NSB334 - The National Safety and Quality Health Service (NSQHS) & Mr Driscoll Case Study - Nursing Assignment Help

Assignment Task -                 
 

Task 1 - Scenarios.

Choose one (1) of the following scenarios and develop your response, utilizing the task booklet information and CRA for full instructions.

Address your responses from the Registered Nurse perspective involved in the patient(s) care. This task requires you to understand the for nurses and midwives, and the appropriate The National Safety and Quality Health Service (NSQHS)   (NSQHS) applied to the clinical situation as well as applied knowledge of the patient’s presenting condition.  

Review the CRA carefully for expectations in your response.

Scenario 1: 

Mr Driscoll is a 37-year-old male with diabetes who has been in the surgical unit for a laparoscopic cholecystectomy following gastric pain. Some of his wounds are reddened and he has been ordered a 48-hour course of IV antibiotics. He is morbidly obese with a BMI of 48.  Postoperatively he complains about persistent heartburn and asks you (the allocated registered nurse) to help him sit up. You seek some help from another registered nurse, Rae, who comes into the room and is very impatient with Mr. Driscoll and tells him to use the overhead frame to pull himself up saying  “ we can’t help you as we might hurt our backs”.

As she leaves the room, she calls you to the door and tells you that “it is ridiculous he would even ask for help as he is so large, he should know we can’t help him”. She adds ‘patients like him have caused their own problems’. You are not sure that he has heard this conversation, but when you go back into the room, he is very quiet and tells you to ring his wife as he is going home. Mr. Driscoll is only day 1 post-operative and is not medically cleared for discharge.

Answer the following questions from a Registered Nurse's perspective.

1. Briefly discuss some of the challenges in nursing bariatric patients and outline the extent of obesity in the Australian acute health care context. 

2. Identify the issues here and briefly explain your responsibilities in the provision of care for Mr. Driscoll relating to applicable NMBA Standards of Practice and  The National Safety and Quality Health Service (NSQHS)   (

3. Identify the specific NNBA Professional Standards and National Safety and Quality Health Service (NSQHS)  (not met by Rae’s practice in the scenario and discuss acceptable professional practice and provision of care in relation to this case. 

4. How would you approach your colleague the other Registered Nurse, Rae, and what actions are relevant given her responses in the scenario? Consider the patient's needs and perspective clearly. 

Scenario 2

Mrs. Esther White is 68 and has had a laparotomy and partial colectomy to treat diverticulitis 2 days ago. She is still nil by mouth due to severe nausea and frequent vomiting and reduced bowel sounds. Her indwelling urinary catheter has not yet been removed, she is on intravenous fluids running at a 12/24 rate and her post-operative wound is still intact. She has a history of depression, mild heart failure, hypertension, and stage one chronic kidney disease (CKD).

She resides with her husband at home and they do not currently require any supports or assistance. She is one day post-operative and her husband, Josef, has told you (the registered Nurse) that Esther seems really off and is confused, and seems not to know him this afternoon. He asks you what is going on and has she got dementia? As you go over to speak with Esther, she appears quite agitated and you have to intervene as she is trying to get out of bed but is quite unsteady and seems unsafe.

She denies having any pain and does not appear to be in pain. Joseph says he is going home as it upsets him to see her like this. You ask him when he will return and he says he thinks he’ll leave it a few days as she’s not seeming that happy to see him and isn’t doing anything he asks her to do. After he leaves, Mrs. White pulls her IV out and resists having it resited.

Answer the following questions from a Registered Nurse's perspective.

1. Identify and briefly discuss the problems in the scenario and outline the evidence-based assessment and nursing care that is required?

2. Briefly explain what information and advice are appropriate for the Registered Nurse to give to Joseph? 

3. Identify the specific relevance to this scenario and link it to your role as a Registered Nurse.

4. What are your responsibilities with regard to ensuring Mrs. White receives appropriate care, the risk is managed, and relevant follow-up care is given? 

 Scenario 3

Becky is a 19-year-old mother of Ethan who is 8 months old. Ethan has been admitted with bronchiolitis and has been very unwell for 3 days. He is recovering now and is weaning off oxygen currently delivered by nasal prongs at 0.5 liters/minute.

Becky stays with Ethan and is a very attentive mother and shows appropriate nurturing care. Ethan’s development is normal for age. He settles with a bottle for his afternoon nap and Becky asks you to add chocolate milk to the bottle. You start to explain to Becky why this is not a good idea and she gets verbally aggressive saying  “leave me alone,  this is my child and I am sick of you do gooders telling me what to do; its not you who have to get him to sleep and cope on your own”.

Becky is also very interested in the other patients and asks you questions about them and their parents when they are not in the room. She comments on another child in the opposite bed saying “His mother hardly visits, I do not understand how a mother could leave such a young child”.

Becky asks you what shift you are on tomorrow and when you tell her you are on the evening shift she asks you to collect some small grocery items on your way to work as she does not want to leave Ethan. She tells you she will give you the money tomorrow. You enter the patient lounge and find Becky eating another mother’s pre-packaged food. You have noticed that Becky and Ethan do not have any visitors. 

Answer the following questions from a Registered Nurse's perspective.

1. Discuss briefly some of the challenges in providing nursing care to a young woman like Becky and her child Ethan.  

2. Consider relevant literature and relevant Briefly outline the issues in this scenario.

3.  Discuss your responsibilities and how you will manage this situation and provide patient-centered care complying with the NSQHS Standards to ensure Becky and her son receive appropriate care. If you consider referral to others, you will need to be very specific about their role.

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