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. 

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. 

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), 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), 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.

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), 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.

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). 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) 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) 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). 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 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 References

  • Airway clearance techniques (ACTS). Cystic Fibrosis Foundation. (n.d.). Retrieved January 8, 2022, from
  • 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).
  • 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.
  • 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.
  • 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.
  • 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).
  • 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.
  • 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).
  • 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.
  • 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.
  • 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.

Remote Collaboration and Evidence-Based Care Video Transcript Sample 2

Date Hi, my name is XXX. I am excited to discuss a topic that has revolutionized healthcare delivery: telehealth and other remote collaboration. We are on the frontline of a healthcare transformation in the modern period that eliminates geographical and temporal boundaries for patient outcomes. Envision a world where people live in remote locations, where access to medical care is further complicated by distance and busy schedules, yet have access to the care they require. With the help of telehealth, we can eliminate these barriers by establishing two-way video connections between medical professionals and their patients. The vast possibilities of remote collaboration will be discussed, emphasizing the remarkable effects of telehealth. I will look into how it helps those who, owing to distance or time constraints, cannot visit a hospital. As a community, we will be eyewitnesses to the revolution in healthcare as we use telehealth to make treatment more universal, affordable, and person-centered.

Background Information on the Patient

Caitlynn, now two years old, is a courageous girl who has faced hardship since birth. Caitlynn’s battle began immediately after birth when she developed meconium ileus, a blockage in her intestines. This unfortunate turn set off a chain cascade of problems with her respiratory system and general health. She has a respiratory rate of 32 breaths per minute and is breathing shallowly, and she has diminished breath sounds at the right bases and rhonchi in the upper lobes on assessment. Caitlynn’s difficulties are not confined to her breathing problems. She also has nutritional deficiencies due to malabsorption. She has been given a CF diagnosis as well. It is a chronic condition that presents additional challenges and requires constant attention and careful management. As we explore Caitlynn’s case today, we have the unique chance to learn about the relationship between Caitlynn’s medical issues, her treatments, and her remarkable resiliency. We can learn a lot about how healthcare workers can help patients with cystic fibrosis live better lives from her experience.

An Evidence-Based Plan of Care

Caitlynn needs an evidence-based care plan to guarantee her well-being and improve her chances of success. This strategy will accommodate her unique requirements while considering the most recent developments in cystic fibrosis treatment. Caitlynn deserves the best care possible, so we will use a holistic, interdisciplinary approach to improve her quality of life. The approach prioritizes respiratory care, emphasizing improving Caitlynn’s breathing. To improve airway clearance, the viscosity of mucus, and pulmonary function, regular chest physiotherapy, airway clearance procedures, and nebulized drugs, including hypertonic saline and bronchodilators, are essential (Dickinson & Collaco, 2021).

Caitlynn’s care plan also includes measures to improve her nutrient absorption. A high-calorie, high-protein diet will be required to improve nutritional absorption. Caitlynn’s nutritional health will be monitored regularly by measuring her height and weight to calculate her body mass index (BMI). Caitlynn’s high susceptibility to respiratory illnesses needs careful attention to infection prevention measures. This will involve promoting a healthy environment, encouraging regular vaccinations, and enforcing stringent hand hygiene practices. Antimicrobial agents and antibiotics medications will be incorporated into the plan to tackle multidrug-resistant infections and reduce exacerbations (Dickinson & Collaco, 2021).

Caitlynn’s emotional health and quality of life will be affected by cystic fibrosis, so the care plan will include psychosocial support. Caitlynn and her caregiver can take advantage of counseling and community resources. We could use telehealth platforms to offer remote psychological help, expanding access to mental health care beyond physical borders. We hope to offer Caitlynn extensive and individualized support by incorporating these elements into her treatment plan. The multidisciplinary aspect of the strategy improves her health and quality of life by addressing her respiratory wellness, dietary requirements, preventing infections, and psychosocial well-being.

More information on baseline assessments is vital to develop a comprehensive care plan for the patient. Baseline assessments help the healthcare providers have a snapshot of the patient’s general well-being and act as reference points to ascertain the patient’s progress and identify areas needing further interventions. A complete respiratory function baseline assessment is crucial as she has been diagnosed with cystic fibrosis. Pulmonary function tests (PFTs), including lung volume measurements and spirometry, can be used to determine her lung capacity, gas exchange, and airflow. These tests can help healthcare providers determine the extent of airway obstruction and help select the appropriate therapies. 

Existing complications of comorbidities associated with cystic fibrosis should also be assessed. Chronic lung infections should also be assessed to guide preventive and management measures. The nutritional status assessments, such as the measurement of the BMI, can provide information on the growth patterns and her overall nutritional status. Her body composition, especially fat and mass distribution information, can help to tailor a high protein and calorie diet to enhance the absorption of nutrients.

The Stetler Model

Caitlynn’s evidence-based treatment plan was developed using the Stetler Model, which provided a helpful framework for systematically incorporating the latest research and best practices. There are various steps in the model. During the first step, Preparation, the care team compiled data from reliable sources like research, recommendations, and professionals’ perspectives. They worked together to pinpoint the most pressing issues, which included respiratory therapy, food safety, disease prevention, and emotional well-being.

The obtained evidence was then subjected to extensive analysis in the Validation phase to determine its reliability and usefulness in Caitlynn’s situation. To ensure the evidence’s reliability, the team assessed the research papers’ quality, their results’ uniformity, and the sources’ validity. After identifying potential interventions and methods, a comparative evaluation was conducted. The team considered the therapies’ possible benefits, drawbacks, and effects on Caitlynn’s well-being. Each intervention’s benefits and drawbacks were weighed, and the quality of supporting evidence was considered.

During the Decision-Making phase, Caitlynn’s care team deliberated and settled on the interventions they would implement. Caitlynn’s specific needs and preferences were considered throughout the decision-making process. During the Translation/Application stage, the chosen interventions were made into doable procedures. The care team created protocols and recommendations for better respiratory treatment, nutritional assistance, infection control, and psychological support. Caitlynn’s care plan met all her needs, was realistic, and was thorough.

Finally, there was a Continuous Evaluation of the care plan’s efficacy. Caitlynn’s safety, medical outcomes, and general well-being were regularly evaluated, attributable to accurately tracking her reactions to the therapies. Caitlynn’s progress and new information were used to adjust the treatment plan regularly. Using the Stetler Model, the care team increased Caitlynn’s safety and improved her health outcomes by creating an evidence-based, evolving care plan sensitive to her shifting needs.

Evidence Collected

It was noted that the parents work for long hours and that they live at a great distance away from the hospital. Individuals who work long hours have limited availability during the hours they are supposed to attend their appointments. Caitlynn’s parents may be unable to take her to the clinic due to work, leading to delayed diagnosis and management of complications. Long distances from the hospitals consume time and resources to reach the facilities, especially for individuals without private transportation. 

The time taken to commute to these facilities may lead to deferred medication attention or rescheduling of appointments, which may lead to adverse health consequences. These factors make it challenging for the parents to come physically to the hospital, prompting remote collaboration by using technology like Skype to conduct appointments with the healthcare providers. Evidence by Manocchia (2020) concludes that telehealth has been determined to provide patients with services remotely by overcoming the geographical barriers that prevent access to timely healthcare services. 

Studies by O’Connor and Bowles (2020) established that offering patients care remotely through the use of technology like Skype can reduce the number of rehospitalizations and improve the satisfaction of the patients and their healthcare providers. This technology reduces the costs incurred through transportation to the hospital and admission fees. It saves the time spent traveling to the hospitals, which can be used productively in other areas. The patients can receive care in a familiar environment, promoting comfort and helping quick recovery.

Benefits and Strategies to Mitigate the Challenges of Interdisciplinary Collaboration

Interdisciplinary collaboration’s ability to bring together a variety of knowledge is one of its main advantages. The participation of experts from a wide range of professions enhances care planning. With this all-encompassing method, the patient’s demands may be evaluated in their totality, guaranteeing that every facet of their health is considered. In addition, working together across disciplines encourages innovative approaches to issues (Specht & Crowston, 2022). Innovative ideas can be found and executed through the collaborative efforts of a team. Care planning is improved, and patient-centered outcomes are encouraged due to this group effort.

Effective communication becomes crucial to overcoming the difficulties of remote transdisciplinary collaboration. Video conferencing and real-time messaging are communication tools that can improve efficiency and teamwork. Each member of the care planning team must be aware of their particular role and what they are expected to do before getting started. Virtual team meetings allow for regular communication, updates, and ideas exchange. Structured agendas and open conversations facilitate collaboration, which enables team members to align their efforts better and tackle difficulties as a unit (Farias et al., 2019). In addition, team members can review, contribute to, and adjust care plans in real time using shared document repositories or collaboration platforms.

Facilitating smooth information flow and reducing communication gaps among a remote team requires the establishment of defined communication guidelines, including response times and preferred channels. These methods allow interdisciplinary teams to collaborate effectively despite being separated by distance, leading to better patient outcomes even in remote locations.


Dickinson, K. M., & Collaco, J. M. (2021). Cystic fibrosis. Pediatrics in Review, 42(2), 55–67.

Farias, F. A. C. de, Dagostini, C. M., Bicca, Y. de A., Falavigna, V. F., & Falavigna, A. (2019). Remote patient monitoring: A systematic review. Telemedicine and E-Health, 26(5).

Manocchia A. (2020). Telehealth: Enhancing care through technology. Rhode Island Medical Journal (2013), 103(1), 18–20.

O’Connor, M., & Bowles, K. H. (2020). Telehealth and mHealth. Research in Nursing & Health, 44(1), 3–4.

Specht, A., & Crowston, K. (2022). Interdisciplinary collaboration from diverse science teams can produce significant outcomes. PLOS ONE, 17(11), e0278043.

Also Read: NURS-FPX4030 Assessment 3 Example