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Workplace Reflection
[Name of the Writer]
[Name of the Institution]
HLTENN001-PRACTICE NURSING WITHIN THE AUSTRALIAN HEALTH CARE SYSTEM
Criteria
Please document examples of what you have observed, practised, performed or discussed related to each criterion
Discuss what is meant by professional boundaries between nurses and clients
A therapeutic relationship is one that allows nurses to apply their professional knowledge, skills, abilities, and experience towards meeting the health care needs of the client.
List some examples of the types of charts or documents used in the health care facility
Observation charts
Neurovascular observation charts
Sliding scale chart
Medication chart
Discuss the effects of hospitalization on patients including the consideration of social and cultural influences
Patients might feel unsafe if they are in a hospital that they don’t know. Patients also feel uncomfortable in a hospital due to diversity and increased interaction with diverse people.
Investigate the role of members of the multidisciplinary health care team, for example:
Occupational therapists
Diversional therapist
Physiotherapist
Doctor
Social worker
Registered nurse
Student RN
Enrolled nurse
Assistant in nursing
Occupational therapists treat disabled patients and ill patients with the therapeutic use of routine activities.
Diversional therapists enhance the psychological and physical wellbeing of individuals through various activities.
Psychotherapists used to treat conditions such as arthritis, strains, back pain, sprains, posture problems, and workplace injuries. They are also responsible for rehabilitation following surgery.
Doctors are licensed medical professionals who diagnose and treat patients.
Hospital social workers are responsible to provide emotional support to patients during times of crisis.
A registered nurse assists doctors to provide effective treatment to patients who are suffering from certain medical issues.
Student RN work to maintain and promote the health of patients in compliance with hospital procedures.
Enrolled nurse work under the direction of registered nurses in a team, contributing to patient care planning and nursing assessments.
Nursing assistants are responsible to provide basic care for patients in certain medical facilities.
Discuss and observe how client confidentiality is maintained in the workplace.
Client confidentiality is the protection of personal information. It is the responsibility of medical staff to lock and secure the files that contain personal information and medical history of client from co-workers, friends, family, etc.
HLTENN002-APPLY COMMUNICATION SKILLS IN NURSING PRACTICE
Criteria
Please document examples of what you have observed, practised, performed or discussed related to each criteria
Participate in a team meeting and/or case conference. Identify communication methods used and their effectiveness.
Upon participating in a team meeting, I have observed that two-way communication method has been used to commute among each other. Two-way communication method allows people to deliver their message and get a response back from the audience. It is notable to mention that two-way communication method in a health care environment allows the participant to share information and get a response that whether a person understands a specific point or not. This method is most appropriate and effective to solve any kind of problems or issues.
HLTENN001-PRACTICE NURSING WITHIN THE AUSTRALIAN HEALTH CARE SYSTEM
Student to identify how nursing practice contributed to the person’s health outcome
Professional Interaction
Situation (e.g. staff members involved/location)
Person’s health outcome
A patient fell out of bed (unwitnessed)
Myself, 3 registered nurses, Clark, and wardsmen. We had to plan on what was the best way to get him back into the bed.
Patient was shaken but have no injury. All those involved suffered no injury.
A patient uses abusive language with medical staff by unintentionally dropping a bottle on the patient due to the slippery surface.
Myself, registered nurses, Clark, and wardsmen. Effective communication to calm the situation.
No serious injury. Minor pain in the arm due to hit by the bottle.
HLTENN004-IMPLEMENT, MONITOR AND EVALUATE NURSING CARE PLANS
Identify how you have implemented and monitored two different nursing care plans
Client problem
Nursing goal
Nursing intervention, implementation & monitoring
The patient fell out of bed
The goal is to get him back into bed.
The patient was shocked and shaken. The patient keeps trying to get up. Nursing staff, wards Clark, wardsmen, and myself were able to come up with a plan to get him back into bed.
Unintentionally dropping a bottle on a patient due to a slippery surface.
The goal is to calm down the patient through effective communication and check for any injury.
Nursing staff, wards Clark, wardsmen, and myself came up with a plan to use effective communication to calm him down and to use medications to reduce his pain.
HLTINF001-COMPLY WITH INFECTION PREVENTION AND CONTROL POLICIES AND PROCEDURES
Criteria
Please document examples of what you have observed, performed or discusses related to each criteria
Identify and observe types of isolation nursing protective/ source isolation
Source Isolation aims to restrict the infectious agent in order to prevent its spreading from one place to another. The major reason behind this isolation is to prevent the spreading of the infectious agent from one patient to another.
Protective isolation is applied to safeguard the hospital staff and patients from an immune-compromised patient.
Ensure appropriate signage is positioned appropriately to manage infection control risk
It is notable to mention that standardised signs are essential to increase the awareness of healthcare workers, patients, and their family members. One should need to make sure that appropriate signage such as airborne standard precautions, contact standard precautions, and droplet standard precautions are in place. These signs should be at an appropriate place and easily visible.
Discuss the use of standard precautions and personal protective equipment (PPE) for at least one of the following
Double bagging
Double bagging of linen from isolation and non-isolation rooms is effective whenever the integrity of the bag has been altered. Double bagging should also be used in case the outer bag has become soiled with bloody fluids. In order to manage the soiled linens, one must use utilize personal protective equipment such as gloves to ensure his/her safety.
Identify protocols within the health care facility related to:
A sharps injury
A splash of blood or other body fluids
Hazard/incident reporting
A person is at increased risk of certain diseases when his/her skin is accidentally punctured. The wound needs to be washed with soap and water. Doctors take blood tests to check for any HCV, HIV, and HBV and advise the patient to reduce the risk of transmission.
Upon exposing to blood or body fluids, one must not soak or squeeze the wound. The area needs to be washed with warm water and soap. A doctor will take blood samples for any infections such as hepatitis B and C and HIV. Antiviral medications are necessary to prevent HIV if they are started within 2 hours of exposure.
In case of any hazard or incident occurrence, one must report to the supervisor or higher authorities without waiting for an inspection team to come by. Health and safety legislation in Australia requires a person to report any such incidence to his/her superintendent or supervisor.
Provide an example of maintaining clean and contaminated zones and limiting contamination in the workplace.
Clean zones in the hospital are storage areas for medicaments, materials, and equipment. Clean zones also include administration areas and sterile storage areas.
Contaminated zones in the hospital working environment include receiving area in the instrument reprocessing centre for contaminated instruments. Also, areas, where materials are contaminated during use, come in the contaminated zones. Appropriate PPE and disposal of contaminated materials help to mitigate infectious spreading.
HLTWHS002-FOLLOW SAFE WORK PRACTICES FOR DIRECT CLIENT CARE
Criteria
Please document examples of what you have observed, practised, performed or discussed related to each criteria
Find and ensure you know the location and use of the following:
Fire alarms
Fire hoses
Fire extinguishers
Duress alarms
Evacuation sites
Fire alarms are required in mechanical rooms, elevator lobbies and waiting areas open to the corridor. These are located within five feet of a fire or smoke door. They are used to alert individuals about the outburst of fire.
Fire hoses can be located within 4 meters of an exit and are used to spray continuous water for protection against radiant heat.
Fire extinguishers can be found in meeting rooms, kitchens, hallways, near exit doors, kitchens, and mechanical-electrical rooms, etc. These are used to extinguish small fires.
Duress alarms are used in locations where there is a risk of hazard or where a lone worker works late hours. These are used to protect employees from assault or other hazards.
Evacuation sites provide protection from various hazards and they are in close proximity to the evacuated building.
Participate in a fire safety drill evacuation and determine the correct use of fire safety equipment.
For fire extinguisher, pull the pin out, aim the base of the fire, squeezing the handle to extinguish the fire, and sweep the nozzle from side to side for effective results.
Fire blankets are put over a small fire to cut off the supply of oxygen.
Locate and read hazard and risk checklist
A workplace hazard and risk checklist include stairways, aisles and floors, lighting, windows, storage of various medical equipment, appropriate beds, office areas, waste disposal, and oxygen cylinders, etc.
Complete an incident report on an actual or simulated incident
Near miss description: the electric winch was used by workers to fit the LED. It is notable to mention that inappropriate fasten of the clamp with LEB lead to LED screen failure. Workers were working at a height of around four meters.
An estimate of loss potential: waiting report from an engineer.
Injury: Nil
Property damage: waiting for the report from the QC department and engineer.
Analysis: Lack of adequate supervision
Corrective actions: The surrounding area must be separated by barriers or signage to avoid any injury. Workers make sure to check the integrity and attachment of the hook.
Reported by: Oliver Hawking, HSE supervisor
Location and use of personal protective equipment
Personal protective equipment is found in various hospital doctor's offices and clinical labs. These equipment act as a barrier between the human body and contaminants. For eye protection, goggles are used. Bacterial contaminants can be avoided by gloves and face mask.
Perform a risk assessment and include strategies to reduce the risk. Report residual risk as per organisational policy
Activities
Moving and handling patients
Use of hazardous substances
Use of both clinical and non-clinical equipment
Dealing with patients
Nursing confused patients
Bathing vulnerable patients
It is notable to mention that risk assessment helps to promote the quality of patient care.
Potential hazards
Uncooperative, patient heavy
Liquids, mists, dusts etc.
Infection such as MRSA
Verbal or physical abuse
Missing patients
Risk of scalding due to hot water
CHCDIV001- WORK WITH DIVERSE PEOPLE
Describe an individual's social or cultural background
How have you respected their needs?
Any adjustments to verbal/non-verbal communication need?
Possible problems that may arise
Reflect on your own view of diversity in this situation
An Italian woman (no English)
Italian women were treated with a warm welcome along with her family and were given the satisfaction that she will be treated effectively.
A translator was needed. Son in law was able to stay with the patient to translate.
Italian women were aged and had difficulty to communicate. Even the translator was not effectively communicating due to the poor guidance of women.
Different people have different views and perspectives on the healthcare system. I observed that she was a little terrified about to get treatment from an unfamiliar place.
HLTAAP002 - CONFIRM PHYSICAL HEALTH STATUS
Criteria
Please document examples of what you have observed, practised, performed or discussed related to each criteria
Give examples of medical terminology used in the work environment for which you had to obtain clarification or for which you had to research the meaning
HRT: hormone therapy treatment
BCG: Bacille Calmette Guerin
Note variations of normal physiology and health status observed in your patients e.g. signs of impairment to circulation
A patient experience digestive issues, fatigue, memory loss and difficulty concentrating. Numbering and tingling in the hand and feet are also observed in the patient with impairment to circulation. Swelling in the feet, legs, and ankles along with variations in the skin colour are also observed.
HLTENN008 APPLY LEGAL AND ETHICAL PARAMETERS TO NURSING PRACTISE
Criteria
Please document examples of what you have observed, practised, performed or discussed related to each criteria
Locate and discuss health care facility policies related to:
Discharge against medical advice
Clothing/valuables
Storage of cash and valuables
Patient with the capacity to make health care decision for himself/herself has the right to decide about leaving the medical facility.
Chief executive has overall responsibility for the safety of patients and their property whilst in the hospital premises.
Associate Directors of Nursing or Charge Nurses are responsible for reconciliation ward safe checks to ensure that patients' cash and valuables are kept in security office safe.
Locate and discuss health care facility policy related to restraints, noting different types of restraints
Physical restraint in a hospital is one or more member of staff holding the person to stop them leaving.
Mechanical restraint is the usage of equipment such as bed rails, mechanical locks, and mittens, etc. to restrain a patient.
Chemical restraint commonly includes sedatives or anxiolytics drugs to restrict a person to leave the hospital.
Listen to and give verbal report/clinical handover
Clinical handover is the transfer of professional responsibility and accountability of a patient to family or legal guardian on a temporary or permanent basis. The handover verbal communication between the nurses is beneficial to increase nurses' satisfaction which leads towards high-quality care.
Reflect on other ethical and legal concepts during your professional experience. This reflection relates to 3-4 situations in your professional experience where you feel that ethical and legal concepts have been applied.
What was the clinical situation and what were the ethical or legal concept?
How has the concept applied and how has this influenced your practice?
Patient injury as a bottle fell unintentionally from a medical staff member. The ethical concept was to calm the patient.
Effective communication has been used to calm him down. It shows that effective communication is an effective way to solve issues.
Clinical depression inpatient. The ethical concept was to sympathize him.
Use of psychotherapy and talk therapy to empathize patient. It shows the efficiency of talk therapy to control the emotion of the patient.
Breaking bad news. The ethical concept was to reduce the pain of the family.
Called the head of the family to tell about the critical situation of the patient in the emergency ward. Assuring him/her that top quality health care practitioners are performing patient's treatment and he/she will be fine soon.
HLTAAP003 ANALYSE AND RESPOND TO CLIENT HEALTH INFORMATION
Whilst on professional experience complete the following table using details with conditions affecting different body systems for at least 6 different clients.
Health information
Physical assessment
Observations
Client Tests
Interpretation of Tests
Planned Services
Osteoporosis
Examination of lost height and spine of the patient.
Decreased density (mass/volume) of mineralized bones.
BMD test or Dual-energy x-ray absorptiometry (DXA or DEXA)
The test can determine the risk of fractures.If the bone mineral density is low then it indicates that a person is having osteoporosis.
Lifestyle changing, regular exercise, and usage of medications such as alendronate and risedronate.
Epilepsy
A neurological disorder causing periods of unusual behaviour and sensations.
Abnormal activities of the brain such as loss of awareness and unusual behaviour.
EEG (Electroencephalogram)
It determines the abnormal pattern of brain waves.
The EMP can be used by the patient suffering from epilepsy.
Alzheimer’s Disease
Loss of memory due to impact on mental functions
The patient is unable to remember anything from the past for some time.
MRI and CT
MRI can detect brain abnormalities linked with mild cognitive impairment.
Therapy and drugs such as donepezil, galantamine, and rivastigmine are effective for this patient.
Polymyositis
Inflammation of the muscles or associated tissues
Joint pain and stiffness, muscle pain, problems with swallowing, and muscle weakening.
MRI scan
Muscle biopsy
Muscle biopsy indicates that inflammatory cells invade and destroy healthy muscle fibers.
Prednisone is effective to control polymyositis’ symptoms.
Pneumonia
Infection that inflames the air sacs in the lungs
Chest pain
Fatigue
Fever
Sweating
Shaking
Coughing
Chest x-ray test is effective for diagnosing pneumonia
Chest x-ray test allow to see heart and blood vessels along with lungs. It gives white spots in the lunges that indicate an infection.
Use nonsteroidal anti-inflammatory drugs along with aspirin.
Drink plenty of fluids.
Asthma
Breathing difficulties
Inflammation in air passage that narrows down the airway that carries oxygen to the lungs.
Lung function tests
This test provides reduced FEV and absolute FEV/FVC ratio that tells about an obstructive pattern.
Reduce the need for quick-relief medicines.
Prevent troublesome symptoms such as shortness of breath.
END NOTES
Duckett, S., & Willcox, S. (2015). The Australian health care system (No. Ed. 5). Oxford University Press.
Wilson, R. M., & Van Der Weyden, M. B. (2005). The safety of Australian healthcare: 10 years after QAHCS. Medical Journal of Australia, 182(6), 260.
Lane, R., Halcomb, E., McKenna, L., Zwar, N., Naccarella, L., Davies, G. P., & Russell, G. (2017). Advancing general practice nursing in Australia: roles and responsibilities of primary healthcare organisations. Australian Health Review, 41(2), 127-132.
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