Remote Collaboration

Remote Collaboration

Hello. My name is ———-, and I am going to give a presentation through this video on Remote Collaboration and Evidence-Based Care: the main focus of the video is how to Make Evidence-Based Decisions.

The video will present discussions and explanations touching these areas;

• I will start by reviewing the villa health Scenario.
• Choose an evidence-based care plan that aims at improving patient safety and positive outcomes based on the Villa Health Remote Collaboration on Evidence-Care scenario.
• Define and describe ways used in developing an evidence-based care plan
• Identify the most relevant evidence used during decision making when preparing the care plan.
• Design strategies that eliminate challenges that result from interdisciplinary collaboration when planning care in the context of a remote team.

Review of the Villa Health scenario

Caitlyn, a two-year-old girl, was readmitted to the hospital for pneumonia within six months.  Through collaboration regarding Caitlyn’s presenting symptoms and history, the pediatric nurse, Virginia Anderson, and the physician, Dr. Copeland, were able to later diagnosis her with cystic fibrosis. With this diagnosis made, Virginia, Dr. Copeland, and the hospital respiratory therapist, Rebecca Hugo, sat down to further discuss the Caitlyn case. This interdisciplinary communication helped identify multiple barriers and possible solutions to providing the best patient-centered care to Caitlyn. These barriers include:

• Living in a remote area which is associated with difficulties to access.
• Concerns on the treatment of respiratory issues that may impair respiratory functions.
• Due to Caitlyn’s parent’s separation, financial problems, and required support from a caregiver, social issues were caused.
• Potential morbidities of cystic fibrosis, for example, DIOS, which can limit unnecessary visits to the hospital.
• The team first needed to deal with the mentioned concerns and develop a care plan that satisfies Caitlyn’s healthcare needs. The care plan’s success depended on the collaboration between pediatricians, community partners, and hospital staff.

Proposed evidence-based care plan for Caitlyn

Cystic fibrosis is a medical condition that requires long term treatment. Caitlyn health depends on an effective care plan with a focus on safety and positive outcomes. Therefore, this means that the plan must be able to maintain enough oxygenation, reduce cases of complications, identify areas that need improvements, and address social issues affecting her care.

Previously I had stated four barriers affecting her hospital stay. I will address these barriers separately through the guidance of an evidence-based practice model for staff nurses. Cited in 2016, Canada states that the evidence-based practice model uses nurses’ and other staff members’ participation to ensure that Caitlyn receives medical attention at her bedside. The model requires the parties to use critical thinking skills to provide care to patients who have limited access to health care services. The following is an in-depth description of each barrier.

• Living in a remote area with challenges accessing health care services.
  • Healthcare services are essential for good health. In our case, Caitlyn lives in a remote area and, therefore, cannot access essential medical care; this barrier can be eliminated through telemedicine.
  • In their research, Goodridge and Marciniuk (2016) indicate that telehealth technologies can now connect the population living in remote places with healthcare providers. The technology is crucial because it provides diagnostic, monitoring, and delivery of therapeutic services.
  • According to Barrett, 2016), telemedicine is the use of videos and online platforms for consultation between patients and physicians; this includes the use of Skype and ace time apps.
  • Therefore the introduction of telemedicine and informal telephonic .communication between Caitlyn’s local pediatrician and Dr. Copeland in Valley City help provide solutions on medications and treatment of cystic fibrosis.
• Concerns on the treatment of respiratory issues that may impair respiratory functions.
  • Caitlyn’s therapist noted complications that are related to her inability to breathe. The hospital was able to take care of her condition, but her caregivers have to be comfortable enough to manage her condition and avoid complications like pneumonia.
  • We also need to educate on respiratory issues and symptoms, perform chest physiotherapy and other medication options, recommendations on how to control infections, medication compliance, and monitor complications such as poor oxygenation and note trigger symptoms. The patient and family should also know who to report symptoms when they arise.
  • There should be a weekly Skype follow-up with a respiratory therapist during the first month to monitor her pulmonary status and ensure that the patient, through the help of her parents and caregivers, manages her respiratory needs. With time, these follow-ups could be reduced because her caregivers will already be versed with the patient’s needs.
  • Initiation of a Home health care is also necessary to reinforce education and help monitor the patient’s health status. Knudson, Anderson, Schueler, & Arsen, 2017) stated that home health care services are services that are delivered at the home comfort of the patient by a licensed nurse/physician. Home care can also assist in improving the level of support to the patient and her parents.
• Social issues due to Caitlyn’s parent’s separation, financial problems, and required support from a caregiver.
  • (Jessup et al., 2017)Mentions that family-centered care is imperative in providing care to families cystic fibrosis families because the condition affects all members of the family. The model, therefore, focuses on the whole.
  • Ensuring that Caitlyn’s parents are connected to community social services will help identify charities that will help reduce financial constraints resulting from the disease. Social services will also give information on the available support groups, which will be fundamental in ensuring good mental health for the family.
  • Educating the family on the disease’s onset creates awareness and develops expertise in treating and coping with the condition.
  • Health insurance must be informed so that they can decide if the patient requires a pediatric manager who will follow up with the support group and help the family determine financial costs for her medications.
• Potential morbidities of cystic fibrosis, for example, DIOS, which can limit unnecessary visits to the hospital.
  • Caitlyn had previous complications, including bowel obstruction and pneumonia; this means that her family should receive education and training services on signs and symptoms of cystic fibrosis and its complications. The family should also know ways on how to prevent these complications through ways such as nutrition and supplements.
  • Copeland and Dr. Benjamin reached an agreement on the most suitable ways to communicate. But there is a need to develop an action plan for concerns that may arise during normal working hours. For instance, a Monday-Friday routine between 7 am to 4 pm, Caitlyn’s parents should be able to communicate with the pediatrician on any arising acute concerns. An emergency care plan should be developed if Dr. Benjamin for Caitlyn’s parents to use. A priority system can be created for identifying symptoms and treatment options vs. and when to visit the hospital or call 911.

The most relevant evidence in decision making

The most important care plan in Caitlyn’s case is the use of telemedicine because of barriers associated with her limited access to health care services due to her remote location. (Goodridge &Marciniuk, 2016) Share relevant and significant information on telemedicine and its benefits in promoting patient outcomes. The article supports the importance of incorporating telemedicine, such as reducing anxiety and reducing unnecessary visits to hospitals that are not easily accessible. The authors further expressed the significance of telemedicine and that it enhances patient care and improves overall patient outcomes. Barrett (2016) also confirmed the benefits of using telemedicine to improve health care delivery through an approach called the constructivist grounded theory.

Strategies and benefits of eliminating issues associated with interdisciplinary collaboration in a remote team

Because of the patients, remote location staff at Valley City gave a list of alternatives, including traditional follow-up care and support. The use of a teamwork approach and communication led to developing a patient-centered care plan that provided positive outcomes. Interdisciplinary collaboration was beneficial since Caitlyn was able to receive care from family, nurse, physicians, and respiratory therapists from the comfort of her home, which reduced anxiety and distress that could have resulted from traveling, and her family was also in a good position to benefit from community social services. To eliminate the challenges that were likely to result from interdisciplinary collaboration efforts, these communication strategies were used:

• Skype was used for follow-ups, which gave providers a chance to ensure education on physiotherapy and provide emotional support to Caitlyn’s family.
• Her pediatrician and physician used telemedicine to facilitate and develop a care plan that assessed if the local health care provider was in a position to treat acute concerns.
• Identify a community-based support group to address issues concerning chronic illnesses.

The outcome of this collaboration led to a family-centered approach to providing a positive outcome for Caitlyn.

In summary, evidence-based practice models give a chance for providers to solve patient problems through critical thinking. The models used provide nurses with appropriate insights to develop individualized patient-centered care plans through problem identification, utilization of research, and implementation of strategies and interventions that aid patient outcomes. Besides, the use of interdisciplinary planning approaches to support communication of patient needs and warrant the success of patient recovery.

References

Barrett, D. (2017). Rethinking presence: A grounded theory of nurses and teleconsultation. Journal of Clinical Nursing, 26(19-20), 3088-3098. doi:10.1111/jocn.13656

Canada, A. N. (2016). Probing the relationship between evidence-based practice implementation models and critical thinking in applied nursing practice. Journal of Continuing Education in Nursing, 47(4), 161-168. doi:10.3928/00220124-20160322-05

Capella University. (n.d.). Remote collaboration and evidence-based care. Retrieved from: http://media.capella.edu/CourseMedia/nursfp4030element17273/wrapper.asp

Goodridge, D., & Marciniuk, D. (2016). Rural and remote care: Overcoming the challenges of distance. Chronic Respiratory Disease, 13(2), 192–203. doi:10.1177/1479972316633414

Jessup, M., Smyth, W., Abernethy, G., Shields, L., Douglas, T., & On behalf of AREST-CF. (2018). Family-centered care for families living with cystic fibrosis in a rural setting: A qualitative study. Journal of Clinical Nursing, 27(3-4), 590-599. doi:10.1111/jocn.14105

Knudson, A., Anderson, B., Schueler, K., Arsen, E. (2017). Home is where the heart is: Insights on the coordination and delivery of home health services in rural America.  Retrieved from Rural Health Information Hub: https://ruralhealth.und.edu/assets/480-1335/home-is-where-the-heart-is.pdf