Answer for NRS 450 Select a clinical scenario from your practice and analyze it using the Foundation of Knowledge Model Topic 1 DQ 2
Data:
The collected data in this scenario includes information obtained during three visits to a home hospice patient experiencing uncontrolled pain. Initial assessment revealed a significant oversight – the patient had not been administering their fentanyl patch, resulting in a reported pain level of 9/10. The data also highlighted a language barrier and the patient’s lack of understanding about pain medications, indicating a potential knowledge gap. Subsequent visits uncovered further concerning data: the caregiver’s indifference toward the patient’s pain, the development of multiple pressure ulcers, and the unchanged fentanyl patch since the last placement, in one case, a week later. The patient’s deteriorating condition and unmet care needs were crucial data points. “Lachs and Berman (2011) found that for every reported case another 23.5 cases go without referral or services, suggesting that they are unreported, with cases of neglect being the least serviced (1 for every 57.5 cases)” (Storey, 2020, para. 6).
Information:
The information gathered from the data emphasizes the urgent need for pain management, proper caregiver education, and intervention to address pressure ulcers. “In their efforts to define the concept of a “Good Death,” narrowed down on 36 studies that addressed the parameters for good death defined by patients at the end of their life. Having a pain-free status was one of the top three priorities noted, with 81% of the studies significantly weighing on its importance” (Sinha, 2023, para. 2). The caregiver’s lack of involvement during visits and the patient’s soiled condition indicated potential neglect or abuse. This information painted a comprehensive picture of the patient’s deteriorating health and the inadequate care they were receiving.
Knowledge:
From the information gathered, knowledge was acquired regarding the necessity for a structured pain management plan, addressing language barriers in patient education, and recognizing signs of neglect or abuse. The need for interdisciplinary collaboration, involving the supervisor, case manager, and social services, became apparent to ensure a more vigilant monitoring and intervention strategy.
Wisdom:
Analyzing the information obtained, wisdom dictates that immediate action is required to safeguard the patient’s well-being. Recognizing the signs of neglect, I reported suspected abuse to appropriate authorities and up my chain of command, demonstrating a commitment to patient advocacy and ethical practice. This wisdom emphasizes the importance of disseminating information about the patient’s condition to the interdisciplinary team, ensuring coordinated efforts for a more comprehensive and effective response. The feedback received, whether from colleagues or authorities, will contribute to refining future interventions and promoting a safer care environment for vulnerable patients in hospice settings.
Sinha, A. (2023, February 26). End-of-Life evaluation and management of pain. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK568753/
Storey, J. E. (2020). Risk factors for elder abuse and neglect: A review of the literature. Aggression and Violent Behavior, 50, 101339. https://doi.org/10.1016/j.avb.2019.101339
