Essay Instructions: Hi, this is a Case study...all information is in reference to the scenario below. I have already completed a draft copy of a very brief outline of what this larger one should entail. (this draft was part of our assessment and has already been marked...so this next 1250 is based on the same scenario, we must just expand apon it) The information I have put in the draft essay needs to be split up and expanded on...I have included the marking criteria for help also. Thankyou very much!
Use your draft summary and associated feedback from the 1st assignment to assist preparing your 1 word essay.
Prepare a essay of the nursing care you would use to manage the case scenario
Use your draft summary from the 1st assignment to assist preparing your 1250 word essay. (I have included this further down the page - It is not to be used as one paragraph, each section expanded on as per marking criteria ...also added further down)
Background: A key role of nursing is to maintain client safety. People living in residential care settings are vulnerable to complications arising from infections, adverse drug effects, and underlying disease processes. Nurses take into consideration the individual needs of the client as well as the impact of individual health problems on the safety of others when planning care.
Aim: The aim of this assessment is for the student to prepare a 1250 word essay of the nursing care required to manage the health needs of your clients and maintain the safety of residents, visitors and staff. Use your draft and relevant feedback to assist in preparation of your report.
Scenario
You are allocated to provide the care for five clients in an aged care facility that also houses a dementia unit. One of your clients Mary Canley (85 years old) confides in you that she has been incontinent of faeces and also has increasing abdominal discomfort. Reading her nursing care plan you notice that Mary is usually continent. Mary lives in room one (see Unit/Ward Floor Plan - The dementia wing is located down the hall from Mary's room, Mary's room however is next to the dirty utility room). You discuss Mary’s concerns to the Nurse Unit Manager who advisors you that another resident in the dementia unit reported cramping abdominal pains and diarrhoea.
To complete this assessment task you should do the following:
1. Identify the relevant client problems supported by the clinical information obtained from the case scenario.
2. Indentify and explain potential cause(s) of the identified patient problems.
3. Discuss the consequences of the identified patient problems drawing on nursing knowledge and support with evidence.
4. Identify relevant patient goals and associated measurable outcomes relevant for managing the identified health problems.
5. Describe and explain appropriate nursing actions to manage the risks associated with the presenting health problems for clients and staff.
6. Describe the level of evidence supporting the nursing decision-making and care planning.
7. Discuss how identified patient problems and health risks, goals, nursing interventions and outcome criteria are linked.
The following is my draft essay... that needs to be broken down and expanded on as per marking criteria.
Mary‘s symptoms of abdominal discomfort, faecal incontinence, and diarrhoea
indicate possible gastrointestinal disturbance (Crisp & Taylor 2009). Of additional
concern is that another resident is reporting similar symptoms in the dementia unit.
A single case of gastroenteritis in an elderly resident of an aged care facility
may signal the beginning of an outbreak. (Kirk, Roberts, and Horvath 2008, 476)
Possible causes for this may be the result of cross contamination via the oral-faecal
route of transmission, or through consuming contaminated foods and water (Kirk,
Hall, Veitch, Becker 2010, 12). The physical location of the dirty utility room
proximal to the eating and food preparation areas appears inappropriate, and should be
reviewed (Department of Health and ageing 2007). The most often cited causes are
salmonella infections and clostridium difficile (Simor 2010)
Depending on the infected resident’s current health conditions residents may
experience dehydration, abdominal pain, fevers, vomiting, diarrhoea and loss of
appetite associated with gastroenteritis. (Crisp & Taylor 2009) If the condition is left
untreated it may be life threatening. (Department of Health and Ageing, 2007)
Immediate nursing actions to manage the suspected infected resident would
include collecting a faecal specimen to confirm infection. (Crisp & Taylor 2009)
Isolating infected patients to reduce infection spreading to other residents and staff
(Kirk, Roberts and Horvath, 2008) Increased hygiene measures and implementing a
management plan, monitoring nutrition, fluid intake, hygiene and pain control. (Crisp
& Taylor 2009)
Patient goals are to implement nursing interventions to care for the two
residents who are already elderly and immunocompromised; ensuring comfort,
decreased abdominal pain, stable vital signs, skin integrity and patients personal
hygiene. (Crisp & Taylor 2009)
Measurable outcomes for these goals; 1. No further outbreaks of
gastroenteritis in the unit, 2. Symptom control and improved health status in the
affected residents 3. Identified possible causes of the gastroenteritis, 4. Review of the
unit’s infection control practices (Garibaldi 1999)
References
Andrew E, Simor,MvD (2010)Diagnosis, Management, and Prevention of
Clostridium difficile Infection in Long-Term Care Facilities: A Review. The
Americans Geriatric Society 58, (8), 1557-1593. doi:10.1111/j.1532-
5415.2010.02958.x
Crisp.J, & Taylor, C. (2010), Potter & Perry’s fundaments of nursing (3
rded.). Chatswood, N.S.W.: Elsevier Australia
M.D Kirk, G.V. Hall, M.G.K. Veitch, N. Becker (2010). Assessing the
incidence of gastroenteritis among elderly people living in long term care facilities.
Journal of Hospital Infection 76 12 – 17. doi 10.1016/j.jhin.2010.04.009
R.A Garibaldi ( 1999) Residential care and the elderly: the burden of infection.
Journal of Hospital Infection. 43 9-18.
Australian Government: Department of Health and Ageing. (2007).
Retrieved from
http://www.health.gov.au/internet/main/publishing.nsf/content/icg-guidelinesindex.htm
ASSIGNMENT MARKING CRITERIA: Please read and structure essay around this...
1.Provide an introduction for your report that
clearly outlines the scope of your report.
(50-60 words)
Clear
Precise
Accurate
2.Have relevant patient problems been identified
and supported with clinical observations?
(40 to 50 words)
New onset fecal
incontinence
Abdominal
discomfort/cramping
Diarrhoea
3.Have the potential cause(s) of the patient
problems been explained?
(150-200 words)
Infection resulting in
gastroenteritis
Constipation
Adverse drug effects
4. Has the consequences of the identified patient
problems been discussed and supported with
evidence?
(200 to 300 words)
Spread of infection
Skin breakdown
Sepsis
Cardiac arrest
Dehydration
Delirium
Psychological distress
Falls
Pain
5. Were relevant patient goals associated with
the management of the identified problems
and measurable outcomes described and
justified with evidence?
(150 to 200 words)
Patients will not become infected with the GIT
pathogen.
Stable vital signs
Haemodynamic stability
Functional continence
Fluid balance goals
described
Adequate nutrition
Infection control
Pain control
Falls prevention
Adequate hygiene
Intact skin
6. Were appropriate nursing actions planned to
manage the risks to the patient, others and
nursing staff associated with the presenting
problems and justified with the highest level of
evidence?
(250-350 words)
rectal examination,
stool inspection
Stool sampling for MCS
Hygiene
Skin care
Infection control
Fluid balance
Nutrition
Psychological comfort
Pain control
Medical review
7. Was the level of evidence supporting the
nursing decision making and care planning
described?
(70-100 words)
Relevant retrieved reports
cited.
Level of evidence
associated with retrieved
reports stated.
8. Conclusion for report: was the link between the
identified patient problems and health risks,
goals, nursing interventions and outcome
criteria discussed?
(100-150 words)
Clear
Precise
Accurate
Benefits summarized
Limitations listed
Suggestions for ongoing
care plan development.
The essay can be set out in paragraphs from the above prompts - word limits are included to help.
INTEXT REFERENCING IS A MUST! (APA style) Please only use 2 websites.
Thankyou for your help.
Annie
