401007 Approaches To Professional Nursing Practice

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401007 Approaches To Professional Nursing Practice

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401007 Approaches To Professional Nursing Practice

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Course Code: 401007
University: Western Sydney University

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Country: Australia

Question:
Write about the Approaches to Professional Nursing Practice. 

Answer:
An incident took place whereby an 88-year old man, Mr. Selir, died in hospital due to neglect and the failure of the nurses to provide proper care. The man was admitted to Gold Coast nursing home with minor pressure wounds on his feet and buttocks. A family member who came visiting noticed a bad smell in his room and it was then discovered that the condition of his pressure wounds had deteriorated. Those on his lower buttocks and back had eaten into his skin and they were developing into gangrene. The other pressure wound on his heel had already turned into gangrene. When asked to call for an ambulance by the visiting relative, the staff said that the wounds were manageable. The family members took matters into their own hands and called for help and Mr. Selir was taken to Gold Coast University Hospital. However, it was too late since the infection had taken a toll and his internal organs were already shutting down. His daughter-in-law claims that while at the nursing home, he was sat in a “fallout chair” for many hours without being changed positions which would have helped in improving his blood circulation, (Lewis, 2016)
From this incident, I feel frustrated and disappointed by the staff, systems, and processes in Gold Coast nursing home. This is because they neglected and failed to provide the proper care to an elderly patient, leading to the deterioration of his health, and eventually, his death. I feel that all this could have been avoided if the patient’s wounds had been screened on arrival and well documented for each member of the staff to access. While in the nursing home, the minor pressure wounds should have been managed according to the best practice guidelines and this way, they would have been treated.
This event had negative effects on both the patient and nurses involved. For the patient, he suffered neglect and did not receive the proper care that the family members hoped he would receive at the nursing home. He had been admitted with minor wounds but by the time he was being taken to the hospital, they had worsened with one on the buttocks measuring fifteen centimeters. At this point, there was nothing that the doctors could do to save his life. For the nurses, they failed in their role to care for the patient, monitoring his wounds and updating Mr. Selir or his family on his condition. However, it was a learning point for the facility since new staff, processes and systems were introduced to the nursing home. This will help in preventing the occurrence of a similar incidence in future and improving the kind of care given to residents. Additionally, the staff underwent a compulsory wound management training program (Lewis, 2016).
A significant amount of learning has transpired from this event. I have learned that elder abuse does not only entail deliberately mistreating residents physically, mentally or emotionally. It is a broad platform that also includes neglect and failure to provide appropriate care to elderly residents (Borzdynski, McGuiness& Miller, 2016). The threat posed by the fatal effects that such abuse can have on a patient will make me through in administering quality care to patients during my practice. When presented with a patient with pressure wounds however negligible, I will manage them according to the proper nursing practice guidelines. I will be thorough with areas such as pain and wound management, skin assessment, patient positioning, pressure redistribution, reduction of risk and evaluating response to interventions and outcomes. Increased mobility, proper nutrition, and continence management are some of the measures to reduce risk. Moreover, I will keep a clinical record of the patient’s condition and update the patient and family on the same. Where the case is beyond my ability to handle, I will ask for assistance from the appropriate specialists.
In order for me to enhance my own learning from this event, I need an action plan. During my practice, I will ensure that the care facility I am practicing in has an enforceable wound management system with a trained clinical workforce assigned to run it. This system should describe the processes of caring for a patient with pressure wounds. Additionally, it should outline the assessment, monitoring, treatment, and documentation of pressure wounds. Further, the patient’s medical records should be reviewed frequently to ensure compliance with the management plan (Fetherstonhaugh, Lewis, McAuliffe & Bauer, 2016). I will follow this to the letter and ensure that the patient and family members are kept up-to-date about the condition of the patient. Moreover, I will use the information from clinical records of the patient so as to determine relevant strategies to use and improve the management plan.
There is new knowledge that could be used in facilitating and enacting the above action plan. For the management, the assessment of the pressure wound should include utilization of a pressure assessment scale. The pain should be assessed with self-recording equipment such as numerical scales, visual analog or verbal descriptor (Hultin, Olsson, Carli &Gunningberg, 2017). Besides pain and wound management, there should be additional treatment alternatives such as medical grade sheepskin or electrotherapy. Furthermore, referrals could be made to related technical and health services such as physiotherapy, occupational therapy, dietetics and podiatry (Price, Kennedy, Rando, Dyer & Boylan, 2017). The patient’s clinical records should be audited frequently to determine whether the management plans and clinical guidelines are being adhered to (Norman, Gibb, Dyer, Prentice, Yelland, Cheng & Edwards, 2016). These records could also be used to come up with improvement strategies that will increase the efficacy of injury management systems (Phelan & McCormack, 2016). With the assistance of the clinical workforce, feedback and audit data should be used to come up with improvement strategies.Lastly, patients and family members should be engaged in developing management plans and this helps in providing a platform to share medical information (Australian Commission on Safety and Quality in Health Care, 2012).
In conclusion, health facilities should have into place effective wound management plans. Upon admission, the patient should be screened and pressure management strategies are carried out according to the best practice guidelines. Both the patients and family members should be updated about the patient’s condition, any possible risks and the management plan being implemented.
References
Australian Commission on Safety and Quality in Health Care, (2012). Preventing and Managing Pressure Injuries.
Borzdynski, C. J., McGuiness, W., & Miller, C. (2016). Comparing visual and objective skin assessment with pressure injury risk. International wound journal, 13(4), 512-518.
Fetherstonhaugh, D., Lewis, V., McAuliffe, L., &Bauer M. (2016). Pain in older adults: development of a tool for measuring knowledge of residential aged care staff. International journal of geriatric psychiatry, 31(4), 428-434.
Hultin, L., Olsson, E., Carli, C., &Gunningberg, L. (2017). Pressure Mapping in Elderly Care: A Tool to Increase Pressure Injury Knowledge and Awareness Among Staff. Journal of Wound Ostomy & Continence Nursing, 44(22), 142-147.
Lewis, D. (2016). Elder abuse enquiry: Man dies in hospital after Gold Coast nursing home staff fail to properly treat wounds. Background briefing.
Norman, R. E., Gibb, M., Dyer, A., Prentice, J., Yelland, S., Cheng, Q., & Edwards, H. (2016). Improved wound management at lower cost: a sensible goal for Australia. International wound journal, 13(3), 303-316.
Phelan, A., & McCormack, B. (2016). Exploring nursing expertise in residential care for older people: a mixed method study. Journal of advanced nursing, 72(10), 2524-2535.
Price, K., Kennedy, K. J., Rando, T. L., Dyer, A. R., & Boylan, J. (2017). Education and process change to improve skin health in a residential aged care facility. International Wound Journal.

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