Health Management Protocol (HMP) is an extended description that provides a detailed knowledge about drug therapy protocol. It is mostly applicable in the health context of rural regions, where the facilities and amenities are mostly do not favor quality healthcare and medication service (Runciman et al., 2012). Therefore, using HMPs, the healthcare facility can establish different restrictions and provide approvals to the facility to carry out quality healthcare treatments (Bourke et al., 2012). Further, risk factors related to health management strategies are also a factor that helps the healthcare facility in the rural region to determine the effectiveness of the medical treatment (Runciman et al., 2012). In this assignment, a case study of a three year old indigenous child Tamara has been discussed who was admitted to a rural health facility after facing the problem of anaphylaxis and high stridor was observed. In this context the Health Management Protocol will be identified and justification of used HMP will be discussed. Further the risk factor of health management will be identified and a well-structured argument will be presented with relation to the given case study.
HMP identification and justification
Health management protocol is a framework through which quality care is provided to a patient in rural settings in limited amenities or facilities. In this process, the healthcare process should be in compliance with the three important factors of healthcare policy such as legislation, cultural safety, advanced nursing practice, and use of drugs that can comply with proper pharmacokinetics, mentioned in the modules (Praveen et al., 2013). In this case study, Tamara, a three year old child was suffering from Anaphylaxis and due to that she was admitted to a rural healthcare facility with high stridor and allergic reaction. It occurred in the rural region, where due to crops, anaphylactic reaction occurs. Tamara belonged to aboriginal community and therefore, for her health management protocol, there are few aspects that should be included in the care process. The top priority should have been given to the cultural safety as it is the basic need of any patient so that their beliefs, thinking and cultural need can be protected. Medication safety delivery is another aspect that should be properly included on the care process, however, due to lack of healthcare facilities and amenities, the medication need was not properly served and the patient had to face severe allergic reaction (Shearer et al., 2012). Thirdly, the care process should comply with the legislation and healthcare policies so that the ethical, and professional code of good healthcare process can be maintained. In this process, compliance to Australian Commission for Safety and Quality in Health Care (ACSQHC) standard four so that treatment can be properly aligned with the standards (Runciman et al., 2012). Furthermore, through this protocols, additional support and efficiency in distribution, of quality healthcare is provided to the patient so that a proper professional relationship can be managed. Hence, using HMP in this clinical scenario, the health care facilities will be able to make the healthcare process according to the healthcare need of the patient care in the process the cultural safety, medical needs and advanced nursing interventions will be implemented in the process (Bourke et al., 2012). Further making the process comply with the legislation and polices make it ethically and professionally correct.
The risk factors and management strategies
Some of the risk factors associated with this case study is the lack of cultural safety, human safety, lack of proper infrastructure, improper health literacy, lack of proper medications. Most of the risk factors are due to the fact that the child has been brought to a rural health care facility. A rural health care facility is likely to contain health care staffs that might lack proper health literacy. It can be seen from the case study that the child was being admitted in the health care facility with an expiratory stridor. The expiratory stridor had been caused due to the swelling of the wind pipe due an anaphylactic reaction. The condition was serious and was life threatening (Vetander et al., 2013). Swelling of the windpipe require proper airway management and pharmacological interventions by proper health care professionals (Fleischer et al., 2012). Some the risk factors that has been identified in this case study is inattentiveness. fatigue, lack of knowledge, memory lapse, fatigue, failure to communicate, noisy working conditions, interruptions, use of deck equipment, and many other environmental and personal factors all perform a role. Error in communication is the primary causative agent in adverse drug events and medication error (Chen et al., 2014). Initially the breaching of the health care ethics has been caused as the child was kept waiting for specialist treatment. Secondly the health care staffs were not competent enough to apply proper protocols of the assessment of the airways. Communication with the patient is one of the crucial aspect of health care, which was found to be difficult in this case due to the aboriginal background of child. Moreover there was a lack of a cultural safe care (Larkin & Murray 2005).
The management strategies for the risk factors includes the ceasing of the adverse drug reaction that is chocking her airways. As stated by Mkoka et al.,(2014) most of the clinical errors are caused due to medication errors. It can be seen that the condition of the patient was further deteriorated by the negligence of the health care member. In order to manage medication errors the health care professionals should have cross checked the medications and have kept a record about her past allergic history (Mkoka et al.,2014). Evidence based practice and collaborative practice has been found to be important for preventing medication errors. Another risk factor that has been identified is the provision of a culture safe care for the patient. The case study reveals that Tamara was an aboriginal and her family is centered around certain health care beliefs such as gender matching and reliance on the bush medicines. This can be addressed by applying proper communication procedures such as provision of interpreters (Newman et al., 2013). Provision of the gender matched caregivers is also an important approach while providing a cultural safe care. Another management strategy is the provision of proper health literacy in rural health care settings.
The protocol regarding the management of anaphylactic reaction in Tamara involve the removal of the agent that has triggered the anaphylactic reaction. Assessment of the ABCD,
A – Airway
B – Breathing
C – Circulation
D – Drug treatment
The pharmacological management of the child should involve the application of proper dosage of epinephrine. Care should be taken regarding the adherence to the HMP protocol for the application of intravenous drugs. There has to be proper facilities for oxygen therapy for improving the lung functional capacity, in case the child suffers from any kind of respiratory distress.
Application of safe medication practice principles in lieu of ethno-medicinesIt is important to apply an evidenced based practice for adhering to safe medication practice. The case study reveals the fact that the child had an aboriginal background and it should be noted that the aboriginal health beliefs are mainly traditionally centered and are mainly based on alternative bush medicines or traditional healers. But it has to be remembered that application of phyto-products can be allergic to patients. In this case I would apply intramuscular epinephrine. I should be mindful about choosing the site for the injection and would ensure that the patient’s lung functional capacity increases (Larkin & Murray 2005). I would ensure to check the vital signs in an interval of 15 minutes before and after the application of the epinephrine. I would place the child in the supine position with her feet elevated as tolerated. I would ensure that all the patient’s current and the future records the clear and distinctly marked in order to prevent any medication error in the future. In case of further deterioration of the patient or a complete blockage of the wind pipe it is better to shift the patient in an emergency care unit form the rural health care unit.
Nursing intervention is a crucial part of healthcare process as while providing care to a patient, professionals need to follow several aspects related to patient’s cultural, physiological and healthcare related needs. However, the process is not equal in rural and metropolitan regions as the rural region mostly lacks fundamental needs, basic amenities and facilities required to make a healthcare facility comply with the health management. Therefore, HMP is used so that the rural healthcare system can be assured for carrying out severe healthcare interventions. In this assignment, discussion of a 3 year-old girl child Tamara was discussed who was suffering from severe anaphylaxis and due to that showed high stridor. She was admitted to the ward, however due to lack of proper healthcare and medication facility suffered from allergic reactions. Hence, in this assignment the HMP related to this case was identified and justification for inclusion of different protocols was mentioned. Secondly the risk factor associated with the healthcare management was discussed. Finally, the discussion of replacing ethanomedicines with intravascular epinephrine was discussed in the light of the case study.
Bourke, L., Humphreys, J. S., Wakerman, J., & Taylor, J. (2012). Understanding rural and remote health: a framework for analysis in Australia. Health & Place, 18(3), 496-503.
Fleischer, D. M., Perry, T. T., Atkins, D., Wood, R. A., Burks, A. W., Jones, S. M., ... & Sicherer, S. H. (2012). Allergic reactions to foods in preschool-aged children in a prospective observational food allergy study. Pediatrics, 130(1), e25-e32.
Larkin C. & Murray R. (2005) Assisting aboriginal patients with medication management. Australian Prescriber. 28(5): 123-125.
Mkoka, D. A., Goicolea, I., Kiwara, A., Mwangu, M., & Hurtig, A. K. (2014). Availability of drugs and medical supplies for emergency obstetric care: experience of health facility managers in a rural District of Tanzania. BMC pregnancy and childbirth, 14(1), 108.
Newman, C. E., Gray, R., Brener, L., Jackson, L. C., Johnson, P., Saunders, V., ... & Treloar, C. (2013). One size fits all? The discursive framing of cultural difference in health professional accounts of providing cancer care to Aboriginal people. Ethnicity & health, 18(4), 433-447.
Praveen, D., Patel, A., McMahon, S., Prabhakaran, D., Clifford, G. D., Maulik, P. K., ... & Peiris, D. (2013). A multifaceted strategy using mobile technology to assist rural primary healthcare doctors and frontline health workers in cardiovascular disease risk management: protocol for the SMARTHealth India cluster randomised controlled trial. Implementation Science, 8(1), 137.
Runciman, W. B., Hunt, T. D., Hannaford, N. A., Hibbert, P. D., Westbrook, J. I., Coiera, E. W., ... & Braithwaite, J. (2012). CareTrack: assessing the appropriateness of health care delivery in Australia. Medical Journal of Australia, 197(2), 100.
Shearer, B., Marshall, S., Buist, M. D., Finnigan, M., Kitto, S., Hore, T., ... & Ramsay, W. (2012). What stops hospital clinical staff from following protocols? An analysis of the incidence and factors behind the failure of bedside clinical staff to activate the rapid response system in a multi-campus Australian metropolitan healthcare service. BMJ Qual Saf, bmjqs-2011.
Vetander, M., Helander, D., Flodstr?m, C., ?stblom, E., Alfven, T., Ly, D. H., ... & Wickman, M. (2012). Anaphylaxis and reactions to foods in children–a population?based case study of emergency department visits. Clinical & Experimental Allergy, 42(4), 568-577.