Clinical Integration: Specialty Practice - Safety and Legal Aspects

This report provides a comprehensive analysis of the roles and responsibilities of nurses in the context of clinical integration within a specialty practice, specifically focusing on the emergency ward. It examines the nurse's multifaceted role in ensuring patient safety, including primary, secondary, and tertiary care processes. The report details the importance of monitoring vital signs, implementing emergency medications, and maintaining hygiene standards. It also highlights the significance of evidence-based practice, patient-centered approaches, and adherence to nursing ethics and legal standards. Furthermore, the report addresses the legal aspects of nursing practice, the responsibilities of nurses, and the importance of communication and collaboration with other healthcare professionals. The conclusion emphasizes the nurse's role as a primary care facilitator and the importance of patient safety and ethical considerations in providing quality care. The report also includes references to relevant literature supporting the discussion.

Running head: CLINICAL INTEGRATION: SPECIALTY PRACTICE
CLINICAL INTEGRATION: SPECIALTY PRACTICE
Name of the Student
Name of the University
Author Note

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Introduction
The specialty practices of the nurses in the emergency wards would require the proper
knowledge and attitude of the patient centered approach of the nurses as well. The primary care
facilitators are the nurses and the basic process of care would be comprised of the proper
diagnostic and also providing required support to the patient within a short period of time as the
emergency ward is responsible for the primary and acute care providence to the patients. The
specialist nurses of the emergency care would be comprised of the cardiovascular, neurological
and specialist discipline nurses as well. In the following section the nursing role in the
emergency ward would be described in details.
Discussion
Emergency ward is the specialty ward in this case and the role of the registered nurse for
the patient safety management would be comprised of several factors. The nursing care in the
emergency care facility would be focused on the emergency response of the nurses for the acute
care of the patients. On this context it can be stated that the factor of the nursing care in the
emergency ward would be dependent on three kind of care process which includes the primary
care, secondary care and the tertiary care.
Primary care
The primary care would be requiring the process of the proper monitoring of the patients.
In the emergency care unit the primary care provider would be the registered nurse or the
enrolled nurse along with the nursing students as well (Halcomb & Ashley, 2017). The factor of
the primary care would be comprised of the vital sign monitoring of the patients which includes
the factor of the heart rate, respiratory rate, oxygen saturation level, temperature checkup,
hemorrhage identification and also the consciousness level identification by the GCS scale

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implementation (Orchard et al., 2016). In this monitoring process the nurses would also be
required to identify the cardiovascular or pulmonary distress based on the vital signs of the
patients (Norful et al., 2017). The process of the primary care would also comprised of the
emergency medication implementation in some cases for example oral administration of the
Sorbitrate for the heart failure of the patient based on the drug regulation and also the age and
condition of the patient. On the other hand the infection detection and first aid providence to
injuries of the patients as well. The hand hygiene and other hygiene factors would be maintained
by the nurses as well based on the WHO standards (Who.int, 2019). However, all these aspects
of the primary care would be considering the patient centered approach and also the evidence
based practice for the better outcome of the patient’s health. On the other hand the process of the
care should be considering of the NMBA and NSQHS standards of care
(Safetyandquality.gov.au, 2019).
Secondary care
The secondary care would be comprised of the care providence to the patients based on
their medical history and also the process of the management of the disease as well. The factor of
the secondary care would be requiring the evidence based practice implementation with more
priority. The hemorrhage management, reduction of pain, hypovolemic shock or hypervolemic
shock management of the patients as well. Providence of the nutrient supplementation with the
saline water or the process of the consciousness detection and stopping the bleeding from injury
area, infection dressing and the assessment of the surrounding areas of the infected or injured
tissues. On the other hand the proper diagnosis of the patient’s condition should also be done by
the nurses by implementing the full body assessment as well (Jakimowicz, Perry & Lewis,
2018). Hence, it can be stated that the secondary care would be dependent on different aspects of

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the nursing standards and also the proper communication with the patient and family members.
On the other hand the proper interaction with the doctor and also following the prescribed
process of care by the doctor as well. However, it should be considered that the process care
provided by the nurse should be considering of all the care standards and nursing ethics that is
the beneficence of the patients as well. Hence, it can be stated that the nurse cannot take any
decision on behalf of the patient however, providing care should be focused on the betterment of
the patient’s health (Zhao et al., 2019).
Tertiary care
Other than all these the nurses can provide the support to the patients in the mobility and
also the advocacy of the changes in the patient’s condition are classified as the tertiary care.
Other than this the medication administration is the factor of the nursing care providence which
also can be placed in the tertiary care process. The medication administration would be done
with the proper knowledge of the dosage of the medicines based on the age and also the
condition of the patient, proper timing of the medication and the pathway of the administration as
well (Polis et al., 2017). All these factors require the knowledge about the medication process
however, the nurses are allowed to provide the medicines to the patients based on the
prescription of the doctors. The nurses do not have the right to provide any kind of medicine on
their own to the patients (Happell et al., 2015). Hence, the factor of care should be focused on the
process of the patient centered approach and the considering the patient safety with the utmost
priority.
On this context it can also be the medication management, monitoring and advocacy of
the patient and also providing the support and the communicating with the patient are the most

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effective process along with the hygiene and quality management of the patient surrounding are
the most important factor in the patient safety management.
Conclusion
Based on the above discussion it can be concluded that the nurses are primary care
facilitators in the emergency ward and also responsible for the safety and hygiene maintenance
of the patients. The primary, secondary and the tertiary care provided by the nurses to the
patients are comprised with different kind of roles and also the process of the care mainly
focused on the health care standards of Australia and the factors of the nursing ethics as well.
Moreover, the providence of care to the patients would be considering the patient centered
approach and also the safety of the patient with utmost priority.

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References
Halcomb, E., & Ashley, C. (2017). Australian primary health care nurses most and least
satisfying aspects of work. Journal of clinical nursing, 26(3-4), 535-545.
Happell, B., Wynaden, D., Tohotoa, J., Platania-Phung, C., Byrne, L., Martin, G., & Harris, S.
(2015). Mental health lived experience academics in tertiary education: The views of
nurse academics. Nurse Education Today, 35(1), 113-117.
Jakimowicz, S., Perry, L., & Lewis, J. (2018). Compassion satisfaction and fatigue: A cross-
sectional survey of Australian intensive care nurses. Australian Critical Care, 31(6), 396-
405.
Norful, A., Martsolf, G., de Jacq, K., & Poghosyan, L. (2017). Utilization of registered nurses in
primary care teams: A systematic review. International journal of nursing studies, 74,
15-23.
Orchard, J., Lowres, N., Freedman, S. B., Ladak, L., Lee, W., Zwar, N., ... & Neubeck, L.
(2016). Screening for atrial fibrillation during influenza vaccinations by primary care
nurses using a smartphone electrocardiograph (iECG): A feasibility study. European
journal of preventive cardiology, 23(2_suppl), 13-20.
Polis, S., Higgs, M., Manning, V., Netto, G., & Fernandez, R. (2017). Factors contributing to
nursing team work in an acute care tertiary hospital. Collegian, 24(1), 19-25.
Safetyandquality.gov.au. (2019). The NSQHS Standards | Australian Commission on Safety and
Quality in Health Care. Retrieved 4 September 2019, from
https://www.safetyandquality.gov.au/standards/nsqhs-standards

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Who.int. (2019). WHO SAVE LIVES: Clean Your Hands 5 May 2019“Clean care for all -it's in
your hands”. Retrieved 4 September 2019, from https://www.who.int/infection-
prevention/campaigns/clean-hands/advocacy-slides-2019_short.pdf?ua=1
Zhao, Y., Russell, D. J., Guthridge, S., Ramjan, M., Jones, M. P., Humphreys, J. S., &
Wakerman, J. (2019). Costs and effects of higher turnover of nurses and Aboriginal
health practitioners and higher use of short-term nurses in remote Australian primary care
services: an observational cohort study. BMJ open, 9(2), e023906.