Remote Collaboration and Evidence-Based Care
School of Nursing and Health Sciences, Capella University
NURS-FPX4030 Making Evidence-Based Decisions
April 16, 2022
Remote Collaboration and Evidence-Based Care
Welcome to my video presentation for evaluation 4 in NURS-FPX 4030: Making Evidence-Based Decisions! My name is ………. This video will analyze the Vila Health Case research published by Capella University. I will recommend an evidence-based treatment plan for the Vila Health patient, taking into consideration the evidence used while making judgments about the care strategy and how that plan improves patient outcomes. I will highlight the benefits of interdisciplinary collaboration in treatment planning and present strategies for mitigating its drawbacks in order to discuss how collaboration among disciplines may be better utilized in a remote team setting to improve future patient outcomes in similar care circumstances. Finally, I will talk about how I included an evidence-based practice approach into my work as I developed a plan of action.
Caitlynn, age 2, was recently admitted to Valley City Regional Hospital suffering from pneumonia and malabsorption syndrome. She has both of these conditions. Dr. Copeland arrived at the conclusion that Caitlynn has cystic fibrosis after doing a comprehensive evaluation of her symptoms and the results of her tests. Caitlynn’s new diagnosis presents significant hurdles for her family, and crucial family factors should be considered while designing her therapy. The Valley City Regional Hospital is around an hour’s drive from the family’s home, which is located in a tiny village that has a population of less than one hundred people. Because of this, there is an inadequate amount of funding available for cystic fibrosis (CF) research, prevention, and therapy. Both of Caitlynn’s parents went through the marriage and divorce process before Caitlynn was born. Together, they put in a significant amount of extra hours of work. Caitlynn’s new medical bills will be covered by her dad’s insurance from his new work. Unfortunately, the family’s financial situation is precarious since he has just lately resumed working after an extended leave. I will be working with a multidisciplinary group to create a successful care plan based on scientific data to ensure Caitlynn’s health and well-being. All of the parents’ worries will be addressed using evidence-based methods, with an emphasis on the positive effects that good interventions can have on Caitlynn and her family.
Caitlynn’s doctor, Dr. Copeland, recommended a variety of treatments that should be part of her ongoing care. Nutrition supplements, high-protein meals, and at-home monitoring are some of the cutting-edge therapies for conditions including intestinal blockage and respiratory discomfort. The therapy suggestions made by Dr. Copeland are in line with those made by Viprey et al. (2023). According to the study, the faulty cystic fibrosis transmembrane conductance regulator (CFTR) protein is caused by a mutation in the CFTR gene. Effects may be felt in the genitourinary, respiratory, pancreatic, upper airway, hepatic, gastrointestinal, and pulmonary systems. Inflammation, tissue reconfiguration, and blockage in the respiratory system (particularly the lungs and upper airways) are the end effects of dysfunction. The presence of extra condition-modifying genes, as well as the patient’s socioeconomic standing, both influence the seriousness of a disease. People with cystic fibrosis benefit from early identification and treatment, which improves their quality of life.
Treatment focuses mostly on avoiding organ failure as a result of the disease. Individuals with CF must take fat-soluble vitamin and trace element supplements in addition to eating a high-calorie, high-fat diet that delivers 110 to 220 percent of the daily caloric consumption indicated for healthy people. Caitlynn’s parents might benefit from seeing a nutritionist in order to develop a balanced diet. Blood tests for fat-soluble vitamins A, D, and E, as well as the international normalized ratio (INR) for vitamin K function, will be part of Caitylnn’s regular checkups to ensure she is getting the most out of her vitamin regimen. Age-appropriate dietary recommendations and education of caregivers, such as kindergarten teachers, are just as important as regular clinical measures at least every three months.
In 77% of patients, lung illness is the ultimate cause of death. Endobronchial bacterial infection that persists over time, recurrent infections, and morphological alterations in the lungs. Treatment focuses on correcting the underlying error in mucociliary clearance, which causes the condition, and preventing and suppressing persistent bacterial infection with antibiotics (Ong et al., 2021). Inhalation treatment, proper coughing techniques, the egress of secretions, and the usage of chest muscles are all things that may benefit Caitlynn until she is old enough to accomplish them on her own. Sports therapy has the potential to aid in the recovery of lung function. Keeping Caitlynn occupied is essential. Patients with chronic lung illness should have frequent clinical evaluations to ensure they are receiving the best care possible. The parents of Caitlin ought to maintain a symptom diary as well, so they can keep an eye out for acute exacerbations.
Additional organ involvement in cystic fibrosis adds a layer of complexity. This condition and fibrosis are hallmarks of the most severe type of secondary biliary hepatic cirrhosis, which affects around 10% of the population. Transaminase and ultrasonography screenings should be performed annually on children and adolescents to identify liver disease. Type 3 diabetes, arthropathy, osteoporosis, and co-occurring mental illnesses including anxiety and depression are all linked to advancing age. Caitlynn and her parents’ (prevalence 10%) anxiety and depression may hinder treatment compliance and efficacy. Such issues need to be addressed in the course of a yearly mental health assessment.
Challenges of Interdisciplinary Collaboration
Caitlynn and her parents are hampered by the lack of medical facilities in their small town. Caitlynn’s new chronic condition may be managed with the support of dieticians, respiratory therapists, pediatric pulmonologists, and other specialists who can be reached through telemedicine. It takes an interdisciplinary team to provide patients and their loved ones the educational and clinical tools they need. Caitlynn’s family must learn to manage her symptoms, ensure she takes her medications, and find ways to cope while she goes through this sickness. Clinics catering specifically to people with cystic fibrosis are commonplace. Although patients’ treatment and results have improved because to regular follow-up visits by multidisciplinary teams, patients have to travel farther to get there, which may result in lost days of school or work.
Caitlynn’s parents might save money and time on transportation expenditures by receiving care for their daughter through video call between regular visits. Patients with cystic fibrosis may experience therapy failure due to poor adherence. Allen et al. (2023) found that individuals with CF are increasingly acknowledging the value of digital technologies in managing their complex medication regimens. These applications not only enable exact inhalation treatment monitoring, but also make it possible for patients to safely inhale any medication. There is evidence that spirometry and smartphone telemedicine applications may detect pulmonary exacerbations early on (Schwarz et al., 2023). These resources may help Caitlynn’s parents figure out how to deal with their daughter’s sickness.
Her parents’ worry and melancholy throughout this transition would be greatly alleviated if they had access to the aforementioned digital technology, in addition to personalized phone counseling by psychologists. Every person in the household needs to feel encouraged and uplifted as they figure out how to care for their child’s chronic health issue and develop healthy coping strategies. Connecting Caitlynn and her family with a telehealth support group is useful for them as they deal with Caitlynn’s illness. They could seek out the advice of parents who have gone through similar experiences. Medication adherence, pulmonary problems, lung function, and standard of life have all improved with telemedicine therapy compared to normal care.
The Knowledge-to-Action (KTA) model was used to develop Caitlynn’s plan of care. This model enabled the interdisciplinary healthcare team to coordinate their efforts via telemedicine in order to create Caitlynn’s individualized plan of care, establish goals for both her and her parents, evaluate the efficacy of interventions, and make any necessary adjustments to the care plan at regular intervals (Panesar, 2023). This plan of treatment was developed by a multidisciplinary team comprising of doctors, physiotherapists, dietitians, psychologists, social workers, and nurses. The healthcare team’s comprehension of how telehealth knowledge management may improve the provision of excellent care that is patient-centered was enhanced by this approach.
Cystic fibrosis treatment is difficult and complex. Symptoms may appear and be very severe in a variety of ways. There is a vast variety of factors that might affect a person’s health and the progression of illnesses. A multidisciplinary team including medical doctors, physiotherapists, dietitians, social workers, psychological professionals, and nurses should assess a patient after a positive test result. In just a few short minutes, Caitlynn’s parents will be able to acquire an expert medical opinion and learn about their treatment options. The couple’s depression, anxiety, and tension may be alleviated, and Caitlynn may be able to avoid hospitalization if they do this. Caitlynn’s parents have limited access to professionals, so they might benefit immensely from telemedicine. Caitlynn’s health will improve and they will save money on gas thanks to this.
Allen, L., Allen, L., Carr, S. B., Davies, G., Downey, D., Egan, M., … & Davies, J. C. (2023). Future therapies for cystic fibrosis. Nature communications, 14(1), 693. https://doi.org/10.1038/s41467-023-36244-2
Ong, T., Van Citters, A. D., Dowd, C., Fullmer, J., List, R., Pai, S. A., … & Sawicki, G. S. (2021). Remote monitoring in telehealth care delivery across the US cystic fibrosis care network. Journal of Cystic Fibrosis, 20, 57-63. https://doi.org/10.1016/j.jcf.2021.08.035
Panesar, A. (2023). Precision Healthcare in Practice. In Precision Health and Artificial Intelligence: With Privacy, Ethics, Bias, Health Equity, Best Practices, and Case Studies (pp. 121-163). Berkeley, CA: Apress. DOI: 10.1007/978-1-4842-9162-7_7
Schwarz, C., Wimmer, E., Holz, F., Grehn, C., Staab, D., & Eschenhagen, P. N. (2023). Antibiotic Therapy for Pulmonary Exacerbations in Cystic Fibrosis—A Single-Centre Prospective Observational Study. Antibiotics, 12(4), 734. https://doi.org/10.3390/antibiotics12040734
Viprey, M., Mougeot, F., Dima, A. L., Haesebaert, J., Occelli, P., Durieu, I., … & Touzet, S. (2023). A Participatory Approach Involving Patients with Cystic Fibrosis and Healthcare Professionals for the Co-Design of an Adherence-Enhancing Intervention Toolkit. Patient Preference and Adherence, 995-1004. https://orcid.org/0000-0002-3281-1970