Evidence-Based Care Plan for Cystic Fibrosis

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Evidence-Based Care Plan for Cystic Fibrosis

Table of Contents

Introduction
Evidence-Based Plan of Care
Knowledge-to-Action (KTA)
Evidence
Conclusion
References

Introduction

Cystic fibrosis is a systemic disease characterized by extensive damage to the endocrine glands and the respiratory, gastrointestinal, and other systems. It significantly shortens life expectancy because the gene mutation results in an inability to control electrolyte transport (mainly chlorine) across epithelial cell membranes (Coverstone & Ferkol, 2021). Nevertheless, well-chosen care and cooperation between the patient and the physician can ensure a nearly full life. In the case at hand, Caitlin requires integrating an evidence-based care plan to improve her safety and treatment.

Evidence-Based Plan of Care

For Caitlin, several rules of care need to be followed, mostly related to her age and her parents inability to provide complete care due to social conditions. The child needs increased monitoring of her airway lumen. Parents can help by assisting in drinking fluids and collecting mucus when she coughs to bring it for analysis (Richards et al., 2022). In addition, cystic fibrosis promotes the collection of mucus in the chest, so the child should be repositioned and given special massages (Castellani et al., 2018). These massages will include breathing exercises and physical therapy to liquefy the mucus accumulated in the lungs (Bell et al., 2020). This will improve blood circulation in the area and facilitate the flow of nutrients to the tissues.

Normal blood and nutrient supply is also maintained in other ways. The child needs adequate nutrition, which can be achieved by introducing protein components into the diet (e.g., cheeses) (McDonald et al., 2021). These will facilitate mucus elimination, and the slow growth of muscle mass will maintain the childs overall condition (Coverstone & Ferkol, 2021). In addition to the care measures themselves, parents should be aware of the critical need to take antibiotics according to the course of treatment (Guo et al., 2022). Not only is it necessary to take the medication on schedule, but also to reduce the risks of complications from the disease by disinfecting surfaces regularly and monitoring vital signs.

Measuring the childs external parameters should be included in the care plan. These include weight (reflects the rate of protein loss), normal urination (flushing out of chloride salts), the presence of edema (fluid accumulation in the intracellular space), and changes in the color and density of mucus (Castellani et al., 2018). Creating a treatment plan should be based on the ability of the childs family to adhere to it. In Caitlins case, there is a risk that the treatment will not be thoroughly carried out because the parents do not have the resources and knowledge to do so (Rowbotham et al., 2019). Integrating educational training and providing parents with lectures or handouts detailing all risks and outcomes is recommended (Richards et al., 2022). In addition, parental accountability for their childs condition should be increased to avoid the aggravation of respiration and ease the diseases course (Pediatric cystic fibrosis, n.d.). Improvements are needed in physician interaction, which may include counseling the parents without the child (Bell et al., 2020). Educating parents about care, including dietary planning and physical therapy at home, can help overcome mucus stasis and reduce the risk of complications.

Knowledge-to-Action (KTA)

The Knowledge-to-Action (KTA) model approaches the assessment with a structured, evidence-based approach that considers not only the benefits but also focuses on the barriers. In a study of cystic fibrosis in children, initially, the main problems were established, followed by a search for interventions that contribute to symptom relief based on the layer of information sources found. After connecting the manifestation of the disease and its alleviation, significant gaps in the study (lack of sufficient evidence-based data) and potential barriers were identified (Rowbotham et al., 2019). Finally, ways to overcome these barriers were integrated based on the fundamentals of nursing practice.

Evidence

The sources selected for the study were found using Google Scholar. The most relevant sources are found treatment protocols that have practical applications (Bel et al., 2020). In addition, McDonald et al. (2021) and Guo et al. (2022) establish the most promising care plans that meet the high level of evidence. Some sources do not have a high level of evidence (Pediatric cystic fibrosis, n.d.) but are valuable resources for parents who can care for a child with cystic fibrosis. Much of the identified evidence includes information on medication-assisted treatments: Coverstone & Ferkol (2021) and Guo et al. (2022) point to the benefits of new modified techniques and the therapeutic triad. It should also be noted that it is challenging to search specifically for evidence-based data, probably due to the lack of diagnosis and the inability to reach medically underserved individuals in the regions (Rowbotham et al., 2019). The proposed treatment plan should be relevant and pertinent since it contains high-index evidence (Bell et al., 2020; Castellani et al., 2018; Richards et al., 2022) and follows the strategy of creating maximum safety for the patient.

Conclusion

Remote collaboration and organization of work in a remote format allow medical staff to exchange relevant information about the patient in a timely and rapid manner. Collaboration makes it possible to reach an agreement in complicated cases, get other opinions, and improve treatment outcomes. The therapeutic pathway will have different strategies, and due to the remote format, discussion of the clinical case can take place conveniently from home. However, there are problems with the fact that not all parties of the collaboration can observe the patients life, in which case there are difficulties in interpreting, for example, the auscultator findings. A solution may be an offline meeting once a period for individual consultations with the patient, followed by a roundtable discussion of the observations.

References

Bell, S. C., Mall, M. A., Gutierrez, H., Macek, M., Madge, S., Davies, J. C., Burgel, P. R., Tullis, E., Castaños, C., Castellani, C., Byrnes, C. A., Cathcart, F., Chotirmall, S. H., Cosgriff, R., Eichler, I., Fajac, I., Goss, C. H., Drevinek, P., Farrell, P. M., Gravelle, A. M., & Ratjen, F. (2020). The future of cystic fibrosis care: A global perspective. The Lancet. Respiratory Medicine, 8(1), 65124. Web.

Castellani, C., Duff, A. J. A., Bell, S. C., Heijerman, H. G. M., Munck, A., Ratjen, F., Sermet-Gaudelus, I., Southern, K. W., Barben, J., Flume, P. A., Hodková, P., Kashirskaya, N., Kirszenbaum, M. N., Madge, S., Oxley, H., Plant, B., Schwarzenberg, S. J., Smyth, A. R., Taccetti, G., Wagner, T. O. F., & Drevinek, P. (2018). ECFS best practice guidelines: The 2018 revision. Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society, 17(2), 153178. Web.

Coverstone, A. M., & Ferkol, T. W. (2021). Early diagnosis and intervention in cystic fibrosis: Imagining the unimaginable. Frontiers in Pediatrics, 8. Web.

Guo, J., Garratt, A., & Hill, A. (2022). Worldwide rates of diagnosis and effective treatment for cystic fibrosis. Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society, 21(3), 456462. Web.

McDonald, C. M., Alvarez, J. A., Bailey, J., Bowser, E. K., Farnham, K., Mangus, M., Padula, L., Porco, K., & Rozga, M. (2021). Academy of nutrition and dietetics: 2020 cystic fibrosis evidence analysis center evidence-based nutrition practice guideline. Journal of the Academy of Nutrition and Dietetics, 121(8), 15911636.e3. Web.

Pediatric cystic fibrosis. (n.d.). Childrens Nation. Web.

Richards, B., Osborne, S. R., & Simons, M. (2022). Introducing a MAP for adherence care in the pediatric cystic fibrosis clinic: A multiple methods implementation study. BMC Health Services Research, 22(1), 109. Web.

Rowbotham, N. J., Smith, S., Prayle, A. P., Robinson, K. A., & Smyth, A. R. (2019). Gaps in the evidence for treatment decisions in cystic fibrosis: A systematic review. Thorax, 74(3), 229236. Web.

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