NRSG355 Clinical Integration System
Discuss about the Recognising Signs and Symptoms of Patient.
Answer:
Introduction:
Prioritization in the healthcare profession refers to the act of healthcare provider attending critical and very serious cases first in order to save lives, preserve and facilitate stability. Delegation simply refers to the process in which the healthcare team leader assigns his/her equals, seniors or juniors’ duties to do in a health care set up. In the issues provided, I shall give first priority to the elderly female patient who collapsed to the floor and lost her consciousness and sustained facial injury. I will personally attend her and perform the first aid after placing her at recovery position and other crucial assessments. I will loosen any tight clothing. I will check for the Dr. ABC in order to ensure that the airway openings are in a good state to allow for fluids to flow out (Aitken, Chaboyer, & Elliot, 2012). Shall check on her breathing system and her circulatory system to determine whether there is any blockage. Lastly, will examine her to check whether she sustained any serious injuries that might lead to disability. For Mr. Smith’s visitor issue, I will delegate the duties to the AIN. AIN should put the patient on a recovery position. It will make the patient feel comfortable, allow any fluids to flow out since all airway openings will be wide open. Also, in that position, the AIN will be able to examine and carry out ABCD and assist the patient (Benner, Tanner, & Chelsa, 2009). The AIN should test the response stimuli of the patient through calling out her name if no response then should try to inflict some pain on sensitive areas of the patient.
I will assign the ward clerk the issue of Mr. Esposito. The ward clerk will make the patient’s medical history available in a well-documented file and have it forwarded to the preoperative medical professional. The medical professional shall be responsible for administering the pre-operative medication on Mr. Esposito. I will assign the staff toilets issue to the AIN, who will immediately prepare a write-up and stick it on the door “Out of Service.” AIN will contact relevant people such as plumbers to come over and rectify the problem fully (Elliot & Coventry, 2012). Cleaners to have the waste removed. For Mrs. Chew’s issue, I will assign the EN who will assess the patient’s condition and fix the IV cannula as she/he compensates for the antibiotics. I handle to hold a discussion with the surgical consultant to determine how everything unfolded and what the possible side effects might have been and what should be done to counter future errors happening again.
Factors Considered in Composing a Health Care Team
Several factors are put into consideration in selecting the type of health care professionals who should form a crew of medical experts. Firstly, the patient’s health status, in cases where the patient is in a dangerous state, a team comprising of emergency doctor and other rescuers should be formed. The more the serious the patient’s situation, the more complex team of healthcare professionals is constituted and vice versa. Secondly, the kind of treatment to be received by the patient. in circumstances where for instance a mother is giving birth through caesarian surgery, a surgeon, maternal nurses, radiologists, and other experts should be included in the team (Leyett-Jones, 2013). The third factor is that considering the location of the health facility and the patient. you get that patients in remote or rural areas are mostly attended to by a small team of health professional unlike where patients are visiting hospitals in urban areas where serious cases are mostly attended to by a complex team of healthcare providers. The availability of medical experts, in developed hospitals where there are adequate professionals a more and strong team is composed including all specialists in different fields in medicine unlike in rural dispensaries where very few specialists exist. In these health centers, a team is composed of very few professionals who even end up giving referring their patients to urban or developed hospitals (Health, 2010).
The fourth factor considered is that of how rich or poor a patient is. For rich patients, a more detailed healthcare team is composed to offer services unlike in situations where poor patients are to be treated. This is because the rich family is at a position to pay for services in well set up and high standard hospitals for their lovers, unlike the poor families whose patients suffer in public hospitals begging for free government services. The fifth factor is the age bracket and gender. Young people tend to be attended by a well-composed team since life-saving for them will economically benefit the nation. Every country does fight for the survival of youths since they are the future source of human labor and carer of the aged (Australia, 2014). Gender also is a key factor to be considered while composing a team, the team should not compose only of ladies or men if there is adequate staff with a balanced gender. A healthcare team is usually headed or chaired by a medical doctor since most patients feel more comfortable to be attended by a team led by a doctor. In a healthcare team, the patient happens to be the most member since the team gets composed because of him/her.
The Key Issues in Case Study 3
Robert who is the patient covered in this case study had his bones fractured. The bones that got fractured included the right tibia, right fibula and right radius. He suffers also from mental health impairment. He is an orphan and on top of this issue the only parent is quite old, a mother of 75 years of age, who instead requires palliative care from her son, Robert. A number of health professionals will be of much help to Robert. A nurse in charge will receive Robert and prepare him psychologically on the anticipated health practices to be conducted on him (Boards, 2014). A medical doctor will assist in Robert’s assessment to ascertain the impact and get any medical history information from him. The physician after physical examination will refer Robert to the radiologist who will take x-rays on the affected areas to produce digital images which will be interpreted by the physician with regard to the severity of the impact suffered (Crisp, Douglas, Rebeiro, & Waters, 2017). Upon realization on the extent of the impact, Robert will be attended to by an anesthetist who will give him an anesthetic injection. The injection will make the patient lose consciousness and this will be much easier for the surgeon to conduct surgery and have the fractures rectified without the patient suffering from any pain during the surgery process (Scovell, 2010). When Robert gains consciousness, he will be under the registered clinical officer who will monitor his progress and give further medical consultations where necessary. Upon recovery, Robert will be assigned a physiotherapist whom will guide him on the basic exercises including yogic ones to assist him in full recovery process. Lastly, Robert will be at liberty to be visiting the guidance and counseling professional to counsel and advise until he recovers fully
Provision and Coordination of Care
As a nurse on duty upon receiving the patient from my colleague, I will make a number of inquiries in regard to the patient being handed over. I would seek more information in regard to what unfolded leading to the patient being brought to the hospital and get admitted. Further, would establish from my fellow nurse on the time and who accompanied the patient to the hospital and if their contracts were captured for further consultations. In addition, I find out from the nurse whether the patient got attended in time, the medical history of the patient that was captured and the medical prescription from the clinical officer, how the patient has responded to the medication administered (Street, et al., 2012). Lastly, I will confirm from the nurse whether the patient’s family or guardians are aware of the incident if they got contacted. Upon the patient’s arrival into the ward, I will conduct a further assessment which will include checking the patient’s body temperature by placing a thermometer in his armpit. With the help of the stethoscope I will check on his heartbeat trend and through touch shall examine his pulses at the wrists and at the lower end of the neck. I will softly interrogate the patient on he is feeling after medication (Berman, et al., 2018).
In addition, I will take a blood sample from his ring right finger and check his sugar level. Furthermore, I will have to reassess the patient on how efficient his airway openings are, determine whether the breathing system is functioning properly and the entire circulation system is working well without any blockage (Kalishma, Stoddard, & O’Sullivan, 2012). Lastly, I will have to monitor the patient’s oxygen saturation levels. This is important because there is insufficient oxygen supply in the circulatory system, some organs will fail to function as high energy requiring cells die. What happens with low oxygen is that the active tissues will fight for reserved oxygen in the hemoglobin and upon depletion, a body crisis emerges. Upon discovering that the patient’s saturation is not attained, I will have to put him under the supply of oxygen from the oxygen concentrator machine. Urinalysis test will also be vital in examining the contents of the output from the patient and if there is a danger sign, I will employ appropriate actions to revert the patient back to his normal condition (Felton, 2012). I shall all the time ensure that the patient’s room is tidy, well ventilated and free of dust, a clean hygienic environment is vital in nursing management.
Time Management and Delegation
Time management refers to the effective and efficient utilization of time utility in the monitoring and evaluation of the patient’s conditions with an aim of providing proper and appropriate professional care in the specified period. Proper time management leads to cost-effective outcomes with minimal or no errors at the end of the healthcare provider. The term delegation simply refers to the allocation of duties to either the seniors, equals or juniors. Delegation serves to reduce workload and create more time for each healthcare professional to attend to his/her patients adequately. It also helps to curb any supremacy and avoidance of duties and staying away from work leaving other professionals struggling to handle a large number of patients alone (Pearce, 2006). In the Australian nursing profession, these two strategies have proven effective in ensuring that the patients do not miss their doses or necessary attention. In this paper, I will focus on the 22 patients who are currently admitted. Out of the 22 patients, 14 of them underwent a surgical operation in the morning shift before handing over was done. The remaining 8 patients are supposed to the operation during my shift. 4 out of the 8 patients requires administration of antibiotics at some time since they have got an IV access.
On duty with me is a fellow RN, an EN, and three AINs. My fellow RN is acting as the NUM, since the NUM is on sick leave. As a registered nurse, am tasked to ensure time management is well observed and duties are equally distributed based on healthcare staff competency (Aitken, Chaboyer, & Marshall, 2015). I will allocate the first slot of patients who have already undergone the surgical operation, 14, to the EN. The EN will be responsible for observing the progress of the patients, monitoring and evaluating their response stimuli to the operation and medication offered. I will give the EN additional staffs whom he/she will coordinate in providing total patient care to the operated patients. These will be the two AINs. The RN, one of the AINs and I will take care of the 8 patients. The RN will guide the AIN in administering antibiotics to the 4 patients who have IV access (Chaboyer & Hewnson-Conroy, 2015). As a team of three professionals will conduct all the necessary assessment on the patients before releasing them to the theatre room. We shall prepare the patients psychologically, monitor their pressure levels and make relevant observations. As the team leader on duty, I will take up the role of offering moral and emotional support to the patients, their family members, and carers.
References
Aitken, L., Chaboyer, W. & Elliot. (2102). Scope of Critical care Practice. In ACCCN’s Critical Care Nursing 2nd Ed. Elsevier, Sydney.
Aitken, L., Chaboyer, W. & Marshall, A. (2105). Scope of critical care practice. In: L. Aitken, D. Marshall & W. Chaboyer (Eds.). ACCCN’s Critical Care Nursing, 3rd Ed. Chatswood, NSW: Elsevier.
Benner, P., Tanner, C. & Chelsa, C. (2009). Expertise in practice; Caring, clinical judgement, and ethics 2nd Ed. New York: Springer.
Berman, A., Snyder, S., Levett-Jones, T. Dwyer, Hales, M…..Stanley, D. (2018). Kozier and Erb’s fundamentals of nursing, (4th Australian Ed.).Frenchs Forest, NSW: Pearson.
Chaboyer, W. & Hewson-Conroy, K. (2015). Quality and safety. In: L. Aitken, D. Marshall & W. Chaboyer (Eds.). ACCCN’s Critical Care Nursing, 3rd Ed. Chatswood, NSW: Elsevier.
Crisp, J., Douglas, C., Rebeiro, G. & Waters, D. (2017). Potter and Perry’s fundamentals of nursing, 5th Ed. Chatswood. NSW: Elsevier.
Department of Health (2010). Promoting effective communication among healthcare professionals to improve patient safety and quality of care. Department of Health, State of Victoria: Victorian Government Department of Health
Elliott, M. & Coventry, A. (2012). Critical care: the eight vital signs of patient monitoring. British Journal of Nursing, 21(10), 621-625.
Felton, M. (2012). Recognising signs and symptoms of patient deterioration. Emergency Nurse, 20(8), 23-27.
https://ezproxy.acu.edu.au/login?url=https://dx.doi.org/10.1111/j.1440-172X.2011.01918.x
https://www.health.vic.gov.au/qualitycouncil/downloads/communication_paper_120710.pdf
Kalishman, S., Stoddard, H. & O’Sullivan, P. (2012). Don’t manage the conflict: transform it through collaboration. Medical Education, 46, 926-934.
Levett-Jones, T. & (2013) Clinical Reasoning: Learning to think like a nurse, Frenchs Forests, NSW: Pearson.
MND Australia (2014). Australia Fact Sheet on Multidisciplinary Teams
National Council of State Boards (2014) A nurse’s guide to professional boundaries. Retrieved from: https://www.ncsbn.org/ProfessionalBoundaries_Complete.pdf
Pearce, C. (2006). Leadership resources. Ten steps to effective delegation. Nursing Management UK,
Scovell, S. (2010). Role of the nurse-to-nurse handover in patient care. Nursing Standard, 24(20), 35- 39.
Street, M., Eustace, P., Livingston, P.M., Craike, M.J., Kent, B. & Patterson, D. (2011). Communication at the bedside to enhance patient care: A survey of nurses’ experience and perspective of handover. International Journal of Nursing Practice, 17, 133-140.
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