Welcome everyone. Today I am going to talk about the Evidence-Based Practice into nursing today, particularly in our dynamic healthcare environment. We have a proposal for evidence-based initiation of a care plan in a patient diagnosed with the chronic obstructive pulmonary disease (COPD), at Vila Health. In which we are trying to meet the patient’s requirements and needs via remote collaboration. Remote collaboration has been followed by several advantages but also has some challenges (Zhou et al., 2021). In this video presentation, I will discuss advantages as well as associated disadvantages of the approach. Moreover, I am going to provide a detailed care plan that can improve the patient’s outcome based on interprofessional practice.
Patient Case Scenario
This is a 70-year-old male patient diagnosed with COPD, who lives in a rural area with limited access to specialized pulmonary care. As told by his primary nurse, Nurse Sarah, the patient goes through chronic cough, has difficulty in breathing, and seems to have respiratory infections so often. It clearly demonstrates the difficulties involved in helping patients with chronic diseases fully manage their conditions. This patient obviously does not have the facilities for ready health care, residing in a rural area; hence this calls for continuous monitoring and regular medication that give a general impression of the complex COPD management. In such a scenario, Nurse Sarah has to come up with an effective and feasible care plan with the help of an interdisciplinary team to care for their patient. Since COPD is a chronic condition, it must be managed cogently: medication, pulmonary rehabilitation, and patient education. In view of all these, the role of Nurse Sarah is very essential in the coordination of all these elements and in the delivery of holistic care to the patient who has respiratory infections and chronic symptoms for so long; this calls for a very robust evidence-based care plan, which provides for both the critical and chronic symptoms of COPD.
Evidence-Based Care Plan
An evidence-based care plan that integrates the best available evidence with clinical expertise and patient preference for chronic obstructive pulmonary disease (COPD) at Vila Health is proposed to address the needs of the patient. First, the diagnosis of COPD depends on a comprehensive assessment of the patient’s health through spirometry tests and history for symptoms and environmental exposures. Given this, it is possible to design a system for treatment according to the patient’s needs. Most probably this will correspond to bronchodilator therapy among others: long-acting beta-agonists and inhaled corticosteroids which help to increase lung function being able to decrease the severity of symptoms of exacerbation (Nici et al., 2020). The nurse, Sarah together with the team members, will implement these treatments into the care plan of the patient in such a way that all the needs for health maintenance of the patient will be satisfied. Medication management is also well taken care of in this treatment plan. The pharmacist makes sure that the patient uses his inhalers accurately and follows to his medication schedule. It also includes education on possible drug interactions and side effects, as well as on the importance of consistent medication use with this patient (Holman, 2020). The respiratory therapist will do video conferencing sessions, which will crucial on breathing exercises and instructions on physical activity and educating on how to self-manage the exacerbations. This should ideally improve the patient’s exercise capacity and quality of life. Both the physical and educational requirements come in regards to when in the management of a patient with COPD (Nici et al., 2020).
Further Information and Improvements
To further adapt the treatment plan, additional data would involve to make an effective care plan. For instance, continuous physiological health monitoring technologies can provide data through oximetric technologies and telehealth platforms. Information from real-time
monitoring can facilitate the need for timely interventions, which is a much-needed condition for optimal COPD management. Socioeconomic status and access to related health resources will describe the level of support services needed and possible access to health care issues (Nici et al., 2020). By being aware of the social and economic environment in which that patient exists, the care team could make the interventions much more realistic and attainable. Improvement will be tracked by interdisciplinary team meetings, so all involved health professionals will be on the same page and lookout for any problems that might arise, which would serve as an indicator to change the treatment plan. In this way, collaboration results in the updating of an existing care plan, ensuring that it stays up to date and effective, responsive to changing needs and circumstances. Also, when the patient is included in such discussions and his suggestions are taken into consideration, then the care plan becomes even more personalized, hence, acceptable and effective (Lewinski et al., 2022)
Practice Model for Care Plan
The care plan for COPD patient at Vila Health was designed based on the Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP). It is one of the most effective and very systematic frameworks to apply the best available evidence to practice (Dang et al., 2021). JHNEBP model identifies the clinical problem, review the relevant literature and guidelines, and integrate the clinical expertise and patient standards into the care. It is the evidence-based approach which would ensure that the care plan would not only reflect the nurse’s knowledge but also patient’s requirements and needs. In our study, we implemented the JHNEBP model and through deep understanding, we made informed decisions that were personalized specifically to patients’ needs and were effective in the management of COPD. This has been found to be quite effective in ensuring that client receives quality and standard care management as pointed out in
the COPD care management patient case. It will help the care team to ensure that the patient is suitably availed the most present and optimum working models at JHNEBP. By adopting this model, the care team can ensure that the patient is receiving the best available treatments and care (Dang et al., 2021).
Positive Benefits
The implementation of JHNEBP in care plan practice has many benefits that brings many positive effects on patient care. First, it ensures that patient is treated through highly recommended and researched interventions particularly in terms of outcome. Also, it enhances the reliability and consistency in clinical practice, hence decreases the variation in the delivery of care through minimizing errors. Furthermore, it enables the continuous assessment and improvement of care practices, promoting a culture of learning and improvement within the healthcare system. The development of an evidence-based plan of care leads to better involvement and adherence to the patient, in making decisions and being informed of what is important in the care of COPD. Therefore, it improves health outcomes and ads to the quality of life of the patient (Engle et al., 2021). Lastly, use of remote technologies in this model enable an interdisciplinary team to collaboratively work towards providing comprehensive and continuous care that provides for every possible aspect of the patient’s health and well-being (Nici et al., 2020).
Evidence Regarding Care Plan
The evidence-based care plan for patients with COPD at Vila Health is based on comprehensive research and clinical guidelines. Exacerbation management in COPD has been taken primary key factor in supporting better quality of life and a reduced need for hospitalization among patients. According to (Kvarnström et al., 2021) evidence-based
pharmacological therapy is the first line of management for COPD exacerbations. Long acting bronchodilators and the use of inhaled corticosteroids for the prevention and management of exacerbations is very effective according to guidelines Long acting bronchodilators is recommended for the purpose of maintaining the opening of the airways in order to reduce the frequency of exacerbations. Inhaled corticosteroids has been used to control inflammation and minimize severe symptoms in patients with repeated exacerbations. Combination inhalers are administered to patients with prevailing symptoms after single-drug treatment, and their medications would be reviewed or altered according to the response and adherence of the patient in the said plan (Kvarnström et al., 2021). Structured pulmonary rehabilitation improves exercise capacities and quality of life, which gives the patient the tools to deal with exacerbations. This plan propose to carry out the program of pulmonary rehabilitation that involves exercise training and breathing exercises as well as the provision of information about the management of this symptoms. The program is personalized for handling the physiological and psychological aspects of COPD. Re-assessments are normally carried out periodically to check on the progress, with modification to the program from time to time to ensure that it continues to offer benefits and reduce on exacerbations (Holman, 2020).
Telehealth can also be used for remote monitoring that is followed by timely interventions. (Nici et al., 2020) note that, telehealth promotes regular virtual communication and real-time assessment, which are very critical for the attainment of optimal exacerbation outcomes. This plan involves the scheduling of periodic tele-rehabilitation sessions to discuss symptoms, medications, and issues. Patients were given mHealth devices which include the remote monitoring gadgets, pulse oximeters and smart inhalers for real time monitoring of the patients’ vital signs as well as use of their prescriptions. These devices link information to health care providers for analysis and a fast response in the exacerbations. Patients instructed on the
proper use of the devices and on the need to report any changes in symptoms without delay. (Holman, 2020) states that major databases like PubMed and the Cochrane Library ensure that the developed care plan includes the most valid and newest research, resulting in clinical decisions. This plan allows recent studies on COPD exacerbation management guidelines and new guidance for specialists to update the care plan. By participating in professional development opportunities, healthcare professionals can know how newly introduced treatments and technologies operate. This will facilitate the sharing of insights for better patient care practices through interdisciplinary collaboration.
Rationale for Relevance
Relevance of study was checked in the care plan using the CRAAP test which integrates evidence-based practice. Authority is maintained through peer-reviewed publications, such as (Nici et al., 2020) and (Kvarnström et al., 2021), conducted by specialists in respiratory medicine. Nici et al. (2020) strongly supports evidence-based interventions individualized in the management of COPD with pharmacologic treatments and rehabilitation strategies fulfills the requirement of authority and relevance. Kvarnström et al. (2021) meet the requirements of relevance, currency and purpose by being written by researchers affiliated with reputable. Studies, like (Holman, 2020) confirm accuracy. This ensures that all interventions are solely based on valid research findings, critically essential while ensuring effective patient care reducing risk factors and improving quality life during COPD management.
Mitigation of Challenges Regarding Interdisciplinary Collaboration
One of the most challenging work is being an interdisciplinary team that collaborates remotely for COPD care plan. Remote collaboration and video-conferencing technology informs about every issue affecting the team and would not leave anyone behind, could be used to break
such barriers (Cazeau, 2021). A care coordinator will be used to assist in communication, resource allocation, and follow-ups for healthcare specialists, nurses and pharmacists, in this way all the members of the team will have the capacity to make a valuable contribution. Other ways that may be utilized to improve the effectiveness of the team include conducting several virtual seminar meetings, setting clear communication guidelines, and developing training meetings on how to effectively work in such a virtual team (Cazeau, 2021). These strategies ensure that all members of the team are aligned in a way that they can work together effectively. Technical issues need to be intervened in at the earliest point, and all members of the workforce need to be at ease with the technology as a necessity for proper coordination. Furthermore, training sessions on how to use communication and collaboration tools can enhance the performance of a team in working together. Clearly defined and assigned roles and responsibilities among team members will reduce probable risks in the implementation of care plans by ensuring that there are regular feedback sessions, in turn exhausting any issues that may arise. This structure to remote collaboration keeps most challenges at bay, ensuring that patients experience comprehensive and coordinated care (Johnson & Mahan, 2020)
Improving Outcomes
The mentioned interdisciplinary approach is concerned and deals comprehensively with every aspect of the patient’s health. Through remote collaboration, healthcare professionals will monitor and intervene accordingly so that optimal lung function remains maintained, while the complications that arise due to COPD are reduced. Patient education empowers the patient with knowledge and skills to better adhere to treatment procedures, hence improving the quality of life. Continuous assessment and the need to change care plans ensure that they are effective (Nici et al., 2020). The approach touches on long-term management and modification for COPD
patient, to the immediate urgent clinical needs. Continuously monitoring progression and changes that should to be done against the care plan ensures that the interdisciplinary team gives the patient the effective and up-to-date care. As a result interdisciplinary collaboration will prevent complications, promote treatment adherence, and overall quality of life (Dang et al., 2021).
Conclusion
An evidence-based care plan was developed for improving safety and outcomes for patients with COPD at Vila Health using the JHNEBP model. This plan included a combination of pharmacologic treatments, pulmonary rehabilitation, and education for the patient. Evidence was chosen by testing relevance and reliability using the CRAAP test. Remote technologies enabled seamless care through effective communication and interdisciplinary collaboration. By constant updating of this plan with the current evidence existed, the approach will improve outcomes in patients and enhance the quality of life for patients with COPD in Vila Health.
References
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Kvarnström, K., Westerholm, A., Airaksinen, M., & Liira, H. (2021). Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research. Pharmaceutics, 13(7).
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