NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Name

Capella University

NURS-FPX 4030 Making Evidence-Based Decisions

Prof. Name

Date

Remote Collaboration and Evidence-Based Care

Hello, everyone. My name is Raven; today I’ll be talking about how evidence-based treatment and remote cooperation can work together to handle a patient’s case in a rural area successfully. The patient, a man with chronic obstructive pulmonary disease (COPD) who is 70 years old, faces limited access to specialized pulmonary care due to geographical constraints. I’ll explain how remote collaboration can effectively manage his COPD, utilize an evidence-based practice model to tailor his care plan and identify the most relevant evidence for developing this plan. Additionally, I will address strategies to overcome obstacles and challenges in interdisciplinary collaboration.

Evidence-Based Care Plan

To enhance the safety and results for the Vila Health patient, a remote team of healthcare experts has to collaborate to develop an evidence-based care plan. An interdisciplinary team of healthcare providers is included in the plan since the patient presents with symptoms such as a chronic cough, shortness of breath, and recurring respiratory infections. The pulmonologist advises starting bronchodilator therapy, which includes inhaled corticosteroids and long-acting beta-agonists. Clinical guidelines from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) approve this combination therapy. It improves lung function and reduces symptoms in COPD patients (Suissa, 2023). The pharmacist will ensure the patient understands the proper use of inhalers, review potential drug interactions, and educate the patient on the importance of medication adherence to prevent exacerbations and hospitalizations.

The respiratory therapist will continue conducting remote pulmonary rehabilitation sessions, including breathing techniques, advice on physical activity, and knowledge of worsening exacerbations. Studies have demonstrated that remote pulmonary rehabilitation can significantly enhance exercise tolerance, reduce breathlessness, and enhance COPD patients’ quality of life (Wedzicha et al., 2024). The therapist will track the patient’s progress and modify the exercises as necessary.The primary care nurse, Sarah, will schedule regular virtual follow-up visits to monitor the patient’s progress, assess symptoms, and make necessary adjustments to the treatment plan. These follow-ups will help detect issues early, allowing prompt intervention and continuous support (Cristina Rezende1 et al., 2023).

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Education is crucial for managing COPD effectively. The pharmacist and respiratory therapist will provide comprehensive education to the patient and his family about COPD, proper inhaler technique, lifestyle modifications, and recognizing early signs of exacerbations. This education will empower the patient to manage his condition more effectively and reduce the risk of complications (Yıldırım & Kaşıkçı, 2023). Given the patient’s rural location, telehealth technology will be leveraged to facilitate ongoing care. This includes video consultations, remote monitoring devices to track vital signs and lung function, and digital tools for symptom tracking (Cristina Rezende1 et al., 2023). Training the patient and his family on these technologies will ensure effective communication and monitoring.

Additional information and data that could have been useful include detailed medical history and previous treatments for COPD to understand what has or has not worked in the past. Moreover, a comprehensive assessment of the patient’s home environment must identify potential hazards or barriers to effective self-management. Furthermore, information on the patient’s access to technology and internet connectivity is crucial for implementing remote care solutions. Lastly, the data on the patient’s nutritional status and any other comorbid conditions that could impact his COPD management should be considered, along with insights into the patient’s support system, including family or community resources, to ensure he has adequate assistance at home.

Ways to Use and Apply Evidence-Based Practice Model

The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model was crucial in developing our care plan for the Vila Health patient with COPD. We followed the steps outlined in the JHNEBP Model: Posing a clinical inquiry, gathering data, analyzing and interpreting that data, fusing that data with patient preferences and clinical knowledge, and assessing the results (Hu & Whitney, 2023). Firstly, we formulated a clinical question based on the patient’s needs and symptoms, such as “What interventions are most effective in managing COPD symptoms in rural patients?” This helped guide our search for relevant evidence. Next, we conducted a thorough literature review to collect evidence from peer-reviewed journals, clinical guidelines, and research studies using different databases, including Google Scholar, PubMed, Cochrane Library, and CINAHL. We focused on finding evidence supporting interventions such as bronchodilator therapy, pulmonary rehabilitation, and patient education in managing COPD effectively.

We critically appraised the gathered evidence to assess its validity, reliability, and relevance to our patient’s case. This step ensured that we only incorporated high-quality evidence into our care plan. Integrating clinical knowledge with the evidence involved synthesizing the research findings with the knowledge and experience of our multidisciplinary team, including the pulmonologist, respiratory therapist, pharmacist, and primary care nurse. Together, we determined the most appropriate interventions tailored to the patient’s needs and preferences. Finally, we will evaluate the outcomes of our care plan by monitoring the patient’s progress through regular follow-up visits and assessing changes in symptoms, lung function, quality of life, and treatment adherence. Additionally, we will gather feedback from the patient and his family to determine their satisfaction with the care provided (Hu & Whitney, 2023).

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Ideas for evaluating the positive benefits to patient outcomes include using standardized measures measuring the quality of life and symptom intensity, such as the Modified Medical Research Council (mMRC) Dyspnea Scale and the COPD Assessment Test (CAT). A CAT questionnaire evaluates how a patient’s health is affected by (COPD). It assesses symptoms such as coughing up phlegm, dyspnea, chest tightness, and decreased activity. A straightforward grading system called the Modified Medical Research Council (mMRC) Dyspnea Scale measures how dyspneic COPD patients feel throughout different activities.

There are five grades, ranging from 0 (no dyspnea unless during vigorous exercise) to 4 (difficulty breathing to leave the house or during clothing or undressing) (Pisi et al., 2021).  We can also track objective measures such as spirometry results to assess improvements in lung function. Patient-reported outcomes, such as decreased frequency of exacerbations or improved ability to perform daily activities, will provide valuable insights into the effectiveness of our care plan (O’Donohoe et al., 2023). Regular communication and collaboration among the healthcare team will facilitate ongoing evaluation and adjustment of the care plan to optimize patient outcomes.

The Most Useful and Relevant Evidence in Making Care Plan

Reflecting on the evidence collected, the study by Cristina Rezende et al. (2023) was particularly relevant and useful for making decisions regarding the care plan. This resource provided comprehensive insights into how telehealth and telemedicine can effectively manage COPD patients, especially those in remote or underserved areas. The study highlighted several key points that directly informed our care plan. Firstly, it demonstrated the efficacy of telehealth interventions in improving patient outcomes post-hospitalization for COPD exacerbations. This reinforced our decision to leverage telehealth for continuous monitoring and follow-up visits. Additionally, the review emphasized the importance of patient education through telemedicine, aligning with our plan to provide thorough education on inhaler use, lifestyle modifications, and recognizing signs of exacerbations. The evidence supported the use of telehealth for ongoing symptom management, which is critical for our patients who experience chronic cough and shortness of breath. Moreover, the study underscored the value of telemedicine in increasing accessibility to specialized care for patients in rural areas, a significant factor for our patients with limited access to pulmonary care.

Applying the CRAAP criteria—Currency, Relevance, Authority, Accuracy, and Purpose—the study was highly current (2023), directly relevant to our patient’s telehealth needs for COPD management, authored by credible experts, and published in a peer-reviewed journal ensuring accuracy. The purpose was clear and unbiased, aiming to explore effective telehealth interventions. Utilizing this study strengthened our evidence-based care plan, providing a comprehensive and practical approach to remotely managing the patient’s COPD.

Benefits and Strategies to Mitigate Challenges of Interdisciplinary Collaboration

There are many advantages to interdisciplinary cooperation in a remote environment, including pooling diverse expertise, enhancing patient care, and improving outcomes through comprehensive care plans. For the COPD patient, this collaboration allowed the primary care nurse, pulmonologist, respiratory therapist, and pharmacist to integrate their specialized knowledge, leading to a tailored and effective treatment strategy. However, challenges such as communication barriers and coordination difficulties can arise. To mitigate these, one strategy is establishing regular, structured virtual meetings with clear agendas and defined roles for each team member, ensuring all voices are heard and all aspects of patient care are covered (Rubinger et al., 2020).

Another strategy is to utilize shared digital platforms for real-time updates and documentation, facilitating seamless information exchange and continuity of care (Watson & Wilkinson, 2022). Leveraging these strategies, interdisciplinary collaboration can be more effective and significantly enhance patient outcomes. For future care situations, better leveraging this collaboration could involve training all team members in telehealth technologies and communication best practices, ensuring a smoother, more efficient remote working environment (Jonasdottir et al., 2022).

Conclusion

In conclusion, remote collaboration and evidence-based care significantly improve the management of COPD in patients with limited access to specialized care, as demonstrated in our 70-year-old patient’s case. By leveraging the expertise of an interdisciplinary team and utilizing telehealth technologies, we developed a comprehensive care plan that includes bronchodilator therapy, remote pulmonary rehabilitation, and patient education. Applying the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model ensured a systematic approach to integrating high-quality evidence into our plan. We optimized patient outcomes by addressing challenges through structured virtual meetings, sharing digital platforms, and focusing on continuous evaluation using tools like the COPD Assessment Test (CAT) and the mMRC Dyspnea Scale. Future improvements in interdisciplinary collaboration can be achieved by enhancing team training in telehealth technologies and communication best practices, ensuring efficient and practical remote care delivery.

References

Cristina Rezende1, L., Geraldo Ribeiro1, E., Carvalho Parreiras1, L., Assunção Guimarães1, R., Maciel dos Reis1, G., Fernandes Carajá1, A., Batista Franco2, T., Patrícia de Souza Mendes1, L., Maria Augusto1, V., & Lara Silva1, K. (2023). Telehealth and telemedicine in the management of adult patients after hospitalization for COPD exacerbation: A scoping review. Jornal Brasileiro de Pneumologia, 49(3), e20220067. https://doi.org/10.36416/1806-3756/e20220067 

Hu, A., & Whitney, R. L. (2023). Evaluating the impact of an evidence-based practice education program in a nurse residency program on evidence-based practice beliefs, implementation, and competency. Journal for Nurses in Professional Development. https://doi.org/10.1097/nnd.0000000000000968 

Jonasdottir, K., Thordardottir, I., & Jonsdottir, T. (2022). Health professionals’ perspective towards challenges and opportunities of telehealth service provision: A scoping review. International Journal of Medical Informatics, 167, 104862. https://doi.org/10.1016/j.ijmedinf.2022.104862 

O’Donohoe, P., Reasner, D. S., Kovacs, S. M., Byrom, B., Eremenco, S., Barsdorf, A. I., Arnera, V., & Coons, S. J. (2023). Updated recommendations on evidence needed to support measurement comparability among modes of data collection for patient-reported outcome measures: A good practices report of an ISPOR task force. Value in Health, 26(5), 623–633. https://doi.org/10.1016/j.jval.2023.01.001 

Pisi, R., Aiello, M., Calzetta, L., Frizzelli, A., Tzani, P., Bertorelli, G., & Chetta, A. (2021). The COPD assessment test and the modified medical research council scale are not equivalent when related to the maximal exercise capacity in COPD patients. Pulmonology. https://doi.org/10.1016/j.pulmoe.2021.06.001 

Rubinger, L., Gazendam, A., Ekhtiari, S., Nucci, N., Payne, A., Johal, H., Khanduja, V., & Bhandari, M. (2020). Maximizing virtual meetings and conferences: a review of best practices. International Orthopaedics, 44(8), 1461–1466. https://doi.org/10.1007/s00264-020-04615-9 

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Suissa, S. (2023). Single-inhaler triple versus dual bronchodilator therapy for GOLD group E and other exacerbating patients with COPD: Real-world comparative effectiveness and safety. The European Respiratory Journal, 62(3), 2300883–2300883. https://doi.org/10.1183/13993003.00883-2023 

Watson, A., & Wilkinson, T. M. A. (2022). Digital healthcare in COPD management: A narrative review on the advantages, pitfalls, and need for further research. Therapeutic Advances in Respiratory Disease, 16(1), 175346662210754. https://doi.org/10.1177/17534666221075493 

Wedzicha, J. A., Allinson, J. P., & Calverley, P. M. A. (2024). COPD in the 21st Century. In Google Books. European Respiratory Society. https://books.google.com/books?hl=en&lr=&id=XPz5EAAAQBAJ&oi=fnd&pg=PA255&dq=remote+pulmonary+rehabilitation+in+copd&ots=tMOrVjqAgt&sig=n8Xzx_RYN09B6kz-R92AVTlf1L0 

Yıldırım, Z., & Kaşıkçı, M. (2023). The effect of education on self-care agency and rational drug use of patients with COPD. Patient Education and Counseling, 114, 107804. https://doi.org/10.1016/j.pec.2023.107804