Enhancing Clinical Practice Essay

Submitted By sarahlouise79
Words: 3434
Pages: 14
Open Document
This assignment illustrates a case study focusing on the management of a patient with multiple pathologies who was cared for in more than one critical care setting. The practitioner will explore the clinical management of the patient who has complex requirements and report the approaches and strategies used in the process of reaching and agreeing clinical decisions regarding their care. Critical reflection surrounding communication and multidisciplinary team working with regards to the patient’s care and the patient’s involvement in that care will also be investigated.
The practitioner understands that confidentiality is of utmost importance and in order to comply with the Health Professions Council (HPC) (2008) the pseudonym of Mrs Foster will be used for reasons of anonymity and confidentiality.
Mrs Foster is a 61 year old morbidly obese female with exacerbating chronic obstructive pulmonary disease (COPD) and a deteriorating chest infection. On admission to the ICU, she was diagnosed with type 2 respiratory failure and was intubated immediately and an arterial cannula and a catheter inserted. Due to prolonged intubation on the unit, Mrs Foster was transferred from the Intensive Care Unit (ICU) to the theatre department for an operation to remove the endo-tracheal tube which was in situ and replace it with a tracheostomy tube. Mrs Foster was then transferred back to the ICU to continue essential invasive and non invasive monitoring of her critical care.

Mrs Foster was admitted to the ICU for type 2 respiratory failure. The Intensive Care Society (ICS) (1997) state that this is the most appropriate setting for Mrs Foster as she needs advanced respiratory support and has a potentially recoverable condition, and would benefit from more detailed observation and invasive treatment than can be provided safely in an ordinary ward or high dependency area.
Type 2 respiratory failure is where there is severe malfunction in gas exchange between the lungs and the blood causing hypoxaemia and hypercapnia and if not treated correctly can be potentially life threatening (Francis, 2006).The cause of Mrs Foster’s respiratory failure was due to exacerbating COPD, a deteriorating chest infection and being classed as morbidly obese with a Body Mass Index (BMI) of 47 (Association of Anaesthetists of Great Britain and Ireland (AAGBI) 2007a). Mrs Foster had been intubated with an endo-tracheal tube which had been in situ for six days. The Intensive Care National Audit and Research Centre (2008) suggest that anticipated ventilation longer than 7-14 days should indicate a tracheostomy is performed. A tracheostomy is the opening of the trachea through a transverse surgical incision just below the cricoid cartilage and the insertion of a cannula and tracheostomy tube establishing a safer, more permanent, comfortable and less traumatic airway for the patient (Rothrock, 2003).The decision to perform a tracheostomy in the theatre department was that of the critical care anaesthetist in conjunction with the specialist consultant surgeon. The contraindications for performing surgery in theatre were explored and included the COPD and morbid obesity but the potential benefits of the theatre surgery outweighed the convenience of a percutaneous technique at the bedside in the ICU should difficulties arise and an open surgical procedure be needed. This communication showed the appropriate use of a strategy and displayed mutual respect for the skills and contributions of each other’s profession. In the practitioner’s view, the decision making was handled in an appropriate and effective way ensuring safety of the patient, high quality care and that the best possible outcomes for the patient were achieved. This decision was supported by Local Trust Policy (2006a) and the ICS (2008) who agree that prolonged endo-tracheal intubation carries a high risk of damage to the soft tissues of the mouth, pharynx and trachea, it also reduces the patient’s ability to
Show More

Related Documents: Enhancing Clinical Practice Essay

Enhancing Evidence Based Practice

https://www.nursingworld.org/practice-policy/nursing-excellence/evidence-based-practice-in-nursing/. Evidence-based practice can be holistic, quality care based on the most up-to-date research and knowledge rather than traditional methods. They use advice from colleagues, or personal beliefs. By using this you will apply the best evidence and clinical expertise for the best outcome. This can be helpful in ensuring the best care options,enhancing patient safety, and fostering professional growth…

Words 304 - Pages 2

Reflective Practice Research Paper

The importance of reflective practice on clinical professional development is demonstrated in the extant literature and the ability to learn from reflection is an important skill for doctors in postgraduate training. As a cognitive skill reflection allows doctors, to inform their ability to collect and process complex clinical information; make sound clinical judgements; deliver patient-centred care, and learn from medical mistakes. Therefore, reflective practice and learning is an important cognitive…

Words 237 - Pages 1

Clinical Practice In Social Work

Clinical practice plays an essential role in the development and training of a social work student. This practice sets the foundation for the growth of professional clinical skills. Working in the field helps to connect course learning by defining the term “clinical social work”, and promoting application of psychodynamic and cognitive-behavioral theories. In addition to connecting classroom learning, clinical learning “is done while experiencing different learning tasks designed to create change…

Words 200 - Pages 1

Evidence Based Fall Prevention

changes in patient outcomes. In this context, the application of evidence-based fall prevention strategies becomes crucial, given its significant impact on patient safety and well-being within clinical settings. Incorporating evidence-based fall prevention strategies into nursing practice is paramount for enhancing patient safety and well-being. This involves conducting comprehensive fall risk assessments, where nursing students can identify individual risk factors and tailor interventions, accordingly…

Words 183 - Pages 1

Social Work Reflective Essay

The opportunity for reflective clinical practice has enriched my journey in becoming a clinical social worker. Conduction of an analysis of my experience afforded me the opportunity to draw on previous learning or concepts, while reflecting on new concepts in order to inform future actions. I discovered two themes relevant to my learning as a social work student; such as, social workers are continuous learners always enhancing their competency in the field. What is learned today in the field may…

Words 151 - Pages 1

In-Employment Self Assessment

pre-employment self analysis. In practice, clinical supervision can be caseload discussions and joint patient treatment sessions to annual reviews (Care Quality Commission, 2008). Following the winterbourne serious incident, the Care Quality Commission developed guidelines to aid implementation of clinical…

Words 1066 - Pages 5

Critical Reflection On Evidence Based Practice

first discuss the benefits of patients and the nursing profession when nurses regularly and effectively reflect on their practice. Secondly this essay identifies and discusses the sources that nurses might use to obtain evidence on which to base practice. Lastly this essay discusses the role of critical reflection in assisting nurses to base their care on evidence base practice. Nurses who are able to reflect-in-action, will…

Words 735 - Pages 3

Advanced Practice Nursing Roles

Discussion 1 The conflicts that have affected the development of advanced practice nursing roles The conflicting expectations, professional responsibilities, professional isolation and competing preferences are the factors impacting the development of advanced practice nursing roles. APN roles have historically been depicted by a focus on physician substitution or support instead of consumer-centered, health-focused, and integrated care delivery (Bryant et al., 2004). This focus portrays the intraprofessional…

Words 436 - Pages 2

Mental Health Counselor Research Paper

and treating undesired behavior and enhancing mental health (flsentate.gov, n.d.). The practice of mental health counseling includes methods of a psychological nature used to evaluate, assess, diagnose, and treat emotional and mental dysfunctions or disorder, behavioral disorders, interpersonal relationships, alcoholism and substance abuse (flsentae.gov, n.d.). The following steps are required for obtaining your license by the Board of Clinical Social Work, Marriage & Family Therapy…

Words 429 - Pages 2

Remote Collaboration Case Study

helps improve patient safety and outcomes through evidence-based care planning and remote collaboration, focusing on a case study of a patient with congestive heart failure (CHF). During this presentation, I will explain how I used an evidence-based practice model to develop the patient’s plan of care, reflect on the evidence relevant to my decisions, and identify benefits and strategies to address the challenges of interdisciplinary collaboration between the remote healthcare team. Background of Case…

Words 2275 - Pages 10