RUA Interdisciplinary Management of Healthcare Technology Essay

RUA Interdisciplinary Management of Healthcare Technology Essay

RUA Interdisciplinary Management of Healthcare Technology Essay

Enteral nutrition is one of the recently introduced therapeutic modalities at the bedside for the care of adult patients with complex conditions. Enteral nutrition is delivered via the gut and can be oral, gastric, or postpyloric feeds. The modality is indicated in patients who cannot sustain sufficient oral intake of food or nutrients to meet their metabolic needs (Preiser et al., 2021). Enteral nutrition will be applied in the case of a cancer patient on chemotherapy who has developed severe anorexia due to inadequate dietary intake. The patient cannot tolerate oral feeding due to mouth sores and nausea and is on a severe caloric deficit. In this case, enteral nutrition via a nasal-small-bowel tube will be used to supply nutrients to correct the caloric deficit.

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Explanation and Background

Enteral nutrition involves the delivery of nutrients directly into the gut through a tube. It is indicated in patients who cannot consume, chew, or swallow food but can digest and absorb nutrients. Enteral nutrition is commonly used in patients with dysphagia since they cannot meet their daily nutritional needs despite modifying food texture and consistency. Enteral feeding is only successful if the GI tract is accessible and functional. On the other hand, patients with malabsorption syndrome, inaccessible GI tracts, and severe GI losses have a challenge with enteral feeding (Schörghuber & Fruhwald, 2018). The different feeding tubes used in enteral nutrition include nasogastric, nasoduodenal, nasojejunal, gastrostomy, jejunostomy, and gastrojejunal tubes. The tubes are placed manually, surgically, endoscopically, or in interventional radiology (Preiser et al., 2021). Enteral nutrition is used for a wide range of patient populations, including critically-ill patients on mechanical ventilation; Patients with neuromuscular disorders that affect swallowing reflex; Severely anorexic patients; Patients with upper GI obstruction, esophageal stricture, or tumor; Patients with mental disorders like dementia; Patients with conditions that cause increased metabolic and nutritional demands.

Risks and Benefits

Enteral nutrition significantly benefits patients by improving nutrition variables, reducing the incidence of infection, and decreasing the length of hospital stay. Evidence demonstrates a significant decrease in septic complications when nutrients are delivered through enteral feeding (Sinha et al., 2020). Enteral nutrition is preferred over parenteral nutrition owing to its efficacy, safety, reduced risk of infection, and low cost. Besides, it is associated with the prevention of gut atrophy and preserves the barrier function of the gut. In postoperative patients, enteral nutrition is associated with reduced mortality rates. Furthermore, some studies have found that enteral nutrition promotes rapid recovery, early resumption of oral diet, reduced duration of nutritional therapy, and decreased costs (Schörghuber & Fruhwald, 2018). Positive outcomes can be attained by using the right tube size, diameter, and material and careful monitoring of the patient’s electrolytes and micronutrients

Patients on enteral nutrition are at risk of developing gastrointestinal, metabolic, and mechanical complications. GI complications include nausea, vomiting, diarrhea, and constipation, while metabolic include refeeding syndrome (Heyland et al., 2020). Mechanical complications include aspiration, tube clogging, and tube-related complications like bleeding and parenchymal, tracheal, or GI tract perforation (Sinha et al., 2020). The complications can be reduced by having trained staff perform the procedure and careful post-placement monitoring. Besides, aspiration can be minimized through periodic assessment of gastric residue and prescribing of prokinetic drugs (Heyland et al., 2020). GI complications can be prevented through adequate hydration, insoluble fiber-containing formulas, decreasing sedating drugs, changing to a low-fat formula, and decreasing the delivery rate.

Interdisciplinary Team’s Roles and Responsibilities

An interdisciplinary team approach is fundamental to improving the outcomes in enteral nutrition. The team will comprise a physician, registered nurse, dietician, clinical pharmacist, and social worker. The physician’s role is to coordinate and direct patient care related to enteral nutrition and develop the patient’s optimal feeding regimen. The nurse is tasked with supervising the care of the enteral feeding tube and informing the physician if any complications develop. Besides, the nurse educates the patient on using the enteral feeding tube (Schaefer et al., 2019). The dietician’s role is to manage the assessment of the nutritional requirements, including calculating the patient’s daily caloric need and the optimal fluid requirements. Furthermore, the role of the clinical pharmacist is to provide the enteral feed and compound the parenteral nutrition per the patient’s needs.

The social worker helps patients cope with the emotional and social stresses of disease and treatment. The social worker also educates patients on the available community resources and health insurance coverage options ad helps them to access these options. The nurse’s role as a member of the interdisciplinary team is to act as the patient’s advocate and communicate the patient’s needs and treatment decisions to the interdisciplinary team. Besides, the nurse facilitates effective communication among team members since communication is fundamental to strong collaboration and achieving the desired patient outcomes (Schaefer et al., 2019). Furthermore, the nurse can take the leadership role in the team, which entails delegating tasks to the other professionals and overseeing that all patient interventions are implemented when adhering to the set standards.

Nursing Scope of Practice

The nurse has a role in ensuring proper nutrition of patients on enteral feeding to facilitate their recovery. Consequently, the nurse should demonstrate knowledge of the indications and the relative and absolute contraindications of enteral feeding. In addition, the nurse should be well-versed in calculating a patient’s daily caloric intake based on their metabolic status (Schaefer et al., 2019). The nurse should know the potential complications of enteral feeding to identify a patient with signs of the complications promptly. Furthermore, the nurse should be well-versed with the feeds used in enteral feeding, including the enteral supplement products. The nurse should also know the delivery techniques for enteral feeding like intermittent cyclic feeding, intermittent bolus feeding with a bulb, intermittent drip, and constant infusion.

The nurse should demonstrate skills in assessing patients’ nutritional status and interpreting the findings. The nurse should be able to use various nutritional assessment tools like Nutrition risk screening, Malnutrition Risk Score, Subjective Global Assessment, and BMI. The nurse should exhibit skills in interpreting the results to determine a patient’s nutritional status and disease severity (Schaefer et al., 2019). The nurse should demonstrate skills in correct manual placement of feeding tubes like the nasogastric tube and daily assessing the feeding tube placement. In addition, the nurse should be able to perform oral and nasal hygiene and care to prevent oral infections.

Patient Education

The patient on enteral feeding should be provided education to alleviate the anxiety associated with tube feeding. The nurse should educate the patient on the indications and contraindications for enteral nutrition, types of enteral feeding tubes, benefits, and potential complications. Besides, the nurse should be educated on identifying warning signs of complications like abdominal discomfort, a sense of bloating, abdominal distension, GI reflux, and a diminished gag reflex (Heyland et al., 2020). In addition, the nurse should educate the patient on the indications for discontinuing enteral nutrition and the factors used to determine if they have attained the desired nutritional status.

The information on enteral nutrition will be through a discussion, and the nurse will apply brainstorming techniques. The nurse will also demonstrate to the patient when teaching the types of feeding tubes and show the patient the different types of tubes. The Teach-Back method will evaluate the teaching session to ensure the patient understands what they have been taught. The nurse will ask the patient to explain what they have learned about enteral nutrition in their words.   

Conclusion

Enteral nutrition entails delivering nutrients directly into the gut through a tube. It is indicated in patients with chewing or swallowing difficulties but can digest and absorb nutrients. Enteral feeding comes with the benefit of reduced risk of infection, low costs, prevention of gut atrophy, and maintaining the barrier function of the gut. However, it is associated with GI, metabolic, and mechanical complications. Enteral feeding requires coordination amongst the interprofessional team. Patients should be educated on its indications, contraindications, benefits, and potential risks. 

References

Heyland, D. K., Ortiz, A., Stoppe, C., Patel, J. J., Yeh, D. D., Dukes, G., … & Day, A. G. (2020). Incidence, risk factors, and clinical consequence of enteral feeding intolerance in the mechanically ventilated critically ill: an analysis of a multicenter, multiyear database. Critical care medicine, 49(1), 49-59. https://doi.org/10.1097/CCM.0000000000004712

Preiser, J. C., Arabi, Y. M., Berger, M. M., Casaer, M., McClave, S., Montejo-González, J. C., … & Wischmeyer, P. (2021). A guide to enteral nutrition in intensive care units: 10 expert tips for the daily practice. Critical Care, 25(1), 1-13. https://doi.org/10.1186/s13054-021-03847-4

Schaefer, A., Benbenishty, J., Gutysz-Wojnicka, A., Slijepcevic, J., Scelsi, S., Bruyneel, A., & Klas, M. K. (2019). Nurses responsibilities on providing enteral nutrition to the critically ill patient—an European Federation of Critical Care Nursing Associations position paper. CONNECT: The World of Critical Care Nursing, 12(3), 86-89. https://doi.org/10.1891/1748-6254.12.3.86

Schörghuber, M., & Fruhwald, S. (2018). Effects of enteral nutrition on gastrointestinal function in patients who are critically ill. The Lancet Gastroenterology & Hepatology, 3(4), 281-287. https://doi.org/10.1016/S2468-1253(18)30036-0

Sinha, S., Lath, G., & Rao, S. (2020). Safety of Enteral Nutrition Practices: Overcoming the Contamination Challenges. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine, 24(8), 709–712. https://doi.org/10.5005/jp-journals-10071-23530

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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