Effective Communication and Multidisciplinary Collaboration in Pediatric Respiratory Care NUR4026

1.Introduction

Outline of the Case Study

Healthcare professionals experience critical situations where they have to deliver sensitive information pertaining to the medical condition of the patient to the family members. This situation is more delicate for pediatric patients as the family members are directly involve in their treatment. The given case study discusses the condition of respiratory distress in a 2-year-old child who was receiving treatment under the supervision of a general practitioner. However, with no visible signs of improvement, the child was admitted to the emergency department of a pediatric care facility where salbutamol inhaler is prescribed. The condition of the child improved but after one hour, the symptoms were visible again. The respiratory rate was extremely high and after detailed physical examination, a growth was observed in the lungs. The parents of the child were informed of this critical situation under the guidance of a consultant and medical practitioner.

Role of Effective Communication for Pediatric Respiratory Care in Children

Pediatric respiratory care involves dealing with children under 5 years of age. Their family members are directly involved in taking informed decisions for their treatment. Thus, it is very important to ensure that nurses and medical practitioners have the ability to deliver any sensitive information to family members with kindness and compassion. (Cassibba, J. et al. 2024)

For instance, even after repeated administration of salbutamol did not improve the condition of the child and diagnostic tests such as chest X-Ray identified the presence of growth in the lungs, this complicated information was revealed to the parents under the supervision of a consultant. They were continuously reassuring them that further treatment of the child has been planned in a childrens healthcare facility. They play a vital role in aiding the parents and other family members in taking informed decisions related to the treatment and coordinate high quality respiratory care for the neonatal. ( Koo, H. Y., & Lee, B. R. 2024)

Outline of the Assignment

This assignment will initially discuss the case study of the 2-year-old child with respiratory distress and growth in the lungs which requires this medical information to be clearly informed to the parents considering all the sensitive and cultural parameters. Followed by this, it will identify the situational variables in providing care to the patient such as the anxiety faced by the parents and the role of evidence-based treatment strategies in guiding nursing interventions. It will also discuss the current national and international trends related to pediatric respiratory care and the challenges in providing pediatric respiratory care to the neonatal population.

2.Situational Variables in Service Provision

Emotional and Psychological Impact

It is a very difficult situation for the healthcare workers to deliver any bad news associated with the health of the patient to the family and other supporting members. It has a emotional and psychological impact on their mental health. It is natural that parents receiving news about the critical medical condition of their child makes them feel shocked and develops fear and grief inside them. (Tekin, M. N., & obano?lu, N. 2024) This can affect their decision-making process and indirectly affect the treatment of the patient. Thus, it is the responsibility of a childs nurse to provide emotional support to the family members of the patient and reassure them by making them understand the positive outcomes of the treatment strategy. In the given case study, the advanced nurse practitioner was continuously communicating with the parents of their child to reduce their anxiety levels and help them understand the severity of their childs medical condition. The nurse also helped the parents to contribute by learning inhaler techniques and observing the atypical symptoms to help them feel positive about their childs improving health. (Andrew, L. M. et al. 2024)

Cultural and Socioeconomic Factors

It is very important for a nurse to consider the cultural and socioeconomic factors before breaking the bad news to the family. Some family members may be conservative and do not appreciate discussing the medical condition of their child in their presence while some would like to keep transparency while understanding the severity of the medical ailment of their child. Thus, it is very important that nurses observe and interpret the cultural beliefs of the patients family as it directly impacts their decision-making process for the child and their expectation from the healthcare systems. (Bush, A et al. 2024)

The childrens nurses should also understand the relation between socioeconomic factors and the emotional impact of it on the mindset of the family members. Breaking bad news to the family members of the patient members with low financial levels may induce a feeling of anxiety and stress in them. They may feel burdened due to the increased costs of the medical treatments involved. Thus, nurses should help the family members in finding resources in such a scenario. They should ensure that the patient receives a high quality of care even in such circumstances (Foronda et al., 2020; Bush, A Chang, A. B et al. 2024).

Complexity of Diagnosis

The way bad news will be perceived by the members of the family depends on the severity of the medical condition of the patient. In the given case study, informing the parents about the diagnosis of a growth in the lung in their 2-year-old child will be extremely overwhelming for them. Thus, it is very important that medical professionals initially discuss the approach for informing the parents under the guidance of a consultant. (Zhang, X. L et al. 2024)

The severity of the medical condition of their child can be explained by using very simple language and can also involve the use of visual aids to enhance their understanding. In addition to this, the advanced nurse practitioner must be well prepared with potential doubts and resolve them by providing clear and concise answers. They should support the members of the family by reducing their anxiety and make them understand the positive outcomes of the treatment strategy. (Henderson, C. M. et al. 2024)

3.Clinical Scenario Analysis

Initial Presentation and Management by GP

The 2-year-old child is diagnosed with respiratory distress by the general practitioner. The patient is prescribed Ventolin and prednisolone for managing the symptoms of the condition. Both these medications are the standard treatments defined for the treatment of acute asthma and inflammation in pediatric patients. Despite following the standard medications for this acute condition of respiratory distress in the child, there were no signs of improvement which prompted the mother to reach out to a pediatric healthcare facility. ( OHagan, K., & Hall, A. 2024) The medical intervention utilized by the doctor for reducing the symptoms of respiratory distress in the child involved using standard medications namely Ventolin and prednisolone. Ventolin, being a beta-2 agonist, relaxes the muscles of the respiratory pathway while prednisolone is a corticosteroid which is involved in reducing the levels of inflammation. However, the general practitioner should have modified the treatment strategy and prescribed more specific medications associated with respiratory distress. (Cabrera, M. et al. 2024)

Assessment and Interventions in Pediatric ED

The Pediatric senior health officer examined the symptoms of respiratory distress in the child. The doctor modified the dosage of salbutamol as initially it was not effective for the patient when prescribed by the general practitioner. With back-to-back frequent dosing of salbutamol, the aggressive symptoms of the condition were suppressed. This points to the fact that the medication prescribed by the GP was adhering to the treatment protocols, but the dosage was not adequate enough to reduce the symptoms. (Pyry, H. 2024)
The advanced nurse practitioner was continuously monitoring the respiratory vitals of the patient. In addition to this, the family members of the child were provided appropriate training and education to learn the usage of inhalers and observe any atypical symptoms associated with respiratory viral illness. Despite the modification of the dosage of salbutamol, the symptoms recurred again after one hour. The patient was showing signs of increased respiratory rate and moderate recession even though the saturation levels of oxygen were 95%. This signaled to the doctor that the underlying condition of the condition needs to be thoroughly examined with the help of diagnostic techniques such as blood tests and chest X-Ray (Mendes & Silva, 2021). The findings of these tests revealed the presence of a growth or mass in the lung potentially indicating a serious medical condition
The severity of the medical case of the child with respiratory distress and lung mass was discussed with a consultant. This information was then given to the parents and a prompt decision was taken to transfer the patient to a childrens hospital for further diagnosis and treatment.

Role of the Nurse in Direct Care and Family Support

The nurse played a vital role in providing medical and emotional support to the patient and their family. The care provider was continuously monitoring the symptoms of the child with respiratory distress. This helped the doctor in identifying that the symptoms of the patient were not related to viral respiratory illness and prescribe some diagnostic tests which helped in identifying the growth in the lung. The nurse was also responsible for reducing the anxiety levels of the parents by making them understand the severity of the situation, the treatment strategies currently used, and keeping them informed about all the steps taken for improving the condition of the child. The nurse also helped them learn the technique of using an inhaler and identify unusual symptoms related to respiratory viral illness. (Koob, C., et al. 2024)

4.Provision of Care

Administration of Medications

The effective management of respiratory distress involves using a variety of drugs from different classes. For the given study, the child has been prescribed with Ventolin and prednisone by the general practitioner and increased dosage of salbutamol in the pediatric care facility. Ventolin, also known by the names of salbutamol and albuterol is generally prescribed to patients undergoing respiratory distress. This drug is a beta-2-androgenic receptor which prevents the obstruction of the airways due to asthma or chronic bronchitis. It relaxes the bronchial muscles and provides symptomatic relief to the patient facing difficulty in breathing. Prednisolone is a glucocorticoid which is responsible for inducing anti-inflammatory signals, thereby reducing inflammation and swelling in the respiratory pathway.
These standard medications were helpful in providing immediate relief to the child from the aggravating symptoms of respiratory distress but were not effective for a longer duration.

Education on Inhaler Technique and Symptom Management

It is very important to ensure that the prescribed drug, namely salbutamol, is properly reaching the body of the patient through proper inhaler technique. In the case study of the child, the advanced nurse practitioner helped the parents in understanding the importance of inhalers in improving the condition of the child. They were provided detailed training on using the inhaler correctly along with coordinating inhalation with actuation. It also guided them on using a spacer if required. In addition to this, the nurse also provided guidance to the parents of the patient in identifying critical symptoms pointing towards viral respiratory illness. They were asked to keep a watch on the parameters such as respiratory rate, changes in color and difficulty in breathing. This helped the medical practitioner to timely diagnose the growth in the lung and suggest a better childcare health facility for the patient.

Coordination with Multidisciplinary Teams

A holistic patient care model is preferred for the medical treatment of children. It involves a diverse team of medical professionals with specific expertise ensuring that all the symptoms of the patient are addressed and treated on time. In this case study, the pediatric registrar, after evaluating the severity of the growth in the lungs of the patient, took advice from the consultant to plan the further course of treatment. The consultant informed the parents about the medical situation of the patient and with their consent decided to shift the child to the childrens hospital. They discussed the medical case of the patient with other hospital facilities and referred the child to a healthcare facility where appropriate treatment would be provided.

Family Education and Emotional Support

Providing emotional support and education to the family members is essential when dealing with neonatal patients. In the given medical scenario, the advanced nurse practitioner regularly updates the family members regarding the childs health and also trained them for using the inhaler technique correctly. The nurse also guided the parents in identifying atypical signs and symptoms pointing towards viral respiratory illness. In addition to this, the pediatric registrar along with the consultant informed the parents of their childs degrading health by ensuring all the cultural and emotional parameters. They were reassured that a better treatment is planned for the patient which helped them in taking an informed decision and relieving them from anxiety.

5.Critical Literature Review: National and International Trends in Pediatric Respiratory Care

Communication strategies for Paediatric Care

Good communication in paediatric care, as well breaking bad news to families, is essential when dealing with distressing situations. points towards different best practice interventions such as giving information clearly and in order to provide coherence for the family. There is a growing emphasis on training programs for health care professionals to develop these skills and simulation with role-playing has been integrated into such mode of practises, which can provide more training in effectively breaking bad news. Thus, European studies particularly stress the role of empathy in communication as it is conducive to trust and allows families to cope with difficult information.

Impact of Bad News on Family Dynamics

Being told that a child has a health problem is likely to have far-reaching effects within the family, frequently leading to stress, anxiety and an upheaval of familial roles. Guilt, fear and powerlessness may be what other families experience. This emotional load leads to family conflicts, kills dialogue between you and your relatives. Healthcare professionals must understand these effects to ensure families receive the required support and can be assisted through an emotional, distressful time in response to a diagnosis.

Counselling and Mental Health Services

After the revealing of bad information, mental health and counselling services play a key role in helping families. Professional counselling would help families process their emotions and come up with new coping mechanisms. Studies in Europe find individual and family therapy beneficial for ameliorating emotional effects. Referral of mental health professionals and awareness of the families on their support networks are important parts in a two-pronged approach.

Conclusion

In the management of pediatric respiratory care, as in many areas of medicine, good communication is paramount for family-centered practice but particularly so when it comes to breaking bad news. For the 2-year-old child who was presented with respiratory distress and a lung mass, healthcare professionals played an essential role in intervening medically as well as emotionally. The child responded initially to treatment with Ventolin and prednisolone, but subsequent investigation reinforced the value of tailoring therapeutic strategies.

The advanced nurse practitioner played a central role in supporting the family emotionally and informing them about their child's medical diagnosis/therapy, providing education on anticipatory guidance for careofthisinfant. Thus, the corresponding explanations, training to use an inhaler, and reassurance from the nurse contributed to the reduction of parents anxiety and improved their understanding of the situation. The interprofessional relationship also afforded the client total care and it involved the family in decision-making processes.
However, there are issues that continue to present significant difficulties in the area of respiratory therapy in children. Discussing difficult and grim information with families and the patients themselves, most of whom come from different cultural and socioeconomic backgrounds, is always a challenge. Saying the right thing with a right communication style that is sensitive to individuals cultural backgrounds and experiences can be challenging, time-consuming and require professionals, and it also discontinuously implies.

A stressful and disruptive experience can occur in the family due to the bad news that they receive. There is often guilt, fear and a feeling of power and this impacts the families during the decision making. Physical health needs, especially concerning illness, requires a certain level of support maybe regarding emotional issues, and services to address these are important; however, access to such services can be an issue as is the perception of such problems. Further, given that the care of respiratory diseases in kids necessitates the collaboration of many healthcare professionals, the coordination processes may be intricate. Co-ordination and continuity of care for patients in different settings are concerns crucial to good patient care but often pose practical problems.

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