Week 1

Question 1

Acute care

Answer 1

where a patient receives active, short-term treatment for any injury, an episode / exacerbation of a pre-existing illness, an urgent medical condition, or a medical condition requiring surgery.

Question 2

Sub-acute care

Answer 2

provided when acute care is finished however the patient / client still requires some form of therapy to assist them to regain functional daily living.

Question 3

Registered Nurse (RN)

Answer 3

Undertakes a variety of roles, including delegation, providing direct care to individuals, families and communities, coordinating care delivery, health promotion, research and education

Question 4

Enrolled Nurse (EN)

Answer 4

Works under the supervision of a RN to provide people with basic nursing care. Within their scope of practice, ENs are accomplished in the practical skills of nursing with advanced ENs able to undertake more complex procedures

Question 5

Nurse Practitioner (NP)

Answer 5

Roles include assessment and management of patients using nursing knowledge and skills and may include, but are not limited to, the direct referral of patients to other healthcare professionals, prescribing medications and ordering diagnostic investigations

Question 6

Nurse Consultant

Answer 6

Often work in a specialised field of practice and are not often not included in nurse-to-patient ratios. Their role promotes continuity of care and effectively coordinates patient management.

Question 7

Midwife

Answer 7

Works with women and their families to give the necessary support, care and advice during pregnancy, labour and the postpartum period

Question 8

Doctor (physician/surgeon)

Answer 8

• Makes medical diagnosis and prescribed therapeutic modalities
• Performs medical procedures (e.g. surgery)
• May specialise in a variety of areas (e.g. gynaecology/obstetrics, oncology, surgery)
• On a hospital ward there may be different classifications of medical staff including interns, residents, registrars, senior registrars and consultants.

Question 9

Pharmacist

Answer 9

• Prepares and dispenses medications for therapeutic use
• Is often involved in patient education

Question 10

Dietician

Answer 10

• Plans diets to meet special needs of patients
• Promotes health and prevents disease through education and counselling
• May supervise the preparation of meals

Question 11

Social Worker

Answer 11

• Assists people with psychosocial problems (e.g. financial. marital)
• Conducts discharge planning
• Makes referrals for placement

Question 12

Physiotherapist (PT)

Answer 12

• Works with people experiencing musculoskeletal problems
• Assess a person’s strength and mobility
• Performs therapeutic measures (e.g. range of motion, massage, application of heat and cold)
• Teaches new skills (e.g. walking with crutches)
• Pulmonary hygiene - teaching patients exercises to help clear airways of mucus and secretions (i.e deep breathing and coughing)

Question 13

Occupational therapist (OT)

Answer 13

• Works with people with functional impairment to learn skills for activities of daily living
• Can assist with sourcing and provision of equipment to support this

Question 14

Speech therapist

Answer 14

Provide assessment and management services for people with complex communication and/or swallowing needs.

Question 15

Chaplain

Answer 15

• Assists in helping people meet spiritual needs
• Provides individual counselling
• Provides support to families
• Conducts religious services (e.g. last rites)

Question 16

Unregistered assistive personnel

Answer 16

• Assist in the provision of patient care activities under the direction of the RN
• May include personal care assistant, nursing assistant, orderly and phlebotomist

Question 17

Patient Journey

Answer 17

From the moment the patient realises they require clinical care and makes contact with the health care provider, the patient journey through an acute care hospital admission includes all of the following. Through the initial scheduling or presentation phase, treatment, and discharge or continuing care phase, it tracks the patient’s movements and advancements through the healthcare system.

Question 18

Aspects of a clinical pathway include:

Answer 18

• Evidence based standardisation
• A timeline
• Patient-centred care
• Interprofessional approach
• Outcome goal
  -Optimise resources

Question 19

Evidence based standardisation

Answer 19

clinical pathways provide a standardised approach to care for a certain diagnosis or procedure. This may include recommended interventions, tests and treatments based on evidence-based guidelines and best practices. (for example the prescription of cardiac medications following a first presentation Acute Coronary Syndrome based on the guidelines from the National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand.

Question 20

A timeline

Answer 20

a schedule indicating when each assessment, intervention or care should occur (an example may include VTE prophylaxis post joint replacement)

Question 21

Patient-centred care

Answer 21

is an important element to include when considering a standardised clinical pathway. Not every patient will fit this journey and it is essential to consider individualised patient history, care needs, characteristics and preferences. (For example: this may include a referral to a social worker for a patient who had a joint replacement following a fall and their journey was complicated by a postoperative infection and they live alone with minimal support).

Question 22

Interprofessional approach

Answer 22

collaboration among the various healthcare professionals involved in the patient care journey. This may include but is not limited to, doctors, nurses, physiotherapists, dieticians and social workers. This approach allows for the comprehensive and coordinated care of patients and can aid as a prompt for nurses when providing the day-to-day care.

Question 23

Outcome goal

Answer 23

A measure to assess the effectiveness of the care and interventions provided. Outcome goals may include patient outcome, patient satisfaction and occurrence of complications.

Question 24

Optimise resources

Answer 24

clinical pathways aim to reduce variations in care, minimise unnecessary tests, improve efficiency of healthcare delivery and provide an expected transition through the healthcare system and discharge date.

Question 25

ISBAR

Answer 25

Introduction Situation Background Assessment Recommendation

Question 26

Introduction:

Answer 26

Clearly state your identity, role, and location. For instance, "This is [Your Name], calling from [Your Location], and I am the nurse looking after Mrs Ng."

Question 27

Situation:

Answer 27

Concisely explain the purpose of your call and express your concern. Identify the patient using complete identifiers such as full name, age, and ID number. For example, "I am calling regarding the patient's full name [Priscilla Ng], age [Patient's Age], with ID number [Patient's ID Number]."

Question 27

Assessment:

Answer 27

Present relevant information without unnecessary details. When necessary, keep it focused on the current situation.

Question 28

Background:

Answer 28

Provide essential medical history, including the admitting diagnosis, admission date, any complications, medical history, prior procedures, current medications, allergies, and relevant laboratory or diagnostic results. Use succinct language and focus on pertinent details.

Question 29

Recommendation:

Answer 29

Clearly explain your request or recommendation and specify the needed action and timeframe. For instance, "Mrs. Ng's antibiotics are scheduled for 1200 and she requires a new IV cannula to be inserted prior to that time. Can you please complete this before then?"

Question 30

Primary Assessment

Answer 30

A: Airway +/- cervical spine precautions and/or protection. B: Breathing and Ventilation C: Circulation with haemorrhage control D: Disability (assessing neurological status) E: Exposure and Environmental Control

Question 31

Secondary Assessment

Answer 31

A secondary assessment is used to assess a patient's condition with a more in-depth and comprehensive focus. It involves assessing the patient and identifying cues, collecting and reviewing information and processing this information and identifying actual and potential problems to provide care on. Assessment may include collecting information on the patient’s history, current illness/injury/ symptomatology reason for current admission, medications, allergies and reactions, family and social and/or work situation. Where relevant, it may also include immunisations, implants or prosthetics.,

Question 32

A focused assessment

Answer 32

A focused assessment addresses a specific healthcare need, issue or a potential risk. Focused assessments are not as detailed as comprehensive assessments and are often used in short-stay situations, specialty units (labour and delivery, surgical ward) and mental health settings. The limited focus enables data to be gathered on an often already identified problem or condition. This can aid in monitoring whether the patient’s health status is improving or declining.

Question 33

Patient Deterioration

Answer 33

The ‘Between the flags’ system is a three-tiered response system (clinical review, rapid response, and emergency call) that aims to disrupt the progression and to provide early recognition and response to patient deterioration. The 'Slippery Slope' diagram depicted below demonstrates the concept that recognising and intervening early minimises harm to patients, and the sooner this occurs, the more favourable the patient outcome.

Question 34

CLINICAL REVIEW (often orange documentation)

Answer 34

A clinical review (also referred to as urgent clinical review or medical clinical review) is a request for a review by a senior (registrar or above) medical officer in the patient's primary medical team/unit responsible for their care whilst they are an inpatient. This review should occur within 30 minutes of the identification of abnormal vital signs or concern regarding the patient's condition.

Question 35

RAPID RESPONSE: MET CALL (often purple documentation)

Answer 35

The MET (Medical Emergency Team) call originated in Sydney, Australia in 1990, and has expanded globally as part of the implementation of Rapid Response Systems. It is a hospital-based alert system for nurses and healthcare staff to request assistance when a patient's vital signs deviate from predetermined criteria, often indicating potential patient deterioration.

Question 36

EMERGENCY CALL: CODE BLUE

Answer 36

The care of the patient will include initiating basic and/or advanced life support to maintain cardiac output and oxygenation whilst trying to restore the heart rhythm by determining and reversing the cause.