1. Duty to Care

The duty to care in a telehealth setting should follow the same principles as in a face-to-face interaction.  The RPN is responsible to provide the client adequate, current, relevant, and ongoing care instructions.  The RPN has taken steps to ensure that they are current and knowledgeable with respect to communication technologies and digital practice.

2. Suitability

The RPN needs to consider whether a client is suitable for telehealth services by contemplating a variety of factors, such as: level of physical care required, availability of support at the client site, ability of the client to participate (physical, mental or cognitive barriers), familiarity with and limitations of the technology being utilized, and the desire to participate in telehealth consultation.  If a crisis plan is needed that it is developed and can be implemented in remote locations.

3. Ethics

RPNs involved in telehealth services need to ensure they establish and maintain the therapeutic psychiatric nurse/client relationship.  Effect communication is central to establishing a psychiatric nurse/client relationship when using information and telecommunication technologies, the RPN is expected to use strategies that reduce the risk of missing important information and must maintain the integrity and value of the psychiatric nurse/client relationship.  RPNs must also be able to recognize when and where potential boundary violations may occur, when a telehealth approach may not be appropriate for the services being delivered and the scope of the practice of the RPN and the profession.

4. Competence

RPNs providing telehealth services must possess current and in-depth knowledge in the clinical area(s) relevant to the role.  This may include having further education, training/orientation, licensure, and ongoing continuing education/professional development, to ensure the necessary knowledge and competencies for safe provision of quality psychiatric nursing service telehealth services.

5. Privacy, Confidentiality, and Informed Consent

The same principles of privacy, confidentiality and informed consent apply in a telehealth setting as they do in providing direct care.  The RPN must ensure that informed consent is obtained before providing any telehealth service, that the RPN identifies clients at the onset of each consultation and that the identity of each client is confirmed prior to the delivery of any telehealth service.  The RPN must also ensure that services are provided in such a manner that the client’s privacy and confidentiality are maintained throughout.

6. Documentation and Client Records

The principles of document and access to client records do not change regardless of where or how the psychiatric nursing care/service is being delivered.  The RPN providing telehealth services must be mindful of where and how documentation occurs and how access to client records can be obtained especially where multiple providers are involved.  RPNs need to consider who is the keeper of the client’s record and how information may be shared while delivering telehealth services and must abide by agency policy (where applicable).  The client is informed what information, including information gained from communication technology will be documented on the client record.