NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

Hello, my name is Lisa Nelson. This recording will focus on remote collaboration and evidence-based care planning for the presented case in the Villa Health scenario. The scenario entails a pediatric female patient, 2year old Caitlynn Bergan, receiving care at Valley City Regional Hospital. The patient has a past medical history of meconium ileus, which she had at birth, along with recurrent pneumonia. She has already been hospitalized within the last six months.

NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

She is in the hospital, accompanied by her parents Doug and Janice Bergan. Upon assessment, the findings show that Caitlynn has decreased breath sounds at the right bases, scattered rhonchi in her upper lobes, and fever. After the respiratory therapist administered a nebulized treatment and physiotherapy, there were thick secretions noted. She is also suspected of having malabsorption of nutrients due to decreased subcutaneous tissue observed in her extremities. Caitlynn also has a positive sweat chloride test which confirms cystic fibrosis. NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

Treatment for Caitlynn consists of intravenous piperacillin, pancreas enzymes, and chest physiotherapy. Her physician also recommends an extra-calorie, high-protein diet, and fat-soluble vitamins. When planning care for Caitlynn some nursing diagnoses to consider would be ineffective airway clearance related to excessive production of thick mucus as evidenced by abnormal breath sounds, ineffective cough, and altered respiratory rate and depth. Caitlynn will maintain clear, open airways as evidenced by normal breath sounds, normal rate and depth of respiration, and the ability to cough up secretions after nebulizing aerosol treatments. According to the Cystic Fibrosis Foundation, this nursing diagnosis is relevant to Caitlynn’s care, in a consensus evaluation, daily airway clearance is recommended.  Imbalanced Nutrition: less than body requirements related to impaired digestive process and absorption of nutrients, as evidenced by weight of 20.7 lbs., and decreased subcutaneous tissue.  NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

The patient will weigh within ten percent of the ideal body weight. For successful implementation of this plan with the help of the care team, Caitlynn parents must record and describe food intake and a referral to a dietitian or nutritional support team may also be needed. A dietician or nutritional support team can individualize Caitlynn’s diet within prescribed restrictions. In support of these care plan decisions for Caitlynn, the consensus recommendation recommended in the CF Foundation Evidence-based Practice is that intensive treatment with behavioral intervention in conjunction with nutritional counseling is used to promote weight gain for children aged 1 to 12 years (Borowitz et al., 2009). Ratchford et al. (2018 NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care), also stated optimizing nutrition is critical, as higher growth parameters are associated with better pulmonary function and outcomes, but unfortunately, patients with this disease are prone to malnutrition, growth failure, and vitamin deficiencies.

Aside from the complexities arising from her latest diagnosis, Caitlynn and her parents reside in a rural area an hour away from the hospital and face several healthcare challenges with limited access to healthcare needs. According to Lahiri et al. (2016 NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care), national and international care guidelines recommend that preschoolers with cystic fibrosis get regular well-child care from a primary care physician. McHenry, where the patient lives, is a small town of less than a hundred without the advanced medical facilities available. The physician’s plan to address these challenges is telemedicine and coordinating care with Caitlynn’s pediatrician. Because of the severity of Caitlynn’s diagnosis, the interdisciplinary team may need to modify a plan to hold a biweekly teleconference meeting with her parents to ensure adherence to her treatment and evaluate and fix barriers as they arise. The benefits of telemedicine use within these specialties include decreased mortality, decreased hospital length of stay, higher adherence to recommended care, cost-effectiveness, and high patient and provider satisfaction (Lilly, 2011). During these teleconference meetings, the interdisciplinary team can educate Caitlynn’s parents on online support groups to help them cope with the new diagnosis. NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

The interdisciplinary team can also further collaborate on providing the family with a weekly survey such as the cystic fibrosis symptom progression survey that will be helpful with Caitlynn assessments. This survey will help the parents be more thorough and standardized when assessing Caitlynn. The survey will also help catch more variances quickly. According to Norrish et al. (2015 NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care), in the Oman Medical Journal, the use of this survey would provide an opportunity for patient engagement and relationship building, thereby enhancing patient education, and improving treatment adherence. Working as an interdisciplinary team provides better chances of quality outcomes of the care for Caitlynn. The interdisciplinary team brings the contribution of various specialized care to one patient and this pooling of knowledge and skills produces synergistic results better than one provider giving all the care in various disciplines. The single care provider might have fewer skills or knowledge in other fields thus inadequate care.

The proposed care plan aims to provide an evidence-based care framework that adequately caters to the patient’s needs for improved safety and patient outcome. From personal experience reviewing cases such as Caitlynn’s, the Ottawa model can help develop a care plan tailored to Caitlynn’s needs considering her conditional and situational background. NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

Christenbery (2018), describes the Ottawa Model as an interactive design that displays research as a 3-step system of interrelated stakeholder decisions and activities.

The first step entails assessing barriers and supports to the care process (Christenbery, 2018 NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care). In Caitlynn’s case, barriers include proximity to healthcare facilities and resources, insufficient access to cystic fibrosis knowledge and education, and the absence of readily available parent support systems. Herbert et al. (2021), who collected a total of 941 responses from 21 countries, note that medication access is a concern for people with cystic fibrosis, contributing to the high strain on management and treatment and having an impact on both mental and physical health of their loved ones. They conclude that it is necessary to develop focused quality improvement programs to aid in the reduction of treatment load. Since Caitlynn is newly diagnosed, the most practical way for her parents to understand the kind of treatment load ahead is for them to be in touch with the healthcare providers and more experienced parents in similar situations.

The pediatrician and social worker at the clinic in McHenry can only do so much for the Burgan family. Kirk & Milnes (2015), while studying online groups for people living with cystic fibrosis, concluded that online support groups tend to augment expert help in terms of self-management. They allow young people and parents to discuss their experiences, sentiments, and methods for living with long-term illnesses with their peers while also developing the knowledge to empower them in discussions with medical care providers. Martinez-Millana et al. (2019 NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care) explored mobile phone applications in the management and care of pediatric cystic fibrosis. They found that all the applications reviewed had features for tracking elements of disease and nutrition, including medications, diets, measurements, alerts, and instructional content. The Burgan family can significantly benefit from one such program with their access to internet services.

The next step in the Ottawa model is monitoring intervention and the extent of implementation (Christenbery,2018). This stage requires that Caitlynn’s physicians select relevant techniques to raise implementation awareness and give the necessary training and education to carry out the adoption. Janice has already received training on how to perform Caitlynn’s chest physiotherapy. However, she still requires other resources to educate her further on similar and different aspects such as nutrition. According to Button et al. (2016), Infants who have just been diagnosed with cystic fibrosis and their families must meet with the multidisciplinary group as soon as possible. It is essential to explain, display, and practice the function of physiotherapy in airway clearing procedures, exercise, and active play. Infants should be treated according to the standard guidelines for cystic fibrosis physiotherapy, including five modified postural drainage positions repeated once or twice a day as needed.

Nutritional treatment and support are vital aspects of cystic fibrosis management. Turck et al. (2016 NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care) suggest that dietary treatment begins as soon as feasible after diagnosis, with frequent follow-up and patient/family education. The adjustment of energy consumption is vital to attain age-appropriate weight and height. In Caitlynn’s case, where pancreatic enzyme and fat-soluble vitamin therapy have started early, close monitoring is necessary. The key aims of multidisciplinary cystic fibrosis centers are to achieve standard development patterns in children and maintain an acceptable nutritional balance (Turck et al., 2016).

The final step in the Ottawa model is evaluating outcomes for the patient and her family (Christenbery, 2018 NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care). The benefits of adopting this evidence-based model include gaining a better understanding of the patient’s needs and obtaining maximum advantages of the remote collaboration process. Following this evidence-based practice should result in safe and positive outcomes for the patient since all the stages in this model can be reviewed and revisited in less than favorable outcomes.

Reflection on the Sources Used

I have used various sources to draw my plan for this patient. These sources have included books and journal articles. They have varied in the rank of their relevance and credibility of the evidence they provided. The most relevant and useful source was a book by Christenbery, (2018), Evidence-based practice in nursing: Foundations, skills, and roles. This was a book published by a renowned company in New York, Springer Publishing. The author, Thomas L. Christenbery is a Ph.D. holder in nursing thus has a command of nursing practice and knowledge. He is also a registered nurse (RN) and a clinical nurse educator (CNE). The book was published in 2018 thus less than five years old and the content are up to date.

This source, therefore, meets the criteria in the rubric for the assignment. Other sources were also relevant and came in handy when needed to complement my plan with knowledge and information. Some, of these sources, were less than five years old but provided relevant evidence-based information for the development of my plan. The other sources that were older than five years were used in this plan because they met the other features of credibility save for the timing of their information. The articles had a clear methodology, the authors’ information was available, and had a good command of knowledge in the subject from their credentials given, the information was provided systematically and in standard English language.

I also used one website that came from the cystic fibrosis foundation cff.org. I deemed this source credible because, the information provided was relevant to my subject and the corporate author was a known organization providing knowledge and medical assistance about my subject issue, cystic fibrosis. NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based  Care References

  • Airway clearance techniques (ACTS). Cystic Fibrosis Foundation. (n.d.). Retrieved January 8, 2022, from https://www.cff.org/airway-clearance-techniques-acts#choose-what-s-best-for-you
  • Borowitz, D., Robinson, K. A., Rosenfeld, M., Davis, S. D., Sabadosa, K. A., Spear, S. L., Michel, S. H., Parad, R. B., White, T. B., Farrell, P. M., Marshall, B. C., & Accurso, F. J. (2009). Cystic Fibrosis Foundation evidence-based guidelines for the management of infants with cystic fibrosis. The Journal of Pediatrics, 155(6). https://doi.org/10.1016/j.jpeds.2009.09.001
  • Button, B. M., Wilson, C., Dentice, R., Cox, N. S., Middleton, A., Tannenbaum, E., Bishop, J., Cobb, R., Burton, K., Wood, M., Moran, F., Black, R., Bowen, S., Day, R., Depiazzi, J., Doiron, K., Doumit, M., Dwyer, T., Elliot, A., … Holland, A. E. (2016). Physiotherapy for cystic fibrosis in Australia and New Zealand: A clinical practice guideline. Respirology, 21(4), 656–667. https://doi.org/10.1111/resp.12764
  • Christenbery, T. L. (2018). In Evidence-based practice in nursing: Foundations, skills, and roles (pp. 356–357). Springer Publishing Company. NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care
  • Herbert, S., Rowbotham, N. J., Smith, S., Wilson, P., Elliott, Z. C., Leighton, P. A., Duff, A., & Smyth, A. R. (2021). Exploring the challenges of accessing medication for patients with cystic fibrosis. Thorax. https://doi.org/10.1136/thoraxjnl-2021-217140
  • Kirk, S., & Milnes, L. (2015). An exploration of how young people and parents use online support in the context of living with cystic fibrosis. Health Expectations, 19(2), 309–321. https://doi.org/10.1111/hex.12352
  • Lahiri, T., Hempstead, S. E., Brady, C., Cannon, C. L., Clark, K., Condren, M. E., Guill, M. F., Guillerman, R. P., Leone, C. G., Maguiness, K., Monchil, L., Powers, S. W., Rosenfeld, M., Schwarzenberg, S. J., Tompkins, C. L., Zemanick, E. T., & Davis, S. D. (2016). Clinical practice guidelines from the Cystic Fibrosis Foundation for preschoolers with cystic fibrosis. Pediatrics, 137(4). https://doi.org/10.1542/peds.2015-1784
  • Lilly, C. M. (2011). Hospital mortality, length of stay, and preventable complications among critically ill patients before and after Tele-ICU reengineering of Critical Care Processes. JAMA, 305(21), 2175. https://doi.org/10.1001/jama.2011.697
  • Martinez-Millana, A., Zettl, A., Floch, J., Calvo-Lerma, J., Sevillano, J. L., Ribes-Koninckx, C., & Traver, V. (2019). The potential of self-management mhealth for pediatric cystic fibrosis: Mixed-Methods study for healthcare and APP assessment. JMIR MHealth and UHealth, 7(4). https://doi.org/10.2196/13362
  • Norrish, C., Norrish, M., Fass, U., Al-Salmani, M., Lingam, G. S., Clark, F., & Kallesh, H. (2015). The cystic fibrosis symptom progression survey (CF-SPS) in Arabic: A tool for monitoring patients’ symptoms. Oman Medical Journal, 30(1), 16–25. https://doi.org/10.5001/omj.2015.04
  • Ratchford, T. L., Teckman, J. H., & Patel, D. R. (2018). Gastrointestinal pathophysiology and nutrition in cystic fibrosis. Expert Review of Gastroenterology & Hepatology, 12(9), 853–862. https://doi.org/10.1080/17474124.2018.1502663
  • Turck, D., Braegger, C. P., Colombo, C., Declercq, D., Morton, A., Pancheva, R., Robberecht, E., Stern, M., Strandvik, B., Wolfe, S., Schneider, S. M., & Wilschanski, M. (2016). Espen-Espghan-ECFS guidelines on nutrition care for infants, children, and adults with cystic fibrosis. Clinical Nutrition, 35(3), 557–577. https://doi.org/10.1016/j.clnu.2016.03.004

Assessment 4 Instructions: Remote Collaboration and Evidence- Based Care

Create a 5-10 minute video of yourself, as a presenter, in which you will propose an evidence-based plan to improve the outcomes for the Vila Health patient and examine how remote collaboration provided benefits or challenges to designing and delivering the care.

Introduction – NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

As technologies and the health care industry continue to evolve, remote care, diagnosis, and collaboration are becoming increasingly more regular methods by which nurses are expected to work. Learning the ways in which evidence-based models and care can help remote work produce better outcomes will become critical for success. Additionally, understanding how to leverage EBP principles in collaboration will be important in the success of institutions delivering quality, safe, and cost-effective care. It could also lead to better job satisfaction for those engaging in remote collaboration.

Professional Context

Remote care and diagnosis is a continuing and increasingly important method for nurses to help deliver care to patients to promote safety and enhance health outcomes. Understanding best EBPs and building competence in delivering nursing care to remote patients is a key competency for all nurses. Additionally, in some scenarios, while you may be delivering care in person you may be collaborating with a physician or other team members who are remote. Understanding the benefits and challenges of interdisciplinary collaboration is vital to developing effective communication strategies when coordinating care. So, being proficient at communicating and working with remote health care team members is also critical to delivering quality, evidence-base care. NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

Scenario

The Vila Health: Remote Collaboration on Evidence-Based Care simulation provide the context for this assessment.

Instructions – NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

Before beginning this assessment, make sure you have worked through the following media: Vila Health: Remote Collaboration on Evidence-Based Care.

You may wish to review Selecting a model for evidence-based practice changes. [PDF] and Evidence-Based Practice Models, which help explain the various evidence-based nursing models.

For this assessment, you are a presenter! You will create a 5–10-minute video using Kaltura or similar software. In the video:

Propose an 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.

Discuss the ways in which an EBP model and relevant evidence helped you to develop and make decision 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. 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. NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

The following media is an example learner submission in which the speaker successfully addresses all competencies in the assessment.

Exemplar Kaltura Reflection.

Please note that the scenario that the speaker discusses in the exemplar is different from the Vila Health scenario you should be addressing in your video. So, the type of communication expected is being model, but the details related to the scenario in your submission will be different.

Make sure that your video addresses the following grading criteria:

Propose an 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 an EBP model was used to help develop the care plan.

Reflect on which evidence was most relevant and useful when making decisions regarding the 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. NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

Refer to Using Kaltura as needed to record and upload your video.

Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@Capella.edu to request accommodations. If, for some reason, you are unable to record a video, please contact your faculty member as soon as possible to explore options for completing the assessment.

Additional Requirements for NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

Your assessment should meet the following requirements:

Length of video: 5–10 minutes.

References: Cite at least three professional or scholarly sources of evidence to support the assertions you make in your video. Include additional properly cited references as necessary to support your statements. APA reference page: Submit a correctly formatted APA reference page that shows all the sources you used to create and deliver your video. Be sure to format the reference page according to current APA style.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final capstone course. NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

Competencies Measured in NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.

Reflect on which evidence was most relevant and useful when making decisions regarding the care plan.

Competency 3: Apply an evidence-based practice model to address a practice issue.

Explain the ways in which an evidence-based practice model was used to help develop the care plan identifying what interventions would be necessary. This requires a particular evidence-based model, such as the Johns Hopkins, Iowa, Stetler, or other. NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

Competency 4: Plan care based on the best available evidence.

Propose an evidence-based care plan to improve the safety and outcomes for the Vila Health patient. Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.

Identify benefits and strategies to mitigate the challenges of interdisciplinary collaboration to plan care within the context of a remote team.

Communicate via video with clear sound and light.

The full reference list is from relevant and evidence-based (published within five years) sources exhibiting nearly flawless adherence to APA format. NURS-FPX4030 Assessment 4 Remote Collaboration and Evidence-Based Care

SCORING GUIDE

Use the scoring guide to understand how your assessment will be evaluated.

VIEW SCORING GUIDE