Development of a Telenursing System for Home Oxygen Therapy Patients and an Educational Program for Telenurses.

为了预防慢性呼吸衰竭患者的急性呼吸衰竭，并能及早发现，我们开发了一套家庭氧疗生命管理远程监护系统（LMS-HOT），该系统由四个部分组成：患者家中的互联网终端，用于患者的身体和心理自我评估;基于文献的算法，触发个性化响应消息的远程监护;五名志愿者（六分之一在第6天由于另一种疾病退出）使用该系统超过两个月（总共953天的经验）。他们的自我监测数据、系统反应和患者对健康相关QOL SF-36的反应以及关于使用LMS-HOT的陈述为我们的评估提供了数据。患者提交了876份报告。当一个或多个参数触发时，识别出701例可能的急性加重发作。 关于我们 紧急报警，总发生率为80%。在可能的急性加重事件中，67.1%被判定为急诊;每例患者每份报告的急诊数量各不相同（4/55、48/230、301/340、71/79、164/172）。在触发当天，SpO_2、峰值流量、脉率、收缩压、体温、博格量表评分和每日总分均显著降低。没有再入院。2. HR-QOL（SF 36）在躯体相关功能（RP）、躯体疼痛（BP）、活力（VT）方面有所改善，但差异无统计学意义。3患者反映LMS-HOT减轻了日常生活中的焦虑，早期解决问题，提高了自我护理意识，提供了安全感。使用LMS-HOT维持患者在家的费用是通常再入院住院时间的25%。我们在2006-2007年组织了两次远程监护研讨会，有146人参加（37.7%为护士; 29.5%为其他保健专业人员; 32.9%为其他人员）。87.5%给予积极评价。我们准备了一本远程教育教材，并分发给每个参与者。少

We developed the Life Management Telenursing System for Home Oxygen Therapy (LMS-HOT) for chronic respiratory failure patients to prevent acute exacerbation of respiratory failure and detect it early.LMS-HOT consists of four systems administered by the nursing monitoring center : internet terminals in the patient's home for physical and mental self-assessment ; telemonitoring with literature-based algorithms that trigger individualized response messages; the server supporting the interactions and care system; and educational systems to guide patient compliance.Five volunteers (a sixth withdrew at day 6 due to another disease) used this system for more than two months (total 953 days experience). Their self-monitoring data, system responses, and patient responses to the Health-Related QOL SF-36 and statements about using LMS-HOT provided data for our evaluation.1. Patients submitted 876 reports. 701 possible exacerbation episodes were identified when one or more parameters triggered the … More emergency alarm, an over-all incidence rate of 80%. Of the possible exacerbation episodes, 67.1% were judged to be emergencies ; the number of emergencies per reports per patient varied (4/55, 48/230, 301/340, 71/79, 164/172). On the day of triggering parameters were significantly lower for SpO_2, peak flow, pulse rate, systolic blood pressure, body temperature, Borg scale score, and daily total points. There were no hospital readmissions.2. HR-QOL (SF36) was improved in function related to physical (RP), body pain (BP), vitality (VT) but changes were not statistically significant.3 The patients reported that LMS-HOT alleviated anxieties in daily life, resolved problems at early stage, improved self-care consciousness, and provided a sense of security.4. The cost of maintaining a patient at home using LMS-HOT was 25% of a usual readmission hospital stay.5. We organized two telementoring seminars in 2006-2007 attended by 146 people (37.7% nurses ; 29.5% other health professionals ; 32.9% others). 87.5% gave positive evaluations. We prepared a telementoring textbook and distributed it to each participant. Less