1. Clinical Practice Issues in Ysabel’s Care
1.Identify all clinical practice issues in Ysabel’s care during all of her hospitalisation.
2.Identify all National Health and Safety Standards that have been breached in Ysabel’s care and discuss how these standards have been breached.
3.From your list of identified National Health and Safety Standards, choose two (2) standards, review literature and discuss how those 2 standards could have been maintained by health care staff in the care of Ysabel and her family during her hospitalisation.
4.Based on your 2 chosen standards, what recommendations would you make for changes to health care practice at the ward level? Support your recommendations with rationales supported by evidence-based literature.
The assignment would mainly be depicting the importance of following important safety and quality standards by the healthcare professionals in the nation of Australia. It would mainly associate a case study analysis in order to provide examples how improper and negligent care delivery has the capacity to affect the life of patients and family members in negative ways.
1.This paragraph would be discussing about the clinical practice issues during the treatment of the patient. In the entire case study, a number of clinical issues were found to be present that had resulted in a poor quality life of the patient. One of the most important clinical issues was that during the time of giving birth to her third child, the patient was already recognized to be suffering from cholelithiasis. However, the healthcare centre did not take any necessary steps to help the patient get over the issue. In the next healthcare centre also, it was seen that the professional completely failed to understand the severity of the situation of the patient and had only provided her pain medication. Such situation further aggravated the health condition of the patient and made her suffer from more pain the following day. Moreover, the second hospital had not give her any medication treatment that she needed to follow in cases when her pain was high in her home.
In the third hospital, a number of issues were identified which showed that the professionals neglected their practices and were lack of proper organizational culture that ensured safety health of patients. While the patient was staying at the hospital, it was seen that the surgery was repeatedly postponed which resulted her to develop a secondary situation of cholecysticis. Even after recognizing that the patient was suffering massively, the professionals were careless and they took such surgery to be a casual one by keeping the other surgeries as their first priorities. Their carelessness resulted in bursting of the gall bladder that created further issues as the gallstones blocked the bile duct (Bansal et al., 2014). This complication was only due to negligence of the healthcare professionals that resulted in suffering of the patient. Another clinical issue that was observed that the healthcare professionals constantly kept the patient in a fasting stage or in a very light diet stage as they were constantly postponing the surgery. This resulted the patient in remaining empty stomach for a long time that was not only a fact of negligence affecting human dignity but also weakened her largely. Therefore, all these issues were noted in the case study.
2. National Health and Safety Standards Breached in Ysabel’s Care
Another issue that was observed is the wound infection of the patient that took place after she was released from the healthcare centre. It was found that the patient has infection in the drainage site and this was contributed to the improper wound dressing and wound management of the nursing professional who was caring for the patient. The wound had inflamed and there arose a risk for sepsis and this might have resulted in improper dry wound management that should have been applied to her (Mikkonen et al., 2016). Moreover, it is the duty of the healthcare professionals to care for the patients in ways so that they remain free from anxiety and fear in the stages before operation is conducted and too not provide any sort of medication before laparoscopic cholecystectomy would be conducted (Cherry & Jacobs, 2016). However, the situation was such that it had the chance of raising her blood pressure that could have acted as a barrier for surgery.
2.This paragraph would discuss about all National Health and Safety Standards that have been breached in Ysabel’s care. In the case study, a number of instances have been found which shows that there had been breaches in the national health and safety standards that had been published by Australian Commission on Safety and Quality in Health Care in the year 2017. There was a complete breach in the maintenance of the clinical governance that is mainly seen to describe the safety and quality systems. These are indeed important in the maintenance in the reliability, quality as well as safety healthcare that would in turn help in the improvement of the outcome of the patient (Auerbach et al., 2015).
It was seen that the patient was in severe situation where she needed Laparoscopic cholecystectomy as the gall bladders had stones and had inflamed as well. However, the professional neglected the surgery stating that they had more severe cases of surgery pending that they have to attend first. This situation resulted in burning of gall bladder resulting in more suffering for the patient. Another standard that was also breached is called the Preventing and Controlling HealthcareAssociated Infection. This mainly helps in describing the systems as well as strategies which would be helpful in the prevention of the infection or management of infections. Limiting the development of the antimicrobial resistance through the prudent use of the anti-microbial is also one of the best procedures for effective antimicrobial stewardships (Scanlon et al., 2016).
3. How the Standards Could have Been Maintained during Ysabel’s Care
In the case study, it was seen that the professionals did not perform the wound dressing at the drainage site, might have handled site in ways without proper washing, or have used unsterilized products that might have resulted in development of infection in the site. This provided her very poor quality of life. Another of the guideline that has been breached is called the Communicating for Safety that mainly includes the different types of strategies as well as the systems that would be helpful in effective communication. This should take place between patients, families and caregivers, multidisciplinary teams as well as clinicians and across different health organization.
In the case study, it was seen that Tom who was the husband of the patient was taking care of the three children who were very dependent on their parents. His wife was supposed to be sent to surgery and Tom tried his best to remain in constant communication with the hospital professionals. He wanted to know about the status of the surgery and everything that was happening with the patient (Halcomb et al., 2016). However, most of the professionals who attended the call were not being able to provide the exact current information about the patient that resulted tom in not only being confused but also stressed and tensed abut health of her wife. Moreover, one of the professional of the patient inquiry branch gave him a wrong information about his wife stating that she had returned to the ward when in reality, the patient was still in recovery room. Moreover, the nursing professional s attending the patient could not answer tom’s questions that created anxiety in him.
All this resulted in mental harassment and anxiety of Tom. Another important arena that also needs to be covered is the Recognizing and Responding to Acute Deterioration. This standard mainly helps in incorporation of the systems and the processes that help in responding effectively to the patients when not only their physical but also their mental as well as cognitive conditions are seen to deteriorate (Braithewaite et al., 2016). In the case study also, the professionals were seen to fail to identify the deterioration in the health of the patient and was seen to be very casual in approach. They continued to postpone her surgery and did not assess the condition of her gall bladder even knowing she was suffering from two of disorders. This negligence resulted in the bursting of the gall bladders reasoning the galls tines that blocked her bile ducts creating more issues for them (Halcomb et al., 2017).
3.Preventing and controlling healthcare associated infections:
4. Recommendations for Changes at the Ward Level
This paragraph would discuss about one of the standard of National Health and Safety Standard called the preventing and controlling if infections. Preventing and controlling healthcare associated infections is one of the most important aspects of nursing practice. It is extremely significant for the maintenance of the safe environment for the patients and this is mainly achieved by the reduction of the risks for potential spread of diseases not only from person to person but also from patients to healthcare professionals and vice versa (Loveday et al., 2014). A large number of consequences remain associated with that of hospital-acquired infections as well as poor hand- hygiene practices. Many of the professionals also do not follow the proper framework for the wound dressing or may not apply the correct method of wound dressing like dry dressing or wet dressing according to the wound. This might result in number of consequences on the social, physical as well as the financial conditions of the patients, their carer and their family members. People who suffer from such form of infections have longer hospital stays or they have to undertake readmissions in the hospitals for further treatment of the wound infections (Herzig et al., 2016).
Both of these result in increased costs. Both the healthcare organizations had to spend additional resources for this form of preventable disorders that could have been used effectively for other patients with severe conditions. Moreover, it also results in huge financial flow from the patents and the family members that also result in poor quality life of the family creating stress and anxiety. Moreover such issues also results in depression and anxiety of the family members as well as the patient when the patient is seen to suffer more unnecessarily due to negligence of the service providers. Financial downfall, stress and anxiety of patients and family members, preventable deaths in the healthcare centers, unnecessary flow of healthcare resources, emotional and mental turmoil, legal obligations for the professionals and many other result from such issues (Mody et al., 2015).
Therefore, it is very important for the healthcare professionals to abide by the guidelines for prevention of and controlling of infection in the healthcare centers, take effective training sessions for the development of skills and knowledge for infection control, development of organizational culture influencing professional practices that influence effective practices. In the case study, it was seen that the patient had developed wound infection that was giving her a hard time. This might have been because the healthcare professional who was attending the patient might not have followed hand hygiene, or wound management procedures or might have applied wrong wound dressing protocols (Zingg et al., 2015). Therefore, the patient was to be admitted again, this affected not only her won mental and physical health but also created huge issues for both tom, and the children as it resulted in emotional turmoil for all of them. This exposes to additional financial outflow of the family that could affect the quality of living of the patient and her husband behind the anxiety, stress and fear that also follow.
Effective communication among stakeholders:
This paragraph would discuss about one of the standard of National Health and Safety Standard called the importance of effective communication among stakeholders. Communication is one of the most tools in healthcare setting and has the capability to develop or worsen the satisfaction of the patient along with affecting the safety and quality of the care provided to the patient. Effective communication among the professionals is important to avoid medication error and any form of missed interventions. It also prevents waiting times of the patients, helps in effective documentation, proper delegation and others. This ensures effective teamwork and hence safe and quality care that not only meets all the needs and requirements of the patients but also enhances patient satisfaction (Foronda et al., 2016). Besides, effective communication both verbal and non-verbal, are found to be extremely important for development of therapeutic relationship with the patent.
When the nursing professionals are seen to communicate with the patients in a compassionate and empathetic manner, the patients as well as their family embers feel that the professionals are aware of their situations and are genuinely trying to help them in this situation. The professionals need to keep the patients and their family members in the centre of the decisions making process and they can provide respect to the dignity and autonomy of the patient through effective communication (Koivunen et al., 2015). By communicating with the family members and the patient, they can develop bonding and mutual trust among each other based on respect and affection. Communication on the other hand also helps in solving queries of the patient as well as the family members in case of informed consent or providing information regarding the health of the patient or the time schedules fixed for the treatment of the patient. It helps not only in solving queries but also in reduction of the anxiety and stress. Informed consents help family members and patients to know about the interventions in details before they are provided to the patients along with their pros and cons before they ask for consents of the patients. This helps the patients and their family members to develop knowledge and ideas about the interventions and thereby reduce stress and anxiety (Riley, 2015). Moreover, when they are able to resolve their queries and get proper answers from the professionals regarding their health, it also tends to prevent occurrence of tensions and stress.
Therefore, for achieving patient satisfaction, it is extremely useful for the healthcare professionals to develop effective communication that will also ensure safe and effective practice. In the case study, it is seen that Tom was not communicated properly by the healthcare professionals, which were making him frustrated, as he was not able to know about conditions of his wife (Gausvik et al., 2015). He was growing anxious and stressed. Moreover, the departments and the healthcare professionals did not document and communicate among them regarding the condition of the patient for which no one was able to solve the query of the patient and her husband. This in a way affects the patient and family member satisfaction
4.This paragraph would be containing the recommendations. The healthcare authority should ensure development of an organizational culture that would promote the maintenance of had hygiene among the healthcare professionals and development and maintenance of environmental hygiene. Effective screening of the patients according to their vulnerability towards infection, assessing their risks for infection and accordingly ranging suitable interventions for them would reduce chances of infection. Effective training session for enhancing the knowledge and skills of the professionals regarding maintenance of safety through proper hygienic maintenance, wound dressing management and safety and quality care would be also helpful (Mody et al., 2015). The organizational culture should also be so that it promotes blames free environment where professionals can report about improper practices and thereby seek for guidance. The authority should also allocate sufficient resources for infection control to the professionals.
For development of effective communication, training sessions would be held, evidence based articles should be circulated, professionals may be asked to attend workshops, arrange for feedback meeting sessions to develop communication skills among members and many others (Gausvik et al., 2015).
Conclusion:
From the above discussion, it can be seen that effective communication, prevention, and control of infection are two important arenas in healthcare. If two of the arenas were followed in the case study, the patient and her family members would not have suffered emotionally, physically as well as financially.
References:
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