Capella 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

Salutations! I, _________, welcome to today’s presentation on collaboration and evidence-based care in remote care settings. This presentation focuses on a patient scenario related to gender dysphoria, where we will establish an evidence-based care plan to integrate healthcare services and reduce health disparities. Firstly, let me share a patient care scenario to offer a brief background of the presentation. 

Background Scenario 

A 25-year-old transgender male living in an underserved area with limited healthcare access was diagnosed with gender dysphoria following a behavioral health assessment. The patient articulated interest in receiving hormonal and surgical management for the health condition. Dr. Smith, who is the patient’s primary care provider, initiated a remote collaboration with a multidisciplinary team, including mental health experts, endocrinologists, surgeons, and registered nurses. The team supports the patient’s preferred treatment modalities; however, they accentuate the need for a more in-depth evaluation to confirm the diagnosis and exclude other conditions before deciding on the best hormonal and surgical treatment options. 

Evidence-based Care Plan Proposal 

An evidence-based is proposed to improve the safety and outcomes for the patient in this scenario, encompassing a multidisciplinary approach that prioritizes comprehensive assessment, patient-centered care, and coordinated follow-up. 

• The care plan begins with a comprehensive psychiatric evaluation (CPE) to confirm the diagnosis of gender dysphoria and exclude other conditions that might present similarly. Levine (2024) mentions that this in-depth evaluation helps ensure that the patient receives appropriate, individualized treatment, such as hormone therapy or surgery, while addressing any co-occurring mental health issues. This assessment evaluates the patient’s mental health history, current psychological state, and any symptoms of psychiatric disorders, ensuring a holistic approach to care. 
• After confirming the diagnosis, we aim to develop a personalized hormone replacement therapy (HRT) plan. Hormonal therapy involves administering hormones, such as testosterone or estrogen, to align the patient’s physical characteristics with their gender identity (Maung, 2024). This plan would be initiated and monitored by the endocrinologist, with regular check-ins to assess the patient’s response and adjust dosages as necessary. 

Capella 4030 Assessment 4 Remote Collaboration and Evidence Based Care

• Simultaneously, the plan includes discussing surgical options in detail with the patient. It is crucial to assess the patient’s readiness for gender-affirming surgeries and ensure the patient understands the risks, benefits, and expected outcomes of each procedure (Amengual et al., 2022). This education is also integral to following ethical and legal requirements.
• Finally, the plan aims to include patient-centered support and education. Given the patient’s rural location and limited access to healthcare, telehealth services will be integrated into the care plan to provide ongoing support, education, and follow-up care. Telehealth can facilitate regular mental health counseling, HRT monitoring, and post-surgical care, ensuring the patient receives continuous care despite geographic barriers. Additionally, telehealth enables connecting patients with local transgender support groups to offer emotional support and help mitigate societal stigma and discrimination (Stoehr et al., 2021).

Need for Further Information 

Additional information could have been valuable in several areas in establishing a more patient-centered and precise care plan. First, more detailed data on the patient’s mental health history and any co-existing mental health conditions would help in tailoring the psychological support provided. Additionally, insight into the patient’s social support system, including family acceptance and community resources, would help in addressing potential psychosocial challenges. Finally, knowledge of local healthcare resources and the availability of telehealth infrastructure in the patient’s area would assist in planning effective follow-up care and support services (Stoehr et al., 2021).

Evidence-Based Practice Model

This evidence-based care plan is grounded in an evidence-based practice (EBP) model called the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model. It is a systematic approach designed to integrate the best available evidence into nursing practice to improve patient outcomes. The model emphasizes three key components: Practice Question, Evidence, and Translation (PET) (Dusin et al., 2023). In developing the care plan for gender dysphoria, the JHNEBP model was instrumental in ensuring that the plan was rooted in the best available evidence and aligned with patient-centered care principles. 

• The process began with formulating a specific practice question (Dusin et al., 2023). The question for this care plan was: How can we improve the safety and outcomes for a transgender male patient seeking gender-affirming care in a rural setting? 
• This question guided the subsequent evidence search, focusing on studies, clinical guidelines, and expert consensus on managing gender dysphoria, especially in rural or underserved populations (evidence phase). 
• Finally, in the translation phase, the evidence was applied to develop a multidisciplinary care plan that included detailed steps for assessment, treatment, and follow-up, additionally emphasizing the integration of telehealth services to overcome geographic barriers, ensuring continuity of care and patient safety (Stoehr et al., 2021).

Assessing the Benefits to Patient Outcomes

According to Churruca et al. (2021), monitoring patient-reported outcomes through surveys and questionnaires assists in evaluating the effectiveness of care and the benefits that it leaves on patients’ well-being. Measuring several metrics, such as the patient’s mental and physical well-being, satisfaction with care, adherence to treatment and medication plans, and availability of adequate healthcare services, will be crucial for assessing the benefits of our EBP care plan. Continuous monitoring and adjustment based on these evaluations would ensure the plan remains responsive to the patient’s evolving needs and contributes to optimal outcomes.

Evaluation of Evidence for Making Care Plan

The evidence-based care plan utilized several literature studies and clinical guidelines to ensure the plan is deeply rooted in research. Yet, the most relevant evidence collected for the care plan was Levine (2024), which discusses the importance of a comprehensive psychiatric evaluation (CPE) in diagnosing gender dysphoria. This evidence supports the intervention decided by the multidisciplinary team, which is crucial to accurately confirm the diagnosis before initiating any treatment.

This literature study emphasizes addressing co-occurring mental health issues and ensuring individualized treatment, highlighting the foundational role of a thorough evaluation in providing effective and safe care (Levine, 2024). The evidence guides the initial step of the care plan, ensuring that subsequent interventions, including HRT and surgical options, are based on a well-established diagnosis and a holistic understanding of the patient’s psychological and emotional state.

Levine (2024) was chosen for its direct impact on the accuracy and safety of the care plan. The CPE provides a comprehensive assessment that is critical in distinguishing gender dysphoria from other conditions, which ensures that the patient receives appropriate and targeted treatment. This evidence was deemed highly useful because it aligns with best practices for managing gender dysphoria, emphasizing the need for a precise diagnosis before proceeding with interventions. The relevance was determined based on the need to base the care plan on a solid diagnostic foundation, which is essential for the effective implementation of subsequent interventions and for addressing any potential comorbidities. 

Capella 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Moreover, it is a credible resource based on the CRAAP criteria – currency, relevance, authority, accuracy, and purpose (Esparrago-Kalidas, 2021). Currency is evident as the resource is recent (2024), reflecting current best practices in psychiatric evaluation. The resource is relevant because it addresses the core need for accurate diagnosis in managing gender dysphoria. A field expert authorizes it, and the article is published in a reputable and relevant journal. Accuracy is assured as the resource aligns with established guidelines and peer-reviewed evidence. Finally, the purpose of the resource is clear, focusing on improving diagnostic processes to enhance patient outcomes without commercial bias or conflicting interests. This makes it a credible and valuable reference for developing the care plan.

Interdisciplinary Collaboration in Remote Care – Benefits and Challenges 

Interdisciplinary collaboration, particularly within a remote team, offers several benefits for planning and providing care. According to Tan et al. (2023), collaboration in tele-healthcare services is crucial to provide comprehensive patient care that integrates different perspectives and specialties. This approach enhances the accuracy of diagnoses and the appropriateness of treatments and ultimately improves patient outcomes by addressing various needs comprehensively. However, challenges such as communication barriers may persist. To mitigate communication barriers, it is essential to establish clear communication protocols and conduct regular virtual meetings (Tan et al., 2023).

Utilizing secure, integrated electronic health record systems can ensure that all team members have real-time access to the patient’s information. Another challenge includes time zone differences, which can be addressed through robust scheduling tools and time management strategies. This ensures that all team members can participate in discussions and decision-making processes effectively.

To improve outcomes in future care situations, interdisciplinary collaboration can be better leveraged by fostering more robust team integration and enhancing communication channels. Alpay et al. (2023) elaborate that the development of shared digital platforms for case management can streamline the coordination process, ensuring that all team members are aware of patients’ healthcare plans. Additionally, incorporating feedback mechanisms to evaluate and refine collaboration practices can lead to continuous improvements (Tan et al., 2023). By creating a more cohesive and efficient remote collaboration framework, teams can better address complex patient needs and enhance the overall quality of care, leading to improved patient outcomes.

Conclusion

I would like to conclude my audio presentation with a quick brief of our discussion. In this discussion, we explored the development of an evidence-based care plan for a 25-year-old transgender male with gender dysphoria, emphasizing a multidisciplinary approach using the EBP model. The plan focuses on comprehensive psychiatric evaluation, personalized hormone replacement therapy, surgical options, patient education, and ongoing support through telehealth services. It is crucial to have interprofessional collaboration for the smooth implementation of the plan and successful results. However, challenges, including communication barriers and time zone differences, may persist. These challenges can be addressed through research-based strategies like transparent and integrated communication systems and robust time management methods. Overall, leveraging remote collaboration will enhance future care outcomes by ensuring comprehensive, coordinated, and effective patient care.

References

Alpay, L., Koster, Y., Dallinga, J., Siemonsma, P., Verhoef, J., Kassens, E., Flaton, P., Baars, K., & van Kessel, F. (2023). Technology-based interprofessional collaboration in primary care for home rehabilitation of the older adults: A Dutch exploratory study. Health Informatics Journal, 29(2), 146045822311692. https://doi.org/10.1177/14604582231169299 

Amengual, T., Kunstman, K., Lloyd, R. B., Janssen, A., & Wescott, A. B. (2022). Readiness assessments for gender-affirming surgical treatments: A systematic scoping review of historical practices and changing ethical considerations. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.1006024

Churruca, K., Pomare, C., Ellis, L. A., Long, J. C., Henderson, S. B., Murphy, L. E. D., Leahy, C. J., & Braithwaite, J. (2021). Patient‐reported outcome measures (PROMS): A review of generic and condition‐specific measures and a discussion of trends and issues. Health Expectations : An International Journal of Public Participation in Health Care and Health Policy, 24(4), 1015–1024. https://doi.org/10.1111/hex.13254

Capella 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Dusin, J., Melanson, A., & Mische-Lawson, L. (2023). Evidence-based practice models and frameworks in the healthcare setting: A scoping review. British Medical Journal Open, 13(5), e071188. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10230988/ 

Esparrago-Kalidas, A. J. (2021). The effectiveness of CRAAP test in evaluating credibility of sources. International Journal of TESOL & Education, 1(2), 1–14. https://i-jte.org/index.php/journal/article/view/25 

Levine, S. B. (2024). What is the purpose of the initial psychiatric evaluation of minors with gender dysphoria. Journal of Sex & Marital Therapy, 50(6), 773–786. https://doi.org/10.1080/0092623x.2024.2362774

Maung, H. H. (2024). Gender affirming hormone treatment for trans adolescents: A four principles analysis. Journal of Bioethical Inquiry, 21, 345–363. https://doi.org/10.1007/s11673-023-10313-z

Stoehr, J. R., Hamidian Jahromi, A., Hunter, E. L., & Schechter, L. S. (2021). Telemedicine for gender-affirming medical and surgical care: A systematic review and call-to-action. Transgender Health, 7(2), 117–126. https://doi.org/10.1089/trgh.2020.0136 

Tan, A., Chua, W. L., McKenna, L., Tan, L., Lim, Y. J., & Liaw, S. Y. (2023). Interprofessional collaboration in telemedicine for long‐term care: An exploratory qualitative study. Journal of Nursing Scholarship, 55(6). https://doi.org/10.1111/jnu.12925 

Capella 4030 Assessment 4 Remote Collaboration and Evidence Based Care