Nursing Clinical Project
Student’s Name
Institution Affiliation
Nursing Clinical Project
Introduction
The main aim of graduate nursing programs is to prepare graduates to provide safe and patient-centered care that reflects ethical clinical judgment. To attain this aim, graduates have to complete a clinical project to experience what is expected of them in their nursing careers. This essay entails a description of my experience in a ward setting during the clinical project. Additionally, it entails the proposed solutions to improve clinical practices in ward settings. Moreover, it entails the National Safety and Quality Health Service (NSQHS) eighth standard, which relates to my clinical project experience.
Part One
My clinical project was in a ward setting whereby my primary role was to take care of and manage patients’ physical needs. I would administer oral medication to patients during the daytime and in the evenings according to their MR6 reports. When I was performing my morning duty in the medical ward, a patient vomited and aspirated his vomit immediately after administering his oral medication as per his MR6.
I immediately elevated his bedhead to 45 degrees to prevent further aspiration of the vomit. Afterwards, I suctioned to clear his airways and made some observations. I noted that his oxygen levels were dropping below 94, which indicated low oxygen saturation in the blood. I administered three litres of oxygen via a nasal prong to increase oxygen saturation in the blood. I checked for the patient’s vital signs and noticed that his oxygen levels continued to drop. The oxygen saturation levels were at 90, and the patient also had an episode of very loose diarrhoea. Later, the blood pressure dropped below 100, and the heart rate increased to 110 beats per minute. The drop in blood pressure indicated hypotension, and the high heart rate indicated sinus tachycardia.
With the advice given to me by my preceptor, I changed the nasal prong to a Hudson mask. I continued checking on the patient’s vital signs, but there were no signs of improvement, only deterioration. My preceptor and I decided to notify the MET call team. The patient met two MET call criteria: his heart rate was 110 beats per minute, and he had a low blood pressure of 88. I handed over the patient deterioration, medication, vital signs, and also answered all the team’s questions. Afterwards, the doctors increased the patient’s oxygen levels. My preceptor and I cleaned the patient while the doctors reviewed and changed his medication.
The medication entailed intravenous fluids, antiemetic, antibiotics, and pain relievers. I immediately administered the medication to the patient, and his condition began showing signs of improvement. Later, I referred the patient to a speech therapist, a dietician, and a physiotherapist. I also withheld all oral fluids and his regular diet until the review was completed. The dietician commenced level one thickened food, crushed medications, and soft meals on the patient.
This experience granted me an opportunity to put into practice the knowledge that I had acquired in the nursing program. It also allowed me to examine whether what I had learnt in class is applicable in real-life situations. The clinical situation made me understand that intravenous medication is the most effective form of medication to use in emergency cases.
Part Two
The clinical situation relates to standard eight of the NSQHS, which is recognising and responding to acute deterioration. The primary aim of the NSQHS standards is to ensure that the public is free from harm (Walton et al., 2006). The Recognising and Responding to Acute Deterioration Standard aims at ensuring that patients receive appropriate and timely care health care that meets their individual needs in acute deteriorating conditions. This standard also ensures the aversion of serious untimely adverse events such as deaths that precede acute sicknesses. It also ensures that patients’ risks during health care are prevented and managed through targeted strategies. Some of these strategies include the provision of support processes and resources that enhance quick responses by clinicians in the management of acute deterioration episodes.
The maintenance of standard eight of the NSQHS involves contributions by the health leaders to set up systems capable of recognising and responding to acute deterioration in patients. On the other hand, the workforce, which consists of the clinicians, utilises the systems to recognise and respond to acute deterioration. I referred the patient to a speech therapist, physiotherapist, and dietician to ensure immediate response to his acute deteriorating condition. The speech therapist assessed the swallowing disorder in the patient (Vitásková & Kytnarová, 2017). The dietician reviewed the patient’s appropriate diet following the patient’s aspiration of vomit. In the long run, I got a solution that met the patients’ individual needs.
When the patient’s condition worsened, my preceptor and I notified the MET call team. We called the team since the patient’s condition had met the MET call criteria. According to Doric et al. (2012), this action was a partial fulfilment of the response to acute deterioration since it was a sign of concern for the patient in acute deterioration. Before the MET call team arrived, my preceptor and I were administering oxygen to the patient. After the MET call team arrived, we administered intravenous medication to ensure the patient’s condition’s fast improvement. Generally, the Recognising and Responding to Acute Deterioration standard ensures utilisation of available resources by the workforce to provide attention and adequate care to individuals in acute conditions for health improvement.
I would recommend a kit containing the medication administered by the MET call team gets implemented in ward settings. The kit should contain a list of medications that can get administered to patients who have attained the MET call criteria. I recommend the kit since I had to continue monitoring the patient without giving him any medication. All I could do was keep on reassuring him that the MET call team is arriving. The nurse’s role should be to administer the medication based on the guidance provided in the kit. The kit’s instructions and mode of application should then be implemented in nursing programs after its design. This kit will aid in reducing the number of emergency cases in patients in various wards, by equipping them to recognise and respond to acute conditions in patients.
Conclusion
In conclusion, the methodology utilised in solving the clinical issue I experienced during the clinical project illustrates best practices in the health sector. The clinical issue granted me an opportunity to apply the Recognising and Responding to Acute Deterioration standard of NSQHS standards. I notified the MET call team and applied the knowledge I had acquired in the nursing program since they were the best strategies to utilise in solving the clinical issue.
References
Doric, A., Mistarz, R., Gellie, K., & Charlesworth, D. (2012). Incidence of MET criteria in ward patients at a non-MET hospital. Australian Critical Care, 25(2), 130. https://doi.org/10.1016/j.aucc.2011.12.026
Vitásková, K., & Kytnarová, L. (2017). The role of speech and language therapist in autism spectrum disorders intervention – An inclusive approach. Advances in Speech-language Pathology. https://doi.org/10.5772/intechopen.70235
Walton, M. M., Shaw, T., Barnet, S., & Ross, J. (2006). Developing a national patient safety education framework for Australia. Quality and Safety in Health Care, 15(6), 437-442. https://doi.org/10.1136/qshc.2006.019216