Date Available


Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Candice Falls

Clinical Mentor

Dr. Sherry Griggs

Committee Member

Dr. Sheila Melander


Background. Integration of tele-intensive care units (tele-ICUs) into healthcare systems is associated with improved patient outcomes and organizational performance. Inadequate bedside nurses’ knowledge about tele-ICU is associated with poor communication and lack of trust between bedside and tele-ICU teams. These problems might diminish tele-ICU’s ability to maximally impact patient outcomes.

Purpose. The purpose of this project was to create a multimodal educational program with the goal of improving knowledge, attitudes, and skills related to tele-ICU among critical care nurses and to assess the effect of the educational intervention on tele-ICU utilization among bedside nurses as evidenced by the number of eLerts initiated at the bedside.

Methods. The study combined a quasi-experimental one group pretest-posttest method with retrospective review of the institutional data. A two-part educational intervention about tele-ICU (lecture, followed by a shadowing experience) was created by the tele-ICU team and presented to 23 Cardiovascular Intensive Care Unit nurses (91.3% never worked with tele-ICU before). The level of nursing knowledge was assessed by a five-question multiple choice survey, and nursing attitudes were assessed utilizing a 10-item survey scored on a 5-point Likert scale. The perceived value of the shadowing experience was assessed by a 5-item survey scored on a 5-point Likert scale. Categorical data were analyzed using frequency distribution. Paired sample t-test and independent sample t-test were used to analyze the changes in knowledge and attitude scores. The median number of eLerts in the three months after the intervention was compared to the median number of eLerts in the same three months of the previous year.

Results. The first part of the intervention resulted in an increase in both knowledge (57.4% [SD 25.1] to 85.2% [SD 19.3], p<0.001) and attitude (3.7 [SD 0.6] to 4.4 [SD 0.4], p<0.001) scores. The second part of the educational intervention did not influence the knowledge scores but resulted in an additional increase in the attitude score (4.2 [SD 0.4] to 4.5 [SD 0.4], p<0.001). The mean score for the perceived value of the shadowing was 4.8 (SD 0.3). The median number of eLerts did not increase significantly (72 vs 74).

Conclusion. This project supports a combination of lecture and shadowing experience as an effective intervention to improve nursing knowledge and attitudes related to tele-ICU. At the same time, the study highlights two important areas for additional research: 1) relative effectiveness of various educational methods in increasing tele-ICU understanding and skills, and 2) how knowledge and skills are translated into tele-ICU utilization.