Objective:
Under the supervision I will be able to safely and competently identify chest pain protocols and/or administer intramuscular injection, in accordance to the NMBA standards of 6 rights of medication administration (6.5). According to Queensland government of health, indigestion, muscle strain, inflammation, shingles, coughing, angina and blockage in the heart are some common causes of chest pain, hence, chest pain does not indicated the symptoms of heart attack always (health.qld.gov.au, 2018). In order to manage a patient with chest pain proper health assessment is the most important procedure to identify the reason for chest pain. Chest assessment should include, ECG, blood test, chest x-ray and CT scan. Further, non-invasive assessment should be done for the identification of diabetes, hyperlipidaemia and hypertension. According to the identification effective action could be taken, for example, proper medication such as artery relaxers, blood thinners, aspirin, acid-supressing medicines, thrombolytic drugs and antidepressant could be provided. In severe cases surgical procedure may be used like, lung reinflation, dissection repair, bypass surgery,stent placement and angioplasty. In addition, the patient could be educated regarding self-management and skipping poor health behaviour such as substance abuse like tobacco and alcohol to prevent the risk of chest pain (Vrints, 2018).
Keywords:
Chest pain, ECG, chest x-ray, non-invasive assessment, knowledge, under supervision, safely, adverse effects, management, classifications, indications, competently
NMBA standard (s) objective links to:
(4.1)to conduct assessments that are holistic as well as culturally appropriate.
(5.3) documents, evaluates and modifies plans accordingly to facilitate the agreed outcomes.
(1.3) Respects all cultures and experiences, which includes responding to the role of family and community that underpin the health of Aboriginal and Torres Strait Islander peoples and people of other cultures.
(6.5) practises in accordance with relevant policies, guidelines, standards, regulations and legislation (nursingmidwiferyboard.gov.au, 2018).
Resources:
References:
health.qld.gov.au (2018).Chest Pain. Retrieved from https://www.health.qld.gov.au/__data/assets/pdf_file/0031/433957/ed-chest_pain.pdf
health.qld.gov.au (2018). Management plans and guidance | Queensland Health. Retrieved from https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/infection-prevention/management-plans-guidance
nursingmidwiferyboard.gov.au (2018). Nursing and Midwifery Board of Australia – Registered nurse standards for practice. Retrieved from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx
Vrints, C. J. (2018). Triage, diagnosis and management of acute chest pain syndromes, atypical and high-risk subtypes of acute coronary artery syndromes. European Heart Journal: Acute Cardiovascular Care, 7(7), 589-590. https://doi.org/10.1177%2F2048872618810252
Objective:
Under the supervision I will be able to safely and competently manage trans-radial band after the procedure in accordance to the NMBA standards of engaging in safe and quality practice (1.1). There are several complications in using TR band, for example, radial artery spasm, radial artery occlusion, forearm hematoma, access site hematoma and others. Hence, it is required to learn about the proper management of trans-radial band post procedure in order to minimize these risks (Edris et al., 2015).Effective management include, understanding proper size of the sheath, using proper assessment for identifying any complications for example, standard deflation technique, rapid deflation technique, feasibility assessment and others. In this regards, Queensland health provides effective clinical guidelines and procedure which could help to understand the process of dealing with trans-radial band post procedure (health.qld.gov.au, 2018).
Key Words:
Rapid deflation, standard deflation, feasibility assessment, clinical guidelines
NMBA standard (s) objective links to:
(1.1) accesses, analyses, and uses the best available evidence, that includes research findings, for safe, quality practice.
(2.6) uses delegation, supervision, coordination, consultation and referrals in professional relationships to achieve improved health outcomes
(5.1) uses assessment data and best available evidence to develop a plan
(7.1) evaluates and monitors progress towards the expected goals and outcomes
(1.3) Respects all cultures and experiences, which includes responding to the role of family and community that underpin the health of Aboriginal and Torres Strait Islander peoples and people of other cultures.
These would prove helpful to identify best process for trans-radial band post procedure, utilise supervision, assessment with proper plan and evaluate the plan to achieve expected outcomes (nursingmidwiferyboard.gov.au, 2018).
Resources:
The Australian Clinical Practice Guidelines by the National Health and Medical Resource Council is a useful resource that could help to achieve the objective (health.qld.gov.au, 2018).
References:
Edris, A., Gordin, J., Sallam, T., Wachsner, R., Meymandi, S., &Traina, M. (2015). Facilitated patent haemostasis after transradial catheterisation to reduce radial artery occlusion. EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 11(7), 765. https://dx.doi.org/10.4244%2FEIJV11I7A153
health.qld.gov.au (2018). Management plans and guidance | Queensland Health. Retrieved from https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/infection-prevention/management-plans-guidance
nursingmidwiferyboard.gov.au (2018). Nursing and Midwifery Board of Australia – Registered nurse standards for practice. Retrieved from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx
Objective:
Under the supervision I will be able to safely and competently learn the procedure of electrocardiograph and effectively implement the diagnostic tool (with lead placement) in accordance to the NMBA standards of engaging in safe and quality practice (1.1). Electrocardiograph is one of the most effective diagnostic tool especially for heat related issues. In order to find out the precordial lead placement Angle of Louis method is used during electrocardiography. In this process the space for V1 need to be identified. In this regards it is required to recognize the sternal notch placed at the second rib and feel down gradually to locate sternal border until the fourth intercostal space is recognized. In case of patient with lead placement, without adequate knowledge about ECG the sub-clavicular space may be identified as first intercostal space in case of a patient with lead placement. Therefore it is important to learn about appropriate ECG process. In this regards the guidelines for performing ECG provided by Queensland health is effective to understand about the proper process of dealing with ECG, as it provides detailed information about ECG procedure such as emergency protocol, infection control, identify the indications and contraindications, proper equipment and required training as well (health.qld.gov.au, 2018).
Key words:
Emergency protocol, electrocardiograph, sub-clavicular space, intercostal space
NMBA standard (s) objective links to:
(1.1) accesses, analyses, and uses the best available evidence, that includes research findings, for safe, quality practice.
(1.6) maintains accurate, comprehensive and timely documentation of assessments, planning, decision making, actions and evaluations
(5.1) uses assessment data and best available evidence to develop a plan
(7.2) revises the plan based on the evaluation
(1.3) Respects all cultures and experiences, which includes responding to the role of family and community that underpin the health of Aboriginal and Torres Strait Islander peoples and people of other cultures.
(7.3) determines, documents and communicates further priorities, goals and outcomes with the relevant persons (nursingmidwiferyboard.gov.au, 2018).
Resources:
References:
health.qld.gov.au (2018).Adult & Paediatric Resting Electrocardiography (ECG) Cardiac Sciences Retrieved from https://www.health.qld.gov.au/__data/assets/pdf_file/0018/147600/qh-gdl-387.pdf
health.qld.gov.au (2018). Management plans and guidance | Queensland Health. Retrieved from https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/infection-prevention/management-plans-guidance
nursingmidwiferyboard.gov.au (2018). Nursing and Midwifery Board of Australia – Registered nurse standards for practice. Retrieved from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx
Objective:
Under the supervision I will be able to safely and competently demonstrate a sound understanding of the storage and usage of schedule 8 drugs that commonly include opioid analgesic such as, buprenorphine, methadone, oxycodone, morphine, fentanyl and pethidine in accordance to the NMBA standards of the 6 rights of administration of medication (6.5). Hence, accomplishing this objective will help me to maintain safety and utilise the drugs in an effective manner. The guidelines indicate that, it is essential for the hospitals, medical practitioners, pharmacists, veterinary clinicians and other individual to comply with the strict legal requirements while using schedule 8 drugs. The drugs need to be stored in a locked compliant drug safe place and consumers are not allowed to store S8 drugs at home (health.wa.gov.au, 2018). Hence, it is important for a nursing professional to know about proper storage and use of S8 drug in order to comply with government regulations.
Key words:
Schedule 8 drugs, locked compliant drug safe place, home, knowledge, under supervision, safely, adverse effects, management, classifications, indications, competently
NMBA standard (s) objective links to:
(1.4) complies with legislation, regulations, policies, guidelines and other standards or requirements relevant to the context of practice when making decisions,
(2.8) participates in and/or leads collaborative practice and
(1.3) Respects all cultures and experiences, which includes responding to the role of family and community that underpin the health of Aboriginal and Torres Strait Islander peoples and people of other cultures.
(6.5) practises in accordance with relevant policies, guidelines, standards, regulations and legislation (nursingmidwiferyboard.gov.au, 2018).
References:
health.qld.gov.au (2018). Management plans and guidance | Queensland Health. Retrieved from https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/infection-prevention/management-plans-guidance
health.wa.gov.au(2018). Storage of Schedule 8 medicines. Retrieved from https://ww2.health.wa.gov.au/Articles/S_T/Storage-of-Schedule-8-medicines
nursingmidwiferyboard.gov.au (2018). Nursing and Midwifery Board of Australia – Registered nurse standards for practice. Retrieved from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx
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