DEME20002 Supporting and caring for people with Dementia

Learning Outcomes Assessed

1. Analyse the diverse presentations of people with dementia and the impact this may have on their care.

2. Demonstrate the comprehensive assessment of people at risk of or experiencing dementia.

Aim

The aim of this portfolio is for you to demonstrate your ability to appropriately assess the diverse presentations of people with dementia using a comprehensive assessment tool.

Instructions

There are three parts to this portfolio.

Part one: Select two case studies located on Moodle and describe the presentation of the two people with dementia.

Part two: Explain how diverse presentations of people with dementia may impact the care delivered to them by health professionals.

Part three: Describe and justify your comprehensive assessment of the people in the two case studies selected. This assessment must include physiological, psychosocial, and cognitive assessment.
Ensure each part of the e-portfolio is substantiated with peer-reviewed literature.

Literature and references

The number of references you should use is not limited. You should consider using references when you have used material from another source .You may also use seminal scholarly literature where relevant. Additional suitable references include textbooks and credible websites. When sourcing information, consider the 5 elements of a quality reference: currency, authority, relevance, objectivity, and coverage. Grey literature sourced from the internet must be from reputable websites such as from government, university, or peak national bodies: for example, the Australian College of Nursing.

Case study

Case Study 2. Mary Hobson.

Mary is a fifty-three-year-old woman who resides in the Fairfield Elsis Residential Aged Care Facility. She has lived in the facility for three years, after being found by neighbours in her house, on the ground, following a fall. Mary has no next of kin and her medical records indicate that she has previously had children, however, she does not appear to have contact with any of them at present. Mary needs encouragement with all areas of ADL care. She will commonly sit for hours on end unless she is encouraged to move. The facility has asked you to come in and assess Mary and suggest some strategies to motive and inspire her to increase her activity.

Meeting with Mary

When you meet with Mary, she immediately embraces you, and calls you the name of one of her children. She asks you about the football and grins widely as she talks happily of how Collingwood is likely to win the grand final. She talks about many different topics: cake making, cathedral windows, and sings hymns through your conversation. She seems very pleased that you have come to visit. She is less motivated to move from her
seat and when you suggest a walk, she says “No no no no...”. She looks slightly disturbed that you want her to move. You notice that toward the end of the meeting, she begins to become slightly over familiar, and you notice that there is a change in her demeanour.

Significant history

Mary has quite a lengthy medical history listed in her notes, involving injuries from previous falls (one only a few weeks ago), dental issues, bunions on both feet, arthritis in her legs and fingers, vitamin B deficiency, anorexia, previous diagnosis of alcoholism, and a past diagnosis of depression, along with her diagnosis of early-onset dementia, possibly alcohol-related dementia.

SOLUTION

Presentation of two people with dementia:

Mary (53 y, Female): The presentation of her symptoms of dementia indicates that she currently does not have any contact with any of her children, nor does she have any close relative to care for her. Her symptoms show that she has absolute disinterest to move, walk or be active.

In addition, she needs encouragement in all areas of daily-life activities. Also, the meeting with Mary has confirmed that she suffers from delusions and hallucinations because she was taking the names of her children and having some conversations about football matches, cathedral, and cake making that were not relevant indeed.

(Barry &75y, Male): Barry resides with his son at his residence who cares about his food and also gives him company. The case about Barry suggests that he has post-traumatic stress resulted from the Vietnam war. Barry has some frightening memories of the Vietnam war and thus suffers from panic attacks and sleep deprivation. Barry’s disease is called vascular dementia (Gowan & Roller, 2019). As suggested in the case study, Barry had recently suffered a stroke and that might have blocked an artery in the brain.

Part two

The way diverse presentations of dementia patients influence care delivery:

The diverse presentation of dementia affects the care delivery process because all patients have unique symptoms and have unique life experiences. In the case of Mary, she has no interest in moving or having doing activity. She suffers from delusions, hallucinations and many underlined diseases such as deficiency of Vitamin B, anorexia, dental issues, and many others. Her past medical history confirms that she has multiple issues and alcohol-related dementia. Patients like Mary need empathy because emotional support provides patience and insights to them. Thus, treating these patients with empathy would generate better care outcomes (Arvanitakis, Shah & Bennett, 2019).

However, in the case of Barry, he is suffering from post-traumatic stress disorder (PTSD) followed by the Vietnam war. He has traumatic memories of the war and gets panic attacks and sleepless nights. His condition reveals that he is not comfortable sharing much about the experience of the war. In addition, Barry also undergone a stroke which resulted in visio-perceptual difficulties. Since Barry is resistive in nature but is open to discussion for possibilities, an effective CBT would help him combat the issues.

Impact of the assessment on nursing care:

The care delivery process by nurses for dementia patients depends on their age, history of their life experiences, severity of dementia, and the presence of other underlying medical conditions (Kim, 2019). Referring to the case study of Mary, patients like her must be provided with suitable tools like an easy chair where they can feel comfortable. Also, ssome familiar and interesting decorations can make them feel engaged to their surroundings. These might encourage them to be more mobile and be active. Also, caregivers and nurses must empathize with patients like Mary and avoid questioning them (Harrison et al., 2018).

Furthermore, patients like Barry often need psychological therapeutic interventions. Gowan & Roller (2019) suggests that psychotherapies and Cognitive Behavioural Therapy can effectively help patients with vascular dementia and post-traumatic stress. For these patients, the nurses must also consider exposure treatments. Thus, it can be said that the diverse presentation of people with dementia tends to influence the way of care delivery by health professionals.

Part three

Comprehensive assessment for Mary:

Physiological: The falls risk assessment of Mary reveals she has high risk of falling as she was found collapsed on the floor before being admitted to the care unit. Also, she is immobile and has number of underlined diseases like anorexia, previous alcoholism, deficiency of Vitamin B and so on. Additionally, the pressure ulcer risks for Mary are also high as she was an alcohol and thus has high chances of liver ulcers. Moreover, the deficiency of Vitamin B can lead to mouth ulcers.

Psychological: Tools like Beck Depression Inventory (BDI) can be used to assess her depression and anxiety. Diagnosis reveals that she still longs for her children and is lonely. The psychological assessment reveals that refusal to walk or move can be characterized by old-age, increasing severity of dementia, orthopaedic aspects, and decreased functionalities. This assessment is important as this reveals about the psychological status of the patients and hence determines the care giving procedure.

Cognitive: The tools like Cognitive Impairment Scale PAS can be used for assessing her cognitive aspects. The diagnosis reveals that she was suffering from cognitive decline and having hallucinations and hence have been facing difficulties with her ADLs.

Comprehensive assessment for Barry:

Physiological: The falls risk assessment of Barry reveals that he has high risk of falling as he has visio-perceptual issues and depression. His old age can be another contributing reason to his falls risk. The pressure ulcer assessment of Barry’s case reveals that he does not have any symptom of developing ulcers and hence the risk is low. Barry must be exposed to some like-minded people as him with whom he can connect and communicate easily.

Psychological: The psychological assessment tool like Cognitive and neuropsychological tests can be used to determine his anxiety and depression scales (Beckman et al., 2019). The diagnosis reveals that barry has declining thinking skills and he finds it difficult to connect and communicate with people. This assessment would help the care givers to determine the level of care needed and to give the most suitable psychotic therapies.

Cognitive: The cognitive assessment can be done through Dementia Severity Rating Scale (DSRS). This assessment reveals that the type of dementia Barry has entails reasoning, memory, planning, and other types of thought processes resulted from the trauma of the Vietnam war. A recent psychological theory called Emotional Processing Theory states that the exposure treatments can be helpful for these patients’ cognitive condition as it would prevent the trauma memories to be negatively incorporated within their brain (Hayes, 2015). 

References

Arvanitakis, Z., Shah, R. C., & Bennett, D. A. (2019). Diagnosis and management of dementia. Jama, 322(16), 1589-1599. https://jamanetwork.com/journals/jama/article-abstract/2753376

Beckman, E., Lazar, K., Van Hulle, C., Cole, A., Asthana, S., & Gleason, C. (2019). Association of traumatic brain injury, post-traumatic stress disorder and vascular risk with cognitive function in a veteran population: the brave study. Alzheimer's & Dementia, 15, P1559-P1559. https://doi.org/10.1016/j.jalz.2019.08.160

Gowan, J., & Roller, L. (2019). Changed behaviours in people with dementia. AJP: The Australian Journal of Pharmacy, 100(1180), 69–77. https://doi.10.3316/informit.320828203940274

Harrison, S., Cations, M., Jessop, T., Hilmer, S., Sawan, M., & Brodaty, H. (2018). Approaches to deprescribing psychotropic medications for changed behaviours in long-term care residents living with dementia. Drugs & Aging, 36(2), 125-136. https://doi.org/10.1007/s40266-018-0623-6

Hayes, A. (2015). Facilitating emotional processing in depression: the application of exposure principles. Current Opinion In Psychology, 4, 61-66. https://doi.org/10.1016/j.copsyc.2015.03.032

Kim, H. (2019). An analysis of the need for aid tools in dementia patients: focusing on the normal elderly, dementia patients, and caregivers of dementia patients. Indian Journal of Public Health Research & Development, 10(11), 4399. https://doi.org/10.5958/0976-5506.2019.04300.6

NURS3015 Health Variations 4 – Acute Life Threatening Condition

Case Analysis- Case Study of an Acute Life-Threatening Condition

Word Count

There is a word limit of 1000 words. Use your computer to total the number of words used in your assignment. However, do not include the reference list at the end of your assignment in the word count. In-text citations will be included in the additional 10%-word count. If you exceed the word count by 10% (1100 words) the marker will stop marking.

Aim of assessment

The aim of this assessment is to enable students to:

1. Demonstrate knowledge by analysing the information provided in the case study.

2. Apply the clinical information provided in the case study and describe this clinical information within a pathophysiological and patient focused framework.

3. Discuss nursing strategies and evidence-based rationales to manage a patient with acute heart failure

4. Discuss the pharmacological interventions related to the management of a patient with acute heart failure

Details

You are to answer all questions related to the case study provided for assignment help. Your answers must be directly related to the clinical manifestations that your patient presents with. You must submit your work with a minimum of six references from the past 5 years including peer-reviewed journal articles, textbook material or other appropriate evidence-based resources.

Case study

Mr. Aloha Das is a 68-year-old gentleman presenting to the emergency department at 0400hrs with worsening shortness of breath. Onset 2 days ago and progressively worsening. He also developed wheeze and right sided pleuritic chest pain this morning. Vomited x1, ongoing nausea. Has history of non-compliance with medication and adherence to fluid restriction.

Past History

Hypertension, Inferior Myocardial Infarction in 2020, Heart Failure, non-ischemic Cardiomyopathy, Permanent Pacemaker inserted 2021, DM Type II, GORD, Osteoarthritis.

Current medications:

Furosemide 40mg OD, Captopril 6.25 mg TiD, Digoxin 0.125 mg BD, Metformin 500mg TiD, Nexium 40 mg BD.

On 1.2 L fluid restriction; Echocardiogram results in 2021- systolic dysfunction, mild mitral valve regurgitation, dilated left atrium and ejection fraction (EF) 33%.

Plan

• Continuous cardiac monitoring
• 12 lead ECG
• Blood pathology order
• Troponin I High Sensitivity
• Chest X-Ray
• Insert IVC right hand
• Furosemide 40mg IV Stat
• Echocardiogram

Results of Investigations:

Chest x- ray: Left ventricular hypertrophy, interstitial edema noted by Kerley B lines in the costophrenic angle.

Blood Results:

Electrolyte, urea and creatinine:

Result/ Reference Range

Sodium - 137 mmol/L 135-147 mmol/L
Potassium - 3.9 mmol/L 3.5-5.2 mmol/L
Chloride- 105 mmol/L 95-107 mmol/L
Urea nitrogen(BUN) - 14.0 mmol/L 3.0-8.0 mmol/L
Creatinine- 147 μmol/L 64 -104 μmol/L

Question 1

In order to prioritise your nursing actions, you are expected to have a sound understanding of the pathogenesis and pathophysiology.
Explain the pathogenesis and pathophysiology causing the clinical manifestations with which Mr Das presents.

Question 2

Choose one high priority nursing intervention that you will perform for Mr Das

– Briefly explain why you chose this nursing intervention
– Explain how the nursing intervention will alleviate the clinical features of Mr Das using physiological linking
– Describe briefly the impact of not performing the intervention

Question 3

Mr Das has been prescribed Furosemide 40mg IV Stat and Glyceryl Trinitrate IV Infusion 10 mcg/min starting rate.

For both medications explain

– The mechanism of action
– Why your patient is receiving this medication in relation to his symptoms and diagnosis?
– What are the nursing considerations for this medication?
– What clinical response you expect?
– What continuing clinical observations will you need to undertake?

Submission

Refer to Section 2.5 of the Learning Guide- General Submission Requirements Submit your assessment through Turnitin

Format

All assignments are to be typed Typing must be according to the following format:
3 cm left and right margins, double spaced.
Font: Arial or Times New Roman
Font size: 12pt
See further submission requirements below

Submission Requirements

1. Electronic copy only. Students are to submit an electronic copy of the assessment. Students are not required to submit the original hard copy of their assessment on campus

2. Submit your assessment electronically through the Turnitin link on the unit vUWS site.

3. Students are to upload the assessment with the following title: Surname_Firstname_assessment title

4. Your assessment must be submitted in .doc, docx format.

5. This assessment is marked online; no paper copy will be accepted. Marks, comments and the marking criteria will be released online. If you do not receive your marked assessment when all others have been returned, it is your responsibility to contact the Unit Coordinator for assistance.

Solution

Question 1:

RHD (Rheumatic heart disease) indicates a major cause of cardiovascular diseases. In this case study, a brief explanation of pathophysiology and pathogenesis causing the clinical manifestations with Mr. Das. This particular case study is based on the diagnosis and clinical manifestations of RHD for Mr. Das, and this includes pathogenesis, diagnosis, epidemiology, prevention of acute rheumatic, and treatment. According to this case study, a 68 years old gentleman, Mr. Das, presented himself to the emergency department with the condition of shortness of breath. It is seen that, 2 days ago, with progressive worsening, Mr. Das suffered and presented to the department of emergency at 0400 hrs.

Due to this, pathophysiology and pathogenesis caused clinical manifestations, and Mr. Das developed right side chest pain this morning along with on-going nausea and one-time vomiting. As per the case analysis of "Acute Life-Threatening Condition", this cannot be managed with successful results, and that is critically dependent on prompt therapy and early recognition (Caraher et al., 2018). For example, in the case of an "Acute Life-Threatening Condition", the person can face different symptoms before the death, and all the symptoms occur within 2-5 days after facing the first symptom.

Question 2:

A chosen high priority nursing intervention is “monitoring of vital signs and recovery progress” and that is considered as independent nursing intervention for this particular case study. Vital signs are most important component for this case of Mr. Das to monitor patient’s health as well as allow prompt detection for delaying recovery or addressing the breathing problem. Furthermore, several plans like Continuous cardiac monitoring, 12 lead ECG, Blood pathology order, Troponin I High Sensitivity, Chest x-ray, IVC insertion in right hand Furosemide 40mg IV Stat and Echocardiogram are included in the nursing intervention (Burchum & Rosenthal, 2021). Current medications include several medicines which are allocated for the patient where Furosemide 40mg OD, Captopril 6.25 mg TiD, Digoxin 0.125 mg BD, Metformin 500mg TiD, Nexium 40 mg BD are used.
On the other hand, on 1.2 L fluid restriction, Echocardiogram resulted in 2021- systolic dysfunction, mild mitral valve regurgitation, dilated left atrium and ejection fraction (EF) 33% are also utilised ((Lewis et al., 2020)). In the nursing assessment, several details of the patients have been discussed. Thus, “monitoring of vital signs and recovery progress” is best nursing intervention for this particular case of managing the health condition for Mr. Das.

Discussion of how a nursing intervention will alleviate the clinical features of Mr. Das physiological linking
As per the case study, a Nursing intervention will help to give alleviation to the patient, Mr. Das. After that, corresponding to the current medications as different medicines including Furosemide 40 mg OD, Captopril 6.25 mg TiD, Digoxin 0.125 mg BD, Metformin 500mg TiD, Nexium 40 mg BD have been allocated. Furosemide 40 mg OD is mainly used for the treatment of fluid retention blended with heart failure, including left ventricular failure. Besides, Captopril 6.25 mg TiD is used for congestive heart failure (Bullock et al., 2017). In order to treat irregular heartbeats, Digoxin 0.125 mg BD is used for the treatment of DM type 2 as Mr. Das is suffering from DM type 2 as per the case study. Creatinine and Urea nitrogen (BUN) is high from the reference rate. Along with that, Nexium 40 mg BD is utilised for the treatment of erosive reflux esophagitis, including the prevention of rebreeding of peptic ulcers. With several intervention reports like blood reports, x-ray and others report the right diagnosis will be taken as per the case study (Suen et al., 2020).

Describe the impact of not performing the intervention

In such accordance with not managing and performing a well nursing intervention, different issues can occur if the intervention is not performed as several medicines as per the case study is too significant for the treatment of heart failure and DM type 2 (Xu et al., 2018). If the restrictions cannot be performed, Mr. Das may suffer from several symptoms. Along with that, if blood reports and x-ray are not considered, medication will not be procured.

Question 3:

The mechanism of action

According to this case study, Mr. Das has been prescribed two medicines for his "Acute Life-Threatening Condition", and these are Furosemide 40 mg IV stat and Glyceryl Trinitrate IV Infusion 10 mcg/min in starting rate. For Mr. Das, the initial dose is to be administered through an intravenous application with 40 mg Furosemide, and if needed, another injection could have to be given after 30-60 minutes (Huether & McCance, 2019). On the other hand, according to the health condition of Mr. Das, Glyceryl Trinitrate IV Infusion 10 mcg/min has been given, and the dosage of 10 mcg/ min was able to obtain Glyceryl Trinitrate 6 ml of admixture/hour. These two prescribed medicines were helpful to manage his health condition at the starting rate.

Why is your patient receiving this medication to his diagnosis and symptoms?

In case of patient diagnosis and symptoms, Furosemide 40 mg IV stat helps the body get rid of some extra water by increasing the urine in the patient's body. Additionally, another one helps to reduce the tone of "vascular smooth muscle" (Atherton et al., 2018). After that, the action is more suitable to manage venous capacitance vessels compared to arterial vessels.

What are the nursing considerations for this medication?

Medication administration is a nursing intervention, and that includes five major activities for prescribing and managing the health of Mr. Das. These are such as diagnosis, implementation, assessment, planning, and evaluation.

What clinical response do you expect?

The major aim of the clinical response is to evaluate changes in lung volumes, diagnosis, and perception of breathing discomfort intensity with pharmacological intervention.

What continuing clinical observations will you need to undertake?

The major clinical observations in the case of "Acute Life-Threatening Condition" for Mr. Das is to manage the pathogenesis and pathophysiology causing the clinical manifestations along with ECG report, and checking irregular heartbeat and sugar test for DM type 2, and many more.  

Reference

Atherton, J. J., Sindone, A., De Pasquale, C. G., Driscoll, A., MacDonald, P. S., Hopper, I., ... & Connell, C. (2018). National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: guidelines for the prevention, detection, and management of heart failure in Australia 2018. Heart, Lung and Circulation, 27(10), 1123-1208.https://www.heartlungcirc.org/article/S1443-9506(18)31777-3/fulltext

Burchum, J., & Rosenthal, L. (2021). Lehne's Pharmacology for Nursing Care E-Book. Elsevier Health Sciences.https://books.google.com/books?hl=en&lr=&id=VGNCEAAAQBAJ&oi=fnd&pg=PP1&dq=PHARMACOLOGY+NURSING+CARE++BOOK+Lehne%27s+pharmacology+for++nursing+care&ots=rRXRiaAdxd&sig=zF4O9V3tIDIScLRzMNYRkvNSLjI
Byrne, J. E., Bullock, B., & Murray, G. (2017). Development of a measure of sleep, circadian rhythms, and mood: the SCRAM questionnaire. Frontiers in psychology, 8, 2105. https://www.frontiersin.org/articles/10.3389/fpsyg.2017.02105/full

Caraher, M.C., Sophocleous, A., Beattie, J.R., O'Driscoll, O., Cummins, N.M., Brennan, O., O'Brien, F.J., Ralston, S.H., Bell, S.E., Towler, M. & Idris, A.I., (2018). Raman spectroscopy predicts the link between claw keratin and bone collagen structure in a rodent model of oestrogen deficiency. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease, 1864(2), pp.398-406. https://www.sciencedirect.com/science/article/pii/S0925443917303848

Huether, S. E., & McCance, K. L. (2019). Understanding Pathophysiology-E-Book. Elsevier Health Sciences.http://repository.stikesrspadgs.ac.id/104/1/Study%20Guide%20for%20Understanding%20Pathophysiology-345hlm.pdf

Lewis, P., Wilson, N. J., Hunt, L., & Whitehead, L. (2020). 1 Nursing in Australia. Nursing in Australia: Contemporary Professional and Practice Insights.https://api.taylorfrancis.com/content/books/mono/download?identifierName=doi&identifierValue=10.4324/9781003120698&type=googlepdf

Suen, L. K. P., Guo, Y. P., Ho, S. S. K., Au-Yeung, C. H., & Lam, S. C. (2020). Comparing mask fit and usability of traditional and nanofibre N95 filtering facepiece respirators before and after nursing procedures. Journal of Hospital Infection, 104(3), 336-343. https://www.karger.com/Article/PDF/488001

Xu, S., Zhang, Z., Wang, A., Zhu, J., Tang, H., & Zhu, X. (2018). Effect of self-efficacy intervention on quality of life of patients with intestinal stoma. Gastroenterology Nursing, 41(4), 341. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6078485/

PBHL20010 Case study Assignment Sample

The first assessment task is a case study of about 2000 words that you will complete on an individual basis.

The case study will require you to choose one of the eight stakeholder groups listed below and discuss their role in a public health emergency; the nature and direction of their interest based on their position in the community and their function in society; and the factors that may affect their actions. You must also choose a specific emergency situation from which you will draw examples to illustrate your discussion. This may be an epidemic of disease (for example, the COVID19 pandemic); a natural disaster (flood, bushfire, earthquake, etc); or an anthropogenic event (chemical spill, industrial explosion, etc). You ust specific the emergency and stakeholder groups clearly in the introduction to the case study. You will also need to use appropriate academic references to support your understanding of stakeholder participation, communication needs, responsibilities, and so forth as relevant.

The stakeholders you may choose from are:

1. Local government

2. Science/health experts

3. Local business interests

4. The media

5. Representatives of the long-term community (people who have lived in a given location for 10 years or more)

6. Representatives of new groups (people who have recently arrived in or moved to a given location)

7. Local health care personnel

8. State (or higher level) government

Your case study must have the following sections for assignment help

1) Introduction – identifies the chosen stakeholder, the emergency and gives a general indication of who they are or what they do;

2) Roles in a Public health Event – for the stakeholder group you have chosen, describe their role in a public health emergency; make sure to consider whether their role is official or non-official and whether they are personally at risk of health impacts and the other kinds of risk they experience;

3) Risks and Responsibilities – for the group you have chosen, describe the nature of the risks identified in the previous section; make sure to consider whether the risk is direct or indirect, whether it is a risk to health or another kind of risk, what the specific health or non-health risk involves, and what the group’s responsibilities are in relation to the public health emergency and its own and the risks of other stakeholders;

4) Role in Public health Decision-Making – for the group you have chosen, consider how they contribute to decision-making in the context of a public health emergency; be sure to discuss whether their contribution is official or unofficial, the channel through which they might affect the decision-making process. and the degree to which their impact is informed by evidence-based and non-evidence-based knowledge; and
5) Conclusion – discuss the position of the stakeholder group you have chosen in a public health emergency; you may want to consider whether they are actors or bystanders, for example, or use some other classification, but be sure to state whether your chosen stakeholder group is likely to be affected significantly, the nature of the impact, and why you believe this would occur. This assignment must be written in a formal, academic style (not first person) and must be fully referenced. Harvard referencing is preferred for this unit. If you need help with referencing, please consult the referencing guides available online and through the Library as soon as possible.

Solution

Introduction

In this paper, a discussion regarding the role of a particular stakeholder group in regard to a public health emergency is going to be elaborated. The stakeholder group that has been chosen in order to make the discussion is the media, and the public health emergency that has been considered in this regard is Covid19. It can be regarded as the most considerable public health emergency in the current situation. The emergency has caused a significant number of deaths throughout the world, and it has caused harm to public health considerably. Along with providing a significant effect on public health, it has caused economic shock to a number of countries. However, the matter is that the media was supposed to play a vital role in regard to the process of making people aware of the emergency and the situational needs, and by considering this key area, the overall discussion is going to be elaborated on here.

Roles in a public health event

Roles

Covid19 is a global infectious disease that emerged from Wuhan, Chin (Anwar et al., 2020). The media can be regarded as the main mean of mass communication that includes radio, television, the internet, newspapers and others. People who are associated with media are mainly responsible to make people aware of the current situation based on every aspect related to society, politics, economic factor, technical area, environmental hazards, health situations, and others. It means that in regard to such a situation where a pandemic has been spreading in an effective manner and causing numerous deaths and affecting uncountable number of people, they were supposed to play an important role in making people aware of the situation. In this regard, their roles have been as follows:

Making people aware of the situation

It can be regarded as the key role of the chosen stakeholder group with respect to the concerned emergency situation. They have been supposed to make people aware of every day’s update, such as the death rates related to Covid19, the way the infection has been spreading each day, what is the current situation of the local area and the world as well. They have been supposed to make people understand the severity of the issue by letting them know about these factors. At the time when people become aware of the severity of a situation, they are able to make the right decision based on the situational needs, and that is why the media has been responsible to make them aware of the situational needs so that they can manipulate their lifestyle and become interested in living a restricted life by considering the emergency of the situation.

Providing authentic information regarding the emergency of the situation

The media, in regard to the situation of a healthcare emergency is responsible to provide authentic information to people so that they can understand the actual scenario and make decision properly based on it. By considering the viewpoint of Mheidlyand Fares (2020), it can be stated that media is a powerful avenue for the dissemination of wellness education. In regard to Covid19, the media was responsible to do the same, From death rates to infection spreading rates, everything are required to be communicated with people while maintaining the highest level of authenticity so that they can understand what they should do in a particular situation in order to be safe. In this case, the media is not likely to be influenced by any political influences. They have been responsible to maintain authenticity with respect to each word they have been sharing with people as the situation has been complex and crucial. Any misleading word of the media might lead people improperly and it would enhance the severity of the issue.

Leading people to the right path in crucial moments

People have been panicked in the situation with the increasing number of deaths and infection rates. At that time period, it has been the responsibility of the media to understand how they should live their lives in order to keep themselves and their family members safe. Instead of making people scared, they have been supposed to encourage them to maintain all safety and precautionary measures so that the situation can be controlled properly.

Whether the role is official or non-official

The roles of the media that have been highlighted in the above-stated passages are definitely official. At the time of public crisis, media is required to ensure to communicate crisis information effectively (Latifet al., 2020). By considering the official responsibilities of media, it can be stated that they are professionally responsible to gather and update information regarding any situation, and correct information throughout the life of a news story. They are also professionally responsible to provide facts that can allow people to be better informed about any issue that matters to the society and the lives of people. It means that covering the Covid-19-based issues can be regarded as the key responsibility of these people and it can also been stated that by considering the official terms and conditions, that these people have to follow, it has been their official responsibility to make people aware of the situational needs, the emergency of the situation, and the way to control the situation. They have been supposed to work by considering that if they can make people aware of these facts and if they can reach people properly, controlling the situation would be easier and battling with the health emergency would also be easier. Hence, it can be concluded that all of the responsibilities highlighted above can be regarded as the official responsibility of these people and they have been supposed to handle these responsibilities by considering the professional ethics of them.

Their personal risk

In this situation, they have some personal risks, and these are mainly about their health. Throughout 2020- 2021 and the beginning of 2022, the spreading rates of Covid-19 were considerable.

Figure 1: Covid19 spreading rates
(Source: Statista, 2022)

The graph is showing the same. In such a situation working with public was a considerable risk for the media as they could be affected anytime as they did not have any scope to isolate themselves from people who were affected. It can be regarded as a major health concern that these people have faced in this situation. In the following section, a detailed discussion regarding the risks is going to be elaborated on.

Risks and responsibilities

Nature of the risk

In the above-stated passages, the risk has been identified, and when the matter comes to making a discussion regarding the nature of the risk it has to be stated that the risk was supposed to impact the stakeholders directly, and it can also be stated that the risk was mainly related to the health of these people and the family members of them. Covid19 is a significant global and public health crisis (Banerjee and Rao, 2020). These stakeholders were supposed to meet with public by considering their professional roles and responsibilities, and that is why they were supposed to be infected in the fastest manner. In this regard, it is also important to state that they have not been free from the risk yet as Covid-19 is still causing harms and death though the infection rates have been decreased, and it means that these people are still dealing with such risks.

Another important risk to be considered here is about their economic and professional security. By considering the information shared by Radcliffe(2020), it can be stated that a number of people have lost their jobs in the Covid19 phase as a number of news companies have been laid off in the Covid19 phase. This situation has actually affected their professional and economic security of these people. It can be regarded as a direct risk to be considered here as it has directly impacted the overall lifestyles of these people in a devastating manner.

Responsibilities of the group in public health emergency

From professional aspect, they are responsible to collect information regarding the current status of Covid19 and it has been the responsibility of them to provide people with accurate information so that they can understand the situational needs and they can take steps based on the same. It has been their responsibility to make people aware of the precautionary measures so that they can deal with the situation perfectly. They have been supposed to provide information not only regarding the impact of the issue on public health but also the impact of the issue on political and economic aspects. In order to avoid risk of Covid-19, effective government interventions have been implemented, and it has been the responsibility of media people to make individuals know about these (Liu et al., 2021). They have been responsible to ensure that people understand the situational needs properly and make decisions based on it.

The risks of other stakeholders

In this regard, other stakeholders were also supposed to face some issues. Along with journalists, press and camera man, some other people work with media people and that includes the drivers of the vehicle that these people are using, their assistants, and others, and these people are supposed to be infected if these people get infected. It means that with the risk of the chosen stakeholders, the risks of other stakeholders are interrelated.

Role in public decision making process

How they contribute to decision making

Bridgmanet al.,(2020) have stated that if people spend time in media that provide misinformation, they are likely to develop wrong attitudes and behaviors. These people are responsible to provide a significant impact on public decision making process. They have been responsible to make people aware of Covid-19 situation that can influence the decision-making process of them. They have been responsible to make people understand the precautionary measures instead of causing them to get panicked. They have been responsible to maintain the highest level of integrity and honesty in regard to the data collection and communication process so that any individual would not be misled and they van make the best decision by considering the actual situational perspectives.

Whether the contribution is official or unofficial

By considering professional aspect, it can be stated that media people are supposed to make people aware of a situation and his kind of awareness can influence the decision-making process of individuals in a considerable manner. From this perspective, it can be stated that the contribution of them that has been highlighted in the above-stated passages is completely official.

The channel through which they can affect the decision-making process

Media people can be associated with any channel that includes newspapers, television, internet and others. From this perspective, it can be stated that all of these channels can be used in order to affect the decision-making process of people. In other words, it can be stated that media people are sharing information by using all of these channels and this information is effective enough to influence the decision-0making process of people, and that is why it can be stated that newspaper, television, radio, and the internet are some channels through which media people can influence the decision-making process of people.

The degree with respect to their impact in this regard

In the above-stated passages, a discussion regarding the way they can influence the decision-making process of people has been elaborated, and by considering the same, it can be stated that the degree to which they can impact the decision-making process is high as they are the primary resource of information for mass people. By considering their viewpoint, mass people have been judging the Covid-19 situation and the way they have to deal; with it. Hence, the degree with respect to their impact in regard to the decision-making process is high.

Conclusion

In the above-stated passage, a detailed discussion regarding the impact of the media on a health emergency (Covid-19) has been elaborated. By considering the discussion, it can be stated that these people have been playing a vital role in the context while providing people with authentic information and making them aware of the situation. They have been contributing to the decision-making process of people in an effective manner as per their professional responsibilities while dealing with considerable risks. By considering the way the stakeholders are playing the role of actors with respect to the situation. Based on the actions of them, the way people can think and manage the issue is being changed, and it means that they are playing the role of actors in this regard. The situation can impacted their lives effectively as it has already been stated that they have been dealing with considerable health risks. Apart from that, they were dealing with job security-layered issues. Health risks can impacted their action with respect to the situational needs and it could prevent them from following their roles and responsibilities. On the other hand, job security issues associated with the situation could affect them physical and mental well-being. The situation-related discussion has been made, and based on the situational perspective, it has been possible to understand that such issues could occur.

References

Anwar, A., Malik, M., Raees, V. and Anwar, A., 2020.Role of mass media and public health communications in the COVID-19 pandemic. Cureus, 12(9).https://www.cureus.com/articles/38293-role-of-mass-media-and-public-health-communications-in-the-covid-19-pandemic

Banerjee, D. and Rao, T.S., 2020. Psychology of misinformation and the media: Insights from the COVID-19 pandemic. Indian Journal of Social Psychiatry, 36(5), p.131.

Bridgman, A., Merkley, E., Loewen, P.J., Owen, T., Ruths, D., Teichmann, L. and Zhilin, O., 2020. The causes and consequences of COVID-19 misperceptions: Understanding the role of news and social media. Harvard Kennedy School Misinformation Review, 1(3).https://www.indjsp.org/article.asp?issn=0971-9962;year=2020;volume=36;issue=5;spage=131;epage=137;aulast=Banerjee

Latif, F., Bashir, M.F., Komal, B. and Tan, D., 2020.Role of electronic media in mitigating the psychological impacts of novel coronavirus (COVID-19). Psychiatry research, 289, p.113041.https://www.sciencedirect.com/science/article/pii/S0165178120309380

Liu, N., Chen, Z. and Bao, G., 2021. Role of media coverage in mitigating COVID-19 transmission: Evidence from China. Technological Forecasting and Social Change, 163, p.120435.https://www.sciencedirect.com/science/article/pii/S0040162520312610

Mheidly, N. and Fares, J., 2020.Leveraging media and health communication strategies to overcome the COVID-19 infodemic. Journal of public health policy, 41(4), pp.410-420.https://link.springer.com/article/10.1057/s41271-020-00247-w

Radcliffe, D., 2020. Covid-19 has ravaged American newsrooms–here’s why that matters. Available at SSRN 3693903.https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3693903

Statista, 2022. COVID-19 new cases worldwide by day | Statista. [online] Statista. Available at: <https://www.statista.com/statistics/1103046/new-coronavirus-covid19-cases-number-worldwide-by-day/> [Accessed 18 April 2022].

NURS3002 Advance Decision Making and Practice Assignment Sample

Length: 1500 words

Curriculum Mode:

There is a word limit of 1500 words. Use your computer to total the number of words used in your assignment. However, At not include the reference list at the end of your assignment in the word count. In-text citations will be included in the additional 10% word count. If you exceed the word limit by more than 10% the marker will stop marking at 1500 words plus 10%.

Aim of Assessment:

The Aim of this assessment is to develop your understanding evaluating the professional conduct of a nurse/midwife in the case study provided.
The case study provided is a decision statement selected from Decisions of the Professional Standards Committee from the Nursing and Midwifery Council New South Wales - The Health Care Complains Commission (HCCC). You are to identify professional practice issues from the case study and then draw on the professional frameworks and regulatory legislation, to develop sound and appropriate responses to the clinical incident that will inform your future practice.

Details for Assignment Help

This assessment requires you to identify and summarise the professional practice issues in the case study from either a nursing or midwifery practice perspective. You need to identify and evaluate relevant professional errors identified that potentially contributed to the incident happening. Finally, discuss on how your future practice might change and develop as a result of this learning.

Students are to draw on the National Safety and Quality Health Service (NSQHS) Standards, NMBA professional practice documents and NSW Health policy documents (where appropriate) to develop informed responses.

Students must refer to and use the case studies located on vUWS under Assessment 2 tab for this assessment. There is one nursing case study and one midwifery case study to choose from. Submission requirements: -

The total word count is 1500 words. - Electronic copy only.

- This assessment is marked online; no paper copy will be accepted. Marks, comments, and the marking criteria will be released online. If you do not receive your marked assessment when all others have been returned, it is your responsibility to contact the Subject Coordinators for assistance.

Solution

Introduction

The professional code of conduct of a nurse embodies an ethical blend of rules and norms that is designed to direct the nurse in providing care to the patients found in critical care situations. The code of ethics comprises veneration for beneficence, autonomy, non-maleficence and justice. The essay consists of three sections. The first section discusses the professional practice issues from the perspective of a nurse. The second section points out the relevant professional errors of two nurses from the case study. In addition, the NSW Health policy documents mark the guidelines to be followed by the nurses rendering service to critical care patients. Finally, the third section discusses the reflection on how the suggested practices might amend and mitigate the issues found in the incident of the case study. The essay identifies the relevant professional errors from the case study and shows that the professional code of conduct followed by the nurses can help to resolve issues.

Section 1

The incident in the case study points out the complaint that has been launched against Ms Nelly Youssef who is a registered nurse. The complaint was launched against Ms Nelley Youssef by the Health Care Complaints Commission before the Administrative Tribunal and NSW Civil.

This complaint was lodged after an inspection of all the allegations charged against her on 13th January 2021 (Gillespie & Reader, 2018). All the allegations were proven, and she was charged with professional misconduct and unsatisfactory professional conduct. The case was filed against her after the Commission noticed an unprofessional act. They alleged her after they found an 80 year patient with a laryngeal stoma unresponsive. Ms Nelley Youssef reluctantly agreed with the junior colleague to dress the stoma and provided the dressing to the patients without proper instruction (Joo & Liu, 2021). Later, the patient was found not responding, thus it was tough for her to remove the dressing. When asked, she provided wrong information stating that she noticed the patient was not responding and the stoma was not covered. When found that the information provided was irrelevant, it was decided that strict actions would be taken against her. She misled her junior colleague (Gillespie & Reader, 2018).

Section 2

The incidents in the case study point out two professional errors committed by two nurses, Ms Nelley Youssef and RN Mc Arthur. Nelly Youssef was accused of unsatisfactory professional misconduct as she improperly responded to a request from a junior colleague who sought advice from her (Caselaw.nsw.gov, 2022). The former stated that it will cause no harm if Meplix occlusive dressing to the stoma of Patient A. By this, she portrayed inadequate knowledge that stoma is the only airway of patient A, covering which will lead to more harm than good. Moreover, the dressing was forgotten to be removed from the patient until he was found unresponsive in the shower. When she was accused of unprofessional conduct under 139B(1), she said she did not find Mepilex border dressing on the stoma. However, later on, she admitted that she lacked knowledge regarding Patient A's anatomy (Caselaw.nsw.gov, 2022). Moreover, she stated that she did not know that the laryngeal stoma was the only airway for the patient.

RN McArthur was also accused of the unprofessional code of conduct under 139B(1)(a). The concerned person also improperly applied a Meplix dressing on the patient's laryngeal stoma before he started to take his shower. Moreover, he also lacked adequate knowledge about the clinical history of the patient (Halcombet al. 2020). He also failed to know that the only airway of the patient is the laryngeal stoma which was unknowingly covered. He further stated that she stayed with the patient for five minutes after applying the dressing. This was falsely stated by the person in a letter sent to HCCC. He had further satiated that at the time of dressing he lacked the information about the underlying anatomy of patient A (Caselaw.nsw.gov, 2022). To everyone's utter surprise, he denies is not guilty of whatever has happened with the patient.

NSW health organisations monitor the incorporation of Policy Documents and guide the implementation as an essential aspect of strong governance, audit formulation and performance. The policy document consists of guidelines, policy directives and information issued by the NSW Ministry (NSWhealth, 2022). Besides encompassing protocols and procedures, it also lays down guidelines that should be strictly adhered to by the health service unit within the local health district. The policy documents formulate superior clinical practices along with the clinical and non-clinical functions. The guidelines are issued by the NSW policy systems and adopted in the NW health units. The components of the policy document are the information bulletin, NSW health organisation and the NSW ministry of health (NSWhealth, 2022). The policy document clearly explains the information bulletin, policy directive and essential guidelines issued by the NSW health organisation.

The organisation found in the case study does not follow the guidelines laid down by the National Safety and Quality in Health Service Standards (NSQSH). So, the company can opt for Safety and quality systems with the help of governance processes so that they can improve and manage the safety and quality of health care for patients (Australian Commission on Safety and Quality in Health Care, 2021). In addition, the NMBA guidelines are not ingrained in the mentioned health care unit of the case study. The NMBA states that nurses shall adhere to professional commitment and abide by the respective law (NMBA, 2022). Thus, the nurses are expected to act with professional obligation for the sake of the patient's recovery and well-being. As a result, the convicted nurses are placed under S139B (1) for conducting unprofessional behaviour (NSWhealth, 2022). The Health Care Complaints Commission (HCCC) has done justice to the complainant by identifying the accused and taking legal measures.

The implementation of the NSW policy documents gives an overview of the roles and responsibilities to incorporate the policy directives (Taylor et al. 2020). The policy documents comprise the codes of conduct that medical professionals are expected to follow. It provides a framework of actions with respect to ethical conduct. Breaching the code of conduct mentioned in the policy documents will be held responsible by law (NSWhealth, 2022). In addition, it leads to disciplinary actions and the punishment is decided by the severity of the crime.

Section 3

Reflection

I have been through both the cases and understood that the first case was related to Ms Nelley Youssef, against whom a case was filed due to her unprofessional negligence towards the dressing of stoma for an 80-year-old patient who was found not responding. At the same time, the second case deals with two professional misconducts by Ms Nelley Youssef and RN McArthur for reluctantly applying Meplix dressing to a patient with a laryngeal stoma (NMBA.gov., 2022). All I understand is that both cases are completely careless, or the nurses are not being provided with proper training. As per my understanding, an individual might own a degree and be an official nurse, but they can still be expected to make mistakes. In both cases, the situation could have been controlled if the nurse had asked for help from their other senior colleagues before conducting the method on the patients (Taylor et al. 2020). Both the patients have been found to act unprofessionally, first for misguiding their junior colleagues and second for showing a lack of adequate knowledge.

After summarising the cases, I had been through the NMBA Standards for Practice documents for Nurse and NSQHS or National Safety and Quality Health Service. I learnt about the patients' professional expectations and the nurse's authority. I can conclude that if I had been in place of Ms Nelley Youssef, I should have taken the responsibility and correctly instructed my junior colleague for the dressing of the laryngeal stoma firstly because the patient had not been responding and second because it was 80 years of age. This is not only the main reason but the main because, as a senior nurse, it is my responsibility to take care of the patients and properly guide the juniors (NMBA.gov., 2022). Thus, this would not have led me to any problems like Ms Nelley Youssef had. As per the case of RN McArthur, firstly, I would have strictly followed NMBA and NSQHS and still, if I was unclear about the procedures, I would have consulted someone, maybe a doctor or an experienced nurse. I would not have reluctantly applied Meplix on the patient's stoma before their bath. It is very unprofessional and showcases carelessness to state a lack of adequate knowledge about the wound (NMBA.gov., 2022). Even if that had happened, I would not have just strongly accepted that it was not my fault, even after knowing it was.

Conclusion

This study is concerned with summarising a case study that had been provided related to the issue or complaints that had been launched against the nurses for misleading or misconducting and performing unprofessional techniques of giving medication to the patients. Here the summary has been provided of the patient's complaints. The study has been divided into an introduction to the nursing case study talking about the professional code of conduct in nursing. Sections 1, 2, and 3 highlights the issues and summarise what the problems had been, under what act they have been taken, and what accusation points have been pointed at the nurses and how they had reacted to it. Reflection is the place where the cases have been heightened with the problems that the patients have faced due to the unprofessional acts of the nurses.
 

References

Australian Commission on Safety and Quality in Health Care (2021). National safety and quality in health service standards (2nd ed.). Retrieved 27th August 2022, from https://www.safetyandquality.gov.au/sites/default/files/2021-05/national_safety_and_quality_health_service_nsqhs_standards_second_edition_-_updated_may_2021.pdf.

Gillespie, A., & Reader, T. W. (2018). Patient?centered insights: using health care complaints to reveal hot spots and blind spots in quality and safety. The Milbank Quarterly, 96(3), 530-567. https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1468-0009.12338

Halcomb, E., Williams, A., Ashley, C., McInnes, S., Stephen, C., Calma, K., & James, S. (2020). The support needs of Australian primary health care nurses during the COVID?19 pandemic. Journal of nursing management, 28(7), 1553-1560. https://doi.org/10.1101/2020.06.19.20135996
HCCC v Youssef & McArthur [2021] NSWCATOD 2

Health Care Complaints Commission v Youssef; Health Care Complaints Commission v McArthur - NSW Caselaw. Caselaw.nsw.gov.au. (2022). Retrieved 27th August 2022, from https://www.caselaw.nsw.gov.au/decision/176ee7c5bee2c2cdb86225c8.

Joo, J. Y., & Liu, M. F. (2021). Nurses' barriers to caring for patients with COVID?19: a qualitative systematic review. International nursing review, 68(2), 202-213. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8013562/

NMBA.gov. (2022). Retrieved 29th August 2022, from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx

Taylor, E. V., Lyford, M., Parsons, L., Mason, T., Sabesan, S., & Thompson, S. C. (2020). "We're very much part of the team here": A culture of respect for Indigenous health workforce transforms Indigenous health care. PLoS One, 15(9), e0239207. https://doi.org/10.1371/journal.pone.0239207

Www1.health.nsw.gov.au. (2022). Retrieved 27th August 2022, from https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2016_049.pdf. 

HAS108 Health Assessment Sample

Individual/Group Individual
Length 2000 words (+/- 10%)

Learning Outcomes

The Subject Learning Outcomes demonstrated by successful completion of the task below include:

b) Identify and demonstrate interview techniques used to enhance communication during history taking

c) Discuss ways to incorporate health teaching as part of the health assessment

d) Perform a thorough and accurate holistic health assessment

e) Discuss the importance of understanding the diversity of society and cultural safety approaches that influences the approach to healthcare

f) Recognise elements of the development of person centred care plans

This assessment requires you to answer 3 questions. The questions are the same for each character however, given the different circumstances, socio-economic and medical histories of the characters, each case study is to be uniquely considered.

Short Answer Questions for case study assignment help -

1) Using resources provided in this subject, identify and explain what information is needed to a gain a more comprehensive past history for your chosen video character. Consider the patients level of health literacy and cultural safety issues in your answer.

2) Based on the information given for each character, identify and explain what abnormalities/concerns you can identify in the physical observations and patient history.

3) Identify and explain what additional physical assessments are needed in order to facilitate a diagnosis for your chosen character, and identify and describe what body systems need to be explored further.

Theo

PULSE: 70 bpm (resting), 100 bpm (on exertion).

TEMPERATURE: 37.5 ?C

RESPIRATION: 18 (Theo reports thick secretions, ‘worse when getting up in the morning’, primary auscultation- audible moist cough that Theo states ‘is hard to get rid of’).

SaO2: 95% room air (RA)

WEIGHT: Body Mass Index (BMI) 16.

BP: 100/70 mmHg

CNS: GCS 15

GENERAL APPEARANCE: Dishevelled, tooth decay, nicotine stained fingers, initial visual inspection

Theo observed to have to have minimal body fat.

Mobility: ambulant does not appear to have any deficits.

Urinalysis: Leukocytes ++. Slight Specific Gravity increase of 1.010.

Solution

1. Title and a brief summary

Personal Improvement Plan

From this project, it can be understood that my BMI score is increasing gradually (32.4). This is quite high. So, to improve my health, I have set an aim to reduce my weight by 5 kilos in 5 weeks and increase my daily walking by 10,000 steps more daily. In this project, I have steed various ways through which I have achieved this aim of mine.

2. Introduction - Why did you choose this project?

a. Problem description

My major problem is my increased body weight. I need to lose some weight since my Body Mass Index (BMI) is much higher than what is considered healthy for someone of my age and height (health.gov.au, 2021). My doctor says that the back discomfort I've been having is related to my weight gain and that my latest blood test reveals an increase in cholesterol. As a result of my recent commitments, I have been too busy to maintain my usual level of physical activity. When I was routinely going to the gym, at least twice a week, I never had the back issues I'm having now. After a consultation with a nutrition specialist, I will also make certain lifestyle adjustments under my power, such as giving up junk food and switching to vegetables and fruits.

This is a major issue. According to data from the World Health Organization (WHO), in 2016, over 1.9 billion adults were overweight, and over 650 million were obese. In the same year, 41 million children under the age of 5 were overweight or obese (Who.int, 2021). The prevalence of obesity has more than tripled since 1975, and it is a major risk factor for several chronic diseases, such as diabetes, heart disease, and certain types of cancer (Who.int, 2021). The increasing prevalence of obesity has been attributed to several factors, including changes in diet, sedentary lifestyles, and environmental factors.

b. Available knowledge

From my problem, I understood that I have a major issue with obesity. Previously I did not know the negative impacts obesity can have on our bodies. After some, I understood that one of the most significant impacts of obesity is an increased risk of chronic diseases such as diabetes, cardiovascular diseases, and certain types of cancer. Obesity can also lead to physical limitations, such as reduced mobility, joint pain, and difficulty performing everyday activities (Gibbons et al. 2019). In addition, obesity can negatively impact mental health, leading to depression, anxiety, and low self-esteem.

c. Rationale

Lewin's Change Management Model is a framework for managing and implementing change within an organisation. The model consists of three stages: unfreezing, changing, and refreezing (Bashori et al. 2020). The unfreezing stage involves preparing anything for change by creating awareness of the need for change and breaking down the existing mindset and habits. During this stage, I will develop my aim to reduce my weight and enter into a healthy lifestyle. The changing stage involves implementing the change, which may involve changes to organisational structure, processes, or culture. During this step, I will change my eating habit and regularly go for a walk to make up to 10000 steps daily. Finally, refreezing involves stabilising the new changes and embedding them into the culture (Cone & Unni, 2020). Under this step, I will make new changes, such as consuming vegan foods and giving up on meat.

d. Aims statement

My proposed aim is to “Reduce my weight by 5 kilos in 5 weeks and increase my daily walking by 10,000 steps more daily”.

3. Methods - What did you do?

a. Context

Previously when I did a check-up, I understood that my BMI score was 32.4, which is higher than a normal person's. With a score above 30.0, I understood that I have obese. A high body mass index (BMI) score indicates being overweight or obese, and it can have several negative impacts on an individual's health. A high BMI can increase the risk of developing chronic health conditions such as heart disease, type 2 diabetes, high blood pressure, stroke, and some types of cancer (Dadar Singh et al. 2022). However, after fulfilling my aim, my BMI score decreased to 26.2. Though it means that I am overweight, I have completed my goal and will focus on having a healthy weight range in the future. To measure my BMI. Firstly I used a scale to measure my weight accurately. Before stepping on the scale, I was sure to remove any heavy clothing, shoes, or accessories. I recorded my weight in kilograms (kg). Then, I used a measuring tape or a wall-mounted height rod to measure my height accurately. Next, I used the following formula to calculate my BMI: BMI = weight (kg) / (height (m))^2. Finally, I interpreted the data and determined my BMI.

b. Intervention/s

To ensure that I can lead a healthy lifestyle, I will take various measures. The interventions include walking 10,000 steps more daily. I will also ensure that I will consume less junk food and healthier food. This will be done by including more fruits and vegetables in my diet. Eating junk food regularly can lead to obesity, which can increase the risk of developing chronic health conditions such as heart disease, type 2 diabetes, high blood pressure, and some types of cancer. Junk food can also negatively impact mental health, leading to depression, anxiety, and low self-esteem. The tools that have been used to measure BMI in this project are digital or analogue scales to measure weight accurately, a measuring tape to measure height accurately, a calculator or a BMI chart to calculate BMI based on the weight and height measurements and BMI apps that use the height and weight inputs to calculate BMI automatically. It is important to note that BMI is not a perfect indicator of an individual's health, as it does not consider factors such as muscle mass, body composition, and overall fitness level. Therefore, it should be used as a general guideline and not as a definitive measure of an individual's health.

c. Measures

I want to keep track of the following for a week or two before I start my 5-week programme to establish a baseline. The data from these items will be used as part of my benchmark.

? My BMI

? Average calories I consume in a day

? Factors include the number of drinks I have each week, the amount of coffee and water I drink, and other things.

? In the course of my normal, regular strolls

? What I eat in terms of produce daily

? My consumption of high-fat, high-sugar, and high-salt meals

I just had a blood test done to get a sense of how my blood is doing right now, and I want to do another one at the end of the five weeks to see if anything has changed.

d. Analysis (if relevant)

From the entire effort given, I have witnessed that, to a certain extent, I was able to improve my health condition. Previously I was obese, but after achieving my aim, I saw that I had become an overweight person. Previously my BMI score was around 32.4, and after achieving my goals, the BMI score reduced to 26.2. My BMI score was reduced by 6.2 scores. This was a huge achievement for me. However, another goal of mine was to walk 10,000 steps more daily. This was not possible for me. With my maximum effort, I could only make up 5000 steps more daily. I tried to control my junk food craving and started having only vegetables and fruits. However, it seemed impossible. So, to please my taste buds, my nutritionist gave me permission to have junk food once a month. In the future, I wish to control all these cravings and keep a target of becoming a healthy person with a normal BMI score.

e. Ethical considerations

Losing weight was a personal goal for me, but ethical considerations need to be taken into account. I ensured that I did not use fad diets or extreme weight loss methods. This is because it can be dangerous and harmful to health. Another ethical consideration is the pressure to conform to societal beauty standards, which can lead to body shaming and discrimination against people who do not fit those standards (Brytek-Matera et al. 2019). Additionally, there is a concern about weight bias and discrimination in healthcare, which can affect the quality of care that individuals receive. It is important to approach weight loss in an ethical and responsible manner, focusing on health and well-being rather than conforming to societal expectations or harmful weight loss methods.

4. Results - What did you find?

BMI

Figure 1: BMI Score Improvement
(Source: Author)

The table above shows my improvement in BMI score week-wise. The BMI score in 5 weeks has been stated above. From the graph above, it can be seen that my initial BMI score in week one was 32.4, it can be seen that my BMI score in week two was 31.9, it can be seen that my BMI score in week three was 29.6 it can be seen, that my BMI score in week four was 27.3 and it can be seen that my BMI score in week five was 26.2. From the graph, it can be witnessed that my improvement from week one to week two. However, from week two to week three and week three to week four was quite impressive.
Steps covered

Figure 2: Steps Covered
(Source: Author)

The table above shows my improvement in steps covered week-wise. The steps covered in 5 weeks have been stated above. From the graph above, it can be seen that I covered around 2000 steps more daily in week one, it can be seen that I covered around 3210 steps more daily in week two, it can be seen that I covered around 4200 steps more daily in week three, it can be seen that I covered around 3600 steps more daily in week four and it can be seen that I covered around 4980 steps more daily in week five. From the graph, it can be witnessed that my improvement from week one to week two. However, from week two to week three and week three to week four was quite impressive.

5. Discussion – What does it mean?

a. Key findings

Losing weight was a challenging task for me, and it was not uncommon to lack motivation at times. There are various reasons I struggled with motivation when it came to losing weight. It was due to a lack of my self-discipline, not seeing results fast enough, or feeling overwhelmed by the process. The main reason was due to the absence of a support system. Losing weight was challenging, and having a support system of friends or family can make the journey easier. Again, it was due to a lack of enjoyment in the weight loss process. When exercise and healthy eating became a chore, it was easy to lose motivation. Finding an activity or food that I enjoy can make the process more enjoyable and sustainable. It was not uncommon to hit a weight loss plateau, where weight loss stalled even with consistent efforts. This was discouraging and led to a lack of motivation for me. For me, eating is a way to cope with stress, anxiety, or other emotions. Breaking this habit was challenging and led to a lack of motivation. Initially, I did not know how to lose weight effectively, which led to frustration and a lack of motivation. Understanding nutrition and exercise was important for success.

b. Interpretation of results

From the entire process, I have understood the negative impacts of junk food and unhealthy lifestyles that can hamper the human body. With excessive consumption of junk food and an unhealthy diet, I became obese with an increased BMI score of 32.4. From research, I understood that according to my age, my BMI score was quite high compared to normal. So, to focus on my health, I developed a plan and set an aim of losing 5 kilos in 5 weeks. After 5 weeks, from the data presented above, it can be stated that I have improved a lot, although I still have to take more action. However, I witnessed that there are still many areas of improvement that I have to focus on. For example, in week three, my steps covered was 4200, whereas, in week 4, it was around 3600. This reduction in the steps was because of my busy schedule. I was so engrossed in my office that I could not give much time to my health. Due to a meeting, I had to delay my walking time. This issue was resolved in the next week as my steps covered increased to 4980. However, this did not have an impact on my BMI score in week 4 because I kept my diet intact. I did not consume any junk food and only ate vegetables and fruits.

c. Limitations

One of the major challenges that I faced while doing this project was searching for a good nutritionist who could guide me in this journey. Another issue that I faced while doing this project was giving up on my favourite food. This was initially very difficult for me as I used to live on junk foods. Losing weight also required lifestyle changes, such as regular exercise and healthy eating habits. These changes were initially difficult for me to implement and maintain. I also received unsolicited advice from others about their weight loss journey, which can be unwanted and demotivating.

d. Conclusions

This project has positively impacted me as I was able to improve my health and lead a healthy life. I could improve my diet and avoid junk foods that were hampering my health.

Losing weight reduced the risk of chronic conditions and improved my overall health. Carrying excess weight can put stress on joints, making it difficult to move around. Weight loss helped me to reduce this stress, making movement easier and less painful. My back pains were alos reduced. It also helped me to reduce or eliminate sleep disorders, leading to better sleep. I will work to maintain a healthy weight range in the future, even if I am now overweight. I want to become a healthy person with a normal body mass index score in the future by controlling my junk food cravings.

6. Critical reflection

My realisation of how unhealthy my life has been was one of the surprises I encountered throughout this transition journey. Although I've always held the opinion that nutrition has no direct connection with back pain, I was surprised to see that various writers have focused on the causes of back pain (Pasdar et al. 2022). The more I've dedicated myself to making this transformation, the more I've learned about various diseases, and health conditions that I may face in the future or that may enhance the chances of their occurring. As a result, people are more likely to believe that they can avoid the ill effects of any area of their lives by just making an effort to do so.

Over the first three weeks of putting the change into action and treating the issue, I mastered the insights that led to its success via in-depth research and concentration on the main keywords involving health, BMI, contributing factors and causes, and prevention. Pain in the axial lumbosacral region, pain in the radiculopathy, and pain that is transferred from elsewhere in the body are the three most common causes of low back pain (Urits et al. 2019). Back pain affects between 10 and 30 per cent of adults in the United States in any given year. This realisation has motivated me to continue taking preventive measures and making efforts to ensure that I do not become one of the many people whose day-to-day activities are hampered by back pain brought on by the additional weight they are carrying, which is the case for me because of the additional weight I am carrying. (Attention is paid to preventive measures)

In addition to this, I came to the conclusion that before I could consider the new method to be completely functioning, it would need a significant amount of time and effort on my behalf to include all of these new aspects into my routine and maintain a record of them. I neglected to carry out what are known as "initial background studies." I should have spent more time researching the issue before making a change, such as how to take into consideration my age in the transition process or how difficult my exercises would be during the first week due to lactic acid and agonising pain in my body. I should have done this before making a shift. When a change is launched, one of my study interests is to investigate the influence of factors such as social pressures, structural adjustments, and preparation for change (Rogerson et al. 2016).

What went right:

? Results are seen during the first three weeks

? I felt better in general (Back pain, general happiness, and similar)

? There wasn't a lot of variation in the process I mapped.

? As a result of my investigation and implementation of the structured change, I now understand the issue better and am less resistant to future adjustments (Kept my motivation high)

? The responsibility for the transition and the difficulties lay with me.
I feel that I have gotten a great lot of insight into the process, and if I were to do it again, I would probably change it so that it is relevant to a wider range of situations. Despite the fact that the change I decided on is extremely individualised, I would want to expand more while yet being focused on the same topic matter.
If I were to carry out this project once again, there are a few aspects of it that I would change in order to guarantee that I get the results I want and am able to classify it as a triumph.

? Some of my measurement tools may be off, so I will have to upgrade them.

? I want to investigate transformation projects of greater length, during which I expect to include outside parties for advice and guidance.

? Nothing else will be ruled out entirely at this time.

? In the process, I will examine rewards.

? I plan to evaluate a potential shift in my lifestyle on many occasions, taking into account the potential influence of external factors like climate, season, and time of year.

? I'd analyse my plan's immediate and distant outcomes.

In addition to this, I would consider how the medication would influence my eating habits, what kind of assistance from the outside world I might need in order to be really effective if a customised or standard solution would be preferable, and the total cost of the process (Chang et al. 2017). 

References

Bashori, B., Prasetyo, M. A. M., & Susanto, E. (2020). Change management transfromation in islamic education of Indonesia. Social work and education, 7(1), 84-99. https://doi.org/10.25128/2520-6230.20.1.7.

Brytek-Matera, A., Czepczor-Bernat, K., Jurzak, H., Kornacka, M., & Ko?odziejczyk, N. (2019). Strict health-oriented eating patterns (orthorexic eating behaviours) and their connection with a vegetarian and vegan diet. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 24, 441-452. https://doi.org/10.1007/s40519-018-0563-5

Chang, M.-W., Brown, R., & Nitzke, S. (2017). Results and lessons learned from a prevention of weight gain program for low-income overweight and obese young mothers: Mothers In Motion. BMC Public Health, 17(1). https://doi.org/10.1186/s12889-017-4109-y

Cone, C., & Unni, E. (2020). Achieving consensus using a modified Delphi Technique embedded in Lewin's change management model designed to improve faculty satisfaction in a pharmacy school. Research in Social and Administrative Pharmacy, 16(12), 1711-1717. https://doi.org/10.1016/j.sapharm.2020.02.007

Dadar Singh, N. K., Loo, J. L., Ko, A. M. N., Husain, S. S., Dony, J. F., & Syed Abdul Rahim, S. S. (2022). Obesity and mental health issues among healthcare workers: A cross-sectional study in Sabah, Malaysia. Journal of Health Research, 36(5), 939-945. https://doi.org/10.1108/JHR-07-2020-0269

Gibbons, C., Hopkins, M., Beaulieu, K., Oustric, P., & Blundell, J. E. (2019). Issues in measuring and interpreting human appetite (satiety/satiation) and its contribution to obesity. Current obesity reports, 8, 77-87. https://doi.org/10.1007/s13679-019-00340-6

Health. (2021, February 26). Body mass index (BMI) and waist measurement. Australian Government Department of Health and Aged Care. https://www.health.gov.au/topics/overweight-and-obesity/bmi-and-waist

Pasdar, Y., Hamzeh, B., Karimi, S., Moradi, S., Cheshmeh, S., Shamsi, M. B., & Najafi, F. (2022). Major dietary patterns in relation to chronic low back pain; a cross-sectional study from RaNCD cohort. Nutrition Journal, 21(1). https://doi.org/10.1186/s12937-022-00780-2

Rogerson, D., Soltani, H., & Copeland, R. (2016). The weight-loss experience: a qualitative exploration. BMC Public Health, 16(1). https://doi.org/10.1186/s12889-016-3045-6

Urits, I., Burshtein, A., Sharma, M., Testa, L., Gold, P. A., Orhurhu, V., Viswanath, O., Jones, M. R., Sidransky, M. A., Spektor, B., & Kaye, A. D. (2019). Low Back

Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment. Current pain and headache reports, 23(3), 23. https://doi.org/10.1007/s11916-019-0757-1

Who.int (2021, June 9). Obesity and overweight. Retrieved February 17, 2023, from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

NUR1203 Cultural Safety and Professional Practice Assignment Help

Brief task description

This assessment task supports you to be an effective Bystander in the workplace and will hopefully extend beyond this. It is a requirement that student nurses and registered nurses are Culturally Safe practitioners. Part of this is when we witness culturally unsafe practice, that we have the skills to navigate this and bring change to the workplace setting.

Length 1500 words +/-10% (word length includes in-text referencing and excludes your reference list and appendices)

Task information

This Assessment requires you to respond to the following case scenario.

You are to identify ONE of the culturally unsafe care points within this scenario and use the four components of the Bystander Intervention Framework as the basis of this essay.

Case study

You are doing a clinical placement on a busy surgical ward, and you are working with a Registered Nurse (RN). Both of you attend to an adult patient, Elliott, who has been admitted for a surgical procedure and requires a blood transfusion intra-operatively. The family identify their religious faith as Jehovah’s Witness, where the belief in the administration of blood and blood products via transfusion is against their faith. Elliott has no vision and is able to communicate using speech.

The RN assumes that Elliott is unable to communicate for himself and talks only to her mother who is in attendance for admission.

The RN turns to face the mother and makes the following comment, “Hello there – who do we have here today? Thanks for bringing Elliott in for his admission. How long has he been unwell for? Do you know? I have his chart here with me and just want to ask you some questions regards his medical history if that’s OK? It says something here about him not consenting to a blood transfusion.... we’ll need to sort that out, because he’s going to need it you know!”

After finishing off admitting Elliott to the ward, you walk back to the nurse’s station with the RN. The RN turns to you and states “What a weird religion that stops you from having a blood transfusion. Why would anyone want to be in that religion?”.

1. Identify ONE of the culturally unsafe care points and explain its relevance to this case study and explain why it is culturally unsafe.

2. Identify 2 Direct interventions that you could use in this scenario. Your response cannot be a replication of any responses that have been provided with, in your Bystander training

3. Identify 2 Indirect interventions that you could use in this scenario. Your response cannot be a replication of any responses that have been provided in your Bystander training.

4. Identify 2 Distraction interventions that you could use in this scenario. Your response cannot be a replication of any responses that have been provided in your Bystander training.

5. Protocol intervention/s: Identify the NMBA Codes of Conduct that this culturally unsafe care is breaching.

Writing Style

• This assessment piece to be written as an report and in third person.
• Do not use headings
• Correct Academic writing as per USQ guidelines
• All discussion is to be appropriately referenced using APA 7th Edition Referencing
• Contemporary Literature must be sourced (no more than 7 years old).

Solution

Introduction

As per professional standards for registered nurses (RN), nurses must reflect dignity and professionalism through their practice and ensure patient right over person-centred and well-informed treatment practice. This report focuses on identifying culturally unsafe care reflected by RN in the case of Elliot, who belonged to Jehova's Witness believers and denied blood transfusion as per religious belief. This report also highlights 2 direct interventions for this case and 2 indirect interventions for this case, and 2 distracting interventions for nursing assignment help.

Culturally unsafe care points

In the case of Elliot, culturally unsafe care practice has been witnessed by an in terms RN responsible for the care of patients disrespecting the religious belief of the patient for not consenting to intra-operative blood transfusion rather than making the patient and family members of the patient agree on the procedure through empathy. The RN has also breached patients' right to the confidentiality of personal information as RN has communicated about patients' religious beliefs and treatment outcomes openly in nurse stations and reflects disrespect towards the religion. As mentioned by Poorchangizi et al. (2019), nurses have the responsibility of safeguarding patients' right to confidentiality. This right has been breached here by the RN, along with disrespect to the patients' culture. The RN has also avoided directly communicating with the patient even though the patient can talk. These are the areas where RN has reflected culturally unsafe care practices, lack of dignified behaviour, and respect towards patients' cultural needs and health conditions. This incident reflected unprofessional behaviour by the RN's breach of patients’ rights.

Direct intervention

The case here is to ensure a culturally safe care environment for Elliot. Direct interventions that can be considered in this case include training RN to deliver care in a culturally competent manner and ensuring collaboration with community health service providers. Authority of care service-providing organisations can consider arranging training for RN to enhance their cultural competence. Cultural competence among nurses can be enhanced by making them aware of different cultures and the importance of reflecting respect for the culture and religion of patients in the nursing profession (Kaihlanen et al., 2019). For example, during training sessions, the RN can be made aware of legal consequences associated with not respecting the religion of a patient, as well as improve the RN's ability to communicate with patients in a culturally competent way for incorporating changes in the RN's behaviour. Further such training can also improve other RNs' perception regarding the importance of maintaining culturally safe care practices to avoid the recurrence of such incidents.

On the other hand, including community healthcare professionals in the care team of Elliot can be beneficial for reducing the cultural barrier in care. The main concern here is no consent for the intraoperative blood transfusion, which is necessary for the patient. Community health service professionals can communicate with the patient and his family to make them understand the consequences of which blood transfusion becomes necessary during treatment and ways the patient can avoid breaching their religious values without impairing the treatment requirement (Bolcato et al. 2021). The community health professional can also help RN to understand patients' perspectives associated with treatment measures that can help to solve complications associated with the treatment plan

Indirect interventions

As the RN has reflected on culturally unsafe behaviour in terms of not respecting the cultural beliefs of patients and not prioritising patient confidentiality, strict measures can be taken against RN by making management aware of the situation. Further, appointing a different RN with professional knowledge of cultural competence and knowledge of managing patients with Jehovah’s Witness beliefs can be beneficial. RN can lose their license and job for not following professional standards and ensuring respect toward the cultural needs of patients. As mentioned by Handke et al. (2019), cultural competencies-related practices in healthcare settings allow limiting cultural disparities associated with treatment specification and help to minimise the consequences of inequality. Thus the respective case reflecting the poor understanding of cultural competencies highlights the presence of inequality in the case of the patient belonging from a significant religious belief only for not providing consent to a treatment requirement. Thus making authorities aware of the situation and taking strict action against the RN can help to limit the recurrence of such a situation in the future.

As the current RN appointed for Elliot has reflected a poor understanding of cultural competence thus, another RN having profound knowledge about the requirements of cultural competency can be appointed to manage this case. Ensuring a cultural competence care environment for the patient can help to limit the cultural barriers arising in the treatment plan as well as the dignity of the patient can be maintained. Further, replacing the existing nurse with an experienced professional will provide understanding regarding patients’ consent redefining other treatment methods that can be applied to replace the intraoperative blood transfusion. Thus it can be considered a strategy for dealing with the current situation.

Distracting intervention

Application of cognitive behavioural therapy (CBT) and counseling sessions with family members of patients in the presence of community service providers knowing dealing with issues of care associated with a patient with Jehovah’s faith can be considered in this case. As mentioned by Babiano-Espinosa et al. (2019), CBT allows the development of an interacting treatment environment for service users and service providers for better delegation and patient care needs. In the current case of Ellitor thus CBT based approach can be applied to reduce resistance to blood transfusion. Under this approach safety of blood transfusion in terms of their religious values and consequences for not considering the blood transfusion can be communicated. The CBT approach focuses on including changes in the behaviour of patients by encouraging and guiding them to judge a situation from a positive side. Thus this technique can be beneficial for making Elliot and his family members provide consent for blood transfusion.

A set of counseling sessions can be arranged for Elliot and his family members, and during the secession, it will be ensured that privacy and confidentiality are maintained. During the counseling session, it can be ensured that the patient and the family members actively participate in the communication to clarify the issues of not considering blood transfusion and the current health condition. Such sessions can also be used for reforming their existing experience due to poor behaviour of RN to ensure the trust of the patient and his family member over the services provider. It will help to ensure a cultural safety care environment and limit the issues associated with consent.

Protocol interventions

NMBA code of professional conduct forces nurses' duty to ensure patients' rights and respect for patients' decisions. In this respective case of Elliot, there are certain arise that RN has avoided and neglected. The first area neglected was the patient's condition, as Elliot could speak; however, the RN preferred to communicate with his family rather than the patient, which highlighted impairing patient-centered practice and informed-making. This activity of RN breaches the first code of conduct of NMBA, which is focused on nurses' practice safely and competently. As per this code of conduct, nurses must act safely and competently without being compromised by patient health limitations (Nursing and Midwifery Board of Australia, 2022). In this case, RN neglected Elliot’s personal views on the matter of blood transfusion though can communicate this code of conduct 1 has been breached. Code of conduct 4 NMBA standard focuses on ensuring nurses respect and dignity towards patients' culture, ethnicity, and values as well as beliefs while receiving care (Nursing and Midwifery Board of Australia, 2022). However, in this case, Elliot, while communicating with his family member RN considered a very informal way of communicating, reflecting the less interest in the patient's cultural and religious identity.

Further, while communicating with other RN, the respective nurse became very disrespectful to Jehovah's Witness's religious beliefs by saying the religion was weird and questioning the following religion. This incident signifies disrespecting the cultural and religious identity of the patient, thus breaching the code of conduct 4 of NMBA standards. Code of conduct 5 has also been breached in this unsafe cultural practice as this code highlights nurses' responsibility to maintain the confidentiality of the personal information of patients as per the National privacy principle 2001 and Privacy Act 1988 (Nursing and Midwifery Board of Australia, 2022). However, the RN, in this case, avoids confidentiality of the patient's details, such as cultural and religious specifications, by openly communicating about it in the nurse station. This code of conduct 5 of the NMBA standard has been breached in this culturally unsafe practice.

Conclusion

Thus it can be concluded that here RN has breached the NMBA code of conduct 1, 4, and 5 through culturally unsafe practice. The issue that arises can be solved through training sessions to improve RNs' knowledge regarding cultural competencies and CBT, as well as community healthcare service providers' engagement for making such patients and their families actively involved with care requirements. These techniques can help to ensure patient rights without impairing treatment specifications.

References

Babiano-Espinosa, L., Wolters, L. H., Weidle, B., Pedersen, S. A., Compton, S., & Skokauskas, N. (2019). Acceptability, feasibility, and efficacy of Internet cognitive behavioral therapy (iCBT) for pediatric obsessive-compulsive disorder: a systematic review. Systematic reviews, 8(1), 1-16.Doi.org/10.1186/s13643-019-1166-6

Bolcato, M., Shander, A., Isbister, J. P., Trentino, K. M., Russo, M., Rodriguez, D., & Aprile, A. (2021). Physician autonomy and patient rights: lessons from an enforced blood transfusion and the role of patient blood management. Vox Sanguinis, 116(10), 1023-1030. DOI: 10.1111/vox.13106

Handtke, O., Schilgen, B., & Mösko, M. (2019). Culturally competent healthcare–A scoping review of strategies implemented in healthcare organizations and a model of culturally competent healthcare provision. PloS one, 14(7), e0219971. doi.org/10.1371/journal.pone.0219971

Kaihlanen, A. M., Hietapakka, L., & Heponiemi, T. (2019). Increasing cultural awareness: qualitative study of nurses’ perceptions about cultural competence training. BMC nursing, 18(1), 1-9. doi.org/10.1186/s12912-019-0363-x

Nursing and Midwifery Board of Australia (2022) Code of Professional Conduct for Nurses in Australia,https://www.anmfvic.asn.au/~/media/files/anmf/codes%20of%20conduct/6_new-code-of-professional-conduct-for-nurses-august-2008-1-.pdf?la=en

Poorchangizi, B., Borhani, F., Abbaszadeh, A., Mirzaee, M., & Farokhzadian, J. (2019). The importance of professional values from nursing students’ perspective. BMC nursing, 18(1), 1-7.Doi.org/10.1186/s12912-019-0351-1

NURBN2025 The Health and Cultural Diversity Assignment Sample

Assessment Description:

Students to explore impacts to health and health outcomes for Aboriginal and Torres Strait Islander Peoples, as well as demonstrate the importance of incorporating cultural perspectives in clinical practice as future healthcare professionals.

Overview:

The purpose of this task is to demonstrate cultural safety in clinical practice. You will critically examine a case study identifying the necessity of culturally safe practice to improve the health and health outcomes for Aboriginal and Torres Strait Islander Peoples.

In assessment task 1 you identified an understanding of your own identity, along with social and cultural factors and how this has influenced your own beliefs about, and interactions with, Aboriginal and/or Torres Strait Islander Peoples. In this assessment task you have the opportunity to apply this self-reflection to practice when exploring the events of the following case study. Your responses are to be evidence-based.

Case Study

Annie is a 59 year old Aboriginal women from the Atherton table lands near Cairns, in north Queensland. Annie is passionate about being an Aboriginal community member, enjoying yarning with her community and attending local community events. Annie has one daughter Sharelle, 32 years old and one son Tony, 30 years old. Sharelle has 3 children, Sarah 12 years old, Kelly 9 years old and Alex who is 3 years old. Sharelle lives close to Annie in the Atherton Table lands.

Annie has lived independently for many years and was employed as a Murri Primary School Teacher which she loved. Annie retired 3 years ago to support her daughter with caring for her children. Annie had separated from the father of Sharelle and Tony many years ago.

Annie is visiting her son Tony and daughter-in-law Kate in Melbourne (within the Monash health catchment area). They have a baby, Lily who is 9 months old. Kate is returning to work so Annie has come to Melbourne for an extended stay to help care for baby. Annie enjoys caring for and getting to know Lily. Lily is relatively easy to look after, sleeping through the night. Annie takes over the care of Lily once Tony and Kate go to work. Annie loves signing songs to Lily. She also takes on the usual care like feeding and changing nappies. Lily will sleep about 3 hours in the middle of the day, so this gives Annie time to rest or tidy the house. Annie will take Lily for a walk if it is warm enough once she wakes up. Tony and Kate will take over the home tasks when they arrive home from work.

Annie is a bit lonely as she does not really know anyone. Annie is missing the mob in the Aboriginal Planned Activity Group where she is involved in yarning, gardening and walking activities. Annie’s favourite was art as she was creating a piece for a local exhibition. Annie does not like hospitals; she has a fear of hospitals because her community have had bad experiences.

Case Study Instructions

Move through this case study by addressing the following situations:

Section one: How do you ensure you are committed to a journey of cultural safety?

You are on a morning shift at Dandenong Hospital, Monash Health and have been informed that you need to admit a patient being transferred from the Emergency

Department. You receive the handover:

Annie is a 59 year old Aboriginal women from the Atherton table lands and has Type 2 diabetes and Hypertension, diagnosed when she was 50. She has managed her diabetes with the support of the

Local Aboriginal Health Service (Wuchopperen Health Service Limited:

https://www.wuchopperen.org.au/health-support). Annie had been informed that her kidney function was deteriorating which she had been following up at this service. Shortly after arrival in Melbourne Annie becomes unwell and is admitted to hospital. Annie was experiencing intense ear pain and had become very unsteady on her feet, later diagnosed with a severe ear infection requiring intensive intravenous antibiotic treatment.

Annie arrives on the ward; you greet Annie while taking her to her bed. How do you ensure you are committed to a journey of cultural safety?

1. Provide an evidenced based strategy that enables you to continue your cultural safety journey.

2. How do you welcome Annie into the ward?

3. Annie reveals her current situation with you, as outlined in the case study. What actions would you take following this conversation? You are advised to investigate an Aboriginal Community Controlled Health Service that would be able to support Annie while she is staying in Melbourne.

Section two: Addressing culturally unsafe practice.

You are now at handover. You are presenting Annie to the nursing team. You have just described Annie’s symptoms. You have said Annie is very unsteady on her feet and before you can continue you hear two nursing colleagues say, “I bet she’s an alcoholic. We will make sure we limit her pain relief”. To unpack this situation please answer the following questions

1. In NURBN2025 you were introduced to racism, the causes and impact on health outcomes Identify from peer reviewed literature the possible reasons why non-Indigenous people make racist assumptions about First Nations peoples. Include the following:

a. The potential beliefs, values and attitudes that have influenced these non- Indigenous nurses to be culturally unsafe.
b. Describe how these nurses have used power differentials related to their beliefs, for nursing care.
2. How would you advocate for Annie in this handover?

Section three: Promoting Cultural safety

You make an appointment to meet with your nurse unit manager (NUM) to address this culturally unsafe practice. What team based solutions could you present to your NUM. Think of this in terms of:

1. How could cultural safety be promoted within this ward?
a. What antiracist group learning strategies could be implemented?
b. How could power differentials be minimised?

Please note the word counts are a guide. The reference list is not included in the word count.

Solution

Section 1:How do you ensure you are committed to a journey of cultural safety?

The case scenario conveys that Annie is afraid of hospitals as her community has had a bad experience with care services. It is very common that Aboriginal and Torres Strait Islander patients mostly confront several issues or challenges as the medical practices including nurses and doctors carry biased attitudes toward the community (Arrow et al. 2018). Thereby for a patient like Annie confirming cultural safety and equality in accessing healthcare is very important to confirm a safe environment for the healthcare setting. In order to confirm cultural safety for Annie, stakeholder engagement is much more important to confirm openness, respect, and offer safe care to a patient like Annie. It can justify a trustworthy, flexible, respectful relationship during the period of treatment. In order to confirm cultural safety, maintaining the privacy and secrecy of the patient is another important consideration as most of the aboriginal people do not have such type of offering during their intervention in the healthcare setting for best assignment help.

Considering Annie's fear regarding her healthcare setup, it is very important to welcome her to the ward with all warmth confirming a friendly environment. It would even help to justify cultural safety in the process. The nurse needs to be skilled and professional enough to carry an unbiased attitude and treat them in the same way as other patients. A welcoming attitude can even be confirmed by behavioral attempts where maintaining eye contact can offer assurance to Annie to be comfortable in the setup. Cultural safety can even be accommodated in the practice through effective communication where more focus would be on listening as most effective communication is mistaken by speaking. More listening to patients like Annie can help the nurse to be more acknowledged of her culture, and background to address her needs accordingly. It would help to sustain cultural safety in the setup. Before proceeding with any intervention for her difficulties taking her decision and discussing the intervention procedure with her is a must to avoid ethical issues like informed consent, autonomy, etc (Beks et al. 2019). Addressing to the referred ethical issues can even help to sustain a positive, safe, cultural environment in the healthcare setup. Having an understanding of Annie's difficulties as well as cultural considerations, it would be better for the nurses to arrange a support system to confirm that her main health issue is being addressed.

Annie does not have an extended family to help her out and her son and daughter might not be that much effective to offer her support. Thereby to confirm her continuous improvement regarding all types of health issues, it will be better to take the help of community services so that she can recover first. Annie is already getting the help of services to manage her diabetes but the service is not available in Melbourne as it belongs to Queensland and Annie is in Melbourne right now. Thereby it is important to arrange for another type of health service for Annie which is available and accessible in Melbourne. The help of any local aboriginal network can be communicated to confirm cultural safety afterward. As this particular network would help to be connected with the support service for the community; thereby it would be a better consideration to confirm cultural safety. The service needs to be such where several segments like raising awareness, building partnerships, information determination, etc which would be much helpful for Annie to be self-dependent in all terms. There are services like ACCHO and NACCHO that can help Annie in her situation through their programs and policies (Bovill et al. 2021). It would even help her to get rid of her fear of hospital services as these particular support services are for the community she belongs to and it is definitely help her to be comfortable and feel culturally safe and secure in all terms.

Section 2: Addressing culturally unsafe practice

In legal considerations, it has been confirmed in Australia that equality would be there in the health sector with no discrimination for race, gender, background, tradition, custom, etc. However, the practical scenario does not get properly aligned with the same; rather there are several nonindigenous people who consider aboriginal and Torres Strait Islander people as discriminated, against, and unequal, and make them marginalized. It can be confirmed undauntedly that everyone has their own attitude, value, and beliefs but individualism should not lead to racism including hatred, discrimination, or prejudice due to their origin, or color. It even extracts the negative image of the sector as well as the societal structure of the country. Health Care sector belongs to emergency services and racism cannot be overflowing in such a sector; still, nurses often exercise power differentials as per their values, belief, or attitude. They often ignore Aboriginal and Torres Strait Islander people and do not pay proper attention to their symptoms to offer them safe care intervention (Jayakody et al. 2020). Such a type of attitude immediately confirms culturally unsafe practice on the part of the nurses. Most of nonindigenous nurses believe that aboriginal people can be only one community and there cannot be any variation regarding that. However, that is a complete misconception regarding aboriginals which eventually leads to improper addressing of cultural diversity followed by culturally unsafe practices. Furthermore, most of the non-indigenous people believe that aboriginals or indigenous people are illiterate, ill-mannered and live a gross life where they always get involved with drinking, smoking, and the use of drugs. Research even confirms that they are not very interested to work but rather always ask for everything for free. Such type of wrong information or improper belief regarding indigenous people on the part of non-indigenous people eventually attracts unsafe practice by creating a barrier in the care intervention (O’Donnell et al. 2020). Due to such type of wrong beliefs, nurses often do not share enough concern or focus for the patients or their symptoms and rather carry a biased attitude which becomes the main barrier for the entire care process. Such a type of attitude will definitely make Annie very uncomfortable, hurt, and angry due to the involved discrimination. She can even think of racist activities in the health care center which eventually can increase her uncomfortable regarding the healthcare setting. Thereby, it would be better for the nurses to exercise an open flexible environment in the setup. It is even important to exercise effective communication and shared decision-making in the process where the patient like Annie would not feel left out but rather can play an active role in the entire intervention. As the nurses of the next shift have a misconception regarding the aboriginal community and already have confirmed their biased attitude towards Annie, thereby, it is important for the nurse of the present shift to make them aware of some important considerations while the handover. It is very important to convey human rights, patient rights, and several ethical issues to be followed by the nurses during handover to assure or informed them about consequences. It would help them to be more focused on the patient without sharing any biased attitude toward her aboriginal background. It would be even more relevant if the nurse on the present shift would convey her experience with Annie (Quinn, 2019). Such information can remove the misconceptions of the nurses conveying the fact that all aboriginals are not involved in features like smoking, drinking, taking the drug, etc to confirm a culturally safe environment for Annie.

Section 3: Promoting Cultural safety

Such unfair practices need to be stopped as well as promoting cultural safety is another important consideration to be taken care of. In order to promote cultural safety in the hospital care setting, the nurse unit manager needs to be conveyed of such unfair practices. Apart from conveying the thing, it is even important to take some initiative to promote cultural safety. The first and foremost concern to promote cultural safety in the practice can be training (Skoss et al. 2021). Training would be much helpful to make the nurses informed or acknowledge about cultural diversity. The training can make them more efficient, skilled, and effective to remove the issue of cultural diversity and promote

cultural safety. If the nurses of the next shift had enough information about aboriginals then they might not have such type of generalized attitude or behavior towards Annie rather they can secure a friendly safe environment for her treatment. Hence, it immediately can confirm cultural safety in the process. Decision makers and nurses in the healthcare sector are the main stakeholders to exercise or initiate action to attain sustainability as well as success for their efforts. There are some nursing principles and foundations to avoid ethical issues. The training even needs to accommodate the same so that the nurses would have enough knowledge regarding informed consent, authority, non-maleficence, and beneficence which eventually would help them to avoid improper addressing to the patient and automatically culturally safe practice will be aligned in the setup (Tremblay et al. 2020). The training even needs to convey the consequences of otherwise situations to make the nurses aware of all positive and negative to secure cultural safety in the process.

References

Arrow, P., McPhee, R., Atkinson, D., Mackean, T., Kularatna, S., Tonmukayakul, U., ... & Jamieson, L. (2018). Minimally invasive dentistry based on atraumatic restorative treatment to manage early childhood caries in rural and remote aboriginal communities: Protocol for a randomized controlled trial. JMIR research protocols, 7(7), e10322. https://www.researchprotocols.org/2018/7/e10322/

Beks, H., Binder, M. J., Kourbelis, C., Ewing, G., Charles, J., Paradies, Y., ... & Versace, V. L. (2019). Geographical analysis of evaluated chronic disease programs for Aboriginal and Torres Strait Islander people in the Australian primary health care setting: a systematic scoping review. BMC public health, 19(1), 1-17. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7463-0

Bovill, M., Chamberlain, C., Bennett, J., Longbottom, H., Bacon, S., Field, B., ... & O’Mara, P. (2021). Building an Indigenous-led evidence base for smoking cessation care among Aboriginal and Torres Strait Islander women during pregnancy and beyond: Research protocol for the Which Way? project. International journal of environmental research and public health, 18(3), 1342. https://www.mdpi.com/1660-4601/18/3/1342

Jayakody, A., Oldmeadow, C., Carey, M., Bryant, J., Evans, T., Ella, S., ... & Sanson-Fisher, R. (2020). Frequent avoidable admissions amongst Aboriginal and non-Aboriginal people with chronic conditions in New South Wales, Australia: a historical cohort study. BMC health services research, 20(1), 1-12. https://link.springer.com/article/10.1186/s12913-020-05950-8

O’Donnell, R., Hatzikiriakidis, K., Mendes, P., Savaglio, M., Green, R., Kerridge, G., ... & Skouteris, H. (2020). The impact of transition interventions for young people leaving care: a review of the Australian evidence. International Journal of Adolescence and Youth, 25(1), 1076-1088. https://www.tandfonline.com/doi/full/10.1080/02673843.2020.1842216

Quinn, A. (2019). Reflections on intergenerational trauma: Healing as a critical intervention. First Peoples Child & Family Review: An Interdisciplinary Journal Honouring the Voices, Perspectives, and Knowledges of First Peoples through Research, Critical Analyses, Stories, Standpoints and Media Reviews, 14(1), 196-210. https://www.erudit.org/en/journals/fpcfr/1900-v1-n1-fpcfr05475/1071296ar/abstract/

Skoss, R., White, J., Stanley, M. J., Robinson, M., Thompson, S., Armstrong, E., & Katzenellenbogen, J. M. (2021). Study protocol for a prospective process evaluation of a culturally secure rehabilitation programme for Aboriginal Australians after brain injury: the Healing Right Way project. BMJ open, 11(9), e046042. https://bmjopen.bmj.com/content/11/9/e046042.abstract

Tremblay, M. C., Graham, J., Porgo, T. V., Dogba, M. J., Paquette, J. S., Careau, E., & Witteman, H. O. (2020). Improving cultural safety of diabetes care in Indigenous populations of Canada, Australia, New Zealand and the United States: a systematic rapid review. Canadian Journal of Diabetes, 44(7), 670-678. https://www.sciencedirect.com/science/article/abs/pii/S1499267119307300