Nursing Case Analysis Paper

b. Restraints should be used as a last resort on patients that are at a high risk for hurting either themselves or others. If this particular hospital is found to be overusing their restraints, they should look into why this is happening and where it is happening most often. What is the patient to staff ratio? Are acuities being considered when staffing the unit? If restraints are being overused, maybe a shortage of staff could be to blame.

A solid understanding of nursing-sensitive indicators can assist the nurses in the case of Mr. J in identifying issues that may interfere with patient care. Knowledge of appropriate restraint use, as well as the care involved while caring for a patient in

Data can be collected on multiple ways, from the point of medical care and patient satisfaction. The scenario points to pressure ulcers and the use of restraints, in both situations I believe that there was a fundamental lack of knowledge by the staff and disconnect by management.

The staff could also have done something different so as not to have to use restraints on the patient. A sitter could possible have been

Nursing Sensitive Indicators The Nursing Sensitive Indicators found in this scenario are patient satisfaction with nursing care, patient satisfaction with overall care, and pressure ulcers. If the staff were to have an understanding of what Nursing Sensitive Indicators are, this can assist them to identify issues that may have interfered with Mr. J’s patient care. The nursing staff should have had the proper knowledge of restraint use, like assessing the patient every two hours to see if restraints are even appropriate, assessing the patient’s vitals, circulatory status, and skin integrity (Joint Commission, 2010), removing and repositioning the restraints every two hours, repositioning the patient every two hours, and offering Mr J frequent bathroom breaks and sips of water. In this scenario it is reported that Mr J has a spot on his back that is red, as a nurse this is an indicator of a

As a nurse, I would prioritize by who is at risk for an emergent situation. I would prioritize the following:

Restraint prevalence is one of the core outcome indicators. Because Mr. J was lying on his back in restraints, he was starting to have skin breakdown on his bony prominences which would lead to pressure ulcers. He may have had another fall when the restraints were removed due to weakness. He could develop hospital acquired pneumonia, due to lying still in his bed. If Mr. J did in fact develop any of these unfortunate consequences from restraints, all these would extend his stay or have the need for a readmission, with the outcome making his stay costly and not at all satisfying for himself, and his family

Discuss how an understanding of nursing-sensitive indicators could assist the nurses in this case in identifying issues that may interfere with patient care.

Rosa exhibits personality traits such as neuroticism, carelessness and introversion. Throughout her treatment, Rosa expressed that she experienced poor care from the health staff and became hostile and aggressive towards staff. Rosa also communicated that she had anxiousness towards the pain caused by her hip surgery and further aggravations of her injury that may have occurred due to movement or rehabilitation. From these instances Rosa displayed neurotic tendencies. Additionally, these tendencies may have caused Rosa to have lowered conscientiousness and openness to experiences in regards to health outcomes and rehabilitation. Throughout the case it is documented that Rosa was reluctant to engage with suggested health recommendations

Upon review of this case study, it became paramount to differentiate between the diagnosis of the fall. The plan of care was dependant on the evaluation from the history and physical exam. The history of present illness needed to extract enough information to determine the cause of the fall as this would guide the treatment. The timing of the fall, the loss of consciousness would give clues to differentiate between a fall that was related to intrinsic or extrinsic. Secondarily, identifying and learning more related to community resources was critical. I was unaware of services available to help patients with dementia in the sorrowing tri-city area. Thirdly, I was able to recognize how essential it is to integrate the family in the plan and to offer support to them. The daughter, in this case, was the sole caretaker and resources were made available to her.

For nurses, the workload and patient assignments are the most significant factors in their perception of their ability to provide quality care to their patients. Of course, this is directly related to nursing job satisfaction. Nursing is a career in which patient satisfaction and caregiver satisfaction go hand in hand. When the nurse is happy, he or she provides high quality care to the patient, which in turn makes the patient happy. In addition, when the patient is pleased with the care they are receiving, this makes the nurse happy and improves nurse job satisfaction.

The three areas of the tutorial I notice that I am confident in is the Case Studies tutorial on the Drill 1 tutorial explains the when Mary asked Mr. Hernandez questions about his chest pains. The important values for here determined was duration, the location of pain, and intensity. Mary asked about the duration of pain as well as the location, and intensity. By asking these questions she was able to provide information to assist the physical in determining the cause of Mr. Hernandez’s pain and what potential further test may be necessary. In the chest pains tutorial clip, it showed Mary checking his blood pressure and noticing it being low and asking Mr. Hernandez a few questions such as do you feel light headed or dizziness? He indicated that he feels tired, light headed, and he had a difficult time getting from the parking lot to the office today, he feels pain on his chest, he informed that he had a big lunch, so he assumed it was just gas bubbles, when he finished talking she asked David that he feels pain on his chest, he said that it was not a big deal and that it was just a little gas, and then she asked when did it start? He said right after lunch. She wanted to confirm the type of pains he was having, such as stabbing, throbbing, or burning? He confirmed he was feeling pressure in the middle of his chest; she asked if he can rate his pain to 0 being no pain

Reginald is an octogenarian with multiple health issues. He is living in a regional NSW town and was recently widowed. He has a son who is not geographically close and his daughter, who does live nearby, has heavily laded family commitments. The community registered nurse visits three times per week to dress an ulcer on Reg’s leg. This report will focus on how to keep Reg living with assisted independence by becoming and staying healthy and promoting safety.

Mr. W is a seventy-three-year-old man with history of a heart attack which was followed by a severe stroke that left him with right sided paralyses. He needs assistance with activities of daily living. Mr. W’s wife has multiple medical problems of her own. One is of which she is a diabetic and has difficulty walking due to multiple toe amputations. She can only provide a limited amount of care and gets tired easily and quickly. He has a daughter that lives in close proximity, but works full-time and has a family of her own to take care of. She has exhausted her vacation time and does not want to lose her job. She loves her father and is not ready to lose him.

Mary Allison, a nurse at the Mayo Clinic in Rochester, MN. In fact Mary has been an RN for over 25 years, throughout this time she has been able to work in a variety of health care setting, from the hospital setting to outpatient care areas and as well as being able to perform lumbar punctures in the outpatient setting, this is where Mary and I became friends. Mary has been an inspiration and role model for many that have met her and has graciously volunteered for this interview.