Using Evidence to Guide Nursing Practice - Assignment Example

? Discipline of Nursing 4: Transition to Professional Nursing Practice Executive Summary Mr. Michel Sutherland died due to misdiagnosis and mistreatment in Bega Hospital. Mr. Sutherland was admitted to Bega Hospital where without proper investigation and analysis of medical presentation he was diagnosed to be suffering from constipation. Mr. Sutherland was not treated in an appropriate manner with dignity as well as respect. The health condition of Mr. Sutherland was not inspected at determined time interval by the medical staff which resulted in deterioration of his health. Moreover, without further diagnosis, he was discharged from the hospital. All these hesitation and negligence of the medical practitioners and nurse led to the death of Mr. Sutherland. Clinical governance in Australia are adopted as well as implemented by medical institutions in order to ensure that safe as well as quality services are offered prudently to patients. Furthermore, medical practitioners, nurses and staff should ensure that they update their medical practices on the basis of ‘Evidence-based practice’ (EBP). Introduction The case is related to the incident of Michael Sutherland’s death on 3rd March, 2006. Mr. Sutherland was admitted in the emergency department of a clinical facility named Bega Hospital. He was discharged from the hospital on 2nd March, 2006 without proper diagnosis which led to his death. The incident took place in Southern New South Wales, Australia. It was observed that Mr. Sutherland was suffering from pain in the lower abdomen. Moreover, Mr. Sutherland was also experiencing from faecal peritonitis but was discharged without diagnosis (NSW Government, 2011). In this respect, the clinical facilities of Australia are required to offer clinical or medical services in accordance with the standards and principles of clinical governance laid by the government of Australia. Clinical governance lays standards and programs on the basis of which healthcare services can be improved. Clinical governance offers framework which assists healthcare facilities to adopt programs and principles in order to improve healthcare service quality towards the achievement of better patient care. The primary purpose of the clinical governance is to provide improved care and medical services to patients in better clinical environment (Balding, 2008). Discussion Deviation from Best Practice Clinical governance standards and principles are implemented in the healthcare facilities with the objective of improving the healthcare quality services and clinical environment for better care of patients. Additionally, clinical facilities adopt ‘Evidence-based practice’ (EBP) with the aim of offering healthcare medication and services in accordance with current practices. According to the inquest case Mr. Sutherland was admitted at Bega Hospital for severe pain in the lower abdomen but was not properly treated which eventually led to his death. There are many root causes which led to the death incident of Mr. Sutherland. The primary root cause for his death can be attributed to misdiagnosis of his medical condition. Mr. Sutherland who was suffering from immense pain was not offered with any pain relief medication which worsens his condition. The nurses of the Bega Hospital were not allowed to offer pain relief medication without the consent of doctors. Correspondingly, it can be argued that nurses are required to practice adequate EBP in nursing so that effective medical services are offered to patients during emergency situation. Sadly, nurses in Bega Hospital were seldom engaged in such practices. The Hospital is also seemed to lack CT scanning facilities. A private healthcare facility in Bega has CT scanner but, no arrangements were made to shift Mr. Sutherland for CT scanning in the private facility. Regrettably, a supine abdominal or chest x-ray was also not taken which resulted in misdiagnosis of his medical condition. . The treatment and medication was misled due to the negligence of Dr. Dorothea Bonney towards acquiring proper evidences in relation to the problems experienced by Mr. Sutherland. It was perceived on the basis of Mr. Sunderland’s drug seeking behaviour that he was under the influence of opioid drugs. Contextually, no further diagnosis measures were undertaken to identify his illness. Such imprudent and negligence on the part of hospital authority eventually cost Mr Sunderland to his death (NSW Government, 2011). Furthermore, the medical treatment provided to Mr. Sutherland failed to recuperate him from constipation problem. It can be argued that misdiagnosis of his medical health deprived him from the proper treatment. Conversely, he was offered with constipation medication, instead of medication based on the appropriate diagnosis. In addition, the behaviour of animosity towards drug abuse person revealed by Dr. Bonney was also a major cause behind the imprudent treatment of Mr Sunderland (NSW Government, 2011). Mr. Sutherland was under severe abdomen pain for the entire day which immensely deteriorated his health by the day end. Despite his deteriorating health condition he was not offered with proper medication in order to relieve him from pain. It can be firmly admitted that such negligence was primarily due to the wrong perception of Dr. Bonney who took this matter very lightly as meagre substance abuse. It can be further argued that the first and foremost task of healthcare facilitators is to provide pain relief services or medication to patients who are under severe pain unless in case of any medical complications. Nonetheless, in the case of Mr Sunderland no serious heed was accorded towards relief services. No observations and information were taken into account in relation to the medical condition of Mr. Sutherland. The records in relation to tachycardia, blood sugar levels and hyperventilation revealed that the health condition of Mr. Sutherland was deteriorating in accordance to his last records. However, the hospital authority did not find relevant to observe his past record and went on medicating him without paying heed to the need for diagnosis or on the past record Moreover, without further diagnosis Mr. Sutherland was discharged which eventually led to his death incident. These are the various factors which depicted a deviation from current EBP (NSW Government, 2011). Analysis The death incident of Mr. Sutherland due to inappropriate healthcare treatment and diagnosis are seemed to be the major factors associated with hospital authority. These factors proved that Bega Hospital did not follow or adopt suitable EBPs in the facilities which led to misdiagnosis and mistreatment and eventually death of the person. It has been observed as per the case that from the time of arrival of ambulance to taking him to the hospital and ultimately releasing him, Mr. Sutherland was not offered with adequate medical services. At the same time, without prior diagnose, Mr. Sutherland was offered with medicines and treatment services which is considered as unethical in accordance with clinical governance and practices. Clinical practitioners as well as nurses should follow EBPs in order to provide appropriate medical and care services to patients for their quick revival of their health. Moreover, every patient in healthcare facilities should be treated in an equal manner without biasness. According to the case of Mr. Sutherland it has been observed that his health complication was not diagnosed suitably and thus proper medication was not provided which led to his death. EBP signifies that decisions and healthcare services are offered on the basis of current practices as well as evidences. Moreover, EBP improves knowledge base as well as skills of medical practitioners and nurses leading to the enhancement in healthcare services and facilities (Kadar, McDonald & Lentin, 2012; Head, 2009; Waters, Rychetnik, Crisp & Barrat, 2009). Below presented diagram reveals that EBPs should be practiced by nursing professionals in order to ensure timely and effective patient care. Fig. 1: Process of EBP EBP has been adopted by many clinical facilities with the objective of offering better and efficient medical services to patients with enhanced responsibility and accountability. Moreover, on the basis of EBP suitable and appropriate policies can be devised and implemented with the aim of improving medical and patient care facilities. The medical practitioners and nurses of Bega Hospital are observed to lack in EBPs in their management and policy implementation which led to the death incident of Mr. Sutherland (Turner & Davis, 2011; Courtney & McCutcheon, 2010). Below is the ‘Patient Safety Model: Helmreich-Mosson Model’ that will be undertaken to analyse the various causes and problems associated with Bega Hospital. Fig.2: Patient Safety Model Source: (Helmreich & Musson, 2012) The causes or problems which are identified in the aforementioned discussions are analysed with the assistance of ‘Patient Safety Model: Helmreich-Mosson Model’ which was formulated with the aim of identifying adverse situations or events. The medical practitioners and nurses are to be offered with adequate training services in order to execute their operations suitably based on the current requirements and time. Accordingly, medical or healthcare facilities should devise strategies or policies so that patients are offered with appropriate services or care. The structure of the model comprises five parts which include latent threats, overt threats, human errors, error management and outcomes. In accordance model and case, the latent threat which exists in Bega Hospital can be attributed to lack of CT scanning facilities which was the major reason for mistreatment of Mr. Sutherland. There are various overt threats and human errors which led to deterioration and death of the health of Mr. Sutherland. On the day of admission to the hospital, Mr. Sutherland was wrongly perceived as a drug-seeking person. Moreover, in relation to his severe pain in the abdomen areas, he was wrongly diagnosed to possess the problem of constipation and was offered with inadequate treatment services which led to the failure of constipation treatment. Error management related with Bega Hospital can be related with inadequate treatment and medical services offered by the hospital to Mr. Sunderland which eventually led to his death incident (Helmreich & Musson, 2012). Recommendations On the basis of problem identifications or causes in accordance with the case and aforementioned model, it has been recognised that there are various factors which are responsible for death incident of Mr. Sutherland. In this regard, certain recommendations are advocated for Bega Hospital and its medical practitioners as well nurses. The detailed recommendations are represented below. Medical Equipment Bega Hospital should acquire latest medical instruments or equipment so that correct medical conditions of patients are diagnosed in an appropriate fashion. According to this case, on proper diagnosis of Mr. Sutherland’s medical condition with the help of CT scanner, faecal peritonitis problem would have been diagnosed. The proper diagnosis of his medical condition would have come up with different outcomes with improved health of Mr Sunderland (Balding, 2008). Evidence-Based Practices (EBPs) The medical practitioners of Bega Hospital should adopt EBPs in their management procedures so that appropriate policies as well as medical strategies are adopted with the aim of offering adequate medical treatment as well as care services to patients. Moreover, the medical practitioners with EBPs are likely to make effective decisions on the basis of current practices. In this respect, Mr. Sutherland from the time of admissions should have been diagnosed properly with dignity and equality. Additionally, Mr. Sutherland should have been offered with appropriate medical aid and services for better recovery (Turner & Davis, 2011). Developing Communication There should a proper communication amid staff and medical practitioners so that proper as well as adequate medical services are offered to patients. According to the case, it has been observed that the records in relation to tachycardia, blood sugar level and hyperventilation were not communicated appropriately to concerned health professionals. Moreover, there was also communication gap in managing the health related issues of Mr. Sutherland. In this respect, proper communication would have been efficient in restoring and addressing the health problems and pain suffered by Mr. Sutherland (Turner & Davis, 2011). Study of Clinical Presentations The clinical records of Mr. Sutherland should have been evaluated as well as examined suitably with the intentions of determining the health related issues in order to offer adequate medical and care services for better recovery. The clinical records in relation to history, symptoms as well as signs with proper analysis and management would have assisted in restoring his health condition. Additionally, with proper scrutiny of the health conditions of Mr. Sutherland on constipation medication would have facilitated in early detection of his deteriorating health which would have further contributed towards proper medication (Turner & Davis, 2011). Proper Further Investigations As per the case, it has been recognised that Mr. Sutherland was discharged from the hospital without proper investigations. In this regard, further investigations should have been undertaken with the aim of diagnosing as well as examining the health condition of Mr. Sutherland prior to his discharge. This would have also facilitated in saving the life of Mr. Sunderland (Balding, 2008). Hospital Rules and Regulations Bega Hospital has been identified to lack certain laws, rules as well as regulations which are responsible for inadequate care and medical services towards patient treatment. In this regard, it has been conceived that the staff members and medical practitioners were reluctant to follow medical laws and treatments which are offered in case of emergency patients as observed in the case. Nonetheless, it can be argued that adherence to prescribed standards and rules would have resulted Mr. Sutherland with proper medical aid and treatment services. These are the various recommendations which can be taken into consideration for eliminating another case similar to Mr. Sunderland (Balding, 2008). These recommendations will also prudently assist in improving the quality of healthcare services in hospital in near future. Conclusion From the above discussions, it has been identified that Mr. Sutherland owing to improper medication and wrong diagnosis has led to his death. Mr. Sutherland was admitted in Bega Hospital where misdiagnosis and mistreatment cost him his life. On his admission to the hospital, it was wrongly perceived that Mr. Sutherland was suffering from constipation and was treated accordingly. But, the treatment offered to him was inappropriate. Moreover, Mr. Sutherland was required to have a CT scan but due to the absence of such facility in the hospital it was neglected. The health condition and treatments offered to Mr. Sutherland was also not inspected on a determined basis which led to the deterioration of his health conditions. Additionally, without proper investigation and diagnosis, Mr. Sutherland was discharged. Correspondingly, these are the major causes which led to his death. In this respect, it can be comprehended that the medical facilities should follow clinical governance standards with the aim of providing medical aid and care to patients within a better environment. Moreover, adequate training should be offered on the basis of EBP to medical practitioners and nurses so that proficient services and care is offered to patients. References Balding, C. (2008). From quality assurance to clinical governance. Australian Health Review 32(3), pp. 383-391. Courtney, M., & McCutcheon, H. (2010). Using evidence to guide nursing practice. Australia: Elsevier Health Sciences. Head, B. (2009). Evidence-based policy: principles and requirements. Chapter 2, pp. 13-26. Helmreich, R. L., & Musson, D. M. (2012). The University of Texas threat and error management model: components and examples. British Medical Journal, pp. 1-52. Kadar, M., McDonald, R., & Lentin, P. (2012). Evidence-based practice in occupational therapy services for children with autism spectrum disorders in Victoria, Australia. Australian Occupational Therapy Journal 59, pp. 284-293. NSW Government. (2011). Local court of New South Wales. Retrieved from http://www.coroners.lawlink.nsw.gov.au/agdbasev7wr/_assets/coroners/m401601l7/106_sutherland.pdf Turner, C., & Davis, S. (2011). Establishing a governance framework for nursing and midwifery clinical guidelines, procedures and resources in a large, complex organisation. Nursing & midwifery services, pp. 47-48. Waters, D., Rychetnik, L., Crisp, J., & Barrat, A. (2009). The Australian experience of nurses' preparedness for evidence-based practice. Research, pp.1-14. Bibliography Australian medicare local alliance. (2012). Clinical governance framework. Access to Allied Psychological Services, pp. 1-41. Speech Pathology Association of Australia Limited. (2010). Evidence-based practice in speech pathology. Position Statement, pp. 1-9. 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