. Through practicing elements of telehealth encounters in a
simulated environment, students are able to refine and develop telehealth competencies
before entering a practice environment. Although this infrastructure development and
grant collaboration allowed faculty to create learning spaces for students to practice with
telehealth technologies, it also led to a partnership and collaboration with a critical access
facility to help the system start a telehealth program. Through the infrastructure
development, faculties are able to meet a societal health need. The thrust s King’s (2007)
statement related to technology: As the explosion of knowledge and advances in technology
continue to increase, it is important for professionals in the 212 healthcare system to
function in multidisciplinary teams and to deliver healthcare to individuals and families.
Interdisciplinary collaboration among healthcare providers is important to provide care in
the 21st century. (p. 111) The transaction process among disciplines can lead to “quality
care and evidence based practice” (King, 2007, p. 111). These two schools and their related
programs now have expanded opportunities to learn with and among each other by
conducting research in the area of telehealth. Faculty will plan experiences with healthcare
facilities that are using or pursuing the incorporation of telehealth technologies. Telehealth
Content in the Nursing Program King’s general systems model has applications in
curriculum development. There are many facets to curriculum development, but as Gulitz
and King (1991) stated, the three systems “are operationalized through knowledge of
concepts, professional values, skills, axioms, and disturbances in health status that have
been identified as essential to nursing practice” (p. 130). As students move through the
baccalaureate, master’s, and doctoral levels, the concepts of informatics and healthcare
technologies are leveled and increase in complexity. Recognition that telehealth
technologies need to be emphasized as an important part of this technology discussion has
been recognized by faculty. In the curriculum, the educators’ intent is to help students not
only build skill in using telehealth technology but also reflect upon personal and
professional values, decision-making, and telehealth technology’s role in facilitating nursing

7. outcomes. The integration of telehealth information at the Decker School of Nursing
undergraduate level consists of the introduction of the concept of telehealth technologies
into the care of clients. Students at this level learn the foundation of telehealth technology,
its principles, and typical uses in client care through integration in course lectures,
discussions, and simulated lab experiences. Undergraduate students learn to use
therapeutic communication skills and the importance of effective listening, a hallmark of
King’s work. Opportunities to learn about, see, touch, and use telehealth communication
tools are incorporated into undergraduate clinical assessment skills simulated lab
experiences. In doing so, students begin to establish a comfort level with new technology
and gain knowledge of telehealth tools. In one introductory professional socialization
course, students learn about telehealth applications through an introductory overview of
telehealth and information technology. Students are shown examples of companies that
offer health services via telecommunications and videoconferencing. This discussion is
followed by a reflection on how they would feel as practitioners practicing remotely and on
the client’s perspective as to how they would feel seeing a practitioner through a web
camera. In a later medical-surgical Nursing Science Quarterly 30(3) course, the cardiac
didactic content includes discussion abKing Nursing Theory Application & Essential
Information in Telehealth Essay