Telehealth increases nurses’ workload

MU study shows telehealth doubles the tasks nurses complete to assist patients with chronic diseases.

Link to original post here

April 29, 2021
Story contact: Brian Consiglio, 573-882-9144, consigliob@missouri.edu

When the COVID-19 pandemic hit, Chelsea Howland saw firsthand how telehealth helped her dad, who has Type 2 diabetes and lives in rural Illinois, see his diabetes specialist virtually. As a nurse herself, Howland understands the convenience virtual appointments provide for patients, particularly in rural communities where access to health care can be limited.

However, she also sees the strain telehealth puts on the workload of nurses, who are already stressed in the midst of a nationwide nursing shortage.

So, in a recent study, Howland, a doctoral student at the University of Missouri Sinclair School of Nursing, reviewed the activities nurses completed to document and analyze blood glucose and blood pressure data that was transmitted from diabetic patients’ in-home, telehealth devices to six family medicine clinics affiliated with MU Health Care. After comparing the results with nursing activities completed during traditional, in-person appointments, she found the use of telehealth leads to twice as many activities completed by nurses, which impacts their workload.

This is a photo of Chelsea Howland's dad using telehealth.

Telehealth has helped Howland’s dad, who has Type 2 diabetes and lives in rural Illinois, see his diabetes specialist virtually.

“Telehealth can be an effective and convenient service for patients managing chronic diseases such as diabetes or hypertension, but what often gets overlooked is all the work being done by the nurses on the back end to assist patients,” Howland said. “They are entering the data they receive into medical records, identifying instances when patients have abnormal blood glucose levels, reminding patients to self-monitor and submit their data, requesting input from primary care providers, and making referrals to other providers for more specialized care.”

While the patients who attended in-person appointments followed up once every three months on average, the patients using telehealth submitted their blood glucose and blood pressure levels multiple times a week. As a result of the increased communications with nurses, the telehealth patients received more guidance to help them monitor their chronic diseases more closely, leading to more medication adjustments and lifestyle changes, ultimately resulting in better health outcomes.

“As a nurse, I am always thinking of new and innovative ways to use technology to help people manage their chronic conditions and live a more healthy, active lifestyle,” Howland said. “As telehealth continues to become more popular, it can be used to get health behavior intervention tools to the people who need them most, but we also need to keep in mind the strain it puts on nurses that are going above and beyond to make this possible.”

Howland’s goal is to improve access to chronic disease management resources to people like her father who live rurally.

This is a photo of Chelsea Howland.

Chelsea Howland is a doctoral student in the MU Sinclair School of Nursing.

“My dad often worked the midnight shift in a factory when I was younger, so he was exhausted during the day,” Howland said “Driving more than an hour to see the nearest endocrinologist was likely not his highest priority, so telehealth has helped reduce access barriers for rural patients seeking the care that they need.”

While telehealth will continue to increase accessibility for patients, Howland’s research shines a spotlight on how nurses have integrated new telehealth systems into their daily routines.

“We can’t expect nurses to use these tools successfully without better understanding the impact it will have on their workload,” Howland said. “Going forward, this research can provide the framework for quantifying how much time nurses spend on these telehealth tasks, especially with the current nationwide nursing shortage. If the nurses are completing twice as many tasks via telehealth, should they be responsible for half as many patients?”

“Primary care clinic nurse activities with a telehealth monitoring system” was published in the Western Journal of Nursing Research. Funding was provided by the National Institutes of Health and the Agency for Healthcare Research & Quality.

Blosses Use Blessings to Give Back

March 10, 2021

Bob and Pam Bloss are problem solvers. He’s used the problem-solving skills he learned at Mizzou Engineering to ascend through the ranks of industrial engineering, management and human resource leadership. She successfully navigated a rewarding career in nursing while raising three children. Now, the Blosses are ensuring that the College of Engineering and the Sinclair School of Nursing can solve current and future challenges, too, through Giving Day 2021 contributions. The couple donated to an existing endowment fund they established several years ago and helped start a new faculty endowment fund in Mizzou Engineering. They also contributed to the Nursing Alumni History Preservation Fund.

“We wanted to help the schools that really provided us the life we’ve been able to lead,” Bob said. “I’ve been blessed with a career that has given a lot back to me. I’m never going to teach an engineering class or work in what I call ‘hardcore’ engineering again, but what I can do is give back and help others through the use of the blessings that we have.”

The Robert C. and Pamela K. Bloss Faculty Enhancement Fund supports startup costs for new faculty hires within the Industrial and Manufacturing Systems Engineering (IMSE) Department.  This fund enables faculty to hire graduate or undergraduate students and provides funding to recognize exceptional performance in IMSE.

The new IMSE Hall of Fame Faculty Endowment will be used to support teaching, professional development, research, equipment and materials.

The Nursing Alumni History Preservation Fund will allow the Sinclair School of Nursing to create and curate an interactive historical display in the new nursing building, expected to open spring 2022. A group of nursing alumni started the fund to inspire future generations by showcasing the incredible achievements of alumni and faculty.

An Engineering Foundation

Bob Bloss graduated in 1977 with a BS in Industrial Engineering. He started his career at Colgate-Palmolive, working for several years in industrial engineering, manufacturing management and human resources before transferring to the company’s corporate headquarters in New York City.

He returned to Missouri in 1986 to begin a long and successful career at Hallmark, where he retired as senior vice president and chief human resources officer in 2019.

Engineering, he said, provided a foundation he was able to build upon throughout his career.

“The problem solving and technical capabilities I learned in engineering gave me some good skills that translated into leadership positions,” he said. “I gravitated toward the human resources discipline because industrial engineering tends to be a little more involved in human factors, plant layout and design and work measurements. Those translated to human resources in areas such as organizational design, job development and pay practices. So it was an easy transition for me.”

Early on, he said, engineering gave him opportunities to move into leadership roles and opened a lot of doors for him.

Bob began giving back to the college through time and talent more than 20 years ago when he joined the Dean’s Engineering Advisory Council. He was inducted into the IMSE Hall of Fame in 2011.

Through his service to Mizzou Engineering, Bloss learned more about the college’s needs, such as providing competitive salaries. Having spent much of his career in HR leadership, he understood the importance of recruiting and retaining high-quality faculty.

The couple established the faculty enhancement endowment funds to help support and recognize talented IMSE faculty members.

Inspiring Future Generations

Pam (Morris) Bloss graduated from the School of Nursing in 1978. During the course of her career, she’s worked on cardiac and progressive care units for hospitals and spent 28 years working in a doctor’s office. The best aspect of the profession, she said, was the flexibility.

“Nursing provided me the opportunity to continue to work and yet be a mother and a wife,” she said. “I think that’s one of the best things about nursing. I could do all of that and could pick and choose what worked for me.”

Bob and Pam have three children. Justin Bloss earned a BS in Mechanical Engineering in 2004, and Brian Bloss earned BS degrees in real estate and finance and banking in 2007. Their daughter, Abby, attended school out of state. They now have three grandchildren.

Pam believes the COVID-19 pandemic has highlighted the importance of the nursing profession and will result in more entering the field.

“It has inspired a lot of young people to go into nursing because they see the importance and what they can contribute to society and their communities,” she said.

That’s why she was compelled to direct the family’s gift to help preserve the nursing school’s history. The Nursing Alumni History Preservation Fund will honor and celebrate alumni, faculty and student milestones and accomplishments through their own words while inspiring future generations.

“I think it’s really important students see the history,” Pam said. “It will be very inspirational to see the history of nursing and where it’s going in the future.”

Rely on Co-Workers, Look for Opportunities & Give Back

Through their varied and successful careers, the Blosses have garnered some wisdom they can now pass on to current students and younger alumni. It’s a three-part recipe for success.

First, rely on your co-workers for support, Pam said.

“That’s where you get a lot of support because they’re in it with you,” she said. “That’s especially important for those on the front lines. Lean on one another and help each other out where you can.”

Second, keep an eye out for opportunities within a company to grow and explore new areas, Bob said. Try to use what you learn in current roles to translate those skills to new areas.

And third, if you are able, give back to the school that helped you get there, he added.

“Look to what engineering, nursing or what Mizzou overall has provided you and how that’s helped you get where you are today,” he said. “If you are able, even at a small level, I’d really encourage people to do that. Give regularly, even if it’s a small amount every year.”

Be part of Mizzou Giving Day 2021! Learn more about ways to contribute to Mizzou Engineering and the Sinclair School of Nursing.

December 2020 Virtual Graduation Celebration

CONGRATULATIONS! Sinclair School of Nursing has some really fun things in store for you on our Commencement Celebration page. You’ll be able to:

  1. Link to commencement.missouri.edu to see what campus is doing.
  2. You can sign the commencement guest book!
  3. Download fun fillable pages to post or make your own memory sheet.
  4. Download fun stickers and Facebook banners to support your nursing grad.
  5. See our featured Outstanding Graduate, ALEXANDRA KICKERT
  6. Find your name on our virtual program. 
  7. Follow what we are posting and sharing on our social media sites.
  8. Graduate Flipbook will be posted and graduate names will scroll at 3 P.M.! 


foam finger imageWe hope you have a wonderful day of celebration. Our graduates have worked so hard and deserve so much. All of us at SSON are proud of you and cheering you on until we can meet in person again.

MU School of Nursing Trailblazers Impact Senior Care During Global Pandemic

Article by BioNexus|KC 
See original article here.


A good partnership is often greater than the sum of its individual parts. For Dr. Amy Vogelsmeier, Associate Professor at the University of Missouri (MU) Sinclair School of Nursing, and Dr. Lori Popejoy, Associate Dean for Innovation and Partnerships and Associate Professor at the MU Sinclair School of Nursing, their research symbiosis has been a major driver in improving elder care across the state of Missouri. Since the onset of the COVID-19 Pandemic, they have turned their work towards preparing and equipping nursing homes to better protect the health and safety of residents and employees. By focusing on the nursing home patients most at risk during the pandemic, their impact is exponential and reaches both patients and their caretakers.

Because of their shared experience in nursing, Vogelsmeier and Popejoy can create and lead better process changes for elder care in hospitals and nursing home facilities. They each have their own areas of interest. Vogelsmeier has worked to highlight the unique contribution of registered nurses in nursing homes and identify and implement best medication safety practices. For Popejoy, her focus is on care coordination, transitional care, and discharge planning.

Working collaboratively through the Missouri Quality Initiative Program (MOQI), a Centers for Medicare and Medicaid Services (CMS) funded innovation project, they studied the influence of advanced practice registered nurses (APRN) and improvement of nursing home systems of care delivery on reduction of avoidable hospitalizations. Both have also been part of the Quality Improvement Program for Missouri (QIPMO) since its inception in the late 1990s. QIPMO is a collaboration between the Sinclair School of Nursing and the Missouri Department of Health and Senior Services supporting nursing facilities by providing access to Gerontological nurse experts, guiding best practices to improve care delivery and outcomes for nursing home residents.

At the beginning of the pandemic, limited access to personal protective equipment (PPE) was the biggest concern for nursing home staff.  Working in collaboration with QIPMO, “We were able to collaborate with various community organizations to help QIPMO distribute more than 3,000 face shields to nursing homes throughout the state,” Popejoy said. The challenge went beyond PPE though, as nursing home residents were being isolated more often, reducing or eliminating opportunities to dine in groups, share social activities, or invite outside visitors inside the facilities.

Between the MOQI and QIPMO, 500 Missouri nursing homes were provided with guidance and support for staff and administrators to navigate and implement changing COVID-19 infection control practices to better protect their residents. “The main goal of our response effort was to make sure nursing home residents are staying as safe as possible during this very traumatic and challenging experience,” Popejoy said.

With some their MOQI colleagues, the duo has developed a business called NewPath Health Solutions that works to carry forward innovations developed from the School of Nursing to continue after federal and grant funding support has ended.

Other projects Popejoy and Vogelsmeier are involved in are envisioning the use of healthcare technology. Vogelsmeier is excited by a future in which registered nurses and APRNs play a significant role in improving the future of safe senior care. Popejoy’s role at MU as the Associate Dean of Innovation and Partnerships helps advance technology such as sensor-based technologies across settings. “It’s hard to keep health system innovation functioning and moving, so this role was developed to keep projects moving forward when there is no longer grant funding to keep these projects alive,” Popejoy said.

The two of them have been long-time friends and colleagues likely in part because their strengths and weaknesses are complementary. “My ability to be strategic and Lori’s ability to be creative and think outside the box work together to get it done,” Vogelsmeier said. Both enjoy living in central Missouri, being outside with their families, and traveling.

The impact from COVID-19 was an immediate concern for both of them. “When we first heard about the disease in Washington state, my heart sunk thinking about how bad it could be,” Popejoy said. “It was like watching a tsunami coming and people were oblivious until it hit and then suddenly were lost as to what to do next,” Vogelsmeier recalled. “Almost like it didn’t exist until it hit the crisis point.” However, as the country has gotten further into the pandemic, these two have seen improvements. “Everything we know about this disease is constantly changing as we gear up to help them face these challenges, but the problems seem to be somewhat more manageable now,” Vogelsmeier said.

For both professors, the drive to improve senior lives and the careers of nurses across Missouri is motivation enough but faced with a once in a century pandemic, they both have responded. Between the state quality care initiatives and support programs and the outreach during COVID-19, Vogelsmeier and Popejoy’s impact is bigger, together.