A poster entitled: Promoting Optimism: An Interprofessional Approach to Treating Long Covid-19 via Telehealth
The objective is to approach a case of chronic illness using an interprofessional team in order to collaboratively and positively address the holistic needs of a patient as a result of long-haul COVID-19https://dune.une.edu/cecespring2022/1008/thumbnail.jp

Bhuma, Shruthi

Bochanis, Alana

Doran, Olivia

Hash, Emily

Howe, Emily

Tenhoor, Kursten M

Zazulak, Hannah

English

University of New England

Printing:This poster is 48” wide by 36” high. It’s designed to be printed on a large-format printer.Customizing the Content:The placeholders in this poster are formatted for you. Type in the placeholders to add text, or click an icon to add a table, chart, SmartArt graphic, picture or multimedia file.To add or remove bullet points from text, click the Bullets button on the Home tab.If you need more placeholders for titles, content or body text, make a copy of what you need and drag it into place. PowerPoint’s Smart Guides will help you align it with everything else.Want to use your own pictures instead of ours? No problem! Just click a picture, press the Delete key, then click the icon to add your picture.Promoting Optimism: An Interprofessional Approach to Treating Long Covid-19 via TelehealthSummary of Encounters with Amanda • Thank you to Kelli S. Fox, DSWc. MSW, LCSW, LADC, CCS, UNE SSW, Kin Ly, PharmD, UNE COM, and Jordan Agabin for their guidance and support throughout this experience • We would also like to thank the Center for Excellence in Collaborative Education (CECE) at University of New England and Dewitt C. Baldwin Institute for Interprofessional Education at RFUMS for the opportunity to participate in IPTI and engage interprofessionally with students • Special thanks to the actresses who played Amanda and Mo for their real life experiences and valuable feedback Acknowledgements At the end of encounter 2, Amanda gave us valuable feedback which lead us to have further thoughts of how our interprofessional team dynamic could improve. These future considerations include: ● Have everyone on screen introduce themselves before starting their patient interaction. Amanda noted that it was intimidating seeing new faces on the screen without knowing who they were. In future telehealth scenarios, we could include introductions and contact information into the zoom chat. ● Summarize our plan of care and be clear with what we want to accomplish in each session. Although we ran out of time towards the end, it would have been beneficial to reiterate our main treatment plan and goals for Amanda at the end of the patient encounter. ● Give Amanda tangible and specific advice for things she can work on herself. This will help empower her to reach her goals. What each individual profession wished they could have done with her : ● OT: With more time, I would have informed Amanda about some energy retention techniques. My goal for her was to implement them so that she could be able to build endurance for necessary tasks and well as have more energy to participate in her most desired occupation of spending more time with her children.● PT: Given another opportunity, I would have collaborated with OT to discuss treatment options for improving mobility and function so she can get back to meaningful activities she enjoys.  Shruthi Bhuma, CMS M1; Alana Bochanis, UNE BSN; Olivia Doran, UNE PA-S1; Emily Hash, UNE MSOT;  Emily Howe, UNE SPT;  Kursten Tenhoor, UNE SSW; Hannah Zazulak, UNE OMS-IIIntroduction  After reviewing informed consent, confidentiality and safety concerns while using Telehealth, Encounter 1 involved learning about Amanda’s symptoms, primary concerns and struggles with her persistent illness.The team's physician, nurse, & physician assistant members proceeded to conduct a history of present illness (HPI), collecting relevant information regarding Amanda’s chief complaint of debilitating migraine headaches and fatigue, associated symptoms, history of past medical conditions, and medication usage. Beyond defining the extent of and context surrounding Amanda’s health issues, this initial encounter helped establish trust in the interprofessional team and laid the informational groundwork necessary for treatment changes and adjustments in the subsequent visit.The team then wanted to know more about Amanda as a person, her interests, strengths and family life in addition to her job, financial situation, support systems and what gave her life meaning. At the end of the first encounter Amanda asked why so many “sad questions” were asked. The team realized how much Amanda was missing out on in her life due to this illness and we all wanted to offer empathy and optimism.Encounter 2 also included the participation of Amanda’s partner Mo. We began with an acknowledgement of the sad questions and the impact this left on Amanda. We aimed to validate her feelings, her experience and share our hope to help her through her journey.After inquiring about Amanda’s recent emergency room visit, the team was determined to make concrete recommendations to help alleviate her symptoms. In addition to prescribing diet adjustments and new medications better suited to Amanda's circumstances, the team solicited the advice of our physical therapist and occupational therapist. Admittedly, answering questions regarding the side effects of medications proved challenging in real-time. This mishap, however, was overcome by the optimism generated by the easy-to-do maneuvers recommended by our physical therapist. The immediate impact the maneuvers had on Amanda’s pain dramatically shifted her disposition from a state of despair to one of hope.The objective is to approach a case of chronic illness using an interprofessional team in order to collaboratively and positively address the holistic needs of a patient as a result of long-haul COVID-19. Working on an interprofessional team allowed us to provide care to encompass the whole person. Each profession brought unique knowledge from different specialties, and working collaboratively promoted sharing of this knowledge. There were multiple instances where the expertise lacked by one profession was a strength of another. We learned to feel more comfortable with specialties other than our own and to be able to recognize their particular scope of knowledge. The varying personalities of a team dynamic and, furthermore, perspectives of multiple professions was advantageous in order to promote optimal patient outcomes; A team in itself allowed us to give and receive feedback and validation for potential plans prior to presenting them to the patient. Additionally, the collaboration of the group in decision making promoted high efficiency in patient care. This is in contrast to disjointed communication that could have resulted from each profession seeing the patient individually and/or communication only via patient charts.Amanda Berry-Mantel is a 39-year-old female patient presenting with symptoms of long-haul COVID-19 symptoms after being hospitalized for COVID-19 for six days in April 2021. Since her hospitalization, Amanda has experienced distressing symptoms such as severe fatigue, brain fog, and migraines that have negatively impacted her life. Amanda is seeking help in dealing with these symptoms and would like to return to a sense of normalcy, but she resides in a rural Maine town where resources can be hard to access. To help further Amanda’s care, our multi-disciplinary team approached this case of chronic illness to collaboratively address Amanda’s needs. The interprofessional collaboration was conducted via telehealth, which has become an important part of healthcare delivery during the COVID-19 pandemic. Amanda has faced many obstacles in receiving healthcare. Knowing that Amanda has had difficulties, our team utilized diverse healthcare backgrounds to establish trust and rapport while providing validation and quality care. The care delivery experience took place during two sessions across two days. Each session consisted of a twenty minute patient encounter involving select professions, followed by a ten minute whole team debrief and another twenty minute patient encounter. The second encounter had the two twenty minute encounters, and the patient’s partner was also present for the visit. Our team met prior to the sessions to create a plan of action and reconvened after the sessions to discuss challenges and insights.Our team utilized empathy and active listing to validate the patient’s concerns. We attempted to leave the patient and her partner with a sense of hope and optimism following each interaction, which is a key element for the patient’s care and hope for the future. Working in an interprofessional team was critical in providing concrete, easy-to-do exercises and recommendations for the patient to meet her needs and lifestyle. Ultimately, these recommendations from the interprofessional team strengthened the patient's self-efficacy and instilled her with the hope that her condition can improve, while leaving her with a positive outlook on interprofessional care.Benefits of Seeing Amanda in an Interprofessional Team Table 1. Contributions from Each SpecialtyFuture Considerations Profession Contribution to AmandaPhysical Therapy PT gave recommendations aimed to decrease migraine symptoms, shortness of breath, and promote functional activity. These included postural awareness, chin tuck exercises, using different modalities such as heat or ice, and various deep breathing techniques.Medicine/Physician Assistant Medical students and physician assistant interviewed the patient and gave medication recommendations. Students offered patient recommendations that would help treat her migraines, which were one of her most distressing symptoms. Additionally, PA referred patient to obtain blood work to rule out underlying comorbid medical conditions which could have been contributing to her symptoms. Occupational Therapy OT promoted the continued use of assistive devices, such as blue light glasses, as well as the implementation of additional assistive equipment that would minimize some of the harmful effects of Amanda’s daily migraines. Furthermore, OT suggested for Amanda to create a structured nightly routine that would encourage more consistent rest patterns. Nursing Nursing collaborated and oversaw interactions with Amanda and gave feedback or criticism when needed. While nursing was not present in the room, behind the scenes, nursing implemented interprofessional care by giving suggestions and interpreting the team’s interactions with Amanda from an outward perspective. Nursing advocated for the patient’s needs by emphasizing certain points that may have been missed by others. Social Work Social work aimed to assist the team with not only viewing the whole patient, but also the patient’s environment, family and supports, strengths what things in a patient’s life bring the most meaning. Through this view the team could better address symptoms and concerns with the patient’s point of view at the forefront.Objectives• Through this experience, our team agreed that we were grateful to be placed in a group rooted in mutual respect, collaboration and empathy for Amanda’s condition and struggles due to long-haul COVID-19. • Working under the condition of teletherapy presented itself as a challenge, but we responded to any issue with flexibility, understanding and through supporting one another.• Our team’s goal was to encourage Amanda to be optimistic of positive change regarding her condition as well as to provide her with empathy and validation during this difficult time. • Through the use of our knowledge, based on our scopes of practice, motivational interviewing and constant reassurance that her feeling are valid, we pursued our goal to help Amanda feel  well supported through her battle with her long-haul COVID-19 symptoms. • We found that providing the right amount of support and empathetic validation in combination with simple and easily integrated interventions were most helpful for Amanda. Summary/Takeaway

Promoting Optimism: An Interprofessional Approach to Treating Long Covid-19 via Telehealth

https://dune.une.edu/cgi/viewcontent.cgi?filename=0&article=1008&context=cecespring2022&type=additional

Promoting Optimism: An Interprofessional Approach to Treating Long Covid-19 via Telehealth

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University of New England