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UTS HEALTH: Family and Children’s Nursing 92319 (Autumn 2013) Assessment: Case study analysis.

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In the first year of the Bachelor of Nursing program, two key areas of student learning were assessment and therapeutic intervention in health care and development across of the life span. In second year, the focus moves to episodic care. In this assignment students will draw on their knowledge of assessment and therapeutic intervention relevant to children and child development to discuss episodic nursing care of sick children and their families. The purpose of this assignment is to provide students with the opportunity to plan and organize care of a sick child and their family using clinic...

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In the first year of the Bachelor of Nursing program, two key areas of student learning were assessment and therapeutic intervention in health care and development across of the life span. In second year, the focus moves to episodic care. In this assignment students will draw on their knowledge of assessment and therapeutic intervention relevant to children and child development to discuss episodic nursing care of sick children and their families. The purpose of this assignment is to provide students with the opportunity to plan and organize care of a sick child and their family using clinical practice guidelines and other supporting literature, before participating in a simulation for recognition of the sick child. Students are required to locate and utilize relevant clinical practice guidelines and other supporting literature in the assignment. The case study will be discussed in the lecture in week one to assist student preparation for the assignment. Case study: Spring 2012 Lucas is a 7 month old male infant. His parents have brought him to the emergency department of their local hospital at approximately 0200 hours. On admission, the medical record notes the following assessment: For this assignment, students are required to: 1. Locate and utilize relevant literature for the assignment. This will include: o Two clinical practice guidelines that relate to the management of children with the condition:  One relevant clinical practice guideline from Australia (provided by teaching staff – see below), and;  Another relevant clinical practice guideline from another country. o Relevant journal articles and children’s nursing textbooks (no older than 5 - 10 years) 2. Write an introduction that explains: o Background to the topic; o Purpose of the assignment; o Search method used to locate the clinical practice guideline from another country 3. Identify the two immediate and important priorities for nursing care of Lucas 4. Outline and discuss a plan nursing care for Lucas and his family, using the clinical practice guidelines and other relevant literature to support discussion. This discussion should include: o Relevant nursing interventions to address the two identified priorities of nursing care. o Nursing care that supports the development of the infant o Compares and contrasts the clinical practice guidelines o Appropriate strategies for communication with children and families and health care professionals 5. Write a clear and logical conclusion that explains the key findings of the assignment 6. Prepare and submit their assignment in accordance with NMH requirements for presentation and referencing. Marking criteria: Assignments will be assessed according to the following marking criteria: • Introduction and organization of the assignment (10 marks) o Topic background and purpose of the assignment is explained o Assignment is clearly structured o Referencing and presentation meets NMH requirements. • Use of technology to locate and utilize clinical practice guidelines (CPG) (5 marks) o CPG are identified o Reason for inclusion is provided. o Search history is provided • Clinical judgment (30 marks) o Priorities are relevant and rational. o Interventions for identified priorities are relevant and based on current practice. o Plan of care supports the development of the child o Appropriate literature is used to support the discussion. • Communication (10 marks) o Relevant strategies for communication with children, families and health care professionals are explored o Appropriate literature is used to support the discussion. • Conclusion (5 marks). Key findings of the assignment are summarized.

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The guidelines for the recognition of a sick baby and child in the emergency department are to provide appropriate and well set channels to the clinicians and to the paediatric staff. They can be defined as a set of systematically developed statements that are aimed at assisting the decisions related to the patients and practitioners so that these help in providing the best possible directions for specifically determined clinical situations (McGillis, 2010). Here, a case study about a seven month old infant Lucas is given. He was admitted in the hospital by his parents at 0200 hours and his condition was well analysed by the medical staff to locate that he has been irritable and crying since many hours. He was pale and warm at the peripheries. He was observed to have profuse nasal secretions and dry mucous membranes. Also, he had not passed urine since 6 hours and his chest is clear. Other statistical measures of Lucas include heart rate of 172/minute, weighing 6.1 kilograms and temperature of 39.7 degree C per axilla. The condition of Lucas as analysed by the medical staff was indicative of him suffering from acute otitis media, moderate dehydration and upper respiratory tract infection. The plan framed by the medical staff includes paracetamol for analgesia, IV fluids until he is fed, observation of fluid intake and output and then finally admitting Lucas to the children’s ward. His condition has to be assessed after intervals of 4 hours. The relevant practices, top priority steps, role of nurses and other medical staff are further discussed. Also, it is strongly recommended that the documentation that is accurate, consistent and correct be maintained by the paediatric staff throughout the process of the management of the patient (Blom, 2006).

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