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NUR1201 The Patient Experience and Partnering in Care Assessment Item 2 Answer

NUR1201: The Patient Experience and Partnering in Care

S2 2019 Assessment Details

Assessment Item 2: Written Assignment

Task 1: Online discussion forum activity posts (15%)

From the forum titled: Forum - linked to Assessment 1 and 2 (seeded online forum Activities)’. 

Take a screen shot of each of the following posts to your group forum and copy them onto your assignment document.

Weeks 9: Reply post to a peer and a self-post


Week 10: Reply post to a peer and a self-post: due Monday 23rd September by 12 midnight

Be sure to include in your capture your name and the date of posting.

Instructions: how to take a screen shot: 

Using snipping tool: Go to your search icon located bottom left-hand side of your computer screen. Type in the search bar ‘Snipping tool’. 

Click the desktop app – snipping tool. Find the word New click the down arrow, click Rectangular snip. 

Drag the cursor around the area you want to snip. Click file, save as pictures. Create a folder NUR1201 Forum Posts. Save your capture in this folder.

Using control/alt/print screen (PrtScn)

Place the curser on the screen you want to copy.

Hold down the control and Alt tabs and click on print screen (PrtScn)

Place curser on the assignment doc and click on control 

Task 2: Case Scenario Reflection task using Gibbs 6 Stage Reflection Cycle

Case Scenario Recording: ‘The Age 75 Recording’

Two Topics of Focus for this case scenario: 

1. ‘Preventing falls and harm from falls’ 

2. ‘My health record’ (e-health record)

Background Information

Reflection is a way of thinking and working for Registered Nurses and is useful in raising our conscious awareness of aspects of care that may be hidden from our view. This raised awareness about these aspects of care improves our understanding as nurses and assist us in directing action strategies that can improve both the patient and their family’s experience and the ‘partnering in care’ strategies that we utilise. Improving the ‘patient care experience and partnering in care’ and using Gibbs 6 Stage Reflection Cycle (adapted version by Burns and Bulman 2000) as a framework in combination with drawing upon relevant theory provides a foundation for nurses to operate from and as such is required for Task 2. 

Instructions:

  • View the Case Scenario – Recording ‘The Age 75 Recording’

This Recording is located at the top of this study desk page within the white ribbon, under useful links: course recordings

  • After viewing the ‘patient experience and partnering in care’ case scenario recording – ‘The Age 75 Patient Experience and Partnering in Care’, write a 1500-word reflection using Gibbs 6 Stage Reflection Cycle (adapted version by Burns and Bulman, 2000) as the framework, in an essay style.  
  • Within your reflection aim to draw upon relevant literature/theory to help you analyse this patient experience with the goal to improve the care experience of patients and their families. 

Drawing upon relevant literature (theory) will support and strengthen your reflection. 

Examples of relevant literature you could draw from include: 

  • Theory taught this semester. For example the weekly NUR1201 topics such as the nursing philosophies of care (for example person-centred care, family centred care and holism) and nursing governances (for example, the Code of Ethics for Nurses, the Code of Professional Conduct for Nurses and the Registered Nurse Standards) that guide the application of nursing care practice, and other related standards such as the National Safety and Quality Health Service Standards, particularly Standard 2 Partnering with Consumers - partnering in care ‘action’ strategies.
  • Aim to also include relevant theory linking to this patient experience topic - Preventing falls and harm from falls; My health record (e-health record).
  • Other relevant literature from the weekly NUR1201 readings, including peer reviewed journal articles you have researched, using the USQ library data bases.

Reflection - using Gibbs reflection - 6 stages: adapted version by Burns and Bulman (2000) in an essay style: helpful hints

When to use third person and when to use first person.

  • Write in third person for this reflection /essay style - in most instances, for example the introduction and conclusion. 
  • Write in third person for - stages 1, 4, 5 and 6.
  • Write in first person for stage 2 (feelings and thoughts)
  • Write in first person and third person for stage 3 (Values/Beliefs), as applicable.

Please structure in the following way:

Suggestions to help you write your reflection in an essay style. See page 4.

Introduction –Purpose is to orientate your reader (150 words)

Write in third person here.

Write one paragraph here (no dot points)

  • The first sentence of your paragraph should provide the thesis statement (this is your position statement – your argument).
  • The second sentence should state the chosen case scenario, the Gibbs 6 stage reflection framework (adapted version by Burns and Bulman, 2000) and the main theories (for example the nursing philosophy of care, standards and other relevant theory/literature) that you will use in your reflective essay. 
  • The remaining sentences should include the overview of main points or brief plan for what will be included in your essay. 

Body of Essay – Gibbs reflection - six stages: adapted version by Burns and Bulman (2000)

  1. Description(guide only – up to 250 words at the most) Describe the patient’s experience overall in a general, but succinct manner. Within this general description, aim to draw out a particular relevant aspect. Next, detail whether the patients experience included falls prevention and harm from falls care, as well as care information related to My Health e-Record. 

From this description paragraph you have written, identify two key themes and briefly justify these themes of care focus.

Write in third person here.

Write one paragraph here (no dot points)

The first sentence of your paragraph should provide the main point.

The remaining sentences – describe the patient experience, identify the key themes and include a justification for these themes of care focus.

Feelings and Thoughts: (guide only 125 words) Describe and examine your feelings and thoughts in response to your description. Identify the values and beliefs that connect you to your feelings and thoughts and evaluate your response to the patient’s experience in terms of those feelings and thoughts. For example, why did you feel that way? (Link your response back to stage 1)

Write in first person here.

Write one paragraph here (no dot points)

The first sentence of your paragraph should provide the main point.

The remaining sentences – describe and examine your feelings and thoughts in response to your description. Identify the values and beliefs that connect you to your feelings and thoughts and evaluate your response to the patient’s experience in terms of those feelings and thoughts.

Values and Beliefs: (guide only 125 words) Describe some of your values and beliefs that may have impacted on your feelings and thoughts about what went on. After reflecting about the ‘values and beliefs’ that connect to your feelings and thoughts, identify where these values and beliefs originate from? Why are these values and beliefs important? Who are they important to and why? Are they important to you, the patient and the patient’s family? (Link your response back to stage 1 & 2).

Write in first person and in third person as applicable

Write one paragraph here (no dot points)

The first sentence of your paragraph should provide the main point.

The remaining sentences - describe some values and beliefs of yours that may have impacted on your feelings and thoughts about what went on. Identify the ‘values and beliefs’ that connect to your feelings and thoughts. Identify where these values and beliefs originate from and justify why they are important to you as a person and nurse as one, the patient and the patient’s family.

Analysis (400 words) Analyse the patient experience and partnering in care case scenario, identify and explain the care displayed in the case scenario (inadequate and adequate care).  Draw upon some literature to support your analysis of the case scenario and relate it to the scenario by providing examples. Aim to make sense of this patient experience in terms of how you reacted to it. (Link this analysis to your responses to stages 1-3).

Write two paragraphs here (no dot points)

The first sentence of your paragraph should provide the main point - relating to a reason why aspects of the care in the scenario were inadequate

The remaining sentences will explain and support the main point by referring to the evidence and relating it to the scenario using examples.

The first sentence of your paragraph should provide the main point - relating to a reason why aspects of the care in the scenario were adequate.

The remaining sentences will explain and support the main point by referring to the evidence and relating it to the scenario using examples.

Conclusions Drawn: (150 words) Identify the conclusions/new meanings that can be drawn here. (Link these conclusions to your responses to stages 1-4). 

Write one paragraph here (no dot points)

The first sentence of your paragraph should provide the main point.

The remaining sentences will link back to your responses in stages 1 to 4. Identify at least 2 negative and two positive indicators and detail how these indicators will direct future change in patient/family care.

Action Plan: (150 words) Describe an action plan that you would initiate based on your conclusions and say how this action plan you describe will improve patient care? 

Write one paragraph here (no dot points)

The first sentence of your paragraph should provide the main point.

The remaining sentences will select at least two ways to partner with patients/families – linking to the case scenario and justify the choice of these strategies selected.

Conclusion – Link back to your introduction thesis statement and summarise main points (150 words)

Suggestions to help you write your essay

Use one paragraph for this conclusion, restating your thesis statement, providing an overview of main points and providing a concluding sentence or two, that rounds out your learning from the assignment.

Essay style requirements 

  • Make sure to include your name and student number on both the assignment and the assignment file name 
  • Adherence to the stated word limit is required
  • Do not use headings or subheadings
  • All parts of the essay should be attempted 
  • Margins: 2cm on 4 sides; & line spacing: 2 (double spacing), however 1.5 is accepted; Font size: 12 Times New Roman 
  • Referencing:
    • Use APA 6th Edition referencing style 
    • A full reference list is required at the end of the assignment. For further information on referencing at USQ, refer to  https://www.usq.edu.au/library/referencing
    • Each paragraph’s first sentence is indented according to APA style
    • Refer to current (no later than 7 years; older seminal literature is accepted) academic peer-reviewed journal articles to justify your ideas.

Paste your 4 Screen shots here.

(Please note, this space will naturally expand as you insert your forum posts).

Start writing your Case Scenario Reflection task using an essay style here

Note: Assignment 2 Submission 
  1. On a word doc include your name, student number, marking criteria sheet and the two tasks of the assignment and submit it to the Assignment 2 submission link on the NUR1201 Study desk
  2. Please note checking your assignment through Turnitin is required before final submission. 
The Turnitin process may take up to 24 hours to produce a report. 
Therefore, allow adequate time to do this and address any issues of plagiarism detected by Turnitin before final submission. 
*Any percentage that relates to plagiarism detected by Turnitin is a concern and requires you to address this. 
The following link provides information on Turnitin (sourced from USQ learning centre). There is a drop-down box that you can click. 


Answer

Reflection 

Introduction

Health care professionals should comply with different values and beliefs such as rights, human relationship, commitment, sympathy, autonomy indecision making, respect, justice and privacy(Australian Institute of Health and Welfare: Waiting time for emergency department care, 2018). The particular reflective essay has adopted a case scenario to identify different positive and negative indicators so that those can be improved in providing better patient care facilities. The essay is developed with the application of the Gibbs 6 stage reflection framework, adapted version by Burns and Bulman, 2000. The key theories that have been applied in the essay are nursing philosophy, standards of care and code of nursing care. The essay describes the patient’s experience followed personal feelings and thoughts and values and beliefs that are related with the patient’s feelings. Adequate and inadequate indicators are highlighted in the analysis section, that again supported in drawing conclusion and developing an action plan to address those identified inadequate health care in the care provision service that are depicted in the case.

1. Description:

Patient’s experience about public hospital has been very disappointing because of which when he was suggested to visit hospital he had declined. Instead he had decided to wait till next morning and see his GP who had advised him to do an x-ray. The patient had shared his previous bad experience of suffering 11 hours in waiting room of the hospital before getting relief from intense pain because of kidney stone. Another bitter experience he had shared about his surgeon’sdescription of his shoulder injury was inhumane. The surgeon analysed to the patient that he had a tear in his muscle that is 30 cmand that could be ‘repaired and sewed’ and the use of words had made patient disappointed and shocked. He further did not offer the patient a choice and he sent him to the ‘best’ physio according to the surgeon and thus choice and empowerment have not been complied with.

The patient further had added that physio was very good who had provided detailed information about using aids such as sticks and performing exercise. He informed about his dizzy feeling to his GP and he ordered for a blood examination that identified his anaemia and this health issue has resulted to another severe fall. Since colonoscopy and endoscopy did not help in finding the cause of his anaemia, the health care providers have used advanced technology to identify the reason. Patient’s experience included falls prevention when he reported that he is feeling short of breath and dizzy. Patient also has added information about his physio’sdetail information about care and exercises that he had been following. 

Two key themes for care focus are choice and empowerment and information(Australian Nursing and Midwifery Council, 2010). These themes of care focus are essential in providing effective and patient centred care. Choice and empowerment allows patient to select the right decision as per theirhealth needs that has positive impact on theirhealth condition where they are efficient of making their decision by themselves(Bach & Grant, 2015). Adequate information helps the patient understand their health conditions, treatment and care facilities available and adopt right preventative measures and treatment procedures as per the given information(Blais, Hayes, Kozier, & Erb, 2015). 

2.Feelings and Thoughts:

In regards to the feelings and thought that the patient had experienced when he was described by the surgeon as old rag can be repaired and sewed as new pair of jeans was truly unacceptable and shocking especially when we hear such words about our body. Additionally, the surgeon had sent him to the physio as per his choice and no freedom was given to the patient in choosing a physio as per his decision. My feelings and values to providing respect and empathise with the patient connect with him and thus he should have respect from the surgeon as I believe every individual should be cared with adequate respect, sympathy and dignity. Additionally I feel that the surgeon’s referencing the patient to the physio was not right as patient’s right of making his own decision by supporting their autonomy has been violated. 

3. Values and Beliefs:

Some of my values and beliefs are respect, dignity, autonomy in decision making, justice, privacy, sympathy and human relationship suggested by Burkhardt & Nathaniel, (2013). These beliefs and values have affected my feelings and thoughts. These values and beliefs originated from my family, my background, relationship with my relatives and friends and my educational background. I believe the mentioned values and beliefs that I have developed over time are significant for me as a person, as a nursing professional, to the care users and their family members. I believe every individual has their right to be respected, their autonomy should be valued, treat care users and their family members with sympathy and be included in the therapeutic plan so that the care is patient centred(Nursing and Midwifery Board of Australia, 2010). Patient’s information should be protected and must not be exposed without their consent(Code of conduct for nurses, 2018). 

4.Analysis

Instance of adequate care has also been drawn in the given case where physio was found to be very good who had taught the patient about using aids and about conducting resistance exercises. Additionally upon informing the GP about his dizziness when standing, the GP had suggested for blood test that showed that he was anaemic. Here the GP had valued and respected patient’s health issues and suggested for blood examination that shows respect towards patient’s thoughts and feelings and engaging him in the care planning. Patient also was found to be satisfied with GP’s and physio’s treatment procedure that also supports adequate care process. The patient had swallowed pill cam to identify the cause of his anaemia as both colonoscopy and endoscopy failed to do so. Health care sector is using advanced technology for identifying health issues in patients. The patient was very satisfied with the use of advanced technology in the health care system in identifying issues. 

Inadequate care that is demonstrated in the case, is not valuing the autonomy of decision making of patient. The surgeon referred the patient to the physio who he believed was the best in the town without asking patient’s opinion or giving him any choice. Additionally, ill experience that the patient has come across in public hospital is again an instance of inadequate care. While the patient was suffering from excessive pain due to his kidney stone he was made to wait for long 11 hours before getting relief. Studies demonstrated that Australia has good health care but it needs to be improved further. Half of all patients wait more than a month across the nation for elective procedure such as hip replacement(International Committee of the Fourth International (ICFI), 2017). Patient was suffering from pain for 11 hours in the waiting room of the public hospital that has affected on his attitude towards hospitals. His intense pain has made him suffer where other patients were prioritized for emergency. Elective is referred here as patients can do without this procedure that is they may have been experiencing pain or suffering while moving during their waiting time. Elective means that the treatment cannot be performed immediately but can be scheduled(International Committee of the Fourth International (ICFI), 2017). To obtain dental services, about 25% of Australians wait for more than a year. Additionally in emergency departments of hospitals, patients with mental health illness wait for more than 8 hours (Australian Institute of Health and Welfare: Waiting time for emergency department care, 2018). 

5. Conclusions Drawn:

One of the most important positive indicators that have been identified from the particular case are effective communication, information sharing a respecting feelings of the patient(Nursing and Midwifery Council, 2015)by the physio and GP. Additionally use of advanced technology in health care settings for identifying health issues is another positive indicator. These two positive indicators can drive future development in patient and family care by as communication and providing information with the care users have very significant role in health are settings. Additionally engaging care users in the care planning also has very important role in providing patient centred care as by engaging or valuing the patients, health care professionals are able to identify the healthissues and health needs of the patients and thus can design care planning accordingly. 

One negative indicator that has been identified from the particular case are not involving patient in decision making and thus not complying with their rights and autonomy(The Code: Nursing and Midwifery Council, 2015). Long waiting hours and ignorance of patient’s pain is another negative indicator that has ill impact on patient’s attitude towards health care settings. These two negative indicators can be addressed to have better patient care facilities. 

6.Action Plan:

The action plan will help developing effective and patient centred care by promoting autonomy of patients and respect to their thoughts and opinions in the care planning. The care providing professionals will ask about different health issues, and seek their suggestions providing them with options so that the patients are allowed to get engaged in the care provision facilities. Involving patients and seeking their opinion will help the care professionals identifying their health needs and health issues that they have been facing. Developing care panning based on the health needs of patients are effective in preventing future health issues as well as providing right therapy. Further, family members also need to be engaged in the care planning so that they can also provide different health related information about the patient and thus help in care planning according. Long waiting hours needs to be minimised basedon patient’s severity of pain so that they grow trust on the health care professionals as well as system. This trust will help patients visit to public health care in future when they are in need. 

Conclusion

The reflective essay focuses on different values and beliefs such as rights, human relationship, commitment, sympathy, autonomy indecision making, respect, justice and privacy that are significant in providing holisticand patient centred care facilities. It has been identified in the particular essay that the patient’s autonomy indecision making, engaging him in care planning and sympathy towards the care user have been breached by the health care professionals. Additionally, long waiting hours also has been found to have deep negative impact on patient’s attitude health care settings that prevents him to visit hospital in need. However an action plan has been designed that can help in improved care facilities and provide a patient centred care. Two positive indicators that are identified in the particular reflective essay are application of advanced technology in the treatment provision and effective communication and information sharing from the physio that made the patient very satisfied. Key learning from the assignment is patient’s or/and family member’s engagement is care provision facilities have very important role in providing holistic and patient centred care that will facilitate in better health outcomes as well as avoiding ill health consequences. 

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