NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Remote Collaboration and Evidence-Based Care

Audio tutorial script

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Hello everyone. I am Peeches and recording this audiovisual video with a purpose to propose a evidence-based care plan for remote collaboration to improve patient outcome and safety along with importance of implementing a right EBP model and translate evidence to develop care plan and identify benefits of the plan and strategies to mitigate the challenges related to remote interdisciplinary collaboration. The COVID-19 situation has exposed the inability of health care organizations to provide effective and timely care for the patients to increase quality care outcomes and patient safety. 

One of the major reasons is failing to collaborate from different health care setting, locations, or zip codes. According to study by Calleja and other authors (2019), nurses and health care workers face different challenges, which affects health care delivery system negatively. Authors Anthony (2020), Chu and co-authors (2021), and Whillans (2021) highlighted that interprofessional and multidisciplinary strategies with a well-designed plan based on EBP can mitigate challenges. 

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

We will now look at the remote collaboration scenario provided in the Valley city hospital

The patient Caitlynn is a two-year-old girl who as admitted to the ER after suffering from pneumonia. She was cared by interdisciplinary team of Dr Erica Copeland (pediatrician), Virginia Anderson (the pediatric nurse), and Rebecca Helgo (respiratory therapist). Dr. Copeland and nurse Anderson collaborated together to understand the patient’s condition that she was admitted to the hospital once in last six months for pneumonia treatment and she has history of breathing problems. She also suffered due to meconium ileus at birth and now, chest physiotherapy and nebulized aerosol were administered by the respiratory therapist. It was noted that thick secretions caused breathing issues after the aerosol. 

She weighs 20.7 pounds and subcutaneous tissue was observed in her extremities. Based on their discussion and observation from sweat chloride test results, it was diagnosed that she has cystic fibrosis. Dr. Copeland, nurse Anderson, and respiratory therapist Helgo determined that her case is complex and as a result, it is important to monitor her condition and plan a care plan. However, Caitlyn lives in McHenry, which is over an hour drive and as a result, it is not recommended to travel especially due to winter. The doctor recommended Pancrease enzymes and high-protein, extra-calorie diet was recommended along with huff breath treatment, aerosol treatment, and dornase alfa to manage her condition by collaborating with pediatrician. 

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

She cannot perform huff breaths and at a risk for respiratory distress and impaired gas exchange, which might result in anxiety and increased distress. Thus, it was recommended to discuss with pediatrician and parents of the patients even though they are busy and married, but separated to educate them to monitor the patient and manage the condition. It was also discussed that to make use of telemedicine, skype consultation and education, and social service consultant to collaborate remotely. 

Now, I will propose an evidence-based care plan to improve the safety and outcomes for the patient

 The very first part of the plan is to provide literature, pamphlet, videos, or any other articles related to the condition and treatment through email to both the parents to increase their knowledge. After that it is critical to schedule a skype collaboration meeting with parents and pediatrician after the working hours to explain the possible challenges, plan to care for each challenge, and the ways to make use of the telemedicine and telehealth services to monitor the patient (Ohannessian et al., 2020).

The plan is to implement patient monitoring system, which includes pulse monitor, oxygen saturation, and other vital signs monitor connected to remote monitoring and telehealth system to monitor the patient continuously on mobile devices or web help in tracking changes in breathing pattern and other conditions. (Whillans et al., 2021) As both the parents will be busy, such system reduces stress and anxiety among parents and nurses can track the patient and alert parents even if they fail to monitor the patient or vice versa. This reduces failing to provide service during emergency condition. Chiridza (2019) in the article about use of patient monitoring identified that it reduced risk factors and improved quality outcome. 

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

The telehealth service increases collaboration and communication between everyone involved as they can make use of audio and video communication to monitor the patient (Lee et al., 2020). If needed, the monitoring can be done in real-time. Further, it helps in communicating with social service helpers to provide assistance if there is a need. As Caitlyn suffered from pneumonia twice in last six months, the monitoring system help in maintaining good health post recovery as the data recorded by monitoring system help in predicting the emergency need or worsening health conditions (Jong et al., 2020). 

The system combined together provides quick assistance button at patient’s end for any assistance, event monitoring, and real-time monitoring prevent adverse effects as early treatment will be possible. Sasangohar et al. (2018) concluded that patent monitoring in real-time prevented adverse effects and enables nurses and health professionals to track the patient’s recovery from remote places. The purpose of implementing is found to be effective in reducing unnecessary emergency visits and also, it is found that telehealth system reduces health care cost as parents of the patients need not travel to the hospital as nurses, pediatrician, and respiratory therapist assist them through video calls (Chu et al., 2021). 

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

The system also reduces increased burden on health care professionals as they can collaborate from their home or places. Kaplan in his study highlighted that telehealth and health information system reduced complexities as it helped in identifying different problems and solutions to problem through technology and remote collaboration (Kaplan, 2020).   

Now I will explain the ways in which an EBP model was used to help develop the care plan and reflect on most relevant and useful evidence decision making along with benefits

  The EBP models or frameworks follow ask, attain, appraise, apply and assess EBP process to create and implement caring plan. The approach helped in valuating Caitlyn’s condition and needs. Portnoy et al. (2020) found in their study that telemedicine based on critical analysis reduced unnecessary emergency visits, which increased burden on nurses. Further, the model helped in identifying future problems and issues such as travelling during winter, need for educating the parents, monitoring the patient continuously to prevent any adverse effects, critically analyze the effectiveness of the evidence, and applying the action plan to evaluate the outcome. Study by Lee et al. (2020) on telehealth and remote monitoring highlighted that system improved quality care implementation and patients had high satisfaction due to availability of care at home. 

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

For example, even after implementing the care plan, it is important to consider appointments and meeting during recovery and post recovery to continue the care as she has history of breathing issues and pneumonia. The EBP model helped in understanding the need for such interventions to prevent future health scares. Author Jong (2020) highlighted that telehealth system increased remote collaboration and reduced health care cost. Other studies by Kaplan, Lee, Portnoy, Whillans, and Anthony highlighted that the system reduced cost and also increased interprofessional collaboration. 

Further, Caitlyn can suffer from anxiety and other issues, which are critical for recovery. Telehealth-based psychological support can be provided to solve the issue as during COVID-19 the use of tele-mental health service increased, which improved patient safety and outcome (Uscher-Pines et al., 2020). Connolly (2020) also concluded that telehealth improved patient outcome. 

Now we will identify strategies to mitigate the challenges of interdisciplinary collaboration

Now we know that the care plan is beneficial as it helps in monitoring patient, increasing collaboration, reducing health care cost, reducing burnout as nurses can monitor the patient remotely, and different adverse events can be prevented (Chu et al., 2021). However, there will be challenges such as leaking information about patient, failing to establish secure and reliable connection, and licensure to use telehealth and practice effectively. The challenges can be solved by using strategies such as high speed and bandwidth internet connection (Jong et al., 2020), use of encrypted video and meeting platforms such as Skype and Google meet, scheduling with google calendar with reminder, and following licensure regulations (Calleja et al., 2019) along with opting a reliable telehealth system (Connolly et al., 2020). 

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

References

Anthony, B. (2020). Use of telemedicine and virtual care for remote treatment in response to COVID-19 pandemic. Journal Of Medical Systems44(7). https://doi.org/10.1007/s10916-020-01596-5

Calleja, P., Adonteng-Kissi, B., & Romero, B. (2019). Transition support for new graduate nurses to rural and remote practice: A scoping review. Nurse Education Today76, 8-20. https://doi.org/10.1016/j.nedt.2019.01.022

Chiridza, T., Wesson, J., & Vogts, D. (2019). A smart home environment to support risk monitoring for the elderly living independently. South African Computer Journal31(1). https://doi.org/10.18489/sacj.v31i1.534

Chu, C., Cram, P., Pang, A., Stamenova, V., Tadrous, M., & Bhatia, R. (2021). Rural Telemedicine Use Before and During the COVID-19 pandemic: repeated cross-sectional study. Journal Of Medical Internet Research23(4), e26960. https://doi.org/10.2196/26960

Connolly, S., Miller, C., Lindsay, J., & Bauer, M. (2020). A systematic review of providers’ attitudes toward telemental health via videoconferencing. Clinical Psychology: Science And Practice27(2). https://doi.org/10.1111/cpsp.12311

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Jong, M., Boonen, A., van der Meulen-de Jong, A., Romberg-Camps, M., van Bodegraven, A., & Mahmmod, N. et al. (2020). Cost-effectiveness of telemedicine-directed specialized vs standard care for patients with inflammatory bowel diseases in a randomized trial. Clinical Gastroenterology And Hepatology18(8), 1744-1752. https://doi.org/10.1016/j.cgh.2020.04.038

Kaplan, B. (2020). Revisiting health information technology ethical, legal, and social issues and evaluation: telehealth/telemedicine and COVID-19. International Journal Of Medical Informatics143, 104239. https://doi.org/10.1016/j.ijmedinf.2020.104239

Lee, I., Kovarik, C., Tejasvi, T., Pizarro, M., & Lipoff, J. (2020). Telehealth: helping your patients and practice survive and thrive during the COVID-19 crisis with rapid quality implementation. Journal Of The American Academy Of Dermatology82(5), 1213-1214. https://doi.org/10.1016/j.jaad.2020.03.052

Ohannessian, R., Duong, T., & Odone, A. (2020). Global Telemedicine implementation and integration within health systems to fight the COVID-19 pandemic: a call to action. JMIR Public Health And Surveillance6(2), e18810. https://doi.org/10.2196/18810

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Portnoy, J., Waller, M., & Elliott, T. (2020). Telemedicine in the era of COVID-19. The Journal Of Allergy And Clinical Immunology: In Practice8(5), 1489-1491. https://doi.org/10.1016/j.jaip.2020.03.008

Sasangohar, F., Davis, E., Kash, B., & Shah, S. (2018). Remote patient monitoring and telemedicine in neonatal and pediatric settings: scoping literature review. Journal Of Medical Internet Research20(12), e295. https://doi.org/10.2196/jmir.9403

Uscher-Pines, L., Raja, P., Qureshi, N., Huskamp, H., Busch, A., & Mehrotra, A. (2020). Use of tele–mental health in conjunction with in-person care: a qualitative exploration of implementation models. Psychiatric Services71(5), 419-426. https://doi.org/10.1176/appi.ps.201900386

Whillans, A., Perlow, L., & Turek, A. (2021). Experimenting during the shift to virtual team work: Learnings from how teams adapted their activities during the COVID-19 pandemic. Information And Organization31(1), 100343. https://doi.org/10.1016/j.infoandorg.2021.100343

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