A comprehensive model of the process of telephone nursing

Abstract

Aim: This paper is a report of a study conducted to develop a theoretical model of the process nurses use to deliver care over the telephone.

Background: Telephone nursing is practised internationally in diverse settings, and research has shown it to be an effective service. Although studies have identified important variables that influence the practice, the telephone nursing process in its entirety has not been described.

Method: In this grounded theory study, data were collected from ten experienced telephone nurses from four different sites using semi-structured interviews. Concurrent data collection and analysis took place in 2005. A cumulative process of theoretical sampling and constant comparison was used to identify initial concepts, and then expand, validate, and clarify them until the concepts and relationships were fully developed. The findings were validated through peer and participant review.

Findings: Telephone nursing is a dynamic and goal-oriented process consisting of three phases: gathering information, cognitive processing, and output. While generally sequential, the phases can be simultaneous or recurring in response to caller needs. Interpreting takes place throughout the call; that is, the nurse translates data from the caller into healthcare information and healthcare information into caller language. Factors shaping the process are call prioritization and level of complexity, resource availability, and the nurse's need for validation.

Conclusion: Telephone nursing training and practice should emphasize gathering information, using implicit and explicit information to identify client needs, and translating healthcare information back into language comprehensible to clients.