Hello everyone. My name is Rebecca. In this recording, I will focus on making evidence-based decisions using the Villa Health Scenario. In healthcare, remote collaboration enables healthcare professionals to work together, share information, and communicate without the need to be physically present in the same location. According to Franco et al. (2021), remote collaboration has become increasingly important due to the need for accessible and flexible healthcare services and technological advancements. Caring for individuals in remote areas can be challenging due to the shortage of health professionals, limited access to healthcare, and geographical barriers. With technological advancements and innovative approaches such as telemedicine and telehealth, providing quality healthcare services to patients in remote areas has been more effortless. Through remote collaboration and evidence-based care, health professionals can leverage technology to access and analyze research evidence, collaborate effectively, and deliver high-quality care to patients irrespective of their geographic location. In this video, I will discuss the case of Caitlynn Bergan and explore how healthcare professionals can collaborate remotely and virtually to provide care for the patient.
First, let me share some information regarding the patient, Caitlynn Bergan.
Miss Caitlynn Bergan is a two years old patient who has been admitted to the pediatric unit for pneumonia. Dr. Erica Copeland and Virginia Anderson, a pediatric nurse, discuss her condition and what they have done so far since this was Caitlynn’s second admission for pneumonia in the last six months. Ms. Caitlynn had a meconium ileus at birth, which is a condition that entails the obstruction of the small intestine among newborns due to abnormally sticky or thick meconium (the first stool passed by a newborn). Diagnosis confirmed that Ms. Caitlynn had cystic fibrosis, and the team of health professionals, including the hospital’s respiratory therapist, Rebecca Helgo, realized that Caitlynn’s care might not be easy. Caitlynn lives in McHenry, and her parents, Janice and Doug, have been separated. The primary concern is the day-by-day treatment, and one of the parents is required to care for her since she is too young. Otherwise, the pneumonia case will escalate. In addition, from McHenry to Valley City, North Dakota, is a long drive. Therefore, it would be challenging for the healthcare team to develop an effective plan of care. Dr. Copeland consults with Caitlynn’s pediatrician, Dr. Benjamin, on how they can coordinate her care. In addition, Virginia also meets with Madeline Becker, a social worker at the McHenry clinic, to discuss resources available for the Bergans, such as access to the internet and the issues they may later deal with. While Caitlynn’s condition is extensive, the care team has been able to help her mother through telemedicine to care for Caitlynn.
Now, I will propose an evidence-based care plan to improve the safety and outcomes of Ms. Caitlynn.
Before planning for Ms. Caitlynn’s care, Dr. Copeland and other healthcare professionals ensured they were dealing with the right condition, cystic fibrosis. While attending to the patient, the doctor, pediatric nurse, and respiratory therapist adopted a plan based on evidence. Cystic fibrosis has no available cure; however, the healthcare team focused on easing the symptoms, reducing complications, and improving the quality of life for the patient. In order to slow down the progression of cystic fibrosis, close monitoring, as well as early and aggressive interventions, are recommended. Developing evidence-based care for patients with cystic fibrosis requires a comprehensive approach that takes into account different aspects of the condition. Therefore, there is a need for a multidisciplinary care team that includes social workers, dieticians, nurses, respiratory therapists, and pulmonologists. This team should work collaboratively to provide comprehensive care and address the different needs of Caitlynn. According to Jaques et al. (2020), encouraging daily airway clearance methods like percussion and postural drainage is useful for clearing mucus from the lungs. In addition, Caitlynn is too young; therefore, her parents should ensure adherence to prescribed medications like antibiotics, mucolytics, and inhaled bronchodilators.
For patients with cystic fibrosis, nutritional support is necessary. According to Somaraju & Solis-Moya (2020), pancreatic enzyme replacement therapy (PERT) prescribed with meals and snacks for patients can help with digestion and prevent malabsorption. Also, collaboration with dieticians can ensure regular nutritional assessment to examine the nutritional status and growth parameters for Caitlynn. Besides, this can help develop an individualized high-fat, high-calorie diet taking into consideration any diet restrictions and Caitlynn’s preferences. In order to compensate for malabsorption, vitamin supplements like fat-soluble vitamins (A, D, E, and K) are appropriate. For infection prevention and management, ensuring up-to-date vaccinations for the patient is required. While Dr. Benjamin, Caitlynn’s pediatrician, stated that she was done with most of her immunizations, Caitlynn still needed her HAV and influenza, and other recommended vaccinations.
Caitlynn’s age brings complexities to managing her condition since she is too young for exercise and physical activities. For example, she cannot do her huff breaths. However, the respiratory therapist administered chest physiotherapy and nebulized aerosol to help keep secretions thin and manageable. While Caitlynn is a remote patient, regular visits to the hospital are not on the table; hence educating one of the parents about the care plan can help manage the condition. This would involve providing comprehensive education about cystic fibrosis, including treatment and medication adherence, and disease management, like doing chest physiotherapy. Transitioning to home care will require a telemedicine strategy to ensure collaboration with healthcare providers and continuity of care for Caitlynn. Thus, her parents can raise any concerns about her condition and get necessary advice from healthcare providers, as they previously did through Skype.
Let’s proceed to discuss how an evidence-based practice model was used to help develop the care plan for Ms. Caitlynn.
The Johns Hopkins nursing evidence-based practice model is a common framework that guides the implementation of evidence-based practice in nursing. In the Villa Health scenario, the model has been adopted to develop care for Ms. Caitlynn. Dr. Copeland and other healthcare professionals follow various steps such as discovery, evidence summary, and translation to develop the care. According to Speroni et al. (2020), the discovery phase entails identifying the clinical problem using various resources such as expert opinions, literature reviews, and patient assessments to gather relevant information. After utilizing such resources, Dr. Copeland and his team diagnosed Caitlynn with cystic fibrosis. By gathering evidence through a comprehensive literature search, the model ensures that the latest research findings are integrated into the care plan. Evaluation and synthesis of evidence enable healthcare professionals to create an action plan and implement the plan by developing an effective care plan. Furthermore, the Johns Hopkins model supports multidisciplinary collaboration in developing specific interventions to enhance patient outcomes. In the Villa Health case, health professionals collaborated through telemedicine to improve Caitlynn’s condition and also incorporated the best available evidence in her care plan. According to Ketchell (2018), telemedicine is essential for caring for patients with cystic fibrosis as it promotes remote consultations, monitoring and follow-up, medication management, nutritional counseling, and education.
Next, I will reflect on which evidence I found most relevant and useful when making decisions regarding the care plan.
For a patient like Caitlynn, managing her condition would require regular visits to the hospital. However, there is a problem with geographic location due to the long hours required to commute to the hospital. This issue may cause complications and escalate her condition, which could be life-threatening to the two-year-old. As a result, there was a need to implement a telemedicine program that would require multidisciplinary collaboration to manage her condition. Caitlynn’s condition requires a care plan that focuses on pulmonary care, nutritional support, and infection prevention and management. Therefore, through telemedicine, a multidisciplinary team can collaborate to provide comprehensive care that addresses all the patient’s needs. In support of telemedicine, the article by Ketchell (2018) concludes that telemedicine complements traditional care models, ensures access to specialized care and convenience, and enhances patient outcomes. Moreover, with the adoption of an evidence-based model, the practicability and usefulness of the care plan can be evaluated through improved patient outcomes
Lastly, I would like to identify benefits and strategies to mitigate the challenges of interdisciplinary collaboration to plan care within the context of a remote team.
The case of Ms. Caitlynn, considering she is two years old, requires alternative approaches to traditional follow-up appointments due to the long drive from her location. The benefit of interdisciplinary collaboration is that healthcare providers such as pediatricians, nurses, dieticians, and therapists can provide consistent care without the patient having to travel to the healthcare facility. In Caitlynn’s case, different stakeholders, such as her parents, social worker, nurses, and doctors, used Skype to seek the best medical interventions for her and also consult on any arising issues. This collaboration was essential for the family as they received necessary advice while caring for Caitlynn, and it also enabled healthcare professionals such as the pediatrician, nurses, and doctors to share ideas, knowledge, and best care practices. In order to mitigate the challenges of interdisciplinary collaboration, it is essential to utilize clear communication channels, such as video conferencing platforms, that facilitate real-time communication and information sharing. Additionally, using secure and centralized platforms like electronic health record systems ensures all teams have access to updated patient information which enables the interdisciplinary team to contribute to the care plan efficiently. Overall, interdisciplinary collaboration within a remote team leads to better patient outcomes since it brings together diverse expertise, improves decision-making, and promotes the development of s comprehensive, efficient, well-rounded, and patient-centered care.
Conclusion
In conclusion, interdisciplinary collaboration and evidence-based practice are vital in providing effective care, especially in remote settings. For patients with cystic fibrosis, remote collaboration, and evidence-based care are crucial in improving outcomes, ensuring safety, and enhancing patient experience. Also, utilizing evidence-based practice models enables baccalaureate-prepared nurses to systematically integrate the best available evidence into the development of care plans for patients. Therefore, care plans care to be tailored to individual patient needs, values, and preferences, leading to more effective and targeted interventions. Conclusively, interdisciplinary collaboration in a remote care setting enhances the quality of care, helps optimize patient outcomes, and ensures comprehensive and patient-centered approaches.
Reference
Franco, C. M., Lima, J. G., & Giovanella, L. (2021). Primary healthcare in rural areas: Access, organization, and health workforce in an integrative literature review. Cadernos de Saude Publica, 37(7), e00310520. https://doi.org/10.1590/0102-311X00310520
Jaques, R., Shakeel, A., & Hoyle, C. (2020). Novel therapeutic approaches for the management of cystic fibrosis. Multidisciplinary Respiratory Medicine, 15(1), 690. https://doi.org/10.4081/mrm.2020.690
Ketchell R. I. (2018). Telemedicine is the way forward for the management of cystic fibrosis – The case in favour. Paediatric Respiratory Reviews, 26, 19–21. https://doi.org/10.1016/j.prrv.2017.03.004
Somaraju, U. R. R., & Solis-Moya, A. (2020). Pancreatic enzyme replacement therapy for people with cystic fibrosis. The Cochrane Database of Systematic Reviews, 8(8), CD008227. https://doi.org/10.1002/14651858.CD008227.pub4
Speroni, K. G., McLaughlin, M. K., & Friesen, M. A. (2020). Use of evidence-based practice models and research findings in magnet-designated hospitals across the United States: National survey results. Worldviews on Evidence-Based Nursing, 17(2), 98–107. https://doi.org/10.1111/wvn.12428
write