NSB336: Coroners case: Recognising and responding to clinical deterioration Assignment Help
Question
NSB336: This academic essay assignment is based on the review of a case study provided to the student. In order to complete the assessment, the student will need to undertake an analysis for Coroner’s case, carefully explore his case of clinical deterioration to understand what went wrong in the clinical approach taken by the registered nurse and how it can be improved in the care provided to the patients in the future.
Solution
The solution for the case study is structured into an introduction, body and conclusion.
Introduction
A brief introduction provided by our experts orients the readers to the case study as well as the purpose of writing this essay.
Streptococcal toxic shock syndrome (STSS) is a life-threatening complication of acute onset, which is primarily caused by group A streptococcus bacteria, like Streptococcus pyogenes characterised by systemic immune response, which leads to acute exacerbation and rapid deterioration in the patient. Consequently, absence of timely assessment and treatment leads to fatality among patients. In this context, this essay aims to critically analyse 8-year-old Maya’s coroner case, who was presented to the emergency department (ED) by her parents. However, despite Maya’s timely presentation to the ED and her mother’s repeatedly raising concerns, there was a significant delay in Maya’s treatment and she passed away.
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Body
Next, a comprehensive body for the assignment is provided which discusses the key problems behind the clinical response to Coroner’s case. Furthermore, the clinical actions taken by the nurse are reviewed in detail to understand the role it played in the patient’s deterioration. The solution also demands an exploration into how the barriers of communication contributed to the deterioration and actions to improve them for the future.
Our experts have demonstrated understanding concerning anatomy, pathophysiology, and physiology for the clinical data which was identified in the case. Keep reading to see how this contributed to a richly critical and comprehensive essay.
Firstly, inadequate triage by the RN in the ED was a crucial issue in Maya’s case. The National Safety and Quality Health Service (NSQHS) Standards 8.4 clearly establishes repeated monitoring and documentation of vital signs as a crucial step in recognising and responding to deteriorating patients, like Maya (Australian Commission on Safety and Quality in Health Care [ACSQHC], 2017). Additionally, vital sign assessment is foundation to triaging in ED as it helps give a quick yet comprehensive view of the functioning of all the crucial body systems (Alshaibi et al., 2021). Moreover, repeated assessment of the vital signs would have enabled monitoring Maya’s status overtime and this observation would have been vital in formulating her care plan (Balamuth & Schlapbach., 2020). However, despite presenting to the ED at 17:33, Maya’s vital signs were not documented in the initial triage or until 18:00. During this delay, the bacterial superantigen-led unregulated, systemic inflammatory response in Maya’s body must’ve triggered pathological sequelae, like increased capillary leakage into interstitial space (Cook et al., 2020). Consequently, Maya’s blood volume decreased, causing her to become hypotensive, which further triggered tachypnoea and tachycardia (Schmitz et al., 2018). However, this pathology remained undetected until 18:00 and Maya’s health deteriorated.
In addition to these issues in the service provision process, certain shortcomings in the nursing care practiced in Maya’s case also contributed to her poor prognosis. Effective nursing care is crucial in ensuring quality of healthcare service and addressing both the patient’s and their caretakers’ needs. However, the nursing care in Maya’s case was significantly poor and potentially foundational to the poor prognosis. The most crucial shortcoming of nursing care provision in this case was the inability of the ED RN to identify Maya’s deteriorating health even after her vital signs were finally documented at 18:00.
In addition to the inadequacies in the nursing care, certain barriers to effective communication also challenged the timely escalation of Maya’s care concerns. Firstly, language barrier between Maya’s mother and the RNs can be a likely cause of delayed escalation of care concern. When Maya’s mother approached the ED window at 17:41 informing the RN about spots in her eyes, the RN felt it was difficult to understand her concern despite her being clearly anxious. Similarly, her mother’s repeated complaints regarding her health went unheard, which could likely be attributed to the fact that English is second language for Maya’s mother.
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The last section includes a brief conclusion for the assignment. Our experts write articulated conclusions, a snippet of which you can read below.
Conclusion
8-year-old Maya presented to the ED following acute complaints of vomiting and diarrhoea. Despite the timely presentation, Maya passed away shortly after presenting to the ED, which can be attributed to various factors. Firstly, inadequate triage and lack of nurse-parent collaboration led to poor prognosis in this case.
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