• Internal Code :
  • Subject Code :
  • University : Univeristy of South Australia
  • Subject Name : Public health

Section 1: Description of The Scenario

A 70 years old man named Max was bought to the emergency department with complaints of left sided legs and arms weakness, sudden onset of severe headache, left-sided facial drop and slurred speech. The patient have disturbed ICF components. He have problem in performing activities of daily living at individual level. He does not participate in the physical exercise programs that are organized in the society and he lives an isolated life. His personal interests include gardening and listening to his favorite opera music. He lives alone from past 10 years but he have 2 children who lives in another state. He have a history of hypertension and he have had 2 transient ischemic attacks in the past year. Max is obese and he is physically inactive. Moreover, he takes an improper diet which is rich in salt concentration. He is a heavy drinker and smokes 20 cigarettes per day. His smoking and drinking habits have already raised concerns for him as he was admitted for transient ischemic stroke twice in the past year. The doctors recommended him to undergo smoking cessation programs but he failed to do so. A CT scan have revealed a cerebrovascular accident. Max is suggested to undergo the tissue plasminogen activator treatment at soonest.

Section 2: Description and Justification of The Intervention

As a health professional I will recommend the tissue plasminogen activator treatment for Max. According to Finkel et al., (2018), a health professional have diverse role in patient care as it involves acute reasonability and responsibility. The healthcare professionals plays a critical and central role in patient management and improvement (Raymond, Lee & Bloomer, 2017). They follow their technical knowledge to provide best care to the patients. The healthcare professionals access the safety and quality of the health interventions and they provide essential and effective care to the patients. The healthcare professionals provide interventions that not only treat a condition but they also develop strategies that reduce the risk factors of further complications and comorbidities (Raymond, Lee & Bloomer, 2017). The health care individuals develop interventions that are patient-centered, effective and safe.

The patient will be recommended to undergo tissue plasminogen activator treatment in order to treat the diagnosed cerebrovascular accident. According to Huang et al., (2019), the tissue plasminogen activator is considered as the only FDA approved ischemic or thrombotic stroke treatment for patients under influence of cerebrovascular accident. Ischemic or thrombotic stroke which is caused by an interruption in the blood flow due to a blood clot in the brain (Liu et al., 2018). This process use an enzyme to dissolve the blood clot formed in the brain. The tissue plasminogen activator enzyme is developed by the cells lining blood vessels and it is also made manually in laboratories. It is basically a clot bursting agent (systemic thrombolytic agent) which is used in the treatment of conditions such as myocardial infraction and cerebrovascular accident (Liu et al., 2018). The patient will be educated about the side effects of the process and efficiencies of the process. He will be assessed for his blood pressure before the therapy as high blood pressure is one of the most significant contradiction of receiving tissue plasminogen activator treatment.

The intervention will be effective in improving the overall health of Max. It will address the ICF needs of body functions and structures. The ICF component of body function and structure is focused on improving the physiological, anatomical and structural function of the body (Nund et al., 2019). The tissue plasminogen activator treatment will recover the symptoms such as headache, slurred speech, left sided arm and leg weakness and left sided facial drop. The tissue plasminogen activator treatment can result into complications such as symptomatic intracranial hemorrhage and angioedema (Nund et al., 2019). The strategies used to minimize the risks include risk assessment scores and novel imaging strategies. The intracranial hemorrhage can be a result of risk factors such as male gender, uncontrolled hypertension, obesity and congestive heart failure. Use of a risk assessment score for all such risk factors can indicate the success or failure of the intervention. Use of angiotensin-converting enzyme inhibitor can be a risk factor for angioedema hence novel imaging strategies will be used to prevent risk.

Section 3: Inter-Professional Team

It is important for the management to coordinate the nursing tasks and responsibilities among different staff members. According to McGill et al., (2017), multi-disciplinary team acts in a coordinated and comprehensive manner to address the needs of patients and provide optimum health benefit to them. Max will require assistance by another health professional so that his activities and participation in activities can be increased. The health professional will address the educational needs of the patient. Since the patient is obese, have hypertension, smokes cigarette and drinks alcohol so it is important to educate and aware him about the strategies that can help him overcome these situations. Informing the patient about smoking cessation services and guiding him throughout the process can help him stay in the service and obtain optimum health benefits.

It will address the activities and participation component of the ICF because educating the patient about primary causes of the disease and guiding him about the strategies that can help him overcome those primary issues can bring up improvements in the patient. According to Darzins, Imms and Di Stefano (2017), the activities component of the ICF include the tasks or actions performed by an individual on daily basis. These actions include the activities of daily living, recreation and leisure and having a proper community life. Strategies such as smoking cessation will help the patient to gain healthy lifestyle and this can reduce his hypertension and obesity. According to Barajas et al., (2019), people who smoke cigarettes experiences conditions such as hypertension and obesity. Moreover, Max is on a salt rich diet which increase the risk of stroke and hypertension. Educating Max about the importance of healthy diet can help Max achieve success in his activities and participation component of ICF.

Section 4: Professionalism Characteristics

The intervention of tissue plasminogen activator and patient education need professional characteristics such as technical knowledge, effective communication and competence. Tissue plasminogen activator therapy for treating cerebrovascular accident is a complex and difficult therapy (Popowicz et al., 2017). Inability to perform proper therapy can result in complications. Moreover, lack of knowledge regarding the potential contradictions and side effects can also make the patient condition worse (Popowicz et al., 2017). Having knowledge regarding the risk factors such as diet rich in salt concentration, hypertension and obesity can minimize the risk of stroke ad increase the efficiency of intervention.

The healthcare professionals should educate the patient whenever it is required. For this, they require effective communication skills. Communication is an active process of interaction in which a healthcare professional interact with the patients in a patient-centered and appropriate way (Rathert et al., 2017). A professional nurse or physician can recognize the patient’s problems and needs after communicating with them. They use soft skills such as compassion and empathy while communicating so that the patient can feel comfortable and he can get the best possible care (Rathert et al., 2017). The third skill for providing patient care must be competence. Competence in nursing care, patient education, treatment strategies, patient progress and prevention of complexities can be an effective approach toward enhancing patient safety (Santisteban & Iadecola, 2018). The goal of enhancing functional capacities, and activities and participation in the patient can be achieved by competence in patient care and safety. Safe and effective care to the patients can be a result of professional competences of the nurses and other healthcare professionals.

Section 5: Person Centered Care

It is one of the best approach used by healthcare professionals while providing care to the patients. The person centered care ensure the needs of patients are met with complete comfort and satisfaction. According to El-Alti, Sandman and Munthe (2019), the person centered care keeps the patient at the center of treatment and the treatment interventions revolves on the patient and health outcomes of the patients. The person-centered strategies are designed after analyzing the patient’s situation and priority problems. The strategies that will be used to ensure that the practice is person-centered include integration of care and respecting the patient’s preferences and choices.

According to Kullberg et al., (2017), patient cantered care is highly effective if the patients are respected, valued and informed during the treatment. Person centered care is focused upon proper coordination and integration of care. Patients with serious problems are managed by several health professionals that works in multidisciplinary teams as per their specialization. Max will be managed by two healthcare professionals in which the first professional will provide the tissue plasminogen activator based therapy and the second healthcare professional will provide patient-centered education to the patient. Another strategy of patient-centered care is to respect the patient’s preferences and choices. The patient loves gardening hence he will be helped with gardening during his recovery. This will relax him mentally and it will also increase his acceptance to the treatment. The patient will be educated and informed about the disease and the treatment so that the goal of patient centered care can be achieved.

Reference

Barajas, C. B., Jones, S. C., Milam, A. J., Thorpe, R. J., Gaskin, D. J., LaVeist, T. A., & Furr-Holden, C. D. M. (2019). Coping, Discrimination, and Physical Health Conditions among Predominantly Poor, Urban African Americans: Implications for Community-Level Health Services. Journal of Community Health, 44(5), 954-962.

Darzins, S. W., Imms, C., & Di Stefano, M. (2017). Measurement of activity limitations and participation restrictions: examination of ICF-linked content and scale properties of the FIM and PC-PART instruments. Disability and Rehabilitation, 39(10), 1025-1038.

El-Alti, L., Sandman, L., & Munthe, C. (2019). Person centered care and personalized medicine: Irreconcilable opposites or potential companions?. Health Care Analysis, 27(1), 45-59.

Finkel, R. S., Mercuri, E., Meyer, O. H., Simonds, A. K., Schroth, M. K., Graham, R. J., ... & Muntoni, F. (2018). Diagnosis and management of spinal muscular atrophy: Part 2: Pulmonary and acute care; medications, supplements and immunizations; other organ systems; and ethics. Neuromuscular Disorders, 28(3), 197-207.

Huang, D., Wu, K., Zhang, Y., Ni, Z., Zhu, X., Zhu, C., & Hu, J. (2019). Recent Advances in Tissue plasminogen activator-based nanothrombolysis for ischemic stroke. REVIEWS ON ADVANCED MATERIALS SCIENCE, 58(1), 159-170.

Kullberg, A., Sharp, L., Johansson, H., Brandberg, Y., & Bergenmar, M. (2017). Patient satisfaction after implementation of person-centred handover in oncological inpatient care–A cross-sectional study. PloS One, 12(4)112-2128.

Liu, S., Feng, X., Jin, R., & Li, G. (2018). Tissue plasminogen activator-based nanothrombolysis for ischemic stroke. Expert Opinion on Drug Delivery, 15(2), 173-184.

McGill, M., Blonde, L., Chan, J. C., Khunti, K., Lavalle, F. J., & Bailey, C. J. (2017). The interdisciplinary team in type 2 diabetes management: Challenges and best practice solutions from real-world scenarios. Journal of Clinical & Translational Cndocrinology, 7, 21-27.

Nund, R. L., Brown, B., Ward, E. C., Maclean, J., Roe, J., Patterson, J. M., & Martino, R. (2019). What Are We Really Measuring? A Content Comparison of Swallowing Outcome Measures for Head and Neck Cancer Based on the International Classification of Functioning, Disability and Health (ICF). Dysphagia, 34(4), 575-591.

Popowicz, N., Bintcliffe, O., De Fonseka, D., Blyth, K. G., Smith, N. A., Piccolo, F., ... & Lee, Y. G. (2017). Dose de-escalation of intrapleural tissue plasminogen activator therapy for pleural infection. The Alteplase Dose Assessment for Pleural Infection Therapy Project. Annals of the American Thoracic Society, 14(6), 929-936.

Rathert, C., Mittler, J. N., Banerjee, S., & McDaniel, J. (2017). Patient-centered communication in the era of electronic health records: What does the evidence say?. Patient Education and Counseling, 100(1), 50-64.

Raymond, A., Lee, S. F., & Bloomer, M. J. (2017). Understanding the bereavement care roles of nurses within acute care: a systematic review. Journal of Clinical Nursing, 26(13-14), 1787-1800.

Santisteban, M. M., & Iadecola, C. (2018). Hypertension, dietary salt and cognitive impairment. Journal of Cerebral Blood Flow & Metabolism, 38(12), 2.

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