Aim of assessment:
The aim of this assessment is to develop your understanding evaluating the professional conduct of a nurse/midwife in the case study provided. The case study provided is a decision statement selected from Decisions of the Professional Standards Committee from the Nursing and Midwifery Council New South Wales. You are to identify professional practice issues from the case study and then draw on the professional frameworks and regulatory legislation, to develop sound and appropriate responses to the clinical incident that will inform your future practice.
Critical Analysis Essay Of A Case Study Assessment – Australia.
Details:
This assessment requires you to identify and summarise the professional practice issues in the case study from either a nursing or midwifery practice perspective. You need to identify and evaluate relevant professional errors identified that potentially contributed to the incident happening. Finally, discuss on how your future practice might change and develop as a result of this learning. Students are to draw on the National Safety and Quality Health Service Standards, NMBA professional practice documents and NSW Health policy documents (where appropriate) to develop informed responses.
Students must refer to and use the case studies located on vUWS under Assessment 3 tab for this assessment. There is one nursing case study.
Case study
Health Care Complaints Commission v Yous sef & Health Care Complaints Commission v
Preamble:
1) The Health Care Complaints Commission prosecuted a complaint against
Registered Nurse, Ms Nelley Yous sef before the NSW Civil and Administrative Tribunal.
On 9 February 2017 an 80-year-old patient who had a laryngeal stoma was found unresponsive. The Commission alleged that Ms Yous sef had inappropriately agreed that a junior colleague apply dressing to the stoma and provided the dressing to the colleague for that purpose. It was also alleged that when the patient was later found unresponsive, she failed to remove the dressing for resuscitation to occur and provided misleading information by stating that when she found the patient unresponsive, the dressing was not covering the stoma.
In its decision on 13 January 2021 the Tribunal found all allegations against Ms Yous sef proved and that they amounted to unsatisfactory professional conduct and professional misconduct.
2) The Health Care Complaints Commission prosecuted a complaint against Registered Nurse, Mr Seamus McArthur before the NSW Civil and Administrative Tribunal.
On 9 February 2017 Nurse McArthur was caring for an 80 year old patient who had a laryngeal stoma. The Commission alleged that Nurse McArthur inappropriately placed a dressing over the stoma to enable the patient’s stoma to remain dry while having a shower. The dressing obstructed the patients only airway. The Commission also alleged that Mr Mc Arthur provided misleading information to the Commission.
The Tribunal found that Mr McArthur’s decision to apply the dressing to the stoma and his lack of knowledge surrounding the stoma amounted to unsatisfactory professional conduct.
Reason for the decision:
On 13 March 2020 the Health Care Complaints Commission (the HCCC) applied to the Tribunal under the Health Practitioner Regulation National Law (the National Law) for orders against Registered Nurses Nelley Yous sef (proceeding 2020/00081521) and Seamus Mc Arthur (proceeding 2020/00081523).
At a direction hearing on 24 July 2020 an order was made that both proceedings be heard together, with evidence in one to be evidence in the other.
The complaints against each practitioner are brought in relation to their conduct on 9 February 2017, when they were rostered to work on Ward DB4, the respiratory and infectious diseases ward at a large metropolitan hospital in Sydney (the Hospital).
Patient A was an 80-year-old man who had been admitted to Ward DB4 the afternoon before after spending several days in the Intensive Care Unit (ICU) for hypotension with a background of infective exacerbation of chronic obstructive pulmonary disease (COPD).Patient A had an established laryngecto my stoma following surgery for laryngeal cancer in Patient A had a total laryngecto my, which meant that his larynx had been surgically removed and a permanent neck stoma created. That stoma was his sole airway.
Patient A sought RN Mc Arthur’s assistance in preparing for a shower. RN Mc Arthur at that time, with the consent of Patient A, applied a Mepilex occlusive dressing that covered the whole of Patient A’s stoma. Prior to applying the dressing, RN Mc Arthur checked with RN Yous sef to see if the application of the dressing would be appropriate, which course of action RN Youssef agreed to. RN McArthur then left Patient A to shower.
Critical Analysis Essay Of A Case Study Assessment – Australia.
Sometime later RN Yous sef entered the bathroom and observed that Patient A was non- responsive. Attempts were made to resuscitate Patient A which were unsuccessful.
NSW Police attended, and an autopsy report was prepared for the Coroner and witness statements were taken from a number of Hospital staff. The autopsy report concluded that the disease or condition directly leading to death was “occlusion of the external airway in the context of a permanent tracheosto my after the treatment of laryngeal carcinoma”. The Tribunal was informed at the hearing that the matter is still being considered by the Coroner. There are no pending criminal proceedings.
The complaints:
The complaints against each practitioner were amended by consent at the hearing. Particular 1 of Complaint One against RN Yous sef originally was that RN Youssef had“advised a nursing colleague” to apply the dressing and was amended to be that she“responded to a request for advice from a junior colleague by agreeing that it was okay” to apply the dressing. Particular 1 of Complaint Two against RN Yous sef and RN Mc Arthur originally was that each had provided false and misleading information “to the Hospital” in their statements of 27 February 2017 and 9 March 2017 respectively; the reference to “the Hospital” was deleted from particular 1 of Complaint Two against each of RN Yous sef and RN Mc Arthur.
RN Youssef
There are three complaints against RN Youssef.
Complaint One is that she is guilty of unsatisfactory professional conduct under s 139B(1)(a) of the National Law in that her conduct was significantly below the standard reasonably expected of a practitioner of an equivalent level of training or experience, in that she:
Inappropriately responded to a request for advice from a junior nursing colleague by agreeing that it was okay to apply a Mepilex occlusive dressing to cover Patient A’s stoma;
Inappropriately provided a Mepilex dressing to her colleague to be used to cover the stoma before Patient A commenced his shower;
Demonstrated a lack of knowledge of the underlying anatomy and clinical history of Patient A;
Failed to seek advice from a more senior colleague regarding the appropriate management of Patient A’s laryngecto my with respect to the appropriate dressing to cover his stoma while he showered; and
Failed to remove the dressing from Patient A’s stoma when she found him unresponsive in the shower, thereby failing to ensure he had a clear airway when resuscitation efforts were commenced.
Complaint Two is that she is guilty of unsatisfactory professional conduct under s 139B(1)(l) of the National Law in that she engaged in improper or unethical conduct relating to the practice or purported practice of nursing, in providing false and misleading information:
In a statement dated 27 February 2017 when she stated that at the time, she found Patient A unresponsive, “I noticed that the Mepilex Border dressing was no longer in situ. The stoma was not covered, and I did not see the dressing in the surrounding area”, in circumstances where the dressing was in situ at the time; and
In her letter to the HCCC dated 15 June 2017 when she stated that when she found Patient A unresponsive “the Mepilex dressing was no longer in situ, the stoma was not covered”,contrary to s 99 of the Health Care Complaints Act 1993 in circumstances where the dressing was in situ at the time.
Complaint Three is that she is guilty of professional misconduct, relying on the particulars of Complaints One and Two both individually and cumulatively.
RN Youssef admits in response to Complaint One that she agreed a Mepilex dressing would be suitable, and that she provided a Mepilex dressing. She admits that she had a lack of knowledge of the underlying anatomy of Patient A’s altered anatomical state after his laryngec to my in 2002, and denies that she did not have knowledge of Patient A’s clinical history. She admits she had a lack of knowledge that the laryngeal stoma was Patient A’s sole airway, and that she failed to seek advice from a more senior colleague. She denies that she failed to remove the Mepilex dressing when she found Patient A unresponsive in the shower.
In response to Complaint Two RN Yous sef denies that she provided false and misleading information. In response to Complaint Three she relies on her responses to Complaints One and Two.
RN Mc Arthur:
There are three complaints against RN Mc Arthur. Complaint One is that he is guilty of unsatisfactory professional conduct under s 139B(1)(a) of the National Law in that his conduct was significantly below the standard reasonably expected of a practitioner of an equivalent level of training or experience, in that he:
Inappropriately applied a Mepilex occlusive dressing to cover Patient A’s laryngeal stoma before he commenced his shower;
Demonstrated a lack of knowledge of the underlying anatomy and clinical history of Patient A; and
Demonstrated a lack of knowledge that the laryngecto my stoma was Patient A’s sole airway.
Critical Analysis Essay Of A Case Study Assessment – Australia.
Complaint Two is that he is guilty of unsatisfactory professional conduct under s 139B(1)(l) of the National Law in that he engaged in improper or unethical conduct relating to the practice or purported practice of nursing, in providing false and misleading information:
In his statement dated 9 March 2017 when he stated that after covering Patient A’s entire stoma site with a Mepilex occlusive dressing he waited with Patient A for “at least 5 minutes or longer after I had applied the dressing to Patient A’s stoma site”, in circumstances where he did not remain with Patient A for a period of 5 minutes or longer after he applied the dressing;
In a letter sent to the HCCC by his legal representative dated 15 June 2017 in which he stated that when he “applied the dressing prior to entering the bathroom and it was at least 5 minutes or longer after applying the dressing that RN Mc Arthur left Patient A in the bathroom”, in circumstances where he did not remain with Patient A for a period of 5 minutes or longer after he applied the dressing; and
In the letter sent to the HCCC by his legal representative dated 15 June 2017 which stated that “when Patient A was responding to RN Mc Arthur’s questions about the dressing he was speaking without difficulty and in full sentences, and did not show any signs of respiratory distress”, contrary to s 99 of the Health Care Complaints Act 1993, in circumstances where the practitioner did not remain with Patient A to observe him speaking without difficulty nor showing signs of respiratory distress.
Complaint Three is that he is guilty of professional misconduct, relying on the particulars of Complaints One and Two both individually and cumulatively.
RN McArthur admits that he inappropriately applied the Mepilex dressing to cover Patient A’s stoma, and that at the time he had a lack of knowledge of the underlying anatomy and clinical history of Patient A and demonstrated a lack of knowledge that the laryngecto my stoma was Patient A’s sole airway. He denies providing false and misleading information in the statement of 9 March 2017 or the letter dated 15 June 2017. He denies that he is guilty of professional misconduct.
NURSING:
There is no need to use in-text citations in the summary section, but you will have to somehow refer to the case as per the following suggestions.
To refer to the case in the essay you can use any of the following examples:
In-text citation
According to the HCCC v Youssef & McArthur case…
In the HCCC v Youssef & McArthur case…
In the Youssef & McArthur case…
Later in the text you can use:
In the case…
According to the case…
Critical Analysis Essay Of A Case Study Assessment – Australia.
Reference list:
All borrowings from other sources must be properly referenced and a reference list must be included at the end of the assignment – In-text citations and refrence list must be APA7 format
Introduction:
Orientates the reader to the selected topic with a correctly structured, concise and clearly articulated original thesis statement. The meaning of all relevant major concepts is clarified and defined.Provides an insightful and analytical outline of how the topic will be addressed in the body of the essay
Critical Analysis Essay Of A Case Study Assessment – Australia.
Body: Summary of the case
A comprehensive and clear summary of the case is provided
Identify the relevant professional errors that potentially contributed to the incident happening. Refers to NSW Health policy document(s)
Comprehensive identification of the relevant professional errors that potentially contributed to the incident. Outstanding, clear, concise clinical reasoning that is well-matched to the context of the identified errors with considerable insight. Discussion is supported by evidence-based sources including the use of current NSW Health policy documents.
Body: Discuss how your practice might change and develop as a result of this incident. The discussion has a logical sequence and coherent flow. The text is
Discussion provides the reader an excellent insight into how their practice may change and develop following this incident. Excellent evidence of critical thinking which consistently gives consideration to the context of the case.Use of current, relevant and reliable literature consistently used to support the discussion. This includes the use of NMBA Standards for Practice document(s) and the National Safety and Quality Health
Critical Analysis Essay Of A Case Study Assessment – Australia.
supported by recent and relevant academic references.
Service (NSQHS) Standards.
Conclusion:
Makes a clear, concise, and original insight and provides a well-reasoned summary of the significant points discussed in the essay.Anticipates future developments, with clear reference to the thesis statement provided in the introduction.
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