[Brittany McDonald]

1. Currently my roles are in nursing leadership on a Labor and Delivery Unit at an Academic Medical Center and Adjunct Faculty Member for a College of Nursing. The hospital I work for takes care of patients on all ends of the spectrum of obstetric risk, including patients who desire low intervention birth to the most complex critically ill patients. In addition to providing care to patients in the main hospital, our health system has another Obstetric Unit in Southern Rural Virginia that only takes low risk patients. I believe the future of Obstetric Care heavily involves Telehealth and would like to be a part of the change as well as educate the future nursing teams on these aspects.
2. In OB a combination of MHealth and Video conferencing would benefit the patient population. Having video conferencing for patients who may not be able to attend OB appointments due to work or other commitments or for patients in our rural location needing complex care consultation would be a benefit. MHealth would help patients monitor their blood pressures (even a coping strategy for the white coat syndrome) or blood glucoses and avoid unnecessary trips to the hospital or clinic. Maybe even possible for obtaining fetal heart rates.
3. I would use a combination of all the equipment for patients and nursing education.
4. Many patients cannot attend prenatal appointments due to having conflicts such as with work or transportation. By having telehealth interwoven in prenatal visits, these patients would be able to attend appointments and not have to sacrifice other necessary costs experienced by those with SDOH concerns.
5. My role is as an instructor and nursing leader.
6. I would evaluate the adherence to prenatal care prior to telehealth program and then after. I would also assess student education levels pre/post.
7. The legal considerations are patient location and provider treatment location, patient ability to get care if emergency was identified, as well as HIPPA, and Medicaid reimbursement.
8. Other possible involved professions Social work, dental hygiene (dental caries can cause an assortment of pregnancy complications), physical therapy, dietician, diabetic educator, doula, mental health providers and other providers as indicated.
9. The protocols for when patients would have to be seen in clinic versus virtually, emergencies, and for the prenatal care structure would be developed.
10. During the first prenatal appointment would require in person and a consent would be obtained for the future appointments. At the beginning of virtual appointments provider would obtain verbal consent to proceed.

[Brittany McDonald]

1. Currently my roles are in nursing leadership on a Labor and Delivery Unit at an Academic Medical Center and Adjunct Faculty Member for a College of Nursing. The hospital I work for takes care of patients on all ends of the spectrum of obstetric risk, including patients who desire low intervention birth to the most complex critically ill patients. In addition to providing care to patients in the main hospital, our health system has another Obstetric Unit in Southern Rural Virginia that only takes low risk patients. I believe the future of Obstetric Care heavily involves Telehealth and would like to be a part of the change as well as educate the future nursing teams on these aspects.
2. In OB a combination of MHealth and Video conferencing would benefit the patient population. Having video conferencing for patients who may not be able to attend OB appointments due to work or other commitments or for patients in our rural location needing complex care consultation would be a benefit. MHealth would help patients monitor their blood pressures (even a coping strategy for the white coat syndrome) or blood glucoses and avoid unnecessary trips to the hospital or clinic. Maybe even possible for obtaining fetal heart rates.
3. I would use a combination of all the equipment for patients and nursing education.
4. Many patients cannot attend prenatal appointments due to having conflicts such as with work or transportation. By having telehealth interwoven in prenatal visits, these patients would be able to attend appointments and not have to sacrifice other necessary costs experienced by those with SDOH concerns.
5. My role is as an instructor and nursing leader.
6. I would evaluate the adherence to prenatal care prior to telehealth program and then after. I would also assess student education levels pre/post.
7. The legal considerations are patient location and provider treatment location, patient ability to get care if emergency was identified, as well as HIPPA, and Medicaid reimbursement.
8. Other possible involved professions Social work, dental hygiene (dental caries can cause an assortment of pregnancy complications), physical therapy, dietician, diabetic educator, doula, mental health providers and other providers as indicated.
9. The protocols for when patients would have to be seen in clinic versus virtually, emergencies, and for the prenatal care structure would be developed.
10. During the first prenatal appointment would require in person and a consent would be obtained for the future appointments. At the beginning of virtual appointments provider would obtain verbal consent to proceed.

[Brittany McDonald]

Final Telehealth Discussion Assignment
This assignment was very enlightening for me. While I am not a Nurse Practitioner, it was very informative for a Nurse Executive. The cases we participated in were Stroke, Diabetes, and Cardiopulmonary. The interprofessional professional partnerships that could have assisted with these complex patient scenarios including Physicians, Specialists (Cardiologists, Neurologists, and Endocrinologists), Social Workers, Physical Therapists, Speech Therapists, Occupational Therapists, Nutritionists, and specialty nurses for both Congestive Heart Failure and Diabetes. The technology that could be utilized would include live video devices, store and forward devices, and remote patient monitoring devices. For these scenarios specifically a glucometer, heart rate monitor, oxygen monitor, blood pressure monitors could have been utilized.
Zoom link:
https://drive.google.com/file/d/1JNq59aPW4A_lLFAJ54_6cmscTLZgIzd5/view?usp=drive_link

My Peer was Stacy Crawford
Orientation – 5
Verbal clarity – 5
Active Listening – 5
Patient-Focused – 5
Tone of Voice – 5
Eye Contact – 5
Other Body Language – 5
Empathy – 5
Rapport – 5
Respect -5
Therapeutic Alliance-5
Environment – 5
Overall Rating 5 – Stacy was amazing with the patients. She made them feel welcome, wanted to hear their concerns and had really great teaching points to appeal to their health needs.

Patient Case: Diabetes and Cardiopulmonary (evaluated by Brittany McDonald)
Check
1. Identifies reason for the visit-1
2. Confirms that patient agrees with the reason for the visit and accepts that it is delivered by telehealth-1
3. Obtains history of symptoms or situation-1
4. Obtains approaches/treatments patient has taken to address the issue-1
5. Conducts an appropriate physical using equipment at home, and/or other individuals to assist or provides telehealth education using appropriate learning style-1
6. Discusses findings/Overview of education-1
7. Develop plan (follow-up, referral, medication, etc.)-1
8. Determines patient’s understanding of plan/education-1
9. Determines how patient will get information on the visit (email, portal, secure text, etc.) 1
Total (1 point each) 9/9

[Brittany McDonald]

https://drive.google.com/file/d/1JNq59aPW4A_lLFAJ54_6cmscTLZgIzd5/view?usp=drive_link

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