• Subject Name : Nursing

Nursing Competency Standards in Primary Health Care

Healthcare system across the globe strives on the foundational grounds of striving and improving the quality of care provided to the patients. Healthcare systems provide an evidence-based approach model that helps in defining the best possible healthcare solutions for the patients in their best interest. Standards of health in quality care provision not only help the patients but also influence upon the economic performance and overall quality of life (Budrionis 2016, pp. 87-92). Quality care management should be the prime focus of any healthcare organization as it helps largely in protecting the patients against any harm. These standards apart from governing patient care help in formulating better and advanced methods of care to be used for the benefit for the patients, in sync with the rules and regulations of the working of the medical system. These healthcare standards help in realising an organizational philosophy, vision and strategies to be formulated, promoting the best interest of the patient (Halcomb 2016, pp. 1193-1205). These standards are an integral part of the system to ensure that the requirements are met. It also helps as a driving force in ensuring constantly improving functioning of the system to severe the customers for their specific healthcare needs and requirements. There are eight healthcare standards dictated under National Safety and Quality Health Services Standards (NSHQS, 2020). However, in the given case study the prime focus will be highlighted on 8th principle of recognising and responding to acute deterioration of the patient.

The role of nurse can be observed as the most vital in the process of patient care and management. They are not only responsible for providing care to the patients, but also play the role of ensuring their safety during delivering healthcare solutions to them. Patient safety can be a multi-directional approach including medication error prevention, protection of patient from any harm or injury and enabling solution through team collaboration (Andersson 2017, pp. 204-210). They can also safeguard any patient from harm by making use of their expertise in noting for any abnormal clinical signs, reflected by the patient, so that timely and adequate clinical management can be provided to the patient. Nurse can help in various manners to ensure that a continuity of care is provided to the patient along with the safety measures ensured in place. Some of the duties of nurses that can ensure the same include, conducting rounds on patient safety, creating a sound and robust reporting system which helps in charting all important turn of events, by involving patient in the safety promotion and by properly documenting the events in a chronological manner. Communication between the team members is also deemed to be quite crucial, making sure that safety measures and set protocols are followed religiously and aiming mainly at promoting advanced and improved patient care and coordination.

The Nursing and Midwifery Board of Australia (NMBA) helps the nursing professionals in making sound clinical decision-making which in the best interest of the patient and helps in promoting overall health and quality of care. These are based on set guidelines and code of conduct that help in providing clinical judgement, by detecting the faults and finding remedies for the same (NMBA, 2017). These guidelines also ensure safe clinical practice as per the defined regulatory standards and thus, help in promoting overall clinical governance and competence. Communication in nursing care makes up for an integral part of the system that helps in ensuring safe clinical practice. Communication can be either verbal or in a documented format that helps in collecting important clinical clues and information pertaining to the patient.

In the given case study not only, there was a lack of communication between the team members but also safe standards of care were not provided to the patient. The team members and the doctors assigned in in patient care, failed to recognize the abnormal signs and symptoms reflected by the patient. This led to deterioration in the patient condition and eventually led to her death. Monitoring the patient is one of the main factors by which not only keen observation can be made but the required care can be managed within the estimated time frame. Despite having a necessity of monitoring the clinical signs of the patient, for a longer duration the patient was left un-noticed and un-observed. There was also a lack of clinical judgement on the part of doctors, to admit the patient prior for the surgical procedure, rather than waiting for her symptoms to subside (Ghahramanian 2017, pp. 168). The obvious signs of deterioration of patient’s condition were neglected and were not even diagnosed with apt methodology. There was also confusion amongst the nursing staff as to what care plan was to be administered for the patient. As per NSHQS standards of care, the clinicians are supposed to detect acute physiological deterioration for the patient. This should include dully noting vital signs, monitoring patients on an hourly basis and keeping a close track on the progress of the patient’s health (NSHQS, 2020). However, for a crucial and evident time-frame the patient was noted for any clinical observation to be noted as per physiological changes in the patient. It also requires patient care by recognising acute signs of deterioration to acknowledge for the early warning signs which should have been duly noted in this case. This is also essential for deciding the required standard of care needed to manage the patient. Documentation and communicating the clinical changes in the patients define the course of treatment and the probability of fetching improved healthcare outcomes from the patient (Burgener 2020, pp. 128-132). Due to lack of acknowledging the indicators the nursing care staff failed to call in for emergency care within the stipulated time frame and this eventually led to patient’s death.

References for Judith McNaught Case Study

Andersson, F. and Hjelm, K., 2017. Patient safety in nursing homes in Sweden: Nurses’ views on safety and their role. Journal of Health Services Research & Policy22(4), pp.204-210. https://doi.org/10.1177%2F1355819617691070

 Australian Commission on Safety and Quality in Healthcare, NSHQS, 2020. Retrieved from https://www.safetyandquality.gov.au/sites/default/files/migrated/National-Safety-and-Quality-Health-Service-Standards-second-edition.pdf

Budrionis, A. and Bellika, J.G., 2016. The learning healthcare system: Where are we now? A systematic review. Journal of Biomedical Informatics64, pp.87-92. https://doi.org/10.1016/j.jbi.2016.09.018

Burgener, A.M., 2020. Enhancing communication to improve patient safety and to increase patient satisfaction. The Health Care Manager39(3), pp.128-132. https://doi.org/10.1097/HCM.0000000000000298

Ghahramanian, A., Rezaei, T., Abdullahzadeh, F., Sheikhalipour, Z. and Dianat, I., 2017. Quality of healthcare services and its relationship with patient safety culture and nurse-physician professional communication. Health Promotion Perspectives7(3), p.168. https://dx.doi.org/10.15171%2Fhpp.2017.30

Halcomb, E., Stephens, M., Bryce, J., Foley, E. and Ashley, C., 2016. Nursing competency standards in primary health care: An integrative review. Journal of Clinical Nursing25(9-10), pp.1193-1205. https://doi.org/10.1111/jocn.13224

Nursing and Midwifery Board (NMBA), 2017. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

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