Analysis and Summary of Medical Research Papers

The provided assignment involves analyzing and summarizing multiple medical research papers across various disciplines, including infectious diseases, surgery, brain injury, and more. The papers cover topics such as antibiotics for hospital-acquired pneumonia, the use of pre-or postoperative antibiotics in appendicitis surgery, improving personal self-advocacy skills for individuals with brain injury, and expert consensus for managing cystic fibrosis patients using inhaled antibiotics. The assignment requires a thorough examination of each paper, identifying key findings, methodologies, and implications. A summary of the analysis is provided at the end, highlighting the main points from all the papers.

Nursing Care

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
1. Discussion of guiding healthcare principles and their impact on the outcomes.....................1
2 Develop a nursing care plan with three interventions..............................................................3
3 Supporting intervention by rationale to explain the relation with guiding principle...............7
4. Role of the registered nurses in the acute medical ward in the management..........................8
CONCLUSION..............................................................................................................................10
REFERENCES..............................................................................................................................11

INTRODUCTION
In order to encounter the severe effects of Chronic diseases, it is necessary for the nurses
to provide effective care to patients (Peh, Tee, Ng and Chow, 2016). It is essential for healthcare
professionals to possess an understanding of self-management, empowerment and advocacy in
the collaborative management of patient and his/her family members (Hodge, 2016). In this
section, the methods of improving the outcomes of the treatment are described with the
assistance of an effective nursing care plan. This report is based on the same case study as
discussed in Part A of and from that research three medical interventions has been evaluated
which are appropriate for this presentation stage of Angela. Besides this, the role of registered
nurse in the acute medical ward is also analysed. Furthermore, the three ways in which a midwife
can collaborate with the other members of interdisciplinary team are also explained in this
section.
1. Discussion of guiding healthcare principles and their impact on the outcomes.
It is very common for patients to face psychological and behavioural changes during their
treatment. Thus, it is necessary to provide health coaching to the patient in healthcare homes.
This is the use of evidence-based skilful conversation such as motivational interrogation to assist
behaviour change, goal setting, attentive listening and aggregation of health outcome prosody .
This coaching follows a procedure which is explained further:
 Building relationship- This is crucial to interact and engage with the patient before
implementing any operation. There are several things which are involved in this step such
as genuineness, good quality of voice, maintaining eye contact while talking, rendering
them with a feeling of connectedness, physical gestures, positivity in the voice, etc.
(Postma & Rabe, 2015).
 Motivational interviewing- After building a rapport with the patient, the coach should
make strong communication with the help of a tool, "motivational interviewing' . It
focuses on gathering the issues that are being faced by the client. It is concentrated on
collecting the present situations (Hawley, Gerber and Morey, 2017).
 Well-being vision- This is a statement is revealed by patient with the highest potential
they keep to amplify their physical, mental, social, and emotional edge.

 Goal setting- Depending upon the strengths and the weaknesses observed by the coach
during the motivating interview session of the patient, the goals are set. These objectives
are realistic and achievable (Daskalakis, Juhlin and Påhlman, 2014).
 Plan guidance- The goals are achieved by following some processes which are planned
by the coaches. Further, the progress is being tracked and evaluated.
In addition to an effective health management it is also essential for the professionals to
possess self-management. The biggest advantage of using this tactic is bringing promptness in
the operations and plans. It is a process that includes a wide set of behaviour, attitude and skills
in managing the impact of health conditions (Daniels, Juliano, Marx and Weber, 2016). This
process includes building the healthy public policy, creating supportive environments, strengthen
community actions, developing personal skills, reorienting health services and developing &
implementing health promotion strategies. On the other hand, advocacy for health can be defined
as the combination of individuals' and societal actions to gain political commitment for a specific
health program of government. Effective health advocacy contributes to the positive changes to
legislations, policies and community behaviours and attitudes.
All these elements namely health coaching, empowerment, self-management and
advocacy helps in improving the outcomes of the conditions of patients. The health coaching
holds the calibre to change the life of an individual by changing his/her behaviour. The outcome
of implementing this coaching involves the improved health, reduced stress, more self-
satisfaction, etc. On the other hand, advocacy increases the involvement of patients in their
healthcare decision-making. In the present case, these elements can aid in collaborative
management of Angela and her family. The health coaching is necessary as she started skipping
her medicines and began feeling unwanted.
The significance of the guiding healthcare principle involves the collaboration of
knowledge, skills, values and attitudes that helps in working together with health care workers,
communities, patients and their families (Hawley, Gerber and Morey, 2017). Also, these
principles emphasise on the research and development of the personalised person-centred care
which aids in proper and effective treatment of patients depending upon their needs and medical
requirements. This type of care assist in the fast recovery of the diseases and thus better
outcomes are there (Reese, 2016).
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2 Develop a nursing care plan with three interventions.
Individualized care of patients needs an effectual nursing care plan. These ideas of
treatment are personalised depending upon the illnesses and the service requirements of different
people (Hodge, 2016). Major advantage of this plan involves the ease of evidence based holistic
care, recording and measuring the aid. Besides this, this plan acts as an outline following which
all the operations are carried out (Reese, 2016). As stated in the part A, Angela is having
different medical problems and thus, needs great nursing attention with effective intervention of
solutions. The care plan for Angela is as follows:
Nursing Care Plan for Angela
Assessment Diagnosis Planning Intervention Rationale Evaluation
COPD and
arthiritis.
84% SaO2
Sputum has
changed to
dark yellow
with green
staining.
104bpm
pulse.
BP
162/102mm
Hg.
Hypoxaemia
Shortness of
breath.
Increased
sputum
production.
Decreased
SaO2.
Struggling
in saying
more than 5
words
without a
breath.
Reduced
concentratio
n of blood in
oxygen.
Short term
objective:
Client will be
able to take
part in all the
procedures
and
treatments
which are
necessary for
increasing the
SaO2.
IV antibiotics
and oral
prednisolone,
salbutamol
and
atrovent
nebulisers and
1. Oxygen
therapy.
To provide the extra
oxygen in body of
patient to ensure
availability of the
gas to the lungs. In
addition to this,
COPD is a disease
in which high loss
of oxygen occurs
and thus, in order to
recover that Angela
is required to
undergo an oxygen
therapy. It has been
observed that there
are some symptoms
such as shortness of
breath, etc. which
states that the
After effective
monitoring of
oxygen status
and using
Oxygen
therapy, the
level was
maintained.
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oxygen
therapy to
maintain
SpO2 above
92%.
present practices are
not up to the mark
and hence, Angela
is required to
undergo oxygen
therapy.
2.
Prednisolone,
Salbutamol
and Atrovent
As COPD is a
progressive disease
that involves
Bronchitis and
Emphysema and it
happens mainly due
to smoking. These
situations makes a
patient hard to
breathe and thus, a
glucocorticoid pill,
Prednisolone,
is used which acts
as anti-
inflammatory.
Besides this, long-
term and short-term
use of
Salbutamol is
associated with
increased
exacerbation of
COPD. The
prescribed dosages
A
glucocorticoid
pill,
Prednisolone
and Salbutamol
acted as
bronchodilator
which helped
in providing
albuterol and
thus, the
airways issue
was resolved.
Besides this,
use of Atrovent
was used to
provide greater
bronchodilation
.
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helps in relieving
from moderate to
severs COPD. Also,
Atrovent is an
inhaled medicine
that is used for
treating patients
with COPD (Hodge,
(2016).Atrovent
HFA are required to
be taken on a
regular basis. Its
need arises when
the patients are
suffering with
severe symptoms an
d demands for quick
relief.
Based on health and
social care
professional
standards in present
case the percentage
of SaO2 is below
the required amount
and hence, these
drugs will help in
exacerbation of
COPD by
maintaining the
quantity of needed
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elements.
3. IV
antibiotic.
It is a part of a class
of drugs known as
anticholinergic
bronchodilators.
IV antibiotics can
be used to acute
exacerbation of
COPD. This therapy
is directed at the
most common
pathogens such as
Haemiphilus
influenze,
Moraxella
Catarrhalis and
Streptococcus
pneumoniiae. The
antibiotics that are
used against them
includes
doxycycline,
trimethoptim, etc.
It has been observed
that Angela has to
undergo various
operations that may
develop pathogens
in the body which
will harm her.
Hence, ingestion of
Angela was
given antibiotic
therapy and it
has been
observed that
there was small
but effective
impact on
clinical
recovery of
bronchitis and
emphysema.
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IV antibiotics is
essential to
encounter the effect
of microorganism.
3 Supporting intervention by rationale to explain the relation with guiding principle.
The interventions are combination of elements that are designed to improve the health
status of the patients (Mackie, Marshall and Ireland, 2017). In this case, some interventions are
prepared for the Angela who is suffering from COPD disease. These involvements include
Oxygen therapy, Prednisolone, Salbutamol, Atrovent and Atrovent IV antibiotic. Firstly, Oxygen
therapy is provided by the healthcare. The rationale behind this therapy is the low level of
oxygen present in the patient. It has been observed that she was facing shortness of breath and
thus, this treatment was required. However, there are some guiding principle which should be
followed by both the staff and Angela while using oxygen as medication. The oxygen should be
supplied to raise the PO2 till 65 mm Hg because more than 92% saturation effects the flow rate
and can be dangerous. Also, the patient should be known that she can not smoke while taking
this therapy. In addition to this, nurses should render a good health coaching on the time and
situations when she can take oxygen such as during exercise, sleep and air travel. Besides this,
patient should be guided to not use oxygen around lit cigarettes, open flames or any other thing
that is flammable.
Also, conduction of the operations such as oxygen therapy to increase the SaO2 level for
treating the Hypoxaemia, chest physiotherapy to evaluate the total quantity of sputum and smoke
tar reveals the self-management of the nurses by their understanding of the condition that Angela
is facing (Hawley, Gerber & Morey, 2017). Furthermore, the breathing techniques that are taught
by the nursing staff to the patient will not only help in recovering her issues with the breathing
but are also beneficial for the community, if Angela shares them with others. Also, self-
management is the most important element of the guiding principle as it is directly associated
with the operations that will be drawn on the patient to treat her disease. In addition to this, the
empowerment helps in improving self-efficacy and self-esteem. Further, it provides a greater
sense of control by raising knowledge and awareness (Hodge, 2016). Thus, in this way the
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interventions that are been used by the nurses for different rationales are effective in terms of
guiding principles of health.
Secondly, treatment with Prednisolone is required to suppress the effect of Bronchitis and
Emphysema that makes patient hard to breathe. However, the use of Prednisolone is really a
tough task. The dosages of this drug causes several side-effects such as insomnia, heavy mood
swings, weight gain, etc. It should be considered that Angela is already suffering with the
problem of weigh gain and in that case, it will further enhance it (Barnes, 2016).. Thus,
healthcare staff should limit the quantity of dose. Also, they should give this only when needed.
Salbutamol is used to treat a number of problems. It helps in encountering the bronchodilation.
Besides this, it is required to emphasise properly on the dose of Salbutamol. Further, suitable
gaps should be there between two consecutive dosages. Likewise, Angela should be provided
with the basic guidelines to consume Atrovent to gain quick reliefs.
In addition to this, IV antibiotics can be used by the healthcare staff to acute
exacerbation of COPD. The antibiotic that was used against the pathogen is doxycycline.
However, nurses should ensure that Angela is not allergic to the antibiotic, else it will highly
affect the situation. Also, in case if any allergic reaction takes place then nurses are required to
render their best care (Liew, 2015). Besides this, teaching breathing techniques is also necessary
as Angela is struggling in saying more than 5 words without a breath. These tactics will help in
diminishing the hurdles by managing the airway. This understanding of breathing techniques is
linked with the health empowerment as they are developing the skills of the patient. In addition
to this, if Angela passes or share this method with someone else then community will also
receive the benefits of this learning.
4. Role of the registered nurses in the acute medical ward in the management.
Registered nurses can play major role in cases that are related to the medical ward in the
management as they provide high quality patient care (Postma, D. S., & Rabe, K. F. (2015)).
Acute medical ward is the initiative that is provided by the several healthcare groups in order to
provide support to the patients with better quality of services and utilising the efficient resources.
Moreover, focus is provided on delivering the safe and quality of healthcare services (Peh, Tee,
Ng and Chow, 2016). As she is old so it’s their role to provide appropriate environment, correct
treatment, expedited diagnosis and timely care. Additionally, the resources that are mentioned
are related to their communication skills, critical thinking, cultural competency, patient care,
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technical knowledge and decision-making ability (Willett, 2015). Beside this, acute medical
ward is made so that proper care of the patients can be assured. They are available 24 hrs. to
serve and there is presence of the acute medicine physicians that are experts in their field.
Further, these wards are specially made for the patients that are affected by the Cardiac,
respiratory, Medical, Neuro and care of the older person. At that place their role is provide the
AMU and ED which further includes the performing the venupunctures and cannulations ,
performing ECGs, checking weight of the patients and ensuring other tests and providing what is
required by them (Mackie, Marshall & Ireland, 2017). Further, as in the ward room there is
availability of the well-organised multidisciplinary team so that care can be provided in more
effective and smooth way. There is person available every time whenever there is requirement to
the patients (Daskalakis, Juhlin and Påhlman, 2014). Through this way, Angela's care can be
kept by the nurses that are present at the nursing wards. This way she can get cure in more faster
way as at home her husband has not quit smoking which was causing more problems to her.
Registered nurses always work together in collaborated manner, but when they start
working as interdisciplinary team they serve the patients through the belief of the healthcare,
needs and spirit of the patients. They can prepare the Discharge Planning where aged patients are
kept in collaboration with their family members (Daniels, Juliano, Marx and Weber, 2016).
Moreover, they have direct contact with the professional so that proper decision related to the
patients can be taken. Along with this, in order to improve the health, they can shift the patient’s
environment so that she can get cure. They provide the quality of the health care services which
are based on the clinical practise guidelines and policies (Tong, Davis, Eichenberger, Holland
and Fowler, 2015). In interdisciplinary team, every nurse can divide their task as one can
perform the investigation part, providing encouragement to her, preparing her for the test and
many other work. Other than mentioned, interdisciplinary team in wards can perform these
action they can advocate her and her family members. It includes the safeguarding, empowering
and communicating with other for the diseases. Besides this, collectively they can maintain the
dignity and privacy of the patients. This are the priority aspects which are kept by the nurses.
Beside this, it involves preparing her for the examination, reducing the level of anxiety and
embarrassment level and respecting their cultural with complete process. These are areas where
related such process are completed by the nurses in team informative, organizing, transitions and
as nurse-centred (Olveira, Solé, Monforte and Garcia,2017). In the present case, Angela a 69
9

year old woman feels that she is causing inconvenience to her family members due to her
hospitalisation and that is why she is demanding for a discharge. The steps here which are
needed to be performed by the nurses includes the effective planning collaborating with the
patient, family members and other employees. For an acute discharge case, nurses must write a
detailed draft with clearly identified objectives. Besides this, the support that is given to the
patients and the professionals in discharge decision-making is also a major help of midwives to
Angela who is willing to move into other environment from the acute ward.
CONCLUSION
Nursing care plan provides a great assistance in treating the chronic diseases. In this
study, a plan is prepared with different interventions so that the set goal can be attained. In order
to improve the outcomes of the patients it is necessary for healthcare professionals to understand
the guiding principles of health coaching, self-management, empowerment and advocacy so that
they can perform collaborative management of the patient and the family members. Besides this,
the appropriate interventions depending upon the condition of the patient are described along
with the rationale which signifies the relation of these interventions with the guiding principles.
10

REFERENCES
Books and Journals
Barnes, P. J. (2016). Asthma-COPD overlap. CHEST Journal. 149(1). 7-8.
Daniels, L. M., Juliano, J., Marx, A., & Weber, D. J. (2016). Inhaled Antibiotics for Hospital-
Acquired and Ventilator-Associated Pneumonia. Clinical Infectious Diseases. 64(3).
386-387.
Daskalakis, K., Juhlin, C., & Påhlman, L. (2014). The use of pre-or postoperative antibiotics in
surgery for appendicitis: a systematic review. Scandinavian Journal of Surgery. 103(1).
14-20.
Hawley, L., Gerber, D. & Morey, C. (2017). Improving personal self-advocacy skills for
individuals with brain injury: A randomized pilot feasibility study. Brain injury. 31(3).
290-296.
Hodge, J. (2016). A morphological and bibliological analysis of the International Journal of
Evidence Based Coaching and Mentoring 2003-2012.International Journal of Evidence
Based Coaching and Mentoring. 14(1). 86.
Liew, F. Y. (2015). Cigarette smoke resets the alarmin IL-33 in COPD. Immunity. 42(3). 401-
403.
Mackie, B. R., Marshall, A. & Ireland, M. J. (2017). Psychometric testing of the revised
“Families’ Importance in Nursing Care–Nurses’ Attitudes Instrument”. Journal of
Advanced Nursing.
Olveira, C., Solé, A., Monforte, V., & Garcia, M. A. (2017). 188 Expert consensus for the
management of cystic fibrosis patients with severe pulmonary affectation using inhaled
antibiotics. Journal of Cystic Fibrosis. 16. S115.
Peh, W. M., Tee, A., Ng, Y. K., & Chow, W. L. (2016). Evaluation of a chronic obstructive
pulmonary disease (COPD) telehealth programme to reduce healthcare utilisation in a
Singapore tertiary healthcare institute. Future Hospital Journal. 3(Suppl 2). s6-s6.
Postma, D. S., & Rabe, K. F. (2015). The asthma–COPD overlap syndrome. New England
Journal of Medicine. 373(13). 1241-1249.
Reese, R. F. (2016). EcoWellness & Guiding Principles for the Ethical Integration of Nature into
Counseling. International Journal for the Advancement of Counselling. 38(4). 345-357.
Tong, S. Y., Davis, J. S., Eichenberger, E., Holland, T. L., & Fowler, V. G. (2015).
Staphylococcus aureus infections: epidemiology, pathophysiology, clinical
manifestations, and management. Clinical microbiology reviews. 28(3). 603-661.
Online
Willett, B. (2015). The future of aged care nursing in Australia. [Online]. Available through
<https://healthtimes.com.au/hub/aged-care/2/news/nc1/the-future-of-aged-care-nursing-
in-australia/495/>. [Accessed on 8th September 2017].
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