Complex RUA Interdisciplinary Care

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NR341/342 Complex Adult Health
RUA Interdisciplinary Management of Healthcare Technology Guidelines

NR341/342 RUA Interdisciplinary Guidelines V5 Revised: 11/5//2021 1
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.
https://library.chamberlain.edu/APA
2
NR341 Complex Adult Health
RUA Interdisciplinary Management of Healthcare Technology Guidelines
NR341/342 RUA Interdisciplinary Guidelines V5 Revised: 11/5/2021 2
• 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.
• Discuss one challenge in working with an interdisciplinary team.
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.
• Discuss potential cultural considerations to teaching.
• 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.

NR341 Complex Adult Health
RUA Interdisciplinary Management of Healthcare Technology Guidelines

NR341/342 RUA Interdisciplinary Guidelines V5 Revised: 11/5/2021 3
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.
NR341 Complex Adult Health
RUA Interdisciplinary Management of Healthcare Technology Guidelines

NR341/342 RUA Interdisciplinary Guidelines V5 Revised: 11/5/2021 4
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.
NR341 Complex Adult Health
RUA Interdisciplinary Management of Healthcare Technology Guidelines

NR341/342 RUA Interdisciplinary Guidelines V5 Revised: 11/5/2021 5
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 4 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

1
Extracorporeal Membrane Oxygenation
Tamika Therlonge
Chamberlain University College of Nursing
NR341: Complex Adult Health
Professor Bacchus
14 February 2021
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Introduction
The therapeutic modality I will be discussing with this paper is Extracorporeal Membrane
Oxygenation, or ECMO. This therapeutic modality is one that requires specific training above
and beyond general entry-level nursing education as it deals with very complex technology and
is utilized in patients with a severe condition that could potentially be life-threatening and must
be handled delicately. An example of a case study in which this therapeutic modality would be
utilized is an 80-year-old female client who is experiencing myocarditis, or inflammation of the
heart muscle. The patient is frail and having difficulty breathing, fainting, experiencing chest
pain, and is feeling lightheaded and fatigued. After administrations of ACE inhibitors, diuretics,
and beta blockers have not helped improve her heart condition, the health care provider has
decided to focus on measures to ease the load off of the patient’s heart instead. This is when the
ECMO therapeutic modality will come into play as the provider has ordered for the patient to be
placed on extracorporeal membrane oxygenation to allow her heart and lungs to rest and heal.
Explanation and Background
Extracorporeal Membrane Oxygenation is essentially a machine that provides life support
for patients with illnesses that are so severe and even life-threatening that their heart and lungs
can no longer sustain the workload to continue to properly support their systems on their own
(American Thoracic Society, 2020). ECMO provides these individuals with a support by working
outside their bodies to pump blood from the patient to an artificial lung device where oxygen is
added, and the blood is artificially pumped back into the patient as their heart normally would.
There is no specific patient population that this therapeutic modality is used for, as it can be
utilized across all age ranges from pediatric to geriatric, however it is meant for people suffering
from certain illnesses or disorders. The patient population this modality would be aimed towards
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3
would include individuals who have a heart condition in which their heart can no longer
effectively pump enough blood to their entire body, those whose lungs are not strong enough to
provide oxygen for their bodies even with administered oxygen or their lungs are not able to
adequately remove carbon dioxide, even with the use of a mechanical ventilator. Additionally,
this modality is also utilized for patients who are suffering from an incurable disease and may be
waiting for a transplant of a heart or lungs. The medications administered to patients utilizing the
ECMO machine include analgesia, sedation, blood thinners, and opioids to treat any pain the
patient may experience and to ease any stress or discomfort that may occur (Sieg et al., 2019).
Examples of sedation drugs include benzodiazepines while examples of opioids to treat pain
include morphine or fentanyl. An example of a blood thinner that may be utilized to prevent the
blood from clotting in the tubes is heparin When starting a patient on an ECMO machine, a
healthcare professional with advanced training, such as a perfusionist, a nurse, or respiratory
therapist must ensure to adjust the settings of the machine to ensure the patient is safely given the
adequate and accurate amount of heart and lung support needed. The therapeutic modality of
ECMO is one that is very costly with the mean estimated cost of this procedure being $70,000
including pre- and post-procedures for ECMO along with hospital stay, making it a resource
demanding procedure (Mishra et al., 2016).
Risks and Benefits
The therapeutic modality of ECMO can greatly benefit patients suffering from illnesses
impairing the function of their heart and lungs as it allows these organs to rest and essentially
heal from the straining and stressful workload that may have been placed upon them before,
trying to pump blood and oxygen throughout the body. Some ways to promote positive outcomes
for these patients include implementing actions to prevent infections such as frequent
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4
handwashing before and after care and frequent monitoring of the tube insertion sites for any
signs of infection. Along with positive outcomes with this modality, there are also complications
that may arise. Patients utilizing an ECMO machine are at risk for complications such as
bleeding, infection, stroke, and kidney failure during the use of this modality (American
Thoracic Society, 2020). Bleeding can be prevented with constant and careful monitoring of the
patient through lab tests and physical examinations to ensure there is no active bleeding. Kidney
failure can also be prevented through careful and frequent assessment of lab values to ensure
they are functioning and receiving adequate blood flow. In the event that the kidneys are not
receiving adequate support, the patient may be connected to a machine to do the work of the
kidneys for them, called dialysis. Infections can be prevented by methods previously stated such
as frequent hand hygiene and assessment of tubal sites. The prevention of stroke due to small
blood clots that may occlude flow to the brain can be prevented with the use of heparin as a
blood thinner.
Interdisciplinary Team’s Roles and Responsibilities
The interdisciplinary team that would provide direct care for a patient utilizing the
ECMO modality include an ECMO specialist and surgeon, an intensive care nurse, a respiratory
therapist, a cardiologist, a pharmacist, and a dietician. The cardiologist initially assesses the heart
conditions of the patient and determines whether or not the patient may need the ECMO
modality. The surgeon places the tubes, or cannulas, into the large veins or arteries of the patient
that may either be located in the neck, chest, or groin. The ECMO specialist and respiratory
therapist work together to control the machine and adjusts the settings of the machine based off
of the patient’s condition to give the patient the accurate amount of support needed to their lungs
and heart (American Thoracic Society, 2020). The intensive care nurse provides frequent
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5
monitoring and assessment of the patient in order to ensure all the patient’s systems are working
well and receiving adequate blood and to ensure the patient is not developing any infections. The
ICU nurse also provides education and therapeutic communication to the family and loved ones
of the patient. The pharmacist provides the medications that will be required for this procedure
for the patient including the sedation, opioids, and anticoagulants. The dietician will work with
the ICU nurse to ensure the patient receives adequate nutrition through intravenous fluids. The
roles and responsibilities of the nurse as a member of the interdisciplinary team caring for the
patient is to be an advocate for their patient and ensure their patient is receiving therapeutic care.
The nurse monitors and assesses the patient constantly to ensure the machine is working
therapeutically and the ensure there are no developing complications such as infections, bleeding
or kidney failure. The nurse also ensures to provide education and communication with the
family and loved ones of the patient to the extent desired by the patient.
Nursing Scope of Practice
The Registered Nurse providing care for a patient utilizing the therapeutic modality of
ECMO must have advanced knowledge in providing intensive and critical care to these patients,
as the illnesses that tend to lead to the use of this modality are those that are more severe and
incurable such as lung and heart failures. These patients require close and constant monitoring
and assessment as their status may change for the worse as they have tubes directly leading into
their arteries and ventricles. The skills needed for this care includes the ability to read and
interpret vitals and lab results, the ability to perform a complete and thorough head to toe
assessment, the ability to initiate IV lines and maintain correct flow, the ability to provide
therapeutic communication and education to families, and the ability to work well with other
professional members of the staff caring for their patients. The attitudes needed by a nurse caring
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6
for this type of patient needs to include compassion, patience, confidence in skill, therapeutic
towards family and loved ones, and willing cooperation with other members of the
interdisciplinary team to provide the best care possible for the patient.
Patient Education
As a nurse caring for a patient utilizing the ECMO modality, there will be concerned
family members and loved ones who do not fully understand what is going on, including the
patient themselves. The education that must be provided to the patient and family first and
foremost will be explanation of the patient’s condition or diagnosis, and what it means. The nurse
will then have to provide an explanation of the ECMO modality, including what it is used for,
how the procedure is performed, and what it means for the patient to have it done and what they
can expect as risks, benefits, and outcomes of this procedure. The nurse can discuss this
information with the patient and family by providing informative brochures and booklets that go
into detail and provide images to help the patient and family better understand. The nurse will
explain the care that will be provided while the patient is on this machine, along with the
medications that will be administered, their purpose, effects, and benefits. The nurse can evaluate
the effectiveness of their teaching by asking the patient and family to repeat back to her what
they have learned and understood about the procedure and asking for any concerns or questions
they may still have.
Conclusion
Overall, with this paper, I attempted to thoroughly discuss the therapeutic modality of
Extracorporeal Membrane Oxygenation, also known as a life support machine. This machine
provides a therapeutic support to patients whose heart and lungs have been severely impaired and
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7
can no longer supply adequate blood and oxygen needed to support their organs and body
functions as a whole. This machine essentially does the work of the lungs and heart for the
patient, allowing the patient’s organs to rest and heal themselves as much as possible. For
patients and family members who may want to learn further about this therapeutic modality, the
American Thoracic Society provides thorough information on the therapeutic modality of
Extracorporeal Membrane Oxygenation.
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References
American Thoracic Society. (2020, March). What is extracorporeal membrane
oxygenation? https://www.thoracic.org/patients/patient-resources/resources/what-is-
ecmo.pdf
Mishra, V., Svennevig, J. L., Bugge, J. F., Andresen, S., Mathisen, A., Karlsen, H., Khushi, I., &
Hagen, T. P. (2016). Cost of extracorporeal membrane oxygenation: Evidence from the
Rikshospitalet University hospital, Oslo, Norway. European Journal of Cardio-Thoracic
Surgery. https://doi.org/10.1016/j.ejcts.2009.06.059
Sieg, A., Pandya, K., Winstead, R., & Evans, R. (2019). Overview of pharmacological
considerations in extracorporeal membrane oxygenation. Critical Care Nurse, 39(2), 29-
43. https://doi.org/10.4037/ccn2019236
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