Details : The following written assignment is based on a scenario of Mr Alan Rogers.

The video of the scenario is available on the Moodle site and is called ‘Alan Rogers and you as a first year nursing student’. (There video is broken up into 3 parts specific to your assignment).

You cannot complete this assignment without referring to the video.

In preparation for the assignment, you will need to download the following documents:

· Fluid Balance chart, · QADDS chart, · Nursing Progress Notes.

These will be available in the assignment section on the Moodle site. You are then to read the assignment task set out below and watch the video in all 3 parts. This assignment has a focus on patient assessment, fluid balance charts, vital signs, stoma assessment and professional communication.

Each of these are linked to the National Safety and Quality Health Service Standards.

Setting the scene for your assignment

You are a first year nursing student on your first clinical placement. You are on the Rehabilitation ward at CQUniversity Hospital. It is the morning shift and you have been assigned the responsibility of looking after Mr Alan Rogers.

Who is Alan?

The following are Alan’s demographic details taken from his patient chart.

This is important information that you will require when completing patient charts for your assignment.

· Patient’s full name: Alan Rogers· Date of birth: 24.7 .1947· UR number: 305987· Address: 13 Omeo Street, Ulma, Queensland.· Hospital name/ ward: CQU Hospital, Ward A, bed 6· Doctor: Dr William Down· Weight: 85kgs · Height: 172cm

It is 0700hrs and you have just started your shift. Clinical handover has begun. You receive the following information at Alan’s bedside from the nurse who is about to go off duty. The nurse refers to Alan's care plan in the process of delivering the information to you.

Situation: Mr Alan Rogers was transferred from the surgical ward to the rehabilitation ward yesterday after experiencing an episode of dizziness at home one week prior.

Background: Mr Rogers has a history of chest pain, a painful left knee, bowel cancer and Prostrate Cancer, for which he had an operation called a Trans Urethral Resection of the Prostrate (TURP). He has a stoma and wears a urinary pad, as he experiences some incontinence following a complication of his TURP. He lives alone after his wife passed away two years ago. Mr Rogers is currently taking an anti-hypertensive, one tablet mane.

Assessment: Mr Rogers has a walking stick and is mobilising with it when he remembers. He is high risk for falls. He needs assistance with his stoma care and will ask for help when required. He will ask for urinary pads when he needs them. He is currently scoring zero on his QADDS chart. Mr Rogers’s pain score is 0 at rest but on movement he says it is a ‘2.’

Recommendations: Standard precautions are in place. Alan is on a fluid balance chart and we are measuring all input and output. Alan requires vital signs observations 4/24. He requires full assistance with activities of daily living and is A 1 for mobilization. He requires falls prevention and pressure injury prevention care. The medical team will review Alan this morning at 1000hrs but Notify Dr Crane if you have any concerns.

Your responsibilities in looking after Alan whilst under the supervision of the registered nurse includes: · attending to his hygiene and toileting needs; · assisting with meals; · mobilising Alan safely; · pressure injury and falls prevention; · monitoring his vital signs and · maintaining his fluid balance chart.

What do you need to do next?

Title page and general instructions

Create a title page for the assignment and include all relevant information including student name, number, unit name and number, assignment number & word count. Ensure you use 12 point font and double line spacing. Please also ensure you include a contents page.

The first part of your assignment Open your assignment with an introduction then move into the required tasks as per instructions (allow 200 words).

The second part of this assignment Prior to caring for Alan, you are conscious that you need to maintain hand hygiene. Complete the hand hygiene package. Please refer to online hand hygiene package available at www.hha.org.au/home/student-health-practitioners.aspx.

Once completed you will need to print off the certificate.

You will need to submit this in Appendix 1 of your assignment.

The third part of this assignment

You are also aware, based on the clinical handover, that Alan has a walking aid and is at risk of falls. You are to briefly explain:

· What puts Alan at risk of falls injuries and

· What is the nurse’s responsibility in assessing, managing and documenting that risk.

You should allow 500 words for this.

Please back up your information with quality references.

The fourth part of the assignment

Your shift progresses. You attend to alan's care. It is now 1130 in the morning. You realize that you have not completed the fluid balance chart so you go to Alan to ask about his intake and output. Download the fluid balance chart from the Moodle site and document all input and output from 0800hrs until 1130hrs according to what Alan tells you in the video.

This completed fluid balance chart will be Appendix 2 of your assignment.

The fifth part of the assignment

Continue watching the video. At 1255hrs you go into Alan’s room and he is sitting on the side of the bed. He states to you “my stoma is running fast”. Alan appears embarassed and upset. You ask alan permission to look at his stoma bag and on examination it is full of runny brown faeces. you empty the stoma bag into the measuring jug and it measures 250mls of faeces. You note it has an unusually pungent smell to  it. Alan apologises and states that it "smells awful and that it does usually smell like that". 

You then take Alan’s vital signs.

It is 1200hrs and your findings are as follows.

· Respiration 16 · Pulse 115 and irregular · Blood pressure 120/80 (usual BP 110/70) · Temperature 37.5 · Oxygen saturation 99% · Oxygen flow rate 0- Mode Room air · Conscious state – Alert

Document the vital signs on the Adult QADD’s chart you downloaded from the Moodle site. Include all points of identification on the chart. You are to add the score and complete ALL the documentation on the QADDS chart.. You will need to submit this as Appendix 3.

In the written section of your assignment you then need to explain,

· what action should be taken based on the criteria of the score you calculated.

· what nursing action you would take in regards to his reported stoma changes.

You should allow 200 words for this.

The sixth part of your assignment

Based on the above scenario you have sought the assistance of the registered nurse. It is 1230hrs and you are to apply ISBAR in communicating alan's current situation to the registered nurse. 

In the written part of your paper you are to include the communication you gave under the ISBAR framework.You should allow 300 words for this.

Explain in the written part of your assignment:

· What clinical handover is and how it relates to Standard 6 ‘Communicating for Safety’,

· describe what the nurse should do when providing the handover to the oncoming staff,

· describe what the nurse should do who is receiving the handover.

You should allow 500 words for this part. Please back up your information with quality references.

The final part of your assignment

You are now required to enter what has occurred in the nursing progress notes. Enter the situation assuming the time is now 1400hrs and the date is Tuesday 28/08/2018. Your documentation can commence from the point of Alan advising you that his stoma is "running fast". All events unfolding from that point should be documented on the downloaded nursing progress notes adhering to the principles of professional documentation. You will submit this as Appendix 4 with your assignment. You should close your assignment with a conclusion (allow 150-200 words).

Summarising what you need to do:

View the scenario of Alan Rogers and your written assignment on the Moodle site.

Open your assignment with an introduction then move into the required tasks as per instructions.

Complete the hand hygiene package. Please refer to online hand hygiene package available at www.hha.org.au/home/student-health-practitioners.aspx.

Briefly explain in the written part of your assignment the following: why alan is at risk of falls injuries and what is the nurses responsibility in assessing and documenting that risk.

Download the fluid balance chart from the Moodle site and document all input and output from 0800hrs until 1430hrs.

Record the vital signs on the Adult QADD’s chart as downloaded from the Moodle site.Include all points of identification on the chart. You are to add the score and include appropriate interventions.Ensure you complete ALL the required documentation from the information you have about Alan in this scenario. 

In the written section of your assignment you then need to explain what action should be taken based on the criteria of the score you calculated.

In the written part of your paper you are to include the communication you gave under the ISBAR framework.

Explain in the writtwen part of your assignment the following,

What clinical handover is and;

what steps should the nurse take at the bedside when providing the handover to the on coming staff and

What steps should the nurse take who is receiving the handover.

You are now required to enter what has occurred in the nursing progress notes.

Make sure you have a conclusion at the end of your paper.