A case study: A patient s Advocacy An insight of renal nurse s inpatient experience in Emergency Department (ED) promoting a person-centred care (PCC)
Presentation's contents 1: Renal nurse s inpatient event in ED 2: Reflection using (GIBBS) Cycle on rendered care 3: Contemporary clinical practice s & adverse impacts 4: PCC approach in caring for end stage kidney disease (ESKD) population 5: Take home key message: PCC & nursing advocacy
Reflection using (GIBBS) Cycle
Renal nurse s inpatient event 1: 46 year old woman, living with family 2: Admitted twice to ED with acute pain 3: Headache, black outs, nausea & projectile vomiting 4: Got operated & received speedy recovery
Reflection using (GIBBS) Cycle: On first physician care Description: Patient was kept in vulnerable position Feelings: Young & active person / sudden illness / severe clinical presentations Evaluation: Missed clinical judgement in making clinical diagnosis
Reflection using (GIBBS) Cycle: On first physician care Conclusion: Discharge home without treating the root cause Action: Negligence Near miss event or an adverse event
Critical thinking on near miss event s outcome Near miss or adverse event impacts: Poor patient s outcome: Stroke / Brain death Disability / Death Impacting client's family Impacting to their community
Reflection using (GIBBS) Cycle: Second doctor s care decisions Description: Patient autonomy is respected PCC by listening to the client Feelings: Physician comprehended client s situation / strived to make right clinical judgement Evaluation: Right clinical assumption was made
Reflection using (GIBBS) Cycle: Second doctor s care decisions Conclusion: Transfer to right health care facility to treat root cause Action: Promoting PCC Life saving event Positive client outcome Pleasant inpatient experience
Contemporary clinical practice and impacts 1: Early discharge 2: The culture of professional practice in ED 3: A pre-set clinical guidelines and organisational policies 4: Increased number of patient admissions 5: Shortage of heath care professionals
Learnt insight principles from our case study & renal care application: Importance of Application of PCC approach Application of nursing advocacy role Application of GIBBS reflective critical thinking cycle In preventing near miss & adverse events
Case study s insight PCC application for ESKD population Available to Walk an extra mile with our clients Listening to their present problems Supporting them with information to resolve Involving them in chronic disease management Empowering them to live with improved quality of life
Shared decision making Case study s insight PCC application (ESKD people) Informed decision making Conservative renal care approach Collaborative chronic care approach Home dialysis decision making Refusal to dialysis treatment
Renal Nursing advocacy & Near miss or adverse events Renal nurses can prevent near miss or adverse events: 1: By being great resource 2: By updating clinical knowledge & skills 3: By involving right interdisciplinary team member 4: By identifying abnormal variants AEAP
Take home key message: PCC & client s positive outcome PCC: Reflective clinical practice / Clients positive outcome Nurses-patient therapeutic relationship role / Education Importance of nursing advocacy / vulnerable clients Empowerment of clients / choosing their treatment
This case study s client is not anybody else & is about myself
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Thank You & Questions