Nrsg258 Acute Care Nursing | Assessment Answers

For this case management assignment, you will first watch the video on Mrs. Smith’s home visit.

You will assess Mrs. Smith as you have been trained as a nurse case manager. 

1- Develop and write down the problem in plain language & diagnosis (nursing or medical)
2- List possible solutions and actions
3- Identify already existing knowledge
4- Determine the need for new knowledge
5- Present and defend a plan of action
6- criterion is linked to a Learning Outcome Review performance- what are the expected outcomes for this plan

Answer:

Develop and write down the problem in plain language & diagnosis:

After analysing the interview in details, it is found that the nursing professionals in the hospital had failed miserably in providing therapeutic care service to the patient. It is seen that although they had treated her and given her education, she was not provided patient education. Her health literacy was not developed and therefore she had no clue why she was taking certain medicines. It might be also possible that she had not been treated with care, respect and she had not been empathetically and compassionately cared for, and therefore she had developed a negative feeling about healthcare professionals. Her quality of life is therefore very poor and she is socially separated from everyone due to her restricted mobility.

List possible solutions and actions:

The patient has restricted mobility and therefore experts would be appointed to help her develop her gait through therapies. Occupational therapists and physiotherapists should be allocated who would help her developing a better quality life and help her to gain her independence. The second issue is she has no idea about the cause of her disorders and takes medications without having any knowledge about how the medications are affecting her. Therefore, she feels tired in taking her medicines, as she is very unaware of her effects. She also cannot control her blood glucose level effectively by insulin administration and therefore she needs to be given patient education on these topics so that she develops knowledge n the topics. This would ensure her to comply with the medication, as she would know their importance. She is socially isolated due to her restricted ability and has poor quality life that has affected her zeal to live. Therefore, social care workers need to be appointed for her to care for mental, emotional and physical needs and help her live better life.

 Identify already existing knowledge:

The paramedics who have attended the patient had good knowledge of their job role and responsibilities. They not only helped the person to get up and stabilise herself but also immediately referred her to hospital. This means that they had the skill to identify the immediate requirement of the patient to maintain her safety. The professionals who worked for the patient had prescribed her medication must have had good knowledge about their clinical skills and therefore they had rightly provided her medicines on her blood pressure and for insulin control. They also had assisted the patient with walking support to reduce her chances of fall. Therefore the learning case manager can be sure that they had clinical skills to support the patient but ;aced other sets of skills.

 Determine the need for new knowledge:

From the entire discussion, it can be understood that the patient was not comfortable with the professionals and was somewhat upset with them. The professionals could not ensure patient satisfaction with her and this can be the result of improper therapeutic communication, ineffective relationship building and lack of development of trust among them. The knowledge of the importance of these attributes were entirely absent in the professionals. Moreover, they also did not have the knowledge of the significance of patient education and therefore they did not conduct any health literacy plan for the patient. Therefore, the patient was confused with the medications (Bellomo, 2018). They also failed to indentify the need of a social worker to help her to be socially active and improve her quality of life by engaging in community activities. All the skills and knowledge for these were entirely absent

Present and defend a plan of action:

In order to develop the skills and knowledge of the healthcare professionals, training sessions need to be arranged where the importance of effective communication strategies and patient education would be discussed to the professionals. They would be also assigned to the workshop classes where they can have practical classes on effective communication. Moreover, they should be advised to undertake evidence based studies by which they develop interventions for caring of the patients in the most modern way. This would include proper risk management for fall and therapy sessions as well as ways by which patients with restricted mobility can develop access to society.

Expected outcomes for this plan:

All these activities would ensure that the professionals develop their verbal and nonverbal communication skills by which patients feel included in decision-making as well as care service (Kourkouta & Papathanasiou, 2014). Professionals should give emotional, mental and physical support so that patients feel highly satisfied. Professionals would also learn the necessity to educate patients and develop their health literacy. They would also learn to focus on the social needs of the patients an try their best to meet the social need

References:

Bellomo, C. (2018). Oral Chemotherapy: Patient Education and Nursing Intervention. Issues, 9(3).Retrieved from: https://www.jons-online.com/issue-archive/2016-issue/july-2016-vol-7-no-6/oral-chemotherapy-patient-education-and-nursing-intervention/

Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia socio-medica, 26(1), 65. doi:  10.5455/msm.2014.26.65-67