Vital Signs Assessment

Reflect upon the clinical problem that you have identified in your area of nursing practice (as identified in Module 1). Critically appraise the research and summarize the knowledge available on the clinical problem.

This allowed staff to become an emotional and in some ways spiritual support for patient. Patient did not desire religious spiritual leader, because he is agnostic. Also, by providing staff that knew that patient’s non-verbal cues this helped increase communication between staff and patient.

I will ensure my growth towards these competency areas by seeking consultation from more experienced colleagues when clinical data do not support my working diagnoses. To ensure safe clinical outcomes, I will act on the clinical intuition that I developed as an ICU nurse to rule out worst case scenarios, refine my 12-lead electrocardiogram interpretation skills as a bedside nurse, listen carefully to patients while charting accurately on electronic health records, and remaining cognizant of time pressures and increased susceptibility to errors in these situations. To proactively prevent future ethical dilemmas, I plan to address end-of-life directives with all appropriate patients in a sensitive manner while in the primary care setting.

Quality improvement efforts and risk management are complementary, and together are key modules of clinical governance. Risk management reinforces quality management in healthcare. This leads to:

Bedside reporting has been shown to improve communication and quality of handoff between nurses. It is also credited to promote patient safety and improve patient satisfaction. Patient satisfaction, patient safety and nursing communication and quality of report from a 32 bed surgical hospital in Dallas, Texas is to be evaluated using various surveys, HCAHPS scores, incident reports, and call light logs. Data will be collected 2 months prior and 6 months following the implementation of bedside report. Scores and communication survey results will be reviewed in this time period to determine increases or decreases from pre-implementation results using traditional nurse-to-nurse report.. The projected goals and outcomes of this project are to increase quality of report, increase patient safety and increase patient satisfaction.

During conscious sedation respiratory therapy should have been notified and standing by, as well as evaluating the patient post sedation. They should have been notified of the low oxygen levels.

Understanding respiratory volumes, capacities, and measurements will help me perform my job as a medical assistant because they are significant being a medical assistant. First of all, when the patient is on the bed, I will measure the respiratory rate while he/she is at relaxation. In the next, I will observe the rise and fall of the victim 's chest and count the number of respirations for one full minute. Then, I will record the current time, respiratory rate and respiratory characteristics. Spirometry is used diagnose conditions that affect breathing such as asthma, pulmonary fibrosis, and cystic fibrosis. Spirometry is used periodically to assess whether breathing problems are under control and how well your medications are working. A nebulizer

Nursing consideration: Require regular monitoring of activated partial thromboplasitn time (aPTT) and needed frequent heparin dose changes (Brunner and Suddarth’s, et al, 2010: 765).

The Institute of Medicine (IOM) published a report in 2000 that estimated there were around 100,000 deaths each year in American hospitals from medical errors. IOM results were mostly based on errors of comission. In ICUs, the errors of omission are much larger as compared to the errors of commission. The number of patients dying becomes even higher if these errors are included. The follow-up report by IOM in 2001, provided a direction towards the need for making the basic changes in the health care delivery. The most important message from the new report was that the results will improve only if the new technology and methods of care are introduced in the healthcare

The Joint Commission on Accreditation of Healthcare Organization (JCAHO) National Quality Safety goals stresses the standard of palliative care provided to patients and families using an interdisciplinary approach. JACHO added pain assessment and symptom management standards making pain the fifth vital sign in an effort to improve the standards of care. The Joint Commission has encouraged all staff to seek education, experience and certification in palliative care. In addition the Joint Commission states that the NCP Clinical Practice Guidelines for Quality Palliative Care originated from evidence based national guidelines which are used to deliver care including physical and psychological interventions, focus on imminent death, taking into

The physician has written discharge order for Rudd. Rudd`s son, Matthew is also at the bedside, waiting for the nurse to bring the discharge paperwork. Rudd`s blood work and X-ray, CT scan results do not show any signs of organ damage. The assigned RN checked vital signs before discharge. The vitals are as follows: Temperature: 97.20F, Heart rate: 70 beats per minute, BP: 130/76 mmHg, respiration: 18breaths per minute, and Pulse oximetry: 98% on room air. Rudd reports no pain on pain assessment using PQRST pain assessment method. Rudd is looking very happy to go back home. The nurse brings the discharge paperwork, educational booklet and discharge medication reconciliation form. The nurse also calls the hospital pharmacy and gets the one month supply of Rudd`s medications as per discharge medication reconciliation orders.

The RN would first review the goals and outcomes of the patient care plan. The next step would be to collect Reassessment Data, " Assess the client response to the interventions."(pg. 128 Treas, Wilkinson) in which include vitals, auscultation of breath sounds, observation of activity, and asking the patient how they are feeling and family for observation. The RN would record the evaluation summary in the nursing note or care plan about the conclusion whether the outcome was achieved and the reassessment data supports the judgment. In order to revise a care plan, an RN must " review all the steps of the nursing process."(pg. 130 Treas, Wilkinson).

Opioids are a category of pain medications that reduce the stimulus of pain signals sent from the brain. Within this category are medications such as hydrocodone, oxycodone, morphine, codeine, and other similar drugs. These medications are used to treat mild to severe pain depending on dosages and type of opioid given. With the reduced perception of pain also comes a plethora of unpleasant symptoms such as drowsiness, mental confusion, nausea, constipation, and, depending upon the amount of drug taken, can depress respiration. However, many experience a euphoric experience after administration that drives them to abuse opioids. This abuse leads to addiction or overdose which

The patient is reported to have shortness of breath from initial handover between emergency department nurse to ward nurse. With the patient’s history of a chronic obstructive pulmonary disease, their level of consciousness should have been observed frequently to classify the patient had not undergone hypoxia and hypercapnia. Furthermore, evidence between two nurses from the time of 0300 hours to 0500 hours, did not comply. As the attending nurse had said she left at 0300 hours and returned at 0500 hours, the nurse left on standby said the attending nurse had, indeed, made an appearance within that time (HCCC v Jarrett, 2013, 116, 118-121).

This paper includes a discussion and analysis of nursing sensitive indicators (NSI) and system specific resources. Identification of indicators and interventions could improve the care that was received by Mr. J., a 72 year old retired rabbi with mild dementia that was admitted for a fractured right hip after falling at home. In the course of his stay and treatment there were a few indicators of issues/problems regarding the care he received during his stay. These issues/problems might affected his healthcare outcome, safety and satisfaction with his stay at the