Weight: Pass/Fail (students must pass this assessment to complete the unit)

In order to pass this assessment, you must achieve a mark of at least 50% in each section of the marking criteria. Please see this document for additional details.

Length: 2500 words + uploaded charts

The word count is considered from the first word of the introduction to the last word of the conclusion. It excludes the cover page, abstract, contents page, reference list and appendices. It includes in-text references and direct quotations.

Referencing Style: APA 6th Edition

Format:

• Size 12 font (Times New Roman or Arial)

• 1.5 spacing

• 2.54cm margins

• Page numbers, name and student number on each page

Learning Outcomes Assessed

• Construct and adapt an evidence-informed and culturally safe nursing care plan based on patient assessment data with consideration of Aboriginal and Torres Strait Islander peoples and other culturally or linguistically diverse backgrounds

• Communicate with patients, families and healthcare teams, adhering to legal and professional standards

• Evaluate medications used in Australia and their uses in different client groups

• Prioritise and plan the safe administration of medications to a variety of patients

Graduate Attributes

1. Knowledge: Acquire and apply a body of knowledge and appropriate professional judgment relevant to a discipline.

2. Communication: Communicate and interact with others and in culturally diverse contexts.

3. Cognitive, technical and creative skills: Investigate, analyse and synthesise complex information, problems and concepts.

4. Research: Critically appraise outcomes and products of research for translation into the discipline

5. Self-management: Reflect on and critically evaluate one’s performance

6. Ethical and Professional Responsibility: Demonstrate ethical, legal, social and civic responsibility

Overview

The ability to think critically about a situation and communicate effectively and clearly are two of the most valuable skills for success as a nurse.

It is essential for nurses to follow clear processes, such as the clinical reasoning cycle. This enables the nurse to collect patient cues, process the information and come to understand the patient’s situation in order to plan, implement and evaluate interventions and to reflect on the process.

This assessment will provide you with the opportunity to demonstrate your ability to analyse a complex situation, synthesise information and prioritise nursing care.

This assessment will also provide you with the opportunity to demonstrate your ability to complete nursing documentation.

Task - Part A

Time: 1200hrs (midday)

Scenario: Sonny Gray

Sex: Male

Date of birth: 10 January 2014

Address: 24 Spring Street, Rockhampton, QLD 4700

Patient Identifier: 2254351

Sonny is a 4 year, 11month old Torres Strait Islander boy who has just been transferred from the General Practitioner (straight through the Emergency Department) to an isolation room in the paediatric ward with pneumonia and suspected pertussis. 

Sonny has a 20-gauge cannula in his right hand. The emergency nurse who gives you hand over states that Sonny has not had any medications in the emergency department.

Sonny’s father, Greg, is with him. His mother, Heather is with their newborn at home.

Weight: 23kg

Height: 117cm

Sonny is allergic to eggs and has a medical history of asthma.

Sonny looks very pale when he arrives on the ward. He is drowsy, but is responsive to you when you engage him in conversation.

Physical Assessment:

• His respiratory rate is 37 breaths per minute.

• His oxygen saturations are 95% on room air.

• His temperature is 37.8 (taken aurally).

• His heart rate is 145 beats per minute.

• His blood pressure is 115/70 mmHg.

• His capillary refill time (finger) is 2 seconds.

• His Blood Sugar Level is 5.5mmol.

• His pupils are a size 4 and are reactive to light.

• He follows directions if you repeat the directions twice or three times.

• His breathing is audibly crackly without the stethoscope. When you auscultate his lungs, you hear crackles in all lobes. You also hear an audible expiratory wheeze.

• He tells you that he has a sore head and throat and points to the frowning face on the CEWT chart when you ask him how much pain he is in.

• Coughing episodes currently last for 2-3 minutes which are very upsetting to both Sonny and his father.

On visual inspection, he has no tracheal tug and no intercostal recession at rest, however when he has a coughing episode he has both.

No medications have, as yet been ordered for Sonny.

Step 1 (Clinical Reasoning) (1600 words)

Using resources you have come across in this unit, work through the eight (8) steps of the clinical reasoning cycle for this presentation. Please indicate what you will take into consideration when synthesising/evaluating this information and your nursing care considerations for each of those nursing actions.

You should use a separate heading for each of the Clinical Reasoning Cycle Steps.

Reference your sources of information (i.e., The Primary Care Clinical Manual).

Step 2 (Children’s Early Warning Tool).

Complete the appropriate Children’s Early Warning Tool (CEWT) and any other clinical observation forms you feel are warranted with the above information.

Step 3 (Handover) (300 words maximum)

You decide to relay this information to the paediatric registrar by phone. Write out the ISOBAR handover that you will use to transfer this information and seek assistance.

Part B (Medication Safety) (200 words)

The doctor advises you that he is coming to review Sonny and will be there in about 30 minutes.

Over the phone, the doctor orders:

· Clarithromycin liquid 7.5mg/kg orally

· Benzylpenicillin 60mg/kg intravenously

· Salbutamol inhaler 2 puffs stat

· Paracetamol 120mg/kg orally stat

· Ibuprofen 10mg/kg orally stat

Step 1. Document this in the appropriate section of the Paediatric Medication Chart and on the Fluid Chart (you may assume that another nurse has heard this order).

Step 2. Based on your nursing assessment, prioritise the order in which you would give these medications (provide a brief justification for your prioritisation).

Step 3. Calculate the appropriate medication dosages based on Sonny’s weight. Show your working calculations in your submission.

Step 4. Use the Australian Medicines Handbook (AMH), Children’s Dosing Companion and Australian Injectables Drug Handbook (AIDH)

1. The vial size and dose you would select (e.g., "XX drug comes in a 1g in a 5ml Vial, a 5g in a 10ml vial. For this situation I would choose .... because...”)

2. The volume and what type of fluid you would use for reconstitution.

3. The volume of the reconstitution required.

4. The volume you need to dilute this in.

5. The time needed to administer.

Please reference the AMH and AIDH in your submission.

PART C (Nursing Notes) (400 words)

Write contemporaneous nursing notes, using SOAPIE format (or a format you are familiar with and have used previously) for this event adhering to the legal principles of documentation.

UPLOAD SUGGESTIONS

1. Individually upload the CEWT (PDF) and Medication Chart (PDF).

2. Clinical Reasoning Cycle, Handover, Medication Safety and Nursing notes may be submitted as one document (docx or PDF). Ensure this document has a cover page. I suggest that each section begins on a new page with a clear heading.

A comprehensive assessment marking guide is provided in Moodle.

Broadly, the assignment is marked under the following domains:

1. Ability to construct and adapt an evidence-informed and culturally safe nursing care plan based on patient assessment data with consideration of Aboriginal and Torres Strait Islander peoples and other culturally or linguistically diverse backgrounds.

2. Ability to communicate with patients, families and healthcare teams, adhering to legal and professional standards.

3. Ability to evaluate medications used in Australia and their uses in different client groups.

4. Ability to prioritise and plan the safe administration of medications to a variety of patients

During Residential School you will undertake a medication calculation quiz. This quiz will be done online using a computer program called MedSafe.

You may bring calculators and any mathematical formulae that you feel you may require. 

You must achieve 100% to Pass this quiz. You have 3 attempts to achieve 100%.

Length: Ongoing over 5 days

Learning Outcomes Assessed

Graduate Attributes Assessed

Throughout the Residential School, you will undergo ongoing assessment activities. These activities will vary in complexity and will relate to patient scenarios introduced throughout the Unit.

You will undertake assessment following your review, practice and consolidation of the scenarios.

The assessment will be formative and summative in nature. This means that you are given the opportunity to improve throughout your time the 5 days of Residential School.

Your assessment has been developed under the domains of the Registered Nurse Standards for Practice:

1. Thinks critically and analyses nursing practice

2. Engages in therapeutic and professional relationships

3. Maintains the capability for practice

4. Comprehensively conducts assessments

5. Develops a plan for nursing practice

6. Provides safe, appropriate nursing practice

7. Evaluates outcomes to inform nursing practice

Each item is also linked to one or more of the 8 NSQHS standards.

The formative assessment item requires you, the learner, first to engage with these standards prior to undertaking the activity. Next, you are required to conduct an evaluation of your performance. Consider what you have done well, what your knowledge/practice gaps are and what you will do in the coming days to bridge this gap. Next, your lecturer will provide you with an evaluation of how well you have performed. Guidance will be given as to how your performance can be improved. It is important that you actively engage with this feedback prior to the summative assessment.

A comprehensive assessment marking guide is provided in Moodle.

Broadly, you will be assessed under the following domains:

1. Thinks critically and analyses nursing practice.
2. Engages in therapeutic and professional relationships.
3. Maintains the capability for practice.
4. Comprehensively conducts assessments.
5. Develops a plan for nursing practice.
6. Provides safe, appropriate and responsive quality nursing practice.
7. Evaluates outcomes to inform nursing practice.

• Communicate with patients, families and healthcare teams, adhering to legal and professional standards.
• Prioritise and plan the safe administration of medications to a variety of patients.
• Apply the Nursing and Midwifery Board of Australia’s Registered Nurse Standards for Practice in the safe and effective care of individuals, families and the community whilst in the industry based learning environment.

Graduate Outcomes Assessed:

• Knowledge: Acquire and apply a body of knowledge and appropriate professional judgment relevant to a discipline.
• Communication: Communicate and interact with others and in culturally diverse contexts
• Ethical and Professional Responsibility: Demonstrate ethical, legal, social and civic responsibility.
• Cognitive, technical and creative skills: Investigate, analyse and synthesise complex information, problems and concepts.
• Research: Critically appraise outcomes and products of research for translation into the discipline.
• Leadership: Exercise initiative and responsibility, taking action and engaging others to make a positive difference as a global citizen.
• Self-management: Reflect on and critically evaluate one’s performance.

The Tasks

After Residential School, you will be ready to commence Work Integrated Learning.  This is a 160-hour clinical placement, undertaken in one clinical setting.  You have two assessment items which you must undertake while on placement.

Task A

Throughout your placement, you must keep a daily reflective journal.  This is an opportunity for you to reflect on the nursing care you have delivered during the shift, work through the decisions you made and consider if you would act in the same way again, and link theory to practice.  Please consider the NMBA Registered Nurse Standards for Practice and how they relate to your journal entries as you will need this in Task B.

Task B

Using your journal reflections as evidence of your practice, you will undertake a performance review with a clinical supervisor.  The clinical supervisor will evaluate your ability to demonstrate how your ability to meet the NMBA Registered Nurse Standard for Practice.  You will be assessed twice; formative assessment occurs at 80 hours and summative assessment occurs at 160hours.

A comprehensive Work Integrated Learning guide is provided in Moodle.

Broadly, Work Integrated Learning is marked according to the Australian Nursing Standards Assessment Tool (ANSAT).

You must achieve a score of 3 or more in each domain of the ANSAT.