Remote Collaboration and Evidence-Based Care for Cystic Fibrosis: Enhancing Safety and Outcomes for Vila Health Patients

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. Can you please help me write a sample narrative per scoring guidlines? 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 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?. The  scoring guide and the story are attached. 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

Remote Collaboration and Evidence-Based Care for Cystic Fibrosis: Enhancing Safety and Outcomes for Vila Health Patients

Introduction

In this narrative, we explore the case of Caitlynn, a 2-year-old patient with cystic fibrosis (CF), and her treatment journey at Vila Health. The interdisciplinary team, comprising Dr. Copeland, nurse Virginia, and respiratory therapist Rebecca, collaborates remotely to develop an evidence-based care plan for Caitlynn. By utilizing the Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP), the team aims to improve patient outcomes while addressing the challenges of remote collaboration. This narrative highlights the team’s approach to care planning, utilization of relevant evidence, strategies for interdisciplinary collaboration, and the benefits associated with remote care delivery.

Care Plan Development using JHNEBP

The JHNEBP model serves as the framework for developing the evidence-based care plan for Caitlynn. The team gathers comprehensive patient history and assessment findings, considering current treatment options and future plans. By adhering to the model’s five steps, including framing the clinical question, finding the best evidence, assessing the evidence, integrating evidence with clinical expertise, and evaluating the outcomes, the team ensures a systematic and evidence-based approach to care planning.

Relevant and Useful Evidence

To formulate the care plan, the team extensively searched for evidence-based resources on symptom management for CF. Notably, the NICE guidance on diagnosis and management of CF by Dayasiri, Hull, and Rao (2021) was identified as the best evidence-based and relevant resource. Additionally, the ECFS best practice guidelines by Castellani et al. (2018) and other scholarly articles provided valuable insights. These resources helped the team understand CF symptom management, dietary considerations, medications, and interventions suitable for Caitlynn’s age group.

Mitigating Challenges and Enhancing Interdisciplinary Collaboration

Collaborating remotely presents unique challenges, such as limited face-to-face interactions and the need for effective communication channels. To overcome these challenges, the team established clear lines of communication using text messaging, phone calls, and video conferencing. They involved stakeholders from Valley City and McHenry, ensuring seamless coordination between the hospital and Caitlynn’s primary care physician, Dr. Benjamin. By sharing Caitlynn’s medical records, discussing the care plan, and leveraging telemedicine capabilities, the team promotes comprehensive and continuous care.

Evaluation and Positive Benefits

To evaluate the positive benefits of the care plan, the team outlines parameters for monitoring patient outcomes, such as reduced rehospitalization rates, improved nutritional status, and enhanced symptom management. By closely monitoring Caitlynn’s progress, the team can refine the care plan and ensure its efficacy in improving patient safety and outcomes.

Conclusion

In conclusion, the Vila Health interdisciplinary team, consisting of Dr. Copeland, nurse Virginia, and respiratory therapist Rebecca, employs the JHNEBP model to develop an evidence-based care plan for Caitlynn, a young patient with CF. By integrating relevant and useful evidence, collaborating effectively through remote communication channels, and evaluating patient outcomes, the team strives to enhance safety and improve outcomes for Caitlynn. The utilization of telemedicine and remote collaboration facilitates seamless care delivery, mitigating the challenges of distance and limited resources. Through this approach, Vila Health sets a precedent for future care situations, leveraging interdisciplinary collaboration to optimize patient outcomes in remote care settings.