Assessment Task 2 weighting 20% – Due week 9 & 10 during tutorial class time.
Students will undertake within their tutorial IBL working groups the following activities related to the role of the community nurse in caring for patients with chronic illness or disability. Each team member is responsible for equal contribution to the activities and all team members are required to be present for the team presentation. Presentation days and times will be allocated by Lecturer in Charge and tutorial facilitators
Assessment activities
Teams will be asked to function in the capacity of a community nurse who is allocated a workload for a single day in a designated area. Teams will be given patient scenarios related to 4 patients with varying chronic conditions who require to be seen in single day. One of these patients will be a new client.
Each group will present the following information to the tutorial facilitator and be able to respond to all questions. The presentation will take the format of a case load conference or community handover.
• A job description or outline of the role of the community nurse
• Patient/client handover for each patient, including New Patient/client.
o Part 1- Client/patient care plan- utilizing the clinical reasoning cycle o Part 2- ISBAR based handover sheet
• Daily Planner including travel time, patient consult time and meal breaks • Reference list
• Teams will be required to handover or present the new admission in detail to the case manager (tutorial facilitator)
For each patient/client complete the following components of Clinical reasoning cycle.
1. Pathophysiology of current condition/s, including assessment of pharmacology and pharmacokinetics
2. Consider the patient/collect cues- what information do you have?
3. Assessments required- What further information do you need or would like prior to your visit.
4. Identify problem/Issue- why are you visiting them? What will you do once there?
5. Establish Goal- How will you undertake the care required?
6. Evaluation- what strategies will you use to evaluate the outcomes
Use the following to write a handover for each patient/client for your case study meeting (this is your group presentation)
ISBAR
I Identify/patient information
S Situation/current issue
B Background/history if known
A Assessment
R Recommendation/Plan
Daily planner
Make sure you include time for consult, travel, notes & breaks
Time Patient 1 Patient 2 Patient 3 Patient 4
0700 Start work collect patient/client notes and all equipment needed. Work out planner
0730
0800
0830
0900
0930
1000
1030
1100
1130
1200
1230
1300
1330
1400
1430 Report back to office complete all paper work and prepare for next shift
1500 Finish work
Patient 1. Estimated consult time 30min
Name: Mr Sebastian Jones
Street Address: 234 Catherine St.
Leichhardt.
Age: 52 Medical
History-
Type II Diabetes Mellitus
Hypertension
Cataract in left eye
Social History –
Married with 2 children, lives with wife in urban community.
Owns an accountancy business, wife works in office.
Have 2 large but friendly dogs that have access to front yard.
Current medication
Ramapril 10mg Mane
Actrapid pen 100units/ml as per sliding scale
Current Issue –
Ulcer (venous) on left leg weekly dressings
Patient 2: Estimated consult time 60min Name: Mr Tim Hewson
Street address: 16/116 Illawarra Rd.
Marrickville
Age: 61
Medical History-
Ischemic stroke 6 months ago
Hypertension
Ischemic Heart Disease
Gastro oesophageal reflux
Social History –
Widowed, no children, lives alone in apartment block.
Current medication
Lisinopril: 20mg mane
Frusemide: 40mg daily
Aspirin: 150mg daily
Coloxyl and Senna: 2 tablets mane
Nexium: 40mg mane
Cymbalta 60 mg Nocte
Panadol 1gm PRN
Ibuprofen 400mg TDS- frequently taking prior to bed.
Current Issue –
Increasing symptoms/side effects related to medication
Patient 3 Estimated consult time 45min Name: Mrs Wilma Weston
Street Address: 4 Station St. Petersham.
Age: 74
Medical History-
• Renal Failure
• Type II Diabetes Mellitus
• Hypertension
• Impaired vision
Currently on overnight peritoneal dialysis
Social History –
Married with 4 adult children and 6 grandchildren, lives with Husband at home, both retired.
Active in local community and community projects. Active in local catholic church community
Wishes to continue to manage PD at home for as long as possible
Current medication
• Calcium carbonate 1500mg mane
• Ramipril 10mg mane
• Omeprazole 20mg mane
• Captopril 12.5 mg TDS
• Calcitriol 0.025mcg BD
• Metformin 1gm BD
• Erythropoietin 60 units per week
Current Issue –
Reddened area around catheter site, care review
Patient 4. Estimated consult time 2-3hrs Mrs Rebecca Smyth
Street address: 118 The Boulevarde, Lewisham.
Age 44
Medical History
• Relapsing – Remitting Multiple Sclerosis (RRMS) following her diagnosis three years ago.
Current medical history:
• Symptoms of spinal syndrome characterised by paraesthesia, pain, muscle spasms and spasticity.
• Muscle weakness and stiffness in her limbs • Increasingly experiencing pain and fatigue • Sense of hopelessness.
• Impaired vision which makes reading more difficult • Diplopia which affects her balance.
• Slurred speech
Social History –
Rebecca lives with her husband Jim in their three bedroom home. They have no children. Jim runs the family plumbing business from home but is often out on the road. Rebecca left her position as a customer relations officer at the Westpac bank and is trying to maintain the books for Jim’s business.
House has overgrown front yard and 3 broken steps to the front door.
Current medication
• Baclofen 5 mg tds
• Diazepam 5 mg nocte
• Trial of Gabapentin 300 mg mane
Current Issue –
Pain management and increase in symptomology