Reflection on Clinical Practice Issues in Hospital Cardiac Stroke & Medical Ward

This reflection discusses clinical practice issues in Hospital Cardiac Stroke & Medical Ward, including financial challenges, patient safety, personnel shortages, government authorization, and patient satisfaction. It also explores the impact from the professional, clinical, and patient perspective, and reviews literature on improving patient care in acute care centers.

Reflection based on clinical practice issue or
critical incident in Hospital Cardiac Stroke &
Medical Ward

Table of Content.
INTRODUCTION ..........................................................................................................................1
MAIN BODY...................................................................................................................................1
Clinical Practice issue..................................................................................................................1
Impact from the professional, clinical and patient perspective....................................................2
The literature informs the clinical practice identified in the issue or incident.............................3
CONCLUSION................................................................................................................................4
REFERENCES................................................................................................................................5

INTRODUCTION
The branch of secondary healthcare is refer to an acute care. It is a place where patient
receives active care but for a short term treatment to a severe injury or after the surgery. The
practice which involve the activities and are performed on the behalf of client. Especially the
activities which are performed in client's presence or with their collaboration are termed as
clinical practice. The case study emphasised on some clinical practice issues such as financial
challenges, patient safety and quality of treatment, personnel shortages, government
authorization as well as patient satisfaction. The case study analyse the importance of
professional, clinical as well as patient perspective for an example that the patient and nurses are
not always agree on the quality of care but exposure to some times impact a positive perception
of nurse caring. The case study also review some literature as perspective for improving the
patient care in acute care centre as well as the clinical practices issue including their positive or
negative incident.
MAIN BODY
Clinical Practice issue
Clinical practice is a model of practice which involves, activities on behalf of patients
including their corporation or their presence. Me as a registered acute care nurse has
responsibilities to do the all activities of patient in their presence or with their cooperation. When
I was working as an acute care nurse in cardiac department, I witness a lot of issues while caring
the patient. One of the scenario, I witnessed that one patient was admitted in the hospital for
some days as because he was suffering from acute coronary syndromes. Due to which he was
suffering from breathing issue, chest pain as well as the pain was spreading from chest to
shoulders, arms, back, neck. But due to shortage of medical staff in the hospital, he was not
getting regular check-up in the hospital. He was given proper primary care treatment at the time
of unstable condition. As it was very unethical in case of treatment, as doctors could have to
monitor the patients regularly in terms of care. But they visited to their bed irregularly
(Voorhees, Fombelle & Bone, (2020).
At one night, when I was enter to acute care ward for my shift, I notice one of the patient
felt uneasy and severe chest pain along with breathing problem. When he was not able to bear
the pain he faint and fall asleep near the bed. I rush towards him with other medical staff and
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take back to his bed and check his condition. As his condition was not stable, I move to doctor's
cabin in order to reporting his condition. But the doctor who was handling his case was on leave
that night. So, I inform to other doctor as one of the patient condition is not stable but that doctor
instead of checking him personally he suggested me to give a patient of 4mg Morphine
intravenously in the interval of 15 minutes and add Atorvastatin 40mg in his medication from the
next morning. While giving him Morphine 4mg intravenously his condition back to normal or in
stable. But this was very unethical procedure which I was notice at the acute care department.
(Audet, Bourgault & Rochefort, (2018)).
Apart from this the patient satisfaction is also one major issue I was notice in that
department. Like that patient whom I administered the Morphine in his unstable condition seems
to be unsatisfied because in his unstable condition the doctor was not present. patient was
complaining chest pain or breathing issue in the evening of the same night but doctor do not
visited to his bed. There was need to examine each person carefully as it is very important in
clinical practice in the acute care centre. Every person including all staff have responsibilities to
take the patient actively as well as carefully (Downie, et. al., (2020)).
Impact from the professional, clinical and patient perspective
Each and every person who are included in healthcare department need to maintain the
professionalism. As professionalism is a standard value which are to be maintained by the
doctors, nurses and the medical staffs. The process of building such values is gradual as well as
organic process and need to be maintain throughout the lifetime. Maintaining the professionalism
in acute care department or in any clinical practice increased the patient care quality as well as
built the faith in patients. But the give case scenario emphasised that the department do not
maintain the professionalism they simply provide treatment to the patient during his first visit
only or some of the em condition. From my perspective as a nurse, it was very unethical as each
patient should be important for the doctors including the medical staff (Granja, Janssen &
Johansen, (2018)).
From the clinical perspective, I would like to add on that the knowledge about the health
must be attributed to the patient. The clinical facilities must involve in primary care to every one
including those who cannot afford. Basic treatment do not involve high efficiency machine. I
remember one more thing from the case scenario that the basic clinical practices are not
according to the patient health condition as expert medical staff was required for his care, but
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due to shortage of medical staff, only the new trainee was present which make difficulty in
handling the situation. Also there was not basic clinical diagnosis machine in the department for
immediate treatment. According to me, this whole scenario built negative perspective towards
the acute care centre in patient perspective (Smith, et. al., (2020)).
The literature informs the clinical practice identified in the issue or incident
As per Martin (2015), In hospital, the care should be provided to the patient by an expert
while ensuring the guidelines and protocol. The guidelines and protocols are followed as per
government norms and have to be implemented by all the front end healthcare provider in order
of treatment to all patient carefully. As per author Martin (2015), he identified some consensus
policy recommendation in order to provide acute care treatment to the patients such as
optimization patient care transition in acute care treatment, increase patient eduction and support
in acute care centre, provide equal care treatment to all patient, improve and develop better care
quality to all patient and promote heart failure prevention program.
The acute coronary syndrome is a condition in which the heart loss their function or work
abruptly due to this an individual feel breathing problem as well as consciousness problem. \
As per Martin (2015), out of 10, one were dies in hospital due to acute cardiac arrest. The
symptom of cardiac arrest is heart attack, breathlessness, chest pain, swelling in lower leg and
ankle as sometimes these symptom was not recognized by the patient or even by the healthcare
professional like doctors. The similar kind of clinical issues are mentioned in above case
scenario. This one mistake from clinical practice leads to life-threatening symptoms as by
decreasing or declining heart function. According to Martin (2015), explain that the patient who
survive first episode of cardiac arrest, acute care treatment may reduce the risk of another
episode this care was not provided to the patient as mentioned in above case scenario.
According to Michael (2015), when patient were treated or followed up by the acute care
taker are more likely to survive even the patient with heart failure. As acute care department
provided the treatment from an expert while involving the multidisciplinary team in acute care
department. After some days of treatment in the acute care centre, when the patient discharge
from the centre or from the hospital, the patient need smooth care transition follow up care by
having registered nurses on their side in order to provide the activities which is required to be
maintained such as right medication at right doses at right time. Apart from this, the patient need
support as well as education in order to keep engage in own care. As per author, there is a
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survey which shows that the many people with cardiac arrest or acute heart failure remain
vulnerable about the warning symptoms of heart failure for future episodes. So, there is need
provide the education programme on heart failure to all the patient in order to increase the
awareness about the disease as well as improve the patient outcomes.
CONCLUSION
From the above report writing it is concluded that cardiac arrest is a condition in which
the heart abrupt their function or work due to which the patient feel uneasy, chest pain, breathing
issues as well as unconsciousness. The above discussed case study include some clinical practice
issues such as unethical practice, patient satisfaction, financial challenges as well. These clinical
practice needs to improve for increasing the patient safety. There is need to provide the equal
treatment to all the patient in the acute care centre or in hospital without any kind of
discrimination. And lastly from the literature review it is concluded that when the cardiac arrest
is treated in initial episode by providing care in acute care centre there is a chances to reduce the
future episode of cardiac failure.
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REFERENCES
Books and Journals:
Voorhees, C. M., Fombelle, P. W., & Bone, S. A. (2020). Don’t forget about the frontline
employee during the COVID-19 pandemic: Preliminary insights and a research agenda
on market shocks. Journal of Service Research, 23(4), 396-400.
Audet, L. A., Bourgault, P., & Rochefort, C. M. (2018). Associations between nurse education
and experience and the risk of mortality and adverse events in acute care hospitals: A
systematic review of observational studies. International journal of nursing studies, 80,
128-146.
Downie, A., et. al., (2020). How common is imaging for low back pain in primary and
emergency care? Systematic review and meta-analysis of over 4 million imaging
requests across 21 years. British journal of sports medicine, 54(11), 642-651.
Granja, C., Janssen, W., & Johansen, M. A. (2018). Factors determining the success and failure
of eHealth interventions: systematic review of the literature. Journal of medical Internet
research, 20(5), e10235.
Smith, C. H. et. al., (2020). British Association of Dermatologists guidelines for biologic therapy
for psoriasis 2020: a rapid update. British Journal of Dermatology, 183(4), 628-637.
Coyne, I., Holmström, I., & Söderbäck, M. (2018). Centeredness in healthcare: a concept
synthesis of family-centered care, person-centered care and child-centered care. Journal
of pediatric nursing, 42, 45-56.
Online:
Improving care for patients with acute heart failure: before, during and after hospitalization,
2015 [Online] <https://onlinelibrary.wiley.com/doi/10.1002/ehf2.12021>
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