This assignment examines the roles and responsibilities nurses have in making decisions about the practice to keep patients safe in Australian healthcare.

Weighting (%):40
Assessment Notes:Written assessment and reflection
No. Words: 2000
Relates to Learning Outcomes: 1, 2, 3, 4, 5
Due Date:See below

Submission: Online only via Moodle site

Assessment 1: Safeguarding patient care

This assignment examines the roles and responsibilities nurses have in making decisions about the practice to keep patients safe in Australian healthcare.

As a core skill for nurses, reflection is a conscious effort to think systematically about an activity or incident that allows us to consider the impact on individuals and their professional futures.

In preparation for the assessment task

View– the script below of the case study
review –the associated relevant documents below

i. Review the NMBA Registered Nurse Standards of Practice

ii. Australian Commission Safety and Quality in Health Care National Safety and Quality Health Service (NSQHS) Standards:Partnering with consumerstandards and following the linkPartnering with patients in their own care.

iii. Code of conduct;Code of Conduct for Nurses

iv. Code of Ethics;Code of Ethics for Nursesfrom 1 March 2018, the International Council of Nurses Code of Ethics is in effect for all nurses in Australia

Part 1 – Written Essay (1500) 30marks (to be written in essay format)

Registered nurses, enrolled nurses, and midwives are responsible for making professional judgments about when an activity is within their scope of practice and, when it is not, for initiating consultation and collaboration with, or referral to, other healthcare team members.

Differentiate and critically discuss the ethical, legal and clinical issues that is associated with the Ms Smith? Identify and integrate the relevant Codes of practice and the Australian Registered Nurses’ Standards of Practice that aims to prevent these events throughout the discussion. (20 marks)

Determine and discuss how the registered nurses’ values and attitudes impact their responsibilities in keeping patients safe. (10 marks)

Part 2 – Recorded Reflection (500 words equiv) (4-5 minutes) 10marks

Through an audio recording, reflect on how Ms Smith’ story impacts you and your values, beliefs and attitudes about your future role as a Registered Nurse and your strategies in safeguarding patient care.

Within this, present professional practice challenges that may arise within the nursing practice; What do you believe are the most important ways to demonstrate your integrity as a health professional? And how will you evaluate your professional practice and your professional identity?

Referencing the audio recording – Identify the reflection references separately to your written reference list with an additional heading; Reflection references.

The Case Study – Jun 2022
A tribunal has ordered the cancellation of a registered nurse’s registration after she failed to conduct necessary observations of a patient and made false amendments to the patient’s medical records.
26 May 2019, Ms Christina Smithfield was given a directive to monitor a patient who had taken a fall in an aged care facility (the facility) for signs of injury to the brain. Ms Smithfield failed to conduct any neurological observations and recorded in progress notes that the patient had settled throughout the night with no behavioural issue of concern.
The patient then deteriorated and spent time in the hospital, only to return to the facility for palliative care. On 5 June 2019 the patient died.
Out of concern for professional and personal ramifications, Ms Smithfield made amendments to the progress notes and recorded false neurological observations. When questioned, Ms Smithfield denied making any changes, but when confronted with time stamps, alleged that her observations were written on a piece of tissue at the time and she forgot to transfer the details into the progress notes that night.
Ms Smithfield’ employment was terminated on June 2019, and a notification was made by the facility to the Australian Health Practitioner Regulation Agency (Ahpra), and the Nursing and Midwifery Board of Australia (NMBA).
The NMBA initially proposed immediate action in the form of suspension, as at this time Ms Smithfield maintained that she had made the necessary observations. The NMBA imposed conditions on her registration which, among other things, required her to be supervised by another registered nurse when practising.
March 2020, the NMBA referred Ms Smithfield to the NSW Civil and Administrative Tribunal (the tribunal). Ms Smithfield formally admitted to falsifying the patient’s progress notes and that she failed to conduct the necessary observations of the patient. The tribunal found that Ms Smithfield had engaged in professional misconduct and ordered that she:

be reprimanded
have her registration cancelled, and
be disqualified from applying for registration until 1 May 2023.

The tribunal agreed with the NMBA that a fundamental assumption made by patients, clients, colleagues, employers and the community in general is that nurses will faithfully record true observations in clinical records and said that Ms Smithfield’ conduct ‘amounted to behaviour that was inconsistent with her being a fit and proper person to hold registration in the profession’.


Creating and submitting your assessment

* You are expected to support this section with quality scholarly journals, books, policies & professional standard references applicable to the Australian context in APA Version 7 Style in-text and end referencing list.

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