Department Annals Of Emergency A Medicine -Myassignmenthelp.Com

Question: Discuss About The Department Annals Of Emergency A Medicine? Answer: Introduction Jim Karas (68) was admitted to hospital after being unresponsive and breathing inability. As the fluid resuscitation was unable to raise the blood pressure of the patient, doctors decided to insert a three lumen central venous catheter into the right subclavian vein of Jim Karas. After spending few weeks in the healthcare facility, Jim wanted to return to his home as he used to live alone with his wife Amara, who had COPD and heart failure. His CVAD was removed prior to his discharge. This assignment is going to provide a detailed care plan, including the aspects of Jim and Amaras care and the local community service available in their locality. Further legal and ethical principles for decision-making and strength-based approach will be discussed critically. financial, the aspect of culturally safe care plan will be discussed. Course of action for discharge As Jim lives in the Campbell town council and was admitted to a healthcare facility in New South Wales, the care transfer ethics for NSW was used to conduct his discharge and transfer protocols (NSW Public Hospitals 2018). The care Coordination process is consisting of five steps namely pre-admission or admission, multidisciplinary team meetings, estimate date of discharge, referrals and liaison and finally transferring to home (NSW Public Hospitals 2018). The following flow chart describes the process. As per the care needed for Jim Karas, The transfer of care plan was provided to the multi-disciplinary team and therefore according to that, transfer of care risk assessment was done. Process of patient transfer Before the estimated date of discharge, the patient care plan and referral form need to be completed so that the discharge process becomes easier. The hospital can provide the patient with a care representative who will explain the level and type of care required by the patient in the transfer of needs. Hospital can also appoint a community care team, including a manager and 2 workers to coordinate the care needed by the patient (Berghout et al. 2015). Further, the allied health services such as occupational therapy, nutrition and dietetics and physiotherapy should be provided to the patient with the help of community health team. A community service organization, Whiddon care will be asked to provide care to Jim and Amara. The Whiddon group provides care to elderly patients in the Campbell town area (The Whiddon Group 2018). This is mandatory for him as well as his wife as wife has complication and he is looking after his wife. After the removal of CVAD, Jim needs complex ongoing ma nagement of infection sites and the information of this should be provided to the community service team before the discharge of patient (Ding et al. 2012). Therefore, for the care of Jim and his wife, ACAT assessment or the aged care assessment team should be arranged, who can decide the level of care and cultural safety required by Jim and his wife. Discharge plan of care The care plan of Jim and his wife should include- The discharge will be planned on the day of admission, upon rejection by the patient and his family, a further discharge date will be provided to them (Brennan et al. 2014). On the day of discharge, the patient will be provided with the medication, diet, treatment, activity and follow up updates. To reduce the tension and responsibility of the patient, as he was the only member in his house to take care of Amara, care plan should include interventions for his wife too (Shepperd et al. 2013). Therefore, a Greek social worker will be appointed for the care of Jim and Amara, so that the social worker can provide culturally safe care to both of them. The type of healthcare workers need to be assisted for such interventions. The Whiddon care center will be contacted for healthcare workers such as culturally safe social worker and cook for the dietary and nutrition related needs of Amara and Jim. The frequency of service will be decided and the signs and symptoms of any critical situation or infection will be written in the plan. Service such as meals on wheels can be appointed for Jim and Amara, as the meals on wheels service helps people like them, who are unable to fulfill their own dietary requirements. Medical equipment such as wheel chair, walker, respiratory equipment, hospital bed home health nurse and home OT/PT (Occupational therapy or physical therapy) will be included after discussion with the lead clinician (Brennan et al. 2014). Legal and ethical principles (on decision making with strength based approach) The legal principles of decision making involve the responsibility of the decision maker to consider the matters before making the decisions, must not make decisions for improper purposes, decisions should be based on evidence and should be reasonable, considerations of government policies, decisions to be made within power, procedural fairness, among others (Acma.gov.au 2018). Strength based nursing or SBN is based on the principles of person centered care, empowerment, collaborative partnerships, health promotion, innate capacities for health and healing. SBN helps to maximize the level of functioning and also helps to promote health of the patient and conditions of healing (Gottlieb, Gottlieb and Shamian 2012). There are four principles of strength based nursing approach such as autonomy, dignity, sharing of information and collaboration and participation. Provision of family centered care is the first pillar of the strength based nursing interventions. Respecting autonomy and pri vacy of the patient is the primary aspect in this care process and according to the principles, while providing care to a patient, the care provider should always discuss the provision of the care with the patient, his family and to the authorized physician. In case of Jim, the care provider that is the Whiddon group should discuss the care plan with Jim, Amara, their daughter Angela and the hospital authority (The Whiddon Group 2018). Involving hospital authority about the care plan progression will help the physicians to understand the recovery rate of Jim, and will further include interventions for faster recovery (Knibbs et al. 2012). Jim is concerned about his privacy and privacy and autonomy was the reason he wanted to shift to his home with Amara. On the other hand, the hospital care team will be discussing his health status to the hospital authority and the general physician observing him and Amara. Therefore a proper conversation between, Jim, Amara, and the physician shoul d be done before his transfer from the hospital. Further, to maintain the patient autonomy, the details of Jim and Amara will not be shared with the community service team provided by the Whiddon group. This will respect the autonomy and decision-making power of Jim and his wife Amara. Empowerment is the second pillar of strength-based nursing intervention. Understanding the emotional and medical need of Jim and letting them provide their knowledge to combat with the situation will let him feel his importance in the care process and he and his wife will be empowered to take necessary steps to improve their own health condition. Further promotion of health and healing can in Jim and Amaras case will be helpful in increasing their mental strength and influencing themselves to strictly follow the nursing interventions and will provide fruitful results in this collaborative partnership (Barry and Edgman-Levitan 2012).. However, apart from these enablers, few barriers such as their cultu ral approach, their dietary habit, delirium of Jim can delay the recovery, as the care support unit will take time to understand these factors about Jim and his family. Apart from the strength-based approach, there are four ethical principles present in nursing, such as autonomy and dignity, beneficence, non-maleficence and justice. In the case of Jim, it was Jim that he used to take care of his wife Amara by his own and did not take help of any care supporter (Boswell and Cannon 2012). Irrespective of the reason, Angela wanted her parents to stay at a residential home as logically, however according to the ethical code of nursing, maintaining patients dignity is the top priority (Butts and Rich 2012). They are specialized in community care and providing collaborative care and support to patients. Therefore, the proactive approach of the healthcare facility help to maintain the autonomy as well as dignity of the patient and his values. (Lindberg et al. 2014). In case of Jim and Amara, these ethical codes of nursing will help the healthcare providers to evoke the courage to fight with their deficiencies and attain health. Respecting their autonomy an d dignity and collaborating with both of them for their health interventions will include them in the recovery process and the dilemma of the healthcare professions will be solved. Culturally safe care plan Cultural safety is the environment that provides the patient with physically, socially, mentally and emotionally safe care (Purnell 2012). Australia is the house of a pool of multicultural society, having different thinking, religions, behavioral and dietary habit and health and safety related norms. Jim Karas is Greek and after discharge, the care provider team, who will provide care in his home, should be aware of the cultural safety measures so that the respect and dignity of the patient can be maintained (Douglas et al. 2014). accounting to Malliarou et al. (2017), people generally assume that Greek culture is about bigger families, and in those families everyone cares about every member. However, despite of that, Jim wanted to stay alone with her wife Amara. Therefore, the community nurse from Whiddon group should be aware of these unusual cultural facts about Jim, as assuming about patients need according to famous cultural stereotypes can hamper the quality of care provided to the patient. Conclusion Discharge care plan including cultural safety measures are decided prior to the patient discharges form the healthcare facility, as several aspect depends ion such document provided at the time of discharge. Jim Karas, after recovering his three CVAD related infection decided to stay at his own place. Accordingly, his discharge care plan including nursing interventions for him and his wife has been prepared. The legal and ethical factors such as autonomy, privacy, dignity was given importance in case of Jim and Amara. Further, a group Whiddon, for providing culturally safe care to the patient was decided and to maintain the autonomy of Jim and Amara, the patients information was not shared with them. References Acma.gov.au (2018).Principles for decision making | ACMA. [online] Acma.gov.au. management: https://www.acma.gov.au/theACMA/principles-for-decision-making [Accessed 22 Jan. 2018]. Barry, M.J. and Edgman-Levitan, S., 2012. Shared decision makingthe pinnacle of patient-centered care.New England Journal of Medicine,366(9), pp.780-781. Berghout, M., van Exel, J., Leensvaart, L. and Cramm, J.M., 2015. Healthcare professionals views on patient-centered care in hospitals.BMC health services research,15(1), p.385. Bernoth, M., Dietsch, E., Burmeister, O.K. and Schwartz, M., 2014. Information management in aged care: cases of confidentiality and elder abuse.Journal of Business Ethics,122(3), pp.453-460. Boswell, C. and Cannon, S. eds., 2012.Introduction to nursing research, 3rd Edn, pp. 234-256, Jones Bartlett Publishers. https://books.google.co.in/books?hl=enlr=id=uzMTKEazwekCoi=fndpg=PR5dq=strength-based+nursing+interventionots=VOCmocNsahsig=WVgUl-WAWwOk5Bz0iqTLx4t6WF0 Brennan, M.E., Gormally, J.F., Butow, P., Boyle, F.M. and Spillane, A.J., 2014. Survivorship care plans in cancer: a systematic review of care plan outcomes.British journal of cancer,111(10), pp.1899-1908. Butts, J.B. and Rich, K.L., 2012. Nursing ethics, 3rd Edn, pp. 123-145, Jones Bartlett Publishers. https://books.google.co.in/books?hl=enlr=id=9R_ET0JLvEwCoi=fndpg=PR5dq=Butts,+J.B.+and+Rich,+K.L.,+2012.+Nursing+ethics.+Jones+%26+Bartlett+Publishers.ots=faDeLR8r3Csig=OKCDLdD0Tu3TUz-mEA2NfTP8Mso#v=onepageqf=false Ding, H., Moodley, Y., Kanagasingam, Y. and Karunanithi, M., 2012, August. A mobile-health system to manage chronic obstructive pulmonary disease patients at home. InEngineering in Medicine and Biology Society (EMBC), 2012 Annual International Conference of the IEEE(pp. 2178-2181). IEEE. Douglas, M.K., Rosenkoetter, M., Pacquiao, D.F., Callister, L.C., Hattar-Pollara, M., Lauderdale, J., Milstead, J., Nardi, D. and Purnell, L., 2014. Guidelines for implementing culturally competent nursing care.Journal of Transcultural Nursing,25(2), pp.109-121. Edge, J.S. and Hoffman, S.J., 2013. Empirical impact evaluation of the WHO global code of practice on the international recruitment of health personnel in Australia, Canada, UK and USA.Globalization and health,9(1), p.60. Gottlieb, L.N., 2012.Strengths-based nursing care: Health and healing for person and family, 1st Edn, pp. 234-245, Springer Publishing Company. https://books.google.co.in/books?hl=enlr=id=1qTjvNP94fwCoi=fndpg=PP1dq=strength+based+care+in+nursing+ots=y1x7szTdb0sig=BX1V-d2IdgfLXEUl7yJbB3YFqcs#v=onepageq=strength%20based%20care%20in%20nursingf=false Gottlieb, L.N., Gottlieb, B. and Shamian, J., 2012. Principles of strengths-based nursing leadership for strengths-based nursing care: A new paradigm for nursing and healthcare for the 21st century.Nursing Leadership,25(2), pp.38-50. Health Information Training Institute (2018). Smooth Patient Flow Guide. [online] Heti.nsw.gov.au. Available at: https://www.heti.nsw.gov.au/Global/ola/SPF%20Guide%205%203%202%20January%202014.pdf Knibbs, K., Underwood, J., MacDonald, M., Schoenfeld, B., Lavoie-Tremblay, M., Crea-Arsenio, M., Meagher-Stewart, D., Leeseberg Stamler, L., Blythe, J. and Ehrlich, A., 2012. Appreciative inquiry: a strength-based research approach to building Canadian public health nursing capacity.Journal of Research in Nursing,17(5), pp.484-494. Lindberg, C., Fagerstrm, C., Sivberg, B. and Willman, A., 2014. Concept analysis: patient autonomy in a caring context.Journal of advanced nursing,70(10), pp.2208-2221. Malliarou, M., Oikonomou, A., Nika, S. and Sarafis, P., 2017. Greek Military Nurses Readiness to Provide Transcultural Care to Immigrants.British Journal of Medicine Medical Research, 19 (6): 1-11, 2017; Article no. BJMMR,30615. NSW Public Hospitals (2018). Care Coordination: From Admission to Transfer of Care in NSW Public Hospitals. [online] Health.nsw.gov.au. Available at: https://www.health.nsw.gov.au/pfs/Publications/care-coordination-ref.pdf Nursing and Midwifery Board of Australia (2018). Nursing and Midwifery Board of Australia - Professional standards. [online] Nursingmidwiferyboard.gov.au. Available at: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx Purnell, L.D., 2012.Transcultural health care: A culturally competent approach, 4th Edn, pp. 342-356, FA Davis. https://books.google.co.in/books?hl=enlr=id=KdU-AAAAQBAJoi=fndpg=PR4dq=culturally+safe+nursing+cre+ots=ouK-bzdMbTsig=HjShzcuGrKGx3rIHYRiMXVEy_0c Samuels-Kalow, M.E., Stack, A.M. and Porter, S.C., 2012. Effective discharge communication in the emergency department.Annals of emergency medicine,60(2), pp.152-159. Shepperd, S., Lannin, N.A., Clemson, L.M., McCluskey, A., economics, I.D. and Barras, S.L., 2013. Discharge planning from hospital to home.Cochrane Database Syst Rev,1(1). DOI: 10.1002/14651858.CD000313.pub4 The Whiddon Group (2018). Whiddon's Community and Home Care Services. [online] Available at: https://www.whiddon.com.au/care-solutions/community-care/