analyse the simulation and undertake a holistic understanding of the situation drawing on prior knowledge and skills. In this simulation you will be expected to use and understand the requirements for integrated knowledge and skills, including communication, collaboration, leadership, ethical and culturally safe approaches to healthcare, and interprofessional collaboration. Once you have completed the simulation, you will be required to complete the National Health Priority module on Cancer Control, search the literature for further information and complete the case-based scenario workbook questions. What you need to do: 1. Review the knowledge and skills relating to the National Health Priorities of Cancer. 2. Attend the NSB334 Case Based Simulation Scenario 3. Complete the on-line module for this National Health Priority 4. Complete the NSB334 Assessment Task 1 Workbook on the case scenario of Mr. Dwight and answer all questions. Each answer must be justified and referenced appropriately. Length: Maximum word count of 2000 words (including in text references, and excluding reference list). Estimated time to complete task: Approximately 20 hours. Weighting: Satisfactory (>=50%) or Unsatisfactory (<50%) How will I be assessed: Your responses will be assessed according to clinical content, evidence of critical thinking, adequate standard of academic writing and referencing formatting and quality of sources used. Due date: Week 7 Friday 4th January 2019 submitted via Turnitin in your NSB334 Blackboard site by 11:59pm More information about Turnitin is available on the FAQs about Turnitin page. Presentation requirements: This assessment task must: Use the NSB334 Assessment Task 1 workbook to answer the questions related to the simulation. Use the template provided on Blackboard under the assessment item (includes cover sheet). Formatting should be as outlined below. Workbook questions do not need to be rewritten; just number your responses. Final submission should be submitted in PDF format. Use at least seven (7) valid contemporary peer reviewed journal articles with the addition of text books as appropriate Any responses that are not referenced to academic sources will receive a mark of zero (0). Use APA referencing for citing academic literature (see https://www.citewrite.qut.edu.au/) Be submitted in electronic format as a PDF document via Turnitin. It should also be formatted with the following: Include a footer on each page with your name, student number, unit code and page number. 3 cm margins on all sides, double-spaced text Times new roman, font size 12 Learning outcomes assessed: 1. Demonstrate evidence-based practice, clinical reasoning and decision-making to provide culturally safe, quality, person-centred care consistent with the NMBA Registered Nurse Standards of Practice and the National Safety and Quality Health Service Standards. 3. Coordinate and lead provision of care for consumers, families, and the broader community. What you need to submit: You must submit one PDF document that contains the following items: 1. Use the template provided on Blackboard under the assessment item (includes cover sheet). 2. Workbook questions do not need to be rewritten but clearly identify your responses 3. Include a reference list at the end of your responses. 4. Final submission should be submitted in PDF format via Turnitin. Resources needed to complete task: A minimum of 10 academic sources can be used. You will need to use at least seven (7) valid, contemporary peer reviewed journal articles no older than seven (7) years as supporting evidence. In addition, you could use: Textbooks (maximum of four text books, and no older than five (5) years old Guidelines for health professionals that are peer reviewed, Authoritative websites and government websites such as NHMRC, NSQHC Organisation resources intended for health professionals. You may also refer to: QUT Cite|Write APA guide. Turnitin Tip Sheets. Academic Integrity The School of Nursing takes academic integrity very seriously. All work submitted must be your own work and work not previously submitted for other study. The work of others needs to be correctly acknowledged and referenced according to the APA guidelines. There are serious consequences that will be imposed should you be found to breach academic integrity. Make sure you are familiar with the MOPP C/5.3 Academic Integrity and view the Academic Integrity video and explore the Academic Case Studies available on your Blackboard site. Maintaining academic integrity is your responsibility. If in doubt, check it carefully. NSB334 Assessment Task 1 Page 2 of 5 NSB334 Integrated Nursing Practice 4 NSB334 Collaborative Practice Simulation Workbook / Assessment 1 Rubric Learning outcomes assessed: 1 & 3 This workbook will be marked in written exam format. Each question is weighted with marks for the response and justification. Marks for academic writing and referencing will also be awarded as per the marking rubric. 5 marks Excellent 4 marks Good 3 marks Satisfactory 2 marks Limited 1 mark Unsatisfactory 0 marks Academic Writing High level of academic writing Correct terminology and professional language Skillful use of language that conveys meaning with clarity and fluency. No errors in tense, spelling, punctuation, or grammar Good level of academic writing Generally, uses Correct terminology and professional language Uses language that effectively conveys meaning with clarity and fluency. Minimal errors (2-4) in tense, spelling, punctuation, or grammar Satisfactory level of academic writing Uses correct terminology and professional language for some of the workbook Uses straightforward language that generally conveys meaning. Occasional errors in tense, spelling, punctuation, or grammar that reduce readability. Limited level of academic writing Incorrect terminology and professional language frequently throughout the workbook Language used means it is frequently difficult to determine meaning Frequent errors in tense, spelling, punctuation, or grammar that reduce readability Unsatisfactory level of academic writing Uses incorrect terminology and professional language throughout the workbook Uses language that often does not convey meaning or is difficult to determine meaning. Frequent errors in tense, spelling, punctuation, or grammar that interfere with effective communication. Serious problems with mechanics of language No submission Referencing All aspects of APA referencing are technically correct in reference list and in-text referencing. High level of academic sources used Minimum of 10 peer reviewed journals accessed in addition to other sources to support work. Most aspects of APA referencing are technically correct in reference list and in-text referencing. Generally high level of academic sources used 8-10 peer reviewed journals accessed in addition to other sources to support work. Infrequent errors in APA referencing in reference list and/or in-text referencing. Mostly academic sources used with some non-academic sources Some peer reviewed journals accessed in addition to other sources to support work. Frequent errors consistent in APA referencing in reference list and/or in-text referencing. Mostly non-academic academic sources used Limited number of peer reviewed journals accessed in addition to other sources to support work. Serous issues with referencing in reference list and/or in-text referencing Has not used APA referencing Has used all non-academic sources to support work AND/OR Very limited number of peer reviewed journals accessed in addition to other sources to support work. Absent referencing No evidence of use of sources to support work ? Satisfactorily complied with the Academic Integrity standards outlined in the MOPP C/5.3 Academic Integrity. NSB334 - Assessment 1 NSB334 Integrated Nursing Practice 4 Mr. Dwight Simulation Setting the scene Refer to your simulation documents Epidemiology / pathophysiology of disease processes The National Health Priority Area of Cancer Control was established with the aim of improving health outcomes in this area. The most common diagnoses for cancer in men are prostate (1 in 5 males), colorectal (1 in 11 males), melanoma of the skin (1 in 13 males) and lung (1 in 13 males). For women, the most common diagnoses are breast (1 in 8 females), colorectal (1 in 16 females), melanoma of the skin (1 in 23 females) and lung (1 in 22 females). Cancer screening programs have been large public health initiatives in this area aimed at reducing illness and death resulting from cancer through an organised approach to screening. It would be of benefit for you to research the three cancer screening programs of Breast Screen Australia, National Cervical Screening Program and the National Bowel Cancer Screening Program to understand the importance of these programs and the benefits obtained. The World Health Organisation defines palliative care as: An approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. Your own values and beliefs about death and dying may impact on your interactions with a dying person, reflect on your own self-awareness as an important strategy in palliative care nursing. WORK BOOK QUESTIONS 1. Review patients background and history. Mr. Dwight had a history of bowel cancer. Identify (2) signs and symptoms that support the diagnosis of bowel cancer. Discuss how these signs and symptoms support the diagnosis? Justify your response with evidence. (4 marks) 2. Mr. Dwight has had a Hartmanns procedure with the formation of a colostomy. Discuss the anatomy and physiology of the procedure and why it was necessary. (3 marks) 3. Identify and justify two (2) risk factors that may have contributed to Mr. Dwights diagnosis of bowel cancer? (4 marks) 4. Mr. Dwight had a colostomy. List four (4) signs of a bowel obstruction? (2 marks) 5. Mr. Dwights BGL on admission to the ED is 22mmol. State the normal BGL levels for adults. Discuss one (1) intervention in detail that address his BGL level. Justify your answer. (3 marks) 6. Mr. Dwight might require a blood transfusion. a. Discuss the clinical use of blood and blood products for patients with a diagnosis of bowel cancer. (1 mark) b. Review Standard 7 of the NSQHS. Using the standard and relevant literature, list four (4) actions required of the registered nurse to ensure safety when managing and administering blood products. (2 marks) 7. Review and recall your knowledge on nasogastric tubes. a. Provide a rationale why Mr. Dwight required a nasogastric tube inserted? (2 marks) b. What routine checks are required and how should these checks be completed? Justify your answer. (2 marks) Choose ONE of the following sections. Provide responses to either questions 8-12 or 13-17. Questions directly related to Mr. Dwights Acute Admission in Emergency Department 8. Effective and accurate clinical assessment skills are imperative for the nurse working with Mr. Dwight at all times. Identify and discuss (1) clinical priority for Mr. Dwight during his admission to the emergency department. Justify the priority with evidence. (3 marks) 9. From the identified clinical priority in the emergency department, state one (1) short term goal for Mr. Dwights management using the SMART framework. (2 marks) 10. Based on the short-term goal, state and describe (2) interventions (nursing, collaborative or pharmacological) which would assist to achieve Mr. Dwight's short-term goal. (4 marks) 11. Provide and justify two (2) methods of how you would evaluate the outcomes. (4 marks) 12. Review Standard 3 of the NSQHS. Identify and discuss (2) risk factors for patients like Mr. Dwight who are undergoing chemotherapy that puts them at higher risk of a hospital acquired infection. Justify each risk with evidence. (4 marks) Questions directly related to Mr. Dwights Palliative Care Consultation 13. Effective and accurate clinical assessment skills are imperative for the nurse working with Mr. Dwight at all times. Identify and discuss (1) clinical priority for Mr. Dwight during his palliative care consultation. Justify the priority with evidence. (3 marks) 14. From the identified clinical priority in the palliative care consultation, state one (1) short term goal for Mr. Dwights management using the SMART framework. (2 marks) 15. Based on the short-term goal, state and describe (2) interventions (nursing, collaborative or pharmacological) which would assist to achieve Mr. Dwight's short-term goal. (4 marks) 16. Provide and justify two (2) methods of how you would evaluate the outcomes. (4 marks) 17. Review Standard 5 of the NSQHS. For Mr. Dwight, identify two (2) interdisciplinary team members or teams who potentially would be involved to deliver comprehensive care. Justify their involvement in Mr. Dwights care demonstrating understanding of that health discipline role in relation to palliative care. (4 marks) Marks allocated as per marking rubric in task assessment booklet All answers should be justified and referenced appropriately (5 marks). All answers should be written in academic format (5 marks). Medical records Welcome to the Clinical Simulation Click on the tabs to learn more about the Clinical Simulation and the story of Mr Thomas Dwight. Welcome to the Clinical Simulation Welcome to this Clinical Simulation Learning Experience! It is designed to help you, as a third year student, begin to integrate concepts and principles that are needed for practice as a beginning-level nurse in various clinical settings. The first hour of this simulation will involve a scenario in an Emergency Department within a tertiary hospital facility, however it could apply to nursing practice in other settings as well, . rural/remote health care facility, an acute care hospital ward, an aged care facility. We hope you enjoy this learning experience and use it to build on your knowledge and skill base for practice. Welcome to the Clinical Simulation Simulation Learning Outcomes The Simulation Experience Preparation for Simulation Handover Medical records Welcome to the Clinical Simulation Click on the tabs to learn more about the Clinical Simulation and the story of Mr Thomas Dwight. Simulation Learning Outcomes To successfully complete this simulation you should be able to: to rapidly changing nursing actions work effectively as a team member in providing care effectively as part of a health care team. The simulation will require you to: factors that can facilitate/impede appropriate responses when a patients condition is rapidly changing and discuss a framework/s for prioritising nursing actions factors that can facilitate/impede effective communication between team members. You need to be able to demonstrate/describe the: a process for recognising and interpreting rapidly changing patient situations a framework for prioritising nursing actions principles related to effective teamwork. Simulation Learning Outcomes Broad Capabilities Specific learning goals Critical elements Loading Simulation Learning Outcomes The Simulation Experience Preparation for Simulation Handover Medical records Welcome to the Clinical Simulation Click on the tabs to learn more about the Clinical Simulation and the story of Mr Thomas Dwight. The Simulation Experience The Simulation Experience The following video provides specific details on the expectations of students and how the simulation will be conducted on the day. This is essential viewing for the simulation. Simulation Learning Outcomes The Simulation Experience Preparation for Simulation Handover Medical records Welcome to the Clinical Simulation Click on the tabs to learn more about the Clinical Simulation and the story of Mr Thomas Dwight. Preparation for Simulation Preparation for Simulation care implications regarding: complications of diabetes mellitus: hyperglycaemia and diabetic ketoacidosis obstruction failure. for prioritising nursing actions for effective teamwork in rapidly changing situations. Knowledge and skills regarding: assessment sign monitoring reduction tube insertion/management and insulin infusion management reasoning and decision-making. Knowledge-based competencies Skill-based competencies View Page 2: Preparation for Simulation Loading Simulation Learning Outcomes The Simulation Experience Preparation for Simulation Handover Medical records Welcome to the Clinical Simulation Click on the tabs to learn more about the Clinical Simulation and the story of Mr Thomas Dwight. Preparation for Simulation Preparation for Simulation Watt, E. (2017). Maintaining bowel elimination. In J. Crisp, C. Douglas, G. Rebeiro and D. Waters (Eds.), Potter & Perrys Fundamentals of Nursing (5th ed.). (Chapter 32). Sydney: Mosby. Schmelzer, M. (2015). Nursing management: Lower gastrointestinal problems. In D. Brown, H. Edwards, L. Seaton & T. Buckley (Eds.), Lewiss Medical-Surgical Nursing (4th ed.) (Chapter 39). Sydney: Mosby. J. Lazear. (2015). Nursing management: Diabetes Mellitus. In D. Brown, H. Edwards, L. Seaton & T. Buckley (Eds.) Lewiss Medical-Surgical Nursing (4th ed.) (Chapter 45). Sydney: Mosby. C. Moffa. (2015). Nursing management: Heart Failure. In D. Brown, H. Edwards, L. Seaton & T. Buckley (Eds.), Lewiss Medical-Surgical Nursing (4th ed.) (Chapter 31). Sydney: Mosby. Patient health assessment Management of intravenous therapy Management of intravenous therapy pump devices Management of a nasogastric tube. Diabetes Australia Recognising and Responding to Clinical Deterioration Skills to practice prior to simulation Websites/online resources to explore: Back to Page 1: Preparation for Simulation Pre-reading to be undertaken: Simulation Learning Outcomes The Simulation Experience Preparation for Simulation Handover Medical records Welcome to the Clinical Simulation Click on the tabs to learn more about the Clinical Simulation and the story of Mr Thomas Dwight. Handover Handover Mr. Thomas Dwight has been brought by ambulance to the emergency department at 0715 complaining of abdominal pain and vomiting. The ambulance officer stated that Mr. Dwight has vomited foul smelling bile stained fluid once since leaving home and has ketotic breath. Mr. Dwight told the ambulance officers that he is a diabetic and hasnt eaten or drunk anything much for a few days. Six months ago Mr. Dwight was diagnosed with bowel cancer and had a Hartmanns procedure with the formation of a colostomy. Postoperatively he developed 'heart trouble' and since then has been taking Lasix on a daily basis. His blood glucose level on arrival in the ED was 22mmol/L. Mr. Dwight has had blood collected for FBC, blood culture, electrolytes and liver function tests. He has two IV lines running at present: a 3% Dextrose 1/3 Normal Saline infusion and a continuous Insulin infusion. An urgent abdominal X-ray has been ordered. You have been asked to check his nasogastric tube and insulin infusion is all satisfactory to enable him to go for an urgent x-ray. Situation: Background/History: Assessment and Actions: Recommendation/Request/Responsibility/Relevant/Other: Simulation Learning Outcomes The Simulation Experience Preparation for Simulation Handover Medical records Welcome to the Clinical Simulation Click on the tabs to learn more about the Clinical Simulation and the story of Mr Thomas Dwight. Medical Records Insulin Order IV Fluid Order Fluid Balance Chart Progress Notes Observation Chart Medication Chart Medical records First hour This is a collection of Mr Dwights medical records. You need to review these documents prior to attending the simulation. Back to Medical Records View Page 2: Progress Notes Back to Medical Records View Page 1: Progess Notes View Page 2: Observation Chart Back to Medical Records Loading View Page 1: Observation Chart Back to Medical Records Back to Medical Records View Page 2: Medications Chart Back to Medical Records View Page 1: Medications Chart Back to Medical Records Back to Medical Records Thomas Dwight Medical Simulation Documents Page 2 of 12 Simulation Scenario Situation: Mr. Thomas Dwight has been brought by ambulance to the emergency department at 0715 complaining of abdominal pain and vomiting. Background/History: The ambulance officer stated that Mr. Dwight has vomited foul smelling bile stained fluid once since leaving home and has ketotic breath. Mr. Dwight told the ambulance officers that he is a diabetic and hasnt eaten or drunk anything much for a few days. Six months ago Mr. D wight was diagnosed with bowel cancer and had a Hartmanns procedure with the formation of a colostomy. Postoperatively he developed 'heart trouble' and since then has been taking Lasix on a daily basis. His blood glucose level on arrival in the ED was 22mmol/L. Assessment & Actions: Mr. Dwight has had blood collected for FBC, blood culture, electrolytes and liver function tests. He has two IV lines running at present: a 3% Dextrose 1/3 Normal Saline infusion and a continuous Insulin infusion. An urgent abdominal X--ray has been ordered. Recommendation/Request/Responsibility/Relevant Other: You have been asked to check his nasogastric tube and insulin infusion is all satisfactory to enable him to go for an urgent x--ray Thomas Dwight Medical Simulation Documents Page 3 of 12 Thomas Dwight Medical Simulation Documents Page 4 of 12 Thomas Dwight Medical Simulation Documents Page 5 of 12 Thomas Dwight Medical Simulation Documents Page 6 of 12 Thomas Dwight Medical Simulation Documents Page 7 of 12 Thomas Dwight Medical Simulation Documents Page 8 of 12 Thomas Dwight Medical Simulation Documents Page 9 of 12 Thomas Dwight Medical Simulation Documents Page 10 of 12 Thomas Dwight Medical Simulation Documents Page 11 of 12 Thomas Dwight Medical Simulation Documents Page 10 of 12 Second Hour Simulation Medical Documents Thomas Dwight Medical Simulation Documents Second Hour Page 2 of 20 Simulation Scenario Situation: Thomas Dwight, a 75-year-old previous accountant has been admitted to the palliative care unit you are working in due to his and his wifes inability for him to continue functioning at home. He was admitted from home, and arrived on the ward at 1400hs this afternoon. You are coming onto an afternoon shift and are allocated to Mr Dwights care. Background/History: Thomass wife, Andrea, has accompanied her husband and they have three adult children who will visit later this evening. Over the last week, Thomas has been unable to do anything for himself without a significant amount of pain and fatigue. Mr Dwight has Diabetes Mellitus Type II which has sometimes been difficult to control, he was diagnosed with bowel cancer 12 months ago and had a hemicolectomy with the formation of a colostomy. 6 months ago, he developed a bowel obstruction after investigation it was indicated that there were extensive secondary metastases in the liver, lung and spine. Mr Dwight has not eaten for three days and has had very little in the way of fluids. Mr Dwight now is extremely fatigued, cannot mobilise without assistance or undertake Activities of Daily Living - and has increased pain. He is worried that his colostomy will block up once he starts eating again because he knows the effect the morphine will have on him. He has been managing to care for his colostomy himself but is worried how his wife will manage if he becomes more debilitated he states She has always found it difficult to look at. He reluctantly consented to admission for review by the palliative care team today. He has not accepted community services (including community palliative care services) to date. His care has been managed by the GP since his discharge after the previous admission. Assessment & Actions: Since being on the unit he has indicated a significant amount of pain and has been too fatigued to mobilise to the toilet. Recommendation/Request/Responsibility/Relevant Other: You are to complete the ward admission process. Thomas is still in pain, and seems angry about everything. He is also for review by the palliative care team later today. Thomas Dwight Medical Simulation Documents Second Hour Page 3 of 20 Thomas Dwight Medical Simulation Documents Second Hour Page 4 of 20 Thomas Dwight Medical Simulation Documents Second Hour Page 5 of 20 Thomas Dwight Medical Simulation Documents Second Hour Page 6 of 20 Thomas Dwight Medical Simulation Documents Second Hour Page 7 of 20 Thomas Dwight Medical Simulation Documents Second Hour Page 8 of 20 Thomas Dwight Medical Simulation Documents Second Hour Page 9 of 20 Thomas Dwight Medical Simulation Documents Second Hour Page 10 of 20 Thomas Dwight Medical Simulation Documents Second Hour Page 10 of 20 Thomas Dwight Medical Simulation Documents Second Hour Page 16 of 20 Thomas Dwight Medical Simulation Documents Second Hour Page 17 of 20 Thomas Dwight Medical Simulation Documents Second Hour Page 18 of 20 Hide
