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Historical Development In Nursing Research And Utilization

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Collaborative Practice Paper

This paper will be addressing a clinical case study from the writer's current experience that illustrates collaborative nursing practice. According to Schueller and Kimbrell (2003, p. 2), "When one refers to collaborative practice within a hospital setting, they are referring to healthcare personnel working together to care for patients and families". Collaboration is defined as "working together, especially in a joint intellectual effort to achieve a desired outcome; to cooperate" (American Heritage Dictionary, 2000).

Describe Clearly a Specific Clinical Case and Use it to Showcase How Collaborative Practice Occurs

The writer is a registered nurse in the operating room (OR) who had the profound pleasure of providing care to a patient who was scheduled for elective surgery. Mrs. K.M. is a pleasant fifty- five year old, married white female who was scheduled to have an infusa port inserted for chemotherapy post operatively. Mrs. K. M. was diagnosed on February 22nd 2006 of having invasive right breast cancer.

The writer reviewed Mrs. K. M. past medical history which was nil significant. The patient's vital signs were within normal range; there were no known allergies. Past surgical history indicated that the patient adenoids and tonsils were removed as a child and Mrs. K.M. have had two caesarean sections which were uncomplicated. Family history showed that the patient's mother died from complications of uterine carcinoma. K.M. (personal communication, March 15, 2006).

Collaborative practice occurred from the patient's initial arrival at the hospital's facility. On arrival at the facility, the patient had to be registered. Personnel's in the admission department obtained pertinent biographical data which was then entered into the computer system; this would assist in maintaining continuity of care. Communication plays a vital role in collaborative nursing practice; since if the data obtained from the patient is incorrect it will affect the outcome of care rendered by the different departments and health care professionals.

In the above scenario, collaborative practice also occurred through the media; during the initial interview with the patient, the writer discovered that it was through the media which stresses the importance of obtaining routinely and yearly mammograms that the client decided to visit her primary care physician, whereby an abnormal mass was detected, the physician then ordered further diagnostic tests.

Identify the Health Care and Social Services Groups which Participated or should have Participated in the Collaboration

The health care services group that participated in the collaboration included the patient's primary care physician. It was during a routine examination that an abnormal mass was detected in her right breast. The physician then referred the patient to a radiologist who then did an in depth analyst and biopsy. After the biopsy was taken, the radiologist sent the specimen obtained to a pathologist who then confirmed what was already suspected.

The pathology report was sent to the patient's physician who then informed the patient of the results and its implication; this meant not having a mastectomy since the tumor was advanced and had metastasized to other adjacent tissue. The patient was then referred to a general surgeon for insertion of an infusa port. An infusa port is an implantable vascular access device designed to provide repeated access to the vascular system for the delivery of medications, intravenous fluids and blood products (Bard Access Systems, 1997).

The OR staff also assisted in the collaboration, the team consisted of persons having to gather the necessary equipment and supplies for the procedure. The peri-operative nurse, who was the writer, ensured that the patient was prepared for surgery, consents for the procedure was signed and that the hospital's policy was adhered to. The phlebotomist obtained blood as was ordered by the surgeon; the blood studies were normal. Any questions the patient had were addressed. The scrub nurse who was assisting the surgeon was informed of any undue changes or anything that might be of significance.

The writer is of the view that spiritual care should have been offered to the patient considering the severity of the disease and its prognosis. The patient will need supportive care and encouragement. The nutritionist or dietary team should have also participated in the collaboration; with chemotherapy good dietary habits is of extreme importance; nausea is just one of the many side effects of chemotherapy so this area should have been addressed. Chemotherapy can bring on nausea and vomiting by injuring stomach cells that start the process of nausea and vomiting (Understanding Chemotherapy-Induced Nausea and Vomiting, 2005).

Describe the most Common Situations in which Collaborative Care is Provided

In the above scenario, this is one of the most common situation in which collaborative care is provided. For the infusa port insertion, the nurse had to ensure that the radiology department was informed of the procedure since it is done using X-ray. The x-ray technician came to the OR to assist with the procedure; an x-ray was also done post-operatively. Each team member's role was vital for effective collaborative care.

Personnel's employed in the transportation department were also involved; they assisted in transporting the patient from the different department as needed throughout the hospital. After the surgery, the patient was transported to the Post Anesthesia Care Unit (PACU) whereby the anesthesiologist and the peri-operative nurse informed the PACU nurse about the patient and about the procedure that was done.

The family also played a very important role in the collaborative care of the patient; the patient's husband was present during the initial interview. The husband seemed very supportive and was eager to meet the surgeon; questions were asked and answers given accordingly. The husband stayed in the family's waiting room, where an update was given after the procedure by the surgeon.

Differentiate between Nursing Diagnoses and Collaborative Problems

A nursing diagnosis is a standardized statement about the health of a client (who can be an individual, a family, or a community) for the purpose of providing nursing care (Nursing diagnosis, n.d. p. 1). Nurses have four fundamental responsibilities: to promote health, to prevent



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