Medicine: Interprofessional Collaboration Essay

Analytical Summary

The domain of healthcare has witnessed dramatic changes, especially about new information related to enhanced approaches and practices for better patient outcomes. To access and use this information for enhanced patient outcomes, healthcare providers need good interprofessional communication (IPC) and collaboration for effective coordination of patient care (Reeves et al., 2008). A growing body of research has been found asserting the importance of interprofessional education (IPE) in the domain of healthcare (Buring et al., 2009). IPE outlines the use of interactive learning methods such as seminars, discussions, workshops, and e-learning to effectively exchange information related to patient healthcare for better results. I have taken into account the patient’s history and their past experiences by interviewing them and having discussions with their families where possible. The summary integrates the important skills necessary for interprofessional practice and improving patient care.

Week 1 – Gastroenterology on a 60-year-old woman complaining of adnominal pain

The patient was diagnosed with emphysema, candidiasis Albicans, respiratory infection, knowledge deficit, and prone to anxiety to acute hospitalization. In the care plan for medical treatment for emphysema, I recommended steroid inhalation, bronchodilators, smoking cessation, and obtaining a baseline ABG. I gauged the patient’s knowledge of the illness and her approach to it. I explained the importance of compliance with medication when managing the disease process to the patient. I also felt the patient needed to be referred to social services or case management to find an alternative means for covering her medication.

Patient health care is a complex task, necessitating health care professionals and social workers to work together for better health outcomes among patients (Reeves et al., 2008). Enhancing patient healthcare outcomes necessitates interprofessional collaboration (IPC) and interprofessional education (IPE) (Reeves 2009). Research and literature suggest that IPE helps in the development of knowledge-based attitudes, attributes, and skills among healthcare professionals which enhance collaborative practice (Reeves, 2009). Reeves (2009) asserts that collaborative practices among healthcare professionals will produce positive healthcare outcomes due to the enhanced quality of patient care.

I considered two options – Referring the patient to a healthcare provider and referring to social services. Referring the patient to the healthcare provider helped her improve her adherence to completing medicinal regimes, probably due to a lapse of insurance coverage for her medication. Referral to social services will help her find an alternative means for covering her medication. Referring the patient to a social worker enhanced my IPE through interactive learning methods such as seminars, problem-based learning discussions, and other exchange-based learning methods.

The patient stated that she visits her primary care provider (PCP) 3-4 times annually but is unable to spend more time with her. Research confirms that communication barriers put patients at the risk for poor health outcomes through the providence of below-average health care treatments (Ratanawongsa et al., 2012). Since the patient stated that she can do much more to maintain her health and her PCP is busy, I put together several options to help her improve her health and increase her health knowledge. My research highlighted several options I could use to help the patient and achieve the best healthcare outcomes. These options are:

The Self-management Support Program

This allows the patient to individually assess herself through collaborative goal-setting, enhancement of self-care skills by providing access to healthcare-based resources (Ratanawongsa et al., 2012). The self-management support program showed promise of enhanced healthcare outcomes in the patient since she seemed motivated to improve her health. I began to research the available literature to find similar programs for the patient. However, during my research from journals and databases, I found that despite the demand for self-management programs, providing self-management support to patients requires high availability of resources, training and re-training staff members, huge investments in information technology, and designing specifically tailored programs to suit the diverse needs of patients (Fiscella & Geiger, 2006).

Patient-facing health information technology (HIT)

The HIT showed to be a promising program that suited my patient’s needs. I decided to use this program to help increase access of patients to self-management support (Schillinger et al., 2008). The program employs the use of the telephone to provide surveillance, education, and support to patients also termed automated telephone self-management (ATSM) (Schillinger et al., 2008). I found that the ATSM can be an excellent approach for my patient since it showed promise to promote collaborative goal setting by way of behavioral action plans which help patients accomplish short-term goals in self-management (U.S. Department of Health and Human Services, 2010). Research indicates that the employment of the ATSM strategy showed marked improvements in patients’ self-management behavior (Handley et al., 2008; Schillinger et al., 2008). I am confident of better outcomes in my patient’s health through the use of the ATSM.

Week 2 – Pulmonology patient

The patient was diagnosed with Emphysema, candidiasis Albicans, a respiratory infection. The patient showed a deficiency of knowledge and demonstrated anxiety to acute hospitalization. In my medical care plan, I proposed treatment including steroid inhalations bronchodilators, and smoking cessation. Obtaining a baseline ABG was also recommended. The patient demonstrated adherence to continual and complete medication, possibly due to a lapse of insurance coverage. I recommended referral to case management or social services to find alternative means for covering her medical expenses. Since the patient needed treatment for emphysema, I referred her to a pulmonologist.

The patient needed help from more than one health care professional. I used the interprofessional collaboration approach (IPC) which involves the active partnership between two health care professionals to effectively solve patient problems (Reeves, 2009). I provided her with information through various mediums such as verbal explanations, discussion, demonstration, and pictures to help her understand her health issue and foster optimal health outcomes by facilitating understanding. I referred her to a social worker so that we could work together to achieve optimal outcomes in interprofessional care in my patient (IPC) (Reeves, 2009).

Week 3 – Genitourinary Clinical Case Study

In week 3 patient of the Genitourinary Clinical Case Study, I obtained the patient’s history to determine his concerns and level of understanding of his illness. I found that he had no experience with cancer. Prostate cancer in males requires serious treatment involving severe side effects such as urinary incontinence and erectile dysfunction (Northouse et al., 2007). I confirmed if he knew his diagnosis and determined to see what his support systems were and how he would cope with stress. He was living with a spouse who I realized could be a primary caregiver to my patient. The spouse, as the primary caregiver can undergo much stress due to the complexity of the situation and the intimate nature of the disease (Northouse et al., 2007).

When providing education about the nature of the disease and the associated problems, I considered several aspects of the illness. The patient is living with his spouse who could be affected by the disease. Research confirms that the symptoms of prostate cancer can negatively affect the quality of life of patients as well as their spouses (Northouse et al., 2007). Studies indicate that psychosocial intervention can enhance the quality of life of cancer patients (Marcus et al., 2010). In keeping with my research findings, I suggested a family-based intervention plan which would help the patient as well his family cope with the stress of the disease.

The recommendation was based on the positive results of a study conducted with cancer patients to determine the efficacy of professional telephone counselors in psychosocial oncology to reduce stress related to the disease (Marcus et al., 2010). The intervention would help my patient’s spouse cope with the stress as primary caregiver (Northouse et al., 2007). I suggested they take an intervention program from an expert in oncology psychology. In the telephonic intervention program, a psychosocial oncologist would provide accurate information to the patient and the spouse and be responsive to their concerns (Northouse et al., 2007). Consultation sessions to patients as well as their spouses would offer systematically structured programs of care to help them cope with the effects of cancer (Northouse et al., 2007).

Week 4 – Cardiology Clinical Case

In week 4 of the Cardiology Clinical Case study of the patient, I recommended referral to a cardiologist. He complained of acute chest pain. Additionally, the patient reported smoking one packet of cigarettes daily. It was important to educate the patient about the harmful effects of smoking, considering his weak health condition. I informed him that the chemicals found in tobacco damage the vessels of the heart and cause atherosclerosis (Thrasher, 2012). The patient revealed that he did not have any exercise program; so I educated him about the importance of physical activity in reducing stress and blood pressure (Weekly News, 2013).

Patient history revealed that he was taking an unhealthy diet of pasta and fast foods. The patient lacked education on the importance of a healthy and low-fat diet for managing weight and symptoms of heart disease. With a BMI of 31.6 as compared to a normal BMI of 25 (Kee, 2013), the patient needed an education program to maintain weight and prevent further serious heart problems. The patient is diabetic and has a family history of diabetes, necessitating the need to be educated about the importance of maintaining blood sugar levels.

Nurses play an important role in providing education to patients (Stromberg, 2005). Nurses can begin to provide education to patients in hospitals or primary care as soon as the patient has been diagnosed (Stromberg, 2005). Stromberg (2005) explains the importance of repeated education due to a large amount of information to be given to patients. As such, I used different occasions to educate the patient about the importance of diet and exercise in taking care of his health.

I gave educational materials such as books, booklets, and links to web pages along with verbal education. I asked the patient to subscribe to newsletters so that he could access information on heart diseases, medications, and recommendations related to them. I understood that the patient is a knowledge deficit and needs an understanding of his health problem. I also considered telemonitoring as an effective educational intervention and enrolled the patient in one such program (Louis et al., 2003).

After accessing his understanding, I developed a therapeutic plan with him to increase his compliance with dietary measures and exercise regimes in his lifestyle. I asked him to maintain a logbook to record his diet and exercise regime.

Since the patient is dealing with a bedridden spouse, I engaged him in a community-based support group program that will help him release his emotions and reduce his levels of stress. Research affirms the importance of relieving stress and emotions as an essential therapy (Stress & Coping, 2010). I considered this important since the patient seemed lonely and was not in contact with friends, family members, or neighbors. Support groups will help the patient to adapt to his health conditions by gaining and receiving emotional support from peers in the group (Stress & Coping, 2010).

Week 5 – Musscoskeletal clinical case study

The patient, a 40-year-old Asian American male roofer complained of intense pain in the back and numbness in the toes. Stress and depression were visible as the patient worried about the inability to work in the future. The patient is divorced and considered to be a failure in marriage. He does not smoke but consumes alcohol on weekends and has a history of substance abuse, marijuana. He has bad dietary habits and eats his meals at fast-food restaurants.

He is a heavy consumer of caffeine and beverages. He has no exercise program and lacks knowledge about exercise. He expresses a desire to lose weight with the help of dieting but has no clue of how to go about it. He resides in a suburban community where he can access resources but lacks knowledge of these resources. His lab results show a mild degeneration of the lumbar vertebrae due to the high-intensity labor work he is engaged in. The MRI reveals a moderate disc bulge at L5: S1.

The patient needed to be informed about the importance of diet and exercise. He believed that his intensive work is sufficient exercise for his body. Keeping in mind the severity of his pain, I researched the database for therapies that would work for him and help control the degeneration of his vertebrae. I found that a variety of yoga programs have been developed and implemented in clinical and community settings for patients with musculoskeletal pain and degeneration (Reid et al., 2008).

The specific techniques used for breathing, stretching, and relaxation help in building strength and flexibility when practiced regularly (Reid et al., 2008). I suggested the patient enroll in a yoga program delivered by a qualified professional to reduce the pain as research indicated (Kolasinski et al., 2005). I found substantial literature on the use of yoga as an effective therapy program for the management of pain and stress is ever-expanding (Williams et al., 2005; Sherman et al., 2005).

My research for the patients provided me with the latest interventions, techniques, and therapeutic approaches to educating patients about their health conditions with the goal of better health outcomes. As a nurse, I would be able to intelligently use my available resources with the aid of my research. Knowing that resources can sometimes be few, research and investigation conducted by scholars would help me to utilize the available resources to the best potential and achieve the best possible goals of enhanced health outcomes in patients.

Instructional Worksheet – An Overview

Assessing the needs of the patient is an essential learning need. This includes understanding what the patient knows, what they need to learn, and their level of learning, understanding, and coping in the given situation. Some questions the nurse can get an overview of the patient are:

What is your average day like?
How long have you been ill?
What are your hobbies?
How do you spend your spare time?
What work do you do?
What are your primary concerns related to health?

Instructional Worksheet

References

Buring, S. M, Bhushan, A., Broeseker, A., Conway, S., Duncan-Hewitt, W., Hansen, L., & Westberg, S. 2009. Interprofessional Education: Definitions, student competencies, and guidelines for implementation. Am J Pharm Educ, 73(4), 59.

Fiscella, K., & Geiger, H. J., 2006. Health information technology and quality improvement for community health centers. Health Aff (Millwood), 25(2):405-412.

Handley, M. A., Shumway, M. & Schillinger, D. 2008. Cost-effectiveness of automated telephone self-management support with nurse care management among patients with diabetes. Ann Fam Med, 6(6):512-518.

Kolasinski S. L., Garfinkel, M., Tsai, A. G., et al. 2005. Iyengar yoga for treating symptoms of osteoarthritis of the knees: A pilot study. J Altern Complement Med, 11:689–93.

Louis A., Turner T., Gretton M., Baksh A. & Cleland J. 2003. A systematic review of telemonitoring for the management of heart failure. Eur. J. Heart Fail, 5:583-590

Marcus, A. C., Garrett, K. M., Cella, D., Wenzel, L., Brady, M. J., Fairclough, D., & Flynn, P. J. 2010. Can telephone counseling post-treatment improve psychosocial outcomes among early-stage breast cancer survivors? Psycho-Oncology, 19, 923–932. Web.

Northouse L. L., et al. 2007. Randomized Clinical Trial of a Family Intervention for Prostate Cancer Patients and Their Spouses.Cancer. Web.

Ratanawongsa, N., Handley, M. A., Quan, J., et al. 2012. Quasi-experimental trial of diabetes Self-Management Automated and Real-Time Telephonic Support SMARTSteps) in a Medicaid managed care plan: study protocol. BMC Health Serv Res, 12:22.

Reid, M.C., et al. 2008. Self-management strategies to reduce pain and improve function among older adults in community settings: A review of the evidence. Pain Medicine, 9(4), 409-424.

Reeves, S. 2009. An Overview of Continuing Interprofessional Education. Journal of Continuing Education in the Health Professions. Vol. 29, No. 3, pp. 142-46.

Reeves, S., Zwarenstein, M., Goldman, J., Barr, H., Freeth, D., Hammick, M., Koppel, I. 2008. Interprofessional education: effects on professional practice and health care outcomes.Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD002213. Web.

Schillinger, D., Hammer, H., Wang, F., Palacios, J., McLean, I., Tang, A., Youmans, S. & Handley, M., 2008. Seeing in 3-D: examining the reach of diabetes self-management support strategies in a public health care system. Health Educ Behav, 35(5):664-682.

Sherman, K. J., Cherkin, D. C., Erro, J., Miglioretti, D. L. & Deyo, R. A. 2005. Comparing yoga, exercise, and a self-care book for chronic low back pain. Ann Intern Med; 143:849–56.

Stress and Coping. (2001). Encyclopedia of Women and Gender: Sex Similarities and Differences and the Impact of Society on Gender. Web.

Thrasher, J. 2012. Heart disease; pictures effective in warning against cigarette smoking. Heart Disease Weekly, 575. Web.

U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. 2010. National Action Plan to Improve Health Literacy. Washington D.C.: U.S. Department of Health and Human Services.

Williams KA, Petronis J, Smith D, et al. 2005. Effect of Iyengar yoga therapy for chronic low back pain. Pain; 115:107–17.