...among older adults living in the community?) | 1) Chaboyer W, McMurray A, Wallis M. Bedside nursing handover: A case study, International Journal of Nursing Practice 2010: 16:27-34 | Level I: Evidence from a systematic review or meta-analysis of all relevant randomized controlled trials (RCTs) or evidence-based clinical practice. | This research aimed to better understand the structures, processes and perceived outcomes of bedside nursing handover as a beginning step to facilitate its implementation. | Randomized control trial, clinical trial. | 532 bedside handovers, 34 interviews with nurses. Six wards in two hospitals in Austrailia. 3 medical, 1 surgical, 1 medsurge, 1 rehabilitation ward. Semistructured observation and interviews. | SBAR was used in 45-65% of handovers in 3 situations when: patients were new or condition changed, patients were unfamiliar to staff such as when staff had been off for a few days, or casual/agency staff were part of the team. On average each bedside handover took just over a minute. | Before handover patient handover was completed and handover sheet updated. Just before handover pts were informed that handover would shortly take place and were asked if they required any assistance in order to limit disruptions during handover, visitors were excused. Information was prompted by pts presence. Safety scan and medication review was done. Kept handover short and simple and to the point. Information found might be used as the basis for standard operating...
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...3.3 CHARACTERISTICS OF HANDOVER Laxmisan et al (2007) conducted an ethnographic study involving analysis of emergency department handover in a US hospital. The study found that interruptions within the emergency department were prevalent and diverse in nature and that there were gaps in information flow due to multi-tasking and shift changes. The communication process is complex and cognitively taxing during and after team handover, that can compromise patient safety. The study also discusses the need to tailor generic electronic tools to support adaptive processes like multi-tasking and handoffs in time constrained environments. Arora et al (2005) conducted interviews using the critical incident technique to handover failures between inpatient physicians in a US hospital. The study interviewed 26 interns and found 25 discrete incidents. The 21 worst events are described. Omitted contents and failure prone communication processes were identified as a major category of failure in communication. These may result in inefficient or sub-optimal care, leading to patient harm....
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...Assessment task one This essay is about communication in health care system and illustrates about the belief of inter-professional practice, the roles and responsibilities of healthcare team members and the importance of inter professional communication in health care. Firstly, inter-professional practice has been discussed along with its significance for quality health outcomes. This is followed by the roles and responsibilities of a healthcare team member, which in this essay is a nurse. Lastly, the utilization of inter-professional communication has been described. Inter-professional practice in a healthcare setting refers to the relationship shared by the health professionals to get outcomes in the best interest of their patient as explained by my teacher. To provide a safe, caring and effective patient care the communication between health care members should also be effective and for this it is essential for them to understand communication concepts and techniques like, attending listening and probing (Berman, Kozier & Erb, 2012). The basic reason behind most of the medication errors, adverse reactions and near misses is due to inadequate communication between different health professionals be it oral or written, also the conclusion of many health care quality improvement investigations state that there is a lack of Inter-professional communication and hence suggest to improve it (Berman, Kozier & Erb, 2012). This collaboration between the professionals forms an...
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...care, but the process varies and is not entirely evidenced based. A Cochrane review analysed 11 randomised controlled trials looking at discharge planning in over 5000 patients and failed to show a reduction in mortality among elderly medical patients, lower readmission rates, or a shorter length of hospital stay.1 However, two trials in the review did report greater satisfaction of patients and carers when discharge planning was used.2 3 The Cochrane review concluded that discharge planning remains important as a small improvement, not detected by the studies performed so far, could still yield highly significant gains in health care with huge resource implications and better use of acute hospital beds.1 Unfortunately, none of the included trials assessed communication with primary care staff about patient transfer of care. This is an important aspect of discharge planning and another potentially important advantage for patients. On a patient’s initial contact with health services, discharge planning should be started.4 This is often difficult to achieve when acutely unwell patients are admitted as a thorough social history may not be immediately available without a collateral history from a relative or primary healthcare provider (who may be difficult to contact). Taking a comprehensive social history is often thought to be time consuming but can be obtained quickly through the use of systematic open questions (see the four scenario boxes). Effective discharge planning...
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...recognized that the Those services include application services, data center services, 24X7X365 help desk services, desktop and network services, and telecommunications that are affected and need to be outsourced. This change will lead to a significant financial turnaround for the hospital (PR Newswire). Because they serve such a large part of the country and are counted as one of the leading hospitals, they must maintain the interest of all stakeholders involved. To do this it would require the CEO and CFO to make major changes that will affect everyone. The admitting staff that inputs patients coming in to the facility, the emergency room staff that depends on the computers to bring up and put in data regarding a patient, the nursing staff and doctors who depend on the information on each patient, the billing department that sends out information to the patients. Also affected would be the community that may be calling in to reach loved ones. This must all be down as quickly and efficiently as possible as the entire facility would depend on the information put out by this system. We recognized three years ago that moving to the 'next level' would require a significant upgrade in the delivery of information to our care providers," said Steve Johnson, Bay Medical's Chief Executive Officer. "The decision to outsource our information technology was time-consuming, thoughtful, and deliberates (PR Newswire). Being one of the one hundred best hospitals in the world...
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...What? A 35 year old woman was attended to by paramedics after reportedly fainting and losing consciousness during breakfast. Paramedics were called and assessed the situation and found it necessary that the patient seek further care due to her hypertension, tachycardia and Glasgow coma scale score of 13. As the paramedic hands over to the nurse they both utilise inter professional techniques such as listening actively, willingly communicating with team members and effective communication skills as Kozier emphasises that “Communication between colleagues is based on an understanding of communication concepts and techniques such as attending, listening, probing and instructing” (Kozier and Erb, 2015). Inter professional communication consists of health workers communicating with each other in an open, collaborative and responsible manner. This type of communication builds trust amongst colleagues and team members. So What? As the paramedic hands over the patient to the nurse he incorporates sophisticated terminology that the nurse is familiar with therefore they can mutually understand and interpret the patient’s situation and apply the correct care. These skills are necessary for any professional seeking a health directed career as “Effective communication between health professionals is vital for safe care” (Kozier and Erb, 2015). I have not developed these skills as yet and through continuous study and research I can build up my knowledge of terms such as tachycardia...
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...Immediate Post Operative Care 2 The following essay will use a systematic approach to critically evaluate the care and treatment delivered to a non-elective paediatric orthopaedic patient within the Post Anaesthetic Care Unit (PACU) by a student Operating Department Practitioner at a local trust hospital. The assessment and management of the patients care will be examined and rationale provided for strategies employed during delivery of individualised patient care. In accordance with Health and Care Professional Council’s standards of conduct, performance and ethics (HCPC, 2012) the confidentiality of the service user will be up held at all times. The service user shall be referred to as “Daisy” to protect her confidentiality. Daisy was received to the PACU after surgical stabilisation of her left fibula and tibia with flexible intramedullary nails following a fall. A specified paediatric bay was utilised enabling the patient to be cared for separately from the adults in the PACU (RCOA, 2013). Anaesthetic and surgical handover was received (RCOA, 2013) which detailed that she was 14 years old with no known allergies. She had no significant medical history. She had a general anaesthetic with 140mfg of Propofol used on induction followed by Sevoflurane as a maintenance agent. 30mg of Atricurium, 4mg Dexamethasone, 4mg Ondansatron, 10mg Morphine and 1g Paracetemol had been administered intraoperatively. 1 litre of Hartmanns solution had been administered during surgery and...
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...Characteristic symptoms of appendicitis incorporate unclear periumbilical pain or pain to the right lower quadrant, nausea, vomiting, and low-grade fever (Moris, Paulson and Pappas, 2021). Nurse’s care spans from the time of arrival at the emergency room to the discharge moment after surgery (Wagner, 2023). Nurses must be prepared to treat symptoms, prevent complications, and educate patients (Wagner, 2023) guided by the best practices. Assessing the patient Jane Smith is a patient that presented to the Emergency department complaining of abdominal right lower quadrant pain (see appendix I). A primary survey will be carried out in order to prioritise the care (see appendix II). The first step for the nurse is to carry out a comprehensive and systematic assessment of the patient, paying particular attention to features such as pain, appetite, nausea, fever, constipation, diarrhoea, family history and past medical history (Wagner, 2023). A patient with complicated appendicitis experiences severe abdominal pain, with guarding position and avoiding deep breaths, the patient normally presents in a bending position and the pain tends to increase with leg extension (Eta, et al., 2023). Jane presented herself with pain in the lower abdominal quadrant, initially along the belly button region and migrating later with history of evolution for 2 days. The nurse should use a numerical pain scale to assess intensity and perform a PQRST pain assessment to collect relevant information and help identify...
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...Question 1.1 Identify two (2) likely medical diagnoses for his presenting condition. Provide a rationale for your answer including the underlying pathophysiology and presenting clinical symptoms. 1. Congestive Heart Failure, (CHF) occurs when the heart cannot pump sufficient blood to meet the body’s demands where weakened chambers allow blood to pool triggering fluid retention in lungs, legs and abdomen (Figueroa & Peters, 2006). The patient has left sided congestive heart failure where left ventricle is not pumping blood sufficient blood out of the lungs/pulmonary vein sufficiently. The lungs become over saturated with blood and the pressure from the right side causes a shift of fluid from the intravascular space into the lungs causing increased respiratory rate and impaired gas exchange. The patient’s symptoms are shortness of breath and cough, swollen ankles due to the excess fluid build up and fatigue. X-ray shows congestion in the middle and lower lungs. The patient was also taking digoxin on admission which is a drug commonly used for treating patients with CHF (Figueroa & Peters, 2006). 2. Digoxin toxicity, Digoxin toxicity is caused by high levels of digoxin in the body a drug Mr Marshall is currently prescribed. His digoxin levels are 2.4 ng/mL and the therapeutic range is 0.6 to 1.3 ng/mL showing increased levels beyond the therapeutic range (Chan, Bradley & Harrigan, 2002). Mr Marshall’s irregular pulse as well as his nausea and vomiting are clinical symptoms...
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...------------------------------------------------- Does delegation help or hurt nursing? A Research Paper April 11, 2013 Fiona Molloy Dr. McDonnell HAS 420 April 11, 2013 Fiona Molloy Dr. McDonnell HAS 420 Fiona Molloy Dr. McDonnell/Bill Miller HSA 420 Does Delegation Help or Hurt Nursing? Chapter One: The History of Nursing. The first nursing school was established in India in about 250 B.C., and only men were permitted to attend because men were viewed to be more pure than women. If you think of a woman dressed in scrubs with a stethoscope around her neck and a clipboard in her hands, you aren’t alone. An overwhelming majority of nurses in the United States today are women. However, nursing began as a practice reserved for men. It wasn’t until the 1800's that nursing became an organized practice. During the Crimean War, Florence Nightingale and 38 volunteer nurses were sent to the main British camp in Turkey. Nightingale and her staff immediately began to clean the hospital and equipment and reorganized patient care. Nightingale pushed for reform of hospital sanitation methods and invented methods of graphing statistical data. When she returned to Britain, Nightingale aided in the establishment of the Royal Commission on the Health of the Army. As a woman, Nightingale could not be appointed to the Royal Commission, but she composed the Commission’s report. (Travel Nurses of America, 2010) Completed, the report was over 1,000 pages in length and included detailed...
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...Introduction In the current days, the characteristics and needs of the patients in Australia and the rest of the world keep changing. The hospitals have been receiving an increased number of patients with different ailments and sometimes they get more ill during their stay in the health facility. The warning sighs always show on a patient before the adverse events such as unexpected deaths, admission to the ICUs or even cardiac arrests. It has been noted that, these warning signs are sometimes not identified, hence not acted upon (Adam, Odell, & Welch, 2010). This study is meant to discuss the case of Mrs. Jones, a 72 year old lady who has been admitted in the ward with increasing confusion and decreasing mobility. Her recent history suggests that she has had Urinary Tract Infection, and she usually has a GCS of 15. Her normal blood pressure always ranges from 140 to 150. During the primary assessment, it is noted that she is not in danger and she opens her eyes when her name is called. She is able to talk and her airway is patent. Her accessory muscle use is increases; her RR is at 22 and SP02 is at 95% on room air. She is also pale and diaphoretic. Her pulses are weak and thread y with the heart rate of 120 and blood pressure of 95/50, GCS at 13/15, temp at 38.5, BGL at 13.2mmol/L and pain in the lower abdomen. Nurses role in recognizing and responding to clinical deterioration The nurses also have a role of ensuring that the medication that a specific patient...
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...Patient Safety Workshop Learning From Error PATIENT SAFETY WORKSHOP LEARNING FROM ERROR WHO Library Cataloguing-in-Publication Data Patient safety workshop: learning from error. Includes CD-ROM 1.Patient care - standards. 2.Medical errors - standards. 3.Patient rights. 4.Health facilities - standards. 5.Health Management and Planning. I.World Health Organization. ISBN 978 92 4 159902 3 (NLM Classification: WX 167) This publication is a reprint of material originally distributed as WHO/IER/PSP/2008.09. © World Health Organization 2010 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies...
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...Managing Change in the NHS Organisational Change A REVIEW FOR HEALTH CARE MANAGERS, PROFESSIONALS AND RESEARCHERS Valerie Iles and Kim Sutherland Managing Change in the NHS Organisational Change A REVIEW FOR HEALTH CARE MANAGERS, PROFESSIONALS AND RESEARCHERS Valerie Iles and Kim Sutherland Contents Purpose and Acknowledgements Foreword 5 7 8 Introduction Part 1 The literature on change management Part 2 Tools, models and approaches: a selective review 1.1 1.2 1.3 1.4 Where does the literature come from? What kind of evidence does it provide? What is meant by ‘change’? Organisational change in the NHS 12 13 14 18 2.1 How to access the models 2.2 How can we understand complexity, interdependence and fragmentation? Weisbord’s Six-Box Organisational Model 7S Model PESTELI Five Whys Content, Context and Process Model Soft Systems Methodology Process modelling Process flow Influence diagram Theory of Constraints (TOC) 22 25 25 27 29 30 32 34 36 37 38 39 40 40 42 43 45 46 47 48 48 50 54 54 55 56 56 58 2.3 Why do we need to change? SWOT analysis 2.4 Who and what can change? Force field analysis ‘Sources and potency of forces’ ‘Readiness and capability’ Commitment, enrolment and compliance Organisation-level change interventions Total Quality Management (TQM) Business Process Reengineering (BPR) Group-level change interventions Parallel learning structures Self-managed teams Individual-level change interventions Innovation research...
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...HLTHIR403C. Work effectively with culturally diverse clients and co-workers Author John Bailey Copyright Text copyright © 2008 by John N. Bailey. Illustration, layout and design copyright © 2008 by John N. Bailey. Under Australia's Copyright Act 1968 (the Act), except for any fair dealing for the purposes of study, research, criticism or review, no part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means without prior written permission from John N. Bailey. All inquiries should be directed in the first instance to the publisher at the address below. Copying for Education Purposes The Act allows a maximum of one chapter or 10% of this book, whichever is the greater, to be copied by an educational institution for its educational purposes provided that that educational institution (or the body that administers it) has given a remuneration notice to JNB Publications, Disclaimer All reasonable efforts have been made to ensure the quality and accuracy of this publication. JNB Publications assumes no responsibility for any errors or omissions and no warranties are made with regard to this publication. Neither JNB Publications nor any authorised distributors shall be held responsible for any direct, incidental or consequential damages resulting from the use of this publication. To Order this Publication This publication can be ordered in a wire bound...
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...MANAGEMENT Leading & Collaborating in a Competitive World Foundations of Management • Managing • The External Environment and Organizational Culture • Managerial Decision Making Planning: Delivering Strategic Value • Planning and Strategic Management • Ethics and Corporate Responsibility • International Management • Entrepreneurship Strategy Implementation Organizing: Building a Dynamic Organization • Organization Structure • Organizational Agility • Human Resources Management • Managing the Diverse Workforce Leading: Mobilizing People • • • • Leadership Motivating for Performance Teamwork Communicating Controlling: Learning and Changing • Managerial Control • Managing Technology and Innovation • Creating and Managing Change PART ONE Foundations of Management The three chapters in Part One describe the foundations of management. Chapter 1 discusses the imperatives of managing in today’s business landscape and introduces the key functions, skills, and competitive goals of effective managers. In other words, it discusses what you need to do and accomplish to become a high-performing manager. Chapter 2 describes the external environment in which managers and their organizations operate— the context that both constrains and provides opportunities for managers. It also discusses what can be described as the organization’s internal environment: its culture. Chapter 3 discusses the most fundamental managerial activity: decision making. Because managers make...
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