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quality health care

  •   Deliver a 5–7-page analysis of an existing quality improvement  initiative at your workplace. The QI initiative you choose to analyze  should be related to specific disease, condition, or public health issue  of personal or professional interest to you.
    Too often, discussions about quality health care, care costs, and  outcome measures take place in isolation—each group talking among  themselves about results and enhancements. Because nurses are critical  to the delivery of high-quality, efficient health care, it is essential  that they develop the proficiency to review, evaluate performance  reports, and be able to effectively communicate outcome measures related  to quality initiatives. The nursing staff’s perspective and the need to  collaborate on quality care initiatives are fundamental to patient  safety and positive institutional health care outcomes.
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  • Toggle Drawer  Context
    The purpose of the report is to assess whether specific quality  indicators point to improved patient safety, quality of care, cost and  efficiency goals, and other desired metrics. Nurses and other health  professionals with specializations and/or interest in the condition,  disease, or the selected issue are your target audience.
  • Toggle Drawer  Questions to Consider
    As you prepare to complete this assessment, you may want to think  about other related issues to deepen your understanding or broaden your  viewpoint. You are encouraged to consider the questions below and  discuss them with a fellow learner, a work associate, an interested  friend, or a member of your professional community. Note that these  questions are for your own development and exploration and do not need  to be completed or submitted as part of your assessment.
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  • Toggle Drawer  Resources
    Suggested Resources
    The resources provided here are optional. You may use other  resources of your choice to prepare for this assessment; however, you  will need to ensure that they are appropriate, credible, and valid. The Nursing Masters (MSN) Research Guide  can help direct your research, and the Supplemental Resources and  Research Resources, both linked from the left navigation menu in your  courseroom, provide additional resources to help support you.
    Capella Resources
    Capella provides a thorough selection of online resources to help you understand APA style and use it effectively.
  • APA Module.
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  •  Assessment Instructions
    Preparation
    You have been asked to prepare and deliver an analysis of an  existing quality improvement initiative at your workplace. The QI  initiative you choose to analyze should be related to a specific  disease, condition, or public health issue of personal or professional  interest to you. The purpose of the report is to assess whether specific  quality indicators point to improved patient safety, quality of care,  cost and efficiency goals, and other desired metrics.
    Your target audience consists of nurses and other health  professionals with specializations or interest in your selected  condition, disease, or issue. In your report, you will define the  disease, analyze how the condition is managed, identify the core  performance measurements used to treat or manage the condition, and  evaluate the impact of the quality indicators on the health care  facility:
    Note: Remember, you can submit all, or a portion  of, your draft to Smarthinking for feedback, before you submit the final  version of your analysis for this assessment. However, be mindful of  the turnaround time for receiving feedback, if you plan on using this  free service.
    The numbered points below correspond to grading criteria in the  scoring guide. The bullets below each grading criterion further  delineate tasks to fulfill the assessment requirements. Be sure that  your Quality Improvement Initiative Evaluation addresses all of the  content below. You may also want to read the scoring guide to better  understand the performance levels that relate to each grading criterion.
  1. Analyze a current quality improvement initiative in a health care setting.
    • Evaluate a QI initiative and explain what prompted the  implementation. Detail problems that were not addressed and any issues  that arose from the initiative.
  2. Evaluate the success of a current quality improvement initiative through recognized benchmarks and outcome measures.
    • Analyze the benchmarks that were used to evaluate success.  Detail what was the most successful, as well as what outcome measures  are missing or could be added.
  3. Incorporate interprofessional perspectives related to initiative functionality and outcomes.
    • Integrate the perspectives of interprofessional team members  involved in the initiative. Detail who you talked to, their professions,  and the impact of their perspectives on your analysis.
  4. Recommend additional indicators and protocols to improve and expand quality outcomes of a quality initiative.
    • Recommend specific process or protocol changes as well as added technologies that would improve quality outcomes.
  5. Communicate evaluation and analysis in a professional and  effective manner, writing content clearly and logically with correct use  of grammar, punctuation, and spelling.
  6. Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style.
  7. Submission Requirements
  • Length of submission: A minimum of five but no more than seven double-spaced, typed pages.
  • Number of references: Cite a minimum of four sources (no older  than seven years, unless seminal work) of scholarly peer reviewed or  professional evidence that support your interpretation and analysis.
  • APA formatting: Resources and citations are formatted according to current APA style and formatting.
  • Assessment 2 Example

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Next Health

Prior to the FBI raid, you’re a provider receiving kickbacks from Next Health. You’ve been able to upgrade your office, invest in more advertising, and increase the pay of your staff. In general, life is good. Your conscious starts to eat at you, and you want to end the informal agreement. However, Next Health approaches you with one of the most financially lucrative offers to date. Do you accept this offer but say this the last time or do you just deny it and move on? Write a response defending reasons why you should accept the offer and reasons why you should not. You’ve previously been assured “you’ll never get caught,” and this deal could make you financially stable for a few years.  300 words

https://www.dallasnews.com/news/crime/2018/07/29/feds-raid-another-pharmacy-company-as-dallas-becomes-hot-spot-for-physician-kickbacks

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Proofreading

Reflecting on Your Writing: Proofreading

Proofreading and ensuring correct grammar and punctuation is an important final step before completing any scholarly writing assignment. Be sure to allot the necessary time for this step when planning the timeline for this and future assignments.

This week’s Learning Resources will help you better understand the proofreading tools available to you so that you can submit a strong final draft. For this Discussion, you will reflect on your own writing in relation to final proofreading. Based on what you have learned from the week’s Resources, you will share your thoughts and experiences on proofreading. You may also choose to reflect on any grammar- or punctuation-related strategies you have used in the past or are currently using.

To prepare:

  • Review      the Learning Resources on proofreading.
  • Review      the Learning Resources on grammar and punctuation.
  • Reflect      on your writing process in relation to proofreading. You may even choose      to consider how you approached this specific assignment in relation to      proofreading, grammar, and/or punctuation.

By Tuesday 01/09/18 by 10 pm, post a 1- to 2-paragraph reflection with at least 1 reference on your use of proofreading. (Note: You may choose to reflect specifically on how you will apply concepts of proofreading in this week’s Assignment.) In addition, identify any grammar-related issues in your writing and ways you have addressed them in this course.

Finally, post your Final Plan and Course of Action timeline for your colleagues to review. Your Final Plan and Course of Action consists of 1–2 sentences where you outline your plan for finishing your essay, including the exact sentence, “I will submit the final draft of my evaluative essay for WCSS 6060/6061: Graduate Writing II by XX/XX/20XX.” You may also add the phrase, “I will complete final proofreading, editing, and revision of my evaluative essay by XX/XX/20XX.” Be sure to fill in the date that you will complete your revision and submit your final draft!

Required Readings

Walden University Writing Center. (2015i). Walden templates: General templates: APA course paper template (6th ed.). Retrieved from http://academicguides.waldenu.edu/writingcenter/templates/general

Laureate Education. (2015). [Infographic]. Tips for Proofreading, Baltimore, MD: Author.

Walden University Writing Center. (2015j). Writing a paper: Reflecting & improving. Retrieved from http://academicguides.waldenu.edu/writingcenter/writingprocess/reflecting

Walden University Writing Center. (2015d). Grammar: Overview. Retrieved from http://academicguides.waldenu.edu/writingcenter/grammar

Walden University Writing Center. (2015g). Punctuation: Overview. Retrieved from http://academicguides.waldenu.edu/writingcenter/punctuation

Nadeau, N. (2014, October 14). Top 5 paragraph-level mistakes in student writing [Blog post]. Retrieved from http://waldenwritingcenter.blogspot.com/2014/10/top-5-paragraph-level-mistakes-in.html

Required Media

Walden University Writing Center (Producer). (2014, June 15). WriteCast: Faculty writing advice: Residency interview with Dr. JaMuir Robinson (Episode 10). [Audio podcast]. Retrieved from https://soundcloud.com/writecast/010-residency-interview-with-dr-jamuir-robinson

Note: The approximate length of this media piece is 6 minutes.

Transcript: http://academicguides.waldenu.edu/writingcenter/transcripts/podcasts/ep010

Walden University Writing Center (Producer). (2015, May 4). WriteCast: Writing expectations at U.S. colleges and universities (Episode 21) [Audio podcast].

Retrieved from https://soundcloud.com/writecast/episode-21-writing-expectations-at-us-colleges-and-universities

Note: The approximate length of this media piece is 16 minutes.

Transcript: http://academicguides.waldenu.edu/writingcenter/transcripts/podcasts/ep021

Optional Resources

Smith, M. (2012, August 14). Incorporating Grammarly into your writing process [Blog post]. Retrieved from http://waldenwritingcenter.blogspot.com/2012/08/incorporating-grammarly-into-your.html

Walden University Writing Center. (2015e). Grammarly: Incorporating feedback. Retrieved from http://academicguides.waldenu.edu/writingcenter/grammarly/incorporating

Walden University Writing Center. (2015f). Interactive & multimedia resources: Grammar modules [Multimedia file]. Retrieved http://academicguides.waldenu.edu/writingcenter/multimedia/modules/grammar

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Art Creation

Instructions

This week you will use your readings from the past week as a point of departure to create your own artistic production and a reflection paper.

Part 1: Art Creation
Select a poem, musical piece, or dance piece to use as a point of inspiration. Create a work of poetry, lyrics, music, or dance, inspired by your selected art piece.

Part 2: Reflection
Write a reflection about the relationship between your art production and the inspiration piece. Include the following in the reflection paper:

  • Introduction
  • Inspiration Piece
    • Include the inspiration poem, lyrics, or recording of musical or dance piece within the document. Use a link in the case of a recording.
    • Record the title, artist/author/composer, year, and place of origin.
    • Briefly explain the background of the inspiration piece.
  • Your Art Piece
    • Include your original poem or lyrics within the document. If you selected a musical or dance piece, submit as a separate file in the Art Creation Submission (Recordings) area following this assignment.
    • Provide a title.
    • Explain the background of your piece.
  • Connection
    • Explain the thematic connection between the two pieces.
    • How are they similar and different?
    • Are they the same medium? How does the medium impact what the viewer experiences?

Original Artwork Requirements

  • Methods: typed poem or lyrics, or recording of musical or dance piece
  • No computer-generated pieces

Writing Requirements (APA format)

  • Length: Minimum of 2 pages (not including title page, text of inspiration piece, or references page)
  • 1-inch margins
  • Double spaced
  • 12-point Times New Roman font
  • Title page
  • References page (minimum of 1 scholarly source)

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Using Evaluations to Prepare For Accreditation

APA format 1 and half pages 3 references 1 from walden university

 

Using Evaluations to Prepare For Accreditation

Your course text defines evaluation as “a systematic assessment of all components of a program through the application of evaluation approaches, techniques, and knowledge in order to improve the planning, implementation, and effectiveness of programs” (Billings, 2012, p. 503). When carefully constructed, a master plan of evaluation can run like a well-oiled machine. Data are collected, analyzed, and acted upon. When documented correctly, this data can also help institutions and agencies prepare for accreditation.

In this Discussion, you consider the curriculum components you might include in your team’s evaluation plan. You also consider how information gathered about these components can help your team’s setting prepare for accreditation.

To prepare:

  • Review Chapter 26, “Educational Program Evaluation,” in the Billings text. Specifically, examine how Table 28-2 illustrates one piece of an evaluation plan. Then, explore each of the overarching curriculum components nurse educators may choose to evaluate: mission and goals, curriculum organization, course, teaching effectiveness, environment, intervening mechanism, and generalization.
  • Reflect on the evaluation models your team discussed for your Course Project.
  • Consider the curriculum components you could integrate into these evaluation models. How would feedback on these components help your assigned setting improve the quality of the curriculum? In addition, how might this same information help to prepare for accreditation?

By Day 3

Post a brief description of at least two curriculum components you would include in the evaluation model(s) used in your Course Project and why. Explain how this information, as well as your team’s overall evaluation approach, could help your setting prepare for accreditation, if applicable. Justify your response by providing references to your Course Project and Learning Resources as applicable.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

  • Ask a probing question, substantiated with additional background information, evidence, or research.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

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Basic Windshield Survey – Rural

Basic Windshield Survey – Rural

Enter Sentinel Town® via the link to begin your virtual experience by taking a tour by car of Sentinel Town®.  Since this is your first tour, select the slowest speed and stay in the car the entire time at least once before getting out of the car.

As you take the tour, write down your observations, specifically those that align with the following demographics and/or subsystems listed in the left-hand column of the rubric.

  • Describe the characteristics of the people you see in Sentinel Town®.
    • What are the race/ethnicity distribution, age ranges, and gender mix?
    • Are there signs of poverty or wealth? What are they?
  • Who do you see on the streets?
    • Parent with child, teens, couples, disabled persons?
    • Are there homeless persons, beggars, etc.?
    • Is there anyone in the city you would not expect to see?
  • Are there dogs on or off leash? Are there other animals?
  • Are there churches and other formal religious buildings?
    • What are their denominations?

Compile your observations addressing each item listed in the first column of the rubric.  You are encouraged to add other relevant observations that may not be listed in the first column.

Select a target population of interest and discuss relevant demographic data and health status indicators for this population group.  Identify major health concerns for this target population.  Include a discussion of major health concerns in relation to a global health issue.

Reading and Resources

Additional Instructions:

  • All submissions should have a title page and reference page.
  • Utilize a minimum of two scholarly resources.
  • Adhere to grammar, spelling and punctuation criteria.
  • Adhere to APA compliance guidelines.
  • Adhere to the chosen Submission Option for Delivery of Activity guidelines.

Submission Option

Instruction

Paper

  • 4 to 6-page paper. Include title and reference pages.

Note: Title and reference pages/slides do not count towards the count requirements.

Attachments areaPreview YouTube video Henry Street Settlement: 120 Years in 4 MinutesPreview YouTube video Community Assessment Windshield SurveyCommunity Assessment Windshield SurveyReplyReply allForward

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grand theory

Please, before you respond to the following prompts refer to the attached PowerPoint.

This is based on the PowerPoint (Myra Levine) you did for me last week.

Please respond to the following prompts:

1. Describe your thoughts on the grand theory about which your group presented.

2. What were the challenges that you faced in understanding the theory?

3. How did you attempt to resolve those challenges?

– Your initial post should contain two to three (2–3) paragraphs of three to four (3–4) sentences per paragraph.

– Integrate a minimum of three readings and/or other evidence-based research articles no more than three years old.

– Use APA formatting for citations and references.

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non-maleficence

What expertise, supports, and character traits do you believe a nurse needs to possess in order to practice non-maleficence in nursing? For each item you name, give an example and show how this skill/trait will help nurses to become more ethical in their practice.

Describe a situation in which non-maleficence might potentially come into conflict with a different precept in nursing. Write about the conflict you describe and analyze what you see as the most ethical approach to dealing with this tension.

Requirements: Word Count—Minimum 1500-1800 words

APA Format

Minimum 3 Peer reviewed references – No older than 5 years

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hip replacement

URN: QUT174806 | PATIENT: JANKOVIC, Ivan Janos

This case study is based on Mr Ivan Jankovic who is 78 years old. He is admitted for a left total hip replacement. He undergoes surgery and is now three days post-operative, in the orthopaedic ward.

NSB335 Assessment 3 Page 2 of 8

Caring for a patient post-operatively with arthritis and multiple co-morbidities.

Setting the scene

Background- social:

Mr Jankovic is 78 years old and has enjoyed good health over his lifetime.

He moved to Australia in his late teens following the communist uprising in his home country in Eastern Europe in the late 1950s. His education was disrupted, and he has worked in a variety of skilled and semi-skilled jobs that have required manual labour at times, retiring 12 years ago. He says his English is good.

Ivan lives independently with his wife in a retirement living unit. His wife Marla is 74 years old and is in good health but recently had a fall and suffered a # wrist that required surgery. She is unable to drive for 8 weeks. They have 2 children – one daughter lives a fair distance away and works full time in a high-pressure job. Their son lives interstate and visits infrequently. They report having a lot of friends and social contact in the retirement village, but their friends are all elderly and are unable to assist at all.

Epidemiology / pathophysiology of disease processes

The National Health Priority Areas (NHP) of Arthritis and Musculoskeletal conditions, Mental Health Disorders, Cardiovascular Disease, and Injury Prevention and Control were established with the aim of improving health outcomes in these areas. They were established in response to the World Health Organization’s global strategy of Health for all by the year 2000. They are also the areas with the highest economic and health burden for Australians; this assessment considers the following NHP areas in relation to a case (Ivan Jankovic):

• Musculoskeletal conditions are conditions of the bones, muscles and their attachments (e.g. joints and ligaments). Osteoarthritis, rheumatoid arthritis and osteoporosis are the most commonly occurring musculoskeletal conditions. They have substantial influence on a person’s quality of life and impose a heavy economic burden on the community (AIHW, 2018).

• Injuries are adverse effects on the human body. They are a significant source of preventable illness, disability and premature death in Australia (AIHW, 2018).

• Mental Health Disorders relate to behaviours and conditions which interfere with social functioning and capacity to negotiate daily life. They can occur acutely at times of illness (AIHW, 2018).

• Obesity is when the energy consumed from food and drink is greater than the energy used, fat is deposited on the body, which over time can lead to obesity. Obesity increases the risk of many other chronic and potentially lethal diseases (AIHW, 2018).

NSB335 Assessment 3 Page 3 of 8

Your Task:

Use the Clinical Reasoning Cycle (CRC) on the following pages to review the nursing priorities in relation to the care of Ivan.

Consider the CRC on the following pages and following your work on the modules that encompass the NHP and National Health and Quality Safety (NHQHS) Standards, you should be able to answer the workbook questions. This task will assist you to critically think about typical clinical situations that will arise when you are a Registered Nurse and you will be required to assess and make clinical decisions for your patients.

When you have done this, answer the questions at the end of this workbook and submit into Turnitin in the provided template.

NSB335 Assessment 3 Page 4 of 8

Now we shall step through the CRC in relation to Ivan’s’ case to prepare you for the workbook assessment questions.

Watch the video –At home

Gain an initial impression of your patient

Consider Ivan’s situation, both socially and health wise. What is your initial view of this patient?

Consider Ivan’s osteoarthritis and obesity and how these may be linked.

Ivan is at risk of injury – both at home and when he comes to hospital. Consider why and what can be done in these settings to prevent injury.

Further background information

Mr Jankovic is 78 years old and has enjoyed good health over his lifetime. He has gained a lot of weight over the past few years and has severe osteoarthritis in his hips. He also has had resection of a prostatic cancer that has no current treatment and has residual prostatamegaly. He has occasional angina, high blood pressure and obstructive sleep apnoea, using a CPAP machine infrequently as it dries his mouth and nose and the noise annoys his wife.

Past medical history

• Osteoarthritis (diagnosed 10 years ago)

• Mild left cardiac failure and occasional angina (diagnosed 2 years ago)

• Hypertension (diagnosed 5 years ago)

• Frequent gout

Surgical history:

• Internal fixation left tibia and fibula following motor cycle accident at age 21years

• Appendectomy at age 23 years

• Resection prostatic carcinoma (7 years ago)

Medications:

• Omeprazole 20mg nocte

• Frusemide 20mg mane

• Isosorbide Nitrate 60mg mane

• Atorvastatin 40mg mane

• Prazosin 5mg mane

• Panadol osteo tds

• Brufen 400mg mane

• Glycerol Trinitrate 5mg S/L prn

• Colchicine 0.5mg prn

• Allopurinol 300 mg mane

Now watch the videos of Mr Jankovic-

1. Waiting room:

2. Pre-operative preparation – checklist:

3. Pre-operative preparation – medication:

4. Patient’s conversation after pre-operative checklist

NSB335 Assessment 3 Page 5 of 8

(a) Review current information

(b) Gather new information

(c) Recall knowledge (A&P, ethics, law, cultural safety)

Consider the pre-operative phase.

What are the issues here with the communication?

What may be contributing to this?

Ensure you understand the co-morbidities Ivan has presented with and how they may complicate a surgical recovery.

Now watch the video below and review the clinical documents for Mr Jankovic.

Day 3 post-operative Handover

Nursing Documents:

1. Pre-operative checklist [document link]

2. Nursing Notes [document link]

3. Med Chart [document link]

4. Observation chart [document link]

5. Neurovascular obs [document link]

For your convenience a transcript of the handover is provided at the end of this workbook.

Interpret data – what does it all mean?

It is important to consider the potential inter-relationships between mental health, cardio vascular, obesity, musculoskeletal problems and injury prevention.

What are the general nursing problems for patients undergoing major orthopaedic surgery?

What do you anticipate may be post-operative complications for this gentleman given his co-morbidities?

Synthesize all information that has been collected and processed.

You need to consider Ivan’s priority problems and any actual or strong potential problems he may experience while in hospital, based on your assessment of him and your knowledge of the pathophysiology of his presenting condition and co-morbidities.

Consider the pre-operative, acute post-operative and recovery phase.

NSB335 Assessment 3 Page 6 of 8

As a nurse, what are your desired outcomes for Ivan?

Now you have identified his problems, you need to identify your goals of care for each problem using the SMART acronym.

What action/interventions will you do?

The next step is to consider what you will do and ensure your nursing interventions suit the context and are evidence based.

Assess the effectiveness of actions

Now think about your interventions and how you will evaluate them.

What have you learned from this experience?

Now consider what you have learnt and what you need to follow up with.

References:

AIHW, (2018), Australia’s health 2018, Retrieved 4/12/18 https://www.aihw.gov.au/reports/australias-health/australias-health-2018

NSB335 Assessment 3 Page 7 of 8

Workbook Questions

Complete the following questions in the provided template following the instructions in your task booklet.

• Do NOT replicate the questions, just identify by number.

• You must attempt all questions, incomplete papers will be asked to resubmit

• References must be provided – remember no reference provided = 0 marks.

• Include a reference list at the end.

• Word count is up to 2000 words; responses beyond this will not be marked.

• You will be awarded 10 marks (total) for academic writing and quality of references and reference formatting- see CRA in your task booklet.

1. Mr Jankovic has presented with severe osteo-arthritis requiring a hip replacement. Discuss briefly the pathophysiology of obesity and its link to Ivan’s arthritis. (2 marks)

2. When you watch the pre-operative videos, what communication issues do you observe? Critically analyse the situation and consider both the patient and the nurse perspective and what may have contributed to this? (4 marks)

3. Explain the importance of the pre-operative checklists and how these link to patient safety and the NSQHS standards? (2 marks)

4. State 3 risks to Mr Jankovic linked to his obesity pose when having a General Anaesthetic? Support your answer with contemporary literature. (3 marks)

5. You realise that Ivan has been given incorrect medication. He received the medication for the person in the next bed and has incorrectly received

• Metformin 500mg

• Gliclazide 5mg

• Aspirin 100mg

• Omeprazole 20mg

What are your immediate responsibilities as an RN to ensure Ivan’s safety? (1 mark)

What responsibilities do you have in regard to medication administration? Discuss this incident with relation to 2 of the NSQHS Standards. (4 marks)

6. Ivan becomes very confused and a little aggressive in the immediate post-operative period. He does not have a history of dementia or confusion. This is quite distressing for his wife, Marla.

Discuss what is happening here in relation to the case study patient and outline briefly 2 key areas of nursing management linking to the evidence.

(4 marks)

7. Effective and accurate clinical assessment skills are imperative for the nurse working with Ivan at all times. State 3 priority nursing problems and justify for Ivan in the acute post-surgical phase. Following left total hip replacement. Phrase your problem statements as “Problem related to cause” (3 marks)

8. For each problem state a goal in SMART format.

(no reference required for this response) (3 marks)

9. For each problem above, state 2 nursing interventions to address these and briefly justify. These interventions can be independent or collaborative. (6 marks)

NSB335 Assessment 3 Page 8 of 8

10. Based on the clinical priorities of care and short-term goals, state 2 means you would use to evaluate the outcomes of each intervention.

Justify with links to the evidence to support your answer. (6 marks)

11. Ivan is having difficulty voiding post-operatively. He is demanding to get out of bed post his hip replacement. He passes 120mLs into the urinal with difficulty. What further two assessments should you perform and state 2 nursing actions that may assist him? (4 marks)

12. On day 3 the nurse handover says that Ivan does not greet his wife Marla when she arrives to visit and she reports she can’t understand him. He appears confused and when you investigate further, he is quite drowsy, has slurred speech and does not give comprehensible answers to your questions, you can’t decide if he is orientated or not.

There are several possibilities for this – review the documentation provided and state one possible reason for this

List and briefly justify 3 further assessments that should be done? (4 marks)

13. Ivan’s wife, Marla discloses that she is very worried about Ivan’s return home and that she is concerned how they will cope.

Outline the importance of discharge planning and 3 realistic strategies that could be put into place for this elderly couple. (4 marks)

Transcript of nursing handover (video 5)

Situation: Mr Jankovic is a 74 year old and is day 3 post-operative left total hip replacement. He has an IV cannula still in place in his left hand.

Background: Ivan has a history of osteoarthritis, prostatic malignancy resected, hypertension and mild left heart failure with infrequent angina. He also uses CPAP infrequently for sleep apnoea. Post-operative he has not been himself and was a bit aggressive and confused.

Assessment:

His neurovascular obs are intact. The toes of that left leg have been pink and warm with full movement and sensation, pulses normal.

His left hip wound remains intact with no strike-through.

He has been doing deep breathing and leg exercises. He has been resting quietly.

At 1400 hours vital signs: BP 174/80 mmHg; HR 96 BPM; RR 18 BPM; O2 sats 98%; Temperature 36.9 degrees.

I noticed that he wasn’t very responsive to his wife, Marla, this morning and he refused his tablets, so I think he is still confused. His wife just told me she is having trouble understanding him. I have not got round to calling the doctor yet.

Recommendations: I think you should do a more comprehensive assessment on him and call the doctor. I am a bit concerned but I have been too busy to do a full assessment.

 

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mild head injury.

Due to a fall from a second story townhouse, Jimmy sustained a fractured left femur and a mild head injury. Jimmy is 10 years old. He was reaching for a ball that had gotten lodged into the gutter over the small balcony of his parent’s bedroom. He thought if he stood on the railing and reached with the badminton racket he could get it.

Currently he is 2 days postoperative from repair of the left femur. He is being transferred out of the pediatric ICU where the Neurologist has stated he is stable but needs continued neuro checks q2 hours. He has a full left leg cast. The Foley catheter is to be replaced today, or he can attempt to roll onto a bedpan if needed.

Please list the systems that are affected by this boy’s injuries.

List the nursing interventions now that he is on your nursing unit.

Start a list of nursing diagnosis match the system you are presenting.

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