T1 2018 NURS13128 Nursing Care for children and their families

Assessment 1: Written Assessment Item 1 -­‐ Case Study

Word limit: 2000 words

Weighting: 40% Due: Week 7, Monday 23rd April, 1600hrs

Assessment item one addresses unit learning outcomes one, two, three and four.

1. Utilise evidence-based practice principles to compare the unique biopsychosocial stages of child development and the impact these have on children and their families.

2. Examine legal, ethical and socio-cultural trends and their effect upon the provision of safe collaborative nursing care to children and their families.

3. Discuss cultural awareness principles and family centred care as applied to the nursing care of children and families.

4. Evaluate health promotion strategies at a local, national and international level relevant to the health and wellness of children and their families.

Instructions to students

When addressing the assessment topic, it is expected that you will write in the third person, read widely around the topic and correctly reference your paper using the APA referencing style. Please note: referencing constitutes of 10% of your overall mark for this assessment. The Unit Study Guide and Unit Profile school should not be used as reference sources. Please ensure all assessable items are in the body of the paper, as any unnecessary appendix included will not attract extra marks.

A 2000-word limit has been set for this assignment. The assignment should be in essay format, utilising evidence based resources to support your discussion. The essay should include a cover page, contents page (if headings used), introduction, body of assignment, a conclusion and reference list. 10% leeway on either side of the word limit will be accepted. Word count will be measured from the first word of the introduction to last word of the conclusion. Not included in the word count are in text references (for example your reference in brackets), the contents page, reference list and appendix (if included).

Submitting your Assignment through Turnitin

Please submit your assessment into the course moodle site assessment 1 submission box.

Your document should contain your assessment item 1 inclusive of a reference list. This document should be saved with the following:

• your name

• student number and

• NURS13128 Assessment item one

This case study is based around the inquest into the death of Hunter Campbell Marr, a 9 year old boy, who died at the Logan Hospital, Logan Queensland on the 6^th January 2014 after suffering from a severe asthma attack.

The coroner’s complete report can be found by clicking on the following link however it is not necessary to read the entire report for this assignment. *Please note that coroner’s reports can be distressing to read and if you require any assistance please ensure you seek assistance from your unit coordinator who can refer you on to student counselling if required.

http://www.courts.qld.gov.au/__data/assets/pdf_file/0005/370067/cif-marr-hc-20150508.pdf

This is an abbreviated story taken from the coroner’s case above.

Hunter Marr was born on 20 October 2004. His parents are Matthew and Michelle Marr. The Marr family lived at Ormeau, Queensland.

Hunter was diagnosed with asthma in August of 2010 after suffering from an episode of coughing and wheezing. Hunter went on to have a number of exacerbations of asthma during the period 2010 – 2014. According to the report the attacks were sporadic occurring in 2011, 2012, at the end of 2013, and beginning of 2014. During this time Hunter and his parents were given multiple asthma action plans, numerous education sessions by a number of clinicians and Hunter’s parents also had in their possession medication to relieve the symptoms of asthma which was reportedly used infrequently.

At the time of the inquest in 2014 Hunter’s parents could not recall Hunter being diagnosed with Asthma in 2010. The Parents appeared to believe that Hunter was a seasonal asthmatic and had only suffered one severe episode of asthma in 2011. The report clearly states that Hunter’s parents denied the diagnosis of asthma despite considerable evidence to the contrary.

Hunter’s final admission to hospital was very early January 2014 where he was treated at the Mater Children’s Hospital for another episode of asthma. Hunter was discharged home from hospital after being able to be stretched to 3-4 ventolin via an inhaler and spacer. It appeared as though Hunter had an action plan in place and the treating clinician’s at the hospital appeared to believe the parents had been educated on the plan.

The report does detail significant differences in the perception of Hunter’s wellbeing during the night prior to his day of discharge from both the parents and clinician’s point of view. These differences explain why from a clinician’s perspective why they felt he was ready for discharge. At the inquest the verbal testimony given by Mr and Mrs Marr indicated they were very concerned about Hunter being discharged but this was not clearly handed over or written in the medical notes. Testimony given by one of the nurses at the inquest does indicate she had some idea of the parents concern but again this was not handed over and it appeared as though the parents did not voice this prior to leaving on the day of discharge.

Hunter was discharged home on the afternoon of the 5^th January. Mrs Marr reports administering Ventolin a number of times through the night but then called an ambulance on the morning of 6^th January as the ventolin did not appear to be relieving Hunter’s shortness of breath and coughing. A short time later Hunter became unconscious and Hunter’s parents commenced CPR as guided by QAS telephone staff. QAS arrived at the family home and attempted to continue resuscitation efforts. The QAS team transported Hunter to Logan Hospital where resuscitation efforts continued without success. Hunter was pronounced at 10am at Logan Hospital.

The three main issues identified by the coroner are as follows:

Comment 1, page 41
Parents' lack of acceptance or understanding of the diagnosis and appropriate management of their child's illness, as understood by the treating clinicians, particularly in relation to a potentially life-threatening illness, must be flagged, documented, escalated and addressed as a matter of urgency.

Comment 2, page 41
An expressed or perceived reluctance or dissatisfaction about the discharge of a child by a parent, particularly in relation to a potentially life-threatening illness, must be flagged, documented, escalated and addressed as matter of urgency

Comment 3, page 41
Didactic education of patients and parents must be supplemented by active assessment of understanding, particularly in relation to a potentially life-threatening illness and clinical staff reminded that it is what patients/parents understand that is crucial, not what information has been provided in oral or written form.

Task Details/Description.

The following assignment requires you to take into consideration the three comments from the Coroner’s report and apply those recommendations as you manage the care of a child with asthma.

You are a graduate RN working in a Paediatric ward in a regional hospital. You are commencing on an afternoon shift and receive a clinical handover. You have been allocated to care for Xavier, a 7 year old boy who was admitted to the ward with exacerbation of asthma. Xavier has been in hospital for two days and has been seen by the treating paediatric team that morning. Xavier is able to be discharged home once he has been able to stretch to 3-4/24 doses of Ventolin and both he and his parents have been educated on management of his illness. Xavier should be discharged home with appropriate medication and a copy of the asthma education plan.

Prior to attempting the assignment you are required to watch the video on the moodle site entitled ‘Caring for Xavier’.

The assignment is broken up into four sections.

1. In the first part you are to consider the handover given by the nurse with regards to Xavier. You are to critique the handover provided, compared with evidence based best practice and the national safety standards, and consider how this handover could impact on the care of Xavier.

2. As reflected in the video, Xavier’s mother verbalizes to the nurse that she is unsure of Xavier’s diagnosis and also indicates she is not sure about taking Xavier home.

The second part of your assignment requires you explain and justify with supporting evidence from the literature what actions you would take as the paediatric nurse in response to Xavier’s mother and Xavier. You are aware that family centred care and safe collaborative nursing care is crucial to enable good outcomes for patients and their families.

3. In the third part of your assignment you are to discuss the education you would provide to Xavier and his parent/s to ensure they understand the diagnosis and the management plan for discharge. Part of the education plan must include health promotion strategies that are appropriate given Xavier’s age and diagnosis. It is also important to consider Xavier’s developmental stage and engagement strategies that involve both Xavier and his Mum.

4. It is now late in the afternoon. The treating paediatric team have reviewed Xavier. They are satisfied that he is now having Ventolin 4^th hourly and advises that he can be discharged. Dr James states that he does not need to see Xavier again and leaves the ward. You are aware that prior to any discharge of a child, it is policy to take a set of vital signs. As you are taking Xavier’s vital signs his mother again states ‘I am really worried about taking Xavier home, I don’t feel safe with him’.

In this fourth and final part of the assignment you are to review the CEWT form provided and interpret the vital signs taken from Xavier. Based on the findings and the concern voiced by Xavier’s Mother you should explain what actions should occur. Your discussion needs to consider your legal and ethical responsibilities in managing the care of Xavier.

Student: Grade: Marker:

Overall Comments:

T1 2018 NURS13128 Nursing care for children and their families

Assessment 2: Written Assessment & Power Point Presentation – Adolescent Health

Word limit: 2000 words and slides for a 10 minute presentation with audio

Weighting: 60%

Due: Monday 28^th May, Week 12, 1600hrs

Assessment item two addresses course learning outcomes one, two, three and four.

1.Utilise evidence-based practice principles to compare the unique biopsychosocial stages of child development and the impact these have on children and their families.

2.Examine legal, ethical and socio-cultural trends and their effect upon the provision of safe collaborative nursing care to children and their families.

3.Discuss cultural awareness principles and family centred care as applied to the nursing care of children and families.

4.Evaluate health promotion strategies at a local, national and international level relevant to the health and wellness of children and their families.

Instructions to students

When addressing the assessment topic, it is expected that you will write in the third person, read widely around the topic and correctly reference your paper using the APA referencing style. Please note: referencing constitutes 10% of your overall mark for this assessment. The Unit Study Guide, Unit Profile or handouts from on-campus clinical laboratories/residential school’s should not be used as reference sources. Please ensure all assessable items are in the body of the paper, as any unnecessary appendix will not attract extra marks.

Assessment 2 Task details

The purpose of this assessment/presentation is to encourage critical analysis and reflection on nursing practice that would be applied in a community paediatric setting. It is expected that you will utilise up to date, evidence based literature to inform your responses.

Scenario

You are a graduate Registered Nurse on rotation in the final half of your graduate year. It is your second week in your current rotation your local Child and Family Community Health Clinic. You have learned that a number factors increase the risk of poor outcomes in adolescence if they are not managed well. Two of these factors are listed below.

You are required to: Conduct a ten minute verbal presentation on ONE of the topics below.
• Adolescent mental health

• Adolescent sexual health

*The topics are deliberately broad so that you can provide an overview of the larger issue or focus on one particular area of interest – for example: depression and anxiety in adolescence or teenage pregnancy.

When you are developing your powerpoint with audio please ensure you consider the audience that you would deliver your presentation to (this might include your colleagues or adolescents in school for example).

Note: It is expected that you would need at least 7 – 10 slides for a ten-minute presentation. You should include and address the following:

• Your chosen topic should identify the significance of the health problem in your local community and within Australia by using demographic data/statistics. Compare Australian statistics to world health data.

•Give a brief overview of how your chosen topic influences adolescent health both in their present and in their future health.

•Ensure that you review age groups as well as ethnic and cultural groups to establish who is most impacted by this issue.

•Address why the issue is so prevalent in this target group, providing evidence to justify your view point.

•From a nursing practice perspective communicate with the audience how you address the legal and ethical issues that arise when adolescents present to the clinic for support and advice with your chosen issue.

•Establish a health promotion plan that provides at least three family-centred, ethically and culturally appropriate interventions that could potentially prevent and improve outcomes for adolescents within your chosen topic. The plan should incorporate evidence-based rationales for the interventions.

•Consider developmental stages and needs of the adolescent group to ensure safe, therapeutic nursing care when forming your health promotion plan.

•When finalising your powerpoint presentation document the strategies utilised to demonstrate that you have considered your target audience.