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Homework answers / question archive / Amir (he/him) is a 34 year old who has lived in disability supported accommodation for the last year

Amir (he/him) is a 34 year old who has lived in disability supported accommodation for the last year

Nursing

Amir (he/him) is a 34 year old who has lived in disability supported accommodation for the last year. He has intellectual disability (ID) and needs communication support. Amir has a suspected ingrown toenail which is causing him pain and discomfort. He does not have a regular GP however Amir attends the local bulk billing clinic close to home. Clinic reception staff are unfamiliar with working with people with ID and their lack of confidence and communication skills unnerves Amir, who becomes anxious and wants to go home. In the confusion of the moment, there is no time for the general practice nurse to assess Amir's needs around communication support, mental health and ID support.

May 15th 2022 Several days later it is clear to the accommodation staff that Amir's condition is worse and he is unable to weight bare on his right foot. Margi the accommodation team leader drives Amir to the Emergency department at the local hospital. He is afraid of being in hospital with people he does not know, especially as his past visits to hospital were not pleasant experiences. The Triage Nurse attempts to reassure and communicate with Amir enabled her to record the following vital signs: May 15th 07.00 BP: 132/80 mmHg, HR: 120 bpm, REV: 25 bpm, Temp 37.5 degrees.

Full neurovascular obs and swab of nail bed unable to be taken however on observation right toe is swollen. Margi leaves ED to return to the home while ED arrange Amir's transfer to Ward.

May 11th 12.00 The transfer to a mixed ward has increased Amirs distress and anxiety. Several attempts by the RN and EN on duty to reassure Amir and conduct a focused assessment were unsuccessful. Amir has refused Panadol PRN. They call for a medical review. BP- error reading, HR 125, Temp 38.9 no further observations recorded. May 15th 16.00 Amir is yet to receive a medical review and continues to refuse Panadol and assessment. He is requesting to go home. The RN advises the ward clerk to update the care home however Margi does not receive a call. A discharge summary with a recommendation to follow up with GP for referral to community podiatry clinic is provided and Amir returns to his supported accommodation via taxi.

May 16th 10.00 Amir refuses to consider attending the community clinic appointment. The GP is unable to conduct a home visit. He is placed on a community podiatry waitlist.

May 16th 19.00 The supportive accommodation staff become extremely concerned for Amir's health. He has remained in bed all day and refusing water and his favourite juice box. Evening staff record his temperature at 39.8 degrees. Margi, the team leader reassures Amir who is too unwell to mobilise and unable to cope with the car journey to the emergency department. Margi calls an ambulance at 20.00 hours and Amir is taken to hospital.

Amir is treated for sepsis and stays in hospital for a duration of six weeks. This is much longer than the expected treatment and recovery time for his original fungal nail infection.

 

RCA FAQ's Do we use the template provided? Can we make the recommendation section bigger to for content? You must use the RCA template to capture the appropriate content. You may extend the Recommendations section as this is where most of your content will be located. For formatting reasons, this may mean one contributing factor and corresponding recommendations per page- this is perfectly acceptable.

Is this an essay? It doesn't seem like enough words. This is not an essay. While it may seem to be less wordy than previous academic assignments, this assessment is an opportunity to demonstrate critical thinking and problem solving skills. Can 1 provide more than 4 contributing factors? The assessment requires you to identify the most relevant factors that contributed to Amir's adverse outcome. This will involve 5 Whys thinking and analysis- skills you practiced in Week 7 tutorial when exploring the case study that led to development of the REACH initiative.

What's the deal with word count?

There is no 'minimum' word count, it is best to consider the content in each area. For example; do your recommendations outline critical, appropriate and person-centred solutions?, this will require a paragraph at least (roughly 3-5 sentences). Maximum word count is 1000 however given the template format, we predict students will not exceed this.

The Description of Root Cause section is already completed on the template. Are we allowed to use it in our assessment?

Correct! The actual root cause is provided for you. Please use this. Your task is to analyse the case study, extract the most relevant factors and provide person-centred recommendations to prevent the adverse outcome from reoccurring.

Do I have to fill out this bit of the template?

Description of root cause

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You are not required to fill out the b ank space (displayed above). Do we need to reference the RCA case study? No need to formally cite or reference the case study within the template. Be considerate of person-centred language throughout. How do I know if I've got the categories right? Use the Checklist Flip Chart for Root Cause Analysis to understand the definition of each subset (available in At Resource folder) In addition, p4 of week 7 moodle book

 

moodle.uowplatform.edu.au

Do I have to fill out this bit of the template?

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You are not required to fill out the blank space (displayed above). Do we need to reference the RCA case study? No need to formally cite or reference the case study within the template. Be considerate of person-centred language throughout. How do I know if I've got the categories right? Use the Checklist Flip Chart for Root Cause Analysis to understand the definition of each subset (available in A3 Resource folder). In addition, p4 of week 7 moodle book provides an outline for each category. Do I have to write examples in the categories box?

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Recommendations Descriptionof actions to be taken

No, not required. Remember this assessment is designed to challenge your analytical skills. Follow the Root Cause Analysis Approach and 'tick' the most appropriate category. Shortcut- select 'Wingdings' as font, insert symbol, select tick. The contributing factor I've identified feels like it ticks all categories. This may be a sign that your contributing factor is too broad. Remember your aim is to identify a specific contributing factor then link this factor to certain issues or 'failures' in the system. For example if you've outlined a specific interaction between Amir and the RN as a factor- ask yourself what was the issue(s)? Poor communication? RNs knowledge skills and competence? Absence of policy? Identify the most relevant category(s).

The contributing factor I've identified is relevant to 3 categories. Is that too much? Not necessarily, see answer above. If all 3 are clearly relevant to the description of contributing factor and subsequent recommendations, this is appropriate. Recommendations  I have two recommendations to make for one contributing factor? Is that ok? Yes. Depending on the description of contributing factor, it may be possible to identify 2 really relevant recommendations to address the issue. For example; a good solution may require an educational intervention and a change in policy/process. The key thing is to avoid replicating the same recommendation for each factor. As part of the editing process, it's worth taking a holistic overview of your recommendations- re-read, review and check for repetition.

How do I know if my recommendation is appropriate? Defer to your critical thinking skills- ask yourself "Does my recommendation aim to prevent future harm?" Rerv.mhor nn, all nr."^", m.rwl.tinn are  Module 7 moodle honk nutlinea weak_ medium and ctrnnn levels of action.

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