New Zealand nurses' experience of tele-consultation within secondary and tertiary services to provide care at a distance

The advancement of information and communication technologies and their application to healthcare has driven the emergence of telemedicine.  One aspect of telemedicine is tele-consultation, which involves the use of information technology to provide advice or information from a distance.  Nurses use tele-consultation as part of their practice and in New Zealand this has mostly been by nurses who work in specialist services, connecting with nurses who work in geographically isolated or remote areas.  The aim of this study was to explore New Zealand Registered Nurses' experience of using tele-consultation to provide care at a distance.  The design was qualitative using a general inductive approach.  Single semi-structured interviews were undertaken with nine experienced New Zealand nurses who provide secondary and tertiary services to patients and healthcare teams.  The findings were derived from a thematic analysis that identified five themes.  Nurses' roles in tele-consultation involved co-ordination, advocacy and support to ensure a positive experience for the patient.  Its use created a sense of connection to, and strengthened relationships with the healthcare team, particularly among those working in remote areas.  Tele-consultation provided the opportunity for more timely care for patients with increased access to specialist expertise and proved more convenient, and supported a patient and family focus.  Although the number of participants was limited, all were strong advocates for the use of tele-consultation within their practice.