Week 12

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School

University of South Asia, Lahore - Campus 1 *

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MISC

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Nursing

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Nov 24, 2024

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Hello Classmates, The other stages in nurse depend on the results of the first and most important stage, evaluation, hence it's important that these results be accurate (Kelly & Weber, 2018). The surgeon and trauma critical care unit where I work has 18 beds. All four kinds of health tests are routinely performed by us. New trauma patients need a multidisciplinary admissions team consisting of nurses and other medical professionals. A person may need resuscitation if too much blood has been lost. Two nurses are responsible for swiftly testing blood products and delivering them while using a blood warmer if resuscitation is necessary. Since this might rapidly progress into an emergency assessment, we are often doing a problem-oriented or specific evaluation at this point. Maintaining a clear airway and making sure the patient is breathing and getting enough blood flow are top priorities. A tension pneumothorax is a potentially fatal complication of chest trauma that may drastically worsen a patient's prognosis. Checking for subcutaneous airway and tracheal deviation is crucial. This issue might arise suddenly, therefore finding a solution as soon as possible is essential. At least 2 nurses will assess the skin for lacerations, bruises and other injuries that disturb the integumentary. After the first, more limited examinations have been completed and the patient has stabilized, we may go on to a more thorough evaluation. Motorcycle accidents, falls, and car accidents are only some of the leading causes of brain trauma here. Florida law does not require helmet wear for motorcyclists, which has led to several tragic cases of serious brain trauma. Patients with traumatic brain injuries need neuro or targeted tests every hour. Gathering objective data on a trauma patient might be particularly challenging owing the patient's being intubated and sedated. Our intubated patients' levels of awareness and delirium

are evaluated using the RASS (Richmond Agitation Sedation Scale) and CAM-ICU scales. The family unit plays a crucial role in essential subjective information for a comprehensive health evaluation when the patient cannot provide it. The collection of objective data is where we are able to make the most accurate assessments of our critically ill patients. When a patient is hospitalized, the first thing we do is examine their skin thoroughly for any signs of injury. Every patient is hooked up to a machine that measures their vitals in real-time, allowing for regular checks on their blood pressure, heart rate, breathing rate, and oxygen a saturation point. All patients are weighed first thing in the morning. A wide range of initial and follow-up laboratory tests are performed on every trauma patient. Most of our patients get daily chest x-rays and arterial blood gases until they are extubated. The test findings tell us whether or not they can safely have their breathing tubes removed. All patients have a full physical evaluation at the start of each shift and then again every two hours, unless there has been a significant change in their status, in which case they receive a more focused or emergency assessment. The morning and evening nurses will undertake a bedside report and evaluation together during the shift change. For instance, a comprehensive neuro evaluation will be performed jointly if the patient has had a traumatic brain injury; this will allow for early detection of any neurochanges that may occur during the shift. Throughout the course of a shift, nursing plays a crucial role in gathering objective data. Our usual patient demographic includes both young children and senior citizens. Although the number of pediatric patients is modest, we are nonetheless expected to get PALS certification. We try to get the kids to places that are better equipped to care for them, but sometimes the weather doesn't cooperate or the kids are too fragile. Our primary demographics are individuals in their twenties and their nineties.

Identifying patients might be difficult at times. Due to intubation and sedation, most of our patients are unable to provide us with subjective data. Some patients lack the means to prove their identities, such as those who are homeless or socially isolated. It might be days into their hospitalization before we acquire an identify and are able to contact relatives to get a medical or family history. When this happens, we ask the police to take fingerprints so we can identify the patient and notify their loved ones. Further, we may use social media to track for long-lost relatives. If a patient can be identified, we may look them up in the electronic health record (EHR) and learn more about their medical history. The inability to communicate with the patient or their family due to a language barrier is another common challenge we face that hinders our ability to collect an accurate health history. In this instance, we may use our in-house interpreters or the Martti interpreting service to collect the subjective information required for the in-depth evaluation. Understanding how culture can affect the provision of other healthcare services (e.g., diet, activity level, pain management) is enhanced by learning about the patient's cultural background, practices, and beliefs (Schub & Balderrama, 2017). References Kelly, J. H., & Weber, J. R. (2018). Health assessment in nursing ( 6th ed.). Wolters Kluwer. Schub, T. & Balerrama, D. (2017). Physical Assessment: Performing-Cultural Considerations. CINAHL Nursing guide

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Hello Classmates, Depending on the program's aims and objectives, as well as the setting in which it is conducted, program process measurements may or may not be useful for assessing the efficacy of public health initiatives. Of the above program process measurements, "Number of individuals who complete the program" stands out as the most useful to me ( McKenzie, 2022) The percentage of people who finish a program designed to improve health or prevent illness is important for several reasons. First, it is a powerful benchmark for measuring participation and the success of a program. For the program to have a significant influence on public health outcomes, it is crucial that it engages and retains participants at high rates. Second, it may serve as a predictor of the program's long-term success in altering participant behavior and enhancing health. After completing the program, participants are more prepared to make healthy decisions and better manage their health. Furthermore, effective completion of the program suggests that participants are more likely to adopt and retain the suggested practices or behaviors, which is a key objective of many public health campaigns. Last but not least, it may aid in cost-benefit analysis, which is useful since a program with an unacceptably low completion rate may not be the best use of money ( McKenzie, 2022) . Completion rate captures the core of a program's efficacy and its potential to have a concrete influence on public health, whereas other criteria indicated, such as the number of participants participating in screenings or the production of instructional materials, are obviously essential. Nonetheless, it is essential to stress that a thorough assessment of a public health program should take into account numerous variables to offer a more holistic view of the program's success and impact on the intended population. Ultimately, the program's intended results and goals should guide the selection of the most appropriate evaluation tool ( McKenzie, 2022)

References McKenzie, J. F., Neiger, B. L., & Thackeray, R. (2022). Planning, implementing and evaluating health promotion programs . Jones & Bartlett Learning.

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