Assignment 1: A Case Study Of The Clinical Microsystem

I also agree with you that nurses should collaborate with other members of the patient's health care team. Collaborating is an important part of the patient's plan of care. In this particular situation the nurse, could use the collaboration to gather information to aid in the plan to approach the patient's family about their mother's decision pertaining to end of life

Assist the patent and family, as appropriate, in coming to a consensus regarding the options that best meet the patient’s goal for care.

A clinical microsystem is a “small, interdependent group of people who work together regularly to provide care for specific groups of patients” (Institute for Healthcare Improvement, p.1). It is the goal of this paper to discuss the findings of the Johnson Clinical Microsystem Assessment Tool to the microsystem where I am employed on-call, the Multnomah County Health Department (MCHD), HIV Health Service Center (HSC), a primary medical home for patients with HIV/AIDS. Additionally, I will address each of the 5 P’s of the microsystem; purpose, patients, professionals, procedures and patterns that will then inform a practice change for the clinic.

Develop an alliance by using caring gestures to the family. Asking caring, sensitive and perceptive questions convey sincere concern for the patient and will help develop trust with the family

For example, the eldest male of the family is the one who makes healthcare related decisions for the family members and the entire family needs to be included in all aspects of the patients care (Giger & Davidhizar, 1999). Nurses should conscience of this and try to include family whenever possible.

Communication is key to effective healthcare practices. According to American Journal Of Critical Care (2014), Patient-centered care starts with “effective communication, being empathetic and available, avoiding personal prejudges, and listening therapeutically are integral parts of patient-centered care” (Riley, White, Graham, Alexandrov, 2014, p. 320). This will improve communication; promote patient involvement in care, which creates a positive relationship with the healthcare provider and medical team. This results in improved adherence to treatment plan. Clinical practice guidelines need to be implemented for the patient and family members to be able to be involved in informed decision-making regarding healthcare needs. The fundamental core of nursing is to have a partnership with the patient and their family regarding the patient’s outcome.

A patient barrier might include having limited knowledge surrounding life-support systems and treatment options, thereby hindering their ability to fully comprehend or demand certain interventions. Good counseling is therefore essential to overcoming this barrier in implementing the patient’s true and best wishes (Kroning, 2014, p. 222). Another barrier in implementing advance directives concerns the role and influence of family members and the patient. There may be discordance between the desires of the patient and family, which can result in serious debate and tension if not addressed and taken into consideration. Physicians still may have reservations, as certain demands made by the patient may raise ethical concerns in the future, if the provider feels the interventions being done are no longer medically appropriate.

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).

I believe that the immediate family members should be given the option to be present during resuscitation of the patient. I believe that it is the immediate family members’ right to be present if they

Emotional Support and encouraging involvement of family and friends- Listening to patient with undivided attention .Providing clear, timely and meaningful information regarding the illness. Providing enough information regarding the patient’s illness. Respecting and acknowledging the family and friends’ support in patient care and providing supportive environment.

The process of deciding when a terminally ill patient should die lies within the patient, family members, and the

As an administrator I would need to take into consideration the patient’s autonomy, autonomy is recognizing an individual’s right to make his/her own decisions about what is best for them regarding their health care (Pozgar, 2012). The patient’s rights always should be considered before any decisions are made by any other family members. In this scenario it is clear that the patient is unable to make any decisions, the patient has suffered a serious brain damage, and although it is not complete brain death, we must determine how to proceed.

Every seriously ill patient and their family should have decided the following issues: proxy, resuscitation, hospitalization, and specific treatments. Every seriously ill person needs to have pointed out a person to speak on their behalf when they get too sick to do so. A “proxy” can be filled out at any hospital or nursing home granting “power of attorney” to a loved one to be able to make decisions. A person

Family is playing an important part in helping to ensure that patients are fit and following the advice of health care professionals. This is because the family is a foundation of support for everyone. At the same time, members can learn about what is impacting their loved one and what kind of procedures need to be followed. When this happens, there will be higher amounts of compliance as they will ensure that the patient continues to stick with their treatment protocol. (Saleeba, 2009)

We must approach the patient and their family with an attitude of caring, empathy, and respect. We can explain that we would be happy to learn of the patients’ needs and concerns, and of any accommodations we can make so they will feel comfortable