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Module 1: 500 words
Activity:
On returning from your tea break you are met by several staff members who relate the following information to you concerning your patients.
i. Mrs Chew’s intravenous (IV) infusion has tissued, her IV fluids are running behind and she has missed her 14.00 hrs IV antibiotic.
ii. Mr Smith’s visitor has fainted.
iii. One of the staff toilets has blocked and is overflowing and waste is pouring out rapidly.
iv. Mr Esposito is scheduled to leave the ward now for his cardiac catheterisation and he has still not received his preoperative medication.
v. One of the surgical consultants (VMO) is waiting to discuss a medication error that happened last week.
vi. As you are taking this handover, an elderly female post-operative patient collapses to the floor and is unconscious. She has had facial surgery.

The other RN is busy with NUM role. Staff currently available on the ward to assist you in addressing these issues include: the ward clerk, an Enrolled Nurse who is currently undertaking her IV cannulation certificate but is not yet competent, and an Assistant In Nursing.
Questions to answer:
Using the above scenario:
1: In order of priority, identify which tasks you yourself will undertake and which tasks you will delegate.
2: Document your rationales in detail.

References from Module 1.
1/. Aitken, L., Chaboyer, W., Elliot, D. (2102). Scope of Critical care Practice. In ACCCN’s Critical Care Nursing, 2nd Ed. Sydney: Elsevier.

2/. Benner, P., Tanner, C., Chelsa, C. (2009). Expertise in practice; Caring, clinical judgement, and ethics 2nd Ed. Springer, NY.

3/. Campbell, L., Gilbert, M., Laustsen, G. (2010). Clinical coach for nursing excellence.

4/. Casey, A., Wallis, A. (2011) Effective communication: Principle of nursing practice E. Nursing Standard 25(32), 35-37.

5/. Chaboyer, W., Hewson-Conroy. (2012). Quality and safety. In ACCCN’s Critical Care Nursing, 2nd Ed. Elsevier, Sydney.

6/. Elliott, M. & Coventry, A. (2012). Critical care: the eight vital signs of patient monitoring. British Journal of Nursing, 21(10), 621-625.

Module 2: 500 words total for both Activities

Activity:
The “MND Australia Fact Sheet on Multidisciplinary Teams” outlines professional groups who could make up a multidisciplinary health care team for a patient with motor neurone disease (MND).

http://www.mndaust.asn.au/Get-informed/Information-resources/Living_better_for_longer/WEB-MND-Australia-Fact-Sheet-EB3-Multidisciplinary.aspx

Please read this fact sheet, answer the following questions
1. What factors determine the professional groups on a health care team?
2. Who should lead the health care team?
3. Who is the most important member of the health care team?

Activity:
Robert Hughes is a 52 year old male who was injured in a bicycle accident two months ago where he suffered fractures to his (R) tibia/fibula and (R) radius. Robert is intellectually impaired and was living with his elderly mother until the accident. Robert has been known to engage in verbally aggressive outbursts towards staff and other patients. His mother who is now 75 years of age feels she can no longer look after Robert. You are the NUM of the rehabilitation unit that is admitting Robert for his ongoing rehabilitation. You are required to gather together a health care team to determine immediate and long term care options for Robert.
Discuss the following questions
1. What are the key issues in this situation?
2. Who would be included in the health care team and what role would they play?
References for Module 2.
1/. Crisp, J. & Taylor, C. (Eds). (2009). Potter and Perry’s fundamentals of nursing, 3rd edn. Elsevier, Chatswood.

2/. Berman, A., Snyder, S., Kozier, B., Erb, G., Levett-Jones, T. Dwyer, T….& Stanley, D. (2010). Kozier and Erb’s fundamentals of nursing, First Australian Edn. Pearson, Frenchs Forest.

3/. Kalishman, S., Stoddard, H. & O’Sullivan, P. (2012). Don’t manage the conflict: transform it through collaboration. Medical Education, 46, 926-934.

4/. MND Australia (nd). Australia Fact Sheet on Multidisciplinary Teams

5/. Weller, J. (2012). Shedding new light on tribalism in health care. Medical Education, 46, 132-142.

Module 3 500 Words Total for both Activities
Activity 1/.
Patient: Joe Bloggs, 92yr old male, presented to ED with abdo pain and a 3kg weight loss in the past week. He has now been transferred to your ward from Emergency department.
He has had a chesty cough with frothy sputum production, which we suspect may be pneumonia
He has been on hourly observations in ED
He has a history of CCF, CVA and gastric ulcer
He is currently on 1.5lt Oxygen via nasal prongs
He has peripheral Intravenous Cannula in his left hand
He has IV antibiotics Cephazolin and Gentamycin as per drug chart, which need to be given.
He is currently Nil by mouth,
He has good urine output, having gone twice today
His Bowels were Open YESTERDAY
The Doctor has written up an order for him to start on 50ml/hr of IV normal saline.
The patient has a Chest X-ray booked today at 1600 which you will need to get him ready for, as well as a Sputum test required this shift.
Routine Observations required also.
Please answer the following In relation to this patient and the handover:
1. What further questions will you need to ask the nurse?
2. List what further assessments you would complete when the patient arrives onto the ward
3. Complete detailed admission notes for this patient.

Activity 2/.
Bed 1: A 45 year old female presented to ED with a haemothorax, and had an ICC inserted. She arrived on the ward at 1230hrs. She has an IVC in-situ in her left antecubital, and currently has 100ml/hr of NaCl 0.9% running. She has a morphine PCA which she is using appropriately, and it has kept her settled and pain-free. She is on 3 doses of prophylactic cephazolin 8 hourly, and she has received a dose in ED at 1200 hrs. There is an IDC in-situ, which is draining 35ml/hr, the urine appears cloudy. She will require a CXR in the morning, physio assessment, as well as a pain review by the medical team. Diet and fluids as tolerated.
Bed 2: A 23 year old male has been admitted with suspected cholecystectomy, and has been placed on the evening emergency theatre list. He is complaining of severe abdominal pain with a numerical pain score of 8/10. He has been fasting for 8 hours since he came to the ward this morning. He has no IV inserted, and has been prescribed PRN oral paracetamol and oxycodone for pain.
Bed 3: A 17 year old male who is Day 4 following a laparoscopic appendectomy with perforation, and is ready to be discharged home. He has been on PRN paracetamol and oxycodone, and has been prescribed amoxicillin and lactulose for use at home. His parents will pick him up at 1700hrs, once they have finished work.
Bed 4: Dirty bed. A new patient is to come up from ED in 1 hour with abdominal pain of unknown origin. She has no relevant past medical history, and has been booked in for an abdominal ultrasound at 1600 hrs. She is fasting and has not yet been prescribed any analgesia.
Draw up a shift planner with an hourly plan.
Prioritise these hourly tasks by rating it A, B, C or D – do the most important first which would be A, second most important B and so on.
4. Ask a colleague to review and provide feedback on your shift planner.
Patient / Time 0700 0800 0900 1000 1100 1200 1300 1400 1500

Shift Planner

References for module 3
1/. Aitken, L., Chaboyer, W. & Elliot. (2102). Scope of Critical care Practice. In ACCCN’s Critical Care Nursing 2nd Ed. Elsevier, Sydney.
2/. Campbell, L., Gilbert, M. & Laustsen, G. (2010). Clinical coach for nursing excellence. Imprint: Philadelphia, Pa.
3/. Department of Human Services (2006). Sentinel event program: Annual report 2005-06. Department of Human Services, State of Victoria: Victorian Government of Human Services, Melbourne.
4/. Department of Health (2010). Promoting effective communication among healthcare professionals to improve patient safety and quality of care. Department of Health, State of Victoria: Victorian Government Department of Health
5/. Felton, M. (2012). Recognising signs and symptoms of patient deterioration. Emergency Nurse, 20(8), 23-27.
6/. Jacox, L. & Cole. A. (2012). ISOBAR: Standardising nursing handover. Retrieved 21 June, 2013, from: http://yhhiec.org.uk/wp-content/uploads/2012/07/34.pdf
7/. Levett-Jones, T. & (2013) Clinical Reasoning: Learning to think like a nurse, Frenchs Forests, NSW: Pearson.
8/. Scovell, S. (2010). Role of the nurse-to-nurse handover in patient care. Nursing Standard, 24(20), 35-39.
9/. Siviter, B. (2013). Effective time management for nurses. Retrieved 21 June, 2013, from http://nursingstandard.rcnpublishing.co.uk/students/from-student-to-qualified-nurse/effective-time-management-for-nurses
10/. Street, M., Eustace, P., Livingston, P.M., Craike, M.J., Kent, B. & Patterson, D. (2011). Communication at the bedside to enhance patient care: A survey of nurses’ experience and perspective of handover. International Journal of Nursing Practice, 17, 133-140.
11/. Virtual Simulated Patient Resource (VSPR) (2013). Standards of effective communication. Retrieved 19 June, 2013, from 10
https://www.vspr.net.au/joomla/index.php?option=com_joomdle&view=wrapper&moodle_page_type=course&id=5&Itemid=
12/. Wentworth, S. (2003). Time management strategies in nursing practice. Journal of Advanced Nursing, 43(5), 432-440.

Module 4: 500 words total.
ACTIVITY:
You are a Registered Nurse on the afternoon shift on a short-stay (24 hours) surgical ward. One other Registered Nurse, an Enrolled Nurse and three Assistant in Nursing aids are also on duty. The Nurse Unit Manager (NUM) is off sick and the other RN is acting as NUM as well as taking a patient load. The ward is full: there are 22 patients, 10 of whom went to surgery in the morning, and 8 are going on your shift. Half of these a patients have Intravenous access and antibiotics at some time during your shift.
Questions:
Using your knowledge and experience of various patient allocation models (e.g. total patient care, team nursing and task allocation), outline how the staff may be allocated to the patients. Include in your discussion your rationale for the model of allocation chosen and the scope of practice of the various staff.

References for Module 4:
1/. Australian Nursing and Midwifery Council (ANMC). (2010). A nurse’s guide to professional
boundaries. Retrieved from: http://www.anmac.org.au/

2/. Benner, P. (1984). From novice to expert: excellence and power in clinical nursing practice. Menlo Park Ca: Addison-Wesley.

3/. International Council of Nurses (2014). Retrieved from: http://www.icn.ch/

4/. Pearce, C. (2006). Leadership resources. Ten steps to effective delegation. Nursing Management UK, 13(8), 19.

4/. Schwartz, L. (2002). Is there an advocate in the house? The role of health care professionals in patient advocacy. Journal of Medical Ethics, 28(1), 37-40.

6/. Wood, D. (2010). The nurse’s role as patient advocate. Retrieved from http://www.nursezone.com/nursing-news-events/more-news/The-Nurses-Role-as-Patient-Advocate_33962.aspx Link not working

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