Gift Of Change

It is widely known that early recognition of a deteriorating patient can contribute largely to a successful outcome, through recognising and taking action on the deteriorating health status of the patient (National Consensus Statement, 2010). This report will explore the ways in which deteriorating patients and clinical reasoning are used in the public health care system in New South Wales (NSW).

Develop health and safety and risk management policies procedures and practices in health and social care (M1)

Bradley, S., & Mott, S. (September 2012). Handover: Faster and safer? Australian Journal of Advanced Nursing, 30(1), 23-32.

More recently, early warning systems have been developed in an effort to recognise the at-risk patient who may be deteriorating

Every health professional has a legal obligation to patients. Nurses as part of the health care team share an important role in the quality and safe delivery of patient care. They have the major responsibility for the development, implementation and continuous practice of policies and procedures of an organisation. It is therefore essential that every organization offer unwavering encouragement and resources to support their staff to perform their duty of care in every patient. On the other hand, high incidences of risk in the health care settings have created great concerns for healthcare organizations. Not only they have effects on patients, but also they project threat to the socioeconomic status. For this reason, it is expected that all health care professionals will engage with all elements of risk management to ensure quality and safe patient delivery. This paper will critically discuss three (3) episodes of care from the case study Health Care Complaints Commission [HCCC] v Jarrett [2013] Nursing and Midwifery Professional Standards Committee of New South Wales [NSWNMPSC] 3 in relation to Registered Nurse’s [RN] role as a leader in the health care team, application of clinical risk management [CRM] in health care domains, accountability in relation to clinical governance [CG], quality improvement and change management practices and the importance of continuing professional development in preparation for transition to the role of RN.

John was a 76 year old gentleman returning to an orthopaedic ward following a total hip replacement under general anaesthetic. The agreed care plan was to regularly monitor John’s vital signs over the next several hours in accordance with local hospital resuscitation trust policy (2012) and the National Institute

The nursing handover was defined in 1969 by Clair and Thrussel as the oral communication of pertinent information about patients. This was supported by Thurgood in 1995 who adopted the view that patient centred care is central to any definition of handover and that it is its primary function.

Management of the acutely ill adult is a complex and perplexed procedure. It requires underpinning knowledge of the pathophysiology of the disease currently affecting the patient, as well as ensuring that professionals are equipped to deal with the development of a rapid deterioration. The National Institute for Clinical Excellence (2007) explain that patients are sometimes inadequately treated due to staff not acting in a sufficient time manner, and so a systematic assessment of the patient recommended by the Resuscitation Council (2006) should initially be followed (Jevon, 2009).

The patient on which the care plan will be assessed will be a 72 year old female, May Watters who I assisted in the care of during clinical placement in the Emergency Department (ED). May Watters is a pseudo name to ensure confidentiality to An Bord Analtrais standards (ABA 2000). May was brought in by ambulance which was called by her husband Jimmy. May was brought into the ED for Diarrhoea and Vomiting 5/7 days and generally unwell and weakness and non productive cough. Mays’ husband who is her next of kin was concerned about her deterioration

Mulloy, D. F., & Hughes, R. G. (2008). Patient safety & quality: an evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from http://www.nlm.nih.gov/books/NBK2678/

"To continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value” (Jointcommission.org, 2015). These requirements are regimented in the National Patient Safety Goals and are enforced via surveys and internal inspections to ensure that healthcare institutions abide by the safety mechanisms put in place to facilitate the optimal patient outcomes and environments.

This study examines the prevalence and nature of unreported patient deterioration in the emergency department (ED) and explores the relationship between ED patient characteristics (age, clinical urgency) and ED characteristics (ED occupancy, ED staffing). The authors conducted their research in a government funded health service in Melbourne using a prospective, exploratory descriptive method and point prevalence surveys (PPS) in collecting data. This research is very much useful in establishing how frequent the signs of clinical deterioration have been overlooked in the ED despite being able to document one or more physiological parameters that warrants escalation of care and the possible reasons behind it. However, this study has several

This pathway gives staff structure, support and professional integrity. Additionally, The Royal College of nursing, SCIE, and primary care trusts are all involved in the development of protocols and guidelines. This does however indicate that no service users are involved in the creation process, possibly resulting in service and organisational focused guidelines. Successfully implementing protocols has its barriers. The Open University, (K101 Introduction to Health and Social Care, Resources, 2014) highlights several problematic factors including, limited resources, staff shortages and equipment and medical supply problems. However, once implemented successfully these policies may help to manage risk, control budgets and reduce litigation.

One day a five-year-old girl returned to the center with her mom. The nurses told me that she had been a patient a few years earlier. She spent the first two years of her life cooped up within the four walls of the healthcare center until she was well enough for her parents to manage her care at home. Looking at her in that moment it was hard to imagine. She was adorable and shy clinging onto her mom. Most of all just really normal. Her mom shared with the staff how her daughter was nearly ready to begin kindergarten in a public school.

Human factors include organisational, environmental and job factors, and human and individual characteristics. These factors influence the behaviour at work which can influence people’s health and safety (Human Factors in Patient Safety Review of Topics and Tools, 2009). Work performance determines the quality and quantity of work expected from each employee. Acknowledgement of the relationship between human factors, work performance, patient safety and quality in healthcare can promote a positive work environment. This