Identify 4 incidents or issues that fall below best practice standards
1. analyse a clinical scenario2. identify 4 incidents or issues that fall below best practice standards3. explain the role of the Registered Nurse in achieving best practice standards on the ward in relation to the 4 incidents chosen4. demonstrate analytical skills supported by recent evidence based literature
NOTE: The focus in this assessment is on the professional role of the RN to achieve quality practice and is not to provide solutions to the clinical conditions of the clients in the scenario
SCENARIOYou are the RN team leader on a 32 bed acute medical ward in a large metropolitan hospital. You graduated two years ago, completing a Transition to Professional Practice Program (TTPPP) in your first year after graduation and are now frequently allocated as shift team leader on this ward. You are working the early shift, handover has been completed, staff have received patient assignments. It has been a hectic morning on the ward and you respond to an unanswered call bell for the patient in Room 16 Bed C.
?In Bed 16 C is Mrs. Jones aged 72, admitted last night for re assessment, management and stablilization of asthma. As you approach you note she is pale, sweaty and very short of breath. You assist her to sit up, the Nursing Care Plan reveals her 10.00am dose of Ventolin has not been documented as administered (it is now 11.00pm). Once you have completed the management of Mrs. Jones? immediate condition you review the remaining patients in the room.?In Bed 16 A is Mrs. Green, a 65 year old women, admitted with palpitations for investigation, and an electrocardiograph (ECG) indicated atrial fibrillation. She is being given Digoxin for this condition. When you ask how she is feeling she states she had chest pain after breakfast but its better now. You note that there is no report of this in the nursing notes, no documentation of vital signs or any indication of nursing actions taken regarding this episode.?In Bed 16 B is Mrs. Milly Rowling, aged 82 years. Milly doesn?t speak English very well having migrated a number of years ago from Slovakia. She was admitted with confusion for investigation, with a provisional diagnosis of Dementia. Milly is very restless in bed, which you note is in the high position. Her hair is unkempt, her face has traces of food, breath is acrid smelling, nightgown is unclean and her fingernails are dirty. Her housecoat and slippers lie on the floor beside the bed, newspapers have fallen on the floor as well and she does not have a call bell.?In Bed 16 D is Mrs. Smith, aged 56 years. She is recovering from a Cerebrovascular accident . She is out of bed gathering her toiletries and is about to go to the shower unaided. You note from her Nursing Care Plan that she must have a single person assist for all ambulationThe preceptor and student nurse assigned to these patients cannot be found. You check with a nurse assistant who indicates they both went to morning tea about 35 minutes ago.
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