University of Derby 6NU518 Minor Injuries Unit Assignment

This assignment, completed by a student, focuses on the Minor Injuries Unit (MIU) and covers various aspects of patient care within this setting. It begins by defining the role of an Advanced Practitioner and the four pillars of advanced practice, followed by defining minor injuries and the function of th...Read More

Running head: END OF UNIT ACTIVITY
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Name of the Student:
Name of the University:
Author note:

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Activity 1.1
Advance practitioner can be defined as a registered nurse who has acquired expert level
of knowledge and complex decision making skills, through years of experience (Royal College
of Nursing 2014). Generally, a master’s degree is required.
There are mainly four pillars for advance practitioner in England. These four pillars are a)
Clinical Practice, b) Leadership and Management, c) Education and d) Research(NHS 2019).
Advance practitioners have to practice in compliance with their respective code of conduct, have
to demonstrate professional judgement and also exhibit critical understanding (NHS 2019). They
also have to partake in multi- disciplinary services as well as evaluation of team and personal
practice (NHS 2019). One of the primary roles of advance nurse is to provide rapid access and
service from the nurse led clinic (Iglehart 2013).
Activity 1.2
Minor injuries can be defined as an injury which does not affect long term survival,
mobility or threaten and individual’s life (Purcell 2016).
Individuals suffering from minor injuries can go to the MIU or Minor Injuries Unit for
treatment of their minor injuries. However, sometimes symptoms do get complicated due to
improper management or poor hygiene management. In these scenarios, minor injuries may
exacerbated which in turn may lead to the life threatening situation (Purcell 2016).

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Activity 1.3
MIU or Minor Injuries Unit can be defined as a walk in unit situated in the hospitals of
United Kingdom which provides clinical service in relation to the minor injury. These clinics are
generally staffed by ENPs or emergency nurse practitioners and they operate independently for
the treatment of minor injuries (NHS Services London 2019).
The Minor Injuries Unit that I am working in, is situated independently in a small
treatment centre separated from the main hospital building. One of the primary advantages of
this is that the person does not need to go to the hospital for treatment of minor injuries which
can be tended easily and hence, saves time and money of the sufferer as well as cost on the
health care system. Often people come to the Minor Injuries Unit with serious and severe
conditions and need to be hospitalised immediately. In such cases, the sufferer loses precious
time which might have been saved if the Minor Injuries Unit was situated nearby or inside
hospital perimeter.
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I am currently employed as a Band 5 Agency nurse at the MIU department of a local
healthcare organization. The injuries I cater to, include fractures and lacerations. My professional
responsibilities include adhering to NMC (Nursing and Midwifery Council), professional codes
and standards of 1, 2, 3, 4 and 5, which requires me to prioritize patients and standard 8 where I
must cooperatively work with health professionals, as well as standard 9 where I must
communicate with professionals for feedback. My professional boundaries are limited by
standard 13 where I must obtain help from other health professionals for treatment beyond my
scope of practice (Nursing and Midwifery Council 2019).

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Activity 2.1
One of the primary roles of nursing professionals while working in the healthcare facility
is building good rapport with the patients within the healthcare facilities. As mentioned in the
research of Dang et al. (2017), building a connection or rapport with patients helps professionals
to understand the need and requirements of the patients in the care facility. Besides
communication, maintenance of patient dignity, positive and helpful body language and
complying with code of conducts are important while developing rapport with the patient
(Virdun et al. 2017). These aspects are helpful in building trust within the care process and
then help them to shape the care process for the development of the communication skills
(Kazadi, Lievens and Mahr, 2016). Further, as per Dang et al. (2017), listening alone is the
most effective way to develop rapport with the patients and then, with the help of interventions
the nurses could reciprocate in a positive way that maintains a nurse patient relationship.
Activity 2.2
While conducting the patient assessment, it is important that the nursing professionals
look for the history of allergy. As mentioned by Agache et al. (2015), it is important that their
allergic reactions are known to the healthcare professionals. This would help to determine the
medication or the type of diet that would be provided to the patients for their faster recovery. If
nurses do not assess the past allergic reactions of the patients, there is a risk of having severe
allergic reaction due to any ingested antibiotic (Savage, Sicherer and Wood 2016).
In the case of Mr. Orange, it is mentioned that due to the consumption of penicillin, he
developed an allergic reaction. Hence, it was important to assess his allergic condition so that he
could be provided with effective intervention. It was also researched by Mirakian et al. (2015),

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that assessing and identification of the drugs they are allergic to, helps the healthcare physicians
improve the health and wellbeing of the patient.
End of Unit Activity: Mr. Oliver Orange
Date: 20th June
Age: 50 + years
Gender: Male
Past Medical History: Angina, allergic to Penicillin (allergic symptoms include, rashes and
swelling of face)
Drug History: Atenolol, Beclomethasone, Salbutamol, Glycerol Trinitrate
History of presenting complaint: Feeling unwell and uneasiness during working with the
automated plastic injection moulding equipment.
Examination and findings: Physical examination and pain assessment: redness, swelling and
sagging at the shoulder, perception of pain while moving his arms, slight pain in the chest and
shortness of breath.
Differential Diagnosis: Possible fracture at the shoulder, possible cardiovascular disorder
considering chest pain and shortness of breath - hence, hyperglycaemia, hypertension,
hypercholesterolemia.
Investigations and further tests: Shoulder examination, Radiograph at the shoulder region,
(Anteroposterior and inferosuperior clavicle), cardiovascular assessment, respiratory assessment,
vital signs assessment, head-to-toe assessment, falls assessment to assess range of mobility and
motion, blood tests assessing blood glucose, blood lipid profile.

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Working Diagnosis: Fractured Clavicle
Brief management issues and referral: Further investigation by an orthopaedic and
administration of analgesics, supports like an arm sling or physical therapy like exercise based on
recommendations by multidisciplinary team consisting of a general practitioner, orthopaedic and
occupational therapist, referral to a cardiologist for further cardiovascular assessment
Activity 3.1
In the case study of Mr. Amber, while assessing his healthcare conditions, it is important
to ask the patient few questions so that the answers could be collected. According to Hally et al.
(2017), these questions should be inclusive of a cumulative approach so that a collective
understanding of the patient’s condition could be understood. The questions would be as follows:
 Was the patient was provided with any first aid after the accident and in the
condition, what medication or treatment was provided to him?
 What assistance was provided to the patient and in what time he was taken to the
healthcare facility?
 Did the patient acquire any allergic reaction after the immediate treatment?
Activity 3.2
A Colles' fracture is a fracture of the radius bone that is present in the forearm near to the
wrist. As per Jantzen et al. (2016), fracture in this bone could lead to upward displacement and
radius deformity. There are multiple aspects that could be observed during assessment such as
the origin of the condition are associated with dorsal and radial displacement. However, due to
ulnar styliod, the fracture and the condition must also be observed. According to Hosseini et al.

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(2017), this type of surgery are termed as one of the critical and crucial surgery for which X-ray
would be used as the diagnosis of this fracture. Morphine would be implemented as the first
line for pain relief of the patients that are suffering from this fracture. Further, mild
paracetamol, ibrufen and upon requirement, more codeine would be provided to the
patients who are suffering from Colles' fracture (Stanton-Hicks 2018).
Activity 3.3
Pins and needles are felt by the patients suffering from severe pain and results due to the
injuries in arm and legs. Pins and needs could increase patient’s risk of Paresthesia (Slopsema et
al. 2018). Symptoms include numbness in the hands and feet and sudden prickling and tingling
sensation which would normalise after few minutes. The reasons that could increase the
complication of this sensation are nerve injury, neurological disease, and decreased blood supply
to the hands, sclerosis and diabetes (Marmor et al. 2017).
Activity 3.4
The pain assessment and scoring tools which are used widely include the Visual
Analogue Scale (VAS), Numerical Rating Scale (NRS) and Behavioural Rating Scale (BRS).
According to the British Journal of Anaesthesia, NRS and VAS can be considered as evidence
based assessment tools of acute pain, while BRS is considered as an effective option for patients
who are unable to self-report their level of pain (Levy, Sturgess and Mills 2018).
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A hand and wrist assessment can be conducted to examine his level of pain and range of
motion. Additional examination may include a radiograph of the wrist, Allen’s test to assess

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blood circulation and physical examination of the distal interphalangeal joint and proximal
interphalangeal joint (Pelletier et al. 2018).
Activity 4.1: 4 year old girl with eye infection
Date: 20th June, 2019
Age: 4 years
Gender: Female
Past Medical History: None
Drug History: None
History of presenting complaint: Irritation and redness in left eye, soreness in right eye
Examination and findings: Eye examination, presence of sand in her eyes
Differential Diagnosis: Allergic responses to any allergen
Investigations and further tests: Patient examination and obtaining history of allergies and
intolerances

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Working Diagnosis: Irritation and redness in left eye, soreness in right eye due to intrusion of
sand particles
Brief management issues and referral: Washing with saline water, examination by an
ophthalmic specialist for eye drops and associated medications
Reflection: Description: A 4 year girl was admitted upon complaints of irritation and
redness in left eye, soreness in right eye.
Feelings: Initially I believed that conjunctivitis in her friend had contributed to her eye
irritation.
Evaluation: A bad experience was my incorrect diagnosis and absence of reflection. A
good experience included the correction of my actions, followed by reflection and obtaining
history.
Analysis: Obtaining comprehensive patient history is essential for obtaining a correct
diagnosis.
Conclusion: In addition, I should have further questioned the patient’s parents as well as
reflected before I administered a final diagnosis.
Action Plan: For the future, I must compulsorily engage in personal reflection as well a
holistic assessment and medical history collection for correctly diagnosing a patient’s health
condition.

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End of Unit Activity: Reflection
Description: An 8 year old was admitted to the MIU upon complaints of a swelling and
irritation in the left eye. The child has asthma and allergies towards cats.
Feelings: I felt agitated since a calm and composed attitude from the parents would have
assisted us in a comprehensive medical history of the child. I then calmly persuaded him to relax
since his behavior may also agitate child and explained I need his help in obtaining a medical
history. Such efforts comprise of emotional intelligence – a practice of analyzing and
demonstrating awareness of one’s own and other emotions (Sánchez-Álvarez, Extremera and
Fernández-Berrocal 2016).
Evaluation: The bad part of the experience was the father’s agitation and my initial
judgment of his behaviour. However, the good part was that this situation assisted me in my
demonstration and understanding of emotional intelligence.
Analysis: I realized that usage of emotional intelligence goes a long way in maintaining
optimum therapeutic relationships. Emotionally intelligent actions such as empathy and gentle
persuasion assisted me in calming the patient’s father and in understanding that the baby sitter
may had attended another home with pets before arriving at the child’s home e (Serrat 2017).
Conclusion: I should have first prioritized obtaining a comprehensive history first
instead of concluding with haste that the child’s asthma or a pet at home may have contributed to
the symptoms. Indeed, misdiagnosis is very common in the absence of a comprehensive patient
history and examination.
Action Plan: To manage such a situation in the future, I will promptly use emotional
intelligence and also advice my colleagues to use the same.

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Activity 5.1
Possible questions:
 Is there any burning sensation or irritation in the patient’s eyes?
 Is there any swelling and pain in the patient’s ankle?
 What movements are acting as triggers of the patient’s pain? How severe is the pain
reported by the patient?
Ms. Green may be suffering from acute nociceptive pain – a type pain caused due short
term injuries occurring due to physical and chemical incidents (Zaki et al. 2016). Preferably,
selective NSAIDS must be administered which do not cause the side effects of vision blurring,
burning eye sensation, shortness of breath, fatigue and gastrointestinal bleeding to occur
(Chou et al. 2016).
Activity 5.2
Description: Ms. Green was admitted with an acute eye and ankle pain following an
accident at laboratory which caused her to stumble with vinegar injuring her eye.
Feelings: At first I was confident that I must consider only her eye injury. After
reflection, I felt that I must conduct a comprehensive health assessment.
Evaluation: The bad experience was that I was hastily concentrating only her eye injury
and medication with NSAIDs. The good experience was that I conducted a complete health
assessment and corrected the medication prescription.
Analysis: Health professionals must engage in a complete assessment and reflect on side
effects before prescribing a medication.

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Conclusion: Additionally, I should have considered other pain medications other than
NSAIDs.
Action Plan: If it arose again, I will conduct a holistic assessment and consider
alternatives of medications to reduce side effects.
End of Unit Activity: Ms. Green
Date: 2nd April, 2016
Age: 30 years
Gender: Female
Past Medical History: None
Drug History: None
History of presenting complaint: Pain in right ankle, irritation and watering in eyes
Examination and findings: Eye examination, pain assessment, swelling and tenderness in right
ankle, corneal abrasions
Differential Diagnosis: Acute nociceptive pain, in right ankle, corneal abrasions

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Investigations and further tests: Holistic clinical assessment, Pain assessment, medication and
surgical history
Working Diagnosis: Corneal abrasions
Brief management issues and referral: Occupational therapist, ophthalmic specialist,
management will include compression with ice, lubricating drops and selective NSAIDs
administration
Ms. Green should not be given medications like naproxen, diclofenac, aspirin and
indometacin to prevent side effects of gastrointestinal bleeding. Such medications must be taken
within intervals of 8 to 12 hours between each other (Walsh et al. 2016).
Activity 6.1: Dr. Blue
Date: 20th June, 2019
Age: 50 years
Gender: Male
Past Medical History: None
Drug History: None

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History of presenting complaint: Slipped on wet floor, resulting in laceration and twisting of his
ankle
Examination and findings: X ray: bone tenderness, pain and slight fracture at the fifth
metatarsal
Differential Diagnosis: Superficial laceration in the ankle
Investigations and further tests: Eye examination, Glasgow coma scale (GCS) for head injury
assessment
Working Diagnosis: Bone tenderness, pain and slight fracture at the fifth metatarsal
Brief management issues and referral: RICE method, walking assistance, surgical wound for
wound management
Examination of Mr. Blue would include a physical examination of his ankle, an X ray to
detect fractures, wound assessment to check for infections in his laceration and GCS to assess for
head injuries.

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Activity 6.2
A vital signs assessment can be conducted. In case of pain, analgesics such as ibuprofen
may be administered. The practitioner must also interact with the patient to detect any slurring in
his speech or distortions of his facial features (Silver, McAllister and Arciniegas 2019).
End of Unit Activity
The various upper and lower limb injuries, associated with damage to the arms,
shoulders, hands and elbows, which I have encountered in my practice include: golfer’s elbow,
tennis elbow, frozen shoulder, runner’s knees, fractures in the leg, quad strain and plantar
fasciitis.

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