Collaboration for Improving Outcomes -Case Management Plan

Collaboration for Improving Outcomes -Case Management Plan

The moment a baby is born, it is essential to assess the newborn’s condition to determine the care needed for its survival. Premature infants are mostly born between 32-37 weeks of gestation and require intensive care to increase survival (Lawn et al., 2013). Depending on their birth weights and health conditions, they are taken to the Kangaroo mother care or the incubators. Failure to provide care subjects the infant to mortality risks. Hence medical facilities need care units equipped with care packages to cater to intermediate and exclusive breastfeeding, skincare, hygienic cord, and thermal care. Thus, the paper addresses the packages for implementing a 34 weeks infant from the admission day to discharge day. The plan is an integrative implementation of patient-centered care, teamwork and collaboration, and evidence- based practices toward the infant’s safety and quality improvement.

Thermal Care and Neonatal Resuscitation

Immediately after the baby is born, it is essential to maintain the infant’s temperature. During the infant’s transference and stabilization process from specialized neonatal care wards, wrapping the child will help prevent the risks of hypothermia. The baby is wrapped with. If the child is unstable and weighs 2000g or less, they will be put into a thermally neutral environment, radian warmers, or incubator (Crider, 2020). The infant may be assisted in breathing through a tube mask or a bag and mask resuscitation. A surfactant may be administered to replace the absent natural surfactant to enhance breathing. If further complications occur, the baby should be referred to ventilation.

Kangaroo Mother Care/Incubation

The baby may be either subjected to a kangaroo mother care or a thermal incubator. Lawn et al. (2013) explain its efficiency in reducing neonatal mortality by 51%. The system is more friendly to both the baby and the parent and health-friendly, reducing the hospital stay and the nursing loads hence reducing the overall cost. Babies under 2000g can be put in the KMC practice, where feeding support will be initiated. If the infant is put

Additionally, the nurses should educate the parents and caregivers on the incubator’s reason and purpose. Accessibility to the incubator requires the necessary skills to access to ensure continued touch and comfort for the baby. Hygiene should be observed throughout the incubation process to prevent infection (Crider, 2020). The incubators should be changed every seven days and cleaned with hot soapy water, and the inserts removed, cleaned, and dried. During the phototherapy, the incubator’s temperatures will be decreased after the phototherapy commences. The incubator should be thoroughly monitored to recheck the axilla temperatures within half an hour of making adjustments and temperature monitoring. The axilla temperature is recorded on admission, rechecked within the first hour, and documented within 4-6 hours as per the conditions (Crider, 2020).

Feeding Support

Early initiation of breastfeeding within the first hour of birth reduces neonatal mortality and increases the chances of the baby’s survival. Breast milk improves the baby’s immunology and development, thus lowering the risks of infection. Premature babies may require assistance through spoons, cups, or gastric tubes. Preterm babies with less than 1000g or extreme conditions may revive intravenous fluid supplements of parenteral nutrition (Lawn et al., 2013). Supplementation of vitamin D, phosphorus, iron, and vitamin and calcium for low birth weight. Supplementation should be done with meticulous attention to flow rates and volumes.

Infection Prevention

Hygienic practices diminish neonatal and maternal mortality and morbidity from infection-associated. Premature infants are at higher vulnerability to bacteria sepsis, so hand cleansing must be paramount for neonatal care units. Since the skin o premature babies is unprotected, topical vernix application of emollient ointment will reduce water loss, sepsis risks, and dermatitis (Lawn et al., 2013). The environment of the baby should be maintained clean to prevent infection risks.

Special Attention and Discharge

Clinicians should monitor the baby’s vital signs during the hospital stay to assess whether the baby qualifies to be discharged. Premature newborns with jaundice are at risk of other infections. A systematic discharge will be initiated before discharging the baby to prevent potential complications. Babies who are assessed to have a sign of infection are given treatment before discharge, and the advantages of maintaining breastfeeding are paramount. Nurses should advise the mother on common problems likely to occur to their babies and primary home care. They should also educate them on identifying abnormalities in their children and referring their newborns for a professional check-up. For babies suffering from respiratory distress syndrome, nasal catheters, and nasal prongs may be used.

Goals for the Care Management

The primary goals for the case management plan are to promote optimal respiratory functioning, maintain a neutral thermal environment, and maintain physiological and homeostasis to prevent and reduce risks for potential complications of the infant to promote their survival. It also aims to foster a healthy family unit (Crider, 2020). The nurse should involve the caregivers and parents during the decision-making process. The goal is to promote social support to the maternal parents. The period is also intended to offer womb-like environmental conditions to help the infant recover from the birth trauma. Additionally, it will be used to sustain the premature organs befitting from the oxygen-controlled incubators.

References

Crider, C. (2020). Incubators for babies: Why they’re used and how they work. Healthline. https://www.healthline.com/health/baby/incubator-baby

Lawn, J. E., Davidge, R., Paul, V. K., von Xylander, S., de Graft Johnson, J., Costello, A., … & Molyneux, L. (2013). Born too soon: care for the preterm baby. Reproductive health, 10(1), 1-19. https://reproductive-health- journal.biomedcentral.com/articles/10.1186/1742-4755-10-S1-S5

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Collaboration to Improve Outcomes

Competency

Collaborate in healthcare delivery systems settings for improved patient outcomes.

Transferable Skill

Diversity, Equity, & Inclusion.

Scenario

You have a final interview for your first registered nurse position.

All candidates must come prepared to discuss a time when they collaborated with others to solve a problem in a healthcare delivery setting. The collaborative solution must have improved patient outcomes and incorporate diversity, equity, and inclusion.

To prepare for the interview, you will create notes.

Directions

Select an example that demonstrates collaboration with others to solve a problem in a healthcare delivery setting to improve patient outcomes. The collaborative solution must incorporate diversity, equity, and inclusion.

Describe the problem, including the healthcare delivery setting and its impact on patient outcomes.

Explain the collaborative solution, including the people involved and the improvement in patient outcomes.

Describe how diversity, equity, and inclusion were incorporated into the collaborative solution.

Resources

RasGuide: Transferable Skills: Diversity, Equity, and Inclusion