Question:
Discuss About The Health Education For A Patient Regarding?
Jenny is an aboriginal who has been suffering from childhood diabetes form the age of 13. The occurrence of diabetes often restricts the life of a person in several ways as she or he has to maintain a proper lifestyle to assure that no threatening condition occurs. Proper diet, proper intake of insulin, proper education to maintain the different medication and insulin intake – all need to be done in a systematic approach so that the patient can have a proper quality life (Forsberg et al., 2014). However at the time of her year 8, she left her home which not only resulted in incomplete education of the patient but also exposed her to large number of vulnerabilities. It is stated by the researchers that health education for a patient regarding her ailments helps the patient to be careful about her activities and also helps her to maintain different medication effectively. However in case of Jenny as her education was incomplete, she could not develop a concept about her ailment and the different negative aspects of the symptoms. Moreover she was found also not educated about her medication administration and self management tactics which made her vulnerable to different accidents like insulin shock. Moreover, she is altering her places depending upon the places of her stay and therefore he is consulting different healthcare professionals which are delaying the course of treatment and interventions as it becomes important for every individual to start his or her diagnosis form the very start. Moreover, each and every professional have different ways if handling an issue and these patterns vary from one another. Therefore this has also affected her treatment of diabetes making her confused as well as kept her uneducated as none have provided importance to teaching her about her disorder and how to take care for her (Hunter & Arthur, 2016). She has also been homeless for a large number of days which also had affected her health as she had not been able to maintain the important rules required to be followed by a patient of diabetes. In the recent days, she had been staying in a boarding hospital which is dirty and run down. This implies that she would have no one to care for as she requires assistance in her activities due to her head injury and also due to her uncoordinated movement. She needs care and affection as this moment which will help her to recover. Moreover a dirty and run down environment affects the mental stability of a patient negatively which will also delay her recovery process.
After her treatment in the emergency ward, she was transferred to the neurology ward which consisted of nurses, the ward physiotherapists, neurologist as well as diabetes educator and social worker. After three meetings of the team and after a period of four days, she was transferred to rehabilitation center as the professional thought it would benefit her properly. Not much information is present in the case study regarding the activities that had been conducted by the team in the neurology wards. The team in this ward contained of different professional who should have at least diagnosed her symptoms for seven days to monitor whether any negative conditions in her head or in her health had occurred or not (AlSayah et al., 2014). It seemed that they hurriedly transferred her to the rehabilitation centre. They mainly conducted a transitional mode of care where they transferred the patient to the rehab care. From the hospital course shown, it is seen that follow up is done for loss of balance, coordination and difficulty in ambulation but proper procedures have not been followed as is evident from case study. Secondly, in the rehab centre, it was seen that the multidisciplinary team consisted of physiotherapist, occupational therapist, rehabilitation medical consultant, and the nursing staff. They had been assessing her condition on a daily basis and therapy for assistance in coordination and walking went for six days (Gausvik et al., 2015). They were following a model of shared care programs where they were writing notes about jenny in the medical record to inform each other about the updates of Jenny’s case. However the procedure was not a proper one as it indirectly affected her health. As one member of the team took a wrong observation by stating that she has been walking with confidence just from one observation, she had noted the information without taking other observations. This was a mistake from her part as this went on to several errors (Rodrigues et al., 2014). The rehab consultant as well as the physiotherapist without conducting their respective assessment discharged her which is not ethically and intellectually correct. All of them have confirmed about the assessment individually before proposing for discharge, a proper training is required by the team in order to strengthen their critically analysing power so that each of them conduct their assessments properly to provide higher patient safety. They also did not educate her about the diabetes management and neither evaluated her present condition, as a result she went through another episode of insulin shock that results in further harmful consequences (Klipfel et al., 2014).
The decisions made by the first multidisciplinary team were found to be quite rapid as they did not evaluate the patient’s condition fully before transferring her to the rehabilitation centre. They had not conducted their work responsibly which is evident from the transition of the patient to the rehab centre. However, it is true that they had diagnosed the symptoms correctly and had allotted a multidisciplinary team with the right specialists for her different symptoms. She had faced injury in her head region for which she was having consistent headache, loss of coordination as well as difficulty with walking (Lancaster et al., 2015). These were noted by the professional clearly and therefore they had conducted diagnostic tests of her head region to find out whether she had faced major accident in her brain. They had conducted CAT scan and found out that no issue is present in her brain or skull region. This was an important diagnostic step and they rightly carried out the second point of the clinical reasoning cycle called the gathering information stage. Moreover, they had appointed the right specialists like neurologist to find out any negative symptoms of the neuron in the brain, social worker to look after her daily care and assist her in activities of daily life. They appointed physiotherapist to improve her mobility and joint reflexes, diabetes educator to educate her on the correct ways to control her insulin level and others. However although they had settle the right actions but they did not fix the time frame properly as they should have kept them at least for a week before transitioning her so that to evaluate her condition properly (Koharchik et al., 2015). In the rehab center also, they had correctly allocated the right specialists also but they also failed in the evaluation step of the clinical reasoning cycle for the evaluation they made was incorrect and her condition was not yet stable to walk by herself. Moreover they also did not evaluate the health literacy of Jenny by asking her questions thinking that she already knows everything. This has been negligence on their part and they are therefore accountable for the occurrence that Jenny again had due to insulin shock.
It was seen that the multi-disciplinary team of the hospital communicated over three meetings where they sat together and decided the course of treatment for the patient. It is the right kind of communication as this gives the scope of every specialist to put in their updates in front of all the team members where they can either use the information for their own interventions or they can also inform the others about better suggestions or others. However in the later case, it was not followed. The multi disciplinary team had an improper way of communication. They used to note down the changing symptoms of the patient and jot them individually so that others can see. This form of communication may prove to be harmful for the patient as if a particular professional makes a wrong evaluation; it will lead to several other chains of errors as others will act upon the observation made by the former (Victor-Shmil, 2013). These may be harmful for the patient safety as it happened in case of Jenny. When the nurse informed about the patient walking confidently, all others acted upon the documentation made by her. Moreover, it was also seen that all the professionals did not perform their individual evaluation before discharging the patient and depended upon the nurse entirely. This should not have been the procedure. Before discharge, all the team members should have evaluated her symptoms and jointly come to a conclusion by face to face meetings (Keleher et al., 2017). They should have been more careful with the evaluation part and should have checked her health literacy skills before discharging her. Due to insulin shock that occurred due to her improper taking of insulin and fall from the stairs due to her unbalanced walking could have been avoided if the care team would have been more responsible.
Jenny was discharged from the community center without any planned procedure about how he can take care of herself. She was also not mentioned of the community healthcare services she should take to help her get over her issues like the bump on her head, assistance in her walking, to continue her education on diabetes management and how to be more stabilized with life rather than changing places. With the foundation of many aboriginal community healthcare centers helping aboriginal people by giving support to their healthcare needs according to their cultural preferences. She should have consulted with the diabetes educator ensuring that she knows well about how to take care of herself (Stanhope & Lancaster, 2015). Moreover, she should also consult with the general physician to care for the bump on her head and take proper medication to recover the bump. She should also appoint a social care who would be assisting her with the daily activities. A physiotherapist should visit her regularly to develop her walking procedures and increase her mobility making it balanced and stable (Butterworth & Faugier, 2013). All of these would have been planned for her so that she can develop her quality of life and live better days.
References:
Al Sayah, F., Szafran, O., Robertson, S., Bell, N. R., & Williams, B. (2014). Nursing perspectives on factors influencing interdisciplinary teamwork in the Canadian primary care setting. Journal of clinical nursing, 23(19-20), 2968-2979.
Butterworth, T., & Faugier, J. (2013). Clinical supervision and mentorship in nursing. Springer.
Forsberg, E., Ziegert, K., Hult, H., & Fors, U. (2014). Clinical reasoning in nursing, a think-aloud study using virtual patients–A base for an innovative assessment. Nurse Education Today, 34(4), 538-542.
Gausvik, C., Lautar, A., Miller, L., Pallerla, H., & Schlaudecker, J. (2015). Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction. Journal of multidisciplinary healthcare, 8, 33.
Hunter, S., & Arthur, C. (2016). Clinical reasoning of nursing students on clinical placement: Clinical educators’ perceptions. Nurse education in practice, 18, 73-79.
Keleher, H., Parker, R., Abdulwadud, O., Francis, K., Segal, L., & Dalziel, K. (2017). Review of primary and community care nursing.
Klipfel, J. M., Carolan, B. J., Brytowski, N., Mitchell, C. A., Gettman, M. T., & Jacobson, T. M. (2014). Patient safety improvement through in situ simulation interdisciplinary team training. Urologic nursing, 34(1), 39.
Koharchik, L., Caputi, L., Robb, M., & Culleiton, A. L. (2015). Fostering clinical reasoning in nursing students. AJN The American Journal of Nursing, 115(1), 58-61.
Lancaster, G., Kolakowsky?Hayner, S., Kovacich, J., & Greer?Williams, N. (2015). Interdisciplinary communication and collaboration among physicians, nurses, and unlicensed assistive personnel. Journal of Nursing Scholarship, 47(3), 275-284.
Rodriguez, A., Magee, M., Ramos, P., Seley, J. J., Nolan, A., Kulasa, K., … & Maynard, G. (2014). Best practices for interdisciplinary care management by hospital glycemic teams: results of a Society of Hospital Medicine survey among 19 US hospitals. Diabetes Spectrum, 27(3), 197-206.
Stanhope, M., & Lancaster, J. (2015). Public Health Nursing-E-Book: Population-Centered Health Care in the Community. Elsevier Health Sciences.
Victor-Chmil, J. (2013). Critical thinking versus clinical reasoning versus clinical judgment: Differential diagnosis. Nurse Educator, 38(1), 34-36.
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