Remote Collaboration and Evidence-Based Care

Capella University

Jesmin Stringer

Jamie Kraus

NURS-FPX4030

June 2, 2021

Remote Collaboration and Evidence-Based Care

Providing evidence-based care can be a challenge in any medical situation (Schmidt & Brown, 2017). However, it can be more challenging especially when the care is being provided remotely. Health care professionals should, therefore, collaborate with other health care personnel in different geographical regions to provide evidence-based quality care to patients who live in rural areas or have difficulties accessing a health care facility (Hardin, Kilian & Spykerman, 2017). This paper, therefore, discusses how health care professionals collaborate remotely and virtually to provide evidence-based care for patients.

Proposing an evidence-based care plan to improve the safety and outcomes for a patient based on the Vila Health Remote Collaboration 

Evidence-based care plans provide nurses with important clinical information and best clinical practices that have greater potential to improve patient outcomes and minimize errors by standardizing the provision of care. Caitlyn visited Vila Health Facility and was diagnosed with cystic fibrosis. Cystic fibrosis is a type of genetic disorder. It occurs as a result of a mutation of the protein gene that is present in the body cells that secretes mucus. This particular protein gene is called cystic fibrosis transmembrane conductance regulator (CFTR). Cystic fibrosis primarily affects the gastrointestinal, reproductive and respiratory tracts.

Evidence based-care plans that are implemented should improve the safety and outcomes of patients. An evidence-based nursing care plan for patients with cystic fibrosis should include maintenance of adequate oxygenation, coming up with measures to eliminate pulmonary secretions, emphasizing the significance of adequate dietary and fluid intake, ensuring adequate nutrition, and preventing further complications.

Oxygen therapy should be administered to a patient. Supplemental oxygen will assist in maintaining adequate oxygenation. The work of breathing will be decreased. Calorie expenditure will also be reduced. The patient will then be relieved of dyspnea. This will increase comfort. The nurse administering care to Caitlyn should set a goal of maintaining the percentage of oxygen saturation to be higher than 90%. This is likely to translate to positive patient outcomes.

Several measures can be used to clear pulmonary secretions. The most common effective measure is administering airway clearance therapy to the patients. This will decrease the work of breathing and improve pulmonary function. Caitlyn will then be able to maintain an open and clear airway. This will result in normal depth and rate of respiration, normal breath sounds, and an airway that is free of pulmonary secretions, with a cough that is effective. If all these are achieved, then the patient safety and outcomes will have been enhanced.

It is also important for a nurse to ensure that the patient’s nutrition is adequate. The nurse should encourage the patient to take food that is nutritious. Adequate nutrition is likely to increase appetite and weight. The patient will also be free of signs or symptoms of mal-absorption. This will also translate to improved patient outcomes.

There are several ways in which a nurse can prevent complications of cystic fibrosis. The nurse can assess the patient’s knowledge concerning nutritional requirements, pathophysiology and genetics of the disease, and recommendations for controlling the infection. The patient should be able to verbalize the process of the disease, goals of therapy administered and treatment recommendations. This will finally result in improved patient safety and outcomes that is characterized by improvement in infection and suppression of bacterial growth. The cough will decrease and mucus production will shift to baseline. Positive patient outcomes will also be characterized by normal white blood cell count and normothermia.

Explaining how an EBP model was used to help develop the care plan

The Iowa Model for Evidence-Based Practice was used to help develop the care plan. This is because this particular evidence-based practice model helps in promoting quality care by ensuring the implementation of an evidence-based care plan. The model was used to develop the evidence-based care plan by better addressing the issue concerning patient-centric care for nurses at all practice levels and guiding them through a multiphase, collaborative and team-based process. The path starts with a clinical “trigger” that identifies a problem concerning the provision of care. It also includes decision points with evaluative feedback loops when suggesting and implementing a practice change about the provision of care. The Iowa model outlines the characteristics of a standardized evidence-based care plan that should be implemented by nurses in all clinical settings. The phases of the Iowa model include in are inter-professional team formation; review, critique and synthesis of evidence; implementation of the change via piloting; ongoing evaluation; and dissemination of results. All these processes were also used when proposing the evidence-based care plan.

The evidence that was most relevant and useful when making decisions regarding the care plan included positive results of patient-centered care, culturally competent care and patient education. These pieces of evidence informed the choice of the evidence-based care plans. This is because these pieces of evidence provided accurate and reliable information concerning how care plans can be used to improve the outcomes and safety of patients. The shreds of evidence also provided information on the care plan that is cost-effective.

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

There are several benefits of interdisciplinary collaboration in remote settings. It leads to improvement in patient experiences and satisfaction. Medical errors are also reduced. This, in turn, improves the health outcomes of patients. Health care costs are also reduced. It also promotes coordination of care within the remote settings. Patients living in remote areas can access care.

There are various strategies to mitigate the challenges of interdisciplinary collaboration. Hierarchical structures that discourage interdisciplinary collaboration should be done away with (Supper et al., 2015). Professionals should be trained in interdisciplinary collaboration (Reeves et al., 2017). The interdisciplinary team should not be too large or too small. Interdisciplinary team members should be provided with enough resources as they work in remote areas. These resources can include financial resources and modern reliable technological equipment. The commitment of interdisciplinary collaborative team members should be emphasized. All these strategies are likely to mitigate the challenges faced by an interdisciplinary collaborative team tasked to work in remote areas.

Conclusion

Coordinating care can be challenging especially when a patient lives far from his/her care provider or when many health care providers are distant from each other. As discussed, nurses need to come up with evidence-based care plans. This is likely to quickly improve patient outcomes and safety. Modern technologies are necessary to provide quality evidence-based care to patients when care teams and patients are not in the same geographical location. Nurses and other health care personnel should develop creative solutions when challenges arise so that care planning for remote patients is as outcome-based and comprehensive as that for patients nearby or on-site.

Reflection Questions

How was remote collaboration used to improve the quality and safety of the care being provided in the scenario?

The patient was able to interact with a remote specialist and other health care providers via video-conferencing. The professional was able to remotely monitor the health status of the patient. The data obtained was used by the professional to suggest changes in a patient’s treatment and advise the patient to seek care. This resulted in an improvement in the safety and quality of the care being provided.

In what ways was evidence-based practice being effectively applied to help the patient in the scenario? Were there opportunities for improvement? If so, what were they?

The evidence-based practice was being effectively applied to help the patient in the scenario. EBP was used to keep the knowledge of the nurse up to date. This ensured that the nurse was able to deliver the care that is up to date. EBP was also used to enhance clinical judgment. The clinical decisions that were made by the health care professional were sound. EBP augmented the existing provider-patient decision-making process. The care provider-patient decision-making process was therefore made to be effective and efficient.

References

Hardin, L., Kilian, A., & Spykerman, K. (2017). Competing health care systems and complex patients: An inter-professional collaboration to improve outcomes and reduce health care costs. Journal of Interprofessional Education & Practice, 7, 5-10.

Lemberger, O., & Rossetti, J. (2018). An Integrative Review of Cross-Industry Global Innovation: Evidence-Based Strategies for Nursing Practice.

Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, (6).

Schmidt, N. A., & Brown, J. M. (2017). Evidence-based practice for nurses. Jones & Bartlett Learning.

Supper, I., Catala, O., Lustman, M., Chemla, C., Bourgueil, Y., & Letrilliart, L. (2015). Interprofessional collaboration in primary health care: a review of facilitators and barriers perceived by involved actors. Journal of Public Health, 37(4), 716-727.