NR341/342 Complex Adult Health RUA Interdisciplinary Management of Healthcare Technology Solved
NR341 342 Complex Adult Health RUA Interdisciplinary Management of Healthcare Technology Solved
Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.
- Choose a therapeutic modality or healthcare technology.
- Examples of a therapeutic modality include Extracorporeal Membrane Oxygenation, Automatic rotating pronation beds, right and/or left ventricular assist devices, nontraditional ventilator modes.
- Examples of healthcare technology can include regional O2 saturation monitoring (NIRS).
- Refer to your faculty member if your selection requires prior approval.
- Write a 4-5 page paper (not including the title page or reference page) using APA format.
- For APA, formatting, or grammar assistance visit the APA Citation and Writing page in the online library.
- Include the following sections (detailed criteria listed below and in the Grading Rubric): Introduction – 5 points/5%
- The chosen therapeutic modality or healthcare technology meets one of the following criteria: o Has been introduced recently at the bedside for care of the complex adult patient. o Is a non-traditional modality for very ill patients in special circumstances. o Is being used in a new way to treat a patient with complex needs.
The purpose of strategic planning in a health care environment is not only important in that setting but any business setting as this creates the foundation. It allows systematic approaches to any situation, especially with how complex or simple some procedures might be, this gives guidelines any of those situations. But as it can become more complex with each situation being different, there are planning committees that are available for each organization to help plan for any future issues. Factors that may affect future planning in an organization are budgeting, level of staff, time and level of care (Whitney, 2019). A useful tool in future planning is with the SWOT analysis, identifying the strengths, weaknesses, opportunities and threats to the the organization or the situation at hand. This can then help guide towards a decision that is needed to be made.
o Requires specific training above and beyond general entry-level nursing education.
- Introduce the therapeutic modality or healthcare technology.
NR341/342 RUA Interdisciplinary Guidelines V4 Revised: 11/6//2020 1
NR341 Complex Adult Health RUA Interdisciplinary Management of Healthcare Technology Guidelines
- Name the therapeutic modality or healthcare technology.
- A brief fictional case is used to illustrate the therapeutic modality or healthcare technology.
- Explanation and Background– 15 points/15%
- Include a clear description of the therapeutic modality or healthcare technology.
- Discuss how the therapeutic modality or healthcare technology works.
- Describe the patient population it is used for.
- Include medication, safety, and cost considerations as applicable.
- Risks and Benefits– 15 points/15%
- Describe how the therapeutic modality or healthcare technology can benefit the patient.
- Discuss ways to promote positive outcomes.
- Explain the complications that may arise.
- Discuss considerations for preventing complications.
- Interdisciplinary team’s Roles and Responsibilities– 20 points/20%
- Identify all interdisciplinary team members caring for the patient, such as respiratory therapy, assistive personnel, providers, case managers, clinical nurse specialists, and researchers.
- Describe the roles and responsibilities of each member of the healthcare team that is involved in the use of the therapeutic modality or healthcare technology.
- Discuss the roles and responsibilities of the nurse as a member of the interdisciplinary team caring for the patient.
- Nursing Scope of Practice – 15 points/15%
- Discuss the knowledge needed for the Registered Nurse to provide care for the patient using the therapeutic modality or healthcare technology.
- Describe skills needed for the Registered Nurse to provide care for the patient using therapeutic modality or healthcare technology.
- Discuss attitudes needed for the Registered Nurse to provide care for the patient using therapeutic modality or healthcare technology.
- Patient Education – 20 points/20%
- Describe the information to be taught to the patient and/or family.
- Discuss how information will be taught.
- Explain how the effectiveness of the teaching will be evaluated.
- Conclusion – 5 points/5%
- Provide a summary of the paper.
- No new information is introduced.
- Include additional resources for further learning.
- APA Style and Organization – 5 points/5%
- References are submitted with paper.
- Uses current APA format and is free of errors.
- Grammar and mechanics are free of errors.
- At least three (3), nursing, scholarly, peer reviewed, primary sources from the last 5 years, excluding the textbook, are provided.
Also Read: NR 452 W6 RUA Capstone Evidence Based Practice Solved
Ventilator associated pneumonia (VAP) is one of the commonest conditions that affects critically ill, intubated
patients. VAP is a bacterial infection of the airways that develops after 48 hours of intubation. VAP has a high prevalence with poor outcomes in critically ill patients such as mortality, increased cost of care and prolonged hospital stay. VAP bundles of care have been adopted to minimize the risk of intubated patients developing VAP. The bundles provide evidence-based guidelines on the management of the patients and use of aseptic interventions that minimize infections (Abad et al., 2021). An example of a patient requiring VAP bundle of care is a 40-year-old male patient who has been admitted to the intensive care unit due to inhalation burns. The patient has been intubated and is on mechanical ventilation. VAP bundle of care is adopted to guide the provision of care to the patient while in the unit. Therefore, this paper explores VAP bundle of care, risks and benefits, patient education, nursing scope, and roles of the interdisciplinary team members involved in caring for the patient.
Explanation and Background
VAP bundles are structured, evidence-based approaches to providing care to intubated patients. It entails the use of interventions such as deep venous thrombosis prophylaxis, elevation of the head of bed, daily assessment, peptic ulcer disease prophylaxis, and daily oral care using chlorhexidine (Burja et al., 2018). The VAP bundles of care reduce the risk and rate of VAP among intubated patients in the intensive care unit. It achieves the above outcome by ensuring the utilization of best practice interventions to ensure safety, quality, and efficiency in intubated, critically ill patients. VAP bundle of care is largely used in critically ill patients who will be intubated for more than 48 hours (Jadot et al., 2018). The modality is safe and effective for use in nursing practice. It is safe, as it is incorporated into the existing practices in the institution for enhanced quality and efficiency of patient care in the intensive care units (Klompas & Kalil, 2018). The cost of VAP bundle can be determined based on factors such as the duration of hospitalization in the intensive care unit, expenses incurred by patients, and changes in indicators of safety and quality of care such as mortality rate among intubated patients due to VAP.
Risks and Benefits
VAP bundle of care benefits the patients in several ways. One of the evident benefits of VAP bundle is the reduction and elimination of VAP in intubated patients. The reduction in risk and elimination of VAP enhances the care outcomes of the patients, as evidenced by quicker recovery when compared to no use of the VAP bundle (Vieira et al., 2020). VAP bundle also benefits patients by reducing their length of stay in the intensive care unit. VAP increases the duration of patient stay in the critical care units, as they require advanced, complex care to address their health-related needs (Vieira et al., 2020). The reduction of hospital stay also results in other benefits such as the minimization of costs incurred by the patient and the burden of the disease. VAP also reduces the risk of worse outcomes in patients such as mortality and loss of lung function due to VAP (Osman et al., 2020). Therefore, the adoption of VAP aims at ensuring safety, quality, and efficiency in the care of critically ill, intubated patients.
One of the ways of promoting positive outcomes with VAP bundles is training healthcare providers on its use. Training builds the competence they need in ensuring the provision of high quality care to patients. The other way of promoting positive outcomes entails creating culture of patient safety (Othman & Abdelazim, 2017). Organizational culture should underpin the adoption of quality and safety improvement initiatives such as VAP bundles to improve patient outcomes. The last way is ensuring consistency in use of the VAP bundle. Consistency ensures continuous quality improvement in the safety and efficiency of care given to intubated patients (Abad et al., 2021). VAP bundles have no evidence of complications. However, inconsistent use of the bundles in clinical practice may result in outcomes such as sepsis, pulmonary embolism, pulmonary edema, and barotrauma (Othman & Abdelazim, 2017). Therefore, considerations such as the initiation of prophylactic embolism and antibiotic treatment, consistency in the use of the bundle, and provider training should be implemented to prevent complications.
Interdisciplinary Team’s Roles and Responsibilities
The implementation of VAP bundle requires interdisciplinary approach. The interdisciplinary members often comprise of physicians, critical care nurses, respiratory therapist, and assistive personnel. Physicians intubate the patients and prescribe VAP bundle for use in patient care (Abad et al., 2021). They also prescribe medications that are utilized in ensuring the minimization of VAP in intubated patients. They also work in collaboration with the other team members in patient assessment, planning, implementation, and evaluation of care. Critical care nurses implement VAP bundle in patient care. They also administer medications implemented to prevent VAP. They also work in collaboration with other healthcare providers in assessing, planning, implementing, and evaluating the plans of care (Abad et al., 2021). Respiratory therapist performs chest exercises to help the clients in eliminating secretions. The assistive personnel provide additional patient care such as turning patients 2 hourly and patient feeding.
The nurse plays a number of roles as part of the inter-professional team member. The roles include patient assessment, planning, implementation, and evaluation of the effectiveness of VAP bundle. Nurses also educate other nurses and assist in the implementation of the care bundle. Nurses also communicate any concerns such as signs of VAP in the intubated patients. One of the challenges experienced in working in inter-professional team is the ambiguity in leadership. Often, the team members may lack understanding of the individuals tasked with leading the inter-professional care (Zijlstra et al., 2018). There is also the challenge of coordinating the care that each of the healthcare providers give to enhance care outcomes.
Nursing Scope of Practice
Nurses should possess knowledge in several areas in their implementation of VAP bundle. Firstly, they should be knowledgeable on the need of VAP bundle in patient care. They should also have knowledge in working in inter-professional teams. The nurse should also have the knowledge about the implementation of the bundle (Abad et al., 2021). Nurses should also be skilled in implementing the VAP bundle. They should also have skills of evaluating the effectiveness of the care bundle and recommend additional interventions to ensure elimination VAP in intubated patients. The nurse should also be skilled in assisting other providers in the implementation of the bundle. The nurse should have attitudes such as being curious to determine the effectiveness of care bundles and need for improvements (Abad et al., 2021). They should also be able to utilize reflection to improve on their practice.
Patient Education
Patient education in the use of VAP is largely not adopted due to the critical nature of their illness. However, patient education on ways of preventing pneumonia after intubation and discharge from the intensive care unit is important. Patient education focuses on aspects such as the importance of medication adherence, signs and symptoms of pneumonia, nutritional requirements, and deep breathing exercises. Patient education can be done using demonstrations and one-on-one educational sessions with the registered nurse. The evaluation of the effectiveness of education is done by asking relevant questions about prevention of pneumonia to determine the understanding of the patient.
Conclusion
VAP is a critical problem in intubated patients. VAP is preventable using VAP bundles of care. VAP bundles provide evidence-based practice interventions for preventing and minimizing VAP. Inter-professional care interventions are needed in the implementation of VAP bundles. Optimum outcomes are achievable with the consideration of interventions such as the use of best practice interventions and consistency in the implementation of VAP bundle. Therefore, nurses should explore the ways of ensuring the optimum outcomes of care by using VAP bundle.
References
Abad, C. L., Formalejo, C. P., & Mantaring, D. M. L. (2021). Assessment of knowledge and implementation practices of the ventilator acquired pneumonia (VAP) bundle in the intensive care unit of a private hospital. Antimicrobial Resistance & Infection Control, 10(1), 161. https://doi.org/10.1186/s13756-021-01027-1
Othman, A. A., & Abdelazim, M. S. (2017). Ventilator-associated pneumonia in adult intensive care unit prevalence and complications. The Egyptian Journal of Critical Care Medicine, 5(2), 61-63. https://doi.org/10.1016/j.ejccm.2017.06.001
Burja, S., Belec, T., Bizjak, N., Mori, J., Markota, A., & Sinkovič, A. (2018). Efficacy of a bundle approach in preventing the incidence of ventilator associated pneumonia (VAP). Bosnian Journal of Basic Medical Sciences, 18(1), 105–109. https://doi.org/10.17305/bjbms.2017.2278
Jadot, L., Huyghens, L., De Jaeger, A., Bourgeois, M., Biarent, D., Higuet, A., de Decker, K., Vander Laenen, M., Oosterlynck, B., Ferdinande, P., Reper, P., Brimioulle, S., Van Cromphaut, S., De Clety, S. C., Sottiaux, T., & Damas, P. (2018). Impact of a VAP bundle in Belgian intensive care units. Annals of Intensive Care, 8(1), 65. https://doi.org/10.1186/s13613-018-0412-8
Klompas, M., & Kalil, A. C. (2018). Rethinking Ventilator Bundles*. Critical Care Medicine, 46(7), 1201–1203. https://doi.org/10.1097/CCM.0000000000003173
Osman, S., Al Talhi, Y. M., AlDabbagh, M., Baksh, M., Osman, M., & Azzam, M. (2020). The incidence of ventilator-associated pneumonia (VAP) in a tertiary-care center: Comparison between pre- and post-VAP prevention bundle. Journal of Infection and Public Health, 13(4), 552–557. https://doi.org/10.1016/j.jiph.2019.09.015
Vieira, P. C., de Oliveira, R. B., & da Silva Mendonça, T. M. (2020). Should oral chlorhexidine remain in ventilator-associated pneumonia prevention bundles? Medicina Intensiva. https://doi.org/10.1016/j.medin.2020.09.009
Zijlstra, E., Lo Fo Wong, S., Teerling, A., Hutschemaekers, G., & Lagro-Janssen, A. (2018). Challenges in interprofessional collaboration: Experiences of care providers and policymakers in a newly set-up Dutch assault centre. Scandinavian Journal of Caring Sciences, 32(1), 138–146. https://doi.org/10.1111/scs.12439