The Proper Provision of Quality Health Care and Good Life - Coursework Example

Risk Management affiliation Risk management Medical practitioners are en d with proper provision of quality health careand good life. Negligence is the worst practice that any healthcare provider should endeavour to avoid in practice. Provision of healthcare begins at home where parents, teachers, siblings and other significant others help in maintaining health of individuals. Patient management should always be holistic, all the cadres i.e. doctors, and nurses, pharmacists and radiologists should always work together and discuss the patient problem. These practices will bring good and proper result of patient thus reducing morbidity and mortality in the country. To achieve a dynamic good patient result, the medical practitioners must holistically work together with a focus on mitigating, curative and preventing further development of a disease process. It can only be achieved when all health care providers get determined to practice appropriate medicine without any assumptions or negligence in service offering. Continued provision of proper primary medical care is needed for any society, this led to the establishment of family nurse practitioner (FNP) whose function is entitled to practice and provide primary comprehensive healthcare to family individuals from childhood to adulthood. They are mostly prepared to deal with acute illness in curative and preventive levels. This person can notice something peculiar in an infant and makes the first medical move to solve it or refer to the appropriate medical specialist. Other significant others who play a vital role in maintaining the health of family members include; parents, siblings, teachers and colleagues of an individual in the workplace, since they can notice some signs that point towards a particular disease (Perez-Terzic, 2012). The family nurse practitioner was the first person to see the child presenting with sign and symptom that suggested a cardiovascular disease or nervous system disorder. In the first visit, the nurse noted that the blood pressure was low with other vital sign parameters within normal range. That is highly suggestive of cardiac insufficiency and, therefore, warranted immediate investigations of cardiac functionality and blood volume monitoring. In the second visit to a paediatrician, there was a critical history provided by the physical education teacher of the child fainting, gripping hands to himself clenched and shaking. Even though on physical examination there was no pathology noted, the child might have been suffering from the nervous system or cardiac disease. An immediate referral to cardiologist or neurosurgeon was needed based on the Childs condition. The child be referred to cardiologist six months later; this was a real delay on provision of proper health care to the child. The family nurse practitioner was to take actions of ensuring that the child gets proper investigations to unmask the underlying disease that was now becoming chronic with intermittent signs and symptoms (Bray & Olson, 2009). Family nurse practitioner was in a better place that could have changed the outcome of T.Gs condition. In the beginning, the nurse was to consult with other senior nurses when she first noted the problems of T.G. consulting colleague is one of the fundamental management of patient when an individual is not well conversant with the disease. It could have changed the course and precipitate the management process, this could have been achieved by allocating different days of different patient conditions. It increases the chances of consultant reviewing all the serious clients like T.G thus proper investigations and early detection of the disease. The FNP can organise ambulatory care centres that could have helped in reaching the patient very fast in case of emergencies. It could ultimately help the nurse in obtaining the close monitoring of T.G condition (Bray & Olson, 2009). Linking the school where T.G is studying with the family nurse practitioner and an occasional visit of the school by the FNP is important in close monitoring of the patient. Linkage can be in the form of online contacts or by giving charts that the school nurse fill in order to have a holistic monitoring of the patient. These practices would have helped in providing detailed signs and symptoms of the disease (Szczepanska-Sadowska, Cudnoch-Jedrzejewska, Ufnal, & Zera, 2010). In reviewing the first FNP SOAP note, there are some deficiencies noted in the notes. For example, the FNP did not take the blood pressure of the child; this was a real negligence since a child with episodes of fainting may be likely suffering from heart disease. There was no history or physical examination done to rule out any pathology in the cardiovascular system. The nurse ought to obtain some history like, awareness of the heartbeat, coughing, and immediate exhaustion while playing among others. On examination, the nurse was to listen for the heart sounds, any murmurs and the precordial activity. Cardiologist notes were not sufficient to justify that the ECG was normal. From the notes given, it is clear that there was no QT interval result. QT is a vital marker in monitoring any heart disease. Normally after each heartbeat, the heart’s electrical activity must recharge itself in preparation for the next stroke this is the depolarization phase. In QT syndrome, the heart muscles will tend to take a long time recharge between beats. It appears as a prolonged QT interval in an electrocardiogram. As in the case scenario, the cardiologist omitted the interpretation of the QT interval which was very essential in coming up with a pointing diagnosis of the child condition (Perez-Terzic, 2012). The cardiologist went further and gave instructions to the mother’s child and the teachers that the child was normal and the signs and symptoms will probably disappear as the child grows. The child was to be allowed to resume normalcy in the exercise and should not be limited thereof. It was unwarranted since the child had cardiac output insufficiency he was to have limited exercise that was needed in reducing the episodes of fainting (Perez-Terzic, 2012). The quality of communication appears haphazard in the whole process of managing the patient; this led to allowing time for the disease process to become chronic. The FNP provided less information to both the family and the doctors that the child was referred to. In the first FNP notes, the nurse has not indicated any health care advice to the parent and to the child. It was important to advise the child and parents on low reduced activity, which were the main precipitating factors of the Child’s disease. In the second visit, the FNP nurse does not state well what the cardiologist had advised, but just mentions that the child was seen. The recommendation made by both the cardiologist and the paediatrician were to be inculcated in the notes because they provide expert opinion. It provides cumulative and continuous management of the patient. In the second visit, the FNP discusses the problems that the patient present with to the paediatrician on phone and recommends a CT scan of the head. Discussing a patient medical condition on the phone, occasionally lead to many assumptions by the consultant, since he does not see the patient, but reason based on the information given. Like in this case, a CT scan at this point was not necessary but a thorough cardiac monitoring and scan was very necessary. In the subsequent visit, paediatrician staff indicates that T.G should be taken for EEG not aware that an EEG was on the previous year. It shows there was a miss in communication between the paediatrician and the team as they review their clients (Lyndon, Zlatnik, & Wachter, 2011). The moral principles during the handling of T.G were fairly breached. The ethical principle of beneficence which refers to the actions that promote others wellbeing was violated. It was clear that FNP and the consultants did not give most of the essential information to each other for the recovery and treatment of the patient. They omitted performing some procedures and lack of analysis of the result. Justice as another form of ethical and moral principle was violated; no justice was done to protect the life of T.G in the overall management (Lyndon et al., 2011). Differential diagnosis is a very necessary system in diagnosing diseases that have related signs and symptoms and with possible alternatives. Differential diagnosis is a procedure mostly used by nurses and physicians to come up with a deductive reasoning and pinpoint disease in a patient. Having relevant differential diagnosis is very essential in managing a patient, in that the clinician will ultimately perform several tests and treat suspected conditions. It provides an increased chance of patient survival and detection of diseases that can turn to be chronic and fatal later. It is, therefore, mandatory to have a consideration of the various possibilities of medical diseases in any given patient. In this case, scenario, the differential diagnosis given were almost pointing to where the problem was, and they gave a good clue on what investigations to be ordered. The cardiologist negligence in interpreting the EEG, then T.G could have been put on the right medication and his life saved (Federman, 2007). Consultants are professional in a given field of study in medicine, and they offer specialised care that involves, promotive, curative and preventive services. In locating a professional for a consultant, an individual must be well acquainted with the professional qualification of that person. It is good to know what he offers in his place of business, the standard of the services if they meet the stipulated standards of the country. The climax of consultancy is based on competence of that person rather than the theoretical knowledge alone. Despite the fact that consultants are viewed as the know it all, the client should always take into consideration of the legal rights they have while obtaining the services. Like in this case scenario, there was negligence on the FNP, cardiologist and paediatrician. These consultants have to face the litigation issues based on negligence and omission of work in handling the patient. Conclusion The case scenarios provide spectra in which health care providers learn on full management of patients. In the beginning of the follow up of T.G, it is clear that the family nurse practitioner noted the problem of hypotension. The signs and symptoms of the child showed were direct pointers of cardiovascular problem. It warranted a proper cardiovascular review including physical examination and imaging tests, which were done in late stages. The nurse and the consultant have displayed negligence at work. Medical practitioners, therefore, must always endeavour to perform what is good to save the life of many patient, in aligning with the oath of allegiance that medics take. It is quite unfortunate that one diagnosis was used throughout the management of T.G that is “vaso-vagal syncope” without the FNP and the cardiologist and the paediatrician thinking of anything new that may be causing persistent symptoms. It, therefore, teaches nurses that; any chronic condition should involve much investigation and reasoning to come up with a definite diagnosis. References Bray, C. O., & Olson, K. K. (2009). Family nurse practitioner clinical requirements: is the best recommendation 500 hours? Journal of the American Academy of Nurse Practitioners, 21, 135–139. Federman, D. G. (2007). Differential Diagnosis in Internal Medicine: From Symptom to Diagnosis. JAMA: The Journal of the American Medical Association, 298, 2072–2073. Lyndon, A., Zlatnik, M. G., & Wachter, R. M. (2011). Effective physician-nurse communication: A patient safety essential for labor and delivery. American Journal of Obstetrics and Gynecology. Perez-Terzic, C. M. (2012). Exercise in cardiovascular diseases. PM and R, 4, 867–873. Szczepanska-Sadowska, E., Cudnoch-Jedrzejewska, A., Ufnal, M., & Zera, T. (2010). Brain and cardiovascular diseases: common neurogenic background of cardiovascular, metabolic and inflammatory diseases. Journal of Physiology and Pharmacology : An Official Journal of the Polish Physiological Society, 61, 509–521.  Read More