Nursing professionals' experiences of the facilitators and barriers to the use of telehealth applications: a systematic review of qualitative studies.

The aim of the study was to synthesise the best available research evidence on nursing professionals' experiences of the facilitators and barriers to the use of online telehealth services in nursing practice. Telehealth is used to deliver healthcare services and health-related information by means of information and communication technology (ICT). The systematic review of qualitative studies was conducted using thematic synthesis of previous studies. International electronic databases PubMed, CINAHL, Eric, Web of Science/Web of Knowledge and Scopus, and Finnish databases Medic and Ohtanen were searched in spring 2013. In addition, the search was complemented in fall 2015. Following critical appraisal, 25 studies from 1998 to fall 2015 were reviewed and the findings were synthesised. Both facilitators and barriers were grouped into five main categories which were related to nurses' skills and attitudes, nurses' work and operations, organisational factors, patients and technology. The highest number of facilitators and barriers was found in the category focusing on nurses' work and operations. Based on the findings, nurses' skills and attitudes are preventing factors in the implementation of telehealth. There is also a need to focus on patients' role in telehealth usage although the findings support positive adoption of ICT tools among patients. The findings call for further development of technological tools used in nursing practice and healthcare services. The change from traditional face-to-face nursing to the use of telehealth calls for local agreements and further discussions among professionals on how this change will be accepted and implemented into practice. In addition, organisations need to make sure that nurses have enough resources and support for telehealth use.