Hi, In this assignment we need to apply the ACT/LAW that is current and valid in western australia. So please be careful while you selecting the act. Guardianship and administration act 1990 wa is the one of them and we might need to explain that in 2nd question. Also pay attention in ethical issue and communication strategy and explain it well please. Make sure you use APA 7th edition for referencing and use 8 or more references. Use code of conduct , nursing standards, code of ethics to support your point.
The two most relevant and significant act relevant to the case study are: · Health Practitioner Regulation National law (WA) Act 2010. In relation to this act, Part 1 division 7 5PB state that the · Guardianship and Administration Act 1990 (WA) Guardianship and Administration Act 1990(WA) guide the care for Ethan. As this Act states that the next of kin or person responsible can make a treatment decision on behalf of the patient when patient is incapable of making treatment decision to obtain the health outcomes. In the case study, Ethan is not in a state of mind due to his illness and not compliant with the blood transfusion when it is vital to administered to prevent the risk of his life. Therefore, this Act guide the care by providing authority to next of kin to make a valid decision to save his life. · Guardianship and Administration Act 1990 (WA). Part 9C Division 2 s 110ZD subsection (1) of the Guardianship and Administration Act 1990 (WA) states that the patient responsible can make the treatment decision in respect of the treatment when the patient is unable to provide the valid judgment regarding treatment provided to the patient. In Ethan’s case, his current condition demonstrates that he is medically unfit and is incapable of making a valid judgment regarding his treatment as evidenced by his low GCS and confused status. Further, Part 9C division 2 s 110ZD subsection 2 (a) and (b) states that the responsible person of the patient who is of full legal capacity and is reasonably available can make the respected treatment decision on behalf of the patient. Similarly, Part 9C division 2 s 110ZD subsection 4(a) states that the patient nearest relatives the spouse can be the priority to decide with respect for the treatment. In Ethan’s case, his wife who is also his next of kin is presented in the hospital at a time that can provide treatment decisions for Ethan to obtain the best health outcomes. Under WA Health Consent to Treatment Policy, if the person is 18 years or above and incapable of making a treatment decision, the healthcare professional must consult with the person responsible to make a treatment decision on behalf of the patient. Ethan is an adult and has the legal capacity to refused to treatment regarding blood transfusion however, he demonstrated confused health status that makes him incompetent to provide the valid decision regarding his treatment. Therefore, the guardianship and administration act 1990 (WA) guide the care of Ethan by providing the authority to his spouse to make a treatment decision on behalf of him to save his life. Part 9D division 2 s 110ZI explains that if the patient needs urgent treatment and the patient is unable to make a reasonable judgment in respect for the treatment, it is practical for the health professional to provide the treatment to the patient in the absence of a treatment decision. This act will guide Ethan’s care as his health is in critical state where immediate action in needed to obtain the best health outcomes. Under WA Health Consent to Treatment Policy, consent to treatment in a healthcare is the legal policy that is obtained between patient, health professional and patient responsible to commence any proposed health treatment. The health professional is obligated to provide the related information including risk and benefit associated to the treatment prior to providing treatment. Health professional fail to follow this principal considered trespass and negligence. 3. a) Ethical issue. As a student nurse, I will be challenged by the Ethan’s decision to refused to get blood transfusion. Ethan’s decision to refused to treatments relates to the principal of autonomy. Autonomy literally means the right of self-government, persons self-ability and choices to make their own decision regarding their life (Burkhardt, 2008; Staunton & Chiarella, 2017). The code of ethics for the nurses supports this principal by respecting the right of person’s choices to make a decision on their life (International Council of Nurses [ICN], 2012). According to code of ethics for nurses, I need to respect the Ethan’s choices and withdraw the treatment however, I am concerned about his health and aware of his critical medical condition where he is in need for an immediate treatment to prolonged his life.Ethan medical report which states low GCS and confused status including low hemoglobin is life threatening condition that required an immediate treatment to achieve better health outcomes. Even though I am aware his incapability of making a valid judgement about the treatment due to his medical condition I need to respect his decision. The code of conduct for nurses under section 2.3 states that it is mandatory to obtain valid consent from the patient before performing any proposed treatment, failing to do so considered as battery (NMBA, 2018). Relating this to Ethan’s, he has refused to provide a consent for the treatment. Ethan is legally capable of making his own decision about treatment (Sessums et al., 2011) NURS3002 Inquiry for Complex Care Semester 1 2021 Assessment Two – 50% weighting Due Tuesday 27th April 2021 by 23:59pm (AWST) online via Turnitin This assessment (1000 words) requires you to identify pertinent legislation and ethical issues using the attached case study. You are required to integrate theory, demonstrate analysis using evidence and include other pertinent literature to support your answers. Case study Patient: Ethan Watson 24 year old DOB 20/07/1996 Admitted via ED yesterday morning at 07.00am. ED Notes- Bought in by ambulance after concussion and injury sustained following a hard tackle during a football game on Sunday morning. No loss of consciousness, but GCS 14 at scene (could not remember his name and incident at the time) and maintained GCS15 throughout transfer to ED. Complaints of pain to left abdomen and ribs. Abdominal bruising on left side present. Pain score 9/10. Analgesia given en-route to hospital by paramedics. On arrival to ED, the patient’s next of kin (wife) is called and informed of the situation. In ED primary and secondary surveys were performed. Results of Cervical, Thoracic and lumbar x- rays and Abdominal and Pelvic computed tomography (CT) scans are as follows: Fractures to left ribs #9 and 10– no displacement noted. Plan - Conservative management, pain relief as required and rest in bed. Abdominal and Pelvic CT scans revealed a moderate left lateral abdominal wall hematoma and ruptured spleen. Keep patient nil by mouth and administer IVT as charted. For immediate surgical intervention. HB – 100. Plan – repeat Hb in 24hrs. All other bloods noted as Nil abnormalities detected (NAD). Intravenous (IV) antibiotics commenced - QID Flucloxacillin 1g. For ongoing Neurological assessment – current GCS = 15, PERRTL 3mm, obeys commands, strength L=R. Ward notes: Pt transferred to ward at 11.30am. Admission paperwork completed. Theatre checklist completed and patient prepped for theatre. Ethan’s wife arrived to see the patient but he was already in theatre. Patient returned to the ward area from theatre at 1830hrs following surgery. Large blood loss in theatre due to splenic laceration. Blood pressure low (ranging between 85-90 systolic) post theatre. 1000mls fluid challenge ordered over 2 hrs when reviewed by Dr for ADDS score caused by low BP, modifications noted for BP. Patient is to remain nil by mouth postoperatively. Administer IV therapy and monitor the patient’s abdomen regularly through focused abdominal assessment. For ongoing neurological assessment, vital sign assessment and analgesia as charted. Current situation: You are caring for Ethan on the morning shift. Handover by Night Duty ward RN- Pain in abdomen and ribs was managed overnight following review by Anaesthetist –IV opioid analgesia ordered and given with good effect. Systolic BP remains low but within modifications. Bloods taken at 0600hrs. Abdominal bruising significant with abdominal distension noted. GCS = 14 overnight, night nurse reports patient has been confused and agitated overnight, attempting to climb over bed rails, refusing oral medications and keeps taking off his nasal prong oxygen. Reviewed by Doctor overnight and to continue current management. Ethan also pulled out his IV cannula (IVC) at 0630hrs saying he “needs to get out of here”. IVC still needs to be re-sited this morning. Following handover at 7.15am you introduce yourself to the patient he complains of intense abdominal pain. Ethan appears restless and agitated and complains of feeling short of breath and light headed and just generally ‘off’. As you are about to take patient’s observations, the shift coordinator enters the room and informs you that the FBC is back and Ethan’s Haemoglobin is 75g/L. The Consultant is coming to review the patient to gain consent for a blood transfusion. Ethan attempts to get out of bed and tells you he wants to leave and has asked his wife to come and pick him up. You try to explain to Ethan that ongoing medical care is needed and suggest he puts his oxygen back on. Ethan insists he must go immediately because he has to “get back to the football game because his team needs him”. He tells you he does not want a blood transfusion. You manage to convince Ethan to get back into bed and put his oxygen on. You have concerns about Ethan, so you excuse yourself and go to the Nurses station to find the shift coordinator. The consultant Dr has just arrived on the ward to review the patient. The ward clerk informs you Ethan’s wife has just arrived on the ward and is here to take Ethan home. CASE STUDY QUESTIONS: 1. Identify two most relevant and significant Acts or Laws relevant to the case study that guide care of this patient. Ensure you focus on the current time frame and situation and that identified legislation is current and valid in Western Australia. (HINT: DO NOT refer to the Mental Health Act, it is not pertinent to this case) 2. Choose one of the Acts or Laws you have identified above and explain why and how it applies to Mr Ethan Watson’s current care and situation. Ensure the Act/Law itself is used to discuss and analyse its relevance and significance. 3. a) Identify one ethical issue that you, as a student Registered Nurse, face when caring for Mr Ethan Watson during the morning shift. Explain your viewpoint. b) Outline and discuss one strategy that you may utilise to deal with this ethically challenging situation. You can choose either a type of