In this paper, the health policy selected is the “Patient observation health policy” It involves monitoring the vital signs as the essential components while caring for the patients in order to assess the effects of the diseases and its treatment effects. It also involves procedural detection of complication and being in a position to detect and identify early signs in the health set up by nurses (Cahil, 2014). There are different policies under this policy. These include the Psychiatric observation policy and enhanced observation policy. Nurses, in this case, are supposed to use their clinical judgment where necessary regardless of the observations in the patients. For example, in case of unstable patients, the nurses need to observe all the observations frequently of the vital signs until the patient stabilizes and if not possible they are to report to the senior doctors in the hospital to manage the situations. With this policy in place, there is the prevention of serious events like cardiac arrest and unexpected death in patients through the detection of the physiological observations and treatment in time and effectively.
Patient observation policy originated during the interim period in January 2005 by the Sydney South-West area health services. It was aimed at monitoring the physiological variables in order to evaluate the treatment effects in patients in the hospitals. In addition, the policy also provides guidance on the how nurses are to measure the vital signs in the hospital. Vital sign observations and assessment is vital in the determination of the health status of the patient and also a core function to the enrolled nurses (Bingham et al, 2015). Therefore the policy provides effective and safe healthcare to the patients by describing the vital sign assessments.
The risks associated with the policy are associated with routine observation of patient’s temperature, blood pressure and respiration are emphasized as the major characteristics to monitor and assess. These best achievable practices for nurses toward ensuring effective treatment and healthcare of the patients. The principles of the patient observation policy are also identified in the paper. The performance of nurses based on the procedures during the observation phase of the patient’s physiological state. The nurses are to audited and evaluated and with will able to monitor and also provide effective treatment to the patients (Wenqi et al., 2015).
Engaging and monitoring observation of vital signs in patients
According to the Australian Nursing and Midwifery Council, clarified health care responsibilities are provided to the nurses to prevent harm to the patients. The nurses undertake their nursing intervention basing on accurate and compressive assessments. With this policy, nurses engage with the patients throughout their recovery. Nursing observations have many features including gathering information from the patient. This is significant since it aids in clinical decisions made by nurses. Monitoring the vital signs is undertaken at the start of the nursing shift and the rest of the shift to ensure that there are no gaps in the observation process (Masters, 2017). Patient observation is important and requires commitment and engagement of nurses with the patients basing on the principle of recovery of the patient. Patient requires nurses to communicate with them to improve their health and feel safe depending on the vital signs in them (Churpeket al, 2015). The nurses are urged to work with patients by caring for their conditions. The therapeutic observations restrict nurses and only concentrate on the patients which improve on their welfare towards fulfilling their roles.
Patient observation prescription is done on admission through verbal explanation with the patient so that they receive the information needed for their care. The risk management plan has to be developed for the nurses to minimize risks during the period of observation. With this, the nurses have been trained to improve on their attitudes and understand the policies to provide effective treatments to the patients (Wenqi et al, 2015). Nurses are in a position to convey care and also understand how things are done to the patients.
Nurses used to neglect vital signs monitoring which affects their performance in the healthcare (Moriarty et al, 2015). For example, nurses could ignore patients waiting for rehabilitation and provide less frequent observations and also long-term patients assessed by doctors could be given no observation at all. The attitude toward monitoring vital signs is to increase due to the various tools in place and the regulation of the policy to promote nurses. Procedures seemed too long for nurses but with the policy in place, the nurses are in a position to assess the vital signs accordingly.
Nurses understand and are in a position to differentiate between the palliated patients from those requiring frequent observation. The policy, therefore, provides confidence to the nurses to pursue their roles in this field through collaboration, ensuring safety and teamwork among the nurses. Furthermore, the nurses are required to carry out early detection and treatment of patients deteriorating through the emergency systems in the health sectors of the country (WHO, 2013). These early dictions may lead to complications f not treated early by the nurses. With these procedures done the nurse will be competent to work in diverse condition with a lot of pressure.
Most of the patients have blood pressure, temperature, heart rate and level of consciousness that have to be recorded per every observation made (Storm-Versloot et al, 2014). The nurses are responsible for the measurements and are also able to use these measurements to make clinical decisions. The policy allows more frequent observations face to face interaction with the patients which improves on the relationship between the patients and nurses. Vital signs of blood pressure, temperature and respiration are assessed, measured and recorded and monitored differently in all patients during a blood transfusion in accordance with national guidance (Norfolk, 2014). Nurses are argued to spend time doing research on the matters concerning vital signs in most to help patients feel safe. On this matter, therefore, nurses will obtain knowledge on the way the observations are assessed and treated in the health setup.
Blood pressure monitoring accurate measurement is important in patients and if the reading is underestimated by the pressure of 5mmHg, there could be a denial of life-saving in hypertensive patients. Underestimating the blood pressure could double the number of hypertensive patients in hospitals. Nurses are to use more automated devices to operate in theaters and measure blood pressure accurately (Russell et al, 2013). In addition, Temperature reading differs depending on the site, therefore, nurses are to include sites, time and day of measurement. Lastly monitoring respiration is important since it is at the interface of the bodies and minds. Therefore to ensure accuracy in this measurement, the respiratory rate is supposed to be measured for 60 seconds using a stethoscope. The nurses will learn and be in a position to provide accurate measurement during observations in the hospital.
Adherence to the policy is compulsory to the nurses in order for health facilities to achieve their objectives. Audits and evaluation will help nurses improve their services and track their progress towards delivering services to the people. These audits ensure that vital signs are being measured and recorded. The audit and evaluation act as a performance measure for the nurses (Pasquale and Canton, 2014). The policy also increases pressure on nurses which makes them more accountable for their decision and actions. This audit could also improve the working environment of nurses by identifying other factors that lead to treatment failure in patients. The nurses are to be responsible for the outcomes of their actions during the assessment of vital signs which is important nurse role development in the health sector (Royal College of Nursing, 2015).
Conclusion
Vital signs assessment and monitoring are significant in determining the health status of patients. Careful measurements and standardized methods of assessing and monitoring all observations in patients can only ensure that patients are given correct therapy that prevents adverse conditions in the patient. Nurses are important in ensuring the safety of people and can only achieve this by getting accurate measurements of the vital signs. Monitoring vital signs are the main function of the nurse in a hospital, therefore, the patient observation policy will ensure the nurse is on the right track while assessing and monitoring the patients. With the policy, the nurses are to benefit and also be able to create a strong relationship with their patients with clear understanding is also emphasized that for the nurses to execute their roles with positive attitudes, audits and evaluation shall be conducted to monitor the recording and measurement of the vital signs in patients. The government of New South Wales set objective and also developed the policy due to the poor monitoring and evaluation of vital signs that are critical to people’s health.
References
Bingham G, Fossum M, Barrett M, Bucknall T. (2015). Clinical review criteria using physiological triggers: description and evaluation of a pre-met review system. Crit Care Resusc; 17:167–73. [PubMed]
Cahil, K. (2014). Patient Observation (Vital Signs) Policy – Adult. Royal Prince Alfred Hospital- review. Retrieved August 4, 2018 from https://www.safetyandquality.gov.au/wp-content/uploads/2012/02/RPA-observations-policy-directive.pdf
Churpek MM, Yuen TC, Winslow C, Hall J, Edelson DP. (2015). Differences in vital signs between elderly and nonelderly patients prior to cardiac arrest. Crit Care Med. Apr;43(4):816-22. doi: 10.1097/CCM.0000000000000818.
Masters, K. (2017). Role development in professional nursing practice (4th Ed.). Burlington MA: Jones& Bartlett Publishers.
Moriarty JP, Schiebel NE, Johnson MG. (2014). Evaluating the implementation of a rapid response team: considering alternative outcome measures. Int J Qual Health Care. 26(1):49-57. doi: 10.1093/intqhc/mzt091. Epub 2014 Jan 8.
Norfolk, D. (2014). Hand book of Transfusion Medicine. 5th Edition. TSO. Section 4.11.
Pasquale, E & Canton, A. (2014). Clinical audit, a valuable tool to improve quality of care: General methodology and applications in nephrology. World journal of Nephrology 3(4): 249–255.
Royal College of Nursing. (2015). Accountability and delegation A guide for the nursing team, London: RCN. Available at: www.rcn.org.uk/ publications
Storm-Versloot, MN, Verweij L, Lucas C, Ludikhuize J, Goslings JC. (2014). Clinical relevance of routinely measured vital signs in hospitalized patients: a systematic review .J Nurs Scholarsh; 46: 39 – 49
Russell B, Barnfield J, Baumgartner A, Collins I, Daly W, Denton C. (2013).Nursing observation through engagement in psychiatric inpatient care. Department of Health guideline
Wenqi M, Wenru W, Cooper S, Emily NK, Liaw YS. (2015). Attitudes towards vital signs monitoring in the detection of clinical deterioration: scale development and survey of ward nurses. International Journal for Quality in Health Care, Volume 27, Issue 3
WHO. (2013). World Health Organization [Internet] Progress Report on Nursing and Midwifery, 2008-2012. Geneva: WHO; 2013
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