Explain the need for the blood transfusion.

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In order to answer this weeks discussion board, consider all required readings, but place particular emphasis on the information contained in the article: What do I do now? Ethical dilemmas in nursing and health care. (2013). ISNA Bulletin, 39(2), 5-12. In addition, carefully consider the 9 provisions of the ANA Code of Ethics for Nurses: https://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses (read article part I and II to view all 9 provisions)

You are a nurse in the Intensive Care Unit and have been assigned to care for a 26-year-old male patient who was brought in via helicopter transport the night before, following his involvement in a single motor vehicle accident. The young man supposedly lost control of his vehicle while traveling at a high speed and was not wearing his seat belt because he was thrown through the front windshield of the car, sustaining a traumatic, closed-head injury. The man was coded during the entire transport to the hospital and was unconscious upon arrival. He is currently receiving ventilator support to sustain his life. The medical staff has advised the family they are doing everything in their power to keep the patient alive. In addition, it appears he is bleeding internally; the lab just phoned to say his recent H & H values are critically low. The medical team has just met and the physician has ordered a stat blood transfusion, so the patients fianc and his mother have been called to the patients room to discuss this. When the family arrives in the patients room, you, as the nurse, begin to explain the need for the blood transfusion. Suddenly the patients mother becomes very upset and reports that due to the family�s religious beliefs (the family is Jehovah�s Witness), her son cannot receive a blood transfusion. The patient�s fianc� begins to argue with his mother, reporting that her son is no longer practicing these religious beliefs and she wants him to have the blood transfusion to try to save his life. The fianc� begins to cry, saying that she and the patient were supposed to be married in two months, and she is requesting that all available treatment be provided. The fianc� turns to the patient�s mother and exclaims, �Your son no longer follows or believes in your religious practices; he must receive this blood transfusion!� As the nurse caring for this young man, what would you do?

Health care workforce: Identify the number of General Practitioners and Psychologists per 1,000 population in your region

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You are required to choose a rural or remote region in Western Australia from the list below and complete a simple needs assessment (population profile) for that region. Please chose one of the following regions for your needs assessment.
– Kimberly
– Pilbara
– Wheat Belt

Assessment Brief:
You are working for a Primary Health Network (PHN) in Australia and you have been asked to undertake both; a simple Needs Assessment (Assignment 1) and an Annual Strategic Plan (Assignment 2) for a region of your choice (listed above) in Western Australia.
PHNs were established in July 2015, with the objectives of increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes; and to improve coordination of care to ensure patients receive the right care in the right place at the right time.
Primary Health Networks aim to achieve these objectives on the basis of an understanding of the health care needs of their communities through analysis and planning.�In order to achieve these objectives they must identify the available services and help to identify and address service gaps, while getting value for money.
You have been asked to assist with the first stage of the PHN commissioning cycle, which is the strategic planning stage. You will complete these in two stages.

1. Population Profile (14 Marks)

a. Geography: which area/population does this profile cover? A description of a community includes its location. Defining the boundaries is necessary to identify who is included within a community. (1 Marks)

b. Numbers: how many people? The total number of people within the community should include all people from birth to death. This will show the number of people the community assessment is designed to cover. (1 Marks)

c. Age distribution: What age are they (% of population) and compared to the wider population of WA or Australia (4 Marks)
Identify the age distribution of each of the following categories
� Pre-school children

� School-age children and young people

� Adults

� Elderly people.

d. Gender distribution: Identify how many males and females and compared to the wider population of WA or Australia. Write a brief comment on how this relates to the health needs of the community. (2 Marks)

e. Population trends: Identify the patterns over a period of time Population trends give an indication of patterns of disease and compared to the wider population of WA or Australia. Comment on how population trends can reflect on the health care needs of a community. (2 Marks)

f. Language and literacy: Identify the language and literacy profile of your community. Comment on why this is important when considering the healthcare needs of a community. (2 Marks)

g. Employment and Socioeconomic status: outline the socioeconomic profile and rates of unemployment of your community and compared to the wider population of WA or Australia. (2 marks)
2. The health status and health behaviours of the population (14 Marks)
There are different ways of finding out about the health status of the community and a number of measures commonly used to identify the health of a population such as:

a. Mortality data: *This generally describes patterns of death in relation to age, gender and
cause of death. It is a basic measure of epidemiology � the study of disease in populations.
(2 Marks)

Mortality rate = Number of deaths per year x 1000
Total size of the population
Life expectancy =

b. Morbidity data: *This is information refers to the incidence and prevalence of illness and disability in the community
Identify the incidence and prevalence of the following and compare these to the wider population of WA or Australia. (4 Marks)

Region
Wider population

Prevalence
Incidence
Prevalence
Incidence
Cardiovascular disease

Diabetes

Mental illness

Obesity

c. Health behaviours:
Identify the following for your community: (3 Marks)

� Physical activity:

� Smoking rate:

� Alcohol consumption:

d. Service information: Use the following resource to identify the number of General Practitioners, Psychologists and Dietitians in your region. You may place a screen capture of your map here. Health Service Services: https://www.healthmap.com.au (3 Marks)

e. Health care workforce: Identify the number of General Practitioners and Psychologists per 1,000 population in your region (2 Marks)

General practitioners =

Psychologists =

3. Identifying Health Needs Using the information above, please complete the following table by identifying 3 key health needs for your community. (12 marks)

Based on the learning material presented in this final module, discuss how a social worker could help clients and communities build their social and human capital

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Paper , Order, or Assignment Requirements

Social workers are slowly realizing that improving the wellbeing of rural (and urban) clients requires a commitment to the revitalization of poor rural (and urban) communities where their clients live. Having a community development dimension to one’s practice not only involves the expansion and improvement of social and medical services, but also economic development, housing rehabilitation and/or construction, community planning and organizing, and quality of life activities such as neighborhood security, community gardens and recreation programs. Few social workers are aware of the opportunities to pursue careers in rural and urban development despite the fact that their skills are definitely applicable and needed at the community level. Based on the learning material presented in this final module, discuss how a social worker could help clients and communities build their social and human capital

Evaluate and reflect on their own ability to implement strategies to lead teams and care coordination

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Case Study Report Part B
Length: 2500

Task
This part of the assessment task requires you to develop a nursing care plan for the patient in the provided case study. In order to do this, you will need to consider the role of the interdisciplinary team and registered nurse in the management of this patient.

In addition to a brief introduction and conclusion, Part B of your report should include:
�A discussion of the importance of the guiding principles of self-management, empowerment and advocacy in the collaborative management of the patient and his family.
�A discussion of the role of the registered nurse in the acute medical ward in the management of this patient and his family including an analysis of the ways in which the registered nurse could collaborate with other members of the interdisciplinary team to co-ordinate the provision of comprehensive nursing care to the patient and his/her family. This may include care that may be required when patient returns home.
�A nursing care plan that contains five (5) nursing interventions that would be appropriate for the patient at this stage of his presentation.
�Each intervention must be supported by a rationale that explains at least one or all of the following: how it will address the underlying pathophysiology, how it is keeping with the guiding principles discussed in your report and/or how it is consistent with current best practice.
Your report must adhere to academic writing conventions. Sub-headings may be used, but dot points and tables should not be included in your report.
You should support your discussion with a MINIMUM 12 recent (LESS THAN 7 years old) and credible sources. Credible sources include, peer reviewed journal articles, text-books, evidence summaries, best practice guidelines, government documents, health facility clinical guidelines and policies/procedures and websites containing content aimed at health professionals. Please note that lecture slides will not be considered to be appropriate sources for this assessment task.
PLEASE NOTE that you can and should refer to any relevant information from Part A of your report without needing to repeat it in this assessment item. For example, “as discussed previously in Part A of this report….”

Case Study for Part B

Luigi develops an ulcer on his right leg that will not heal despite oral antibiotics and becomes infected, causing cellulitis to develop over his lower right leg. He is unable to walk unaided. His diabetes remains poorly controlled due to poor understanding and compliance with his diabetic diet as his wife does all the cooking. As a result his renal function is deteriorating. He is admitted to hospital for IV antibiotics, stabilisation of his diabetes and care of his worsening leg ulcer. He is commenced on sliding scale insulin titrated to his BGL�s whilst in hospital and IV Ceftriaxone. He is extremely upset that he has to remain in hospital as his son is away and his wife is home alone.

Rationale
It is known that chronic disease is the leading cause of death across the world (Johnson & Chang, 2014). Nurses need to be able to provide care to all health consumers, with a significant role in assessing a person, planning care, communicating with colleagues and ensuring that the holistic needs are met and evaluated. The ongoing nature of the conditions can result in longer term debilitating outcomes if not addressed appropriately. Children, young people, adults and older adults all experience the full range of health issues yet manage them differently.

This assessment task addresses the following subject learning outcomes:
�Plan nursing care for patients with complex co-morbidities demonstrating rationale for how one affects the other.
�Plan nursing care of a patient with a co-morbidity in consultation with individuals/groups significant others and the interdisciplinary health care team in the clinical setting
�Collaborate with the interdisciplinary health care team to provide comprehensive nursing care in the clinical setting
�Evaluate and reflect on their own ability to implement strategies to lead teams and care coordination