Discussion on the Prevention and Signs of the Deteriorating Patient (Dissertation Sample)

Discussion on the Prevention and Signs of the Deteriorating Patient

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Abstract
Foundations on which modern-day triage is built are extensively linked to war. Triage is utilized during accidents, disasters as well as in trauma and emergency units. In hospitals triage is utilized to sort patients as per the seriousness of their conditions or injuries and the type of care they need. Usually, nurses are the persons who receive a patient first and they evaluate the priority of the patient’s urgent needs. What is more, the nurses also intervene through taking urgent action to avert the deterioration of a patient’s condition or to implement life saving interventions. As such, qualified and professional nurses are needed. In addition, the equipments and locations of a health care facility ought to suit patient’s needs. Triage classification systems offers nurses with the principles they require to review the triaging of patients. Altogether, the triaging system is devised to enable emergency personnel to arrive at informed decisions as well as reduce mortality in cases such as heart problems due to deterioration.
Introduction
Prior the idea of medical triage, the term was synonymous with grading the quality of such commodities as coffee. Nonetheless, triage was incorporated in medical field when people felt it better to care for injured persons. There was increased need to have a process that placed a patient in the right setting and the right time in order to get the right level of treatment/care. Patients need to be classified according to the severity of their condition (Gerdtz and Bucknall 2001, p. 550-561). Also, triage involves determining to which centre a particular patient should be transferred. Each patient’s requirements should be matched up to make the best of available resources. For instance, when a severely injured person is triaged as the top priority patient, she or he should be taken to an intensive care centre. The integrated system should function within a framework of care based on finance, leadership as well as continual system development. Central components on which all features of an emergency unit arrangement should focus include prevention of deterioration.
The Scope of Literature
The purpose of this research is to grow and enhance conceptual understanding of the concept of deteriorating patient condition. In particular, a case involving cardiac arrest in a patient admitted with a supposed minor illness in an accident and emergency centre. This will be achieved via a serial approach to theoretically based research that methodically and incrementally builds the information-base surrounding the concept of interest in the context of emergency care for adult victims of cardiac arrest.
Rationale
Throughout their professional lives, nurses and other healthcare professionals are exposed to various experiences or phenomena. For instance, the experience of sudden cardiac arrest from a seemingly minor ailment is part and parcel of what they experience during care-giving.
Research Method
For the attainment of the aforementioned point, a thorough search of the scholarly material is executed so as to emphasize upon the information available as well as thinking about the identification, diagnosis and management of patients exhibiting ostensibly simplistic signs in contrast to that of quick deterioration. Furthermore, the successful process for the rescue of a cardiac arrest will be incorporated as well as observing the vital role of healthcare professionals in similar situations. Nonetheless, literature review was conducted and involved searches using electronic databases such as EBSCO and Google. One of the parameters used included articles published after 2000. In addition, the research was only concerned with adults.
Studies suggest that after an emergency, triage should be carried out in several rounds. An article compiled by Sandroni et al (2007, p. 237-245) vis-à-vis in-hospital cardiac arrest concentrated on the incidence of and survival following in-hospital cardiac arrest, the key predictive factors as well as the potential interventions ensuing in improved endurance. In the article, interventions which can likely improve the chances of survival include proactive identification as well as stabilization of a patient likely to be an in-hospital cardiac arrest victim among other things. In practice, this is part of triage process in which a health professional seeks to facilitate prevention and early defibrillation.
Some of the principles to guide severely ill in-patients stresses that while they are admitted, most of them possess the impression that they are entering an area where their wellbeing is the preeminent concern (Almes et al 2004, p. 263-268). What is more, they appear assured concerning the fact that if their condition were to worsen there definitely would be no better place as far as immediate and effective treatment is concerned. They believe that every concerned person have a right to think they will be served with the best achievable care. Yet, on the other hand, findings imply that patients who are presently admitted into hospitals might fall victim and become seriously unwell and may get only suboptimal care. A plethora of reasons could be behind this phenomenon, and one of them could be the failure to make out the deterioration. The other reason includes failure to value the deterioration or slow action even after signs of clinical deterioration.
In addition, interactions as well as documentations are unavailable most of the times compounded by the lack of knowledge and interruption in the provision of critical care skills. A paper researched by Considine and Botti (2004, p. 21-31) examined the contributions of nurses in adverse event preparation. Cardiac arrest was used an example and the authors emphasized that the likelihood of patients who might experience permanent disability due to an adverse effect is relatively higher. The preeminent risk factors about adverse effects include the incidence of physiological abnormality, advanced patient age, failure in the identification and parameters of a place in which a patient resides among many others. The crucial fact, nonetheless, that needs to be considered is revolves around the fact that many adverse effects are really avertable.
What is more, nurses have played a significant role in the treatment as well as prevention of adverse effects. Sustained physiological evaluation of patients is the chief responsibility of these healthcare professionals, and the outcomes of the assessments may aid in the groundwork of many care decisions. As a matter of fact, the nurses’ capability to make out, interpret plus act on physiological abnormality translates to a principle element in the adverse effect prediction and or deterrence (Almes et al 2004). A reason behind this is that the hands-on identification plus treatment of physiological abnormality can help in the improvement of patient results via reducing the incidences of adverse effects. Thus, nurses play an utterly vital function in the risk management and are responsible concerning the physical and physiological wellbeing of patients under their care.
Cioffi (2000, p. 108-114) primarily focused on the various experiences of nurses concerning summoning of emergency aid to their patients. The author claimed that even though the experience of these professionals to summon emergency aid has not been detailed yet, the survival of patients time and again depends upon decisions by nurses to do so. The work inquired into the experiences of nurses via the use of unstructured interviews. One of the main outcomes of the work was the fact that these healthcare professionals were ambiguous about their act to call upon emergency aid. Time and again, nurses communicated with relevant persons or bodies prior taking such a vital step.
Meanwhile, others had a feeling of nervousness and anxiety. Even though some of the nurses were unable of precisely pointing out the reason, they identified deterioration of patient from feelings they had something amiss. In addition, some of the nurses were found to lack confidence regarding their judgments in addition to being unsure that they might not take the right decision. Felton (2012, p. 23-27) recognizes patient’s signs and symptoms. Though this is common in acute clinical situations, patient’s condition can worsen at a swift rate and likely cause unnecessary expiration though it could have been avoided. Though, this can transpire in any environment and thus all nurses ought to be familiar concerning symptoms of deterioration. Deterioration appears to occur rather quickly in most of the cases, yet actually it needs the patient deterioration a day before it can reach a critical stage. The study highlighted numerous reasons associated with patient deterioration, and identified the fundamental one to include the inexperience of some professionals as well as the inability to access the outcomes.
Additionally, other reasons involve poor cooperation between the staff plus irregularity of observations. A member of staff who is tasked with the duty to measure pulse through the use of electronic monitors might be unable to record information that is gatherable solely via touch and hearing. Thus, relying excessively on monitor equipment can result in patient deterioration. Triage represents the dynamic process of decision-making that prioritizes an individual’s need for care on arrival at an accident and emergency centre/unit. In their work, Gerdtz and Bucknal (2001, p. 550-561) revealed that the objective of an effective triage system revolves around accelerating time-critical treatment for those with life-threatening conditions. In addition, it ensures that all individuals needing emergency as...