Mr. Sweet, 38 years old, is brought to the Emergency Department unresponsive. He has a history of Type 1 diabetes and has been sick for the last 3 days. On admission his Blood sugar is 532, Potassium is 7.2 and ABG results include pH 7.08, Bicarb 12, and CO2 28. His VS are HR 116, BP 107/64, RR 36 Deep and rapid, and Temp 101.5. Answer the following questions:

1. What interventions do expect to be ordered for Mr. Sweet? Why?
2. What type of acid-base disturbance does he have?
3. What do you think is Mr. Sweet’s Medical Diagnosis?

 

A. Based on what you have found, what is the most important point for your peers?

B. What do you need to communicate to affected patients or other stakeholders?

C. What is the best way to communicate with peers and stakeholders?

Sample Outline for Concept Analysis Paper

See chapter 3 in McEwen and Wills. Use the method by Walker and Avant Box 3-1 ( p 60

I. Title Page: Select one of the following topics

a.
Advanced Practice Competency: A Concept Analysis

b.
Diversity in Nursing: A Concept Analysis

c.
Social Determinants of Health: A Concept Analysis

Format Outline(s)

II. Introduction (
Using Walker and Avant)

a. What is the concept selected-state and define the terms

b. Aims or purposes of this analysis-why are you doing the analysis?

c. Discuss all possible uses of the concept briefly-how is the concept used in different contexts, examples and then how are you using it for this paper

d. Determine the defining attributes-regardless of where it exists, what are the common identifiers that the person has this characteristic

e. Identify a model case-Use the attributes you’ve identified and highlight them in a case. A case that is hypothetical, from a text, or that you have experienced in practice.

f. Identify a borderline case and contrary case-what is a case that is something like the model case, but misses some attributes

g. Identify antecedents and consequences-what happens before the concept instance is identified; what happens as a result of acquiring it?

h. Define empirical referents- how do you know that what you are seeing is really it? How would you measure it? Or know that you are reserving it?

PNSG 1514

Quality Improvement Assignment

Course Learner Outcome Five: Collaborate with other healthcare providers to promote safe and quality patient-centered care.

· Read the policy below and decide if it reflects best practice for a skilled nursing facility.

· Research current evidence-based practice regarding the attached policy to determine if changes need to occur.

· Describe in detail what you would change in the current policy citing the evidence you gathered.

· Please include and cite at least 1 scholarly resource using APA format.

Pressure Ulcer Prevention and Managing Skin Integrity

I. PURPOSE

A. To maintain the integrity of residents’ skin and overall health.

B. To effectively identify residents who are at risk for skin breakdown.

C. To provide early interventions for residents with skin breakdown and minimize associated risks.

D. To educate staff, residents, and families on measures to prevent skin breakdown.

II. POLICY

Nursing is solely responsible for all aspects of the skin risk assessment and will assess and manage skin integrity for all residents. Risk for pressure ulcer development will be evaluated using the Braden Scale. Skin inspections will be completed on admission for all residents. Any resident with a Braden score < 8 shall have skin inspections done every month. Residents with a Braden score > 8 do not need further skin inspections done.

III.
DEFINITIONS

A. Risk assessment: identification of the potential risk that a resident will contribute to the likelihood for developing skin breakdown.

B. Skin Inspection: a head to toe assessment of residents, intended to detect skin breakdown.

C. Interventions: the steps taken by care providers to increase monitoring of the skin and reduce or alleviate pressure on body parts to minimize or eliminate the risk of skin breakdown.

IV.
PROCEDURE

A. All residents will be assessed one time, on admission to the skilled nursing facility. This will include a head to toe assessment, paying close attention to bony prominences and skin folds.

B. Screening, using the Braden Scale, will be completed by an RN, LPN, or CNA. This must be documented in the medical record.

C. Residents with a Braden score < 8 will have assessments done every month until reaching a score of 8 or higher.

D. All interventions must be documented in the medical record.

V.
INTERVENTIONS

A. Patient Repositioning and Turning; required once per shift.

B. Cleanse and dry skin at routine intervals and at the time of soiling;

recommend tub bath once per week.

C. Proper Nutrition; provide meals high in carbohydrates to promote healing.

D. Implement a specialty bed if indicated.

E. Staff Education; require annual training of nursing staff.

Minnesota State Community & Technical College

© PNSG 1514

8.2023