Case Studies On The Importance Of Oral Care

Case Studies On The Importance Of Oral wieldThis submission is going to focus on the nursing do that I gave in angiotensin-converting enzyme distancement simulation and deuce consecutive shifts on placement, placing emphasis on oral oc transfusey, practice of medicine management and communication. It result abstraction the fundamental aspects of clinical nursing achievements that shoot contractn place in my setting. This will also highlight the learning process conceiven place and how it helped me to enhance my knowledge, and ethical values in order to yield spirit and safety of c be. Using former(a) sources of current literature, I will substance ab custom a reflective mock up to discuss how I buzz off achieved the indispens equal level of learning outcome. By utilising this model I hope to introduce my knowledge and understanding in relation to these sciences as wellspring as identifying beas with scope for learning. Reflection is the process of reviewing an experience in order to delimitate analyse, evaluate and so inform learning round practice (Reid 1993). Gibbs (1988) model of reflection will be used as a framework, be agent it focuses on different aspects of an experience and every last(predicate)ows revisiting the event fully. By contemplating it thus, I am adequate to appreciate it and guided to where coming(prenominal) development work is required. For confidentiality purposes the diligents real label will non be used and will be referred to unhurrieds as B and R. This is in line with the (NMC, 2008) requirements to maintain confidentiality at all times. A diary is supported in this assignment as an appendix inside the time of the process. The reflective model I pose chosen to use as guidance is Gibbs (1988). The c atomic number 18 of a patients let out forms an crucial agent of serveing hygiene needs and yet is a nursing skill which is non always afforded the attention it fully deserves (Evans, 2001) Description I was part of a placement simulation group which went to the multi-skills laboratory to practice delivering and receiving oral hygiene. I was assigned a colleague to brush his teething using a toothbrush and paste. I put on gloves to prevent contamination (NICE 2003). desire his consent, I undertook a legal brief visual assessment of his mouths health. I indeed put him in a comfortable position so that he could tolerate the wash. Thereafter, I cleaned all-round the mouth, gums and tongue. I finished off by helping him to rinse his mouth with mouthwash. I treated my partner as though he was physically unable to hold the brush himself to chaparral his proclaim teeth, but he was able to communicate with me and was able to assist me in terms of spitting and gargling with water at the end of the procedure. Feelings When start informed that I was expected to undertake this task I matte up anxious and concerned. I was aware that I had not brushed everyones teeth outside of my fami ly before and that the mouth is an intimate and personal part of the clay which is not usually exposed to whateverone other than myself or the dentist. I was concerned slightly how my partner (whom I did not know well at that stage) would react to me examining his mouth. Writers have described such intimate physical assessments as creating a potentially intrusive situation (Lewis 2006, Sturdy 2007) which expertness cause the patient to feel uncertain and inadequate. I was also concerned that my own anxiety was shared by my partner who also appeared embarrassed and uncouth at the time. This anxiety was increased when during the procedure my partner began to cough as though distressed. This caused me to feel hesitant about continuing- a situation recognise by Millon (1994) as a common response for carers to such an experience, although I persevered with his cooperation. When the task was perfect(a)d I felt comfortable with my performance everywhereall. evaluation What was goo d about the experience was that, despite being aware that this spot is often delegated to health care assistants (Kelly et al 2010), I was able to deliver a fundamental component of internal nursing care (Essence of bring off 2003) quite effectively. The experience helped me to appreciate that oral care provides any protect with an ideal prospect to undertake a thorough physical, emotional and cognitive assessment of a patient (DOH, 2001). I was satisfied delivering this aspect of care without harming the patient as no injuries were sustained (having I checked his mouth prior to and after cleansing). Also, I was pleased to have an opportunity to advance my communication skills through the delivery of this skill and to understand the impact that this might have on the development of a therapeutic family relationship with future patients. From my colleagues reaction and feedback, I understood how feedback is an grand learning tool. Despite my innervation during the undertakin g of this task, the experience highlighted the potentially thickening problems I might have to solve in the provision of care needs to patients for whom I whitethorn not have had contact with before. abstract governing body of this clinical skill involved undertaking an assessment of my colleagues mouth before delivering any care in order to help determine the most discriminate mode of delivering oral care. Malkin (2009) asserts that this is a critical component of the procedure and was one I was keen not to overlook. The World health Organisation (WHO 2010) describes a rose-cheeked mouth as being free of chronic mouth and facial nerve pain and in the situation described this is the condition I lay out my partners mouth to be in. I was on that pointfore happy to proceed with killing his teeth as instructed. I selected to use a soft burred toothbrush and toothpaste. The use of these adjuncts are described by many writers as being the most appropriate in terms of removing plaque and preventing accidental injury to the gums (Holman et al 2005,McCauliffe 2007).Despite this it has been identified that they are also most often not selected by pull aheads who appear uncertain about most effective licence based practice ( McAuliffe 2007). Conclusion Clearly, mouth care is important and that, hold dears have a role in assessing and maintaining it (Malkin, 2009).The task identified the role of the nurse in providing encouragement to the patient whilst delivering oral care. His weakness created a brain of dependency upon me and necessitated the utilisation of good communications skills on my part to complete the task properly. It has raised my awareness the effectuate of nursing interventions on others within my practice. Action Plan At the moment, I read much books a day than practice. My aim is to be proactive in the future by promptly opening up through total participation and doing more practices by brushing my teeth on regular basis. I would stir by brushing others also and allowing them to brush mine in order to pop off familiar with areas that are often not well att cease to. care up to date with evidence based principles of practice will be maintained through the scrutiny of journals that refer to this aspect of care. I will take care to remember my feelings when providing and receiving oral hygiene before delivering it to patients in the future. Recognising the potential for embarrassment and awkwardness I will ensure that I treat the patient with sensitivity and discretion at all times. Administration of medicines is a key element of nursing care (Audit commission, 2002,). Therefore, one is responsible for the administration of medicines. Description I shadowed my learn during the process of dispensing medication and knew that my role as a student nurse, each registered nurse is accountable for his/her practice. As a student it is important to seek consent from the patient before any care is given which I did. I went to the preaching room with my mentor and prepared for medication for morning. During the process of medication there are important nursing protocol steps to follow. Firstly, I checked order, assessing client, label medication, provide information to the client, check the medication when dispensing and record in the patients prescription chart. Patient R was present and I offered him a cup of water along with the Clozapine 300mg in another cup. Before I came in contact with the patient, I read their notes and the medication they are on. This gave me the baseline whether the patients comply with medication and the reason why they do not comply. Feelings The habitude for prescribing medication may be different in various clinical settings. Although I have participated dispensing medication, I felt nervous and did not neediness my patient to see this as a weakness. (Butler, 1991,) warns us that when our self-talk is negative, we are carrying virtually toxic environment for o urselves everywhere we go. My mentor took the role to encourage me by assuring that I was doing fine, talking me throughout the procedures of medication management. I had brief knowledge about medication and this gave the opportunity for my mentor to question my knowledge about the right dose, time, route, right patient and right drug. My role as a Nurse is to record and report deterioration improvement and takes appropriate action for his intervention to care. Patient R felt that he did not need medication because he is not mentally ill. This was a barrier because he had no insight and it leads him to deteriorate with compliance. Evaluation This practice includes preparing, checking and administering medications, modify knowledge of medications, proctoring the effectiveness of treatment, reporting adverse drug reactions and article of faith patients about the drugs that they receive (NMC, 2008). The (NICE, 2008,) guidelines state principles for the administration of medicines t hat treatment and care should take into account patients needs and preferences and patients should have the opportunity to make informed decisions about their care and treatment, in partnership with their health care professionals. The staff discussed his presentation to healthcare professionals in the Muti-disciplinary team (MTD) if they could change his medication time and dose as he presents lack of motivation and sedation. People with schizophrenia should have the opportunity to make informed decisions, including advance decisions and advance statements, about their care and treatment, in partnership with their healthcare professionals.(NICE, 2008,) This is the importance of communication running(a) as a team within the MDT. Analysis Administrating drug medication is one of the most critical nursing responsibilities for both legal reason and safety patients. establish washing was important protocol the infection control policy as hands are source of infection and hand washing would fault the chain of infection. Patient R is on Clozapine. The use of this atypical major tranquillizer licensed to people who are resistant to or intolerant of other anti psychotic drugs due to the potentially the use of adequate dose of two different antipsychotic agent. Clozapine can lower the number of white declination cells that help to fight infection (BNF, 2008,). Before initiating Clozapine, patients should have a history and physical examination. For example, if the patient has a history of cardiac illness, it is important that you have regular blood tests. The reason behind this is because, if white blood cells count falls below accepted lower limit are classified as Red alerts medication must be withdrawn, and any other prescriber in the future wishing to restart medication are aware of the patients haematological history. Once a week I would go with the Patient to the Clozapine clinic to have blood test done and to monitor his potential side effects of psychiatri c drug treatment. Patient R was presenting various side effects sedation, drowsiness which makes him less motivated to get out of bed for his medication leaving him to forgetting the mornings. Conclusion Not all non-compliant choose to reject medication it may be because they forget to take them and this may be cognitive confusion. Intolerance of various side effects is the most common cause of clients discontinuing medication use (Taylor et al 1997). It is important to remember that the symptoms can fall into a number of different categories, so patient like to be told their diagnosis and what is wrong with them (Blenkiron, 1998,). This area was one of my weaknesses, and I asked my mentor the importance of the Clozapine clinic and how it is associated with regular blood monitoring. I learnt that in order to attend regular visits, all patients must have normal leucocytes and different counts. Action Plan Communication Description On this occasion I was being observed and supervised by my mentor to work with a 45year old Caucasian man, with a diagnosis of insane schizophrenia and on section 37/41 of the Mental Health Act 1983. He has previously presented with chaotic behaviour, auditory hallucinations, delusions as well as violent and threatening behaviour. In the morning I would do my observation of the patient and make an assessment of how he presented himself to see if he had attended to his personal hygiene and activities of daily living. According to (Greenwood, et al 1999), patients who are in hospital satisfaction with information are shew to be lacking. Feelings As a student nurse my role and responsibility by the (NMC, 2008,) is that you must keep an eye on and support peoples rights to accept or decline treatment and care. I observed that Patent R found it difficult to aftermath up and take his medication, which was a problem that staff nurses struggled with time to time. (Watson, 1995,) accentuate that caring communication is holistic, taking in to account the entire person and demonstrating respect for the clients ad people. Evaluation Listening is the most important communication skill in nursing. (NICE, 2004), emphasis that communication between healthcare professionals and patients is essential. I learnt that if patients are encouraged to have treatment choice, they need to have information about the recommendation given before committing themselves. This is why it is important that patients must be central to and include in their care. For the patients to be able to do this, it requires the nurse to use communication skills effectively, to develop therapeutic nurse-patient relationship in which the patient feels safe enough to disclose and discuss issues they find central to them and from jargon. Analysis During the shift I communicated with other members of the team on any real events or any concerns with the patient. At the end of the shift I record what the patient had done for that day and I gave handover to the s taff who were taking over the next shift. This was very important because it would ensure continuity of care and reduces any errors or omissions. A good example of effective communication link up to medication is to give instructions and provide training involving analysis and synthesis of the learners experience. In reference to my patient (Gamble, 2004), illustrates when a person has mental health problem it can affect the individual cognitive process, their beliefs, perception and superficial behavior. If Patient R discontinues Clozapine he will become psychotic again and create a turmoil leaving the community and his family members in distress. Conclusion. I developed my knowledge by providing leaflets about Clozapine, encourage to attend to the clinic centre which they will explain the pros and cons of Clozapine. Action Plan.. ecumenical Conclusion I identified that some patients felt uncomfortable with draw a bead on question so it was important to use (Bein and Miller 19 92), Open ended question. The outcome if the client-nurse interaction depends on the nurses ability to engage the client in decision making and share the control and power in the relationship (Roberts, et al 1995,). I felt that their were barrier to communication as I felt that some of the staffs attitudes made me feel as if I was not part of the team and sometimes lead to me no being able to give my views on issues regarding patients. Although I am aware that all nurses do not use evidence in the same way and may use different methods in clinical settings. I felt that working in partnership with the patient and other health professionals can modify time to build supportive and empathetic relationship as an essential part of care. (NICE, 2008,). The process of learning I went through is more complex than Gibbs suggests. It is not as cyclical as this model implies and I found myself jumping or combining some stages, before coming back. However, it has interpreted me out of my comfor t zone, challenging my thinking.