Nrsg355 Clinical Integration For Towards Assessment Answers

Using your knowledge and experience of various patient allocation models (e.g. total patient care, team nursing and task allocation), outline how you would allocate the staff to the patients.

Include in your discussion your rationale for the model of allocation chosen and the scope of practice of the various staff

Answer: 

Healthcare multidisciplinary team entails members of varied disciplines who are called upon to offer services for care processes. A multidisciplinary team for motor neuron care process entails professionals who include a dietician, therapist, social worker speech pathologist, and occupational therapist. The team offers support and communication for the end goal of achieving a patient outcome.

Effective teamwork has positive effects on patient safety and outcome measures. The urgency and creation of effective teams are increasing due to the co-morbidities which arise and the associated complexities in the association of care. Health evolution calls for professional team members to handle the patient, (Babiker et al., 2014).

Factors to consider include;

• Presence of shared knowledge
• Ability to know team member’s role
• Ability to act collectively as a team and
• Possession of specialized complementary knowledge.

Key characteristics which inform team members to be included include;

• Honesty – high-value effective communication within the team cycles
• Discipline – Team members who are tasked at carrying out their roles and responsibilities effectively
• Creativity – excited team members who are motivated to tackle emerging issues creatively
• Humility – team members without having the belief that one type of training super ceded another
• Curiosity – Team members who are able to dedicate and reflect on lessons learned. (Babiker et al, 2014)

Team leaders in multidisciplinary teams

Physicians have been historically team leaders in the healthcare settings; however various factors come into play such as culture, sex, and power. An emerging pattern in modern healthcare calls for equal participation of all members of the team in the care process. Multidisciplinary team members often treat each of their colleagues as equals and colleagues rather than leaders.

As this is a teamwork process, all the team members are both equally valuable to another. Everybody depends on another for effective processes. 

Key issues in the case study

Changing Roles

Many healthcare facilities, often experience overlap and change in roles which are played various healthcare professional. These changing roles often present challenges to the teams and role allocation process. In this case, the team turnover has led to a lack of focus from the new member who is affecting patient outcome processes, (WHO, 2014).

Key solution strategy

Enhancing team discipline and a reminder of the roles will be a key strategy for this scenario. Reminding the team that being discipline and enhancing cooperation is key towards achieving a patient outcome, thus reminding the new health care practitioner on his roles and impact caused due to delay.

En-calculating shred goals and clear roles for the team members are essential for this case. The expectations of each team member need to be clearly spelled out and accountabilities which forms an essential component in optimizing team efficiency for the patient.

Module Assignment three

Activity  1

Parameter	Assessment
I – identity	- This informs identifying the patient status and understanding the primary features of the patient.
S – Situation	- Assessing the overall patient status and all protocols undertaken. This informs on gathering patient information.
B-  background	- assessing the previous medical history of the with regard to previous medication process and drug management criteria this assist in planning the next drug administration   - assessing the current patient status
A- Assessment	- assessing the patient vital status and ensuring that the patient is in a stable - assessing the patient problem and asking about the interpretation of key terms of the patient
R- Recommendation	- entails identification of patient recommendation process, and what should be done to manage the patient status - What is the correct state of the patient situation process.

Activity 2

Considering patient situation

• The patient is Mr. Smith, 18 years old admitted into the emergency center with severe breathlessness. The family is informed of the patient history of asthma, which has been diagnosed two years ago.

Collecting patient information

Upon admission, the following factors were assessed form the patient

• Severe dyspnoea, inability to speak sentences in one breath
• –Respiratory rate of 32 breaths/minute
• –SpO2 90%, on room air
• –BP 150/85 mmHg
• –The pulse rate of 130 beats/minute
• –Auscultation of lungs identifies diminished breath sounds and widespread wheeze 

Process information

• The patient is diagnosed with acute severe asthma 

Identity issues

• Airway edema

 The patient has developed progressive inflammation, which has instituted decline in air flow. The airflow factors include edema, mucushyper secretion, and mucus formation.

• Airway remodeling

This problem is a reversible process, leading to structural changes in the airway. This is linked to the continuous loss of the functions of the lungs. Remodeling of the airway can be initiated by activation of airway constriction.

Establish goals

• Management goals to the patient are to ensure that breathing is minimized and breathing problems restored.
• Application of pharmacotherapy treatment process

 Offering the patient high priority nursing intervention is key in ensuring that the patient recovers well

• Respiratory status management

Managing patient respiratory status is vital in ensuring recovery of the illness’. This improves the overall respiratory process.

Take action

• Action initiated for the patient, include offering nebulized salbutamol treatment, administration of Ipratropium bromide and IV Hydrocortisone management.

Evaluate outcomes

Assessing patient outcomes process is key after delivering appropriate drug and therapy intervention. Key outcomes are essential in ensuring that the patient is recovering positively from the diagnosis.

Reflect on new learning

Gained new aspects entail understanding care process for the management of severe acute asthma case. Management of severe acute asthma is a critical process which needs positive nursing skills so as to offer quick medical attention such as clearing the airways. 

Role delegation

It is important to understand the background o role allocation in nursing practice. Work delegation is concerned with delegating duties and managing time. Thus prioritizing issues is of the key essence in practice. Delegating duties in health care are essential in establishing relationships, (Murray , Parahi,  DiGiacomo, Jackson & Davidson, 2016). As a registered nurse, the case study presents human resource challenge, however, effective all, allocation of available human resource is effective in filling the gap left.

Studies have been conducted assessing on various models used in nursing care. These models include patient allocation, primary nursing, and team nursing. The models have been performed successfully in the workforce and have consisted of registered nurses.  The inclusion of the different nursing roles into the workforce has led to a redefinition of nursing roles with regard to registered nurse and ENs in a bid to maximize resources, (Leeann, Hurley & Provost, 2018).

Various models have been used adaptively or in a combination to offer patient care process, others have risen due to the accommodation of changing roles. Patient allocation models have been undertaken with the use of varying degree. In a study done conducted, it was observed that there was no job satisfaction between team oriented and patient allocation model. However, communication between key members is key in a healthcare setting, (Rantanen, Dimic-Misic, Pirttiniemi, Kuosmanen & Maloney et al., 2015).

 In a study conducted to assess the task allocation model of care, there was no significant difference in communication during 6 months follow up. One disadvantage aspect has come into focus, with limited workforce and limited supervising capacity; inexperience new staff tends to care patients beyond their skills and scope, (Whitehair,  Hurley & Provost 2018)

Approach used

Allocation model

Task allocation in nursing involves allocating tasks to specific nurse to handle the task. In ways of working nurse, it involves allocation of nursing where several patients  are allocated to specific nurse who handles the care process till handover session. The nursing care of passed to incoming nurse after work shifts, (Tiedeman & Lokinland, 2004). This way of working nurse enables transfer of functioning nurse to allocation nurse which improves nursing learning opportunities, (Gullick, LeChevallier, Svindland,  & Friedman,2004).

 Thus in this case, as a registered nurse, allocating the nurse with a specific number of patients to manage is critical so as to ensure that no patient is left out unattended. Hence allocating an estimate of 4 patients to every nurse available ensures that each and every nurse has a reasonability of managing the patient effectively.   

References

Babiker, A., El Husseini, M., Al Nemri, A., Al Frayh, A., Al Juryyan, N., Faki, M. O., ... & Al Zamil, F. (2014). Health care professional development: Working as a team to improve patient care. Sudanese journal of paediatrics, 14(2), 9.

Gullick, R. W., LeChevallier, M. W., Svindland, R. C., & Friedman, M. J. (2004). Occurrence of transient low and negative pressures in distribution systems. Journal?American Water Works Association, 96(11), 52-66.

Gunningberg, L., Mårtensson, G., Mamhidir, A. G., Florin, J., Athlin, Å. M., & Bååth, C. (2015). Pressure ulcer knowledge of registered nurses, assistant nurses and student nurses: a descriptive, comparative multicentre study in Sweden. International wound journal, 12(4), 462-468.

Murray?Parahi, P., DiGiacomo, M., Jackson, D., & Davidson, P. M. (2016). New graduate registered nurse transition into primary health care roles: an integrative literature review. Journal of clinical nursing, 25(21-22), 3084-3101.

Rantanen, J. J., Dimic-Misic, K., Pirttiniemi, J., Kuosmanen, P., & Maloney, T. C. (2015). Forming and dewatering of a microfibrillated cellulose composite paper. BioResources, 10(2), 3492-3506.

Sanders, D., Doherty, T., Kroon, M., & Rhoda, N. (2016). Ending preventable child deaths in South Africa: what role can ward-based outreach teams play?: in practice-issues in public health. African Journal of Health Professions Education, 106(7), 672-674.

Tian, X., Ma, L., Yi, L. J., Lian, J. X., Wang, Y., Cao, H., & Song, G. M. (2015). ORIGINAL PAPER. Research Status and Competence of Clinical Nursing Specialist and Construction on Core Competence Model for Osteoporosis Specialized Nurse in Mainland China. International Journal of Caring Sciences, 8(1).

Tiedeman, M. E., & Lookinland, S. (2004). Traditional models of care delivery: what have we learned?. Journal of Nursing Administration, 34(6), 291-297.

Whitehair, L., Hurley, J., & Provost, S. (2018). Envisioning successful teamwork: An exploratory qualitative study of team processes used by nursing teams in a paediatric hospital unit. Journal of clinical nursing.

World Health Organization report, (2014). Being an effective team player Available from: URL: https://www.who.int/patientsafety/education/curriculum/who_mc_topic-4.pdf Accessed 2sept 2018. [Ref list]