Nursing Remote Collaboration and Evidence-Based Care
Over the years, patient care has primarily been done within the buildings of healthcare facilities. However, in the recent past and recent times, remote patient care and diagnosis have become increasingly prominent thanks largely to technological advancements and the increasing demand for better and improved healthcare.
As such, among the increasingly important competencies for nurses is the delivery of nursing care to patients remotely as well as having a good grasp of the best evidence-based practices. The key to the best remote patient care delivery may sometimes be an interdisciplinary collaboration which can effectively help in establishing functional communication strategies during the coordination of care (Ben-Pazi et al., 2018).
Therefore, as a nurse, an individual needs to be capable of collaborating with other health care team members and develop communication proficiency to effectively deliver evidence-based and quality care. This presentation focuses on an evidence-based care plan proposal that can improve patient outcomes and safety at the Vila Health Remote collaboration. Besides, appropriate evidence and evidence-based practice which guided the proposal will be discussed.
Summary Of The Evidence-Based Care
In today’s presentation, I will present the case of a 5-year-old, Pt Joseph, who has been diagnosed with a medical respiratory condition requiring the attention of medical professionals, and if not checked, has the potential of resulting in poor health outcomes and even death.
Even though the patient is living together with both parents and one sibling, they live over fifty kilometres from the nearest health facility that can help in offering the needed medical attention. Therefore, collaboration between various healthcare professionals is indicated.
Some of the professionals required to form the collaboration team include respiratory therapists, nurses, and the pediatrician. The pediatric nurse and the respiratory therapist have therefore resorted to using remote treatment and collaboration to take care of the patient using a healthcare unit located in the same Zip code as the patient.
The proposed evidence-based care plan for this patient is therefore analyzing various patient data to make an informed decision in the care and management of the condition and using telehealth and telemedicine in the care activities.
Using Evidence To Make Relevant And Effective Decision
Making decisions regarding a patient’s care plan may be challenging since there could be numerous complex factors at play. It is therefore important for the professionals to take their time and not only come up with the best decision regarding patient care plans but use evidence to support such a decision.
The patient, Joseph, needs a proper evaluation because the care to be offered must proceed from a remote location since this condition cannot wait any longer but needs immediate attention. In making the decision, the pediatric nurse has a great role to play, such as keeping the patient data and informing the doctor about the patient as well as the latest information regarding him.
The nurse proposed that Joseph needs daily care and treatment. To achieve this, Joseph’s parents must work in close collaboration with the care team so that they can be educated on the patient’s condition and the care plan.
Since the pediatric nurse has sufficient knowledge regarding nursing care, she has a deep understanding of telemedicine’s importance in offering patient care remotely. The nurse, therefore, took the initiative of checking the availability of internet access in the place where the patient lives.
The nurse obtained the information by sending queries to a social worker in the same clinic. She then inquired about the resources available at the patient’s home for evaluating what sort of assistance should be remotely offered to the patient.
During the home visit, the nurses assisted the parents with chest physiotherapy with the help of a physiotherapist. Using a camera through skype, they were then able to remotely examine the patient. By employing evidence-based strategies, the team was able to successfully diagnose the patient, making it easy to construct an effective care plan.
Since the patient’s remote clinic has stable internet, cell phones, and telephone, remote caring of the patient has been made easier. The patient will have access to an event monitor, which helps in data monitoring. The data collected can then be uploaded to the central analysis center for further analysis and decision support.
The Use of Evidence-based Practice model
Making care and treatment plans for a particular patient requires that the care team be conversant with the evidence surrounding the patient’s condition. Of great help is the evidence-based practice model. The care model which was used in drawing the care plan for the patient is the Johns Hopkins Nursing Evidence-based practice model.
This model permits appropriate and rapid use of the current best practices and research. Through the model, a multidisciplinary team was able to cultivate a culture of offering care based on the evidence available (Dang & Dearholt, 2017). Through the model, the team asks the appropriate question, like what is the best way of caring for the patient, looks for the current evidence, and embarks on translating the evidence into the care practice.
The current evidence available is that the condition can better be managed by frequent observation of passive activity monitor data, daily spirometry, blood oxygen data, weight and temperature. Telehealth and telemedicine can be appropriate when it comes to remote monitoring (Rodger & O’Hara, 2019).
Telemedicine and telehealth have been there since the 1970s but have since grown in prominence, especially during the Covid-19 pandemic. Telehealth and telemedicine allow nurses and other healthcare professionals and providers to talk to the patients via telephone, cell phone, or through the internet to monitor the patient’s wellness and recovery progress depending on the care plan developed, as well as talk about any existing and emergent concerns.
For this patient, some of the modalities include passive activity monitor data, daily spirometry, blood oxygen data, weight, and temperature. If the patient lacks close monitoring, his condition may quickly deteriorate. The use of evidence-based practice entails using expert opinion and information obtained from scientific research methods.
For example, before drawing the care plan, the intervening doctor made an appropriate diagnosis, and a recommendation was made for a cystic fibrosis plan. Evidence-based practice requires that a diagnosis is made prior to treatment and management.
Health outcomes and safety of the patient are also critical. Thus, in addition to ensuring that the outcomes are achieved, it is critical to engage a healthcare professional who is a specialist in strategies for patient safety.
Leveraging evidence-based practice allowed the nurse to establish a clear channel of communication to obtain valuable information regarding the safety of the place where the patient resides. Obtaining such information helps in choosing the best care for the patient, in line with the Johns Hopkins Nursing Evidence-based practice model.
Evaluating The Positive Benefits To Patient Outcomes
When a care plan has been drawn for a particular patient, it is vital to evaluate the positive benefits to the patient outcomes so that the care team can document what to adjust for better care outcomes. One of the ideas of evaluating the benefits is through feedback (Øvretveit et al., 2017) given by both the patient and the caregivers since the child is old enough to talk.
Since the parents, and especially the mother, is always with the patient, she can always note the patient’s progress by documenting response to the care plan drawn by the care team. Since education on medication adherence is one of the aspects of the care plan, it will be one of the indicators of a positive patient outcome. The care team will know whether the patient has been adhering to the medication regimen through the information given by the parents.
The other idea of evaluating the positive patient outcomes is through monitoring the patient’s vital data as transmitted to the data center for analysis. Among the most vital indicators will be the spirometry data, which will reflect how best the care plan is working to impact the patient’s respiratory system.
The Most Relevant Evidence
One of the decisions made when coming up with the care plan was to use telehealth and telemedicine. The patient lives far away from the health facility, hence faces transportation challenges that put him at risk of missing physician appointments. This could have negative impacts on the patient’s recovery process.
Therefore, telehealth and telemedicine come in handy as they can innovatively and excitingly help in delivering remote patient care as well as maximize the expected positive outcomes. The evidence of potential effectiveness of telehealth and telemedicine, especially in remote patient monitoring and care, informed the criteria used in the inclusion of telehealth and telemedicine in the care plan.
Benefits Of The Remote Collaboration In The Scenario
Even though the condition is largely regarded as a pulmonary condition, it is usually more than that as the patient also experiences other problems such as endocrine and gastrointestinal complications. Therefore, among the things that can greatly benefit this patient is a collaboration between various professionals.
Among the benefits of collaboration is that the patient will likely have consistent and ongoing care as served by various members of the care team without having to visit several care centers (Saint-Pierre et al., 2018). This benefit is especially important in this scenario since the patient and the parents live off the major city and therefore have a transportation problem.
Using telehealth allows real-time collaboration between the members of the care team. Patient care decisions that could have otherwise taken a longer duration in the absence of telehealth and telemedicine takes shorter duration as the opinion of every care team member is put into consideration in real-time.
Another benefit of collaboration in this scenario is reduced medication and medical errors. Since the condition is a serious one and needs consistent and persistent care, medication and medical errors may occur. However, with team collaboration, communication channels are well established, thereby assisting various members of the care team in eliminating such errors.
It is no secret that medication and medical errors have adverse patient outcomes and even death; therefore, strategies that help eliminate such errors, such as collaboration among healthcare professionals, should always be welcome.
Mitigate The Challenges Of Interdisciplinary Collaboration
Even though interdisciplinary collaboration can have an immensely positive influence on the patient care outcome, it has some challenges which must be mitigated if the purpose of the collaboration is to be achieved. One strategy of mitigating the interdisciplinary collaboration challenges is the use of an electronic health record system.
With a functional electronic health record system in place, each member of the collaborating team can appropriately access the system and accurately and effectively monitor the patient data. The members can therefore be in frequent communication with each other via communication technology as a way of correspondence. With efficient communication, the activities of the remote collaborating team are more likely result in improved patient outcomes.
Conclusion
Successful management of patients by leveraging telehealth and telemedicine rely extensively on evidence-based practice. Through EBP, nurses, in collaboration with other interdisciplinary professionals can draw an individual-based plan of care for a particular patient by integrating the most relevant and current research in coming up with vital decisions regarding patient care.
However, when not properly constituted, remote patient management through telehealth can result in errors and poor outcomes. To mitigate such challenges, the intervening multidisciplinary team must embrace care coordination to efficiently implement the drawn care plan.
References
Ben-Pazi, H., Browne, P., Chan, P., Cubo, E., Guttman, M., Hassan, A., … & Shalash, A. (2018). The promise of telemedicine for movement disorders: an interdisciplinary approach. Current neurology and neuroscience reports, 18(5), 1-10. https://doi.org/10.1007/s11910-018-0834-6.
Dang, D., & Dearholt, S. L. (2017). Johns Hopkins nursing evidence-based practice: Model and guidelines. Sigma Theta Tau.
Øvretveit, J., Zubkoff, L., Nelson, E. C., Frampton, S., Knudsen, J. L., & Zimlichman, E. (2017). Using patient-reported outcome measurement to improve patient care. International Journal for Quality in Health Care, 29(6), 1–6. doi:10.1093/intqhc/mzx108
Rodger, S., & O’Hara, K. (2019). Exploring the Potential for Technology to Improve Cystic Fibrosis Care Provision: Patient and Professional Perspectives. Proceedings of the ACM on Human-Computer Interaction, 3(CSCW), 1-26. https://doi.org/10.1145/3359223.
Saint-Pierre, C., Herskovic, V., & Sepúlveda, M. (2018). Multidisciplinary collaboration in primary care: a systematic review. Family practice, 35(2), 132-141. https://doi.org/10.1093/fampra/cmx085