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TEMPLATE: NRSG355 WRITTEN ASSESSMENT
Q1: Prioritisation and delegation (module one)
At first I will attend the elderly female patient who had just collapsed on the floor after
the surgery. I will immediately check her vital signs.
Secondly, I will delegate an enrolled nurse for checking the visitor, who had just
collapsed, who would report to me after assessing the patient.
Thirdly, I will attend Mr. Chew and would re insert the channel initiation intravenous
infusion.
Fourthly, I will attend Mr. Esposito and will administer the preoperative medicines.
Then, I will visit the surgical consultant for discussing about the medication error,
with recommendations in mind that can reduce the incidence of the medical errors.
It should be noted that the blockage of the staff toilet will not require any immediate
attention and hence this task can be delegated to some other ward staffs, who can
arrange for a plumber.
Issue Priority Action and rationale
The elderly patient had
collapsed on the floor
The issue is a priority as it
can occur after a
significant blood loss after
the patients leading to
hypovolemic shock. Again
anaesthesia during the
surgery can lead to fainting
and needs to be
addressed (Mohanty et al.,
A MET call should be
initiated (Casey &
Wallis, 2011). The
patient should be shifted
to the emergency ward.
She should be given
with oxygen. The
patient’s legs should be
raised above the levels
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2015). of the heart. If the
patient is not breathing,
CPR.
Mr. smith’s visitor has
fainted
The issue is a priority as
fainting can be caused due
to complications like low
blood pressure, or stressful
triggers, low blood sugar
level or dehydration and all
of them require immediate
attention.
A nursing staff should be
sent to encounter the
visitor for making an
initial assessment.
Rationale: An initial
assessment like ECG or
EEG, is required to
understand the
underlying reason of the
syncope (Elliott &
Coventry, 2012).
Mrs. Chew’s intravenous
(IV) infusion has issued
and she had missed her
IV infusion
This issue needs to be
addressed immediately as
the extravasation can give
rise to local tissue damage
leading to delayed
infection. Again missed
doses has been
associated with several
adverse effect
Mr. chew’s intravenous
channel should be
restored and waited for
the next dose of
antibiotics. Additional
methods should be
looked for to manage
her dehydration.
Mr. Esposito has not
received the preoperative
medicines before the
cardiac catheterization
Missed doses of
preoperative medicines
can deteriorate the quality
of life after the surgery due
to unnecessary pain and
other complications.
Mr. Esposito should be
attended and medicines
will be provided.
Rationale: cardiac
pumping activity can be
located by the
assessment.
Consultation with the
VMO about the
medication error
This is an issue because
medication error can lead
to serious conditions like
adverse drug reaction and
can cause mortality.
An apology and
justification for the
medication error should
be given and the
medication list needs to
be cross checked.
Rationale: Cross
checking of the
medication charts
causes less number of
medication errors
(Chaboyer & Hewson-
Conroy, 2015).
Blockage of the staff toilet This is an issue as it is a
matter of cleanliness and it
can also be a cause of
spreading of infections.
A ward staff should be
delegated to task to see
over the matter and
appoint a plumber to
sort out things.
Rationale: A ward staff
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will be deflated as this is
not an important issue to
be attended
immediately.
Q2: Collaborative and Therapeutic practice (module two)
(a) The Multidisciplinary team
i. Identify factors that determine which healthcare professionals are required to
be involved in a health care team?
The members of the multidisciplinary team includes physicians, nurses,
dieticians, physiotherapists, palliative care team, neurologist, occupational
therapist, a social workers, and psychologist and so on. The “teams” has been
found to be more effective than assigning health care professionals randomly to
the emergency rooms (Epstein, 2014). The members of the multidisciplinary
team depends upon the individual needs of the patient as well as the severity of
the clinical condition. A multidisciplinary team is formed on the basis of a plan of
care.
ii. Who should lead the health care team?
A team coordinator should be leading the health care team. Who will be included in
the health care team, depends upon the severity of the disease. It is not that that
doctors always should be the captain of the ship, but at times leaders can be a
physician, a pharmacist, a therapist or a nutritionist. Moreover they should focus on a
person-centred care (von Kodolitsch et al., 2016). A surgeon or an oncologist can
lead a multidisciplinary team for treating a cancer patient.
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iii. Who is the most important member of the health care team?
The patient is the most important member of a multidisciplinary team, as he/she
is the receiver of care. It is the duty of the physicians and the other medical
professionals to pay heed to the main member of the multidisciplinary team.
(b) Case study name: Case study 4
The case study gives the picture of a busy rehabilitation unit, where there had been
a recent turnover of the staffs in the physiotherapy department and a new
representation from the physiotherapy department has joined the healthcare team,
who is often absent and fails to provide patient updates.
i. Key issues identified
The key issues that has been identified is the recurring leave the worker had been
taking and his failure to provide patient updates.
Recurrent leaves can increase the workload on the other workers. Excessive
workload, on the other hand is related to stress and burnout among the other
workers. Again, missing patient updates can lead to clinical errors as nurses would
as work as per the instruction of physiotherapist. Lack of proper patient
documentation leads to negative patient outcomes.
ii. What strategies would you employ to address this situation?
In order to address such situation, I would at first enquire the reasons behind
the recurrent leaves. Leaves would only be granted for valid reasons. In case of any
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