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Clinical Scenario with Structured Questions - Essay Example

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Appendix: Clinical Scenario A 44 year old white Anglo Saxon male client was admitted to drug and alcohol detoxification unit for detoxification from long term use of alcohol – approximately 1 x bottle of Vodka daily. Client is obese with weight of 165Kg; Difficulty sleeping due to be investigated for same as yet has not had any sleep studies?…
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Clinical Scenario with Structured Questions
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Download file to see previous pages A nurse’s aid who is also a second year nursing student at university saw the client , took his blood pressure which was found to be elevated at 185/112. His heart rate was rapid at 113 beats per minute. The clinical picture indicated that the man was most probably having a heart attack. The student / nurse called an ambulance. As per unit protocol an accident/incident form was filled. Chest pain is a common occurrence with older patients. In the Emergency Department, chest pain needs to be isolated as cardiac or non-cardiac in origin. Physical assessment and proper history taking is very important in identifying the type of chest pain the patient is experiencing. This will also help the health care provider prioritize the plan of care. Proper assessment and history taking through detailed interview could have helped greatly in avoiding errors and reducing incidence reporting. This also indicates that the quality of care is improving. Pain is a very subjective matter. McCaffrey defined pain as whatever the person experiencing pain says it is, existing whenever the person communicates or demonstrates it does (McCaffrey, 1986). Chest pain is one of the most common complaints in emergency departments of hospitals and acute care centers, so common that immediate evaluation and correct diagnosis is very important in the patient’s survival. The situation describes a 44 year old Anglo-Saxon male client presenting with crushing chest pain. History shows long term use of alcohol, obesity, diabetic with insulin infusion, diaphoresis and shortness of breath. The Registered Nurse who first assessed the patient missed critical information such as taking the vital signs of the patient. Vital signs, particularly blood pressure is very important in the assessment of pain. Increased blood pressure usually indicates severe pain (Cox). High blood pressure and tachycardia are symptoms of a heart attack. These symptoms plus the crushing chest pain, diaphoresis and shortness of breath are warning signs of heart attack and is should be considered a medical emergency. Clinical Governance Clinical governance is a term used by the National Health Service to describe a systematic approach in maintaining high standards of care and aims to continually improve the quality of services delivered in the clinical practice environment. Clinical governance is defined as a framework which helps all clinicians – including nurses – to continuously improve quality and safeguard standards of care (Royal College of Nursing). The role of clinical governance in this situation is to correct any mistakes that the drug and alcohol detoxification unit failed to detect. The purpose of clinical governance is to maintain and improve standards of patient care. In this scenario, it will improve the inadequate partenership between and among health care professionals dealing with the patient. It will also improve delivery of health care in other elements of clinical governance such as education and training, clinical audit, clinical effectiveness, research and development, openness and risk management. In education and training, the staff of the unit are equipped for drug and alcohol detoxification but they also need to continually update themselves with regards to medical cases in order for them to promptly idnetify life threatening symptoms such as mentioned in ...Download file to see next pages Read More
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