Introduction
Remote care, diagnosis, and collaboration are becoming common practices in the healthcare industry. With the expansion of technology and the internet, nurses are now expected to perform digital consultations. The presented scenario features a pediatric patient admitted to the Valley City Regional Hospital. However, her family lives an hour away in McHenry, North Dakota. Since the respiratory therapist is concerned about how well the patient’s parents will be able to handle day-to-day treatment, the personnel at the hospital arrange online consultations with a pediatrician and social worker in McHenry. A transcript of their conversations reveals how evidence-based models can help remote workers deliver quality, safe, and cost-effective care.
Patient Background
Firstly, it is necessary to provide some background on the patient. Caitlyn Began is a two-year-old patient that came into the emergency room last night for pneumonia. This is her second admission for pneumonia in the last six months, and she was born with a meconium ileus condition. Her other symptoms include decreased breath sounds, rhonchi scattered in the upper lobes, and decreased subcutaneous tissue in her extremities. Caitlyn’s respiration is 32, with a temperature of 101 and 65 milliequivalents per liter on a sweat chloride test. She was diagnosed with cystic fibrosis at the hospital and treated with an intravenous injection of piperacillin, pancreatic enzymes, and dornase alfa. She is recommended to adopt a high-protein, extra-calorie diet and fat-soluble vitamins. Caitlyn is at risk for another pneumonia infection and bowel obstruction, and her health status depends on her day-to-day treatment.
Evidence-based Plan
Secondly, the evidence-based plan used to improve Caitlyn’s safety and outcomes is the IOWA Model of EBP. This model focuses on how the healthcare system implements decisions based on available research and evidence (Christenbery, 2017). Its essential steps include identifying a need for change, forming a team, finding credible and reliable evidence, and piloting the practice change (Christenbery, 2017). If the pilot change is successful, widespread implementation with continual monitoring at the organizational level follows (Gawlinksi & Rutledge, 2008). Based on this model, an interdisciplinary team composed of two pediatricians, a pediatric nurse, a respiratory therapist, and a social worker was assembled to evaluate Caitlyn’s state. The team developed an effective, patient-centered treatment plan through inter-professional questioning and collaboration.
Relevant Evidence
The medical interventions in Caitlyn’s case were based on relevant and credible evidence. Firstly, she was diagnosed with pneumonia due to cystic fibrosis, for which piperacillin is the first-line antibiotic in cases of respiratory infections (Mathews et al., 2018). Secondly, dornase alfa is a widely used mucolytic that reduces mucus viscosity in the lungs in the same cases (Yang & Montgomery, 2021). Thirdly, Caitlyn weighed 20.7 pounds at the age of two years, and there was subcutaneous tissue in her extremities, which pointed to the malabsorption of nutrients. Eighty to ninety percent of cystic fibrosis patients need pancreatic enzyme replacement therapy to overcome malnutrition (Somaraju & Solis-Moya, 2020). Piperacillin, dornase alfa and pancreatic enzymes are evidence-based interventions for respiratory infections and malnutrition in cystic fibrosis.
Benefits and Challenges of Remote Collaboration
An effective evidence-based plan was implemented for Caitlyn through remote collaboration. This approach’s benefits include coordinating treatment regardless of geographical barriers and ensuring care continuity. Furthermore, communications technology facilitates seamless inter-professional collaboration, improving the quality of care and reducing medical errors. However, the remote collaboration also presents a few challenges that may be detrimental to patients. Firstly, scattered communication channels mean professionals might be confused about whether to text, call, Skype, or utilize telemedicine equipment in order to contact a colleague. Secondly, it is more difficult to perform check-ins and updates since there is no face-to-face contact and remote communication has to be planned in advance. Thirdly, an unclear hierarchy of inter-professional teams may lead to role confusion. Scattered channels, irregular check-ins, and role confusion are the drawbacks of remote collaboration in healthcare.
Strategies to Mitigate Collaboration Challenges
Several strategies can be implemented to mitigate these challenges. Firstly, the healthcare industry needs to create a single digital workplace platform or application for a more efficient working environment and unified communication system. There can be a drop-down menu that professionals press to signal that they want to talk to a specific colleague. Secondly, this same platform should have a management plan with a consistent schedule of check-ups. Employees can be trained to upload updates on this platform regularly using the same format. Thirdly, the team should assign roles and responsibilities during the discussion and document them if possible. Creating a digital workplace platform and clear role delineation will mitigate the challenges of remote collaboration.
Conclusion
In conclusion, evidence-based practices are essential for improving health outcomes. Caitlyn’s case was resolved according to the IOWA model, which focuses on providing patient-centered care through interdisciplinary collaboration. A team composed of two pediatricians, a pediatric nurse, a respiratory therapist, and a social worker was assembled remotely to propose a treatment plan for Caitlyn based on credible and relevant evidence. While remote collaboration has many benefits, it is still in its infancy. It presents many challenges, a few of which can be mitigated by creating a digital workplace platform.
References
Christenbery, T. L. (2017). Evidence-based practice in nursing: Foundations, skills, and roles. Springer.
Gawlinski, A., & Rutledge, D. (2009). Selecting a model for evidence-based practice changes: A practical approach. AACN Advanced Critical Care, 19(3), 291-300. Web.
Mathews, N., Zayed, S., Winters, N., Lands, L. C., Shapiro, A. J., Côté, J., & Quach, C. (2018). Evaluation of the safety of piperacillin/tazobactam use in admitted pediatric patients with cystic fibrosis. Official Journal of the Association of Medical Microbiology and Infectious Disease Canada, 3(2), 93-99.
Somaraju, U. R. R., & Solis-Moya, A. (2020). Pancreatic enzyme replacement therapy for people with cystic fibrosis. Cochrane Database of Systematic Reviews.
Yang, C., & Montgomery, M. (2021). Dornase alfa for cystic fibrosis. Cochrane Database of Systematic Reviews.