Assessment Type

Written Assessment

Task Description

Assignment 1 Written Assignment

Due Date: Monday, 23 April 2018

Weight: 30%

Length: 2500 words + uploaded charts

Referencing Style: APA 6th Edition Format: APA style

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

Objectives and Outcomes:

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

It is essential for nurses to follow clear processes, such as the clinical reasoning cycle, to collect patient cues, process

the information and come to understand the patient’s situation in order to plan, implement and evaluate interventions

and reflect on the process (Levett-Jones, 2012, p4).

The Scenario

Scenario: Lalah Khalili

Scenario Time: 0300hrs

Scenario Date: 30 March 2018

wielding a large kitchen knife, making wild gestures. The police attempted to de-escalate the situation without force, however, resorted to using a taser (conducted energy device). Lalah was subsequently brought to the hospital in the back of a divisional van where she is under police guard.

Her parents are with her. They are from a culturally and linguistically diverse background and do not speak English very well.

Lalah’s Clinical Observations are:

Weight: 46kg

Height: 152cm

Lalah has no known drug allergies.

She is awake and very alert. (Pupils are a size 2mm and react, equally, to light. She has equal movement in her arms and legs)

She is yelling and swearing intermittently in her first language.

Her respiratory rate is 22 breaths per minute.

Her oxygen saturation (Sp02) is 99% on room air.

Her temperature is 37.2 degrees Celsius

Her heart rate is 140 beats per minute

Her blood pressure is 120/75mmHg

Her capillary refill time is 2 seconds

Her blood sugar level is 5.2mmol/L

When asked if she has pain anywhere she tells you, impolitely to go away.

Part A

Step 1: Essay (Clinical Reasoning) (1600 words)

Considering what you already know about Lalah (from the adolescent health module) and in conjunction with the Primary Clinical Care Manual, work through the eight (8) steps of the clinical reasoning cycle for this assessment.

Please indicate what you will take into consideration when synthesising/evaluating this information and your nursing care considerations for each of those nursing actions.

The essay can be written in first person, academic style. A reference list should be included at the end of the essay. You should review Academic Writing which can be found in the Academic Learning Centre site.

Step 2: CEWT

Complete the appropriate CEWT form, documenting the above information correctly and completely.

Step 3: Handover. (300 words maximum)

Write out the ISOBAR handover that you will give to the doctor on call.

Part B (medications)

(200 words)

The doctor advises you that he is on his way and will be there in 5 minutes. Over the phone, the doctor orders:

Diazepam: 2mg orally

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

Step 2. Use the AMH Children's dosing companion and the Australian’s Medicines Handbook to assess the

appropriateness of this medication.

PART C (Nursing Notes) (400 words)

Write contemporaneous nursing notes, using SOAPIE format for this event adhering to the legal principles of

documentation.

Important information to assist you in completing this assessment

When completing this assessment you will quickly see that not all the information you may want is available in the

scenario.

For example, you may decide to complete an assessment for which I have not given you the answers. When this occurs,

explain what you would assess, how you would assess it, and how you would respond to your assessment findings.

Example (abridged):

Collecting the cues.

A patient with an eye injury requires a visual acuity test. I would do this using the Snellen chart (if the patient was

literate or an alternative if not), having the patient standing 6m or 3m away (depending on the chart) in a well-lit room.

If the patient has glasses I would test with the glasses on, and make a note of this on the chart. The injured eye would be assessed first, as testing the good eye first can falsely affect the other eye. The patient will read from the top line down until they make multiple errors. I will document the previous line. The testing distance will be documented measuring distance/line reached (e.g. 6/12) for each eye. I will document this in the nursing notes and advise the medical officer.

Processing the information

In this scenario I have decided the patient’s visual acuity is L) 6/60 and R) 6/12 (injured eye). This tells me that her vision has been affected. I also note that her eye is watery and swollen which may be contributing to the reduced visual acuity in the right eye.

You will be assessed on:

• CEWT and Medication Chart are used very effectively. The Clinical reasoning cycle has a clear and succinct introduction and conclusion: they introduce the topic and outline the direction of the presentation/bring the presentation to a logical close. Appropriate headings are given to each section of the assignment

• Excellent presentation of assignment, double-spaced with11 point font.The submitted written material is very well-presented and free from errors.

• Consistently integrates up-to-date references to support and reflect all ideas, factual information and quotations

• Accurate APA referencing. No errors.

• Content is entirely relevant to the topic, the approach comprehensively addresses the task and the presentation proceeds logically and is within the set word count.

• Correct Children’s Early Warning Tool is selected. The tool has been filled in completely and correctly.

• Correct Medication Chart is selected. The chart has been filled in completely and correctly. Body Surface Area has been correctly calculated

• Excellent explanation and adaptation of clinical reasoning cycle to this scenario. Nursing decisions and activities are entirely correct and well justified. The student selects nursing activities which are within their scope of practice.

• Excellent adaptation of ISOBAR for the scenario. Handover is clear and concise.

• Correctly selection of medication vial, volume and type of reconstitution fluid, volume of reconstitution required, volume of dilute, duration of administration (if appropriate)

• Clear and concise nursing notes which clearly follow the SOAPIE a format and adhere to the legal principles of documentation.

Part A

Length: 1 hour

Learning Outcomes Assessed

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

Overview

Medication errors contribute towards serious outcomes for patients. You are required to complete a medication quiz during residential school. It is a mandatory requirement for all CQUniversity nursing students to obtain 100% on a medication examination prior to going on clinical placement.

The Task

The quiz has been informed by the Med+Safe learning packages which you have been referred to throughout your studies.

You must achieve 100% on this assessment before you are allowed on clinical placement.

You have a maximum of 3 attempts at this quiz.

Items allowed

You may bring a calculator and your math formula into the exam.

Part B

Length: 5 days

Format: Simulation-based learning

Due Date:

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

Overview

As a Re-entry student, you are able, under the supervision of a registered nurse, to undertake the full range of care activities that are expected of a registered nurse. The role of Residential School is to refresh you psychomotor skills, to consolidate your CH79 theory and ensure that you are safe to attend clinical practice.

Task

Throughout Residential School you will undergo simulation assessment activities. These activities will vary in complexity and acuity.

The simulation assessment activities will relate to patients that you have been introduced to throughout the course.

Simulation assessment activities will be conducted after review, practice and consolidation have occurred.

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

Part A: Students must achieve 100% on the medication quiz.

Quiz questions will be sourced from the Med+Safe online learning package which students have been referred to throughout the program.

Part B: Broadly you will be assessed on the following domains.

Domain 1: Preparation and Time Management

Cue 1. Learner consults Primary Clinical Care Manual for guidance on appropriate clinical assessment and management.

Cue 2. Learner consults a Clinical Skills Manual for preparation, planning and performing nursing procedures.

Domain 2: Infection Prevention Control

Cue 1. Learner applies the 5 moments of hand hygiene and infection control principles as described in Standard 3 of the ACSQHC National Safety and Quality Health Service Standards.

Cue 2. Learner selects and applies the appropriate Aseptic Non-touch Technique as describe by ANTT.

Domain 2: Patient Identification and Procedure Matching*

Cue 1. Learner correctly identifies the patient as described in Standard 5 of the ACSQHS National Safety and Quality Health Service Standards.

Cue 2. Learner correctly carries out the correct procedure matching in consideration of the procedure risk.

Domain 3: Medication Safety*

Cue 1. Learner demonstrates safe and timely administration of medications adhering to the “6 rights of medication administration” and the Principles described in Standard 4 NSQHS Standards.

Cue 2. Learner calculates and prepares and checks medications correctly.

Cue 3. Learner adheres to the standards of antimicrobial stewardship when administering antimicrobials and collecting microbiology specimens as described in Standard 3 NSQHS standard.

Domain 4: Recognition of the Deteriorating Patient*

Cue 1. Learner evaluates and analyses patient care in a timely manner with a synthesis of prioritisation of patient care (NMBA Standard for Practice 1, 4,5 and NSQHS Standard 9).

Cue 2. Learner assesses and evaluates changes in patient condition and plans appropriate interventions of nursing care (NSQHS, Standard 9)

Cue 3. Learner demonstrates the ability to incorporate the clinical reasoning cycle and patient assessments, where necessary, in planning patient care (NMBA Competency Standard 5)

Domain 5: Documentation and Communication

Cue 1. Learner applies legal principles of professional documentation (NMBA Competency Standard 10)

Cue 2. Learner demonstrates knowledge of the ISOBAR communication technique (NSQHS, Standard 6).

Domains marked with an asterisk (*) are critical domains. Failure to demonstrate competence in these domains may result in failure of the assessment and therefore you will not be able to attend residential school.

Length: 240 hours clinical-based learning

Weight: 50%

Due Date: Within 5 business days of completing clinical placement.

Learning Outcomes Assessed

• 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 context.

Overview

After successful completion of all theory, students will consolidate their knowledge and skills during 240hours clinical placement. Clinical placement provides a supervised learning experience for students within a work environment and allows nursing students to provide nursing care to‘real patients/consumers within actual healthcare facilities’.

Task 1

As a student Re-entry nurse, you may undertake, under the supervision of a registered nurse, the full range of care activities that are expected of a registered nurse.The decision about what activities you perform as a student must be guided by:

1. The congruence of the activity to the education program (i.e. CL02), and the professional role they will undertake once registered.

(Practice Direction: clinical placement in this course is designed to be undertaken in one ward. Moving through different hospital wards would not be congruent, and therefore activities may be seen as out of the student's scope of practice).

2. CQUniversity's support of the activity.

(Practice Direction: generally CQUniversity supports CL02 students to undertake the full range of activities covered under the profession's scope of practice provided students follow the healthcare facility's policy and procedures. However, the person who supervises the student must be competent and confident in carrying out the procedure themselves).

3. You are competent and confident to perform the specific activity for the consumer in the current context.

(Practice Direction: the way you perform the task/activity should be at the same level as the registered nurse).

You have past education and training outside of this course which should be taken into consideration. In order to accept a delegation from a preceptor, you are instructed to:

1. Verify that the registered nurse buddy/preceptor has conducted a comprehensive assessment of the patient.

2. Verify that the task is within your scope of practice (have you had adequate training throughout your career and is that training current) and in line with local policy.

3. Consider your accountability and responsibility in undertaking the task

4. Consider if your confidence, education, experience and competence are sufficient to safely undertake the task.

Negotiate with their preceptor for education, supervision and support to perform the task OR refer the patient to a more experienced registered nurse to perform the task.

By the end of your 240 hours of clinical placement, you should be confidently and competently managing the nursing activities or caseload for at least four (4) patients (this may vary depending on patient acuity).

Task 2

You will keep a daily reflective journal of each shift that you work. You are encouraged to use the Gibbs Reflective Cycle to write your entries. These journal entries should be uploaded into Moodle each week.

Assessment Criteria

Australian Nursing Standards Assessment Tool

Students will be assessed, by their supervising registered nurse, on their ability to meet the Nursing and Midwifery Board of Australia's "Registered Nurse Standards for Practice".

The assessment tool is called Australian Nursing Standards Assessment Tool (ANSAT) and is available on the NURS20162 Moodle site.

You must achieve a rating of '3' in all domains of the ANSAT by the conclusion of your placement.

Students will undergo formative and summative assessment.

You will undergo formative and summative assessment.

Formative Assessment is a formal assessment conducted halfway through the clinical placement.

Should you fail to pass the formative assessment then the Head of Course (CH79) must be contacted and the option of a Support Plan discussed.

Summative Assessment is a formal assessment conducted at the end of the clinical placement.

If students are at risk of not passing the summative assessment, the Head of Course should be contacted prior to this assessment.

Support Plans

It is essential that you ask your assessor to provide you with feedback early during your placement so that you have ample time to develop the identified skills.

A Support Plan is commenced either at formative assessment or when it has been identified that you have some areas for development in meeting the Nursing and Midwifery Board of Australia (NMBA) Registered Nurse Standard for Practice.

The support plan is developed in consultation with facilitator/ preceptor, Head of Course and yourself.

The Support Plan will outline the deficits and indicate the strategies that you must adhere to in order to improve their knowledge/skills/performance. The learning outcomes must be met within the agreed timeframe stated on the Support Plan

If you cannot meet the learning outcomes of the Support Plan you will not have met the NMBA Registered Nurse Standard for Practice and will, therefore, fail Clinical Placement.