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NSG3RDP Recognising 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
  2. Apply the clinical reasoning cycle to provide person-centred care for individuals experiencing a deterioration in health in order to provide safe nursing
  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

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)

 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

Please 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
  2. Explain what possible further deterioration could occur for this patient, with a detailed evidenced -based

(Please support your justification and rationales with quality peer-reviewed literature).

  • Question 2 (750 words)

There are many tools that can be utilised 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
  2. Explain how the respiratory rate can be measured reliably and

**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 Conmission 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-and- Quality-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 [email protected] 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. Please 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

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

Expert's Answer

QUESTION 1:

1.

A number of causes might be behind changing patient condition, recurrence or ill-treatment of pneumothorax, head injury, her history of diabetes, her obesity etc

  • After observing Joanna’s ISBAR and NOC, we have a very strong idea that a reoccurrence of pneumothorax might be the reason behind changes in her physiological parameters. Her physiological reading indicates tachycardia, tachypnea and low blood pressure which are the initial signs of pneumothorax (Zhigang Li et al., 2014).

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