Adriana's Case Study: Nursing Ethics, Communication, and Informatics

This assignment presents a case study involving an elderly Hispanic woman, Adriana, admitted to the emergency department with unknown identity and injuries. The assignment delves into the formation and purpose of an interdisciplinary team meeting to plan her care, outlining appropriate procedures and strategies for managing the discussion. It explores the role of interpreters in healthcare, listing specific events where they are crucial and their functions. The study also investigates communication strategies for patients with potential sensory loss and examines social media policies within the nursing profession, highlighting ethical considerations and the importance of patient privacy. Furthermore, the assignment discusses open disclosure procedures, the use of health informatics systems to assist in patient history retrieval, and policies protecting electronic communication. It concludes by identifying effective communication strategies for giving and receiving feedback in nursing practice, aiming to improve performance and patient care.

Time 0700hrs
An older Hispanic woman is admitted to the emergency department (ED) by ambulance. The
paramedics inform the staff that they were notified by an anonymous source regarding an
older woman who "looked lost" in the neighbourhood. When they arrived, they found her
bleeding from scrapes on the palms of both hands and the anterior aspects of both knees. She
was only able to communicate to them in Spanish and she would not tell them her name or
where she lived. She was mildly combative, batting them away from her as they approached.
She has no identification.
In the ED, she is disoriented, agitated, and suspicious of attempts to assess her. The person is
given a UR Number 0632799. You observe that she has poor personal hygiene. She is
wearing two different coloured socks, her shirt is inside out and she has a pair of hearing aids
that she has wrapped in a handkerchief. She has extensive bruising to her forearms, small
lacerations to her palms, bruising to both of her knees.
Question 1
Time 0720hrs :
Following her admission, an interdisciplinary team meeting is called to discuss this patient's
care.
Explain the purpose of this team meeting and the procedures appropriate to this type of
meeting.
Describe how you would manage the discussion of this group to achieve the objectives set by
the meeting.
Paragraph Format (Approx. 100 words)
The interdisciplinary team comprises of a health care professional from the diverse sector.
Nurses, a physician from the related field, pharmacist and social worker are involved in the
interdisciplinary team. The patient with multiple health issues of odd nature needs to be
planned before medical care is started. In this case study, the patient condition is crucial and
the health care professionals need to plan a strategy for the complete care plan (Collins et al.
2011).
As a part of the interdisciplinary team, the nurse has to create a goal and nursing care plan to
achieve the goal. The team members need to understand the role of each member and work
together in collaboration to ensure quality nursing care.
Collins, S. A., Bakken, S., Vawdrey, D. K., Coiera, E., & Currie, L Model development for EHR
interdisciplinary information exchange of ICU common goals. (2011). International journal of medical
informatics, 80(8e141-e149
https://www.sciencedirect.com/science/article/abs/pii/S138650561000170X

Question 2
The interdisciplinary team meeting decided that an interpreter would be assigned to facilitate
effective communication with her, your client, to assist staff with her continuing care.
List 5 specific health care events where interpreters should be engaged.
Explain their role in each event.
Paragraph Format (Approx. 80 words)
The interpreter is involved in the interdisciplinary team if there is the language difference
between the health care provider and patient. The interpreters have to present during the
medical and nursing care to ensure prompt communication. The interpreter has to work
towards a better outcome. Patient satisfaction needs to be maintained in interpretation. As the
patient in the case study is drastically affected; the interpreter needs to support the health care
professionals whenever needed. Face to face interpretation between the patient and the health
care professional is the primary role of an interpreter (Brisset, Leanza, & Laforest, K.2013).
Question 3
Realizing that your client may also have some sensory loss which could also lead to agitation
and inability to communicate appropriately:
What are 3 strategies to improve communication with this patient?
The strategies are
 The health care professional need to communicate with the patient face to face.
 Ensure adequate lighting while communicating with the patient.
 In this case, the nurse has to ensure that the interpreter is involved in communication
(Kourkouta, & Papathanasiou, 2014).
Brisset, C., Leanza, Y., & Laforest, K. Working with interpreters in health care: A systematic review and meta-
ethnography of qualitative studies. (2013). Patient education and counselling, 91(2), 131-140
https://www.sciencedirect.com/science/article/abs/pii/S0738399112004569
Kourkouta, L., & Papathanasiou, I. V. Communication in nursing practice. (2014). Material socio-
medica, 26(1), 65 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990376/

Question 4
While caring for your client and organizing the continuing care, you realize that another staff
member is texting on her phone and taking photos of another client and herself within the
department.
Research the Social Media Policy Nursing and Midwifery Board of Australia. Explain your
understanding of the social media policies that apply within the Health Industry.Paragraph
Format (Approx. 100 words)
Use of social media is inevitable in the era of digital. The nurses are expected to implement
professional behaviour and attitude while using social media in the clinical setting. Improper
use of social media can affect the patient and family emotionally and also social life. Privacy
is the fundamental right of the patient. The nurse has to ensure the confidentiality of the
patient information while using social media. The nurse has to pledge Cultural and spiritual
competency of every individual. Inappropriate use of social media in the professional
environment is considered as the breaching of the nursing standards and code of conduct
(Nursing and Midwifery Board,2019).
Question 5
Should an incident occur to the person during her combative stage and she was injured then
some procedures should be followed.Describe your understanding of open disclosure and
its relationship to you as a nurse.
Please read the open disclosure framework. Please watch
this .http://cec.health.nsw.gov.au/Review-incidents/open-disclosure
Nursing and Midwifery Board, Social media: How to meet your obligations under the National
Law, (2019)https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Codes-
Guidelines/Social-media-guidance.aspx

Open disclosure is the legal aspect that supports the patient and health care professional.
Open disclosure is the clinical procedure that confirms open, truthful, ethical consideration
that happens between the patient and health care professional after the incidence of the
patient safety issue (NSW Government, 2019)
Question 6
Information technology is widely used throughout the health industry. Name 2 Health
Informatics systems that could have been used to assist with this patient's medical history
now that they know her identity.
Paragraph Format (Approx. 50 words.)
Please look for Name 2Health Informatics systems that could have been used to assist with
this patient's history
Two health informatics systems that could have been used to assist with the patient’s medical
history are electronic health record and master patient index. The electronic health record is
used to store the patient information assuring the privacy of data. Master Patient Index
locates individual patients by accumulating and assessing the stored information. It also helps
in uniquely linking the patient data (Valdez et al. 2016).
NSW Government, Open disclosure, Clinical Excellence Commission, (2019).
http://cec.health.nsw.gov.au/Review-incidents/open-disclosure
Valdez, A. C., Ziefle, M., Verbert, K., Felfernig, A., & Holzinger, A. Recommender systems for health
informatics: state-of-the-art and future perspectives. (2016). In Machine Learning for Health Informatics. (pp.
391-414). Springer, Cham https://link.springer.com/chapter/10.1007/978-3-319-50478-0_20

Question 7
Explain the policies that protect the use of electronic communication within the health
industry.
Paragraph format Approx. 50 words
Please go the Privacy Act about emailing on moodle and dabblers. the question is as
below.
Explain the policies that protect the use of electronic communication within the health
industry. Please use this link as answering the question.
https://www.lawsociety.com.au/resources/resources/career-hub/10-rules-email-etiquette
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Codes-
Guidelines/Social-media-guidance.aspx
Electronic communication is the inevitable mode of communication in the health care setting.
The standards of Nursing and Midwifery Board of Australia have formulated the policies to
ensure confidentiality of patient information. It also emphasises the importance of cultural
and spiritual safety. The nurses are expected to maintain professionalism while implementing
Electronic communication for the patient (Nursing and Midwifery Board,2019).
Question 8
In relation to Adriana's case study, nurses will often give and receive feedback so that they
can improve performance.
Identify what are effective communication strategies for giving and receiving feedback on
your performance.
Paragraph Format ( Approx. 60 words)

The nurse has to be an active listener. The nurse has to ensure respect in verbal
communication and non- verbal communication and encourage the patient to ask doubts and
questions. The nurse has to involve the patient and the family in decision making (Sargeant et
al. 2015).The nurse needs to confirm the confidentiality of shared information to improve
communication. The nurse should acquire the attitude of accepting negative feedback to
improve the performance.
Sargeant, J., Lockyer, J., Mann, K., Holmboe, E., Silver, I., Armson, H., ... & Power, M. Facilitated reflective
performance feedback: developing an evidence-and theory-based model that builds relationship, explores
reactions and content, and coaches for performance change (R2C2). (2015). Academic Medicine, 90(12),
1698-1706 https://www.ingentaconnect.com/content/wk/acm/2015/00000090/00000012/art00034