Case Study: NMBA Standards and Nursing Practice Analysis

This case study analyzes a scenario where a nurse breached multiple NMBA Registered Nurse Standards for Practice, specifically Standard 5, which emphasizes developing effective care plans to enhance patient outcomes. The assignment identifies inadequate nursing care, including failures in wound management, hygiene, and therapeutic relationships, leading to post-operative complications and delirium. It highlights the importance of adhering to hand-hygiene protocols, proper wound cleaning, medication administration, and timely reporting of infections. The study emphasizes the need for a comprehensive care plan that considers patient-specific risk factors like obesity and poor circulation, and provides recommendations for addressing both systematic and localized wound infections through interventions such as antibiotics, wound assessments, and medical counseling. The analysis references relevant literature to support the importance of preventative measures and effective nursing practices. Desklib provides additional resources like past papers and assignments to aid in understanding and applying these principles.

latrobe.edu.auNMBA Registered Nurses Standards for Practice: 5
INTRODUCTION
• In this case scenario, the nurse had
breached many NMBA nursing standards
as she was not fulfilling her
responsibilities and was negligent
towards her work.
• NMBA standard 5 states that the nurse
must develop an effective care plan
within their nursing practice that will aim
to enhance the patient health outcome
(Nursing and Midwifery Board
of Australia, 2019).
• Inadequate nursing care services
provided to Daisy clearly proved the
breach of the nursing standard 5 of
NMBA Registered Nurse Standards for
Practice which showed the inappropriate
care plan for the patient.
References
Allegranzi, B., Bischoff, P., de Jonge, S., Kubilay, N. Z., Zayed, B., Gomes, S. M.,
... & Boermeester, M. A. (2016). New WHO recommendations on preoperative
measures for surgical site infection prevention: an evidence-based global
perspective. The Lancet Infectious Diseases, 16(12), e276-e287.
Kang, D. G., Holekamp, T. F., Wagner, S. C., & Lehman Jr, R. A. (2015).
Intrasite vancomycin powder for the prevention of surgical site infection in
spine surgery: a systematic literature review. The Spine Journal, 15(4), 762-770.
Nursing and Midwifery Board of Australia. (2019). Nursing and Midwifery
Board of Australia - Registered nurse standards for practice. Retrieved 26
September 2019, from
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Profe
ssional-standards/registered-nurse-standards-for-practice.aspx
Webster, J., & Osborne, S. (2015). Preoperative bathing or showering with skin
antiseptics to prevent surgical site infection. Cochrane database of systematic
reviews, (2).
RECOMMENDATIONS
The following methods must be followed by the nurse to prevent any
wound infections in the patient:
• The nurse should develop an effective care plan for the patient that
includes the patient medication list such as routinely providing
antibiotics to the patient as prescribed by the doctor.
• The nurse must abide to the hand-hygiene protocol and should wash
her hands properly before and after cleaning the areas of wounds.
• The nurses should take precautions in order to avoid such incidence in
future and aim to develop a healthy therapeutic relationship with the
patient.
• The nurses must be aware that the patient is not scrubbing or rubbing
the incisions.
• The tapes should not be removed unless the doctor informs the nurse
and the incisions must not be exposed to sunlight. The nurse should be
more attentive and while handling the patient.
• The nurse should not allow the patient to have a bath until the
incisions are dried. For cleaning the areas of wound the nurse must
use gloves to prevent the spread of infection.
• The nurse must sterilize the medical equipment's before using to avoid
any risk of contamination or infection.
• If any signs of infection are noticed by the nurses, the nurse must
immediately report to the specialist doctor (Kang et al., 2015).
LITERATURE STRATEGY FOR ADDRESSING THE ISSUE
• It is stated that the nurse must clean the wound properly and promptly.
• Providing adequate nutrition to the patient associated with hydration.
• It is very important to note that the infection is systematic or localised around the wound
area. The patient can undergo medical counselling to treat delirium.
• Oral antibiotics can be provided to treat the systematic wounds.
• For treating the localized wounds, the nurse must conduct wound assessments that will help
the nurse to identify the microbes which are responsible for growing the infection.
• The nurse should develop a care plan to address and evaluate the systematic infection
including cellulitis, osteomyelitis and septicaemia, which might increase the risk of infection.
• According to Webster & Osborne (2015), the nurse must evaluate and identify the risk factors
such as obesity, poor blood circulation, decreased immune system and mobility, malnutrition
and lack of hygiene maintenance which is responsible for increasing the prevalence of poor
health condition in the patient.
Clinical issue
• The major clinical issue identified in
the case scenario was that the nurse
was incapable to treat the post
operative complication in the patient.
• The nurse also failed to develop any
therapeutic relationship with the
patient and did not provide any
wound management strategy for
healing the wounds.
• The nurse had failed to maintain the
hygienic environment after the surgery
was over, due to which the patient suffered
from delirium (Allegranzi et al., 2016)