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Quality improvement nursing project proposal
Language differences in healthcare
Language differences in healthcare
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I participated in project red with the Charge Nurse to promote quality improvement. The patient was going to be discharged from the hospital that day and was hospitalized previously for pulmonary pneumonia. I entered the room and introduced myself after I donned on my isolation precaution gear. I proceeded and entered with her instructions and computer on wheels. As I spoked with her she seemed like she was lost then I asked if she was understanding, she said “I prefer in Spanish”. I than continued to read the instructions about how to prevent pneumonia and how to treat it to her while translating them in Spanish. After, we spoke I made sure the charge nurse provided her Spanish written instructions. I than turned on the computer and started
When I met my patient for this service project, I was unsure of how I should introduce myself and how I would explain my role relative to their care. My community health worker, Sherron, took all the pressure away from the situation; she had already established a relationship with my patient and I felt more like an invited member into a health care team rather than a new face with something to prove. Sherron had already taken steps to help my patient and I was an added benefit with pharmaceutical knowledge. I spent most of my time reviewing disease states and answering questions about drug therapy. My first interaction with the patient was the first primary care visit; I spent my time extracting medical information from the patient alongside the new physician. This first interaction lasted over an hour, there is no way the patient retained all the details discussed, however Sherron was keeping contact with the physician and was given copies of the patient’s medical record. Sherron kept in constant contact with the patient and was truly the best resource for information besides the patient
I cared for a 76-year-old end-staged chronic obstructive pulmonary disorder patient who was admitted for respiratory distress. The doctor requested that my nurse and I get the family together for a family meeting. During the meeting, the doctor communicated to the patient and his family members that the patient will be palliative and no longer be in the ICU. The family members were concerned about the transfer of care to the medicine unit, what to expect from palliative care and other options for care. This scenario did not go well because the patient and family would have benefited from a palliative nurse with expertise, respiratory therapist to discuss other options, pharmacist about medication change if needed, social worker to help guide the family through end of life care for their father. In addition, there was no collaboration with interprofessionals prior to the family
Nurse A seemed confident and calm while nurse B appeared tired. With the first patients, I noticed that both nurses were asking for first and last name and confirmed the information with the picture in the computer and the medication cup. After a few minutes, I turned my attention to nurse B because I noticed she did not ask a particular patient for his name. Instead, she relied on the name provided by a patient care technician. When she was about to give the medication to the patient, nurse A noticed that the patient on the computer screen was not the patient on the counter. She immediately told nurse B “ That is not Mr… girl ” and nurse B responded while laughing “ He looks exactly like …, I need to get some coffee ASAP”. The patient immediately realized what happened and told nurse B his name. After that, nurse B reached for the right cup and administered the medication to the patient. Even though a medication error was not committed and no harm was inflicted to the patient, by violating important QSEN competencies this incident could have caused a negative patient outcome.
The patient is a female in her early twenties who came in the hospital due to sickle cell crisis. She was in grave pain especially in the joints. Her hemoglobin level was low so the Physician ordered 2 bags of packed red blood cells and pain meds Q4hrs. The patient explained many times that the dose the physician ordered was not sufficient and that she needed more help. The nurse promised to contact the physician and to inform her of the response. The fact is she never did and was called urgently hours after to calm her patient who was crying in agony and wanted to go home to be in pain. She screamed out that no one cared. Some nurses were even callus enough to say if she wanted to leave then hand her the relevant document and allow her to go.
I enjoyed interacting with the patients, and my nurse. Karie, was amazing. She explained to me everything she did. The routine for each patient was very similar, and this repetition helped me anticipate what Karie needed and helped me feel fairly confident in assisting her with the new patients and their needs. On the other hand, I was extremely disappointed that I was not given the opportunity to administer an intravenous (IV) line. Karie was willing to allow me the opportunity after I watched her place an IV in three different patients, but her fourth patient was transported from a different hospital with peripherally inserted central catheter (PICC) line in place. It was beginning to get late in the day and the patients coming in was slowing down, so Karie told the nurses at the nursing station that I needed to practice IV’s, but no one had any to give. Although I was disappoint that the opportunity to insert an IV into a patient did not arise, I did gain much knowledge regarding the ODS unit. I am now familiar with the physical layout of the unit and what takes place with patients that go there. I know the role of the nurse. I was also given an opportunity to practice nursing diagnoses on a
There was inappropriate staffing in the Emergency Room which was a factor in the event. There was one registered nurse (RN) and one licensed practical nurse (LPN) on duty at the time of the incident. Additional staff was available and not called in. The Emergency Nurses Association holds the position there should be two registered nurses whose responsibility is to prov...
Every Wednesday I was assigned a patient to attend to by a specific nurse who was also my supervisor in a hospital setting. My instructor ensured that this nurse followed my progress in respect to the way I was to handle the patient through written report. While taking care of the patient, I recorded various changes, he/she indicates towards recovery. I reported these changes to the nurse. While participating in this activity, I was expected to follow the strict guidelines by the instructor and nurse; as required by the rules and regulations, and code of conduct in nursing.
On my first day of clinical placement, I was assigned to work at the forensic unit at the North Bay Regional Hospital. I introduced myself to the patient and explained that I was a second year nursing student and I will be his nurse for six weeks. I recalled from the kardex of my patient information that he had been admitted to the forensic unit with a
As a result, she breached the standard 6 which states that “registered nurse should provide a safe, appropriate and responsive quality nursing practice” (NMBA, 2016). In line with this standard, nurses should use applicable procedures to identify and act efficiently to potential and actual risk such as unexpected changing patient’s condition (NMBA, 2016). Through early identification and response by the nurse, this will ensure that the patient’s condition is recognised and appropriate action is provided and escalated (Australian Commission on Safety and Quality in Health Care, 2011). Moreover, the nurse did not immediately escalate the patient’s deteriorating condition to the members of the health care team. Therefore, she also disregards the standard 4.3 stating that nurses should have work with the interdisciplinary health care team and to collaborate, communicate and discuss the patient’s status (NMBA,2016). The purpose of collaborating and communicating with the team is to provide a comprehensive plan of care for the patient and to facilitate early treatments needed by the patient (Cropley,
In the scenario provided, there were several key factors that could have resulted in a poor quality outcome for the patient. There were a number of tasks assigned to the Licensed Vocational Nurse (LVN), which required special training or competency. It was difficult to validate that the LVN had been deemed competent to perform the more specialized skills with the information available. Clarifying the LVN’s skill set and having full understanding of her training would have been critical for the RN in charge. Further, the LVN was simply not delivering the care that had been assigned. The RN needs to critically evaluate the situation. The LVN may have felt intimidated, lacked the skill, failed to understand the assignment, or any other variety of reasons. The point is the patient was not receiving the care needed and an intervention was required. “Delegation is both an art and a science. It includes cognitive, affective, and intuitive dimensions,” states Marjorie Barter (2002). All RN’s, regardless of assignment, should remember that “leaders do more than delegate, dictate, and direct. Leaders help others achieve their highest potential,” (American Nurses Association). The RN would have been remiss in not pursuing an answer to why the LVN appeared to be avoiding ce...
Arrangements need to be made so that they understand what is happening clearly, whether getting in a translator or just taking slightly more time so that there is a clear flow of communication happening. This will improve the quality of care that they are receiving. A study conducted by Hemsley, Balandin and Worrall (2012) has shown that time is an important factor in communication and where there are barriers nurses may avoid opening the communication channel directly with their patient rather than focussing on the patient’s carer or family to relay the message. This is a less effective way of communicating with a patient, as it does not create an environment where a patient will feel able to communicate freely to discuss any problems they may be having. Anthony & Vidal (2010) point out that the use of correct information is vital, as registered nurses rely on information to conduct quality and safe care. There may be issues with that information if it is not communicated correctly which can lead to common nursing
Ever since I was in middle school I dreamed of working in the medical field. I realized nursing was the profession for me when my grandfather became terribly sick with lung cancer during my freshman year of high school. It puzzled me that one of the healthiest and most physically active people I knew could be afflicted by such a damaging disease. After watching my grandfather’s suffering and the pain my entire family felt from his death, I knew I wanted to go into a field to help others that are facing the same challenges. This is when I discovered all of the opportunities that a career in nursing could offer me.
Reflection is the thing that we bring to an experience is fundamental to our understanding of what happens. This is impacted by our past, our future and our present world-sees. In nursing, it reflects the attitude, personality, decision-making and ethics when dealing with sick people. A Cherima (2007) point out that reflection journal is a useful tool for promoting reflection and learning process for nurses. In this assignment, I am going to reflect on one of the clinical situations that had happened during my clinical placement at the surgical orthopedic ward. The incident that I am going to reflect is maintaining patient’s safety in preventing risk of fall during the hospitalization. It is important to prevent the patient from fall because it may further impact the patient’s wellbeing. For instance, the patient might experience fractures from falls. Edwards et al. (2013) claim the risk of fall history is linked with higher incidence of fracture. I choose this issue because I want to explore the importance of patient safety in relation to
On my first day of week three clinical at 0830, client W and I were on our way to the dinning room and client B asked me to put his jacket on, so I told client W that I would meet him in the dinning room. After I helped Client B, I was on my way to the dinning room and nurse A told me that client W was experiencing difficulty breathing and we needed to give him his 0900 inhalers earlier. He was having audible wheezing and rapid respiratory rate. Therefore, we had to give client W his inhalers, SalbutaMOL Sulfate, which is a bronchodilator to allow the alveoli in the lung to open so th...
After the handover, I was asked by my mentor to attend to a patient who is bed ridden to have her personal care done with the assistance of one of the health care assistant staff. The patient was recently admitted to the ward and she looks sc...