CNA153: Foundations for Professional Practice - Case Study - Research Writing Assessment Answer

March 01, 2018
Author : Ashley Simons

Solution Code:  1AFII

Question: Case Study

This assignment falls under Case Study which was successfully solved by the assignment writing experts at My Assignment Services AU under assignment help through guided sessions service.

Case Study Assignment

Assignment Task

Part 1

You are working as a registered nurse in a large metropolitan hospital. The hospital has introduced the ‘EARLY SAVE’ program to reflect best practice in early recognition and response to clinical deterioration in addition to the existing Code Blue process for severe/life threatening medical emergencies. The program includes education for clinical staff, a more formalised Medical Emergency Team (MET) process, and the introduction of an Observation and Escalation Chart.

Figure 1 presents the patient outcomes following a Code Blue or MET call from data collected before the introduction of the program (Pre EARLY SAVE) and data collected over the same length of time post the introduction of the program (Post EARLY SAVE).

Case study

  1. Based on the data presented, do you think the EARLY SAVE program has been effective in improving early recognition and response to clinical deterioration in your hospital? Why/ why not?
  2. How might the data obtained pre and post the EARLY SAVE program be used by the hospital when reporting against National Safety and Quality Health Service (NSQHS) Standard 9: Recognising and responding to clinical deterioration in acute health care?

Part 2

Should family members be allowed to be present during the resuscitation of their loved one in the acute care setting? Why, or why not? Please ensure that you refer to the highest possible levels of research evidence available to justify your answer.

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Solution:

PART-A

Answer -1: The objective behind the introduction of the ‘EARLY SAVE’ program in the hospital was to detect and analyse the disease in its very early phase and initiate the treatment for that particular disease. This is considered very crucial in every type of treatment process as it provides beneficial outcomes in certain medical situations. This was in addition to the already existing Code Blue procedure, which was meant for severe/life threatening therapeutic emergency. The education of the healthcare employees was the primary objective of this program. A more professional Medical Emergency Team (MET) process, and observation and escalation charts were added to the program. The provided data is based on ‘before’ and ‘after’ the introduction of this ‘EARLY SAVE’ program. A total 520 MET calls were arranged, out of which 160 were before the introduction of the programme and 360 were arranged after the introduction of the programme.

The data provided in the given figure indicates that less than 25% deaths occurred before the introduction of this program. Detailed analysis of data has been done to get suitable results for drawing inferences. Further analysis of the data revealed that after the introduction of the ‘EARLY SAVE’ program, the causality rate decreased to 10%. Regarding data of death rate before and after the introduction of the ‘EARLY SAVE’ program, it was observed that the death count was reduced by more than double according to the given data. Before the introduction of this program, more than 30% patients were transferred to the intensive care units (ICU), which was decreased to 20% after the introduction of the ‘EARLY SAVE’ program. The patients transferred to the high dependency unit (HDU) remained the same (20%) ‘before’ as well as ‘after’ the introduction of the ‘EARLY SAVE’ program. The percentage of patients that remained in the ward was drastically increased to 50% from the 20% observed before the program.

There are several things which can be analysed from the generation of data from both the chronological directions. The data generated before and after the introduction of the ‘EARLY SAVE’ program showed marked improvement in the quality of the education as well as the service provided by the hospital staff to the patients. The effect of the improved quality can be easily seen in the data in the form of reduction in causalities and less number of patients being transferred to the ICU and HDU. This is an effective program, which helped a lot in improving the patient care process. Thus, the prime inference of the ‘EARLY SAVE’ program is centred around its usefulness in best in quality patient care process.

Answer-2: The National Safety and Quality Health Service (NSQHS) Standard were established by the Australian Commission on Safety and Quality in Health Care (ACSQHC) with inclusion of with expert technicians, experts from the health care profession and patients. The primary aim of Standard 9 was the early diagnosis of the patient’s disease. The importance of early diagnosis is immense as it contributes significantly for the cure of the patient.

National Safety and Quality Health Service (NSQHS) Standard 9 provides additional health care facilities as well as follows the chain for early detection and treatment provision for the patients. The purpose of this Standard 9 guideline is to make sure that the patient’s disease is identified in time, and a suitable response is initiated to handle the situation thus arising. The guideline has been devised to provide a clear cut response mechanism which can be applied in early stage detection of critical diseases. The Standard 9 guideline is applicable to all categories of individuals irrespective of their age. The Standard 9 is not applicable in case of worsening of an individual’s mental condition.

As per the given experimental data, the ‘EARLY SAVE’ program was functioning in the same manner by following the Standard 9 guidelines provided by the National Safety and Quality Health Service (NSQHS). After the ‘EARLY SAVE’ program, early detection of the patient’s phase and the treatment enhancement required over the current situation became possible, which was the main objective of the ‘EARLY SAVE’ program.

PART- B

Introduction: Intensive Care Unit (ICU) is a place where the families of patients deal with extreme level of tension and pressure amidst high hope. The role of every type of stakeholder is very high in such situations. Communication and positive thoughts are the two important factors for early healing of patients. The meeting of patients with the family members and friends is supported by many organizations but criticized by several healthcare experts. The possible reason behind the restriction may be the difficulties faced in ensuring hygienic conditions for the patient, who is very prone to infections due to weak immune system. Moreover, in such conditions, the overall responsibility of the patient lies with the hospital authority. Hence, the doctors and other allied professionals working in emergency & intensive care units need one dimensional attention without any disturbance.  The current study is based on the fact how the presence of relatives and friends in the ICU provide the strength to the patient for early get rid of the disease. This review is based on the collected data from the latest available literature, for key findings of the role of meeting of relatives and the patients in ICU.

The research evidence supports the presence of the family members and friends of patients: Latest study by Jacob et al conducted at the intensive care unit of the neuroscience showed that when family members were allowed to meet the patients for longer duration, the outcome showed a very familiar environment with reduced level of tension and pressure. The improvement rates of recovery get affected as per the data provided by the experts (Jacob M et al., 2016). Another study conducted by Azoulay et al. showed that time is the main factor on which improvement of the patient admitted in the intensive care unit depends. The longer the duration spent with the family during the hospitalization, more are the chances of seeing improvement in the patient’s health. It also contributes for the speedy recovery of patients by facilitating a healthy atmosphere.   The relationship is dependent on the choice as well as the fulfilment of the healthcare expert chosen by the family of the patient. Previous reports showed that meeting of the patient with his family members for an appropriate duration helps in better emotional connect of the patient, which leads to improved health of the sick person. Study conducted by Farahani et al. at different Iranian hospitals fewer than two subdivisions with information and emotional subheads. The nurses involved in the current study were advised to collect the data with honesty, with the complete details and for other, subhead nurses were advised to collect the data for guarantee and sympathy. The conclusion of that study supported that the increased level of emotional support creates a peaceful environment with the positive energy (Farhani M et al., 2014). On the other hand, the inclusion of emotional support in the patient care system provides a confidence to the family members in the future treatment proceedings. At the condition where the member of a family remains inside the intensive care unit, the other members like spouse, parents or the children’s of the patient eagerly wants to know about the exact condition of the patients with full truthfulness. This is a case of common eagerness to know more about the condition of the loved ones and prospect of recovery. On the other hand, the health care experts have faith that the reality of patients will disturb the mental stability of the rest members of the family. The concern of doctors remains due to the critical situation of the patient at the time of hospitalization as they bear the core responsibility of treatment and cure of the patient. Therefore, it is essential to implement a proper balanced approach while dealing with such conditions and productive handling of all the stakeholders in health care ecosystem.

The study conducted by Davidson et al, at the intensive care unit of the neonatal where the parents were waiting and hoping for their new borne child. The study remained without any conclusion; the further exploration was required because of the low level of the evidence support. But the study revealed that the presence of parents in the intensive care unit helps in the reduction of stress with an improved level of communication (Davidson et al., 2007).

Conclusion: Literature evidences very clearly favour the importance of emotional support in early improvement of patients. The studies with their proven data back the fact that positive surroundings because of the presence of relatives and friends assist in the early recovery of the patient. There are many factors associated with overall patient care in addition to direct medical assistance. Emotional support for the patient is one of the central factors of patient care. In addition to the family members, the healthcare professionals such as doctors, nurses, technicians and other resources can help the patient in providing an environment which has immense contribution in delivering fruitful results for the patient.

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