Due Date: Monday 12^th August, 1700 AEST

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

Length: 2700 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 and reference list. It includes in-text references and direct quotations.

Referencing Style: APA 6^th 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:

·         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. Identify processes to escalate parent/guardian health care concerns.

·         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

Overview

In the context of a clinical scenario, this assessment will provide you the opportunity to demonstrate your ability to analyse a complex situation, synthesise information and prioritise nursing care.

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

This assessment consists of 3 components:

Clinical Reasoning

Medication management and safety

Nursing Documentation

Each component has multiple steps within.

Patient scenario and assessment findings:

Time: 0630hrs

Scenario: Martha Berry

Sex: Female

Date of Birth: 15 May 2016

Address: 6 Maypark Street, Mareeba, QLD, 4880

Patient Identifier: MAR45913

Martha is a 3 year, 3 month old Aboriginal girl who has been brought in by her mother, Beatrice and father, Mark to the emergency department at a rural hospital.

Mark reports that Martha has been complaining of a sore abdomen for the past 12 hours. She has been reluctant to eat and drink for the past 24 hours and a bit “unsettled”.  This morning they have noticed that she felt hot on the forehead and that she has been going to the toilet often and passing smelly urine. They last gave her paracetamol at 0400 but with no improvement so brought her to hospital.

On enquiry you find out that Martha enjoys colouring and attends day care three times a week. She has a history of croup as a baby but otherwise no medical history of note. She is allergic to pawpaw and penicillin. She lives with her mum and dad and two other older siblings in a three bedroom housing commission home. Martha is toilet trained.

Physical assessment reflects the following…

Weight: 15kgs

Height: 95cm

·         Respiratory rate (RR) - 32 breaths per minute

·         Oxygen saturations (SaO2) - 96% on room air

·         Temperature (T) - 39.1°C taken aurally.

·         Heart rate (HR) - 142 beats/minute

·         Blood pressure (BP) - 95/62

·         Capillary refill time is >2 seconds

·         Blood sugar level (BSL) - 5.5mmol/L

·         Pupils are equal and reactive to light (PEARL) – size 4

·         Follows directions

·         Dry oral mucosa

·         She points to the frowning face on the CEWT chart when you ask her how much pain she is in.

As yet, no medications have been ordered for Martha.

Clinical Reasoning - 1600 words

Step 1 – (Clinical Reasoning Cycle)

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/pain scale).

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. Initially write, and then record a verbal ISOBAR handover that you will use to transfer this information and seek assistance. Record as a digital file e.g. mp3 (Max file size 20MB). 

Medication management and safety - 400 words

Scenario update:

Over the phone, the doctor (Dr Kay Jeffries) orders the following:

IV 0.9% Sodium Chloride bolus of 15mls/kg

IV Gentamycin 7.5mg/kg stat

IV Ampicillin 50mg/kg stat and thereafter every 6 hours

Paracetamol 15mg/kg, orally every 6 hours

Ibuprofen 15mg/kg orally stat

The doctor advises you that she will be there in 30 minutes to review Martha.

An experienced nursing colleague who has cannulation endorsement has placed a 20G cannula into Martha’s L) cubital Fossa:

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 Justin’s weight. Show your working calculations in your submission.

Step 4

For IV medication using the Australian Injectables Drug Handbook (AIDH) and the Australian Medicines Handbook (AMH) and assuming that all medication strengths are available:

-       select 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...”)

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

-       The volume of the reconstitution required.

-       The volume you need to dilute this in.

-       The time needed to administer.

Please reference the AMH and AIDH in your submission if used.

Nursing Documentation -  400 words or less

Step 1. Write contemporaneous nursing notes, using SOAPIE format for this scenario adhering to the legal principles of documentation.

Step 2. Outline the advice you would give to a parent/guardian who feels their child is deteriorating and their health care concerns are not being acknowledged by the treating team.

Upload directions

Congratulations on completing your first assessment!

Please be sure to follow the directions below in regard to the formats required to upload your assessment.

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

2.    Upload the verbal handover in an mp3 format

3.    The Clinical Reasoning, Medication management and safety and Nursing documentation components need to be submitted/uploaded as one docx document. Ensure this document has a cover page. I suggest that each section begins on a new page with a clear heading.

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.

The one-hour calculation quiz will comprise of 20 questions.

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

Throughout the Residential School you will take part in a range of activities. These activities will vary in complexity and will relate to patient scenarios you have been introduced to throughout the Unit.

You will undertake the activities following a review, practice and consolidation of the scenarios.

After you complete the activities you will undertake a self-assessment, which will be reviewed by the your lecturer.

The assessment will be formative and summative in nature. This means that you are given the opportunity to improve throughout your learning.

1.    Explicit Criteria and Standards

This assessment tool has been developed in alignment with the Nursing and Midwifery Board of Australia, 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. 

1.    Clinical Governance

2.    Partnering with Consumers

3.    Preventing and Controlling Healthcare-Associated Infection

4.    Medication Safety

5.    Comprehensive Care

6.    Communicating for Safety

7.    Blood Management

8.    Recognising and Responding to Acute Deterioration

2. Active engagement with criteria and standards by student

The formative assessment item requires you first to think about these standards before you undertake the activity.  Next you perform the clinical learning activity.  Then you reflect on and evaluate 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.  Finally your lecturer will provide you with feedback and an evaluation of how well you have performed using a grading scale.

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.

The summative assessment, like the formative, requires you to reflect and evaluate your performance, identify your strengths and knowledge/practice gaps and what you will do in clinical placement to bridge this gap.  Your lecturer will provide you with a final evaluation and guidance regarding your suitability for clinical placement. 

If your performance in the domains is not yet satisfactory, you may either be commenced on a learning support plan or prevented from attending clinical placement.  This is at the discretion of your lecturer and the Head of Course.

 Grading scale

1 = Expected behaviours and practices were not performed

2 = Expected behaviours and practices were performed below the acceptable/satisfactory standard

3 = Expected behaviours and practices performed at a satisfactory/pass standard

4 = Expected behaviours and practices performed at a proficient standard

5 = Expected behaviours and practices performed at an excellent standard

Please note - Items marked with a * are mandatory requirements.  Students must demonstrate the required behaviours in this area in order to proceed to clinical placement.  Students who are yet to demonstrate required behaviours may not be able to complete this Unit.

Additional Feedback:

Student is able to commence clinical placement:             Yes                 No  

Clinical Placement Support Plan Initiated:           Yes                 No  

Length: 160 hours of Work Integrated Learning (Clinical Placement)

Learning Outcomes Assessed:

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

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

3.       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 160 hours.

Please see the ANSAT (formative and summative assessments) located in the work integrated learning booklet