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Evidence Based Approach - Case Study 1
Situation Assessment and Communication
When a patient falls in the hospital, it is always associated with some injury and needs to be taken care of by the caregivers (Andreoli et al., 2014). A fall can happen involuntarily and the patient lies down on the floor which can give rise to head injuries. It is important to inform the patient and the family members about the incidence to minimize the associated harm in future. The patients should be engaged emotionally while describing the situation and while evaluating the pain triggering points. By asking the patient about their health conditions, emotionally satisfying them, and advising them to ask for their support and needs in order to evaluate the contributing factors (Andreoli et al., 2014).
Assessment and Approach
The essential step after fall incidence is informing the senior nurses, as a part of the organization policy moreover, nurses remain closely associated with the patient all the time to ensure effective care (Nursing centre, n.d). Nurse will check the vitals and evaluate the point of pain in the lower limbs which could be the reason for fall. Moreover, the information can be delivered to the risk manager officer in order to minimize the associated harm (Nursing centre, n.d). The information should be delivered effectively to the all the nursing staff in the ward in order to avoid second fall. Finally the incident is well documented that will aid to provide effective care and medical attention from nursing staff.
Documentation
In the healthcare systems, falls are the important cause for mortalities in older patients. Proper assessment, evaluations, and recommendation strategies need to be included in the documentation. Complete recording the date and time of the incident adds more validity to the document (Lapumnuaypol et al., 2019). It assesses the needs of the patient and standardizes care goals for them. Moreover, aims to achieve the modern care approach and design a risk based care management protocol to avoid second fall incidence (Lapumnuaypol et al., 2019). At the end, the discussed recommendations including keeping necessary objects within the patient’s reach and reorienting with the room environment. The risk assessment tool is helpful in medical record documentation which reduces the associated harm and improves patient wellbeing.
Evidence Based Approach - Case Study 2
Confidentially and Ethical Principle
In healthcare systems, confidence can be described as the non-disclosure of patient related information by the nursing practitioners retrieved in therapeutic relationship (Vernon et al., 2015). The information should not be delivered to the third party without patient’s consent justifying the bio-ethic autonomy and the healthcare system should follow the non-disclosure policies strictly for patient health and wellbeing. The non-disclosure policy will be shared with the patients describing what information to be shared and what not (Vernon et al., 2015). One of the best possible way to eliminate threat to patient confidentiality is keeping away of mobile phones form their access to ensure no one can accidently record patients information.
Advocacy
In the healthcare systems, patient advocacy is related with the advocacy of patients and typical advocacy dimensions include privacy matters, patient rights, consent and confidentiality policies (Kalaitzidis et al., 2020). Nurses are in best relation with the patient and can advocate for their wellbeing. Nurses advocate for implementing effective practices to maintain confidentiality of medical records without compromising patient care and safety (Kalaitzidis et al., 2020). Patient advocacy aims to inform and share the knowledge of health policies for their wellbeing and improved outcomes. They ensure to keep all the treatment and care measures are conducted in a confidential way to achieve patient safety outcomes.
Breaching Confidentiality
Confidentiality breaching reflects when caregiver in the healthcare systems disclosed the personal information of the patients either intentionally or unintentionally without consent of patient (Aroca et al., 2016). This act could lose trust in therapeutic relationship which results in unsafe heath environment. The four strategies will include assess the right time and environment, describing non-disclosure policies, report to breach to patient confidentiality, and training for reviewing standard guidelines. The modern healthcare systems have designed various online portals for managing such issues moreover, healthcare systems have separate compliance staff that handles all the legal issues moreover, the compliance staff is well trained to effectively manage all the ethical and legal breaches (Aroca et al., 2016).
Effective Communication
Effective communication is an essential strategy used to understand inner thoughts of the others by body signs, and facial expression (Martin et al., 2015). The relatives and colleagues being emotionally and socially attached with the person understand the non-spoken thoughts appropriately. There are two most important forms of communication and includes verbal and non-verbal. The verbal is typically related with the speech or the information received by speaking or having face to face conversation. On the contrary, non-verbal communication does not involve speech (Martin et al., 2015).The issue of breaching non-confidentiality can be explained using effective communication in a respectful manner using native language.
Evidence Based Approach - Case Study 3
Active Listening
An active listener shows interest in what the speaker/patient is saying by engaging them verbally with questions about what they are saying or non-verbally by showing visual clues that signify that they are giving importance to what the speaker is saying (King et al.,2015). Nurses can give improve listening by summarizing the whole conversation to the patients at the end which will clear the doubts and nurses will get a clear idea of what patient needs which will help in advanced care planning process as well (King et al.,2015). Nurses are trained on active listening skills for improved patient outcomes and wellbeing
De-Escalation
In healthcare, aggression can be considered as a major workplace hazard and includes verbal or physical abuse that can compromise patient safety (Lubna et al.,2016). Aggression is mainly associated with long term illness where they lose sense of speech and result in deteriorating work environment and decrease life quality of the caregivers. The higher prevalence of the increased risk associated with aggression can be neutralized using de-escalation strategy as a part of effective management (Lubna et al., 2016). Nurses can communicate with the aggressive patient in a simple and calm tone in a respectful and non-provoking manner that will help manage the aggressive patient.
Advantages of Debriefing Process
Debriefing process in the healthcare setting will focus on patient safety and improved outcome (Cheng et al., 2017). Its goal is to discuss the best evident action and care plan for patient wellbeing and incorporate the evaluation of all the critical decision making skills that help nurses into future performances. It will guide the nursing staff to improve team performance, and other emergency response outcomes in real time which will provide effective care and safety to critical ill patients (Cheng et al., 2017). Debriefing will is an essential parameter for quality improvement, clinical education, and healthcare system learning and most of the debriefing practices will impart post simulation practices.
Electronic Medical Record Policies
An electronic medical record will contain all the patient related information in an organized and secured manner. Electronic medical records will be based on confidentiality and autonomy policies for patient wellbeing. The objectives of the policies are to guide the patient about the importance of medical records with their written consent (Royal children's hospital Melbourne, n.d).
Communication Strategies
In the healthcare systems, feedback is an important parameter to self-assess skills and capabilities that will increase confidence, promote motivation, behavior, and cognitive skills (Suganya, 2017). The caregivers can understand the non-verbal thoughts of the patient and use convincing and optimistic approach while therapeutic communication. Nurses can change their behavior pattern after receiving feedback for the patient wellbeing and improved patient outcome (Suganya, 2017).
References for Evidence Based Approach
Andreoli, A., Fancott, C., Velji, K., Baker, G.R., Solway, S., Aimone, E., &Tardif, G. (2014). Using SBAR to communicate falls risk and management in inter-professional rehabilitation teams. Healthcare, 94(101), 1-12.
Aroca, C.M.B., Lopez, E., Chao,C., &Barquero, M.M. (2016). Confidentiality breaches in clinical practice: What happens in hospitals?.BMC Medical Ethics, 17(52), 1-12.
Cheng A, Grant V, & Huffman J. (2017).Simulation in healthcare.Journal of the Society for Simulation in Healthcare, 12, 319-325.
Kalaitzidis, E.,Jewell,P. (2020). The concept of advocacy in nursing.The Health Care Manager, 39(2), 77-84.
King, P., Cederbaum, J., Kurzban, S., Norton, T., Palmer, S., Coyne, J., (2015). Role of patient treatment beliefs and provider characteristics in establishing patient-provider relationships.Family Practice, 32 (2) (2015), 224-231.
Lapumnuaypol, K., Thongprayoon, C., Wijarnpreecha, K., Tiu, A., &Cheungpasitporn, W, (2019). Risk of fall in patients taking proton pump inhibitors: a meta-analysis. An International Journal of Medicine, 112(2), 115-121.
Lubna, S., Janciran, A., &Manickam, A. (2016).Key components and strategies utilized by nurses for de-escalation of aggression in psychiatric in-patients: A systematic review protocol. JBI Evidence Synthesis, 14(12),109-118.
Martin,A.M., Lyons,R., &Fenelon,M.CA.(2015). Non-verbal communication between nurses and people with an intellectual disability: A review of the literature. Journal of Intellectual Disabilities, 14(4),303-14
Nursing centre.(n.d). When a fall occurs four steps to take in response to a fall. Retrieved from https://www.nursingcenter.com/journalarticle?Article_ID=751198&Journal_ID=54030&Issue_ID=751137
Onward Healthcare.(n.d). How to address breaches in patient confidentiality. Retrieved from https://www.onwardhealthcare.com/nursing-resources/how-to-address-breaches-in-patient-confidentiality/
Royal Children's Hospital Melbourne.(n.d). Personal information confidentiality. Retrieved from https://www.rch.org.au/policy/public/Personal_information_-_confidentiality/
Suganya, P. (2018). Feedback among nursing professionals: A narrative review. International Journal of Health Sciences and Research,8(2), 266-271.
Vernon, R., Concaccon, M., &Vernon, W. (2015).Confidentiality and patient autonomy in a healthcare framework.International Journal of Health Science and Research, 12(16), 1-18.
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