Patient Care Management With An Example In Nursing Education

Nursing Education and Patient Care Management With An Example

Scenario for Patient Care Management In Nursing Education, Implementation of Client Care Management In Nursing Education.

Scenario for Patient Care Management In Nursing Education

The charge nurse is establishing the patient assignments for the shift. Here are the details of the clients and staff.

Number of clients 30

Number of Registered Nurses 4 plus the Charge Nurse

Number of Unlicensed Assistive Personnel 3

Here is the assignment for each Registered Nurse

RN 1:8 clients (all require routine care routine discharge)

RN 2: 6 clients (2 receiving blood; 1 new admission)

RN 16 clients (1 complex discharges 2 beginning chemotherapy)

RN 4:8 clients (2 routine discharges 1 recent postoperative patient) Charge Nurse 2 clients (1 has a tracheostomy and is on a ventilator, 1 needs routine care)

    You are assigning the unlicensed assistive personnel (UAP) to assist in managing the unit. Here are the details for the care of the clients Score them using the National Council of State Boards of Nursing Decision making Gain an assignment sheet from a local clinical agency, or one made up to reflect the data in the exerted

    Client 1: The client is being cared for by the charge nurse. He has been on a ventilator for 1 year secondary to cerebral anoxia following a cerebrovascular acrodont. The client needs lots of suctioning He receives percutaneous endoscopic gastrostomy tube feedings and needs total care. The UAP a senior nursing student who has cared for complex conditions but is not as familiar with ventilators.

    The charge nurse has 6 years’ experience on the unit and is well versed in client care and delegation. The charge nurse has had the client the last two nights. The client’s status it stable. He is incontinent and has a Glasgow Coma Scale score of 5. The UAP is asked to provide all am care for the client 

    Client 2. This client is under the care of RN 2. He has been newly admitted directly from the doctor’s office. His diagnosis is COPD with acute exacerbation and mild respiratory stress. He is 89 years old and disoriented and has difficulty in swallowing He needs assistance with activities of daily living and ambulation: he can wash and feed himself.

    The UAP has been on the unit for 3 years and typically cares for clients with similar needs. The RN caring for the client has been pulled from the pediatric unit but is experienced in the care of clients with respiratory distress The UAP is asked to provide all am. care for the client.

    Client 3: The client is under the care of RN 3. She is postoperative, having had open heart surgery. She was transferred yesterday from the cardiovascular intensive care unit after being treated for cyanogenic shock and ventricular dysrhythmias. She has a chest tube hooked to 20-cm wall suction through a Pleurevac device. She is receiving 40 percent oxygen through a Venturi mask. She is at high risk for postoperative ventricular rhythm disturbances. 

    The RN assigned to the client has had a telemetry course and has moderate experience with cardiac rhythms and postoperative cardiac care. The UAP has recently finished orientation and has not worked with the cardiovascular surgical population. The UAP is asked to provide all am care for the client.

    Students are divided into groups. They’re given a copy of the National Council of State Boards of Nursing Decision making Grid (available in many texts and at www.ncbn.org). This assignment is an excellent one but does take 15 minutes to complete, potentially taking time from other activities. 

Implementation of Client Care Management In Nursing Education

    Stay in the classroom and roam among the groups. An instructor who leaves the room, checks voice mail, or does other work communicates to the class that the activity in not very entertaining or of much value for participants.

    When students move into groups, allow them to be comfortable Let them sit on the foot, turn chairs, or leave the room if that’s possible. 

    Keep group activities short-5 to 7 minutes and keep time carefully. Difficult or in-depth assignments may prove daunting, and the groups may spend more time complaining than working Set clear time parameters for Group Thought. 

    Use whistles or other attention getting devices to call the class to order. You may want the students to stay in their positions or return so their more traditional seating patterns when the group’s report or when class resumes.

    You may want to vary the size of the groups or their composition. This tactic is helpful if groups aren’t staying on task or if one group appears to be struggling more than another.

    For academic classes, make sure that the students connect the group activity with class objectives and testable material.

    Laten to the volume of the group activities. Experience has taught me that the volume in the room goes up when the groups finish their task and revert no personal conversation. Give 1-minute warnings and roam around the room to ensure that groups stay on task

    Group Thought is a great way to foster cooperative learning of complex material, such as setting priorities interpreting lab, ECG, or arterial blood gas data, determining methods of conflict resolution: or focusing on important nursing interventions related to client needs, as in the perioperative period.

    Group Thought is an important strategy for building rapport among nurses who work together or spend time together between units. Case studies that reflect clinical skills and daily nursing practice are well received.