Discuss About The Consolidating Reflective Clinical Practice?
Mrs. Betty White is an 85 year old woman and a widow of 5 years. She has been living in a low care aged care facility since her husband died. She has a supportive family and has a sonand a daughter.Her daughter lives locallyandvisits twicea week. Her sonlives interstate with his family.Members of her church also visit her once a week.She participates in the social activities within the aged care facility in order to get over from loneliness. She is a retired office worke and does not drive She takes the help of family members and taxis to get around. Betty is an ex-smoker and gave up smoking 10 years ago.She has a medical history of Hypertension, Hypercholesterolaemia, Asthma/COPD, Osteoarthritis.She was admitted in the hospital as she was suffering from a chest infection.The doctors diagnosed that she was suffering from Left lower lobe pneumonia (Chan, 2015).
When she was admitted in the hospital, she developed a fracture in the right neck of femur.Betty was taken to the Emergency Department (ED) with the help of an ambulance. She suffered from high temperature, shortness of breath and congestion in the chest.Her daughter Jane, was informed that her mother was hospitalized. She visited the Emergency Department to visit her mother.A chest x-ray and blood tests were conducted in the ED and the reports showed that Betty was suffering from pneumonia.She was advised on intravenous (IV) antibiotics, oxygen therapy and Ventolin and Normal Saline nebulisersby the clinicians in the hospital. Betty was transferred to the respiratory or a medical ward on the same day in the afternoon (Lancaster, 2015).
The clinical practice issues of concern in Betty’s care that her mother was not given any medicaments in the morning by the nursing staff and usual medications were not written up on her medication chart (McFarland, 2014).Jane had a talk with the nurse that her mother seemed to be a bit confused and it was not normal as her mother was normally quite alert and orientated. Betty became quite distressed and more confused and wanted to meet her doctor. Another concern during Betty’s case was that her daughter was not informed about her condition becoming worse and a fellow patient in Betty’s room rang the bell at 2am in order to call the staff and shouted ina loudvoice to seek help. The nurse found out that Betty was laying on the floor next to her bed.Her IV was pulled out and there was blood was all over the floor.She was moaning.It was observed by the nurses that Betty had developed a laceration on her forehead and her right leg and foot was externally rotated.The nurses also found out that Betty had urinated on the floor.When Jane was informed about it she was furious that proper care was not given to her mother inspite of informing the nurse that she was in a confused state (Wall & Morrison, 2014).
Betty was observed by the resident medical officer, who advised an urgent head CT scan and x-ray of her legs.The reports of the CT scan were normal but the x-ray showed that Betty had developed an intracapsular fracture in her right neck of femur.Betty was advised a surgery by the orthopaedic team in the morning and her hip wound edges were not healing as she had developed an infection.This shows that the surgical procedure was not successful as well (?gotnes, Jacobsen, & Petersen, 2016).
- The National Health and Safety Standardswere developed by the Commission in order to improve the quality of health care in Australia by the implementation of safety and quality systems.There are 10 NSQHS Standards in order to ensure quality care for patients and satisfaction. These are as follows:
- Governance for Safety and Quality in Health Service Organisations which involves the provision of quality healthcare services to the patients.
- 2. Partnering with Consumers which aims to develop several strategies in order to develop a health system that is consumer-centred. It also includes taking a feedback from consumers during the development and design of quality health care.
- Preventing and Controlling Healthcare Associated Infections which involves different types strategies in order to prevent infection in patients during the treatment in the healthcare system and.It also involves using proper methods to manage infections in an effective manner when they occur to reduce the drastic health effects (Alkon, Rose, Wolff, & Aronson, 2016).
- Medication Safety which involves the formation of proper systems and s trategies in order to make sure that the clinicians have prescribed and administer to patients.
- 5. Patient Identification and Procedure Matching which involves the formation of appropriate systems and strategies for the correct identification of patients.This standard is developed to make sure that the identity of the patient matches with the correct treatment (Huber, 2013).
- Clinical Handover which involves the formation of appropriate systems and strategies in order to make sure that the clinical communication is done in an effective manner to provide proper patient care.
- Blood and Blood Products which involves the formation of appropriate systems and strategies to make sure that management of blood and blood products received by the patients safe, effective and appropriate (Moorhead, Johnson, & Swanson, 2014).
Preventing and managing pessure injuries which involves the formation of appropriate systems and strategies in order to prevent pressure injuries developing in patients and providing proper practice management during the occurrence of pressure injuries .
Recognising and responding to clinical deterioration in acute health care which which involves the formation of appropriate systems and processes that should be implemented by health service organisations in order to respond to patients in an effective manner when their health condition gets worsened (Potter, 2014).
Preventing Falls and Harm from Falls which which involves the formation of appropriate systems and strategies in order to reduce the occurrence of patients falls in health service organisations and providing proper care.
It can be observed from the case study of Betty that there are a few National Health and Safety Standards that have been breached in providing her proper care.These are Standard 1, Governance for Safety and Quality in Health Service Organisations because Betty was not provided quality care in the hospital as the nurse allotted to her did not take proper care during the night in spite of knowing that she was in a confused state. She was also being admitted in a 4 bed ward that was quite far off from the nurses (Steven, Magnusson, & Pearson, 2014). Her daughter was also not informed when her health worsened during the night. Another nursing standard that was breached is Preventing and Controlling Healthcare Associated Infections, because after the surgery was done she developed an infection which shows that proper strategies were not followed by the clinicians during the surgery. Standard 4,that is Medication Safety was also breached because Bretty was not prescribed any medicines by the nurse when she was admitted in the ED and her daughter had to inform the same to the nurse (Rosenthal, 2014).
The two standards that could have been maintained by the healthcare staff in the delivery of care to Betty and her family during her hospitalisation are Standard 1 and Standard 4. Standard 1 is Governance for Safety and Quality in Health Service Organisationswhich involves the provision of quality health services by the health service organisations in order to implement safe practices. The clinicians would have transparent towards betty and her daughter Jane and should provided proper information about her disease. The health care professionals should would have made sure that the healthcare services are flexible, easy to access and follow. They should have recruited a dedicated and a nursing staff (Peabody, 2015). This would have led to a positive impact on the well being and the emotional health of the patient and would have taken less duration to get cured. A proper education of patients leads to improvement in the hospital journey and reduces the anxiety, stress and pain in them.
Betty and her daughter should have been given proper information about the disease, its symptoms, treatment plan and preventive measures to avoid any confusion and to tackle the disease.Sometimes a lack of effective communication can result in misinterpretation by the patients as they understand it partially and it leads to adverse conditions. Betty should have been properly counseled and provided emotional support to boost her confidence and improve her self-esteem. Betty should have been motivated to ask any queries or doubts related to the disease that would have helped in improving satisfaction and confidence in her.She should have been provided regular follow-ups to keep a track on the progress made and also if there are any symptoms of ill effects (Jones, 2016).
The clinician along with nurses, dieticians and other health care professionals should have provided various strategies for self-management of the disease to Betty.They should have worked in teams or in collaboration to provide proper communication to her as well to her daughter.This would have helped in enhancing her safety and must have avoid any mishappening with the patient that occured due to ineffective communication. Betty and her daughter should be provided proper instructions regarding the medicaments and other measures to be followed to prevent the side effects (Festini, 2014).There are various precautions that should have been advised to her to get cured from infection such as she should must be provided a separate toilet at home if possible or should flush the toilet every time they use them (Ball, Murrells, Rafferty, & Griffiths, 2013). The caregivers at home should be provided with gloves while handling the blood, stool or urine sample of the patient. This would help her to get rid of infection and get well soon.
Standard 4 that is medication safety was also breached in the case of Bretty. It involves the documentation of correct medicines in the medication chart of the patient in order to prevent serious side effects. Documentation in nursing plays a very important role in healthcare and it is generated by electronic means in to record information about the patient who will be undergoing treatment. Documenting care can be defined as a medical electronic record that includes basic information of the patient, medicaments prescribed, illness and its treatment procedure.It also includes various other reports like Magnetic Resonance Imaging, electrocardiograms and computerized tomography.The main objective of these systems is that it helps in decision analysis and facilitates treatment.The information is recorded in clinical database and can be used as future reference and evidence (Daly & Jackson, 2017). In the case of Bretty, her nurse forgot to write medications in her medication chart and she was not given any medicines. It would have led to serious medical complications in her if her daughter had not informed the nurse at the right time.
There are various advantages of electronic health medical records like the patient records can be accessed more quickly and efficiently. It enables the doctors to diagnose a disease more efficiently and reduces the chances of medical errors during surgical procedures. It also lowers the healthcare costs by proper coordination of the healthcare services by reduction in redundant and useless tests. It also provides better health care by improving all aspects of patient care like proper communication, being patient–centric and other important aspects of patient care.The patients admitted in the ward in the health care organizations should be provided patient centered care as it results in patients to live longer and reduces the pressure on health care organizations. It also improves the quality of the services offered by them and makes people active to get rid of various diseases and look after them by following a healthy lifestyle. This would help in reducing the overall cost of the treatment, improves the overall experience and help them to be more independent(Lewis, 2013). Healthcare professionals and should train their team properly to avoid any misunderstandings regarding the treatment and overcome all the barriers in communication. They should cater to the needs of patients and his family members; solve their queries by being an active listener in a proactive manner. The main aim is to have a strong relation between the patient and the clinician. Nurses who work alongside need to ensure that the patients receive timely care and medications during the treatment
Several protective measures should taken by the health organizations to avoid various kinds of infection, injuries or accidents. It is a top priority in many hospitals but some hospitals are not able to avoid errors during their treatment. It leads to serious complications, slow recovery, increased length of hospitalization and also unnecessary deaths of patients. Patient safety can be ensured by identifying patients correctly by mentioning their name and date of birth, improved staff communication, safe use of medicines by administering them carefully in the patients. There should be safe use of alarms to prevent mistakes in various surgical processes and identify safety risks in patients. This will help in preventing various kinds of infections caused by different pathogens such as bacteria and viruses in the patients especially those who have undergone surgery (Lord & Tiedemann, 2013).The nurses should follow all the legal and ethical principles of nursing. Nurses are responsible for providing person centered care to their patients and help them whenever they are in need because nursing is a profession which emphasizes in providing quality care health services to the individuals and several families. Hospitals should recruit safe and a competent nurse and the one who follows all the regulations, standards and the professional values during the service.They should take consent from the patient and his family members before starting the treatment procedure. They should explain the medications and the precautionary measures to be taken, functions and side effects of the drugs and the risks involved in the treatment procedure. Various laws, acts and policies should be followed by the nurses during the practice as these laws aims to provide quality care to the patients by following the policies and the guidelines of nursing profession.Nurses should follow proper nursing interventions to patients according to the policies formed for the practice.
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