Posted: September 13th, 2022

Discuss/ Reflect on how your practice might change

Purpose of Assessment:
The goal of this Assessment is to develop your understanding evaluating the skilled conduct of a nurse/midwife within the case research supplied.
The case research supplied is a call assertion chosen from Choices of the Skilled Requirements Committee from the Nursing and Midwifery Council New South Wales – The Well being Care Complains Fee (HCCC). You might be to determine skilled practice points from the case research after which draw on the skilled frameworks and regulatory laws, to develop sound and acceptable responses to the scientific incident that may inform your future practice.
Particulars:
This Assessment requires you to determine and summarise the skilled practice points within the case research from both a nursing or midwifery practice perspective. It’s essential to determine and consider related skilled errors recognized that doubtlessly contributed to the incident taking place. Lastly, talk about on how your future practice might change and develop because of this studying.
College students are to attract on the Nationwide Security and High quality Well being Service (NSQHS) Requirements, NMBA skilled practice paperwork and NSW Well being coverage paperwork (the place acceptable) to develop knowledgeable responses.
College students should confer with and use the case research positioned on vUWS underneath Assessment 2 tab for this Assessment. There’s one nursing case research and one midwifery case research to select from.
A Essential Assessment Essay:
1. May be very nicely structured
2. Presents a transparent logical argument
Three. Presents and critiques [interprets] the argument
four. Makes use of vital Assessment language options
5. Is nicely thought of and thought out.
6. Has references to Help the primary concepts.
Introduction paragraph (round 150 phrases = 1 paragraph) 10 marks.
• Orient reader to the subject; make clear and outline all main subjects
• Embrace thesis assertion
• Define the primary concepts of your essay physique
Physique part 1 (round 200 phrases = 1 paragraph)
• Summarise the case research skilled practice points comprehensively and clearly from a nursing/midwifery perspective . 10 marks.
• Reference the case research the primary time you point out it (see subsequent slide for how to reference the case research).
Physique part 2 (round 600 phrases = maybe divided into 2-Three paragraphs)
• Establish the related skilled errors that doubtlessly contributed to the incident taking place. Use clear, scientific reasoning that matches the context of the errors. 30 marks.
• Seek advice from NSW well being coverage paperwork and different helpful sources of literature
Physique part Three (round 400 phrases = 1-2 paragraphs)
• Talk about/ Reflect on how your practice might change and develop following this incident. 20 marks.
• Relate your concepts to the case research context utilizing vital pondering
• Use current and related references to Help your reply together with NMBA Requirements for Practice doc/s and Nationwide Security and High quality Well being Service (NSQHS) Requirements
• First individual writing right here OK, eg. I/me/my
Conclusion paragraph (round 150 phrases = 1 paragraph) 10 marks.
• Summarise your arguments / most important concepts. Restate thesis. Finish with a concluding assertion (eg. suggestion/ software to nursing practice)
• No references wanted.
Reference listing
• Minimal of eight references together with NMBA Requirements for Practice doc/s and Nationwide Security and High quality Well being Service (NSQHS) Commonplace
1 • Establish & summarise the skilled practice points within the case research from both a nursing OR midwifery practice perspective.
2 • Establish and consider [analyse from your perspective] related skilled errors [from the case study] that doubtlessly contributed to the incident taking place.
Three • Hyperlink and Help these utilizing the skilled practice literature and coverage paperwork [nursing policies/ professional guideline documents] [Again, analyse and interpret them-don’t just copy/paraphrase them –tell us what they actually mean in practice]
four • Talk about how your future practice might change and develop because of this incident
Well being Care Complaints Fee v Youssef & Well being Care Complaints Fee v McArthur [2021] NSWCATOD 2
[HCCC v Youssef & McArthur [2021] NSWCATOD 2]
Preamble
1) The Well being Care Complaints Fee prosecuted a criticism in opposition to Registered Nurse, Ms Nelley Youssef earlier than the NSW Civil and Administrative Tribunal.
On 9 February 2017 an 80-year-old affected person who had a laryngeal stoma was discovered unresponsive. The Fee alleged that Ms Youssef had inappropriately agreed that a junior colleague apply dressing to the stoma and supplied the dressing to the colleague for that function. It was additionally alleged that when the affected person was later discovered unresponsive, she didn’t take away the dressing for resuscitation to happen and supplied deceptive data by stating that when she discovered the affected person unresponsive, the dressing was not protecting the stoma.
In its choice on 13 January 2021 the Tribunal discovered all allegations in opposition to Ms Youssef proved and that they amounted to unsatisfactory skilled conduct misconduct.
2) The Well being Care Complaints Fee prosecuted a criticism in opposition to Registered Nurse, Mr Seamus McArthur earlier than the NSW Civil and Administrative Tribunal.
On 9 February 2017 Nurse McArthur was caring for an 80-year-old affected person who had a laryngeal stoma. The Fee alleged that Nurse McArthur inappropriately positioned a dressing over the stoma to allow the affected person’s stoma to stay dry whereas having a bathe. The dressing obstructed the sufferers solely airway. The Fee additionally alleged that Mr McArthur supplied deceptive data to the Fee.
The Tribunal discovered that Mr McArthur’s choice to use the dressing to the stoma and his lack of information surrounding the stoma amounted to unsatisfactory skilled conduct.
Motive for the choice
On 13 March 2020 the Well being Care Complaints Fee (the HCCC) utilized to the Tribunal underneath the Well being Practitioner Regulation Nationwide Legislation (the Nationwide Legislation) for orders in opposition to Registered Nurses Nelley Youssef (continuing 2020/00081521) and Seamus McArthur (continuing 2020/00081523).
At a route listening to on 24 July 2020 an order was made that each proceedings be heard collectively, with proof in a single to be proof within the different.
The complaints in opposition to every practitioner are introduced in relation to their conduct on 9 February 2017, after they have been rostered to work on Ward DB4, the respiratory and infectious ailments ward at a big metropolitan hospital in Sydney (the Hospital).
Affected person A was an 80-year-old man who had been admitted to Ward DB4 the afternoon earlier than after spending a number of days within the Intensive Care Unit (ICU) for hypotension with a background of infective exacerbation of power obstructive pulmonary illness (COPD). Affected person A had a longtime laryngectomy stoma following surgical procedure for laryngeal most cancers in 2002. Affected person A had a complete laryngectomy, which meant that his larynx had been surgically eliminated and a everlasting neck stoma created. That stoma was his sole airway.
Affected person A sought RN McArthur’s help in making ready for a bathe. RN McArthur at the moment, with the consent of Affected person A, utilized a Mepilex occlusive dressing that coated the entire of Affected person A’s stoma. Previous to making use of the dressing, RN McArthur checked with RN Youssef to see if the applying of the dressing can be acceptable, which plan of action RN Youssef agreed to. RN McArthur then left Affected person A to bathe.
Someday later RN Youssef entered the toilet and noticed that Affected person A was non-responsive. Makes an attempt have been made to resuscitate Affected person A which have been unsuccessful.
NSW Police attended, and an post-mortem report was ready for the Coroner and witness statements have been taken from a variety of Hospital employees. The post-mortem report concluded that the illness or situation instantly resulting in demise was “occlusion of the exterior airway within the context of a everlasting tracheostomy after the therapy of laryngeal carcinoma”. The Tribunal was knowledgeable on the listening to that the matter continues to be being thought of by the Coroner. There aren’t any pending prison proceedings.
The complaints
The complaints in opposition to every practitioner have been amended by consent on the listening to. Explicit 1 of Criticism One in opposition to RN Youssef initially was that RN Youssef had “suggested a nursing colleague” to use the dressing and was amended to be that she “responded to a request for recommendation from a junior colleague by agreeing that it was okay” to use the dressing. Explicit 1 of Criticism Two in opposition to RN Youssef and RN McArthur initially was that every had supplied false and deceptive data “to the Hospital” of their statements of 27 February 2017 and 9 March 2017 respectively; the reference to “the Hospital” was deleted from specific 1 of Criticism Two in opposition to every of RN Youssef and RN McArthur.
RN Youssef
There are three complaints in opposition to RN Youssef.
Criticism One is that she is responsible of unsatisfactory skilled conduct underneath s 139B(1)(a) of the Nationwide Legislation in that her conduct was considerably under the usual moderately anticipated of a practitioner of an equal stage of coaching or expertise, in that she:
Inappropriately responded to a request for recommendation from a junior nursing colleague by agreeing that it was okay to use a Mepilex occlusive dressing to cowl Affected person A’s stoma;
Inappropriately supplied a Mepilex dressing to her colleague for use to cowl the stoma earlier than Affected person A commenced his bathe;
Demonstrated a lack of information of the underlying anatomy and scientific historical past of Affected person A;
Demonstrated a lack of information that the laryngectomy stoma was Affected person A’s sole airway;
Failed to hunt recommendation from a extra senior colleague concerning the suitable administration of Affected person A’s laryngectomy with respect to the suitable dressing to cowl his stoma whereas he showered; and
Did not take away the dressing from Affected person A’s stoma when she discovered him unresponsive within the bathe, thereby failing to make sure he had a transparent airway when resuscitation efforts have been commenced.
Criticism Two is that she is responsible of unsatisfactory skilled conduct underneath s 139B(1)(l) of the Nationwide Legislation in that she engaged in improper or unethical conduct referring to the practice or purported practice of nursing, in offering false and deceptive data:
In a press release dated 27 February 2017 when she said that on the time, she discovered Affected person A unresponsive, “I observed that the Mepilex Border dressing was now not in situ. The stoma was not coated, and I didn’t see the dressing within the surrounding space”, in circumstances the place the dressing was in situ on the time; and
In her letter to the HCCC dated 15 June 2017 when she said that when she discovered Affected person A unresponsive “the Mepilex dressing was now not in situ, the stoma was not coated”, opposite to s 99 of the Well being Care Complaints Act 1993 in circumstances the place the dressing was in situ on the time.
Criticism Three is that she is responsible misconduct, relying on the particulars of Complaints One and Two each individually and cumulatively.
RN Youssef admits in response to Criticism One which she agreed a Mepilex dressing can be appropriate, and that she supplied a Mepilex dressing. She admits that she had a lack of information of the underlying anatomy of Affected person A’s altered anatomical state after his laryngectomy in 2002, and denies that she didn’t have data of Affected person A’s scientific historical past. She admits she had a lack of information that the laryngeal stoma was Affected person A’s sole airway, and that she failed to hunt recommendation from a extra senior colleague. She denies that she didn’t take away the Mepilex dressing when she discovered Affected person A unresponsive within the bathe.
In response to Criticism Two RN Youssef denies that she supplied false and deceptive data. In response to Criticism Three she depends on her responses to Complaints One and Two.
RN McArthur
There are three complaints in opposition to RN McArthur.
Criticism One is that he’s responsible of unsatisfactory skilled conduct underneath s 139B(1)(a) of the Nationwide Legislation in that his conduct was considerably under the usual moderately anticipated of a practitioner of an equal stage of coaching or expertise, in that he:
Inappropriately utilized a Mepilex occlusive dressing to cowl Affected person A’s laryngeal stoma earlier than he commenced his bathe;
Demonstrated a lack of information of the underlying anatomy and scientific historical past of Affected person A; and
Demonstrated a lack of information that the laryngectomy stoma was Affected person A’s sole airway.
Criticism Two is that he’s responsible of unsatisfactory skilled conduct underneath s 139B(1)(l) of the Nationwide Legislation in that he engaged in improper or unethical conduct referring to the practice or purported practice of nursing, in offering false and deceptive data:
In his assertion dated 9 March 2017 when he said that after protecting Affected person A’s complete stoma web site with a Mepilex occlusive dressing he waited with Affected person A for “not less than 5 minutes or longer after I had utilized the dressing to Affected person A’s stoma web site”, in circumstances the place he didn’t stay with Affected person A for a interval of 5 minutes or longer after he utilized the dressing;
In a letter despatched to the HCCC by his authorized consultant dated 15 June 2017 during which he said that when he “utilized the dressing previous to getting into the toilet and it was not less than 5 minutes or longer after making use of the dressing that RN McArthur left Affected person A within the lavatory”, in circumstances the place he didn’t stay with Affected person A for a interval of 5 minutes or longer after he utilized the dressing; and
Within the letter despatched to the HCCC by his authorized consultant dated 15 June 2017 which said that “when Affected person A was responding to RN McArthur’s questions concerning the dressing he was talking with out problem and in full sentences, and didn’t present any indicators of respiratory misery”, opposite to s 99 of the Well being Care Complaints Act 1993, in circumstances the place the practitioner didn’t stay with Affected person A to look at him talking with out problem nor exhibiting indicators of respiratory misery.
Criticism Three is that he’s responsible misconduct, relying on the particulars of Complaints One and Two each individually and cumulatively.
RN McArthur admits that he inappropriately utilized the Mepilex dressing to cowl Affected person A’s stoma, and that on the time he had a lack of information of the underlying anatomy and scientific historical past of Affected person A and demonstrated a lack of information that the laryngectomy stoma was Affected person A’s sole airway. He denies offering false and deceptive data within the assertion of 9 March 2017 or the letter dated 15 June 2017. He denies that he’s responsible misconduct.
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