Critical Review: Shaun Bell's Death and Healthcare Standards

This report critically analyzes the Coronial Inquest into the death of Shaun Bell, a four-year-old boy, focusing on the clinical issues that contributed to his death at Tweed Hospital. The report examines the failures in clinical management, including the initial assessment by Dr. Wood, the lack of antibiotic prescription, and the inability of nurses to properly monitor vital signs. It highlights the inadequate communication among medical staff, particularly during shift changes, and the deficiencies in telehealth nursing services. The analysis considers the role of nursing standards, including the need for effective communication, adherence to practice standards, and the importance of recognizing and reporting adverse events. The report emphasizes the need for improved collaboration, timely medical attention, and adherence to professional codes of conduct to prevent similar outcomes in the future.

Running head: HEALTH POLICY
Health Policy
Student Name
University Name
Author Note

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Introduction
Shaun Bell was born on 18 December 2011 and was just four years old when he died
at Tweed Hospital in northern NSW on 14 March 2016. He and his mom Tanya McGlinchey,
and his older siblings Calvin and Dominic lived in Boronia Heights, Queensland. Shaun's
parents had separated and he and his brother Matthew Bell usually went through the ends of
the week. Shaun's formative achievements arrived behind schedule, and when he was aged
two years and seven months he was determined to have a noteworthy worldwide formative
delay. He initiated discourse pathology, physiotherapy, and an Early Childhood Development
Program. After a year he was found to have an extreme language expressive turmoil and
serious improvement coordination issue. His language instruction had included learning
gesture-based communication. Shaun's passing came as an awful stun to his family. Shaun's
dad and his mom at the conclusion of the testimony, each shared with the court adored their
child's recollections. Hearing how Shaun's family had began to practice gesture-based
communication so they could convey a more complete life to him was endearing. It was
critical to them to see how he passed on and in the case of anything should be possible to help
keep this disaster from happening to another family. Thus, this article will concentrate on the
clinical issues that assumed a key job in deteriorating his condition and his ensuing passing at
a youthful age.
Discussion
After careful consideration has been given in the case study provided, it could be
understood that there are many lapses on the part of the nurses which have played a key role
in deteriorating the condition of the child and resulting in his death. The initial issue arose
when Dr James Wood, ED Resident Medical Officer, examined the condition of the patient
after Shaun had been brought in the ED. Previously the mother of the child as contacted

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several medical professionals who had mentioned that the stomach of the child felt soft and
not tender. However, Dr Wood exclaimed that his stomach felt normal and not at all soft. The
second issue arises when the child undergoes a paediatric review with Dr Anthony
Thanasingam and coordinated with a specialist paediatric review for the case of Shaun. They
had jointly agreed that the child is suffering from viral gastroenteritis because of metabolic
acidosis in his blood tests. It is after this event that the doctors did not mention to prescribe
antibiotics for the child for the infection to subside and rather mentioned to administer
intravenous hydration. It is on the lack of the doctor assessing the case of Shaun to proclaim
that the presence of blood in the vomit of the child is due to suspected lacerations in the
oesophagus from prior vomiting. Another issue which could be observed in the case study is
the inability of the nurse delegated to provide care to Shaun being able to take the vital signs
as part of the routine because of fear of causing distress to the child. It is because of this that
the heart rate of the child is not assessed properly for the rest of the night and further
deterioration in his condition. The patient's clinical condition tended to deteriorate further due
to the negligence of the hospital's clinical staff doing the treatment. Shaun needed profound
thought, and was totally unacceptable for entry to a general paediatric ward. He had severe
tachycardia, reduced haemoglobin and low levels of sodium. The findings of the major blood
tests were extremely alarming to cause severe purpose investigation. The fitting response was
an early contact with a tertiary medical clinic, or the lead to desperate exams to figure out
why his case was so. It is clear that when Dr. Ring and Dr. Thanasingam turned over
information to their day shift subordinates they did not convey single dirt about his situation.
Dr. Ring called Dr. McMaster at about 8 a.m. on March 14, but despite the fact that he
disclosed to him that Shaun was the most unwell guy on the ward that he did not pass on a
severe request for further tests. The day shift paediatrics registrar Dr. Zawada was basically
not left with any desire to move quickly following the verbal hand of Dr. Thanasingam that

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morning. Nor did her analysis of Shaun's earlier-night blood test results give her excessive
anxiety. Dr. Zawada did not see any compelling reason to speed up Shaun's own study by Dr.
McMaster or to consider whether the medical evidence of his illness supported the research
hypothesis and treatment plan. RN Kate Greenway was the nurse responsible for the
Paediatrics ward during the evening of 13 March. RN Greenway was concerned about aspects
of Shaun's restorative therapy through the course of the night; she hadn't expressed such
questions to a senior expert or medical caretaker. RN Stobbart of the Tele Triage office of 13
Health needed adequate appraisal aptitudes to acquire a sufficient clinical image of Shaun's
physical condition. Besides, it could be viewed as that she did not have what it takes and
preparing to survey a kid with non-verbal formative deferral was not under her competency.
Phone triage and advice services (TTAS) are progressively being executed in the
world over. These administrations permit individuals to address a medical attendant or
general expert via phone and get assessed and healthcare advice (Jang-Jaccard et al. 2014).
While phone triage attendants approach electronic therapeutic records, the trouble lies in not
having the option to envision the patient (Soroush, Haffez-Baig & Gururajan 2010). Medical
nurses are prepared to survey patients from the minute they look at them. A lot of a medical
attendant's evaluation originates from non-verbal signs. While conventions are useful,
nothing beats an attendant's sharp assessment aptitudes and clinical experience. Phone triage
attendants figure out how to sharpen listening aptitudes and get on different signs and fuse
that into their assessment (Bradford, Caffery & Smith 2015). Phone triage can be testing, yet
a solid medical attendant's basic reasoning and dynamic can beat the difficulties of not having
the option to look at a patient. Enlisted medical attendants give wellbeing related advice via
telephone for wellbeing data and evaluation of side effects. This incorporates an exhaustive
phone assessment bringing about a proposal of a period and spot of care (Windsor, Douglas
& Harvey 2012). The administration additionally gives quick, proof-based medicinal services

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data and referral to other social insurance suppliers which are focused on the proper level and
area of care. RN's additionally instruct guests and guide them to fitting consideration. By
evaluating guests by telephone, medical caretakers gauge side effect earnestness, as opposed
to analyse the reason for the side effects. So as to help Registered Nurses and Nurse
Practitioners to take an interest in Telehealth, the Australian Nursing and Midwifery
Federations National Competency Standards for the Registered Nurse, received by the
Nursing and Midwifery Board of Australia (NMBA) in July 2010, have been stretched out to
incorporate contemplations explicit to Telehealth nursing. As per standard 3 of the Telehealth
nursing code, the enlisted medical caretakers are liable to rehearse inside evidence based
system while exhibiting systematic abilities in getting to and assessing wellbeing data and
research evidence and taking part in quality improvement exercises. As per standard 5 of the
Telehealth nursing code, the enlisted medical caretakers are additionally liable to direct an
exhaustive and precise nursing assessment while utilizing a scope of evaluation strategies to
gather significant and precise information.
As per the nursing scope of practice standard 3.3, the medical attendants are subject to
comprehend that positive expert connections are based on compelling correspondence that is
deferential, kind, merciful and legitimate (Nursing Midwifery Board 2018). To order to
communicate efficiently, professional practitioners need to have understanding of well-being
skills concerns and recognize well-being instruction while communicating to patients and
make courses of action, whenever feasible, to fulfil the particular language, social and
communication needs of people and their relatives, through the use of deciphering and
deciphering administrations when appropriate and competent (Soydemir, Seren Intepeler &
Mert 2017). It is also imperative to seek to guarantee that a person receives any data imparted
to them while clearly and accurately communicating relevant and suitable data about the
individual to spouses, within the limits of important security prerequisites, and is non-

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judgmental and does not apply orally or in correspondence / records to others, including
abstaining from behaviour (White & Whinstanley 2010). Consequently, on account of Shaun,
it was the obligation of the nursing proficient to assemble a helpful association with the kid to
such an extent that the appraisal of the kid and the ailment is not undermined. It could be
attested from the investigation report that if the attendants would be progressively compliant
with their codes for the ideal consideration to their patients, the essential indications of the
youngster could be observed and imparted to the medicinal staff to such an extent that an
improvement could be normal. As per the nursing scope of training standard 2.4, the medical
attendants are at risk to comprehend that when an individual is hurt by human services,
medical attendants have duties to be transparent in speaking with the individual, to survey
what occurred, and to report the occasion in an auspicious way, and as per neighbourhood
arrangement (Nursing Midwifery Board 2018). When something turns out badly, medical
caretakers must perceive and think about what occurred and report the episode and act
promptly to amend the issue if conceivable, and intercede straightforwardly in the event that
it is expected to secure the individual's wellbeing. This duty incorporates heightening
concerns if necessary (Merrick, Fry & Duffield 2014). It is likewise expected of them to
submit to the standards of open exposure and non-reformatory ways to deal with episode the
executives and recognize the most suitable human services colleague to give a conciliatory
sentiment and a clarification to the individual, as expeditiously and totally as would be
prudent, that supports open revelation standards (Wolf 2012). Moreover, they should tune in
to the individual, recognize any trouble they encountered and offer help. Sometimes it might
be fitting to allude the individual to another medical attendant or wellbeing proficient and
guarantee individuals approach data about how to submit a question, and that in doing as
such, not permit an objection or warning to contrarily influence the consideration they give,
and look for guidance from their manager, AHPRA, their expert reimbursement back up plan,

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or other important bodies, if they are uncertain about their commitments (Haddara & Lingard
2013). Hence, in the case of Shaun, it was required of the nurse and the medical professionals
to adequately transfer the information of the medical condition of the patient to the senior
medical professionals while complying with their standards of practice.
Conclusion
In concluding remarks, it could be assertive to say that the medical condition of Shaun
could be improved if timely medical attention was laid out to him and collaboration among
the medical team members would have been effectively used to its full potential. He had
severe tachycardia, reduced haemoglobin and low levels of sodium. The findings of the major
blood tests were extremely alarming to cause severe purpose investigation. The fitting
response was an early contact with a tertiary medical clinic, or the lead to desperate exams to
figure out why his case was so. It is clear that when Dr. Ring and Dr. Thanasingam turned
over records to their day shift subordinates they did not convey a single dirt about his
situation. According to the standards of practice for the nurses, it is their obligation to provide
optimum care to their patient while effectively collaborating and communicating necessary
information about the medical condition of the patient such that an adverse health outcome is
averted. In addition, the role of telehealth nursing professionals was inadequate to undermine
the situation of the child with assessment techniques and advice immediate admission to the
emergency department of an advance child-specialist hospital.

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