[Devin Pawlicki]

NNP:
As a future Neonatal Nurse Practitioner, I would utilize the model of videoconferencing to utilize its capability of bringing specialized care to the neonates. Many level 1/2/3 NICUs do not have the specialized teams that a level 4 is typically known to have. Specialties such as genetics, pediatric surgery, pediatric cardiology: all which lend their skills to higher level care of the neonate. In utilizing the videoconferencing ability, I would allow these specialties to be able to visualize the patient, ask for certain assessment, tests to be completed, and be involved with their care in hopes that an infant could avoid a transfer to a higher-level facility just to be seen by these specialists. Many times, when we have to transfer a baby, this puts them farther away from their parents who then cannot as easily visit. As the NNP involved I would recognize the benefit of a videoconference vs. jumping to transfer them to a facility that has these specialties. I would assess the success of the program by how often a transfer could be avoided after utilizing this service. Legally we would have to obtain consent from the infants parents prior to completing the meeting, as infants would also need the parents consent to transfer this would likely be easy to obtain in comparison to moving the infant. We would need to ensure an individual room to maintain patient privacy and therefore could have a specialized room for these types of calls. We would need to make sure we have all tools available the specialists may ask us to utilize to assess the patient properly. Overall, I think this could be a very helpful tool to bring specialized care to the lower-level neonates.

[Devin Pawlicki]

I was the clinician in the setting of a infant discharged post-op from a g-tube placement with the task of ensuring the mother was comfortable caring for the g-tube now that they were home. Other specialist that could have been present could be ped surgery-who placed the G-tube, the GI specialist following this infant, the pediatrician now following the baby, PT/OT to contribute developmental activities to help the G-tube infant. In an actual clinical setting, I would have had the G-tube teaching doll that would have allowed me to demonstrate the proper cleaning/flushing/maintenance on the g-tube to ensure the mother was in complete understanding of the teaching I was conveying. I also would have had her practice back the teaching to ensure the understanding was successful.

I then was the patient in the scenario for Ashley, the Clinical- I discuss her presentation below:
Patient Case: Developmental Visit
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
9/9
Critical behavior competency: 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
Ashley did a great job simulating the clinician in this scenario to discuss the developmental goals and milestones of a post-NICU grad. She showed her compassion for the patient and used her knowledge of neonatal development to ease the mothers concerns. She was professional, well understood and to the point throughout the visit and used proper protocols for the telehealth environment. Great job Ashley!

[Devin Pawlicki]

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