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A nursing management perspective of a critical incident report

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About the document

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documents in English
term papers
8 pages
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  1. Introduction
  2. Time frame guidance
  3. Good management of a patients care
  4. That healthcare professionals and poor communication skills
  5. A good nurse-manager
  6. The essence of managing and reducing risk
  7. The Waterlow Pressure Damage and Assessment
  8. A nutritional assessment upon admission
  9. Increased risk of malnutrition in psychiatric patients
  10. Guideline dissemination
  11. Conclusion
  12. References

The assignment will discuss a critical incident from a nursing management perspective, being an admission assessment experienced during placement. It is not a care study. There will be an overview of the nurse-managers responsibilities during the admission assessment and attention drawn to local and government policy. Particular consideration is given to risk assessment, Essence of Care (DoH 2001) in respect of the Waterlow Pressure Damage Assessment (1985), pressure sores, nutritional screening and delegation. Other issues considered will be communication, partnership working, the therapeutic relationship, and the nurse as an agent of change. Findings will be supported by literature. Identifying factors have been changed to respect patient confidentiality.

Mary had no previous psychiatric history. She was eighty-four and lived in residential accommodation. She had two adult daughters who were unable to attend Mary's admission.

[...] As a manager in promoting evidence-based practice there is a need to monitor the incidence and prevalence of pressure sores and preventative measures taken by nursing staff alongside any risks specific to individual patient groups like older people and malnourished patients. To this end it is important to audit current practice of the risk assessment, and the degree of nursing knowledge in respect of this during admission assessments (Parker 1998). I believe that good management, competent nursing care and a ?duty of quality? should ensure that these risks are identified upon admission during assessment; failure to do so is poor practice. [...]

[...] To manage patient care from a non-judgmental perspective the nurse-manager should keep an open mind and not label patients as mentally ill when the diagnosis is unknown and could be due to a physical reason (Abayomi, Hackett 2004). The doctor did not weigh Mary during the admission or detect that she was undernourished. Following this, I requested the ward manager purchase some NHS approved digital scales to encourage the doctor or nurse upon admission to weigh the patient. The current scales are a on' style and are locked away in a different area of the ward. [...]

[...] This also goes against the advise of the Standing Nursing and Midwifery Advisory Council (2001) who state that good management should ensure staff are considerate of changing demography, the ageing process, multiple pathologies in old age, communication with patients who may have cognitive impairment, holistic nursing assessment, risk assessment, partnership working, patient as a partner in their care, issues of incontinence, constipation, skin integrity, mal-nutrition, mobilization and activities of daily living before engaging in the admission assessment process to ensure all the patients needs will be met. [...]

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