Evidence-Based Care Plan for Cystic Fibrosis: Improving Safety and Outcomes in Remote Collaboration

QUESTION

I read a Vila Health scenario conversation and wrote down the whole story in paragraph essay type. I need to do Capella  University NURS FPX 4030 assessment 4, Remote Collaboration and Evidence-based Care video.  I searched for resources by entering  ” Evidence-based symptom management for cystic fibrosis’ ‘ and found some articles , then from there extended search for more articles. I had to search for telemedicine related articles separately, I am not sure if that is okay. The model I will use is Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP). Can you please help me write a sample for a video presentation? The assessment instruction, scoring guidelines and the Vila Health story are attached. Can I use NICE guidance on diagnosis and management of cystic fibrosis by,  Dayasiri, K., Hull, J., & Rao, S. (2021) as my best evidence-Based and relevance resource? Or should I look for more research articles?. For this assessment, you are a presenter!

The assessment instruction is: You will create a 5-10-minute video using Kaltura or similar software. In the video:

• Propose your evidence-based care plan that you believe will improve the safety and outcomes of the patient in the Vila Health Remote Collaboration on Evidence-Based Care media scenario. Add your thoughts on what more could be done for the client and what more information may have been needed.
• Discuss the ways in which an EBP model and relevant evidence helped you to develop and make decisions about the plan you proposed
• Wrap up your video by identifying the benefits of the remote collaboration in the scenario, as well as discuss strategies you found in the literature or best practices that could help mitigate or overcome one or more of the collaboration challenges you observed in the scenario. Be sure you mention any articles, authors, and other relevant sources of evidence that helped inform your video. Discuss why these sources of evidence are credible and relevant. Important: You are required to submit an APA-formatted reference list of the sources you cited specifically in your video or used to inform your presentation. You are required to submit a narrative of all your video content to this assessment and to SafeAssign. Make sure that your video addresses the following grading criteria:
• Propose your own evidence-based care plan to improve the safety and outcomes for a patient based on the Vila Health Remote Collaboration on Evidence-Care media scenario.
• Explain the ways in which you used an EBP model to help develop your plan of care for the client.
• Reflect on which evidence you found in your search that was most relevant and useful when making decisions regarding your care plan.
• Identify benefits and strategies to mitigate the challenges of interdisciplinary collaboration to plan care within the context of a remote team.
• Communicate in a professional manner that is easily audible and uses proper grammar, including a reference list formatted in current APA style.
• The scoring guide is : Proposes your evidence-based care plan to improve the safety and outcomes for the Vila Health patient with new content added. Notes areas in which further information or data could have been useful in developing the plan, Explains the ways in which you used the specific evidence-based practice model to help develop your care plan. Notes ideas for how to evaluate the positive benefits to patient outcomes. Reflects on which evidence you collected that was most relevant and useful when making decisions regarding the care plan. Discusses the rationale or criteria that was used to determine relevance and usefulness. Identifies benefits and proposes strategies to mitigate the challenges of interdisciplinary collaboration to plan care within the context of a remote team. Discusses how interdisciplinary collaboration could be better leveraged to improve outcomes in future care situations. Communicates via video with clear sound and light. Content delivery is focused, smooth, and well-rehearsed. Includes a narrative of the video. Video presentation is between 5 to 10 minutes. The reference list is from relevant and evidence-based (published within five years) sources.

The story is about Vila Health Care.  At Valley City Regional Hospital, the pediatrician Dr. Copeland, nurse Virginia and Respiratory therapist Rebccca are discussing Caitlynn’s updated information and treatment, plan of care , and future plan. They gather Patient history, assessment findings from the doctor and the nurse, current treatment and further tests and treatment plans. Caitlyn is 2 years old, weighs 20.7 pounds and was admitted to the ER for the second time with pneumonia in the last six months. She has a history of meconium ileus at birth, decreased breath sounds at the right bases and rhonchi scattered in the upper lobes. Respirations were 32 and shallow with a temp of 101, some decreased subcutaneous tissue observed in her extremities as might have some malabsorption of nutrients. After Rebecca administered nebulizer aerosol treatment she had thick secretions, and got chest physiotherapy. Sweat chloride test was done and result was 65 millie equivalents per liter, with the skin tasting salty per Caitlynn’s mother. Using all of the evidence she is diagnosed for cystic fibrosis, a progressive and lifelong disease. Dr. Copeland plans to start an IV with piperacillin and pancreas enzyme, recommending a high-protein, extra-calorie diet along with the fat-soluble vitamins A, D, E, and K and monitor her temperature, keeping secretions thin by providing aerosol breathing treatment Dornase alfa but not to do huff breath because she is too young. During the hospital stay Caitlynn had one episode of bowel obstruction. In the Vila Health the EBP with stakeholders collaborating and care planning are from the admission, during hospitalization, time of discharge and the follow up after discharge. They found out the patient was from McHenry, which is over an hour drive to Valley City or Jamestown where the nearest medical offices are, the parents are separated and both work long hours, and due to financial difficulty they may not be able to just take time off to bring Caitlyn in for follow up appointments to Valley City after discharge. Discharge plan lead to Caitlynn being cared for by her mother in Valley City. The providers team try planning to make sure the mother gets as much education as possible that she needs for Caitlynn before the discharge, so Caitlynn can get the appropriate care at home, prevent her from rehospitalization, save time and cost for the parents, and reduce stress from the patient and family. Caitlynn was referred to social services consult to coordinate services and identify some assistance for the family in McHenry. Before the discharge, a respiratory therapy Rebacca and the nurse Virginia would teach the mother face to face at the hospital as much as possible and remotely using video, skype, text messaging for symptom management for Cystic Fibrosis,and Distal Intestinal Bowel Obstruction Symptoms(DIOS) in cystic fibrosis, related treatment, and medication. Additionally respiratory therapy was scheduled to be available for after office hours if Caitlynn’s mother has questions or concerns. Caitlyn’s medical record would be sent to McHenry city pediatrician Dr. Benjamin. Dr. Copeland and Virginia Anderson talk to Dr. Benjamin about how his office can coordinate with the hospital on Caitlynn’s care. Dr. Copeland inquired to make sure that Dr. Benjamin had adequate knowledge about the child with the diagnosis of Cystic Fibrosis and the protocol, that Dr. Benjamin could obtain Pancreatic enzyme and medications for Caitlynn, that Dr. Benjamin could access telemedicine to Valley City, suggested using skype, phone call, established that it was best to use text message communication and also suggested to him that it might be good to get connected with Valley City on his telemedicine equipment if needed. Dr. Copeland can also have a telemedicine appointment in their office when Caitlynn has symptoms. Nurse Virginia also offered to Dr. Benjamin to text her if he can’t reach Dr. Copeland. Dr. Benjamin also stated that he would make sure Caitlynn would have all the vaccination needed.  Nurse Virginia and social worker Marta Simmons from Valley City hospital met with the social worker from the pediatric clinic in McHenry by phone, gave Caitlynn’s information, requested to help Caitlynn’s insurance coverage information from her mother and discussed the need for social support to reduce the mother’s stress and grief since she was taking care of a child who had a difficult condition. They also inquire if the mother didn’t have the internet, if there was any possible way to get resources or material to learn about Caitlynn’s progressive and lifelong disease. McHenry city doesn’t have a library in their city or in a nearby city so Martha plans to talk to Caitlynn’s pediatrician who might be able to help the mother get materials if she can’t get them easily at home. The instructions are , Propose your own evidence-based care plan to improve the safety and outcomes for a patient based on the Vila Health Remote Collaboration on Evidence-Care media scenario. Explain the ways in which you used an EBP model to help develop your plan of care for the client. Reflect on which evidence you found in your search that was most relevant and useful when making decisions regarding your care plan. Identify benefits and strategies to mitigate the challenges of interdisciplinary collaboration to plan care within the context of a remote team.

References are

Dayasiri, K., Hull, J., & Rao, S. (2021). NICE guidance on diagnosis and management of cystic fibrosis. Archives of Disease in Childhood.Education and Practice Edition, 106(1), 31-34. https://doi.org/10.1136/archdischild-2019-316882

Castellani, C., Duff, A. J. A., Bell, S. C., Heijerman, H. G. M., Munck, A., Ratjen, F., Sermet-Gaudelus, I., Southern, K. W., Barben, J., Flume, P. A., Hodková, P., Kashirskaya, N., Kirszenbaum, M. N., Madge, S., Oxley, H., Plant, B., Schwarzenberg, S. J., Smyth, A. R., Taccetti, G., Wagner, T. O. F., Wolfe, S. P., & Drevinek, P. (2018). ECFS best practice guidelines: The 2018 revision. Journal of Cystic Fibrosis, 17(2), 153-178. https://doi.org/10.1016/j.jcf.2018.02.006

Boon, M., Claes, I., Havermans, T., Fornés-Ferrer, V., Calvo-Lerma, J., Asseiceira, I., Bulfamante, A., Garriga, M., Masip, E., Woodcock, S., Walet, S., Barreto, C., Colombo, C., Crespo, P., Van der Wiel, E., Hulst, J., Martinez-Barona, S., Nobili, R., Pereira, L., Ruperto, M., … MyCyFAPP consortium (2019). Assessing gastro-intestinal related quality of life in cystic fibrosis: Validation of PedsQL GI in children and their parents. PloS one, 14(12), e0225004. https://doi.org/10.1371/journal.pone.0225004

RHIhub. (n.d.). Telehealth use in rural healthcare. Rural Health Information inHub. https://www.ruralhealthinfo.org/topics/telehealth

Khairat, S., Haithcoat, T., Liu, S., Zaman, T., Edson, B., Gianforcaro, R., & Shyu, C. R. (2019). Advancing health equity and access using telemedicine: a geospatial assessment. Journal of the American Medical Informatics Association : JAMIA, 26(8-9), 796-805. https://doi.org/10.1093/jamia/ocz108

ANSWER

 Evidence-Based Care Plan for Cystic Fibrosis: Improving Safety and Outcomes in Remote Collaboration

Introduction

In this video presentation, we will propose an evidence-based care plan to improve the safety and outcomes of Caitlynn, a 2-year-old patient diagnosed with cystic fibrosis, as portrayed in the Vila Health Remote Collaboration on Evidence-Based Care scenario. We will utilize the Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) to guide the development of the care plan, and we will reflect on the relevant evidence found during our search to make informed decisions. Furthermore, we will explore the benefits of remote collaboration in the scenario and discuss strategies to overcome challenges faced by the interdisciplinary team.

Evidence-Based Care Plan

Our evidence-based care plan for Caitlynn focuses on a comprehensive approach to managing cystic fibrosis. The plan includes administering IV piperacillin and pancreas enzyme, providing a high-protein, extra-calorie diet, and supplementing fat-soluble vitamins A, D, E, and K. We will also monitor Caitlynn’s temperature and provide aerosol breathing treatments with Dornase alfa to keep secretions thin. Additionally, we will ensure adequate education for the mother on symptom management for cystic fibrosis and Distal Intestinal Bowel Obstruction Symptoms (DIOS) through both face-to-face and remote teaching methods, such as video conferencing, Skype, and text messaging.

Use of the JHNEBP Model

The Johns Hopkins Nursing Evidence-Based Practice Model served as our guide to developing the care plan for Caitlynn. The model’s five-step approach allowed us to formulate a patient-centered plan based on the best available evidence, including research articles and guidelines from reputable sources like NICE (Dayasiri et al., 2021) and the ECFS Best Practice Guidelines (Castellani et al., 2018). The model also facilitated collaboration among team members, ensuring that the care plan addressed Caitlynn’s unique needs while considering the remote care context.

Relevant and Useful Evidence

The evidence gathered from our search highlighted the importance of early diagnosis and prompt intervention to manage cystic fibrosis effectively (Dayasiri et al., 2021). The use of respiratory therapy and nebulizer aerosol treatments, as well as the appropriate administration of pancreatic enzyme and medications, were critical components of the care plan (Khairat et al., 2019). Additionally, the ECFS Best Practice Guidelines (Castellani et al., 2018) informed our approach to nutrition and supplementation, emphasizing the significance of a high-calorie, high-protein diet for children with cystic fibrosis.

Benefits of Remote Collaboration

Remote collaboration in the scenario proved advantageous for Caitlynn and her family. The use of telemedicine and video conferencing enabled seamless communication between the healthcare team at Valley City Regional Hospital and Dr. Benjamin, Caitlynn’s pediatrician in McHenry. The sharing of medical records and coordinated care planning allowed for a smooth transition of care from hospital to home, ensuring continuity and comprehensive care for the patient (RHIhub, n.d.).

Strategies to Overcome Collaboration Challenges

Despite the benefits of remote collaboration, challenges can arise. Strategies to mitigate these challenges include enhancing the accessibility of information and resources for Caitlynn’s mother in McHenry. This can be achieved by providing educational materials and resources on cystic fibrosis and DIOS through telehealth platforms, ensuring that the mother is well-informed and equipped to manage her daughter’s condition effectively (Boon et al., 2019). Additionally, establishing clear communication protocols, such as text messaging between healthcare providers, can facilitate prompt information exchange and support timely decision-making (Khairat et al., 2019).

Conclusion

Through the application of the Johns Hopkins Nursing Evidence-Based Practice Model and the integration of relevant evidence, we have developed an evidence-based care plan to improve Caitlynn’s safety and outcomes in managing cystic fibrosis. The benefits of remote collaboration have been highlighted, and strategies to overcome challenges have been proposed. By implementing this comprehensive care plan and leveraging the power of telemedicine, we aim to ensure that Caitlynn receives the best possible care, promoting her overall well-being and quality of life.