Best Health Care Report 2022

Running head: HEALTH CARE
Health care
Name of the student:
Name of the University:
Author’s note

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Module 1:
The main purpose of this module is to consider different clinical situations at the ward,
complete delegation responsibilities and prioritize care in accordance with the scope of practice
for different health care staffs. The scenario is that after returning from tea break, I found many
staffs approached me for different incidents at the ward. All the six situations required some of
immediate intervention and I had to identify which activities to priorities first and which
activities to be delegated to other staffs. The staffs available in the ward include an EN (Enrolled
Nurse), AIN (Assistant in Nursing) and the ward clerk. The prioritization of care will be done by
the use of clinical reasoning cycle to identify the situation at hand and use clinical expertise to
make best judgment for individual patient (Liou et al., 2016).
Considering the six clinical situation received following tea break, the first priority will
be to address the elderly female post-operative patient who has collapsed down to the floor and is
unconscious. This is necessary because she is a post-operative patient with facial surgery and it is
possible that post-operative complications might be the reason for her to collapse. Hence, as a
registered nurse, it will be my responsibility to complete vital sign assessment of patient and
monitor any other injuries sustained to the patient while she collapsed. I will take the AIN with
me so that she can assist me to place the patient back of her bed. The significance of this
assessment is that it will help to identify clinical deterioration of patient and make MET call if
necessary (Mohammmed Iddrisu et al., 2018). This action is necessary to prevent post-operative
adverse events in patient.
The second situation of risk is Mr. Smith’s visitor who has fainted. This is necessary
because the patient might have sustained an injury and providing immediate assistance is

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necessary to help the visitor regain consciousness. The EN can be given the responsibility to
assess the patient and make her regain consciousness. According the NMBA standards of
practice for EN in Australia, all aspects of care starting from assessment to engaging in care can
be taken over by an EN (Nursing and Midwifery Board of Australia, 2016). The third priority in
case of urgency and urgent need of care is Mr. Espisito, who is to leave the ward now for cardiac
catherisation. However, he has not received his pre-operative medications. Providing
premedication during cardiac catherisation is important to prepare the patient for the process
(Hamid, 2014). As registered nurse can only administer medication to patient, I will administer
the medication to patient to ensure that her cardiac catherisation is not delayed. This
responsibility cannot be given to EN as she is not competent yet and it is not known whether she
has completed her medication administration education or not.
The fourth priority area is to address the concern of Mrs. Chew who has tissue in her IV
infusion and her IV fluid is running behind. It is necessary to immediately check the intravenous
infusion of patient because tissue in the fluid could affect normal flow of fluid and lead to
swelling of the skin too. She has missed her IV antibiotics too. Both this activities need to be
completed by me because the EN is not yet competent in IV cannulation. I will have to check the
intravenous catheter and administer medication as per her last dose given (Aitken, Chaboyer &
Marshall, 2105).
The fifth care priority to address toilet blockage issue which is overflowing. I will
delegate this task to the ward clerk. This activity is necessary to prevent flow of water to the
whole ward and prevent risk of contamination. I will give him special hygiene instructions such
as use of disinfectants to appropriately clean the floor. The last activity will be to listen to the
medication error report of the surgical consultant. This activity will be done by me. The main

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rationale for responding to the complaint last is that the situation is not an emergency risk area as
the medication error occurred last week. However, as completing incident report is important, I
will conclude my work with this activity (Jember et al., 2018).

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References:
Aitken, L., Chaboyer, W. & Marshall, A. (2105). Scope of critical care practice. In: L. Aitken, D.
Marshall & W. Chaboyer (Eds.). ACCCN’s Critical Care Nursing, 3rd Ed. Chatswood,
NSW: Elsevier.
Hamid A. (2014). Anesthesia for cardiac catheterization procedures. Heart, lung and
vessels, 6(4), 225–231.
Jember, A., Hailu, M., Messele, A., Demeke, T., & Hassen, M. (2018). Proportion of medication
error reporting and associated factors among nurses: a cross sectional study. BMC
nursing, 17(1), 9.
Liou, S. R., Liu, H. C., Tsai, H. M., Tsai, Y. H., Lin, Y. C., Chang, C. H., & Cheng, C. Y.
(2016). The development and psychometric testing of a theory‐based instrument to
evaluate nurses’ perception of clinical reasoning competence. Journal of advanced
nursing, 72(3), 707-717.
Mohammmed Iddrisu, S., Hutchinson, A. F., Sungkar, Y., & Considine, J. (2018). Nurses' role in
recognising and responding to clinical deterioration in surgical patients. Journal of
clinical nursing, 27(9-10), 1920-1930.
Nursing and Midwifery Board of Australia (2016). ENROLLED NURSE STANDARDS FOR
PRACTICE. Retrieved from: https://www.nursingmidwiferyboard.gov.au/Codes-
Guidelines-Statements/FAQ/Enrolled-nurse-standards-for-practice.aspx

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Module 2:
Activity 2:
1. Multi-disciplinary health care team is important to combine the skills of different
professionals with different expertise and use this combined skill set to address complex
health issues of patients. The immediate care needs of patient and the main disease or
diagnosis determines the members that need to be involved in a health care team. For
example, if a patient is suffering from a motor neurone disease, then the multidisciplinary
team should consists of allied health workers and members with specific expertise such
as neurologist and respiratory specialist. Allied health care professionals may include
nurse, dietitian, speech pathologist, psychologist, physician and physiotherapist. These
members will be provide the following care to patients:
Nurse: The nurse is involved in conducting patient assessment, administering medications,
managing fluids and diet requirement and checking overall health
Physician: General practitioner is important to guide the patient to appropriate specialist health
care professionals.
Dieticians: Dieticians provide dietary and nutritional advice as per the patient current and past
history of disease.
Speech pathologist: Speech pathologist aids in swallowing and communication related issues.
Physiotherapist: Physiotherapist work to address physical activity and mobility related needs.
Respiratory specialist: They are doctors specialized in disorders of the lung and breathing
problems (MND Australia, 2019).

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Hence, the above role of different interdisciplinary team shows how expertise of these staffs
addresses individual components of health of patients.
2. The General practitioner (GP) should lead the health care team as they can play a vital
role in initial diagnosis of patient and organization of integrate care for different patient
group. They can aid patient in guiding patients in referral process and guiding them to
appropriate health care professionals or service which could help them in recovery (Grol
et al., 2018).
3. Nurse is the most important members of a health care team as they have the highest level
of contact with patient and they play a vital role in providing continuous care and support
to patient. They act as advocate for patients and engage in therapeutic communication
process to identify appropriate care needs of patient and address any disparities in care.
In addition, nurses have the responsibility to provide designated and emergency care
when other senior health professionals are not available (Kieft et al., 2014). Therefore,
nurse is the most important part of a multi-disciplinary team as they influence patient
experience and continuity of care.
Part b (Case study 1 on Grant)
A. The key issues in the dilemma are as follows:
 Since Grant is hospitalized and away from his family, it is having a negative impact on
patient and his family
 Another issue is that since his injury, his recovery has been slow and the occupational
therapist both feels that Grant still requires intensive treatment at the hospital.

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b. The best outcome for Grant and his family will be to send him home and physiotherapist and
occupa6onal therapist frequently as an outpatient. The advantage of this decision is that it will
make Grant close to his family and also ensure that his rehabilitation needs are fulfilled. This
will address both physical and mental needs of clients.
c. To guide the group to achieve the best outcome for Grant, it will be necessary to explain all
team members about the approach to fulfil holistic care needs of client. They will be explained
regarding psychosocial effects of hospitalization and staying away from family for long period
The information will develop empathy in staffs and make them aware about emotional burden of
hospitalization (Admi et al., 2015). The team will be educate to support Grant’s family member
too so that they are provide adequate psychological support in dealing with Grant’s medical
condition.

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References:
Admi, H., Shadmi, E., Baruch, H., & Zisberg, A. (2015). From research to reality: minimizing
the effects of hospitalization on older adults. Rambam Maimonides medical journal, 6(2).
Grol, S. M., Molleman, G. R., Kuijpers, A., van der Sande, R., Fransen, G. A., Assendelft, W. J.,
& Schers, H. J. (2018). The role of the general practitioner in multidisciplinary teams: a
qualitative study in elderly care. BMC family practice, 19(1), 40.
Kieft, R. A., de Brouwer, B. B., Francke, A. L., & Delnoij, D. M. (2014). How nurses and their
work environment affect patient experiences of the quality of care: a qualitative
study. BMC health services research, 14, 249. doi:10.1186/1472-6963-14-249
MND Australia (2019). Multidisciplinary care team. Retrieved from:
https://www.mndaust.asn.au/Get-informed/Information-resources/Living_better_for_long
er/WEB-MND-Australia-Fact-Sheet-EB3-Multidisciplinary.aspx
Module 3: Time management, delegation and scope of practice

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As a registered nurse, I have been given the responsibility to delegate and allocate task to
my team members according to their scope of practice. The situation is related to a short stay
surgical wards where 14 patients went to surgery in the morning and rest 8 are due to go during
my shift. The team members available to provide support include one RN, an EN, three AINs
and another RN acting as NUM (Nurse Unit Manager). The task at hand includes half of the
patient require intravenous access and other half requires antibiotic.
While engaging in the process of delegation, my priority will be to ensure that each
member are delegated task according to their scope of practice and prevent overload of task for
any staff. Another priority is to ensure that all patients receive timely care. As the other
registered nurse is involved in taking patient load, I will assign the other registered nurse to six
patients. Two AIN will be assigned to her too so that she can assist the registered nurse during
nursing responsibilities. In addition, the enrolled nurse will be allocated to take care of all eight
patients and one AIN will be allocated to support her.
There are three AINs in the ward. They will be given the responsibility to prepare patient
for surgery and provide support in basic activities like patient transfer, personal care, emptying
urine bags, notifying about the surgery and maintaining confidentiality of patient. Under my
supervision, they will be given the responsibility to instruct each patient about diet restrictions
before surgery and other care instructions. This practice is within the scope of AIN role as such
nurse mostly provides support in basic care such as meal assistance, bed making, patient
transfers and recording vital signs. They can also take over verbal and written communication
responsibilities by communicating about patient self-reported pain status, notifying RN of patient
request and recording fluid intake and food charts (NSW, 2010). Hence, the three AINs can take

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responsibility of providing support to registered nurse and EN while looking after patients in the
ward in order of the surgery scheduled for each of them.
According to the standards for practice of an EN, they can provide nursing care according
to the agreed plan of care and can clarify their responsibilities for delegated care in collaboraaton
with RN. They can engage in assessment of patient, interpreting reports and provide support to
AINs. They can engage in documentation process and prepare verbal and written care reports.
(Nursing and Midwifery Board of Australia, 2016). The NUM and the EN will complete the
assigned duties for four patients individually. The main rationale for delegating this
responsibility to EN is that according to their scope of practice, they have the responsibility to
provide direct and indirect care to patient. They can administer medications and engage in
preoperative assessment of patient. Hence, they can safely complete this activity.
Secondly, the RN acting as NUM will also be given this responsibility to reduce
workload for the EN as there is less number of ENs and more number of patients to be given
medications. I will take over the responsibility of checking intravenous infusion of patient. It is
within the scope of practice of a registered nurse to complete all clinical procedures and
assessment. I will also focus provide supervision to EN and AIN’s to make sure that they are
doing their task appropriately (Nursing and Midwifery Board of Australia, 2016).
The above delegation process is based on team nursing model and it is an approach where
each member of the team contributes to patient care and work in a coordinated manner. The main
rationale for choosing this allocation model is that the scenario required team work in a
coordinated manner to reduce load at the surgical ward. This model helped to delegate

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appropriately ensuring each member contributed to patient care (Levett-Jones & Bourgeois,
2015).
References:
Levett-Jones, T., & Bourgeois, S. (2015). The clinical placement-e-book: An essential guide for
nursing students. Elsevier Health Sciences.
NSW (2010). Assistants in Nursing working in the acute care environment. Retrieved from:
https://www.health.nsw.gov.au/workforce/Publications/ain-acute-care.pdf
Nursing and Midwifery Board of Australia (2016). ENROLLED NURSE STANDARDS FOR
PRACTICE. Retrieved from: https://www.nursingmidwiferyboard.gov.au/Codes-
Guidelines-Statements/FAQ/Enrolled-nurse-standards-for-practice.aspx
Nursing and Midwifery Board of Australia (2016). Registered nurse standards for practice.
Retrieved from: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-
Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

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