Collaborateive Practice

Collaborative Practice 1

Collaborative Practice

Collaborative Practice 2

Collaborative Practice

In the world of today's nursing, it is virtually impossible to take care of patients without the help of others. Others include but are not limited to fellow nurses, physicians, case managers, physical therapists, speech therapists, the patient themselves, nursing assistants, and patient families. The job of a nurse could not effectively been done without collaborative practice. Collaborative practice involves the nurse along with all the above mentioned people working together to ensure the best patient outcome possible. Collaborative practice involves taking nursing diagnoses and collaborating with all other disciplines to reach the desired outcome. This paper will focus on one patient, the collaboration among healthcare workers to ensure a positive outcome for the patient as well as identification of potential barriers to that collaboration along with the most common situations in which collaboration takes place.

The Patient

For the purpose of this paper, one patient will be focused on to show how collaborative practice takes place. Due to HIPPA this patient will be known only by the initials of D.A. D.A. was admitted to the hospital on February 5, 2007 for uncontrolled seizure activity secondary to alcohol abuse. D.A. was admitted to a step-down unit under the care of a hospitalist. D.A. had a past medical history of brain damage due to previous brain surgery for aneurysm repair, aphasia secondary to aneurysm surgery, alcohol abuse, and a history of smoking. D.A. developed a collapsed lung on February 11, 2007 and was transferred the Intensive Care Unit and placed on a ventilator. D.A. was extubated from

Collaborative Practice 3

the ventilator on February 21, 2007 and subsequently transferred to the Medical/Surgical floor. As the nurse taking care of this patient, it was extremely clear this patient was going to require significant collaboration among various healthcare workers to ensure a good outcome. D.A. was unable to communicate and due to the previous brain damage was violent and abusive toward staff. In addition to being under the care of a hospitalist, D.A. was also being treated by a Neurologist and Psychiatrist. Due to the violent nature of the patient, it was nessearary to use wrist restraints to ensure the safety of the patient as well as staff members. D.A. was also notably having difficulty swallowing and was also refusing medication. As the patient was admitted with seizure activity two of the medications prescribed were Dilantin and Depakote. It as of extreme importance that this patient complies with the prescribed anti-seizure medication to avoid further seizure activity. The following paragraph will described how collaborated practice helped to ensure a good patient outcome.

Collaboration

Now that the patient history has been given and picture painted, it is time to describe the collaboration that took place to ensure a good patient outcome. It was essential to collaborate with the physicians in this case regarding any seizure activity as well as the behavior of the patient. Medication needed to be adjusted based on the patient's behavior. It was also necessary to collaborate with the physician regarding the patient's refusal to take medications as alternate ways of delivering valuable seizure medications needed to be explored. It was also important to collaborate with speech therapy regarding the patient's swallowing issues to ensure an appropriate diet could be

Collaborative Practice 4

ordered. It was also important to collaborate with physical therapy to determine what if any rehabilitation was going to be needed before permanent could take place. As all of this was taking place it was important to keep the case manager up to date on patient care so he or she could start to plan for placement whether it is for rehabilitation or long-term care. It is also important to note this patient did not have family to consult regarding the patient's wishes; it was left up to collaborative efforts of the healthcare staff to decide what the best thing was for the patient as the patient was unable to make those decisions.