Assessment Task 2: weighting 20% – Due week 9 & 10 during tutorial class.
Students will undertake within their tutorial IBL teams the following activities related to the role of the community nurse in caring for patients with chronic illness and/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 your tutorial facilitator.
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 are provided with patient scenarios related to 4 patients with varying chronic conditions who require to be seen in single day on your morning shift. One of these is a new patient and requires a longer more extensive visit.
Each team will present the following information to the tutorial facilitator and be able to respond to questions. The presentation will take the format of a case load conference or community handover and include:
• An outline of the role of the community nurse in relation to each patient drawing upon a job description.
• ISBAR handover for each patient. You should use the components of the clinical reasoning cycle (over page) to guide your ISBAR handover.
• Daily Planner including travel time, patient consult time and meal breaks
• Reference list
• Team Contribution Declaration
• One Assessment Rubric Per Team Member
You should aim to answer these questions as part of your ISBAR handover:
1. What is the pathophysiology of the client’s current condition(s)? What is your assessment of the client’s current medication including 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- What is it that you aim to achieve through your care and 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. Complete Day Planner
0730
0800
0830
0900
0930
1000
1030
1100
1130
1200
1230
1300
1330
1400
1430
1500 Report back to office complete all documentation.
1530 Finish work
Patient 1: Estimated consult time 30min
Name: Mr. Sebastian Jones Street Address:
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 being managed:
Ulcer on left leg weekly dressings
Patient 2: Estimated consult time 60min
Name: Mr. Tim Hewson Street address:
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 being managed:
Increasing symptoms/side effects related to medication Patient 3: Estimated consult time 45min
Name: Mrs. Wilma Weston Street Address:
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 TDS with meals
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 being managed:
Reddened area around catheter site, care review
Patient 4: Estimated consult time 2-3hrs
Mrs. Rebecca Smyth Street address:
Age 44
Medical History:
Relapsing – Remitting Multiple Sclerosis (RRMS) diagnosed 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 a ground floor apartment. They have one daughter, Tiffany, 8 years old. Jim runs the family plumbing business from home but is often out on the road. Rebecca left her position as a customer relations officer with Westpac 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 being managed:
Pain management and increase in symptomology