Graduate Certification in Aged Care Nursing

The Graduate Certification in Aged Care Nursing program focuses on teaching the principles of age care nursing practice and aims to improve skills and knowledge related to providing evidence-based nursing care to elderly patients. By participating in this program, nursing students can gain knowledge about aging-related changes and their impact on health, as well as explore specific areas of interest in aged care such as continence and wound management. This program is designed to help nursing students acquire the necessary attributes, skills, and knowledge required for the care of older individuals within a diverse clinical environment.

Running head: NURSING
Nursing:
Name of the student:
Name of the University:
Author’s note

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Section 1:
The graduate certification in Aged Care Nursing is a program of the Australian College
of Nursing that focus on teaching the principles of age care nursing practice. The aim of this
program is to improve skills and knowledge related to provide evidence based nursing care to
elderly patients. Completing the course can help nursing students gain knowledge related to
professional and ethical skills needed to enhance health status of elderly patient group. By
participating in this program, the nurse can learn about ageing related changes and its impact on
health. Students can also explore about specific area of interest in aged care such as continence
and wound management (Australian Collage of Nursing, 2019). The significance of this program
is that it is made in a way to help nursing students acquire knowledge about complex needs of
the older person within a diverse clinical environment. The key attributes, skills and knowledge
required during care of older can be gained through participation in this program.
I am nursing student in my first year of graduate education. I have the aspiration to take
care of older patients as I thinking professionally aged care nursing will be in demand because of
the increase in ageing population. Hence, completing the Aged Care nursing program will help
me to fulfil my goal of entering into hospitals that specially provide care to elderly clients. My
personal interest in serving for older adults with disability and multiple ailments are relevant
with the features and value of the program. The program aims to provide knowledge and skills
related to age care nursing so that nurses are empowered and they gain the exposure required for
career development and progression. Therefore, my personal interest in this field will ensure that
I can acquire advanced skills by participating in the program and integrate specialist knowledge
to maintain effective therapeutic relationship with aged care clients (Australian Collage of
Nursing, 2019).

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Section 2: Clinical question
2.2
After identifying pressure injury (Grade 2) witnessed for a patient during repositioning,
the main responsibility as a nurse will be to take all actions to promote safety of patient. As part
of this goal, the assessment of the pressure injury will be necessary to find out the nature and
severity of injury. This will help to implement appropriate pressure care intervention to prevent
deterioration of patient’s condition. The following assessment will be critical to implement
appropriate nursing action for patient:
 Firstly, skin assessment of patient will be necessary to determine the skin related factors
that resulted in pressure injury for the patient. This will involve assessment of
abnormalities in the entire skin of patient based on the parameter of temperature, colour,
moisture level, turgor and skin integrity.
 Increased temperature will indicate sign of skin problem and skin colour can be detected
by signs of paleness and cyanosis which will indicate increase in pressure and severity of
injury. Darker skin or redness will also give an indication of infection
 To check the moisture level of skin, the skin will be touched to identify if it is dry or wet.
Moisture might also be the cause behind pressure injury
 Skin integrity assessment will involve identifying signs of pruritis, scratches, bruising
and disruptions in the skin (Borzdynski, McGuiness & Miller, 2016). Signs of redness
and moist skin with ruptured serum will confirm stage 2 pressure injury.
 Apart from skin assessment, assessment of pain in the areas of body exposed to pressure
will help to identify level of nursing care support needed by the patient.

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The hypothesis is that by the use of appropriate skin care technique and repositioning
strategy, the patient’s pressure injury can be treated and proper healing of the area can be
achieved. Based on the above assessment, the following actions can be implemented to
prevent progression of injury and promote skin integrity:
 Firstly, it will be necessary to assess pressure point near the sacrum. After this, it will be
necessary to implement repositioning strategy so that pressure near the wound area is
reduced and pressure is adequately distrusted for the safety of patient. As friction and
shear is the risk factor of pressure injury, transfer assistance device can also be used to
reduce friction and shear (De Meyer et al., 2017).
 As excess moisture is one of the causes behind grade 2 pressure injury, another nursing
action that is critical for healing of injury includes implementation of appropriate skin
care. This will involve proper cleaning of the skin near the sacrum and using drying
techniques to protect the skin from excess moisture. Skin cleansers with appropriate pH
are necessary to ensure adequate drying of the skin (Roberts et al., 2016).
 Head of the bed can be raised to prevent pressure on the sacrum and pillow be kept under
the knee so that the patient does not experience discomfort (Byrne et al., 2016)
 Protective barriers like foam pad and hydrocolloid under oxygen tubing can be used to
protect patients skin
 Apart from repositioning and skin care, nutritional support will also be critical to ensure
quick healing of pressure injury. This will involve providing foods rich in protein,
vitamin C and arginine (Roberts et al., 2016).
Section 3: Prioritization

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After morning handover, I have come across four different groups of patient who
concurrently demand different things for me. As attending to each of them at the same time
will not be feasible for me, I have decided to compare each patient’s demand and prioritize
which patient’s request needs to be attended first. The order of addressing to each request is
as follows:
 Firstly, I will attend to the needs of patient 3 whose infusion pump alarm is sounding
and the IV flask appears to be close to empty. This is necessary because based on
comparison of all the four patients, patient 3 is at high risk of adverse event if IV fluid
is not filled up on time. The consequence of drying of the IV flag is that it may lead to
bleeding. As it is 7:30 am, patient’s 3 demand’s need to be addressed fast. This is
necessary because as per safety considerations, assessing patients after infusion
device alarm and when patient complains about pain in the insertion site is important
for nurse (Allam & Sadha, 2019). The site patency can be checked and the bag will be
replaced with IV fluid. This will take around 10 minute times. This action will reduce
the risk of bleeding or other infections like phlebitis for patient
 The second high priority client will be patient be the patient schedule to go to the
theatre at 0800. As the patient is not ready and not preparing the patient for surgery
may lead to delay or cancellation of the surgery. It will also increase anxiety of
patient if preoperative care is delayed and this may have impact of surgery outcomes.
Hence, I will attend to this patient first as before operation, it needs to be assessed
whether all pre-operative procedure has been completed for patient or not. This will
involve verifying vital signs of patient to ensure that the patient is fit for the surgery.
After this is ascertained, it will be necessary to replace personal clothes for patient

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and dress him in the surgical clothes. All the personal items like jewellery and
clothing will be removed. Hygiene and bathing procedure will be completed and pre-
anesthetic medication will be given to prepare patient for the surgery. Patient will also
be educated about the surgery (Christóforo & Carvalho, 2009). The significance of
the above action before surgery is that it will ensure that patient is ready and no delay
in surgery occurs. The significance of orienting patient before surgery is that patient
will not develop anxiety due to fear and delay in preparation of surgery. Malley et al.
(2015) gives the evidence communication breakdown and information loss in the
preoperative period pose greatest threat to peri-operative patient safety. Hence,
completing preoperative assessment on time is vital to promote safety of patient.
 As patient 1 is classified as high fall risk patient, attending to her bowel needs will be
done now. Her care needs has been addressed first because preparing the patient for
bowel would have taken lot of time. After attending to patients at risk of safety issue
and delay in care, I can work to provide adequate transfer assistance so that Mrs.
Peterson can use her bowels.
 Lastly, I will attend to the needs of patient 4 who needs to be given ventilin and
prednisolone at 0800. This patient is at minimum risk because delay in medication by
10 minute will not cause any safety risk. Hence, he is the patient with lowest risk and
his needs have been addressed in the last instance.
Section 4: Professional
4.2
While collecting a patient from the theatre, I have found that the patient is in pain with
score of 6 out of 10. Although the patient should not leave recovery with uncontrolled pain,

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however as the recover RN wants to sort out pain relief on the ward, I will have the
responsibility to engage in proper pain assessment of patient and providing appropriate nursing
intervention for pain relief. This will be necessary according to standard 1 on registered nurse
practice as it mentions that maintaining timely documentation of assessments, planning and
decision making is critical to provide safe and quality nursing practice (Nursing and Midwifery
Board of Australia (2017). Hence, I will take the step to manage the situation myself and
effectively manage pain on the ward.
As the patient is experiencing pain post operatively, the activities that I will implement
include engaging appropriate pain management process. This will involved first assessing the
characteristics, nature and location of pain. As per gold standard in postoperative management,
the next step that will be critical is to conduct patient’s assessment is to quantify the pain and
understand the efficacy of previous pain management. The satisfaction score as well as pain
score of patient will be collected to ensure that the factor contributing to pain is addressed
eventually (Lovich-Sapola, Smith & Brandt, 2015). Ingadóttir and Zoëga (2017) give the
evidence that for better management of post operative pain, it is necessary to accurately assess
pain. This will involve collecting data on location, onset, character, exacerbating and relieving
factors of pain. The timing of analgesic usage will also be a good indicator for change in pain
medications. In addition, subjective data of patient will help to interpret whether anxiety or
depression is the cause behind intense pain or not.
After accurate pain assessment of patient on the ward, I will implement appropriate pain
management steps informed by the pain assessment process. I will use multimodal approach of
both analgesic drug use and education to provide relied to patient. According to procedure
specific guideline, I will provide Panadol and Panediene to patient for pain relief as per the drug

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chart. After this, I will educate patient about the rationale for using this medication and provide
education to patient regarding adverse symptoms of drug. The significance of patient education
during pain management is that many patients experience pain and discomfort because they are
not aware that surgical process may increase pain for some hours (Chou et al., 2016). However,
if the patient is educated about the effects of surgery on main, they can remain calm and not
panic due to pain. Individually tailored education related to information on treatment options,
effect of surgery and goal of next course of symptom is going to promote post-operative
recovery for patient. The importance of the pain medication provided needs to be given too to
ensure that patients adhere to the prescribed analgesics. This will help them to adapt health
promoting behaviour and self-manage the pain. The benefit of including education in pain
management process is that it is likely to improve pain management process, reduce fear, and
increase satisfaction with care and support behavioural change (Ingadóttir & Zoëga, 2017).

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Allam, N. A., & Sadha, N. A. A. (2019). Plan-Do-Check-Act Framework: Effects on Pediatric
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Australian Collage of Nursing (2019). Graduate certification in Aged Care Nursing. Retrieved
from: https://www.acn.edu.au/education/postgraduate-course/aged-care-nursing
Australian Collage of Nursing (2019). Graduate certification in Aged Care Nursing. Retrieved
from: https://www.acn.edu.au/education/postgraduate-course/aged-care-
nursing#outcomes
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