Vacp Bundle Case Study

VA nurses assess, provides nursing diagnoses, plans, implements, and evaluates (ADPIE) care based on maturational focused components. Undertakes accountability for the management of care concentrated on the patient’s process through the range of care, patient and family education, patient self-management, and accompanying circumstances that influence the patient’s satisfaction. The VA nurse considers all attributes of the individual, including age and stages of life, presence of health, race and culture, values, and prior experiences. Administers medications and procedures per policies and procedures. The VA nurse effects patient care outcomes by collaborating with members of the interdisciplinary team. Core fundamentals of performance include know-how and participation in the units’ program level quality improvement processes and initiatives as well as client service

Patient R.S. is a 78-year-old male with a background in accounting; his career prior to retirement 13 years ago as an accountant. R.S. was diagnosed with COPD, community acquired pneumonia, impaired gas exchange, TURP and shortness of breath. R.S. appeared to be worn out and exhausted, he was wearing the hospital gown, had a Foley catheter in, two PICC lines bilaterally in the antecubital area, air compression legs wraps bilaterally, and heart monitor and was also wearing oxygen. He was very friendly and cooperative with having to have his vitals taken, medication given, and bed bath done. R.S. spoke in a low, happy voice. Most of the time he was smiling while we were talking throughout the day, even though he was concerned with his wife having surgery and being in the hospital.

Burnout is classified viewed in three phases. The first phase of burnout is the arousal phase. The nurse shows anxiety, insomnia, forgetfulness, inability to concentrate, feelings of beings overwhelmed, frustration, sadness, and new physical symptoms, such as headaches and stomach problems. If the nurse does not recognize that these symptoms require intervention, the second phase is energy conservation. In this phase, the nurse starts to call in sick to work; o she may be chronically late getting to duty. Deadlines are not met, a cynical or resentful attitude develops, a persistent sense of fatigue pervades both are the nurse’s personal and professional’s life.

Nursing judgment refers to a clinical assessment concerning person’s response to health situations or how vulnerable the response is to individuals, household, clusters or the entire community. Clinical judgment consists of two main sections, descriptor, and attention on examination inclusive critical aspects of examinations. In some cases, exceptions are made on judgment and given in one term like anxiety, pain, and dehydration. Clinical officers should not concentrate most on diagnoses from focused challenge but to risks realized (North American Nursing Diagnosis Association, 2005).

Reflecting on the past seven weeks I have acquired countless knowledge, which I will use to further strengthen my profession as an Advanced Practice Nurse. The course allowed me to think beyond my current practice knowledge and acquired innovative ways to evaluate the situation at hand. The learning objective in program outcome four helps set standards that I will use to guide my clinical practice to meet various healthcare needs. Using the case studies has helped to further enhance my knowledge on disease physiological state, using differential diagnosis, disease manifestations, and clinical presentation. It has also taught me the skills on how to differentiate between similar diagnoses to properly identify the problem and treat the patients.

The feeling of being able to alleviate the suffering of an acutely ill patient is at once incredibly satisfying and immensely humbling. I am constantly in awe of the fact that by coming to work everyday, I have the privilege of helping others who cannot care for themselves. During my time in my Clinical Care Extender Internship, I developed a special interest in caring for the geriatric population and have had the opportunity of serving as a personal caregiver to an elderly woman with dementia. I do not take the trust and confidence that my patient places in me lightly and work hard to advocate and provide for her safety because she deserves no less. Thus, in the interest of patient advocacy, as a nurse in your facility, I will seek to improve the practices that will keep my patients safe and promote their healing. I aim to achieve this goal with the help of your institution by working hard, continually advancing my education, and using evidence-based findings to guide my

Nurses are critical for promoting health in the society. The profession is highly flexible, since they specialize in diverse operations in the medical field. Registered nurses, for instance, are responsible for the administration of medicine and inoculations to patients (American Nurses ' Association, 2000). Additionally, these professionals observe, record, and enlighten doctors of any changes in a patient’s health. Nurses interpret and evaluate diagnostic examinations to determine an individual’s condition, as well as making the necessary adjustments in patient treatment plans on their health progress. In collaboration with other medical personnel, nurses engage in the development and enactment of patient care plans. Furthermore, they provide education to families and groups on various health issues such as disease prevention, among others.

As a first year student I have very specific goals in mind that I hope to achieve through my work in college. My main hopes for the future are that I pass all of my exams in the coming years, graduate and receive my honours degree in general nursing, become a registered nurse and finally get a job as a nurse. Throughout this essay, I have detailed my strengths and the opportunities that will help me finalise these goals along with my weaknesses and the threats that will hinder my progress.

Nurses lack of education, training, and lack of comfort in providing care was also seen as another barrier to good end of life care. Lack of knowing the patience preference or wishes regarding their care and treatment also created another obstacle for end life care. To make changes to these factors one of which that was made was the effective opening of communication, both with their team and with the patience family. Related to this is the use of a family care model and family involvement in clinical decision making. Nurses ability to act on previous experiences and their ability to support one another was also recognized as a positive factor to providing quality end of life care. Although the practice of providing end-of-life care in the ICU setting is becoming more prevalent, new ICU nurses or units that do not frequently engage in end-of-life care involving the withdrawal of life-sustaining therapies may benefit from additional resources to guide them through the

Historians in the medical field such as Hippocrates and Pasture have referenced symptomologies associated with sepsis of today (Angus & Van der Poll, 2013). Sepsis received its official definition of severe sepsis and septic shock in 1992; with terminology being based on the accompanying disease processes present (Angus & Van der Poll, 2013). The definition of severe sepsis indicates the presence of organ dysfunction along with sepsis. Additionally, septic shock is related to the presence of hypotension not responding to fluid resuscitation (Cawcutt, & Peters, 2014). A diagnosis of severe sepsis or sepsis shock has an increased risk of patient mortality, length of stay, and a higher probability of long-term disability (Cawcutt & Peters, 2014; Whittaker, et al. 2015).

A root cause analysis is mandated by The Joint Commission (TJC) to be completed for every sentinel even. By doing this it allows healthcare providers to review contributing factors, establish a baseline and how to prevent future events from occurring. Root causes are identified factors within a process that can be restructured to decrease the risk of harm being repeated. (The Joint Commission, 2013) A sentinel event is defined by The Joint Commission as “unexpected occurrences involving death, or serious physical or psychological injury”. (The Joint Commission, 2013)

Mr. A is admitted to the critical care unit post bowel resection, splenectomy, acute respiratory distress syndrome (ARDS) and patient-ventilator dyssynchrony (PVD). He is an eighteen-year-old African American man who is placed on an IV infusion of Norcuron and Ativan. The major outcomes expected for Mr. A would be for him to be able to wean of the ventilator, be hemodynamically stable, heal adequately, tolerate his diet, have adequate bowel elimination, and be able to adjust to his life with optimal functioning.

The capillary nail refill test is a quick test done on the nail bed. It is used to monitor dehydration and the amount of blood flow to tissue. If there is good blood flow to the nail bed, a pink color should return in less than 2 seconds after pressure is removed.

As the patient Mr McDonald becomes closer to his expected discharge date, it is important to arrange all home care considerations before departure from the hospital. Patients who are beginning self-management at home for discharge are to be given a written plan of action, prescription medication for self-initiating in case of an acute exacerbation. The nurse should offer both written down and verbal information regarding COPD and the therapeutic recommendations that have been made by healthcare professionals. It is also important that they are in contact with their case manager for any support and to have continual monthly check ups by telephone (Sedeno, Nault, Hamd, & Bourbeau, 2009). The nurse should ensure and arrange that the supplier of the oxygen equipment regularly visit and stock up as needed. The nurse should list and specify any other healthcare providers such as a family doctor and how to reach them. Any involved health care member should be notified and the written report should be forwarded to ensure good health care.

Practicum has been a great opportunity for me to connect and integrate all the knowledge I have acquired through out this program into a more effectively clinical practice. The way I came to realize this was during one of my shifts where I was exposed to a difficult situation but thanks to my skills I was able to proceed in a safety manner. The purpose of this journal entry is to describe how my intervention made a difference in the client outcome and a brief explanation of the competencies and skills used.