PATIENT CARE

Posted: January 4th, 2023

PATIENT CARE

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Patient Care

Describing the Case

A 53 year old patient was getting treatment for pneumonia and malaria and was almost being released from the wards when he decided to take a walk around the hospital to break the boredom of being inside the wards. Unfortunately, the man came across a slippery surface as he crossed one of the floors just before reaching the other block. He slid causing the man to break his left leg. He called out on a nurse who was passing by while in pain and she quickly rushed him to the emergency section that was few meters away. An analysis by a general practitioner ruled out that the condition was serious and needed a surgery to manage the situation. The GP recommended that the patient be transferred to an advanced facility where he could get better services, and it is upon his arrival that he started to receive the highly needed care that would save him from the pain and discomfort.

Description of the Patient’s Condition

Falls are among the many issues that medical practitioners deal with in the course of their operations. Spoelstra, Given, and Given (2011) define a patient’s fall as an unanticipated descent to the floor such that one either sustains or does not get any serious injury.  A fall may result in fatal implications, including internal bleeding, lacerations, and fracture among other serious effects, resulting in escalated health care use (Spoelstra, Given & Given 2011). Practitioners can either encounter psychological, physiological, and accidental falls, and must enact adequate measures to address any of these occurrences.

How the Patient was admitted to the Hospital and Care Pathway

The intervener followed certain steps in admitting the patient to the hospital. The initial process was to acquire the patient’s personal information, including his name, date of birth, phone number and address (Pudner 2010). The next phase was to conduct a diagnosis to identify the magnitude of the injury and to identify any possible intervention approach. The diagnosis was important because it provided a pathway to follow when engaging in treatment (Pudner 2010). The next phase was to record the practitioner (doctor) who would handle the case before finding out if the patient is under any insurance plan. The process would entail fining out whether the patient is self-insured or whether they are protected by a particular agency or coverage plan (Pudner 2010). The team or individual handling the admission process would proceed to find out whether the patient is being admitted from home or if they are referred from another health facility (Pudner 2010). The admission process would also determine whether the patient requires operation in theatre, or whether the procedure may not be necessary.

Outlining the care pathway made the intervention process easier and convenient. After admitting the patient, the next process would be to determine the fall risk factors, which include factors such as vision, past falls, environmental threats, mental state, medications, toileting requirements, and mobility (Spoelstra, Given & Given 2011). The caregiver would then enact effective preventive measures if it turns out that the risks are high. The intervener would have to conduct post fall evaluation and enact changes depending on assessment, then prepare an incident report if dealing with the first case of fall (Spoelstra, Given & Given 2011). However, if it is not the first incident of fall the practitioner would have to go back and determine the fall risk factors.

The Nursing Assessment Tools

The Falls Risk Assessment Tool (FRAT) is a vital tool that would help the practitioner to assess the patient situation. The tool is appropriate as it makes it possible to identify any health concerns that may increase a person’s chances of falling, and which may be better to discuss with the general practitioner (Oliver, Daly, Martin & McMurdo 2004). For example, the test would help the practitioner to understand whether the patient has had a fall in the past twelve months because this would provide more valuable information about the current incident (Oliver, Daly, Martin & McMurdo 2004). The test would also help to identify whether the patient is currently under four or more medications, and whether they have Parkinson’s disease. The test is effective as it would allow the caregiver to understand whether the patient have problem with their balance, and whether they encounter any difficulty getting up from a chair (Narayanan et al. 2015). The timed up and go test (TUG) may also provide suitable guidance on how to assess the fall, and give valuable information on how to address the matter. The practitioner would ask the patient stand from their position and try to walk for some few minutes before relaxing again (Narayanan et al. 2015). These tools are important and the caregiver must understand how they function.

Element of Care

A possible element of care would be to familiarize the patient with their environment and to ensure that they are not likely to encounter obstacles that put them at more threat. The familiarization process may involve telling the patient where to go during the hospitalization period and where to avoid (Getttens et al. 2017). Informing the patients about their environment will help them to take additional precaution, and will increase their chances of recovering from the condition (Getttens et al. 2017). However, the caregiver must first plan on how to approach the patient over the matter.  

Application of Medical Principles of Nursing

The principles of medical care in nursing practice provided valuable information that helped to improve care to the patient. One of the principles of medical care that helps to offer effective services to the patient, especially while at the ward is benevolence, which involves commitment on the nurse’s part to help the patient and seek out for the most appropriate health outcomes for them (Burka 2015). The principle of benevolence helped to safeguard and defend the patient’s rights, and to prevent any harm from worsening their condition. Adhering to the guidelines of benevolence was important in providing good care to the patient because it was possible to be kind, charitable, and to express a sense of goodwill while attending to the injured person. The principles of medical care played essential roles in providing care to the patient because they provided guidance on how to apply non-maleficence, which requires nurses to ensure that they do not purposely harm patients under their attention (Burka 2015). The principle acknowledges that while treatment operations and procedures can cause negative effects on patients, caregivers should not inflict intentional harm or pain (Burka 2015). Both benevolence and non-maleficence served vital functions in providing appropriate medical services that restored confidence to the patient and his relatives and colleagues.

Practicing fidelity and accountability, which are part of the principles of medical practices in nursing helped to give the appropriate care and attention to the fall patient. Fidelity provided suitable guidance because it helped to act in a faithful way such that it was possible to be faithful and responsible to give safe and high-quality care (Burka 2015). Fidelity played essential roles in improving the patient’s health and confidence because the affected person knew that he would one day get better because of the positive promises and encouragement he gets on regular basis (Burka 2015). Equally important in providing care was the principle of accountability, which requires nurses to accept the professional and personal outcomes of their operations (Burka 2015). Otherwise, lack of accountability could result in self-denial and other blunders that may harm the patient significantly. Thus, fidelity and accountability served important roles in providing appropriate care and services to the fall patient.

Principles of Surgical Care

The nature of the patient’s injury called for surgery to be able to handle the situation more effectively. The need to perform surgery on the patient indicates how falls could result in adverse consequences, which may require the interveners to apply the relevant principles of surgical care in adult nursing. One of these principles that helped to provide appropriate care to the patient entailed proper planning, evaluation, execution, and assessment of the care using a suitable nursing framework (Pudner 2010). The model provided an opportunity to follow particular steps and provided the chance to gather all the necessary materials before proceeding further with the intervention. Adequate planning and assessment before proceeding with the operation any further offered the chance to identify any factors that could interfere with the entire or part of the process, and created the chance to enact the necessary remedies (Pudner 2010). Moreover, effective planning and adequate evaluation provided the chance to identify and understand the approaches that may not work effectively, and which could result in poor or unexpected outcome. The other principle of surgical care, which offered suitable guidance during the process is managing nutrition, which required a coordinated effort to monitor what the patient consumes before and after the surgery to ensure that their consumption behaviour does not interfere with the surgery. Dietary planning and intervention was an essential part of the surgery to examine the patient’s general surgical nutritional needs and status, and to determine their dietary intake (Elbanna, Tolba & Darwish 1996). The process also offered the chance to create and implement customized dietary plans depending on the patient’s surgical requirements, and to know the implications of managing diet on incisional wound healing (Elbanna, Tolba & Darwish 1996). The caregiver must consider these principles together with others that may help to improve their service towards the patient.

The other principle of surgical care that helped to provide proper services to the patient is managing pain, especially after the surgical process. The care process acknowledged that other than keeping the patient comfortable, effective pain control can hasten the path to recovery and may lower the risks of developing some adverse effects after the surgery, such as blood clots and pneumonia. Including a physiotherapist at this stage may be helpful because this provides the chance to maintain, restore and promote the patient’s well-being and mobility (Tideiksaar 2010). Besides, the services of occupational therapists may be needed to help alleviate pain because these practitioners have the capacity to treat disabled, injured, and ill patients through the therapeutic application of everyday procedures (Tideiksaar 2010). Occupational therapists can help such patients cultivate, recuperate, advance, and preserve the useful skills required for daily living and activities (Tideiksaar 2010). Therefore, abiding by these and other principles of surgical care contributed towards offering the best care during the intervention process. 

The theater-related activities paid considerable attention to the concepts of managing infection and managing wound, also called wound care knowing that following the guidelines of these surgical principles would result in the most desirable outcomes. Managing infection control required the intervener to take appropriate measures that would prevent any form of infection, which included practicing regular handwashing, staralisation of drapes and clothing, ensuring the air inside theater is clean, and proper use of antibiotics (Weston 2013). Other factors considered during the surgery aimed at managing infection control, include proper control of body temperature and blood sugar levels. The practice also considered other factors that played significant functions in preventing infection, including proper use of personal protective equipment (PPE), transmission-based precautions, either through droplets and contact, and respiratory hygiene (Weston 2013). Also, abiding by the directives on managing wounds and wound care provided a suitable chance to take the patient through surgery without much constraints. The process also involved wound debridement, which entailed moderate handling of damaged tissues to reduce cases of bleeding. Managing the wound required the intervener to follow the primary principles for laceration, which include haemostasis, or enacting measures to stop bleeding, cleaning the wound through disinfection, decontamination, debriding, irrigation, and the use of antibiotics, and analgesia, which entails using a local anesthetic to facilitate closure of the wound (Weston 2013).

The principles of surgical care provided guidance on considering effective ways for managing stress and anxiety and offered the chance to embrace suitable ways for handling possible damaged body image. The intervention process acknowledged that unregulated anxiety during the surgical process could have adverse implications on the surgery process, including the possibility of developing hypertension, unregulated bleeding, and increased heartbeat. Moreover, Bailey (2010) reports that high level of anxiety during a surgical process may dampen the rate at which a patient recovers after the medical procedure. The surgery process entailed various approaches to help the patient overcome stress and anxiety and that are related to surgical operations. For example, the practice relied on effective communication, which included speaking appropriately and in layman’s language, explaining everything, including the sequence of activities that will happen during the stipulated stay period (Bailey 2020). The process also relied on using appropriate humor that encourage laughter, visitation, and cool music that does not cause any form of discomfort. The process appreciated the fact that the significance of physical appearance as a feature of identity is very closely linked to the perception of who each person is as a human being. The practice acknowledged that body image relays important meaning, and is consistent with identity, self-esteem, and self-concept (Bailey 2020). The practice also takes into account that body image views adapt to the naturally adjusting incidences such as ageing, pregnancy, and puberty, and that unplanned alterations to body appearance, such as those that can happen due to trauma of surgical operations, sometimes result in prolonged adverse implications. Such devastating transformation may change views of body presentations and self-image (Bailey 2020). Therefore, it was important to rehabilitate the patient to cope with their new condition, while taking into account what the patient was feeling and thinking throughout the process. Adhering to the principles of surgical care served vital roles in promoting a successful intervention.

Discharge

The stay in hospital, particularly if unpredicted, can be overwhelming for the patient and their family. As the caregiver and the patient focus on the treatment plan while in the health facility, the focus may not be what could happen when the time to go back home arrives (Department of Health 2010). Thus, the intervention process for the patient acknowledged that smooth transition out of the health facility is essential for a good recovery and can even lower one’s possibilities of future hospitalization. However, it was important to consider several factors prior to discharging the patient. An important factor to consider was whether the home environment is a good place to promote the patient’s recovery. It compelled the caregiver to find out whether there are factors that could hinder mobility such as long staircases or other obstacles and share information on how to deal with the obstacles. The caregiver identified whether the patient has other people who may help them once they leave the hospital, and whether they have time to assist the patient with a comfortable and safe recovery. The caregiver thought about the transportation model, which entailed finding out how the patient would get home from the health facility (Department of Health 2010). The intervener asked the patient to organize their transport home before their time to leave to avoid any inconveniences. The other factor the healthcare worker considered prior to discharging the patient is whether they have enough food and other requirements at home that would facilitate his recovery process. The patient had the chance to learn some of the foods that may quicken the recovery process, and had the opportunity to ask questions in areas they may require assistance.

Relevant Policies

The intervention process observed all the necessary national and local policies enacted to promote healthcare delivery and individual health. The practice followed the directives of the National Health Service (NHS), which require caregivers to pay considerable attention to upholding safety while engaging in clinical practices (Burka 2015). The NHS informs that reducing the risks of adverse events provides an opportunity to achieve quality outcome, and allows the interveners to lower the risks of unnecessary threat associate with health services to an acceptable range (Burka 2015). Moreover, abiding by the national policies allows the intervener to offer care without any form of discrimination. The policies provide an opportunity to uphold equality in all areas, which increases the chances of achieving patient satisfaction (Burka 2015). Besides, the policies provide valuable information concerning patient empowerment, which allows the caregiver to engage the person receiving treatment in a way that inspires them to be strong while undergoing the medical process.

Conclusion

The study pays attention to service delivery to a patient who sustains serious injuries due a fall. It illustrates how abiding to the principles of medical and surgical care provided an opportunity to give effective and standardized care that helped the patient to be confident and recover in the most effective way. Abiding to the principles of medical nursing offered the chance to practice benevolence, non-maleficence, and fidelity. Furthermore, the practice offered the chance to practice fidelity, accountability, veracity, and patient autonomy that contributed towards providing care that leads to the patient’s well-being and result in satisfaction. Taking care of the fall patient provided an opportunity to apply the principles of surgical care, which helped to give the most suitable attention while the patient passed through theater. The practice largely depended on the principles of surgical care, including proper planning and assessment on how to complete the medical process, managing nutrition and pain, regulating infection and managing wounds, and effective handling of stress and anxiety and appropriate management of possible changed body image. The study illustrates the measures the intervener took while planning to discharge the patient, including ensuring that the home environment provides a safe and secure environment for recovery, planning for the mode of transportation, ensuring the patient will have enough and appropriate food, ensuring the patient has all the medications he will need, and ensuring that the patient will be able to follow the doctor’s appointment. Finally, the report addresses the applicable national policies that define how caregivers ought to conduct their operations to achieve the best outcome.

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