Critically discuss the role of the nurse in leading a team, managing change and maintaining quality of care drawing upon your practice experience.

The assignment title:

Critically discuss the role of the nurse in leading a team, managing change and maintaining quality of care drawing upon your practice experience.

You need to include;

  • Critical consideration of professional transition, leadership and change management.
  • Demonstrate how leadership and team working abilities enhance patient care.
  • Critically consider issues of quality relevant to nursing care delivery.
  • Discuss how nursing care delivery is informed by research and evidence.
  • Reflection upon your own transition to autonomous nursing practice.
  1. What does the question mean?
  2. Break it down into smaller elements:

What is the role of the nurse in leading a team?

Consider leadership styles, essential skills of a good leader, draw on examples of good leadership/poor leadership you may have experienced in practice.

Consider what effective team work is, what skills are needed, team culture. Draw on any examples of good/poor teamwork or team cultures you may have experienced.

Consider the impact on patient care of leadership and team working.

What is the role of the nurse in managing change?

Consider why the nurse has to manage change, how can change be managed effectively – consider change models, the human impact of, and response to change and how this can be managed. Draw on any experiences of change in your practice experience.

What is the role of the nurse in maintaining quality of care?

Think about the individual nurse and accountability

Consider what quality care is, how do we know it has taken place and how is it measured. What systems, processes govern quality of care  – clinical governance, research evidence and dissemination.

You are additionally asked to consider professional role transition and reflect on your own transition to autonomous practice

Explore role transition theories and apply them to your movement from student to staff nurse. How will you use this knowledge to prepare you for being a registered nurse and to manage your transition. How do you think these models could be used by nurse leaders to improve the transition experience?

Critical discussion

With all of these elements you need to take a critical approach. Do not just describe the various theories and models you refer to, be critical about them. Maybe some models aren’t applicable to healthcare for example, or you may find critiques of the models in the literature.

Apply the models and theories to you practice experience. You might consider how they could have been useful in situations you have observed or it may be that you now realise that a particular leadership approach was being used for example. Was this appropriate, inappropriate?

Remember, when you consider opposing views, draw some conclusion from them.

Also, be critical about the literature you use

General academic writing:

You assignment should start with an introductory paragraph which sets out the aims of the essay. What is this assignment going to discuss, what is its purpose?

Structure your work in paragraphs which have a clear focus. The first sentence of a paragraph should be a statement of a key point which is then discussed and evidenced during the paragraph. Then move on to the next key point in a new paragraph.

Ensure there is a logical flow in the order of your key points so it leads the reader through the discussion towards some conclusions.

Complete your essay with a concluding paragraph which shows what you have demonstrated in your essay. Do not just list your key points. Summarize and draw some conclusions from your discussion.

Here is a quick example;

The following essay will explore the life of tadpoles in a glass container. It will consider the water quality, the options of flora and the impact of children watching it on the growth of the tadpoles…

The paragraphs will be – what the normal life of a tadpole is, what options of flora there are and the advantages and disadvantages of them, what impact the children watching has….

It has been demonstrated in the above discussion that the life of tadpoles is complex, dominated by a persistent transition process. While many different flowers are suitable to keep alongside the developing tadpole, none are preferable and personal choice should be applied. Although research demonstrates that watching tadpoles is therapeutic for children, there is insufficient evidence to suggest that being watched has any impact on the growth rate of tadpoles.

Academic style:

This is an academic essay so should be written in the third person, however, you are being asked to relate the discussion to practice and to reflect on your transition. Therefore if you defer to the first person in these areas, you would not be penalized. Some ways of expressing your experience without using ‘I’ are:

It has been observed in clinical practice that…

A situation experienced in clinical practice was..

In the authour’s experience…

Duscher’s transition theory is already relatable to the authour’s experiences as a third year student nurse…

Do not waste all your time and energy presenting your work in this manner and become overwhelmed. Demonstrating you have addressed the assignment question and met the learning outcomes is of primary importance.

Academic Supervision:

Academic supervisors will provide group supervision. Individual supervision will be provided in accordance with individual student Learning Support Plans. It is your responsibility to request and access this if you have an identified plan.

Supervisors will additionally provide brief written feedback on an essay plan and/or a contextualized 600 word draft extract.

In the unlikely event that you experience difficulty in receiving feedback from your allocated supervisor, please make the module leaders aware. It is your responsibility to escalate this.

Academic supervision will not be provided in the week prior to assignment submission date in accordance with University guidance.

Extensions:

If you require an extension for your assignment please follow guidance in the module handbook.

Describe the philosophical or theoretical basis for teaching approaches used in the lesson for each learner.

In a Microsoft Word document of 5-6 pages formatted in APA style, develop the introduction for your project. Be sure to focus on one (1) disease (you choose) but three (3) audiences (patient, family and staff development).
(This is a two part paper, I will be putting in another order for the second part separately and will ask for you, the writer again for the second part)

Contents for this paper should:
-Contain the title of the lesson.
-Identify and describe the learners as listed above.
-Describe the educational setting for:
1-Staff development
2-Patient education
3-Family education

Include learner assessments for the 3 learners:
1-Educational level
2-Developmental level
3-Readiness to learn, and so forth.

-Provide a purpose and rationale for selecting the topic/disease.
-Describe the philosophical or theoretical basis for teaching approaches used in the lesson for each learner.
-Support criteria with relevant examples and journal articles.
-On a separate references page, cite all sources using APA format.

How does glyburide work within the body? How should the patient be educated on this medication?

How does glyburide work within the body? How should the patient be educated on this medication? Is there any medication or food that a patient should avoid while taking this medication?
APA format and at lease 1 peer review journal.

Describe the parent theory. Identify the key constructs and relational statements. Include a diagram of the parent theory.

Background, Significance & Theoretical Background of the  Phenomenon
a. Use the feedback from the Review of Theoretical Perspectives paper
b. summarize the background, significance and theoretical background of the phenomenon including modifications, and add the following new content.
→ my proposition statement (about my phenomenon, population of interest, and outcome of interest) is → Cancer Patients and Post-Operative Venous Thromboembolism
Develop a theoretical or conceptual model that can be used to guide  practice on your topic.
a. From the major theoretical approaches that you described  in your initial paper, choose one theoretical orientation, or theory → The Theory of Unpleasant Symptoms in Practice (TOUS), that you would like to apply to your chosen phenomenon and assigned population and outcome of interest. You may use an existing middle-range theory, you may derive a theory from a grand theory, or you may synthesize one or more theories to create a new middle
-range theory. Provide a brief rationale for your choice of theory.
b. Describe the parent theory. Identify the key constructs and relational statements. Include a diagram of the parent theory.
c. Derive a theoretical model that can be used to guide your research. Clearly identify the conceptual, theoretical, and empirical levels of the model. Include the C-T-E diagram as a Table in your paper.
3. Describe your proposed theoretical model.
a. Identify and explain the key concepts in your model and provide conceptual definitions.
b. Identify and explain the relationships between your concepts.
Include a visual model (diagram) of your theory.
Using your theory as a guide, develop three possible quality clinical questions that you could answer from your conceptual model. Instructor stated: Continue to work on making links between the population, outcome of interest, and the phenomenon. Also, continue to think about what types of clinical questions could be answered with this information.
Write clearly and succinctly. Pay particular attention to integrating and critically evaluating the literature. Present your ideas logically. Use transitions. Include an introduction and summary. Adhere to APA style (7thedition), including heading and subheading structure, reference format, and table/figure format, titles, and placement.
Use subheadings. The total page length should be approximately
16 pages, excluding cover page with changes, references and appendices.

Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements.

This is a continuation of the assessments you worked on medication errors. In this is assignment you must pick 3 or 4 subcategories for eg showing ways to reduce medication errors, causes for errors, error reporting.
For each sub categories if its 4 you choose 3 sources for each subcategory and summarize them. If your pick 3 subcategories like the one mentioned above then you choose 4 sources and site. No matter the choice it needs to equal to 12 sources used equally.

In the instructions that i have attached, the professor gives an example of what the paragraph should say for each article (highlighted in green). i have also attached a sample from another student and you can follow the same subcategories as long as they apply to medication errors. The paper does not have to be that long. the paragraph summarizing the article should include the following :
• Identify necessary resources to support the implementation and continued sustainability of a safety improvement initiative.
• Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements.
• Analyze the value of resources to reduce patient safety risk.
• Present compelling reasons and relevant situations for use of resource tool kit by its target audience.

The sample highlighted in green and student sample should help guide you. Again each article summarized can be a paragraph as long as it answers what the professor wants.

Discuss how change will be evaluated and how will you know that quality of care has been enhanced. This could include audit measures.

Introduce your chosen change management model/framework. Justify why you have chosen this as opposed to other models. Critically analyze the suitability to your change idea, with reference to literature and good change management theory. There should be some comparing and comparison as a start to analysis.
• Consider strategies (from your reading) that will overcome barriers to change and anticipate how you can follow through the model. Think about communication methods and you could link this to leadership styles if you wish?
• Discuss and define the impact on other people using the concept of coproduction and remembering that changing one part of the system will have a potential impact on another part of the healthcare system.
• Explain how the tools you would use to support your chosen change management report will help in implementation e.g. PDSA, 5 whys and fishbone.
• Justify and explain your leadership approach in relation to the relevant theory. Think about the styles of leadership and which will work or not work for the stage of the change.
• Discuss how change will be evaluated and how will you know that quality of care has been enhanced. This could include audit measures.

What is holism and how does it link to good care? – attention to psychological as well as physical needs and consideration of social factors influencing needs?

What is good care?
What difference does good care make to practice- why is it important?
How does communication link to and impact good care?
What political and ethical challenges link to good care? – for example the NHS Constitution, the Francis report and the 6Cs of care.
What is holism and how does it link to good care? – attention to psychological as well as physical needs and consideration of social factors influencing needs?
What are the professional responsibilities of a healthcare professional such as confidentiality, promotion of privacy & dignity, anti discriminatory practice- with reference to your professional codes and standards?

Discuss design biases and threats to internal construct and external validity. How did they minimized these threats?

The Critique will be presented as a professional PowerPoint presentation posted online.  The presentation must include, and only include, the following:

Slide # Content
1 Title slide with author name
2 APA citation of article being reviewed
3- Statement of the problem Description of the problem statement.

Be sure to address all components on page 102 of your book

4 Significance to nursing
5- Hypotheses or research questions What is the research question/aim/purpose or hypothesis?
6- Framework Describe the theoretical or conceptual framework that guides the study
7- Research design Name it. Describe why this was the best design to use or why another one would be more appropriate. Describe comparisons being made within the study if appropriate.
8 Discuss design biases and threats to internal construct and external validity. How did they minimized these threats?
9-Population and sample Describe the population. What sampling design was used to obtain the sample? Was this the best design to use? Why or why not- think biases? Was the sample adequate? Describe how you know this.
10- Data Collection and Measurement Name the independent and dependent variables- define them.
11-12 What instruments or tools were used to measure these variables? Name and describe them. Were these tools the best ones to use?
13 Describe how do you know these were the best tools to use- think reliability and validity as evidence
14- Results What statistical tests did they use to examine the research questions etc.? Were these tests appropriate? Why?
15 Describe the results of the study. What findings were statistically significant?
16 What is the CLINICAL significance of this study?
17- Discussion Describe how findings were consistent or not with prior literature. Does the study present reasonable implications for nursing and/or research? Describe these implications
18- -Global issues What is your overall impression of the article? Provide strengths and weaknesses and support your answer
19- Summary Do the findings appear to be true? Do you have confidence in the results? How can nurses use information in the article to help their practice?

 

Remember, you will most likely paraphrase information from your article in this assignment. A few short quotes are acceptable- if properly cited- but please do not rely too heavily on quotes as this does not tell the instructor that you understand and are able to interpret the questions being asked, only that you know how to cut and paste.

Apply the clinical reasoning cycle to provide person-centred care for individuals experiencing a deterioration in health in order to provide safe nursing care.

SCHOOL OF NURSING & MIDWIFERY NSG3RDP/ NSG3RDM – Recognizing and Responding to the Deteriorating Patient Assessment activity 1 – 2000 words (35% of overall subject mark) Due date: 11.5.2020 (09.00)

Subject Intended Learning Outcomes (SILOS)
1. Explain common pathophysiology, as it relates to assessment data and pharmacology, that can result in deterioration of an individual’s condition in order to develop appropriate interventions.

2. Apply the clinical reasoning cycle to provide person-centred care for individuals experiencing a deterioration in health in order to provide safe nursing care.

3. Develop an awareness of and contribute to the risk management strategies of a healthcare agency, in order to implement incident reporting procedures and apply risk management procedures.

Context

Serious adverse events, such as unexpected death, intensive care admission and cardiac arrest, are often preceded by observable physiological, clinical abnormalities and deterioration. Other serious events, such as suicide and aggression, are also often preceded by observed or reported changes in a person’s behaviour or mood that can indicate deterioration in their mental state. Early identification of deterioration may improve outcomes and decrease interventions required to stabilise patients whose condition deteriorates in a health service organisation.
The warning signs of clinical deterioration are not always identified or responded to appropriately. The organisational and workforce factors that contribute to a failure to recognise and respond to a deteriorating patient are complex and overlapping (Australian Commission on Quality and Safety in Health Care, 2017)

NSG3RDP/NSG3RDM Semester One 2020
Task
In this assessment you are required to further explore the trauma case study introduced in topic two and three of your LMS and workshop materials for NSG3RDP/RDM.
You will be provided with an ISBAR handover and a National Observation Chart (NOC) for Joanna Cleese. (These documents will be attached at the end of this instruction sheet)
Using the provided information and current academic literature please provide a response to the following three questions Instructions
Answer the following questions as instructed • Question 1 (750 words) The condition of your patient Joanna Cleese described in the ISBAR handover, appears to be changing. (Please refer to the attached documentation) Using the information that you have identified from the NOC and the ISBAR case study handover: 1. Discuss the possible causes of Joanna’s changing condition, supporting your response with contemporary literature and the associated significant cues, signs and symptoms listed in the case study. 2. Explain what possible further deterioration could occur for this patient, with a detailed evidenced -based response. (Please support your justification and rationales with quality peer-reviewed literature).

• Question 2 (750 words) There are many tools that can be utilized when assessing a patient. When assessing a deteriorating patient accurate assessment is essential. Compare and contrast the following methods of patient assessment and their appropriate applications for the deteriorating patient. 1. Primary (ABCDE) 2. Head to toe assessment (Please support your discussion with evidenced based literature).

• Question 3 (500 words) A change in a patient’s heart rate, blood pressure, temperature and respiratory rate can all be an indication of clinical deterioration. It has been suggested that a changing respiratory rate is the earliest indication of clinical deterioration and yet it is often not measured correctly, or not measured at all. Using evidence-based literature to support your arguments: 1. Discuss why a changing respiratory rate is an important indicator of clinical deterioration. 2. Explain how the respiratory rate can be measured reliably and accurately.

NSG3RDP/NSG3RDM Semester One 2020

**Discussions are to be supported with relevant and contemporary literature.
**References: Reference list and appendices are excluded from the word count.
**References to be no older than ten years
**10% word limit allowed. Resources
Australian Commission on Quality and Safety in Health Care. (2017). National Quality and Safety Health Care Standards Edition Two,. Retrieved from https://www.safetyandquality.gov.au/wp-content/uploads/2017/11/National-Safety-andQuality-Health-Service-Standards-second-edition.pdf How to find scholarly literature: http://latrobe.libguides.com/finding-information How to reference using APA6: http://latrobe.libguides.com/referencing/referencing_tool Submission process.
Please use the submission template provided to document information. The document, which includes the completed submission template should be submitted as ONE Word document. Your assignment should be submitted via the Turnitin assignment submission link located in the LMS site for this subject by the due date and time. The submission process is an automatic acknowledgement that you have complied with the guidelines for student responsibility for academic integrity: http://www.latrobe.edu.au/students/academic-integrity/explanation If you have any questions about the assignment please contact the subject coordinator Jen Austerberry either by emailing j.austerberry@latrobe.edu.au or calling: 94964457 or 0417562176. Extensions and special consideration
Students must seek a formal extension to submit after the due date where there are extenuating circumstances. Read the instructions on the following web page http://www.latrobe.edu.au/?a=668155
You submit your request for an extension of the due date from this webpage.
If you have a personal issue or illness that is affecting your study, you may need to apply for special consideration. It is recommended that you discuss your situation with the course coordinator (Liz Pascoe) as soon as possible.
Eligibility to apply for Special Consideration does not automatically imply eligibility to receive it. Certain criteria must be satisfied in order to receive Special Consideration. Please refer to the policy information and on-line form located at: http://www.latrobe.edu.au/special-consideration
NSG3RDP/NSG3RDM Semester One 2020

Late submission
There are policies and procedures to guarantee fair, consistent and transparent treatment of late submission of assessment tasks provide equity around extensions to submission dates and penalties associated with not submitting assessment by the due date and time. 5% of the total possible marks will be deducted each day (or partial day) delayed submission, for a maximum of up to five (5) working days after the due date. Assessment tasks will not be accepted after the following occurrences:
• the fifth (5th) working day after the due date; or • feedback on the assessment task has been returned to any student by the Teaching Team member.

The policy relating to late submissions can be located at: https://policies.latrobe.edu.au/document/view.php?id=148

NSG3RDP/NSG3RDM Semester One 2020

School of Nursing & Midwifery: NSG3RDP/NSG3RDM Assessment One

CRITERIA Excellent (> 80 %) Very good (70% – 79%) Good (60% – 69%) Fair (50% – 59%) Poor (<50%) MARK Question One Discusses the possible causes of Joanna’s changing condition Explains what possible further deterioration could occur

USE OF LITERATURE TO SUPPORT DISCUSSION
(35% of total mark)
28 + marks Clearly and consistently discuss possible causes of the Joanna’s changing condition Clearly and consistently explains what possible further deterioration could occur Demonstrated an excellent understanding of links between the necessary concepts. Demonstrated clear and consistent evidence of critical appraisal of reference material Evidence of synthesis of information and logical development of arguments.

24 – 27 marks Clearly and mostly consistently discuss possible causes of the Joanna’s changing condition

Clearly and mostly consistently explains what possible further deterioration could occur Demonstrated a very good understanding of links between the necessary concepts. Demonstrated some evidence of critical appraisal of reference material Some evidence of synthesis of information and logical development of arguments Literature predominantly used effectively to support key ideas.

21 – 23 marks Good but inconsistent attempt to consistently discuss possible causes of the Joanna’s changing condition.

Good but inconsistent attempt to consistently explain what possible further deterioration could occur Demonstrated good understanding of links between the necessary concepts. Demonstrated inconsistent evidence of critical appraisal of reference material Inconsistent evidence of synthesis of information and logical development of arguments Literature inconsistently used to support key ideas.

18 – 22 marks Fragmented and inconsistent attempt to discuss possible causes of the Joanna’s changing condition Fragmented and inconsistent attempt to explain what possible further deterioration could occur Demonstrated limited understanding of links between the necessary concepts. Demonstrated limited evidence of critical appraisal of reference material Limited evidence of synthesis of information and logical development of arguments Literature poorly used to support key ideas.

<17 marks Demonstrated lack of understanding of possible causes of the Joanna’s changing condition Demonstrated lack of understanding of what possible further deterioration could occur Demonstrated lack of understanding of links between the necessary concepts. No evidence of critical appraisal of reference material No evidence of synthesis of information and logical development of arguments Overreliance on direct quotes Key ideas not supported by the literature

/35
NSG3RDP/NSG3RDM Semester One 2020
Question Two Compares and contrasts 1. Primary (ABCDE) 2. Head to toe assessment

USE OF LITERATURE TO SUPPORT DISCUSSION
(35% of total mark)
28 + marks Clearly and consistently compared the two methods of assessment Demonstrated an excellent understanding of links between the necessary concepts. Demonstrated clear and consistent evidence of critical appraisal of reference material Evidence of synthesis of information and logical development of arguments.

24 – 27 marks Clearly and mostly consistently compared the two methods of assessment Demonstrated a very good understanding of links between the necessary concepts. Demonstrated some evidence of critical appraisal of reference material Some evidence of synthesis of information and logical development of arguments Literature predominantly used effectively to support key ideas.

21 – 23 marks Good but inconsistent attempt to compare the two methods of assessment Demonstrated good understanding of links between the necessary concepts. Demonstrated inconsistent evidence of critical appraisal of reference material Inconsistent evidence of synthesis of information and logical development of arguments Literature inconsistently used to support key ideas.

18 – 22 marks Fragmented and inconsistent attempt to compare the two methods of assessment Demonstrated limited understanding of links between the necessary concepts. Demonstrated limited evidence of critical appraisal of reference material Limited evidence of synthesis of information and logical development of arguments Literature poorly used to support key ideas.

<17 marks Demonstrated lack of understanding of the two methods of assessment Demonstrated lack of understanding of links between the necessary concepts. No evidence of critical appraisal of reference material No evidence of synthesis of information and logical development of arguments Overreliance on direct quotes Key ideas not supported by the literature.

/35
Question Three

Discusses why a changing respiratory rate is an important indicator of clinical deterioration.
Explains how the respiratory rate can be measured reliably and accurately.

USE OF LITERATURE TO SUPPORT DISCUSSION
28 + marks Clearly and consistently discusses the changing respiratory rate significance and explains the means of achieving assessment accuracy Demonstrated an excellent understanding of links between the necessary concepts. Demonstrated clear and consistent evidence of critical appraisal of reference material.
24 – 27 marks Clearly and mostly consistently discusses the changing respiratory rate significance and explains the means of achieving assessment accuracy Demonstrated a very good understanding of links between the necessary concepts. Demonstrated some evidence of critical appraisal of reference material Some evidence of synthesis of information and logical.
21 – 23 marks Good but inconsistent attempt to consistently discuss the changing respiratory rate significance and explain the means of achieving assessment accuracy Demonstrated good understanding of links between the necessary concepts. Demonstrated inconsistent evidence of critical appraisal of reference material.
18 – 22 marks Fragmented and inconsistent attempt to discuss the changing respiratory rate significance and explain the means of achieving assessment accuracy Demonstrated limited understanding of links between the necessary concepts. Demonstrated limited evidence of critical appraisal of reference.
<17 marks Demonstrated lack of understanding of the significance of the respiratory rate or the means of achieving accuracy. Demonstrated lack of understanding of links between the necessary concepts. No evidence of critical appraisal of reference material.

NSG3RDP/NSG3RDM Semester One 2020

(25% of total mark)
Evidence of synthesis of information and logical development of arguments.

development of arguments Literature predominantly used effectively to support key ideas.

Inconsistent evidence of synthesis of information and logical development of arguments Literature inconsistently used to support key ideas.

material Limited evidence of synthesis of information and logical development of arguments Literature poorly used to support key ideas.

No evidence of synthesis of information and logical development of arguments Overreliance on direct quotes Key ideas not supported by the literature

ACADEMIC INTEGRITY & FORMATTING (5% of total mark))
4+ marks Correct use of APA V6 intext and end-text format. Use of submission template and specified formatting. No spelling typing or grammatical errors Within 10%-word limit.

4 marks Correct use of APA V6 intext and end-text format, minor errors. Use of submission template and specified formatting. Minor spelling, typing & grammatical errors. Within 10%-word limit.
3 marks Occasional errors in APA V6 format. Use of submission template and specified formatting. Minor spelling, typing & grammatical errors.

Within 10%-word limit
2 marks References provided but incorrect use of APA V6 format. Use of submission template. Inconsistent use of specified formatting. Consistent spelling, typing and grammatical errors. Within 10%-word limit
≤1 mark Referencing does not adhere to APA V6 format. Specified presentation & formatting not used. Spelling, typing and grammatical errors throughout the paper which impact on fluency and coherency. Exceeds 10%-word limit.
/30

/100

NSG3RDP/NSG3RDM Semester One 2020

Attached documentation Handover ISBAR Setting Emergency Department Time frame: Three hours post arrival by ambulance. (1730hrs) Patient identification.

Joanna Cleese 55-year-old female Social history Lives alone Widowed Three adult children Works in IT as a computer programmer
Situation/Setting the scene.

Initial Investigations/treatment

Joanna was up on a ladder cleaning the gutters when she fell approximately two metres onto a concrete path. Joanna was found by her neighbour immediately following the fall, lying face down on her left side on the concrete path. Initially Joanna was unresponsive for 2-3 minutes before responding to voice in a confused manner. An ambulance was called by the neighbour and Joanna was transported to La Trobe Emergency Department. Injuries include Haemopneumothorax Fractured ribs 3-6 Fractured left neck of femur (NOF) Fractured left radius and ulna Head laceration Generalised bruising to left chest and shoulder temporal area, left abdomen, thigh and left arm Chest/abdomen/pelvic/ left arm and leg x-rays Head CT scan Intercostal catheter (ICC) inserted 5th intercostal space mid axillary line Two wide bore intravenous cannulas’ Intravenous (IV) fluid administration Intravenous pain management Left wrist splinted Left leg external traction

Background/Past medical and surgical history

Medications
Hypertension Recently diagnosed Type 2 Diabetes Obesity BMI 40

NSG3RDP/NSG3RDM Semester One 2020

Allergies
Ramipril 5mgs BD orally Metformin 500mgs BD orally

Penicillin
Assessment information

Airway patent Patient verbalising RR 26 ICC insitue 20cm suction, absence of swing or bubbling 200mls frank blood drained initially, nil further drainage O2 Sat 94% nasal prongs 2lpm O2 Temp 36.5 GCS 14 confused to time and place P/S 8/10 chest, leg and abdomen HR 120 BP 90/55

Recommendations/ Important considerations.

Patient awaiting transfer to general surgical ward. Remains nil by mouth (NBM) Surgical repair of #NOF planned for next day Continues IV fluids, analgesia Hourly observations.
Included documentation National patient observation chart.

NSG3RDP/NSG3RDM Semester One 2020

Demonstrate the use of research evidence for nursing practice applied to the care of a surgical patient.

Written Assignment – Nursing the Surgical

Task overview

Assessment name Nursing the Surgical Patient
Assignment Objectives 1.Demonstrate the use of research evidence for nursing practice applied to the care of a surgical patient.

2.Augment skills in clinical decision making and reasoning through synthesizing and analyzing information required to care for a surgical patient.

3.Apply appropriate assessment, problem solving, planning, prioritizing of interventions to care for the selected client scenario chosen.

4.Demonstrate the nurse’s role in monitoring and implementing prioritized nursing interventions in response identified patient needs.

5.Demonstrate the ability to communicate specific patient care issues succinctly according to scholarly writing and referencing conventions.

Due Date  
Length 2000 words +/-10% (including headings) (word length includes in-text referencing and excludes your reference list)
Marks out of:

Weighting:

A total of 80 marks = 40 %
Task description This assignment requires you to consider the case scenario of Frank Wright. Frank Wright has undergone a right total knee replacement.

Applying your knowledge and understanding of the post-operative patient, you will write an academic essay applying the principles of surgery, consideration of patient co-morbidities and implementing nursing actions that identify, assess and prevent potential clinical issues.

Must be written in the format of an academic assignment and in third person.

You may use headings to differentiate the three parts.

The assignment has three parts –

Part A: Using the clinical reasoning cycle, devise a post-surgical plan of care for a patient who has undergone a total knee replacement

Parts B: Discuss the impact of co-morbidities and a general anaesthetic on post-operative recovery

Part C:  Discuss discharge planning for the patient following a total knee replacement

1. Provide an INTRODUCTION (approximately 150 words)

An introduction should provide clear scope about the direction of your assignment.

Part A  Utilising the case scenario and considering the pre and post- operative clinical data and academic literature devise a plan of care (approximately 600 words)

  1. This section will concentrate on the first 24 hours of post-surgical care.
  2. Analyze the case and formulate an appropriate prioritized plan of care for Frank within the defined 24 hour period.
  3. In the plan of care include:

I. Identify relevant assessment (e.g. vital signs, renal, respiratory, etc.)

I. Based on your assessment, propose three (3) potential patient clinical issues.

II. Based on your assessment and three (3) potential clinical issues, develop prioritized interventions (including monitoring). These interventions should include nurse initiated and collaborative interventions.

  1. The scope of your prioritized interventions may include both physical and psychosocial aspects of care.
  2. The care plan must involve justification of your prioritized interventions and supported with rationales derived from the literature.

Part B: Analyzing the case to identify potential clinical issues in relation to co-morbidities (400-500 words)

1.Discuss smoking, and the co-morbidity of hypertension, high cholesterol and obstructive sleep apnoea (OSA) in the context of having a general anaesthetic within the 24 hour postoperative period.

2.In your discussion, include the possible clinical issues related to the smoking and OSA that could arise in this 24 hour period and how Fred might deteriorate (You will need to reason explain the relevant pathophysiology).

3.Detail the nursing interventions the nurse would initiate to decrease risk of clinical deterioration and include your rationale for the nursing interventions. Justify your rationale with reference to the literature.

Part C: Discharge Plan (300 words)

1.Identify and briefly discuss discharge planning for Frank. Identify from the case the discharge planning that would need to be put in place for Frank. Keep this section brief.

Provide an conclusion (approximately 150 words)

Your conclusion succinctly summarizes the main points of your assignment but this section is not an opportunity to introduce new information.

 

 

Case Study Pre-operative

Frank Wright is a 76 year old man, retired architect, married with two grown children and has been admitted for a right total knee replacement. Frank’s wife suffers from dementia and Frank is her main carer.  Consider the pre-operative data in your discussion.

Utilizing clinical reasoning cycle and referring to the post-operative data you will devise appropriate nursing plan for Frank.  Your answer will be divided into three parts with an introduction and conclusion. Ensure you refer to pre and post-operative data to support your answer.

Objective Data Past Medical History Social History
·         Weight 92kgs

·         Height 170 cm

·         BP 140/95

·         HR 86

·         RR 18

·         Temp 36/8

·         Urinalysis – normal

Current Medication

·         Simvastatin 40mg nocte

·         Atenolol 50mg daily

·         Ranitidine 150mg BD

·         Hypercholesterolemia

·         Hypertension

·         Osteoporosis affecting both hips and knees

·         Obstructive sleep apnoea confirmed with sleep study March 2019

·  Married with 2 grown children

·  Main carer for wife with who has early onset dementia

·  Retired

·  Smokes 10 cigarettes a day

·  Minimal alcohol use

Family history

·      Father RIP heart failure

·      Mother RIP pancreatic cancer

Postoperative

Frank has undergone a right total knee replacement and returned to the ward at 2100 hours. You are the nurse looking after him on the night shift.

Observations Medications Post-operative orders
·      BP 100/54, HR 106, Respiratory rate 12BPM, SaO2 95% FiO2 2 litres via nasal prongs, temperature 37.6°C Axilla,

·      Sedation score = 1-2

·      Vacudrain in-situ 50  ml in bag

·      Estimated blood loss (EBL) in OT 200ml

 

 

·         Simvastatin 40mg nocte

·         Regular paracetamol 1G QID

·         Captopril 50mg BD

·         Ranitidine 150mg BD

·         Aspirin 100 mg mane

·         Morphine PCA 1mg bolus: 5 minute lockout

·         Oxygen 2L via nasal prongs

·         Intravenous infusion: Sodium Chloride 0.9% (Normal Saline) (NaCl) 100mls/hour

·         Comfeel, crepe bandage to be de-bulked day one

·         Apply cryotherapy as tolerated

·         Normal diet

·         DVT prophylaxis –TED stockings

·         Aspirin 100mg daily

·         Pain management

·         GP follow up 2/52

·         OPD appointment 6/52 with Dr McMeniman

 

 

 

Submission information

What you need to submit Suggestions:

Microsoft Word document that contains the following items:

·       Coversheet including unit code, unit name, semester and year, assignment title, student name, student number, word count

·       Marking RUBRIC sheet on the last page of your assignment/ as a separate document

Submission requirements This assessment task must:

1.Use APA6 is the appropriate form of referencing.

2.Word count includes in-text references and citations but not the reference page.

3.Achieving correct referencing formatting is just one aspect of referencing.  More important is how you use someone else’s published material and correctly synthesize it into your own work – and correctly acknowledge that it is either theirs – or ascribed to someone else within their work (a secondary citation).

4.Each section of the assignment should read smoothly within itself and bring the reader in (introduce the topic) and out (conclude).

5.Academic staff assistance is provided to answer questions but we are not in a position to review drafts – but we will help with clarifying the assignment instructions.

6. When submitting your assignment you must complete the student declaration statement declaring that the assignment is your own work.

Any breach of this is a breach of professional ethics and this will be penalized appropriately.  Turning in work that someone else has done for you and stating that it is your own is considered fraud.  It does not reflect well on a student who is soon to be a Registered Nurse in Australia.  It does not reflect well on the profession

Moderation All academic staff who are assessing your work meet to discuss and compare their judgements before marks or grades are finalized.