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NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

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    NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

    Student Name

    Capella University

    NURS FPX4030 Making Evidence-Based Decisions

    Prof. Name

    Date

    Remote Collaboration and Evidence-Based Care

    Hello everyone, good afternoon. My name is …… and today I am going to present you all a brief talk about remote collaboration and evidence-based care. First, we will go in-depth into what remote collaboration actually is. Remote collaboration is the work done in a collaborative and cooperative manner by a group of people in a remote setup. Remote collaboration overcomes the geographic barriers which are not part of physical collaboration. This is done by the aid of technologies that help connect people who are dispersed from each other.

    For every collaborative work, communication is the key element. Likewise, in remote collaboration, communication has an immense role in developing effective interaction while overcoming geographic barriers (Druta et al., 2021). Remote collaboration in healthcare systems has helped nurses and other health professionals to take better and more effective care of patients who live miles away from hospitals, especially those suffering from dangerous and chronic diseases. This is possible when nurses apply evidence-based care models in this collaborative effort.

    Ever since the pandemic COVID-19 came into existence, 37% of Americans started working from home by remote collaboration (Yang et al., 2021). Likewise, remote patient care was initiated in healthcare organizations to prevent the spread of the pandemic coronavirus. Remote patient care was also needed in faraway areas where patients could not commute to hospitals and get the care treatments. Now, remote collaboration is the need of the hour as the advancements in technologies have permitted it and every geographical area is not devoid of some technology. This demands that nurses follow evidence-based research models in order to provide effective collaboration and credible care treatment to patients living in remote areas to reduce the death rates.

    Scenario-Based Remote Collaboration 

    Caitlyn, a two-year-old girl who happened to be readmitted to a Vila hospital from her hometown on facing severe symptoms. Dr. Copeland and Virginia Anderson, a pediatric nurse are in charge of her case. In the beginning, her symptoms matched those of pneumonia: coughing with short intervals. Considering her symptoms of pneumonia, she was referred to consult Dr. Rebecca Helogo, a respiratory therapist. This team of health professionals came to the point that Caitlyn’s case was a complex case as her past medical history revealed exposure to repeated infections and that this was her second admission to the hospital as a result of pneumonia. 

    Later, it was found that she suffered from meconium ileus (bowel obstruction) at the time of birth which usually happens to pulmonary patients. There was thick respiratory mucus and she was treated with nebulizers and inhalers that were almost choking her. This created panic in the team of health professionals. After conducting a few laboratory tests, her team suspected diagnosis to be cystic fibrosis (CF). CF is a chronic pulmonary condition that is characterized by the presence of thick mucus and scarred tissue in the lungs.

    NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

    Upon physical examination, her body weight found was unusually low i.e. 20 pounds. Her pathological lab tests showed that scarred tissue of fibrotic nature was present in her lung. Later, her sweat chlorine test confirmed the diagnosis of Caitlyn to be Cystic Fibrosis. This condition can cause breathing huffs that need a suctioning pump or some specific respiratory inhalers which can be complex to use without proper education. 

    Therefore, healthcare professionals made a decision of educating Caitlyn’s parents as they live quite far from the Vila Health facility, hence, lack medical services and facilities. To reduce the chances of life-threatening complications related to CF, the healthcare team with a collaborated effort made the decision of educating parents and nursing staff about telehealth and its significance. The use of social media applications or video calling applications such as Skype can enable remote collaboration among healthcare professionals and Caitlyn’s parents. This will enable timely decision making which will be helpful and effective in the case of Caitlyn. Therefore, a proper care model is required to provide Caitlyn and her parents with informed, educated, and outcome-oriented care related to her condition of cystic fibrosis.

    Evidence-Based Care Plan

    In order to manage a patient’s condition effectively, a care plan must be prepared. These care plans must be based on credible and evidence-based research. Evidence-based care plans are effective for patients with chronic and infectious diseases as any negligence in the care plan can result in further complications and increased mortality rates. For the management of Caitlyn’s case of cystic fibrosis, a strategic care plan needs to be devised that promotes remote collaboration. 

    Care Plan for Improving Patient Outcomes

    Cystic Fibrosis (CF) is a genetic abnormality that causes abnormal transport of salt and water across the cells in the body. This results in an abnormal buildup of mucus and organ dysfunction (Endres & Konstan, 2022). The nursing care plan that enhances the safety and clinical outcomes of patients with CF is as follows:

    • Management of airway obstruction and inflammation
    • Management of reduced respiratory function e.g managing adequate oxygenation
    • Prevention of chronic lung infections and associated complications
    • Evaluation and management of nutritional deficiencies and malabsorption
    • Filling gaps related to education and knowledge gaps (Perrem et al., 2023)

    Among the numerous complications of cystic fibrosis, an abnormal gaseous exchange is the major complication to take into consideration. Others include sinus-related complications such as chronic nasal congestion, CF-related pancreatic disease, nutrition, and growth-related disorders such as clubbed fingers and osteoarthropathy (Chen et al., 2021). Since Caitlyn’s both parents are working, the additional information on Caitlyn’s CF pattern at daycare and how it was managed could have been useful in developing the care plan for her.

    The Ways to Use Evidence-Based Practice Model

    Stetler Evidence-Based Practices Care Model 

    The Stetler Model helps healthcare professionals in finding how the research and evidence data can be implemented in clinical practice. This model investigates how the evidence can be brought into use to bring positive outcomes and promote patient-centered care. This model is composed of five phases including preparation, validation, decision-making, application, and evaluation. First, the need for the application of EBP (CF care plan in Caitlyn’s case) is identified and then evidence-based sources related to the subject (CF in the case of Caitlyn) are assessed to find the quality and merit of the source.

    In the next step of Decision making, findings from the evidence resources are summarized (in our case, care plans interventions and management of CF) and evaluated to check if it is acceptable and feasible to practice. Lastly, the application of the summarized findings (collaboratively decided care plans and telehealth self-management of CF are implemented (Rutland et al., 2021; Todd et al., 2021) takes place and outcomes are evaluated (managing acute exacerbations in CF in the case of Caitlyn) to find whether they meet the expected outcomes of EBP.

    The positive benefits to patient outcomes can be evaluated by analyzing to what extent the symptoms of the patient are controlled. In the case of Caitlyn, the incidence of acute exacerbations of CF is measured as it is an effective marker for evaluating disease severity. The acute exacerbation of CR consists of a spectrum of clinical presentations from cough with no change in lung function to a severe reduction in lung function causing hypoventilation, hypoxemia, and potentially respiratory failure (Goss, 2019). Monitoring and evaluating these symptoms is a good indicator of whether the implications related to Stetler’s EBP care plan were benefitting the patient positively or not.

    Reflections on the Most Relevant and Useful Evidence Collected

    The evidence I collected and deemed the most relevant and useful in making decisions regarding the care plan for Caitlyn in managing her condition of CF is by Rutland and her colleagues (2021). As Caitlyn’s prime need is immediate care provision through telehealth for the timely management of her condition. Therefore, the article by Rutland and colleagues (2021) is the most relevant and useful in the decision-making of care plans for her. Another reason I consider it the most relevant and the most useful is that it fulfills the CRAAP test criteria and is effective for managing the condition of Caitlyn’s CF.  

     The CRAAP test is an authentic method of evaluating the credibility and authenticity of an article or evidence-based research. It includes currency, relevance, authority, accuracy, and purpose (Sye & Thompson, 2023). The research article by Rutland is published in 2021 and fulfills the criteria of currency. It is also relevant to the subject of the issue i.e. mobile health utilization for self-management of pediatric cystic fibrosis. As in the case of Caitlyn, a pediatric CF patient living far away from the hospital needs a telehealth facility for effective management of her condition. This is possible when the nurses and her parents can collaborate remotely and work on the betterment of her condition by providing her with proper and timely care treatments according to her needs.

    NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

    Hence, this evidence-based research is relevant to the subject of our case. The authors of this research article are qualified and come from the field of Pediatric Pulmonary Medicine. The purpose of this article is to find whether the application of mobile health/telehealth is effective in promoting self-management of pediatric cystic fibrosis. All the information coming from this article is well-justified and reliable. Therefore, this source of evidence-based research is the most important and relevant in making decisions for Caitlyn. 

    Strategies to Mitigate the Interdisciplinary Collaboration Challenges

    Some of the challenges related to interdisciplinary collaboration in providing care are related to the accessibility of technology such as unavailability of the internet or smartphone, trouble in logging into apps, and lack of knowledge on carrying out telehealth visits. Other challenges are the need for translation services in case of the language barrier, inability to find a private place to carry on telehealth visits, uncertainty about the quality of telehealth visits, financial barriers i.e. whether the insurance would cover telehealth visits or not, etc (Hosley, 2022). Following are the strategies to mitigate these challenges in interdisciplinary collaboration:

    • Enhancing teamwork in telehealth by using the tool TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) to increase communication and collaboration (Maafoh, 2023)
    • Providing education to the patient’s caregivers and nursing staff to increase knowledge about telehealth and its importance.
    • Incorporating Medicaid and Medicare expansions to facilitate telehealth visits. 
    • Involving the nursing staff who are familiar with the patient and caregiver’s native language to enhance the effectiveness of telehealth 

    Telehealth has numerous benefits in the treatment of cystic fibrosis such as improved access to healthcare, reduced travel costs, reduced risk to infection, improved patient adherence and improved patient engagement, fewer hospital readmissions, etc. (Desimone et al., 2021). Interdisciplinary collaboration can help overcome these barriers to telehealth and provide best practices to improve outcomes for patients with severe health conditions. For example, patients with serious conditions like CF or in need of rehabilitation require health services from multiple disciplines. Therefore, by effective communication and collaboration among team members from multiple disciplines patient care is enhanced and results in improved outcomes (Ransdell et al., 2021).

    Conclusion

    To conclude, remote collaboration is effective in chronic healthcare ailments as we saw in the case scenario of Caitlyn. With the collaborative decision, the implementation of telehealth education is necessary for the effective management of CF in the case of Caitlyn. This requires the use of an evidence-based practice model that can help in effective clinical decision-making for Caitlyn. The use of EBP permits improved health outcomes and patient safety. Strategies should be implemented to overcome the challenges that come along with interdisciplinary collaboration in providing care treatment to patients like Caitlyn through telehealth. Thank you for your time.

    References

    Chen, Q., Shen, Y., & Zheng, J. (2021). A review of cystic fibrosis: Basic and clinical aspects. Animal Models and Experimental Medicine, 4(3), 220–232. https://doi.org/10.1002/ame2.12180 

    Desimone, M. E., Sherwood, J., Soltman, S. C., & Moran, A. (2021). Telemedicine in cystic fibrosis. Journal of Clinical & Translational Endocrinology, 26, 100270. https://doi.org/10.1016/j.jcte.2021.100270 

    Druta, R., Druta, C., Negirla, P., & Silea, I. (2021). A review on methods and systems for remote collaboration. Applied Sciences, 11(21), 10035. https://doi.org/10.3390/app112110035 

    Endres, T. M., & Konstan, M. W. (2022). What is cystic fibrosis? JAMA, 327(2), 191–191. https://doi.org/10.1001/jama.2021.23280 

    Goss, C. H. (2019). Acute pulmonary exacerbations in cystic fibrosis. Seminars in Respiratory and Critical Care Medicine, 40(06), 792–803. https://doi.org/10.1055/s-0039-1697975

    NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

    Hosley, S. N. S. (2022). Challenges to telehealth. Nursing Clinics of North America, 57(3), 315–328. https://doi.org/10.1016/j.cnur.2022.04.001 

    Maafoh, V. (2023). Impact of teamstepps® 2.0 curriculum on teamwork and communication skills of telehealth nurses in a teaching hospital. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.4324083 

    Perrem, L., Martin, I., & Ratjen, F. (2023). Outpatient management of pulmonary exacerbations in children with cystic fibrosis. Expert Review of Respiratory Medicine, 17(4), 1–10. https://doi.org/10.1080/17476348.2023.2202852 

    Ransdell, L. B., Greenberg, M. E., Isaki, E., Lee, A., Bettger, J. P., Hung, G., Gelatt, A., Lindstrom-Mette, A., & Cason, J. (2021). Best practices for building interprofessional telehealth: Report of a conference. International Journal of Telerehabilitation, 13(2). https://doi.org/10.5195/ijt.2021.6434 

    NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

    Rutland, S. B., Bergquist, R. P., Hager, A., Geurs, R., Mims, C., Gutierrez, H. H., & Oates, G. R. (2021). A mobile health platform for self-management of pediatric cystic fibrosis: Qualitative study of adaptation to stakeholder needs and integration in clinical settings. JMIR Formative Research, 5(1), e19413. https://doi.org/10.2196/19413 

    Sye, D., & Thompson, D. (2023). Tools, tests, and checklists: The evolution and future of source evaluation frameworks. Journal of New Librarianship, 8(1), 76–100. https://doi.org/10.33011/newlibs/13/9 

    Todd, S., Sonntag, E., Buchanan, M. L., Jones, B. A., Dellon, E. P., Donaldson, S. H., & Goralski, J. L. (2021). Development of an Advance Care Planning Protocol in a Cystic Fibrosis Outpatient Clinic. Journal of Palliative Medicine, 24(9), 1383–1386. https://doi.org/10.1089/jpm.2021.0186 

    Yang, L., Holtz, D., Jaffe, S., Suri, S., Sinha, S., Weston, J., Joyce, C., Shah, N., Sherman, K., Hecht, B., & Teevan, J. (2021). The effects of remote work on collaboration among information workers. Nature Human Behaviour, 6(6). https://www.nature.com/articles/s41562-021-01196-4