Clinical Integration: Prioritization, Delegation, Health Care Team, Provision and Coordination of Care, Time Management and Delegation

This article discusses prioritization and delegation in the nursing profession, factors considered in composing a health care team, and the key issues in case study 3. It also covers provision and coordination of care, time management, and delegation.

Running head: CLINICAL INTEGRATION 1
Clinical Integration
Name
Institution
Date

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CLINICAL INTEGRATION 2
Prioritization and Delegation
Prioritization in the healthcare profession refers to the act of healthcare provider
attending critical and very serious cases first in order to save lives, preserve and facilitate
stability. Delegation simply refers to the process in which the healthcare team leader assigns
his/her equals, seniors or juniors’ duties to do in a health care set up. In the issues provided, I
shall give first priority to the elderly female patient who collapsed to the floor and lost her
consciousness and sustained facial injury. I will personally attend her and perform the first
aid after placing her at recovery position and other crucial assessments. I will loosen any tight
clothing. I will check for the Dr. ABC in order to ensure that the airway openings are in a
good state to allow for fluids to flow out (Aitken, Chaboyer, & Elliot, 2012). Shall check on
her breathing system and her circulatory system to determine whether there is any blockage.
Lastly, will examine her to check whether she sustained any serious injuries that might lead
to disability. For Mr. Smith’s visitor issue, I will delegate the duties to the AIN. AIN should
put the patient on a recovery position. It will make the patient feel comfortable, allow any
fluids to flow out since all airway openings will be wide open. Also, in that position, the AIN
will be able to examine and carry out ABCD and assist the patient (Benner, Tanner, &
Chelsa, 2009). The AIN should test the response stimuli of the patient through calling out her
name if no response then should try to inflict some pain on sensitive areas of the patient.
I will assign the ward clerk the issue of Mr. Esposito. The ward clerk will make the
patient’s medical history available in a well-documented file and have it forwarded to the
preoperative medical professional. The medical professional shall be responsible for
administering the pre-operative medication on Mr. Esposito. I will assign the staff toilets
issue to the AIN, who will immediately prepare a write-up and stick it on the door “Out of
Service.” AIN will contact relevant people such as plumbers to come over and rectify the
problem fully (Elliot & Coventry, 2012). Cleaners to have the waste removed. For Mrs.
Chew’s issue, I will assign the EN who will assess the patient’s condition and fix the IV
cannula as she/he compensates for the antibiotics. I handle to hold a discussion with the
surgical consultant to determine how everything unfolded and what the possible side effects
might have been and what should be done to counter future errors happening again.

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CLINICAL INTEGRATION 3
Factors Considered in Composing a Health Care Team
Several factors are put into consideration in selecting the type of health care
professionals who should form a crew of medical experts. Firstly, the patient’s health status,
in cases where the patient is in a dangerous state, a team comprising of emergency doctor and
other rescuers should be formed. The more the serious the patient’s situation, the more
complex team of healthcare professionals is constituted and vice versa. Secondly, the kind of
treatment to be received by the patient. in circumstances where for instance a mother is
giving birth through caesarian surgery, a surgeon, maternal nurses, radiologists, and other
experts should be included in the team (Leyett-Jones, 2013). The third factor is that
considering the location of the health facility and the patient. you get that patients in remote
or rural areas are mostly attended to by a small team of health professional unlike where
patients are visiting hospitals in urban areas where serious cases are mostly attended to by a
complex team of healthcare providers. The availability of medical experts, in developed
hospitals where there are adequate professionals a more and strong team is composed
including all specialists in different fields in medicine unlike in rural dispensaries where very
few specialists exist. In these health centers, a team is composed of very few professionals
who even end up giving referring their patients to urban or developed hospitals (Health,
2010).
The fourth factor considered is that of how rich or poor a patient is. For rich patients,
a more detailed healthcare team is composed to offer services unlike in situations where poor
patients are to be treated. This is because the rich family is at a position to pay for services in
well set up and high standard hospitals for their lovers, unlike the poor families whose
patients suffer in public hospitals begging for free government services. The fifth factor is the
age bracket and gender. Young people tend to be attended by a well-composed team since
life-saving for them will economically benefit the nation. Every country does fight for the
survival of youths since they are the future source of human labor and carer of the aged
(Australia, 2014). Gender also is a key factor to be considered while composing a team, the
team should not compose only of ladies or men if there is adequate staff with a balanced
gender. A healthcare team is usually headed or chaired by a medical doctor since most
patients feel more comfortable to be attended by a team led by a doctor. In a healthcare team,
the patient happens to be the most member since the team gets composed because of him/her.

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The Key Issues in Case Study 3
Robert who is the patient covered in this case study had his bones fractured. The
bones that got fractured included the right tibia, right fibula and right radius. He suffers also
from mental health impairment. He is an orphan and on top of this issue the only parent is
quite old, a mother of 75 years of age, who instead requires palliative care from her son,
Robert. A number of health professionals will be of much help to Robert. A nurse in charge
will receive Robert and prepare him psychologically on the anticipated health practices to be
conducted on him (Boards, 2014). A medical doctor will assist in Robert’s assessment to
ascertain the impact and get any medical history information from him. The physician after
physical examination will refer Robert to the radiologist who will take x-rays on the affected
areas to produce digital images which will be interpreted by the physician with regard to the
severity of the impact suffered (Crisp, Douglas, Rebeiro, & Waters, 2017). Upon realization
on the extent of the impact, Robert will be attended to by an anesthetist who will give him an
anesthetic injection. The injection will make the patient lose consciousness and this will be
much easier for the surgeon to conduct surgery and have the fractures rectified without the
patient suffering from any pain during the surgery process (Scovell, 2010). When Robert
gains consciousness, he will be under the registered clinical officer who will monitor his
progress and give further medical consultations where necessary. Upon recovery, Robert will
be assigned a physiotherapist whom will guide him on the basic exercises including yogic
ones to assist him in full recovery process. Lastly, Robert will be at liberty to be visiting the
guidance and counseling professional to counsel and advise until he recovers fully.
Provision and Coordination of Care
As a nurse on duty upon receiving the patient from my colleague, I will make a
number of inquiries in regard to the patient being handed over. I would seek more
information in regard to what unfolded leading to the patient being brought to the hospital
and get admitted. Further, would establish from my fellow nurse on the time and who
accompanied the patient to the hospital and if their contracts were captured for further
consultations. In addition, I find out from the nurse whether the patient got attended in time,
the medical history of the patient that was captured and the medical prescription from the
clinical officer, how the patient has responded to the medication administered (Street, et al.,
2012). Lastly, I will confirm from the nurse whether the patient’s family or guardians are

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aware of the incident if they got contacted. Upon the patient’s arrival into the ward, I will
conduct a further assessment which will include checking the patient’s body temperature by
placing a thermometer in his armpit. With the help of the stethoscope I will check on his
heartbeat trend and through touch shall examine his pulses at the wrists and at the lower end
of the neck. I will softly interrogate the patient on he is feeling after medication (Berman, et
al., 2018).
In addition, I will take a blood sample from his ring right finger and check his sugar
level. Furthermore, I will have to reassess the patient on how efficient his airway openings
are, determine whether the breathing system is functioning properly and the entire circulation
system is working well without any blockage (Kalishma, Stoddard, & O'Sullivan, 2012).
Lastly, I will have to monitor the patient’s oxygen saturation levels. This is important because
there is insufficient oxygen supply in the circulatory system, some organs will fail to function
as high energy requiring cells die. What happens with low oxygen is that the active tissues
will fight for reserved oxygen in the hemoglobin and upon depletion, a body crisis emerges.
Upon discovering that the patient’s saturation is not attained, I will have to put him under the
supply of oxygen from the oxygen concentrator machine. Urinalysis test will also be vital in
examining the contents of the output from the patient and if there is a danger sign, I will
employ appropriate actions to revert the patient back to his normal condition (Felton, 2012). I
shall all the time ensure that the patient’s room is tidy, well ventilated and free of dust, a
clean hygienic environment is vital in nursing management.
Time Management and Delegation
Time management refers to the effective and efficient utilization of time utility in the
monitoring and evaluation of the patient’s conditions with an aim of providing proper and
appropriate professional care in the specified period. Proper time management leads to cost-
effective outcomes with minimal or no errors at the end of the healthcare provider. The term
delegation simply refers to the allocation of duties to either the seniors, equals or juniors.
Delegation serves to reduce workload and create more time for each healthcare professional
to attend to his/her patients adequately. It also helps to curb any supremacy and avoidance of
duties and staying away from work leaving other professionals struggling to handle a large
number of patients alone (Pearce, 2006). In the Australian nursing profession, these two
strategies have proven effective in ensuring that the patients do not miss their doses or
necessary attention. In this paper, I will focus on the 22 patients who are currently admitted.

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Out of the 22 patients, 14 of them underwent a surgical operation in the morning shift before
handing over was done. The remaining 8 patients are supposed to the operation during my
shift. 4 out of the 8 patients requires administration of antibiotics at some time since they
have got an IV access.
On duty with me is a fellow RN, an EN, and three AINs. My fellow RN is acting as
the NUM, since the NUM is on sick leave. As a registered nurse, am tasked to ensure time
management is well observed and duties are equally distributed based on healthcare staff
competency (Aitken, Chaboyer, & Marshall, 2015). I will allocate the first slot of patients
who have already undergone the surgical operation, 14, to the EN. The EN will be
responsible for observing the progress of the patients, monitoring and evaluating their
response stimuli to the operation and medication offered. I will give the EN additional staffs
whom he/she will coordinate in providing total patient care to the operated patients. These
will be the two AINs. The RN, one of the AINs and I will take care of the 8 patients. The RN
will guide the AIN in administering antibiotics to the 4 patients who have IV access
(Chaboyer & Hewnson-Conroy, 2015). As a team of three professionals will conduct all the
necessary assessment on the patients before releasing them to the theatre room. We shall
prepare the patients psychologically, monitor their pressure levels and make relevant
observations. As the team leader on duty, I will take up the role of offering moral and
emotional support to the patients, their family members, and carers.

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