NR341 Complex Adult Health Interdisciplinary Management of Healthcare Technology Guidelines Essay

NR341 Complex Adult Health Interdisciplinary Management of Healthcare Technology Guidelines Essay

NR341 Complex Adult Health Interdisciplinary Management of Healthcare Technology Guidelines Essay

Pronation Bed

The pronation bed is one of the recently introduced healthcare technologies. It is used in pronation therapy, whereby patients are put in a prone position where they lie flat on the abdomen. It is a specialty acute care bed designed to turn a patient to a prone position using slow, gentle movement (Cater et al., 2020). For example, a patient is admitted to the ICU with acute respiratory distress syndrome (ARDS) and is on mechanical ventilation. The patient must be positioned prone to improve response to PEEP and oxygenation. A pronation bed will be used to keep the patient prone rather than manually positioning the patient (Mitchell & Seckel, 2018). The purpose of this paper is to describe the pronation bed, including its benefits, risks, interdisciplinary team approach, and patient education.

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Explanation and Background

The pronation bed allows for a safe and gentle patient repositioning using air-filled modular inflatables that allow patients to be managed in a prone position. It has fixed spaces for the management of ventilation equipment and IV lines. It has a tube management system that allows the bedside nurse staff to securely place endotracheal tubes and invasive lines avoiding entanglement and separation (Cater et al., 2020). Besides, it has fasteners that secure the patient into the bed, which promotes a safe and smooth shift from supine to prone with the help of fewer health providers compared to manual positioning.

The pronation bed has built-in safeguards that remind the provider of key safety measures before repositioning. The pronation bed is used in critically ill patients with ARDS and who are on mechanical ventilation. Putting ARDS patients in a prone position facilitates increased oxygenation because the heart rests on the sternum, promoting increased expansion in the bronchioles and upper lung lobes (Mitchell & Seckel, 2018). Sedated patients on ventilation remain prone in the pronation bed for about 16 hours a day.

Risks and Benefits

One of the benefits of the pronation bed is that it leads to a statistically marked improvement in oxygenation after prone positioning patients on ARDS. This is because the pronation bed rocks backward and forward, alleviating pressure from fluid-filled lungs (Mitchell & Seckel, 2018). Besides, the pronation bed uses less labor to position patients since it uses touch screen controls, which program several intervals of automated prone therapy. The pronation bed also requires less staff to position the patient, which can be done by one staff, unlike manual positioning. Another benefit is that patients on pronation beds can rotate laterally to either side, which lowers the risk of ICU-acquired infections (Cater et al., 2020). Furthermore, the pronation bed facilitates fast CPR since the patient can be turned supine in less than 40 seconds.

Positive outcomes can be achieved by using digital meters, which monitor the daily and cumulative pronation therapy time. The nurse can use the hand control to monitor lines and tubes when shifting from supine to prone. The pronation bed has not been associated with any risks or complications since it helps eliminate the risks of manual pronation therapy, which causes physical injury to providers and the patient (dos Santos et al., 2022). Nonetheless, the key issue is preventing pressure ulcers on the skin since a patient remains in one position for about 16 hours. Foldable pillows can be used to protect the most sensitive areas to pressure ulcers.

Interdisciplinary Team’s Roles and Responsibilities

An interdisciplinary team approach is used when managing ARDS patients on mechanical ventilation and in a pronation bed. The team will include a nurse, respiratory therapist, physician, and support staff. The nurse removes monitor leads on a patient’s chest when on the lateral decubitus side (Ceruti et al., 2021). The nurse also prepares towels for padding, and the monitor leads to position on the patient’s back after pronation. Besides, the nurse assesses the patient’s skin for any signs of pressure ulcers and provides skin care.  

The respiratory therapist provides respiratory care and secures the patient’s head and endotracheal tube when turning to a prone position. The physician monitors the patient’s status, plans treatment, and evaluates it (Ceruti et al., 2021). Furthermore, the support staff are responsible for helping the nurse when positioning the patient and ensuring any equipment needed is available. The nurse’s role in the interdisciplinary team is to be the patient’s advocate and ensure that high-quality and safe interventions are used to promote better health outcomes (Ceruti et al., 2021). Besides, the nurse can take the leadership role in the team, which involves delegating tasks to team members and ensuring that all members perform their tasks.

Nursing Scope of Practice

The registered nurse (RN) providing care to a patient on a pronation bed should have a broad knowledge of the various patient positions and be skilled in positioning patients in these positions. Besides, the RN should know about managing patients with ARDS using the nursing process (Qadri et al., 2020). They should have knowledge of interpreting ABGs, which helps determine a patient’s respiratory status. In addition, the RN should demonstrate skills like performing a head-to-toe assessment, monitoring oxygen saturation, and performing microturns of the head. The RN should also be able to assess the security of an endotracheal tube and pressure points and provide skin care (Qadri et al., 2020). Furthermore, the RN should demonstrate an empathetic and caring attitude when caring for patients on pronation therapy.

Patient Education

Patient education regarding the pronation bed will be provided to the patient and the family. They will be educated about the patient’s oxygenation problems and the reason for using a pronation bed. Besides, they will be informed of the perceived benefit, the anticipated response, frequency of assessments, and parameters for discontinuation from the pronation bed (Mitchell & Seckel, 2018). The nurse will also explain the features of the pronation bed using layman’s language and the procedure for positioning the patient in a prone position. The patient education will be conducted through demonstrations, and the nurse will encourage questions and answer them as they come up. Furthermore, the nurse will provide culturally appropriate education based on the patient’s desire for knowledge, readiness to learn, and overall neurologic state. The teach-back method will be used to evaluate the effectiveness of the teaching by the nurse by asking the patient and family members to repeat what they have learned in their own words.

Conclusion

A pronation bed facilitates proper positioning and turning of patients, which minimizes pressure ulcers. Pronation therapy is provided when a patient requires additional assistance with lung expansion because of reduced oxygenation. The interdisciplinary team is mandated to ensure proper and safe pronation therapy for ARDS patients being managed on a pronation bed. Patients and families should be educated on the reason for pronation therapy, benefits, outcomes, and discontinuation.

References

Cater, D. T., Ealy, A. R., Kramer, E., Abu-Sultaneh, S., & Rowan, C. M. (2020). The Use of a Kinetic Therapy Rotational Bed in Pediatric Acute Respiratory Distress Syndrome: A Case Series. Children, 7(12), 303. https://doi.org/10.3390/children7120303

Ceruti, S., Glotta, A., Biggiogero, M., Bona, G., Saporito, A., Faldarini, N., … Capdevila, X. (2021). Multidisciplinary team approach in critically ill COVID-19 patients reduced pronation-related complications rate: A retrospective cohort study. Annals of Medicine and Surgery, 70, 102836. https://doi.org/10.1016/j.amsu.2021.102836 

dos Santos, AP, de Freitas Souza, AC, Santos, JEC, Oliveira, RC, Ferreira, MER, Silva, JPR, … & de Farias Neto, JP (2022). Pronation strategies in patients with acute respiratory syndromes in intensive care units. Research, Society and Development, 11 (9), e54711932164-e54711932164. https://doi.org/10.33448/rsd-v11i9.32164

Mitchell, D. A., & Seckel, M. A. (2018). Acute respiratory distress syndrome and prone positioning. AACN advanced critical care, 29(4), 415-425. https://doi.org/10.4037/aacnacc2018161

Qadri, S. K., Ng, P., Toh, T. S. W., Loh, S. W., Tan, H. L., Lin, C. B., … & Lee, J. H. (2020). Critically ill patients with COVID-19: a narrative review on prone position. Pulmonary Therapy, 6(2), 233-246. https://doi.org/10.1007/s41030-020-00135-4.

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NR341 Complex Adult Health
RUA Interdisciplinary Management of Healthcare Technology Guidelines

Purpose

This purpose of this assignment is for the student to present a complete picture of interdisciplinary care using specific therapeutic modalities in the care of a complex adult health client. The student will demonstrate clinical reasoning skills and will discuss interdisciplinary care that had been incorporated and/or anticipated using a healthcare technology or therapeutic modality for the care of the complex health client.
Course outcomes: This assignment enables the student to meet the following course outcomes:

1. Provide patient and family centered nursing care to adults with complex health needs using theories and principles of nursing and related disciplines. (PO 1)

2. Initiate the use of appropriate resources in direct care responsibilities within complex adult health situations. (PO 2)

3. Demonstrate effective therapeutic communication and relationship skills in family centered nursing care to adults with complex health needs. (PO 3)

4. Demonstrate effective clinical decision making based on critical thinking skills and legal, ethical, and professional standards and principles when caring for patients and families with complex adult health needs. (POs 4 and 6)

5. Implement a plan of care for continued personal, professional, and educational development related to nursing practice with complex adult health situations. (PO 5)

7. Use evidence including research findings from nursing and related disciplines to answer clinical questions related to nursing care of patients with complex adult health needs. (PO 8)

Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.
Total points possible: 100 points
Preparing the assignment

Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.
1) Choose a therapeutic modality or healthcare technology.
2) Examples of a therapeutic modality include Extracorporeal Membrane Oxygenation, Automatic rotating pronation beds, right and/or left ventricular assist devices, nontraditional ventilator modes.
3) Examples of healthcare technology can include regional O2 saturation monitoring (NIRS).
4) Refer to your faculty member if your selection requires prior approval.
5) Write a 4-5 page paper (not including the title page or reference page) using APA format.
6) For APA, formatting, or grammar assistance visit the APA Citation and Writing page in the online library.
7) Include the following sections (detailed criteria listed below and in the Grading Rubric):
a. 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.
o Requires specific training above and beyond general entry-level nursing education.
• Introduce the therapeutic modality or healthcare technology.

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.
b. 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.
c. 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.
d. 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.
e. 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.
f. 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.
g. Conclusion – 5 points/5%
• Provide a summary of the paper.
• No new information is introduced.
• Include additional resources for further learning.
h. 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.

Please note that your instructor may provide you with additional assessments in any form to determine that you fully understand the concepts learned.

Grading Rubric
Criteria are met when the student’s application of knowledge within the paper demonstrates achievement of the outcomes for this assignment.
Assignment Section and Required Criteria
(Points possible/% of total points available) Highest Level of Performance High Level of Performance Satisfactory Level of Performance Unsatisfactory Level of Performance Section not present in paper
Introduction
(5 points/5%) 5 points 4 points 3 points 2 points 0 points
Required criteria
1. The chosen therapeutic modality or healthcare technology meets one of the following criteria:
• Has been introduced recently at the bedside for care of the complex adult patient.
• Is a non-traditional modality for very ill patients in special circumstances.
• Is being used in a new way to treat a patient with complex needs.
• Requires specific training above and beyond general entry-level nursing education.
2. Introduce the therapeutic modality or healthcare technology.
3. Name the therapeutic modality or healthcare technology.
4. A brief fictional case is used to illustrate the therapeutic modality or healthcare technology. Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no less than 2 requirements for section. Includes no less than 1 requirement for section. No requirements for this section presented.
Explanation and Background
(15 points/15%) 15 points 13 points 11 points 6 points 0 points
Required criteria
1. Include a clear description of the therapeutic modality or healthcare technology.
2. Discuss how the therapeutic modality or healthcare technology works.
3. Describe the patient population it is used for.
4. Include medication, safety, and cost considerations as applicable. Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no fewer than 2 requirements for section. Includes no less than 1 requirement for section. No requirements for this section presented.

Risks and Benefits
(15 points/15%) 15 points 13 points 11 points 6 points 0 points
Required criteria
1. Describe how the therapeutic modality or healthcare technology can benefit the patient.
2. Discuss ways to promote positive outcomes.
3. Explain the complications that may arise.
4. Discuss considerations for preventing complications. Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no less than 2 requirements for section. Includes no less than 1 requirement for section. No requirements for this section presented.
Interdisciplinary Team’s Roles and Responsibilities (20 points/20%)
20 points
18 points
16 points
8 points
0 points
Required criteria
1. Identify all interdisciplinary team members caring for the patient, such as respiratory therapy, assistive personnel, providers, case managers, clinical nurse specialists, and researchers.
2. 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.
3. Discuss the roles and responsibilities of the nurse as a member of the interdisciplinary team caring for the patient.
4. Discuss one challenge in working with an interdisciplinary team. Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no less than 2 requirements for section. Includes no less than 1 requirement for section. No requirements for this section presented.
Nursing Scope of Practice
(15 points/15%) 15 points 13 points 6 points 0 points
Required criteria
1. Discuss the knowledge needed for the Registered Nurse to provide care for the patient using the therapeutic modality or healthcare technology.
2. Describe skills needed for the Registered Nurse to provide care for the patient using therapeutic modality or healthcare technology.
3. Discuss attitudes needed for the Registered Nurse to Includes no fewer than 3 requirements for section. Includes no fewer than 2 requirements for section. Includes no less than 1 requirement for section. No requirements for this section presented.

provide care for the patient using therapeutic modality or healthcare technology.
Patient Education
(20 points/20%) 20 points 18 points 16 points 8 points 0 points
Required criteria
1. Describe the information to be taught to the patient and/or family.
2. Discuss how information will be taught.
3. Discuss potential cultural considerations to teaching
4. Explain how the effectiveness of the teaching will be evaluated. Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no less than 2 requirements for section. Includes no less than 1 requirement for section. No requirements were met for this section.
Conclusion
(5 points/5%) 5 points 3 points 2 points 0 points
Required criteria
1. Provide a summary of the paper.
2. No new information is introduced.
3. Include additional resources for further learning. Includes no fewer than 3 requirements for section. Includes no fewer than 2 requirements for section. Includes no less than 1 requirement for section. No requirements for this section presented.
APA Style and Organization
(5 points/5%) 5 points 4 points 3 points 2 points 0 points
Required criteria
1. References are submitted with paper.
2. Uses current APA format and is free of errors.
3. Grammar and mechanics are free of errors.
4. At least three (3), nursing, scholarly, peer reviewed, primary sources from the last 5 years, excluding the textbook, are provided. Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no less than 2 requirements for section. Includes no less than 1 requirement for section. No requirements for this section presented.
Total Points Possible = 100 points