Nancy Gilbert Student Instructions 2022 Chamberla
Nr324nr329 Nancy Gilbert Student Instructions 2022 Chamberlain Univ
The scenario involves Nancy Gilbert, a patient with a 5-year history of laryngeal cancer requiring a permanent tracheostomy and continuous supplemental oxygen. She has an 80-pack-year smoking history and lives with her husband. The patient was admitted with pneumonia and placed in contact isolation for MRSA. During the simulation, students will assess respiratory distress and perform sterile tracheostomy suctioning while adhering to contact precautions.
Students will assume specific roles such as Charge Nurse, Documentation Nurse, Medication Nurse, Assessment Nurse, and Observer Nurse, each with defined responsibilities focused on ensuring safe, effective patient care, accurate documentation, medication safety, comprehensive assessment, and observation/reporting during the scenario.
The simulation aims to help students meet course outcomes related to providing professional nursing care, effective communication, and critical thinking in acute care settings. The simulation takes place over scheduled time frames, including pre-briefing, optional skills review, the main scenario, and debriefing.
Preparation includes completing assigned readings, practicing assessment skills, and reviewing specific nursing interventions such as acid-base balance, altered gas exchange, and report communication techniques using I-SBAR. Students must answer pre-briefing questions on communication with a tracheostomy patient, MRSA precautions, and IV infiltration assessment and interventions before participation.
Paper For Above instruction
Nancy Gilbert’s case presents a complex clinical scenario that underscores critical nursing responsibilities in managing patients with advanced respiratory needs and infectious precautions. Her history of laryngeal cancer necessitates diligent care for her permanent tracheostomy and specialized respiratory support, which requires nurses to possess advanced skills in airway management, infection control, and patient communication. This case also highlights the importance of a multidisciplinary approach, effective Patient-Centered care, and evidence-based practices in acute care settings.
Introduction
The management of patients with tracheostomies and infectious diseases such as MRSA presents unique challenges for nurses. It demands proficiency in airway management, infection prevention, patient education, and effective communication strategies to ensure safety and comfort. The scenario involving Mrs. Gilbert emphasizes these aspects, requiring nurses to integrate their knowledge and skills holistically within a high-stakes environment. Furthermore, it accentuates the importance of interprofessional collaboration, critical thinking, and adherence to infection control protocols, which are foundational to contemporary nursing practice (Berkowitz et al., 2019).
Assessment and Preparation
Effective care begins with comprehensive assessment, including vital signs, respiratory status, and psychosocial evaluation. The nurse's role involves vigilant monitoring for signs of respiratory distress, infection, and complications related to tracheostomy care. Pre-simulation preparation encompasses understanding Mrs. Gilbert’s medical history, current condition, and environment, including her infection status. Knowledge about the physiological effects of pneumonia, long-term effects of smoking, and the intricacies of airway management are essential (McKinney et al., 2020).
In addition to technical skills, nurses should review communication techniques such as non-verbal cues, using communication boards, and confirming understanding with patients who have tracheostomies. This ensures patient safety and promotes a therapeutic nurse-patient relationship (Reick et al., 2021). Awareness of infection control protocols for MRSA, including contact precautions and proper PPE use, is crucial to prevent cross-contamination and protect both the patient and healthcare workers.
Infection Control and Patient Education
MRSA, or methicillin-resistant Staphylococcus aureus, is a bacterial infection resistant to many antibiotics, raising concerns about treatment difficulties and transmission risks (Chambers & DeLeo, 2019). Care involves strict contact precautions, including wearing gloves and gowns, proper hand hygiene, and environmental cleaning. Educating Mrs. Gilbert and her family is vital to prevent the spread and reinforce infection control practices, such as hand hygiene, not sharing personal items, and cleaning shared surfaces (Lee et al., 2022).
Similarly, proper tracheostomy care involves teaching the patient and family about sterile suctioning, observing for signs of infection or obstruction, and maintaining skin integrity around the stoma. Education enhances patient autonomy and reduces readmission rates by preventing complications (Kent et al., 2020).
Airway Management and Respiratory Care
Management of Mrs. Gilbert’s airway is a priority, including regular tracheostomy suctioning to clear secretions and maintain patency. This requires aseptic technique to prevent nosocomial infections. Nurses must recognize cues for respiratory deterioration, such as increased respiratory rate, accessory muscle use, cyanosis, or decreased oxygen saturation, and respond promptly with appropriate interventions (Harrington et al., 2018).
The use of oxygen therapy, including maintaining continuous supplemental oxygen, should be tailored to her needs. Preparation for potential emergencies, such as airway obstruction or respiratory failure, necessitates understanding of emergency protocols and equipment (Yanez et al., 2021). Continuous monitoring and assessment ensure early identification of complications, facilitating timely intervention.
Communication Strategies
Effective communication with Mrs. Gilbert involves using non-verbal cues, speech therapy techniques, and assistive devices if available. It is essential to create a supportive environment that encourages her to express needs and concerns despite her tracheostomy. Techniques such as speaking with a speaking valve, or employing picture boards, can significantly enhance her quality of life and cooperation with care (Duffy & Evans, 2020). Ensuring clear, calm, and consistent communication reduces patient anxiety and fosters trust.
Critical Thinking and Interprofessional Collaboration
Critical thinking underpins all nursing actions, from assessing signs of deterioration to prioritizing interventions. Nurses must synthesize data rapidly, decide on appropriate actions, and communicate effectively within the healthcare team. For example, recognizing early signs of infection or respiratory compromise prompts immediate action, including notifying physicians and administering necessary treatments (Benner et al., 2018).
Collaboration involves interdisciplinary efforts, including respiratory therapists, physicians, and infection control specialists, to optimize Mrs. Gilbert’s care. Accurate documentation, understanding care plans, and sharing observations are vital to ensure cohesive and patient-centered management (Oelberg et al., 2021).
Conclusion
The scenario with Mrs. Gilbert encapsulates core nursing competencies such as comprehensive assessment, infection control, airway management, patient education, communication, and interprofessional collaboration. It underscores the importance of integrating knowledge, skills, and attitudes to deliver safe, effective, and compassionate care for patients with complex respiratory and infectious conditions. As foundational professionals in acute care, nurses must remain vigilant, adaptable, and committed to lifelong learning to meet evolving healthcare challenges (American Nurses Association, 2021).
References
- American Nurses Association. (2021). Nursing: scope and standards of practice. ANA.
- Benner, P., Hughes, R. G., & Sutphen, M. (2018). Clinical reasoning, judgment, and decision making in nursing. Springer Publishing.
- Berkowitz, M., et al. (2019). Managing infections with multidrug-resistant organisms in healthcare settings. Infection Control & Hospital Epidemiology, 40(4), 445-451.
- Chambers, H. F., & DeLeo, F. R. (2019). Waves of resistance: Staphylococcus aureus in the antibiotic era. Nature Reviews Microbiology, 17(1), 51–62.
- Duffy, M. E., & Evans, S. L. (2020). Communication techniques for patients with tracheostomies. Journal of Clinical Nursing, 29(3-4), 563-572.
- Harrington, J. M., et al. (2018). Recognizing respiratory deterioration in patients with tracheostomies. Respiratory Care, 63(10), 1266-1273.
- Kent, M., et al. (2020). Patient education in tracheostomy care: Improving outcomes through engagement. Supportive Care in Cancer, 28(1), 371–377.
- Lee, S., et al. (2022). Infection prevention and control in healthcare settings: A comprehensive review. Journal of Hospital Infection, 122, 36-44.
- McKinney, M., et al. (2020). Pulmonary nursing care for patients with chest and airway conditions. Nursing Clinics of North America, 55(2), 185-199.
- Reick, S., et al. (2021). Enhancing communication with patients with airway devices. Nursing Standard, 36(2), 43-50.
- Yanez, N., et al. (2021). Emergency preparedness in respiratory care. Respiratory Medicine, 183, 106437.