A Potential Problem Related To This Procedure Includes Impaired Tissue Perfusion Related To Haematoma Formation Or Bleeding.
The simulation scenario involved Mr Bright who had just undergone an angioplasty. A potential problem related to this procedure includes impaired tissue perfusion related to haematoma formation or bleeding.
You are required to find five (7) contemporary, valid research journal articles (no older than 7 years) relating to the care of the
patient undergoing angioplasty. Read the articles focusing on the assessment elements of care required post procedure. (Don’t forget to link your assessment reasoning to anatomy and physiology and pathophysiology).
Introducing Mr Bright
Pre-admission clinic
Mr Bright at home
Handover
Medical records
Welcome to the Clinical
Simulation
Click on the tabs
to learn more
about the story
of Mr Bright
Welcome to the
Clinical
Simulation
This simulation is designed to help you, as a second year student, begin to integrate concepts and principles that are needed for practice as a beginning-level nurse in various clinical settings.
This scenario is located in a ward within a tertiary hospital facility, however it could apply to nursing practice in other settings as well, e.g. rural/remote health care facility, an emergency department or an aged care facility. We hope you enjoy this learning experience and use it to build on your knowledge and skill base for practice.
Scenario Learning Objectives
1. Identify and demonstrate principles of patient assessment – post operative.
2. Demonstrate process to assist in recognition and management of patient with chest pain
3. Identify and demonstrate principles related to effective communication in changing patient situation.
Welcome to the Clinical
Simulation
Introducing Mr Bright
Pre-admission clinic
Mr Bright at home
Handover
Medical records
Welcome to the Clinical
Simulation
Click on the tabs
to learn more
about the story
of Mr Bright
Introducing Mr
Bright
Mr Harry Bright is a 67 year old male with a history of hypertension and DMII – usually reasonably well controlled with medications and diet. He is also a smoker of 20 cigarettes per day.
He had an angioplasty to his right coronary artery where a drug eluting stent was placed and there was 10% residual stenosis at the site. It was quite a difficult procedure and cardiac monitoring during the stent placement did indicate some myocardial ischaemia.
His sheath was removed in recovery and there has been minimal wound ooze since then and no bruising. In recovery he developed some chest pain. Nitroglycerin spray sublingually x 1 was give which resolved the pain. As it was handed over from the Cath Lab staff that the doctor had some difficulty doing the procedure and also that monitoring during the procedure suggested some ischaemia, and the MO was contacted immediately when the patient complained of chest pain. He did not order further treatment once pain was resolved.
Introducing Mr Bright
Introducing Mr Bright
Pre-admission clinic
Mr Bright at home
Handover
Medical records
Welcome to the Clinical
Simulation
Click on the tabs
to learn more
about the story
of Mr Bright
Pre-admission
clinic
The following video allows you to observe the pre- admission clinic visit of Mr Harry Bright and his wife Lucy.
Pre-admission clinic
Introducing Mr Bright
Pre-admission clinic
Mr Bright at home
Handover
Medical records
Welcome to the Clinical
Simulation
Click on the tabs
to learn more
about the story
of Mr Bright
Mr Bright at home
The following video allows you to observe Harry chatting to his wife Lucy at home the afternoon before his hospital admission.
Mr Bright at home
Introducing Mr Bright
Pre-admission clinic
Mr Bright at home
Handover
Medical records
Welcome to the Clinical
Simulation
Click on the tabs
to learn more
about the story
of Mr Bright
Handover
The following video allows you to observe the clinical handover.
Handover
Introducing Mr Bright
Pre-admission clinic
Mr Bright at home
Handover
Medical records
Welcome to the Clinical
Simulation
Click on the tabs
to learn more
about the story
of Mr Bright
Medical records
Progress Notes
Angioplasty Admission
Blood Glucose Record
Vascular/Circulation Observations Sheet
Fluid Balance Chart
Observation Chart
Post-Angioplasty Care PlanMedication Chart
IV Fluid Order
Medical records
This is a collection of Mr Harry Bright’s medical records. You need to review these documents prior to attending the simulation.
ECG
Back to Medical RecordsView page 2 of Progress Notes
View page 3 of Progress Notes Back to page 1 of Progress Notes
Back to page 2 of Progress Notes
Back to Medical RecordsView back of Angioplasty Admission Form
View front of Angioplasty Admission Form
Back to Medical RecordsView back of Observation Chart
View front of Observation Chart
Back to Medical RecordsView back of Blood Glucose Record
View front of Blood Glucose Record
Back to Medical Records
Back to Medical Records
View back of Medication Chart
Back to Medical Records
View front of Medication Chart
Back to Medical Records
Back to Medical Records
Back to Medical Records
2- “Mr Harry Bright”
Student De-Briefing Package
1
Clinical Simulation Learning Experience
This template has been designed to assist you with assessment 1. The number of rows does not indicate the amount of assessment data to be identified. It is only a guide. Use this template as part of the debriefing session after the simulation.
Question 1
Use the table below to identify the assessment that was performed by the student nurses in the SIM that linked to the potential problem of impaired tissue perfusion related to haematoma formation or bleeding.
Assessment performed
Critical thinking/discussion
Research link
2- “Mr Harry Bright”
Student De-Briefing Package
2
Use the table below to identify the assessment that was not performed by the student nurses in the SIM that linked to the potential problem of impaired tissue perfusion related to haematoma formation or bleeding. Assessment NOT performed
Critical thinking/discussion
Research link
2- “Mr Harry Bright”
Student De-Briefing Package
3
Question 2 Reflect on the simulation at the point in time when Mr Bright complained of chest pain. Using the ISBAR format, Use the table below to write your structured verbal handover to the doctor advising of the patient’s chest pain. You will need to reflect back on your SIM as well as the patient’s clinical documentation available on BB to complete thoroughly all areas of ISBAR. If you have not attended your SIM this week use this time to research chest pain post PCI to assist you in your SIM and for this assessment 1 task. Research ISBAR and what you are required to communicate in each step.
Handover Tool
Written Script
I
S
B
A
R
2- “Mr Harry Bright”
Student De-Briefing Package
4
NOTES
Assessment Task 1
Assessment name: Simulation
Learning outcomes measured:
1. Apply knowledge of anatomy, physiology and pathophysiology to support evidence-based decisions for planning and action in a range of clinical situations.
2. Demonstrate clinical reasoning and clinical decision making in line with safe and quality person-centred care across the lifespan.
Length: 1000 words
Weighting: 20%
Individual/Group: Individual
Presentation This assessment task must: requirements: Use APA referencing for citing academic literature Assignment cover sheet must be included as the first page of your document. Then continue using this word document on page 2 to write the rest of your assessment. Question 1: Formal academic sentence structure with in text referencing (approx. 600-700 words) Question 2: Use the ISBAR acronym (approx. 300-400 words)
Task description: You will engage in a face-to-face clinical simulation scenario based on interprofessional teamwork. This scenario will require that you use a collaborative approach to respond to the problems and challenges of the given situation. You will watch videos and
Page 2 of 6
complete pre-reading before the session. After the session, you will undertake critical analysis and evaluation of a particular aspect of the simulation.
What you need to do: 1. Review the Mr Harry Bright case study including the videos that set the context, the simulation pre-reading and the patient related documentation available in your Blackboard site under Week 4 Clinical Simulation and Assessment Task 1.
2. Review the knowledge and skills relating to:
a. Nursing Care implications: Coronary Artery Disease,
Angioplasty (PTCI), Chest Pain, Bleeding and/or haematoma.
b. Processes for patient assessment c. ISBAR framework for effective communication d. Vital sign monitoring e. IVT and infusion management f. BGL monitoring g. Clinical reasoning and decision-making.
3 Participate in the Clinical Simulation and debrief.
4 Reflect on your clinical simulation experience and write your response to the following two questions:
Question 1: (approx. 600-700 words)
Assessment is a key component of nursing practice, required for planning and provision of patient and family centred care. The Nursing and Midwifery Board of Australia (NMBA) in the national competency standard for registered nurses states that, “The registered nurse assesses, plans, implements and evaluates nursing care in collaboration with individuals and the multidisciplinary health care team so as to achieve goals and health outcomes.”
The simulation scenario involved Mr Bright who had just undergone an angioplasty. A potential problem related to this procedure includes impaired tissue perfusion related to haematoma formation or bleeding.
You are required to find five (5) contemporary, valid research journal articles (no older than 7 years) relating to the care of the
patient undergoing angioplasty. Read the articles focusing on the assessment elements of care required post procedure. (Don’t forget to link your assessment reasoning to anatomy and physiology and pathophysiology).
Reflecting on the simulation, you are required to identify CORRECT nursing assessment performed on Mr Bright relating to the problem stated above. Justify your discussion using evidence from your researched articles.
Page 3 of 6
Reflecting on the simulation, you are now required to identify those elements of nursing assessment that were NOT performed on Mr Bright relating to the problem stated above. Justify your discussion using evidence from your researched articles.
Question 2: (approx. 300-400 words)
National Safety and Quality Health Service Standards for Clinical Handover recommend that communication of patient information should be conducted in a standardised format using a structured process in order to transfer relevant patient information.
In the simulation, ISBAR was the structured format used to communicate patient information.
Reflect on the simulation at the point in time when Mr Bright complained of chest pain. Using the ISBAR format, dot point your structured verbal handover to the doctor advising of the patient’s chest pain. (You will need to access the patient’s clinical documentation available on Blackboard to complete all areas of ISBAR). As chest pain is an emergency situation, the information provided in ISBAR needs to be concise.
Resources needed to Clinical Simulation Learning Experience video complete task:
Mr Bright Case Study available in your Blackboard site – Week 4 and also in Assessment Task .
Five valid, contemporary peer reviewed journal articles
Clinical Handover https://www.safetyandquality.gov.au/our-
work/clinical-communications/clinical-handover/
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