Review the Mr Harry Bright case study ? Question

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 Review the Mr Harry Bright case study ? Question 1: Formal academic sentence structure with in text referencing (approx. 600-700 words) ? Question 2: Use the ISBAR acronym (approx. 300-400 words) 2. Review the knowledge and skills relating to: a. Nursing Care implications: Coronary Artery Disease, Angioplasty (PTCI), Chest Pain, Bleeding and/or haematoma. Processesforpatientassessment c. ISBARframeworkforeffectivecommunication d. Vitalsignmonitoring e. IVTandinfusionmanagement f. BGL monitoring g. Clinicalreasoninganddecision-making. https://youtu.be/7ZjO-E_msy8
Instructions:
You are required to find five (5) contemporary, valid research journal articles (no older than 7 years) relating to the care of the patient undergoing angioplasty. Read the articles focusing on the assessment elements of care required post procedure. (Don’t forget to link your assessment reasoning to anatomy and physiology and pathophysiology). Pls read full assessment and all data before you start. I was failed on this unit last time pls do great job this time. I will really appreciate for that also am going to upload all the data once I receive order id. Also pls check the link for video as I uploaded School of Nursing
NSB231 Integrated Nursing Practice 2- “Mr Harry Bright”
Student Pre-Briefing Package
1
Clinical Simulation Learning Experience
Scenario learning objectives
1. Identify and demonstrate principles of patient assessment – post operative
2. Demonstrate process to assist in recognition and management of patient with chest pain
3. Identify and demonstrate principles related to effective communication in changing patient
situations
Simulation Scenario
Situation/Stats: Mr. Bright admitted to the ward post angioplasty. Routine admission for the
angioplasty as he had a 3/12 history of unstable angina.
Background/History: 67 year old male with a history of hypertension and DMII – usually reasonably
well controlled with medications and diet. He is also a smoker of 20 cigarettes per day.
He had an angioplasty to his right coronary artery where a drug eluting stent was placed and there
was 10% residual stenosis at the site. It was quite a difficult procedure and cardiac monitoring
during the stent placement did indicate some myocardial ischaemia.
His sheath was removed in recovery and there has been minimal wound ooze since then and no
bruising. In recovery he developed some chest pain. Nitroglycerin spray sublingually x 1 was give
which resolved the pain. As it was handed over from the Cath Lab staff that the doctor had some
difficulty doing the procedure and also that monitoring during the procedure suggested some
ischaemia, and the MO was contacted immediately when the patient complained of chest pain. He
did not order further treatment once pain was resolved
Assessment & Actions: RTW at 1650hrs. First set of post procedure obs within normal range. Next set
of obs (15 minutely at this stage) are due now.
Only very small wound ooze, no swelling or haematoma, no pain at site
IVT infusion of N/Saline (1000ml) @ 100ml/hr
Routine post angioplasty ECG taken and looks normal. Patient connected to monitor. No complaints
of chest pain at present.
BGL 10mmol/l
Welcome to this Clinical Simulation Learning Experience! It is designed to help you, as a third year student,
begin to integrate concepts and principles that are needed for practice as a beginning-level nurse in various
clinical settings.
This scenario is located in a general surgical ward within a tertiary hospital facility, however it could apply to
nursing practice in other settings as well, e.g. rural / remote health care facility, an acute care hospital ward,
an aged care facility. We hope you enjoy this learning experience and use it to build on your knowledge and
skill base for practice.
School of Nursing
NSB231 Integrated Nursing Practice 2- “Mr Harry Bright”
Student Pre-Briefing Package
2
Recommendation/Requests/Responsibility/Relevant Other: The patients allocated RN has asked you to
take over the care of this patient while she deals with another patient.
You are required to do care as per angioplasty pathway.
The patient is due for his next set of post op obs and a thorough assessment
Because he had chest pain in recovery, contact MO with any episodes of chest pain.
You will receive a nursing report/handover about Mr Bright in your simulation session pre-briefing.
Essential pre-scenario learner activities
In order to maximise your outcomes from this learning experience it is essential that you review the
requisite knowledge and skills.
Knowledge-based competencies Skill-based competencies
 Nursing care implications regarding:
̶ Coronary artery disease
̶ Angioplasty (PTCI)
̶ Chest Pain
 Processes for prioritising nursing actions
 Using framework (SBAR) for effective
communication
 Knowledge and skills regarding:
̶ Patient assessment
̶ Vital sign monitoring
̶ Anxiety reduction
̶ IVT and infusion management
̶ BGL monitoring
̶ Clinical reasoning and decision-making
Pre-reading to be undertaken:
 Bucher, L. & Johnson, S. (2015). Nursing management: Coronary artery disease and acute coronary
syndrome. In D. Brown & H. Edwards (Eds.), Lewis’s Medical-Surgical Nursing (4th ed.) (pp. 737-750).
 Estes, M., Callegia, P., Theobald, K. & Harvey, T. (2016) Health assessment and physical examination
Cengage. (pp. 432- 472).
 Rolley, J, (2011). “Nursing clinical practice guidelines to improve care for people undergoing
percutaneous coronary interventions”. Australian critical care (1036-7314), 24 (1), p. 18.
 Shoulders-Odom, B. (2008). Management of patients after percutaneous coronary interventions.
Critical Care Nurse, 28(5), 26 (THIS IS OLD BUT STILL RELEVANT)
Skills practice prior to simulation:
 Patient health assessment
 Management of intravenous therapy
 Management of intravenous therapy pump devices
 Administering IV medications
Websites/online resources to explore:
 http://heartfoundation.org.au/for-professionals/clinical-information/acute-coronary-syndromes
 http://www.safetyandquality.gov.au/our-work/clinical-communications/clinical-handover/
Essential pre-simulation learner activities
Patient-related information to review:
 Patient related documentation (including clinical documentation) available on blackboard
 Review what is involved in angioplasty procedures
School of Nursing
NSB231 Integrated Nursing Practice 2- “Mr Harry Bright”
Student Pre-Briefing Package
3
Simulation Learning Experience
There will be 3 main components to this Simulation Learning Experience:
Pre-briefing (YOU MUST COME PREPARED)
 Please be on time- your simulation will start on time and will need to finish on time.
 Your Facilitator will conduct a 5 minute pre-briefing and nursing report to help familiarise yourself
to the environment and to ensure the simulation activity is clearly understood.
 In the pre-briefing your group will be split into 2 sub-groups of 4 students each. One sub-group will
be Sim Participants and the other will be Sim Observers. In your other Clinical Simulation session
these roles will be reversed to allow all students to experience both roles.
Simulation activity
 The simulation activity will be 15-20 minutes in duration
 Receive nursing report
 Organise roles
 Assess patient needs, collaboratively plan response to needs
 Undertake patient care in simulation learning experience as a team (or observe same)
De-briefing
 Upon completing the scenario, all will re-join as a group to reflect on the simulation activity
 Your Sim Facilitator will lead the de-briefing discussion in which all students actively participate
 The de-briefing will be approximately 20 minutes in duration
 In the de-briefing you will be guided to include formal reflection to complete this experience
Roles and Responsibilities
Roles
Simulation (Sim) Participant
 Organise into roles within simulation (primary care nurse, supporting team members)
 Assess patient needs (using nursing assessment frameworks may assist e.g. ABCD, Functional
health assessment, APIE) and identify priorities
 Plan appropriate care in collaboration with team members
 Undertake care as a team, responding and reassessing patient needs as care is provided
Simulation (Sim) Observer
 Be prepared to give constructive feedback to colleagues of the simulation events. This can be
thought of as similar to giving feedback in any clinical setting (like you may receive from your
facilitator) we suggest you use sandwiched feedback as a format for this (positive comment,
constructive comment, positive comment)
 Be objective – comment on what could be done differently for the patient benefit or improvement
of nursing activity based on HOW and WHY this would be important
 Use the observer form to undertake a focussed observation

 Responsibilities
As part of participating in this learning activity it is expected that you will:
 Prepare yourself appropriately for this learning experience
 Arrive on time and work promptly through the simulation activities
 Be attired appropriately in your QUT School of Nursing and Midwifery clinical uniform
 Be respectful at all times to your fellow students and your Simulation Facilitator
 Engage positively in the learning experience so as to maximise the outcomes that you achieve
 Provide constructive comment and feedback which assists others to progress and learn
 Treat all interactions as confidential, discussions of observations and student performance to
remain within the group as confidential.
School of Nursing
NSB231 Integrated Nursing Practice 2- “Mr Harry Bright”
Student Pre-Briefing Package
4
NOTES

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