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Camera Assisted Monitoring Device As A Tool To Reduce Falls In Inpatient Adults: An Integrative Review, Pamela Oriaifo Oct 2023

Camera Assisted Monitoring Device As A Tool To Reduce Falls In Inpatient Adults: An Integrative Review, Pamela Oriaifo

Doctoral Dissertations and Projects

Background: Adult inpatient falls remain a significant challenge in many hospitals, resulting in poor quality of life and severe financial burden. There have been tremendous efforts to curb the number of falls ranging from environmental modification, clinician education, review of medications, and use of assistive devices. One such assistive device is the use of camera monitoring systems. This systemic review scopes camera/video-assisted fall prevention programs in hospitals. It was hypothesized that camera/video-assisted fall prevention programs would reduce adult inpatient fall and costs significantly. The outcomes of camera or video-assisted fall prevention programs were considered in some hospital settings. Method: The …


The Efficacy Of Statin Therapy In Reducing Cardiovascular Accident Stroke (Cva) Risk Among Type 2 Diabetes Adult Patients Using Patient-Centered Care: An Integrative Review, Bridgett Simone Anckle Oct 2023

The Efficacy Of Statin Therapy In Reducing Cardiovascular Accident Stroke (Cva) Risk Among Type 2 Diabetes Adult Patients Using Patient-Centered Care: An Integrative Review, Bridgett Simone Anckle

Doctoral Dissertations and Projects

This study was an integrated review that comprehensively analyzed the efficacy of statin therapy in mitigating the risk of cardiovascular accidents (CVA) among individuals with type 2 diabetes mellitus (DM). The research seeks to explore statin management in preventing CVAs, a significant concern for this patient population. The study conducts a thorough synthesis of twenty-one peer-reviewed articles, critically evaluating the efficacy, safety, adherence factors, and cost-effectiveness of statin therapy for diabetic patients. The study adhered to the Whitmore and Knafl Framework and used the constant comparison approach to systematically categorize and pattern findings, culminating in an integrated understanding of statin …


Determining The Effectiveness Of Gender-Based Integrated Care For Women Veterans: An Integrative Review, Karina Karin Espinoza-Palmer Oct 2023

Determining The Effectiveness Of Gender-Based Integrated Care For Women Veterans: An Integrative Review, Karina Karin Espinoza-Palmer

Doctoral Dissertations and Projects

As the Veterans Health Administration (VHA) improves their services to keep up with the needs of the rapidly-rising population of minority veterans, the aspects of gender-sensitive care must be tailored to the needs of women veterans. The purpose of this integrative review was to discover and critique evidence-based research studies of women veterans to determine the state of gender-sensitive care for improving access and coordination care, specifically to enhance mental health approaches needed at VA settings. The women veterans minority population is the fastest growing group of patients in the Department of Veterans Affairs (VA). Women veterans are less likely …


Reducing Readmission Rates In Adult Patients (18–25 Years) With Alcohol And Substance Use Disorder Through Implementation Of Care Coordination Strategy: An Integrative Review, Godswill Evouka Oct 2023

Reducing Readmission Rates In Adult Patients (18–25 Years) With Alcohol And Substance Use Disorder Through Implementation Of Care Coordination Strategy: An Integrative Review, Godswill Evouka

Doctoral Dissertations and Projects

Alcohol and substance use disorders are a major issue in adults ages 18 to 25. According to the 2021 National Survey on Drug Use and Health, 6.6 million young adults ages 18 to 25 reported that they drank alcohol in the past month, and 2.4 million young adults ages 18 to 25 reported heavy alcohol use in the past. Over 20 million alcohol use cases were reported in the past year in the United States. Further, 21.6% of patients with drug use disorders were readmitted to hospitals within 30 days of discharge. Adults ages 18 to 25 years who are …


Implementation Of Nutritional Screening In Adults (Ages 19-65) With Major Depressive Disorder: An Integrative Review, Laurie S. Stephens Oct 2023

Implementation Of Nutritional Screening In Adults (Ages 19-65) With Major Depressive Disorder: An Integrative Review, Laurie S. Stephens

Doctoral Dissertations and Projects

The World Health Organization estimates the total percentage of depression at 3.8% and projects it to be the leading cause of global disability by 2030 (WHO, 2023). The economic burden for adults with major depressive disorder in the United States is estimated at a staggering annual cost of 236 billion dollars (Greenberg et al., 2018). Nutritional psychiatry is a growing subspecialty focused upon how diet can improve mental health outcomes. The evidence shows a correlation between diet and depression, influencing questions on how this translates to current dietary recommendations and treatment. An integrative review of current literature was performed to …


Improving Stemi Transfer Times, Beth Anne Geiger Oct 2023

Improving Stemi Transfer Times, Beth Anne Geiger

Doctoral Dissertations and Projects

Early identification and treatment for the patient experiencing an ST elevation myocardial infarction is imperative. The American Heart Association and the American College of Cardiology have provided national guidelines to standardize the expectation of care for these patients. When organizations are not equipped to perform a percutaneous coronary intervention, the patient requires transfer. Delay in patient transfer leads to increased morbidity and mortality and poor patient outcomes. For this reason, it is essential that non-PCI capable hospitals have a standard protocol that is followed to expedite treatment and transfer of the patient to a higher level of care. This project …


Hypothermia In The Operating Room Promoting Normothermia In The Hysterectomy Population, Adina Indries Sep 2023

Hypothermia In The Operating Room Promoting Normothermia In The Hysterectomy Population, Adina Indries

Doctoral Dissertations and Projects

Certified Registered Nurse Anesthetists are Advanced Practice Providers that provide safe, evidence-based practice to their surgical patients. They not only monitor the vital signs throughout surgery but also strive to improve care and outcome by implementing different measures to keep the patient safe and promote a positive outcome during a stressful time for the surgical patient. To improve outcomes, it has been identified that hypothermia is a common occurrence in the surgical patient, especially in the GYN surgical population at this level one trauma center. Hypothermia is defined as the body’s core temperature less than 36 degrees Celsius. With hypothermia …


Complementary And Integrative Therapies Available For Treating Veterans With Ptsd: An Integrative Review, Kelly Ann Greene Aug 2023

Complementary And Integrative Therapies Available For Treating Veterans With Ptsd: An Integrative Review, Kelly Ann Greene

Doctoral Dissertations and Projects

PTSD is described as the resulting from exposure to threatened or real injury, death, or sexual violence. Its symptoms have four different clusters: avoidance, re-experiencing, hyperarousal, and negative alterations in mood. PTSD is a widespread diagnosis among U.S. military veterans. This is a way of daily life for many veterans, and not all therapy is successful. The Veterans Health Administration (VA) recognizes that conventional therapy is not always appropriate for each veteran with PTSD. The VA has developed the Whole Health approach, which represents a move toward more person-driven health care, which the VA characterizes as proactive, patient driven, and …


High Fructose Corn Syrup And Sugar Substitutes: Hemoglobin A1c Implications In Diabetes?, Rachelle S. Glover Jul 2023

High Fructose Corn Syrup And Sugar Substitutes: Hemoglobin A1c Implications In Diabetes?, Rachelle S. Glover

Doctoral Dissertations and Projects

Diabetes mellitus type 2 (DMt2) is an increasing health concern of epidemic proportion in the United States. High fructose corn syrup (HFCS) and artificial sweeteners (AS) have been implicated as contributory factors to DMt2. This project seeks to demonstrate elimination of daily consumption of HFCS and AS in DMt2 patients can contribute to lower hemoglobin A1C (HgbA1C) levels by comparing two groups of patients receiving two differing diabetes education programs. A reduction of HgbA1C levels by 0.2-0.5% is expected in DMt2 patients instructed to eliminate HFCS and AS, and no change is expected in HgbA1C levels in DMt2 patients receiving …


Evaluating The Need For Return-To-Learn Concussion Protocols In High School Student-Athletes: An Integrative Review, William David Midgette Jul 2023

Evaluating The Need For Return-To-Learn Concussion Protocols In High School Student-Athletes: An Integrative Review, William David Midgette

Doctoral Dissertations and Projects

Over a million high school students are estimated to sustain at least one sports-related concussion annually. Unfortunately, over a third of these student-athletes suffer from post-concussion syndrome, which leads to the question of whether student-athletes are allowed proper time to heal after a concussion or if more can be done to optimize concussion recovery. Proper and optimal recovery post-concussion encompasses both physical and cognitive rest. While concussion management has traditionally focused on the physical aspects of recovery, emphasis has shifted to the cognitive impacts of concussions. There is literature to support that cognitive rest is vitally important, if not equally …


Whether Covid-19 Infection Affects Human Cognitive Function, June Li Alsgaard Jul 2023

Whether Covid-19 Infection Affects Human Cognitive Function, June Li Alsgaard

Doctoral Dissertations and Projects

The COVID-19 pandemic, resulting from the SARS-CoV-2 virus, continues to impact the daily lives of individuals worldwide. Although research has been conducted on long-COVID symptoms, the underlying causes remain unclear. Notably, instances of neurological decline have been observed following SARS-CoV-2 infections. 125,573 articles regarding neurological damage and cognitive disfunction were published and can be found from major research databases. For this scholarly project, 25 peer-reviewed journal articles pertaining to long-COVID and neurologic function changes, as well as potential underlying reasons for these changes, were curated. The proposed hypotheses include the virus' ability to pass through and harm the blood-brain barrier …


Kangaroo Care Impact On Maternal Health: An Integrative Review, Alexis Ann Lawson Jul 2023

Kangaroo Care Impact On Maternal Health: An Integrative Review, Alexis Ann Lawson

Doctoral Dissertations and Projects

Health care should progress and change as the needs of the population change. As light is shed on the mothers’ experiences during the postpartum period, there is an increasing need to find and implement evidence-based interventions to promote their health and wellness. As a vulnerable population, postpartum women require appropriate treatments and interventions to avoid postpartum complications. Three key themes of postpartum health and well-being that directly and significantly impact mothers are postpartum depression, maternal and infant attachment, and exclusive breastfeeding. This integrative review addressed the correlation between each of these themes and how kangaroo care, upright skin-to-skin contact, impacts …


A Clinical Nurse Leader Nurse Navigator Program For Heart Failure Patients, Shanna Lantel Negron Jul 2023

A Clinical Nurse Leader Nurse Navigator Program For Heart Failure Patients, Shanna Lantel Negron

Doctoral Dissertations and Projects

The purpose of this integrative review is to examine the literature regarding nurse-led educational interventions, transitional care (TC) strategies for heart failure (HF) patients, nurse navigation, HF self-care, and the clinical nurse leader (CNL) role to support integrating a CNL into the care delivery model serving as a nurse navigator (NN) for adult HF patients being discharged home from the hospital. The basis for this review is to identify an innovative way to improve patient reported and clinical outcomes for the HF population which increases each year. The economic and symptom burden associated with this disease is high further enhanced …


Stroke Symptom Identification Tool For Hospitalized Patients In A Rural Setting, Cheryl Ann Henderson Jul 2023

Stroke Symptom Identification Tool For Hospitalized Patients In A Rural Setting, Cheryl Ann Henderson

Doctoral Dissertations and Projects

Thousands of persons in the United States yearly suffer acute large vessel occlusion stroke (LVO). Caring for these individuals with strokes and the ensuing issues increases healthcare dollars. In underserved, rural communities, there is a dire need for improved methods to access care for these individuals. A 3-month evidence-based practice (EBP) project was conducted in a small rural town in Virginia with one of the state’s highest rates of acute stroke. Nurses in the rural hospital voluntarily participated in an educational program on recognizing acute stroke and utilizing the Vision, Aphasia, Neglect (VAN) assessment tool. The participants (N-15) were asked …


Managing Burnout In Nursing, Karen Starnes Bell Jul 2023

Managing Burnout In Nursing, Karen Starnes Bell

Doctoral Dissertations and Projects

Burnout is a widespread phenomenon characterized by a reduction in energy that manifests in exhaustion, lack of inspiration, and feelings of frustration which may lead to reduced work efficacy and multiple absences. In the nursing profession, long hours, the pressure of quick decision-making, and the stress of caring for patients who may have poor outcomes may contribute to burnout. This integrative review was conducted to identify variables that contribute to nurse burnout and discover strategies organizations can implement to reduce or prevent nurse burnout.


Nonpharmacologic Measures To Maintain Or Increase Bone Density In Patients At Risk For Osteoporosis: An Integrative Review, Katie Saporsky Jul 2023

Nonpharmacologic Measures To Maintain Or Increase Bone Density In Patients At Risk For Osteoporosis: An Integrative Review, Katie Saporsky

Doctoral Dissertations and Projects

Osteoporosis is a major phenomenon, impacting a large proportion of the population of the United States. Effective prevention and mitigation strategies for this condition and its related complications are necessary to promote health and well-being for the aging population. Current pharmacologic agents used to combat osteoporosis bring the risk of adverse effects, resulting in poor patient adherence. Nonpharmacologic methodologies, specifically weight-bearing exercise, targeted nutrition, and whole-body vibration, have proven to be successful in increasing bone mineral density and mitigating the risk of osteoporosis and its related complications. Implementing these methodologies results in increasing bone mineral density, strength, and well-being.


The Effects Of Dietary And Lifestyle Management On Diabetic Neuropathy, Courtney Renee Wyatt Jun 2023

The Effects Of Dietary And Lifestyle Management On Diabetic Neuropathy, Courtney Renee Wyatt

Doctoral Dissertations and Projects

Numerous patients who have uncontrolled diabetes have developed complications associated with diabetic neuropathy. The apparent knowledge deficit and noncompliance have led to the development of clinical concerns related to improving patient outcomes. This scholarly project assesses the effects of dietary, weight, and exercise management on improving diabetic neuropathy symptoms. The debilitating effects of diabetes continue to affect numerous people each day. Uncontrolled diabetes can create innumerable complications, including diabetic neuropathy. Appropriate nutrition associated with accountability, monitoring, and proper education can alleviate the progression of uncontrolled diabetes. Assessment of the improvement of diabetic neuropathy with dietary and exercise management is examined …


Enhancing The Patient Experience By Providing A Visual Cue To Reference/Reinforce Medication Communication, Janet Radzykewycz Jun 2023

Enhancing The Patient Experience By Providing A Visual Cue To Reference/Reinforce Medication Communication, Janet Radzykewycz

Doctoral Dissertations and Projects

Purpose: The purpose of this project was to examine how placing a visual cue (sticker) for patients and nurses to reference during the patient’s acute care admission on the Telemetry unit will affect the patient’s perception of medication communication (purpose and side effects of medications). Background: Approximately 1.3 million people annually in the United States experience an injury due to medication-related errors. Hospitalized patients are at greatest risk for medication errors at the time of discharge due to medication changes in the acute care environment and these changes being implemented in the patient’s plan of care in the home environment. …


The Effects Of Therapeutic Activities On Depression In The Long-Term Care Population, Stephanie Nacole Knowles May 2023

The Effects Of Therapeutic Activities On Depression In The Long-Term Care Population, Stephanie Nacole Knowles

Doctoral Dissertations and Projects

Therapeutic activities are activities that encourage social interaction and promote cognitive skills. When these activities are put on hold for an extended period of time it can be detrimental to the Long-Term Care population. Depression related to social isolation has plagued the LongTerm Care population since the onset of COVID, causing increased sickness and in some situations death. The purpose of this integrative review is to determine the effectiveness of therapeutic activities in decreasing depression in the Long-Term Care (LTC) population. Literature was collected from 2018 through 2023 from the CINAHL database and analyzed using the PRISMA model. A total …


A Team-Based Approach To Increase Initiation Of Self-Management Goals In Adult Patients Diagnosed With Hypertension With The Use Of A Self-Management Goal Toolkit, Kristel Danette Ramsay May 2023

A Team-Based Approach To Increase Initiation Of Self-Management Goals In Adult Patients Diagnosed With Hypertension With The Use Of A Self-Management Goal Toolkit, Kristel Danette Ramsay

Doctoral Dissertations and Projects

Due to the high risk of cardiovascular disease and other negative complications, it is imperative that patients in the primary care clinic diagnosed with hypertension control blood pressure levels. The purpose of this scholarly project was to increase the initiation of self-management goals (SMGs) among adult males and females age 30 to 60 diagnosed with hypertension. These patients were active duty military, reservists, and dependent beneficiaries who receive care at the Navy Medicine Readiness Training Unit–Memphis. The practice change took the onus of introduction and education about SMGs off the provider and added key responsibilities to support staff, who provided …


Kangaroo Care And Improved Physiological Status In Preterm Infants: An Integrative Review, Kira Juunia Harkonen May 2023

Kangaroo Care And Improved Physiological Status In Preterm Infants: An Integrative Review, Kira Juunia Harkonen

Doctoral Dissertations and Projects

Preterm births continue to cause long-term sequelae for infants worldwide. Interventions in the neonatal intensive care unit (NICU) that promote better outcomes can make an impact on preterm infants’ futures. The purpose of this review was to determine if kangaroo care has positive physiological effects on preterm infants in the NICU. Practice changes to enhance kangaroo care in the NICU include reducing barriers such as medical complexity and staff misconceptions as well as facilitating increased parental presence. The review of the literature found evidence to support the positive outcomes that kangaroo care has on neonates’ growth, vital signs, stress outcomes, …


Reducing Medication Errors In Inpatient Hospital Settings By Implementing The Barcode Medication Administration Technology: An Integrative Review, Kali A. Brown May 2023

Reducing Medication Errors In Inpatient Hospital Settings By Implementing The Barcode Medication Administration Technology: An Integrative Review, Kali A. Brown

Doctoral Dissertations and Projects

Medication administration errors adversely affect patient outcomes, satisfaction, safety, and quality of care. Barcode medication administration (BCMA) technology automates the verification process during medication administration by requiring that nurses scan the barcode on the medication and the patient identification wristband to confirm the five rights of medication administration. The BCMA thus helps to intercept medication errors that occur at the point of administration. A review of 32 articles published within the past six years was conducted to explore the impact of using BCMA technology on medication error rates in inpatient hospital settings. The review findings indicate that systemic and individual …


Improved Education For Caregivers Of Hospice Heart Failure Patients To Reduce Hospital Admissions: An Integrative Review, Sierra Spain Sanford May 2023

Improved Education For Caregivers Of Hospice Heart Failure Patients To Reduce Hospital Admissions: An Integrative Review, Sierra Spain Sanford

Doctoral Dissertations and Projects

Heart disease is the second-leading cause of death in the United States, excluding the COVID-19 pandemic. Despite being the leading cause of death, heart failure only comprises 15% of hospice deaths and remains the most likely to be discharged from hospice services due to acute hospitalizations compared to all other hospice diagnoses. This leads to low patient and family satisfaction as well as high medical costs. This integrative review synthesizes current published evidence highlighting the need to improve caregiver education for symptom management of terminal heart failure patients in hospice. The literature supports that improved caregiver education can lead to …


How Does Obstetric Simulation Impact Undergraduate Pre-Licensure Bsn Student’S Clinical Judgement Related To Using And Understanding Fetal Monitoring?, Brandy Leona Clayton Apr 2023

How Does Obstetric Simulation Impact Undergraduate Pre-Licensure Bsn Student’S Clinical Judgement Related To Using And Understanding Fetal Monitoring?, Brandy Leona Clayton

Doctoral Dissertations and Projects

Obstetric simulation can impact undergraduate prelicensure Bachelor of Science in nursing (BSN) students’ clinical judgment related to using and understanding fetal monitoring. The purpose of this study aimed to determine if a relationship exists between a student's obstetrical simulation practice and increased knowledge gained for fetal monitoring interpretation. Simulation practice provides a tangible way to test knowledge and competency, but is there an effect on student learning with the knowledge and understanding of fetal monitoring, and can simulation practice create that knowledge? A purposive sample of 24 undergraduate prelicensure BSN nursing students, within their obstetrical course, with the intent to …


Addressing Health Illiteracy In The Hispanic Community – A Call To Action: An Integrative Review, Sarah Akers Dersch Apr 2023

Addressing Health Illiteracy In The Hispanic Community – A Call To Action: An Integrative Review, Sarah Akers Dersch

Doctoral Dissertations and Projects

The United States Hispanic population is rapidly growing; however, existing healthcare endeavors are insufficiently accommodating this expansion. This demographic is linked to multiple serious health problems, including obesity, diabetes, hypertension, cardiac disease, cancer, and liver disease. In order to improve health outcomes within this community, interventions, such as health literacy screening, need to be further explored to identify current insufficiencies and help this population overcome these health challenges. This integrative review seeks to determine the effectiveness of current health literacy screening tools among native Spanish speakers in the U.S. This review seeks to amalgamate data from various studies to demonstrate …


Determining The Impact Of Nurse Residency Programs To Increase Retention Rate Among New Nurse Graduates: An Integrative Review, Guiselly Astrid Erazo-Romero Mar 2023

Determining The Impact Of Nurse Residency Programs To Increase Retention Rate Among New Nurse Graduates: An Integrative Review, Guiselly Astrid Erazo-Romero

Doctoral Dissertations and Projects

New nurse graduates account for the largest group entering the profession, but they also have the lowest retention rates among all nursing staff. Due to the nursing shortage, newly licensed nurses undergo a shorter orientation to meet the complex needs of healthcare. Newly licensed nurses often report feelings of unpreparedness, lack of competence, and lack of confidence as they are expected to care for patients with complex needs. In response to the concern over low retention rates and the preparation-practice gap among new graduate nurses, Nurse Residency Programs (NRPs) were implemented. This program further eases the transition from the student …


Increased Prevalence Of Suicide In The Adolescent Population Within The Lgbtq+ Community Compared To Adolescents In The Heterosexual Population: An Integrative Review, Natasha Denese Causey Mar 2023

Increased Prevalence Of Suicide In The Adolescent Population Within The Lgbtq+ Community Compared To Adolescents In The Heterosexual Population: An Integrative Review, Natasha Denese Causey

Doctoral Dissertations and Projects

According to research, young Americans who identify as lesbian, gay, bisexual, transgender, queer, and more (LGBTQ+) are currently experiencing a mental health crisis. Suicide ideations reportedly begin sooner in LGBQ+ adolescents, 13 to 18 years of age. Suicide ideation is defined by the National Alliance of Mental Illness (NAMI), as having serious thoughts about suicide with a plan. This involves LGBTQ+ adolescents shifting from suicidal ideation to planning more quickly than their heterosexual (straight) peers. Adolescents who identify as LGBTQ+ showed a higher lifetime risk of suicide thoughts than their heterosexual peers (26.1 percent to 13 percent, respectively). Additionally, 5.4 …


Mental Health Disorders Among The Adolescent Population In Nigeria: An Integrative Review, Njideka Nkemjika Emenyi Mar 2023

Mental Health Disorders Among The Adolescent Population In Nigeria: An Integrative Review, Njideka Nkemjika Emenyi

Doctoral Dissertations and Projects

Mental illness is a public health crisis with extensive stigma that has been substantially neglected in Nigeria. The general belief in Nigeria is that mental illness originates from supernatural causes such as possession of evil spirits; hence, individuals with mental illness are left in the hands of “the gods” or traditional healers for help. The prevalence of mental health disorders is high amongst adolescents in Nigeria due to rapid biological, social, and psychological changes that increase their susceptibility to mental health complications. Despite the high prevalence of mental illness among Nigerian adolescents, mental health care access and utilization in this …


Implementation Of The Generalized Anxiety Disorder 7-Item (Gad-7) Screening Tool In A Mental Health Outpatient Clinic, Ella Bosunglan Gang Dec 2022

Implementation Of The Generalized Anxiety Disorder 7-Item (Gad-7) Screening Tool In A Mental Health Outpatient Clinic, Ella Bosunglan Gang

Doctoral Dissertations and Projects

Purpose: The prevalent disorder known as generalized anxiety disorder (GAD) can have various negative consequences. GAD harms individuals, families, communities, and society as a whole. People with GAD frequently experience a crippling decrease in their physical and mental health. When generalized anxiety disorders are combined with the pressures of pre-existing medical conditions, the quality of life can be significantly impacted. GAD severely impairs social and functional functioning, resulting in frequent clinic appointments, doctor shopping, emergency room visits, high costs from family and employer treatment, and increased costs for global healthcare spending. Proper diagnosis is essential to effective treatment, and a …


Impacts Of Telemonitoring On Weight Obesity In African Americans, Miranda Bessem Mbutambe Dec 2022

Impacts Of Telemonitoring On Weight Obesity In African Americans, Miranda Bessem Mbutambe

Doctoral Dissertations and Projects

Obesity has become a complex public health issue among African Americans over the last few decades, due to the health risks it poses to this population. Obesity exposes African Americans to a variety of chronic diseases, including, but not limited to, diabetes and cardiovascular diseases. Owing to the complexity inherent in obesity, healthcare practitioners have developed various strategies and interventions to manage weight among vulnerable populations. In this regard, telemonitoring, a continuous or non-continuous process that allows medical practitioners to remotely monitor, collect, and interpret data necessary for medical follow-up and, if necessary, make medical decisions regarding the health state …