• Lisa-Mae S Williams, Lynne S Nemeth, Emily Johnson, Donna Lee Armaignac, and Gayenell S Magwood.
• Lisa-Mae S. Williams is operations director, telehealth and eICU, Baptist Health South Florida Telehealth Center, Coral Gables. Lynne S. Nemeth and Gayenell S. Magwood are professors and Emily Johnson is an assistant professor, College of Nursing, Medical University of South Carolina, Charleston. Donna Lee Armaignac is director of best practices, Baptist Health South Florida Telehealth Center, Coral Gables, Florida. lisamaew@baptisthealth.net.
• Am. J. Crit. Care. 2019 Jan 1; 28 (1): 64-75.

BackgroundAlthough telemedicine intensive care unit (tele-ICU) nurses are integral to the tele-ICU model of care, few studies have explored the influence of tele-ICU nursing interventions on preventing failure to rescue in critically ill patients.ObjectiveTo determine how tele-ICU nurses characterize their interventions to prevent failure to rescue.MethodsThis qualitative interpretive study recruited a purposive sample from 11 tele-ICU centers across the United States for structured open-ended interviews. An inductive and deductive approach suitable for health services qualitative research was adapted to further explain and extend a relevant conceptual framework for tele-ICU nursing practice.ResultsOf 33 nurses practicing in tele-ICUs who responded to a recruitment email, 19 participated in this study. Findings included 4 major interrelated themes: (1) fundamental attributes of the tele-ICU nurse, (2) proactive clinical practice, (3) effective collaborative relationships, and (4) strategic use of advanced technology.ConclusionA conceptual framework extending the American Association of Critical-Care Nurses model of success for tele-ICU nursing practice is proposed to prevent failure to rescue. Tele-ICU nurses use systems thinking and integration of complex factors in their practice to prevent failure to rescue. Tele-ICU nurses' perception of their role in preventing failure to rescue and emotional intelligence competence are key to building and maintaining effective relationships with the ICU. Tele-ICU nurses' intentional use of advanced technology, rather than the technology itself, supports and enhances proactive tele-ICU practice to prevent failure to rescue.©2019 American Association of Critical-Care Nurses.

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