The Patient Safety Education Framework developed by the Australian Council for Health Care Safety and Quality identifies that continuum of care is an important aspect of clinical safety and conveys the significance of all healthcare professionals according to the patient handover guidelines of their institution. The expectations from the nurses and doctors who care for patients to share the information to mitigate errors and maintain security (Healy, 2016). Patients also expect to be respectful of their confidentiality when handling their private information. To ensure patient safety, adequate and appropriate data must be transferred so that the senior and covering clinicians are aware of the medical patients with symptoms. The Team's junior members are adequately briefed on previous shift concerns. The incoming team clearly understands the tasks which have not yet been completed (Sonntag et al., 2016). In this essay, a case study will be discussed where all these laws were not followed by the nurse leading to the negative outcome of the patient’s health.
The incident is in Bungarribee House in which a visitor arrived to ask regarding her husband who had also been referred to the Western Sydney Local Health District mental health facility's Acute Ward the previous day. As RN Sumintra Prasad returned from the handover, she answered for the requirement and went looking for the patient, but did not find him in his room and the other places she looked for. She asked a colleague to verify the patient's room bathroom, and he did so, only to find that the patient had collapsed on the floor, taking his own life. The alarm has been lifted but the patient cannot be revived. During that shift, RN Harivadan Pandya was assigned to take care of the patient, but he had left the ward about half an hour long in advance to move to another facility to begin another shift. RN Prasad had collected the patient's behaviour observation due at 2.40 pm on RN Pandya's early departure, being just before she went into handover at around 2.45 pm. The way and cause of the patient's death have been an issue for the coroner. The task of this Committee of Professional Standards is to investigate the behaviour of RN Prasad and RN Pandya during their shifts that day and the care they exercised towards the patient. RN Pandya's care fell substantially below a practitioner's sufficiently level expected of equivalent experience or training and found unsatisfying professional behavior. The committee has agreed to reproach RN Pandya, put restrictions on his job, as he requires supervision, and start taking some training. RN Prasad's care in deciding to leave for handover fell substantially below a practitioner's standard required of comparable experience or qualifications. They found that the professional conduct was unsatisfactory, and cautioned RN Prasad. While there were weak points in other parts of RN Prasad's behaviour they found no unsatisfying professional behaviour.
In the given case, the RN did not perform his duty and left the patient without informing the seniors or the next person taking over his duty. He was also found to not be undertaking the patient observations and record the findings. There was no communication by the RN regarding the patient's condition which led to the negative outcome for the patient. The Code of Professional Conduct for Nurses in Australia is supported by the Code of Ethics for Nurses in Australia. To ensure the 'strong position' of the nursing field, this Code of Professional Conduct for Nurses sets out the minimum standards for the practice a professional person is expected to maintain both within and outside the professional domains (Cowin et al, 2019). Nurses practice following broader standards related to health care safety and quality and accountability for a safe health system, such as health documentation and data management, risk assessments, and involvement in adverse event analysis and formal information exchange processes. Handover is 'the temporary or permanent exchange of professional accountability and responsibility for most or all elements of a patient's condition, or group of patients, to the next group or person of professionals.' Clinical Handover is among the most essential issues that should be considered to ensure clinical outcomes continues. The regularity of information is critical to our quality care. With the impact on working hours for doctors and increased demand for flexibility in work practices (e.g. part-time work) – both invariably increasing the number of patient caregivers – the need for careful medical information transfer is more essential than before (Manias et al., 2016).
The NSQHS standards also acknowledges the importance of the comprehensive care and clinical handover as is to accomplish effective communications of high-quality clinical information in real-time whenever the accountability for clinical outcomes is transmitted. Good handoff is at the heart of an efficient medical system and is accompanied by relevant health documentary evidence, referral letters, and documentary evidence for transition and release (ACSQHC, 2017). Together all these constitute the linkages in the care delivery consistency string. Handover high inter and personal interest, and educational needs, assistance, cooperation, and on-going attempt to improve that it retains an important position in an already full working day (Redley et al., 2017). The Australian nursing board had released a statement of situation or viewpoint on abandonment. Two situations must have happened in this case scenario for a situation to necessitate patient abandonment: the nurse should have acknowledged the task which maintains a nurse-patient relationship and sever the correlation without notification to either a relevant authority (supervisor, manager, etc.) so some other nurse can proceed and provide treatment to the patients. Many concerns (and dangers to address) are problems related to employees. These distinguish themselves from unprofessional or unsafe behaviour while caring for patients. Both the nurse and the other care provider have lawful responsibilities in this area. Care delivery nurses have a responsibility of providing safe, knowledgeable, skilled, and competent care (Marmor & Li, 2017). They are also obliged to outsource the proposed task to appropriate staff (think of the sudden illness of the care provider, a national catastrophe, a gunman).
The health care organizations' accreditation boards necessitate that the medical record involves aspects from the patient evaluations, the treatment planning and/or concerns of the patient, the nursing treatments, the outcomes shown by the patients, and the aspects of the current nursing plan. The treatment plan may differ from the background of the patient, may have been included in the clinical records, or may be implemented into a multidimensional care plan, depending on the documentation process that has been used. Documentary evidence is a worded and lawful record of the patient-related treatments and contains a series of procedures (Esch et al., 2016). Paperwork methods are multiple, and one of the simplest concepts are the origin or problem-oriented technique, system issue-intervention-evaluation, focused registry, focus graph, exceptional register, digital form, and home data. Some other crucial problem that arises will be whether health care assistants are required to contribute to medical information and document their care. They are presented that the registered nurse who assigns this accountability is comfortable that the health care assistant is proficient to conduct the action and its information so it is in the better interests of the patient/client to allocate that record-keeping (Scheltema et al., 2018). The registered nurse could choose to justify-sign the records created by the health care assistant until they are convinced of their full activity expertise, such as record-keeping. The overall principles of keeping records, if either they write by hand or submit submissions to electronic systems, can be summarised by saying that anything written or submitted must be truthful, precise, and non-offensive and should not infringe the confidentiality of the patient. If they follow these four principles and record-keeping participation will be beneficial. In particular, they should always try to ensure that records are timelines and synchronized as close as possible to the real-time of the events. The record occurrences should be precise and efficient keeping in mind that at a certain point the patient might want to see the record, so the nurse has to make sure that the mention in a language that the patient understands (Badwan et al., 2018).
Documentation is created with the client's record which is the basis of information about his health situation. The significance of nursing documentation is neuralgic, so long as there could be no complete qualitative medical practice without it, and not efficient clinical care. Studies more on the quality treatment of the already detected problems, programming of care through all the organization and alteration of the patient treatment plan, and much more clear interaction among healthcare system experts who work collaboratively on the care of patients are also included in the reasons of nursing documentation. The Bottom line is that once a nurse acknowledges a task or decides to take care of people, he or she should complete the task or finish the treatment with such a safe and appropriate handover, even if there are special cases.
ACSQHC. (2017). NSQHS Standards. Reterived from https://www.safetyandquality.gov.au/standards/nsqhs-standards
Badwan, B., Bothara, R., Latijnhouwers, M., Smithies, A., & Sandars, J. (2018). The importance of design thinking in medical education. Medical Teacher, 40(4), 425-426.
Cowin, L. S., Riley, T. K., Heiler, J., & Gregory, L. R. (2019). The relevance of nurses and midwives code of conduct in Australia. International Nursing Review, 66(3), 320-328.
Esch, T., Mejilla, R., Anselmo, M., Podtschaske, B., Delbanco, T., & Walker, J. (2016). Engaging patients through open notes: an evaluation using mixed methods. BMJ Open, 6(1).
Healy, J. (2016). Improving health care safety and quality: Reluctant regulators. Routledge.
Manias, E., Geddes, F., Watson, B., Jones, D., & Della, P. (2016). Perspectives of clinical handover processes: a multi‐site survey across different health professionals. Journal of Clinical Nursing, 25(1-2), 80-91.
Marmor, G. O., & Li, M. Y. (2017). Improving emergency department medical clinical handover: Barriers at the bedside. Emergency Medicine Australasia, 29(3), 297-302.
Redley, B., Botti, M., Wood, B., & Bucknall, T. (2017). Interprofessional communication supporting clinical handover in emergency departments: An observation study. Australasian Emergency Nursing Journal, 20(3), 122-130.
Scheltema, E., Reay, S., & Piper, G. (2018). Visual representation of medical information: the importance of considering the end-user in the design of medical illustrations. Journal of Visual Communication in Medicine, 41(1), 9-17.
Sonntag, O., Plebani, M., Della, P., Jones, D., Steward-Wynne, E., Walsh, J. & Lee, M. (2016). Effective communication in clinical handover: From research to practice (Vol. 15). Walter de Gruyter GmbH & Co KG.
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