Critically discuss the application of clinical practice and management within the context of individual patient needs.

Summative Assessment

The summative assessment for this module will be in two parts:

Part 1 Written reflection linked to professional portfolio. 1000 notional words; This must meet Learning Outcomes 4 & 5; 25% of the overall module mark. In order to pass the module, both parts of the assessment must be passed (70% or above). It is essential that you follow the word c

Part 2 Discuss an issue affecting patient care; identifying and analysing decision making in relation to the chosen topic 3000 notional words; This must meet Learning Outcomes 1,2, 3 & 5; 75% of the overall module mark.

Use the reflection as the chosen topic in part 2. For example, part one I used a reflection based on someone having an Myocardial infraction. An example of this would be LO1 – Theoretical approaches example: who says we should take to PPCI. LO2 – Patient had chest pain and ST elevation, so we have GTN and aspirin, back up with evidence why we give it. LO3 – This one is similar to the last one but looking at both sides of an argument on why we do certain things for the patient

 

LEARNING OUTCOMES:

On successful completion of the module students will be able to:

1. Examine theoretical approaches to clinical decision making and their effects within clinical practice.
2. Interpret and evaluate clinical information in order to formulate patient assessment plans using relevant theoretical and research evidence.
3. Critically discuss the application of clinical practice and management within the context of individual patient needs.
4. Gather, interpret and reflect upon information gained from service users in relation to their care and experience.
5. Demonstrate the ability to adhere concisely to the requirements contained within the assessment brief.

First part of the assignment is the reflection using the I.F.E.A.R model, this must be 1000 words and below is how the reflection needs to be done

Incident: 150 words

1. Describe the incident; the emergency call
2. Describe your part in it
3. You might want to focus on a description of an experience that seems significant in some way

 

Feelings: 150 words

4. What were your feelings during the incident/call?
5. What were your feelings immediately afterwards?
6. What made you feel this way?
7. How do you now feel about this experience?

 

Evaluation: 300 words

8. What went well?
9. What didn’t go so well?
10. What were the consequences of your actions on the patient and others?
11. Did the patient have any unmet needs (PUNs)?
12. To what extent did you act for the best and in tune with your values (ethics)?
13. Does this situation connect with any other similar experiences?

 

Analysis: 300 words

14. What did you earn from the incident or event?
15. What could you have done better?
16. Can you identify any practitioner (paramedic) educational needs (PENs)?
17. Was there anything you did not know? Reaction:
18. How will you meet the PENs?
19. Do you need to chat to a colleague or mentor?
20. Do you need to research something in books/journals?
21. Do you need to ask questions?
22. Do you need to read an article/book?
23. Do you need to attend a seminar/session/course?
24. How might you respond more effectively given this situation again?

 

Response: 100 words

25. What did you find out in response to your reaction (educational needs?
26. Describe your new learning
27. What can you take forward and apply if faced with the same or similar incidents?

 

 

Reflection;

I have done a brief reflection, but it needs more work. This is the first part of the assignment. Use this reflection to complete part two.

A cat 2 job came through of a patient experiencing chest pains and was very clammy and pale in colour. I was two crew members one was the paramedic and the other was a EMT and I was the third crew member (student) A member of the public had made the call to the emergency service as he was concerned about the patient. The patient had been traveling to work when these chest pain came on, so he was in a public place.

We arrived at the patient and could clearly see he looked unwell. The member of the public was a taxi driver who stayed with the patient until we arrived. When looking at the patient he was alert and talking in full sentences he looked very clammy and pallor in colour, he was also holding his chest describing of a crushing heavy feeling. We assisted the patient onto the ambulance and conducted an assessment, we done a number of observations which included BP, HR, ECG, Respiratory rate, temp and BM we also got a full medical history at the same time. Although the patient had ST elevation and was very tachycardia, he had no previous medical history to suggest or make him a high risk of a heart attack, in fact the patient was a very fit person who cycled every day and has never really been the doctors

The patient observations were all normal apart from his HR which he was tachycardia and is ECG showed ST elevation, with reciprocal changes. This meant the patient was having a myocardial infraction. We had to act fairly quickly and get the patient to nearest PPCI hospital as he met the criteria and the local guidelines for this type of treatment. In the process of getting the patient to the local ppci hospital we had given the patient GTN and aspirin which again is protocol and also morphine was given for the chest pain.

As a student I mainly only assisted with the observations and reported them back to the paramedic, my paramedic what ask what my thoughts were and what I would do. The paramedic made all the clinical decisions based on what was presented in front of us. The other crew member also assisted with the observations and also transported the patient to the nearest ppci centre whilst me and the paramedic stayed in the back with the patient ensuring he was ok.

When the job came through from the call centre, I remember feeling apprehensive as you are never quite sure what you are going to walk into and not all jobs that come through are as what they seem. When we arrived at the job, I became very focused on the patient and ensuring I could do everything I could within my scope of practice. I felt an element of frustration as there were some aspects I couldn’t do yet, for example read the ECG or be able to cannulate. I made every effort to focus however on what I could do, for example taking the patients observations and communicating with the patient and help keeping him calm. Considering the patient was having a heart attack his whole damiana was very calm and not what I expected to see when someone is having a heart attack. This threw me a little and took me a little by surprise.

 

The whole experience itself was a good as the patient got the treatment he needed, and I was able to take a lot of learning away from it. I felt good that I was able to contribute to the patients care plan but at the same time I felt I needed to know a lot more and my knowledge held me back slightly.

 

The patient got the correct treatment plan which was in line with local policy and JRCALC.

Patient received high level of care.

The crew worked well together to achieve fast and efficient care for the patient and meet all the needs.

Because we were able to identify that the patient was having an MI we were able to give the patient the correct treatment which resulted in the patient making a full recovery.

I felt I was out of my depth in terms of knowledge and was unable to fully understand the ECG reading, this left me feeling frustrated.