Physical and Emotional Safety – Clinical Risk Management – Nursing Assignment Help

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Task:-
 An issue of safety/ legal responsibility
1. Roles and Responsibilities
Module 2 Overview
In this module, you will explore the role of the specialist nurse.
You will be asked to identify some of the physical and emotional safety issues related to the specialty and determine some strategies you can use to keep yourself (and your patient) safe.
The module will conclude with an examination of the legal aspects associated with the specialty, both in terms of your responsibilities and the responsibilities of the employer.
Roles & Responsibilities
LO1 Distinguish the roles and responsibilities of a nurse in the selected specialty practice area
LO8 Extend your professional portfolio reflecting on your learning and development towards the NMBA Registered nurse standards for practice using examples of skill development and nursing. 
In Australia, specialist nursing usually requires a post-graduate qualification (Jokiniemi, Pietilä, Kylmä & Haatainen, 2012). However, as registered Nurses you can work in any area of nursing, so what defines specialty practice?  What is the difference between a nurse practitioner and an advanced practice nurse as opposed to someone who has worked in the same clinical area for 10 years or someone who has a postgraduate certificate or Diploma in a specialty area?
To get you started, the following article may address some of these questions for you:
The roles and the responsibilities (scope of practice) of the registered nurse are defined by the Nursing & Midwifery Board of an (NMBA) in consultation with industry and other governing nursing bodies.  The NMBA also have definitions pertaining to nurse practitioners and advanced practice nurses.
The following will help you establish a basis for your reflection and enable you to complete the activity:

Fact Sheet: Advanced nursing practice and specialty areas within nursing 

Shields (2013) discusses the role of the nurse in a reflective personal essay that makes for interesting reading on how nursing is viewed and where Australian nursing fits in the global scene. It makes for a good introduction to the elective and to the module. Please read this article:  Shields, L. (2013). 
A personal essay on the role of the nurse

. 
Contemporary Nurse: A Journal for the Australian Nursing Profession, 43
(2), 213-218.
Having read the above resources it is time to explore what you know and understand about the role of the specialty nurse within your clinical practice area. Consider what you already know in relation to the 
NMBA standards of practice for registered nurses

 (2016).  If all registered nurses need to meet these standards then what more is expected of someone with specialty experience?
To explore the role of the specialist nurse in the area of your elected specialty:

Locate, read and reflect on the standards that guide the practice of nurses in your specialty area (these can often be found on the relevant specialty association webpage). Many of these can also be found via the library catalog – 
this is important!!

Find the job description for a clinical nurse in your specialty area and read it.

Identify the characteristics of the role that is beyond the generic description of the role of a registered nurse, that is, identify what makes the person a specialist in the area.

What is the difference between a clinical nurse specialist (CNS), advanced nursing practice and advanced practice nursing?

If possible speak to a nurse who currently practices in a specialty area. Ask him/her how they acquired the knowledge and skills that make a specialist in the area. You might ask them about what facilitators and barriers they dealt with in the course of developing their specialized knowledge. 

Write down some key messages you learned from these activities.

2. Clinical Risk Management
Clinical Risk Management
LO1 Distinguish the roles and responsibilities of a nurse in the selected specialty practice area
Advocating for the safety of patients in all healthcare settings is the responsibility of all health care workers. A nationally recognized organization titled 
The Australian Commission on Safety and Quality in Health Care
 [ACSQHC] publishes resources, standards, and guidelines relating to safety and quality in health care.  The ACSQHC is frequently used as an important reference point for State and Territory Departments of Health and Ministers of Health in Australia.
ACSQHC (2010) states that all health care services (public and private) should be:
The ACSQHC has been significant in the development of national policies for the reporting of clinical incidents and the publishing of annual sentinel event reports for each state and territory.  Each state and territory now has required reporting of all clinical incidents occurring in health care services, as part of their 
Clinical Risk Management (
CRM) strategy.
Clinical risk management (CRM)
 is an approach to improving the quality and safe delivery of health care by (1) placing special emphasis on identifying circumstances that put patients at risk of harm, and (2) acting to prevent or control those risks.  CRM should be practiced by all health services in Australia. There are terms related to CRM used frequently in health care that are important to define, namely: clinical incident, adverse event, near miss, open disclosure, root cause analysis, harm, sentinel event, and clinical effectiveness.  A brief description of each follows.

A 
clinical incident
 is defined as, “an event or circumstance that could have, or did lead to unintended and/or unnecessary harm to a person receiving care” (State Government of Victoria, 2019a).  Clinical incidents can include adverse events, near misses and hazards in the environment that pose a clinical risk.  It is important to define several terms related to the discussion at this point.

Root cause analysis (RCA)
 is a detailed and thorough investigation of a clinical incident or sentinel event.  
Harm 
may include disease, injury, suffering, disability or death; disability being any type of impairment of body structure or function, activity limitation and/or restriction of participation in society, associated with a past or present harm (State Government of Victoria, 2019b).

Sentinel events
 “are a subset of adverse events that result in death or serious harm to a patient”, a report must be submitted to Safer Care Victoria within three days of the incident and a root cause analysis must be conducted for each sentinel event reported to Safer Care Victoria (State Government of Victoria, 2019b).

In Australia, there are eight categories of sentinel events:

procedures involving the wrong patient or body part resulting in death or major permanent loss of function;

suicide in an inpatient unit;

retained instruments or other material after surgery requiring re-operation or further surgical procedure;

intravascular gas embolism resulting in death or neurological damage;

hemolytic blood transfusion reaction resulting from ABO incompatibility;

medication error leading to the death of patient reasonably believed to be due to incorrect administration of drugs;

maternal death or serious morbidity associated with labor or delivery;

infant discharged to the wrong family;

other catastrophic: Incident severity rating one (ISR1) (State Government of Victoria, 2019b)

ACTIVITY: This task is undertaken for your own learning it is not an assessable task
1. Reflect on your clinical practicum experience individually or preferably in a group. Can you or one of your colleagues recall a time where an incident report needed to be completed? As a group, write a brief summary of what occurred. Do this by asking the following questions:

Who was involved?

What was the context?

Was a patient harmed?

Was a staff member harmed?

Was the incident a near miss?

Was there a debrief or any follow up (you may not be able to answer this question)?

2. According to the clinical risk management definitions above can you categorize the event?
3. In your opinion as a group, could this incident have been avoided and if so, how?

 

3. Physical & Emotional Safety
Physical & Emotional Safety
LO1 Distinguish the roles and responsibilities of a nurse in the selected specialty practice area.
LO8 Extend your professional portfolio reflecting on your learning and development towards the NMBA Registered nurse standards for practice using examples of skill development and nursing. (GA4,10)
Staying safe physically is important and discussed frequently. Nurses are very aware of issues such as manual handling competencies and workplace health and safety issues, but perhaps not as aware of emotional safety issues. We will explore both in this section, but place it in the local context, by examining the environment you are working in.
The next reading is a systematic review looking at stress in the Australian nursing workforce. 

 

Next, compare the findings of the more recent study, to those of the systematic review by Lim, Bogossian, and Ahern (2010):
Exploring safety issues in your specialty area:

If you can, talk to a nurse/ medical practitioner from your chosen specialty and ask them what safety issue, whether physical or emotional, concerns them the most. If you are not on placement yet, engage with some of your tutors/ lecturers who may have experience teaching or practicing in these areas;

Find one
 article from the past 5 years that examines this issue in an Australian nursing context (if possible), read it and document a brief summary of the findings;

In your summary mention, one strategy identified from your reading that will help you to keep yourself safe from this risk.

 
4. Legal Obligations
Legal Obligations
LO1 Distinguish the roles and responsibilities of a nurse in the selected specialty practice area.
As you will be well aware by now, nursing is subject to a number of legal and ethical imperatives. We operate under a nursing code of conduct and a specific act of parliament. These codes and laws are designed to protect patients and clients, but also nurses. The profession of the nurse is protected by law, and the title of nurse cannot be used without proper qualification and registration by an accredited authority.
But nurses also operate under other legal requirements: mandatory reporting of suspected child or elder abuse. 
Here is a link to the mandatory reporting requirements for suspected child abuse in the different states and as you can see it is not consistent across states either.
And here is another link to an article exploring issues of financial abuse of older adults in residential aged care.

 

There may be specific legal obligations associated with your specialty area of practice.

Talk to experienced nursing staff, lecturers or tutors about legal obligations specifically related to your chosen specialty. It may not necessarily be mandatory reporting issues, but be related to other issues. Areas to explore may be confidentiality issues when a person is cognitively impaired or underage, has a positive HIV status and is sexually active, and so on. For this section, you can think outside the square about legalities of what nurses can and cannot do.

Identify one aspect of your legal obligations related to your specialty and write a short paragraph on how you would ensure you honor your legal obligations while working in this area.

 

5. Final Assessment for Online Module 2 (AT2b)

Final Assessment – Issue of safety/legal responsibility (AT2b)
Module one looked at the specific rights and responsibilities of the registered nurse in a specialty clinical area, from the perspective of keeping the nurse and/or her/his patients/clients physically and emotionally safe. It also raised the issue of legal responsibilities and identified issues specific to the specialty area.
For your assessment
: Write a critical analysis of 1000 words on an issue of safety or of legal responsibility that you explored in some depth, ensuring it is specifically related to the specialty area you are/will be completing your placement in. 
Submission – Part A:
 
Your critical analysis should be clearly labeled with
 
module 2
 and uploaded in the relevant drop box in assessment block
 
(Assessment 2b).

 

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