Leadership and Clinical governance Case Study 2022

Laparoscopy care management
Case study review
Leadership and Clinical governance
Assessment task 2
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Patient significant risks
Appendectomy procedure entails the removal of the vermiform appendix. It is
emergency care services crucial in preventing acute appendicitis complication. Laparoscopy
process provided to the patient entails the application of the minimally invasive surgical
process. After completion of the surgery often patients remain in bed ambulation in post-
operative care. Patient Nicole is currently at this stage and there are inherent underlying risks
which can lead to the poor outcome of care during the post-operation phase. The key
underlying risks for the patient Nicole entail risks for the fluid deficit, risks of infection and
risks of acute pain of the belly (Lamba, Bruns & Ponsky, 2017).
Fluid deficit
Fluid management in surgical therapy is essential, administration and maintenance
of proper fluid management are critical especially cases of emergency laparotomies,
resections of the bowel and hepatectomy. Studies have shown that body fluids change within
short of a period in post-operative care leading to impairment of wound healing process and
homeostasis (Kayilioglu et al., 2015). This is crucial for patient Nicole at this state of post-
operative care, examining her and assessing post fluid management strategies is essential in
the care process. Types of fluids to be offered and timing of administration are essential fluid
management therapy to be planed for patient Nicole. Establishment of effective fluid
management is essential in providing the patient with adequate tissue perfusion, reducing
morbidities ad having stable hemodynamic. Proper fluid administration is often criticized as
the patient state can change instantly, thus an effective strategy of postoperative fluid
management is imminent.
Risks of infection
Laparoscopic appendectomy is one of the fundamental care processes in hospitals
among patients exhibiting appendicitis. Due to increasing evidence of short hospital stay,

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rapid recovery phase and better management of pain are essential. Increased occurrences of
complications of infections have often hindered the care quality of patients (Nataraja et al.,
2012). Studies have demonstrated increased risks of intra abdominal abscess (Xiao et al.,
2015). This significance portends greater risks for patient Nicole who is at risks for this
occurrence as she is no different compared to other subjects studied. Underlying prevalent
risks which might occur to patient Nicole entails infection of hernia adhesions and abscess of
the abdominal (Sozutek et al., 2013).
Acute pain
Acute pain in postoperative care is a prevalent issue among patients. Studies have
shown that despite improvements in the management process, the majority of the patient still
develop moderate to severe pain (Maier et al., 2010). Severe pain among patients is linked
with lowered satisfaction levels, delayed ambulation process and occurrence of chronic
postoperative pain (Gerbershagen et al., 2013). This is a great significance for patient Nicole
during this post-operative care process. Adequately preparing for risks associated with acute
pain is essential to improve the overall outcome levels. Thus there is a need for adequate
management strategies towards implementing measures to lower this risk on the patient thus
improving the recovery process.
Resources for use by nurses
The critical resources which nurses could use are evidence-based practice
researches. Evidence-based practice is viewed as the application of scientific evidence to
improve the decision-making process in clinical practice and procedures. EBP uses advanced
nursing care practices however it is not applicable in all situations due to limited skills and
understanding on them (Melnyk et al., 2011). Implementation of care is essential in filling the
research gap between the clinical and research practice and developing professional roles.
Application of evidence-based practises allows for usage of big data processes, enabling

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initiation of care practices in an efficient and bests standard which are fundamental in
providing accurate care services. This will lead to an improvement of the nursing care
process and improving the health state of the patients and achieving positive health care
outcomes (Majid et al., 2011).
Despite this positive attribute of evidence-based practice, it is essential for adopting
the management of post-operative care process. Studies have demonstrated that instructions
and guidelines informing scientific interventions are essential in managing any health care
need arising (Haghighi et al., 2016). Adopting a range of interventions and underlying
rationales for patient Nicole is critical in offering guidance on the care protocol based on the
severity of risks which she is prone to encounter.
Nurses could employ the use of Nursing and Midwifery Board of Australia- NMBA
(Online) standards and scope of practice in ensuring that they offer adequate care for the
Nicole. The applications of the standards of practice in the care process are essential tools
which guide nurses in the care practice. The registered nurse standards of practice
demonstrate criteria and specificity of practice, the scope of practice, fundamental aspects of
person-centred care and aspect of engaging in an interdisciplinary approach for patient care.
Applying these concepts to Patient Nicole will be essential in improving her state of care and
facilitate the positive recovery process.
Resourceful websites such as The Australian Primary Health Care nurses are the
fundamental resource centre for nurses. They offer leadership and nurture the roles of nurses
in ensuring they engage in patient-centred care practice. This website is an essential tool for
caring to patient Nicole in this process. Engaging in person-centred care is fundamental in
optimizing care outcomes and engaging positively towards the patient recovery process.
Further, the website can facilitate the process of how a patient-centred approach on patient
care can be facilitated by the nurse (APNA, online).