Word Evidence-Based Writing: The Review Of Evidence Assignme

1500 Word Evidence Based Writingthe Review Of Evidence Assignment Req

The review of evidence assignment requires you to review the video or transcript of a preventable death true story, comparing, analysing and reflecting on the scenario leading to a preventable death and what could have been done differently, when compared to current best practice evidence and highlight the best processes to follow as a registered nurse. Matt was a 16 year-old who died following a simple appendectomy, the following video is Matt's story told by his mother Heather and Karyn Bousfield, Director of Nursing, West Coast DHB. Examining best practice evidence, explain what ‘Don’t normalise the abnormal’ means and using the A-E systematic approach, review the video and identify the A-E “reg flag” signs of deterioration that were mentioned and how these symptoms were normalised.

As the ward nurse looking after Matt on the night shift, highlight the importance of ‘documentation’ and provide an explanation about the nursing care requirements you would have implemented overnight, including when you would have asked for a clinical review and why? Examine what ‘critical thinking’ is for a nurse and using best practice evidence, explain how Matt’s deterioration and respiratory arrest could have been prevented from a nursing perspective if critical thinking skills had been utilised. As an almost registered nurse, reflect on what ‘Speaking Up’ means as a nurse, in the given situation and in Australia what processes and supports could you utilise, if you are concerned about a deteriorating patient.

Paper For Above instruction

The tragic case of Matt, a 16-year-old who succumbed to preventable complications following an apparently routine appendectomy, underscores critical lessons for nursing practice. By analyzing this incident through evidence-based frameworks, including the concept of ‘Don’t normalise the abnormal’ and the A-E systematic approach to deterioration recognition, nurses can improve patient safety and outcomes. This reflective discussion explores the significance of vigilant documentation, critical thinking, and speaking up within the Australian healthcare context to foster a safety culture and prevent similar tragedies.

Introduction

The healthcare sector continually strives to minimize preventable harm through adherence to evidence-based practices. The case of Matt illustrates how clinical deterioration can be overlooked or misinterpreted, leading to catastrophic outcomes. This paper examines the case, emphasizing the importance of recognizing abnormal signs, accurate documentation, critical thinking, and proactive communication. Through this, nurses can fulfill their responsibilities of vigilant patient monitoring and advocacy, aligning with Australian healthcare standards and ethical principles.

Understanding ‘Don’t Normalise the Abnormal’ and the A-E Systematic Approach

The phrase ‘Don’t normalise the abnormal’ cautions healthcare professionals against dismissing significant clinical signs as normal variations. In Matt’s case, subtle deviations in vital signs and symptoms could have been overlooked or considered insignificant, delaying vital interventions. Instead, these should have been recognized as ‘red flags’ prompting further assessment. The A-E systematic approach—Airway, Breathing, Circulation, Disability, Exposure—is designed to identify early signs of deterioration. For example, respiratory difficulty in Matt, indicated by increased work of breathing or hypoxia, falls under the ‘B’ (Breathing). Recognizing such signs early and acting promptly could have altered the outcome.

Significance of Documentation and Appropriate Nursing Care

Accurate documentation is foundational to patient safety. It ensures continuity of care, facilitates timely interventions, and provides legal accountability. As the ward nurse, meticulous recording of Matt’s vital signs, symptoms, and interventions would have offered a clear clinical picture. Overnight, consistent monitoring and documentation could have highlighted trends indicating deterioration. For instance, recording a declining oxygen saturation or increased respiratory rate would have warranted escalation. In such a scenario, requesting a clinical review promptly is critical; a senior review could have confirmed the deterioration and led to urgent intervention. The appropriate nursing care would include regular assessments, ensuring oxygen therapy was adequate, and maintaining vigilant observation for any signs of respiratory compromise.

The Role of Critical Thinking in Nursing Practice

Critical thinking involves analyzing information logically, evaluating clinical signs objectively, and making informed decisions. It encompasses questioning initial impressions and considering alternative explanations. In Matt’s case, applying critical thinking might have involved recognizing early ominous signs, questioning abnormal vital signs, and prioritizing urgent assessment. Evidence suggests that nurses proficient in critical thinking are better equipped to detect deterioration early and initiate appropriate response (Benner et al., 2010). Had critical thinking been employed effectively, the signs of respiratory distress could have triggered earlier intervention, potentially preventing respiratory arrest (Levett-Jones et al., 2010).

‘Speaking Up’ and Support Mechanisms for Concerned Nurses in Australia

‘Speaking up’ is a vital component of patient safety, empowering nurses to voice concerns about patient deterioration without fear of retribution. In an Australian context, this aligns with the principles of a safety culture and the National Safety and Quality Health Service Standards. Processes such as escalating concerns via clinical hierarchies, utilizing multidisciplinary team discussions, and engaging in open communication foster a supportive environment (Australian Commission on Safety and Quality in Health Care, 2017). Support mechanisms include whistleblower policies, clinical supervision, and access to ethics or patient safety committees. As an almost registered nurse, advocating for the patient by speaking up about observed deterioration is essential, and utilizing these supports ensures concerns are heard and acted upon.

Conclusion

The preventable death of Matt highlights the critical importance of vigilance, evidence-based practice, and effective communication. Recognizing the abnormal early signs using the A-E approach, maintaining accurate documentation, exercising critical thinking, and speaking up are pivotal strategies to ensure patient safety. As future registered nurses operating within Australia's healthcare framework, embracing these principles fosters a proactive, safety-focused culture and minimizes the risk of preventable harm. Continuous education, reflection, and a supportive environment are essential for translating best practices into clinical excellence.

References

• Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating Nurses: A Call for Radical Transformation. Jossey-Bass.
• Australian Commission on Safety and Quality in Health Care. (2017). National Safety and Quality Health Service Standards. ACSQHC.
• Levett-Jones, T., Lathlean, J., Maguire, J., & McMillan, M. (2010). The 'A' for Action: Developing clinical reasoning skills in undergraduate nursing students. Nurse Education Today, 30(6), 602-607.
• Calderon, L. (2018). Critical Thinking in Nursing: Evidence-Based Practice and Decision-Making. Nursing Clinics of North America, 53(4), 481-491.
• Rogers, E., & Mann, M. (2016). The importance of documentation in nursing. British Journal of Nursing, 25(18), 1028-1032.
• Hodgson, D. (2018). Recognizing red flags in early deterioration: An evidence-based review. Journal of Clinical Nursing, 27(21-22), 4050-4060.
• Levett-Jones, T. (2014). The essential role of critical thinking in nursing. Australian Nursing and Midwifery Journal, 22(4), 23-27.
• Jones, S., & de Vries, P. (2019). Speaking up for safety: Nursing communication strategies. Journal of Nursing Management, 27(3), 413-420.
• Weston, C. (2014). Effective team communication and patient safety. Nursing Times, 110(15), 12-14.
• Australian Nursing & Midwifery Federation. (2020). Promoting a Speak-up Culture in Healthcare. ANMF Policy Brief.