Assessment One – Case Study
Type: Written Assessment
Length: 1000 words (+/-10%) excluding reference list
Aim
The aim of this assessment is to demonstrate your understanding of the nursing roles within the perioperative and postoperative care of a patient experiencing an acute musculoskeletal alteration in health requiring surgical intervention. You will apply your understanding of the perioperative and postoperative nursing roles to the care of a patient. You will also apply your understanding of the role of the registered nurse in early recognition of deteriorating and sepsis in the treatment and care of a person in an acute care environment. Completion of this assessment will allow you to deepen your understanding of these concepts and the multifaceted and varied role of the registered nurse in the delivery of care.
Scenario
Matt, a 14-year-old boy, suffered an open fracture involving the tibia and fibula of the right leg while riding his quad bike on his family property in rural New South Wales. An aeromedical retrieval was required. Matt and his father were transferred by helicopter to the nearest regional facility. Upon arrival, Matt was treated in the Emergency Department (ED), where he was stabilised. Imaging was undertaken, confirming the need for surgical management. He was then transferred from ED directly to theatre for emergency surgery for an open reduction and internal fixation (ORIF).
• Explain the role and actions of the ED nurse when transferring Matt from ED to theatre? What information should be included when communicating during transfer of care and why?
Matt’s immediate post-operative phase and recovery is uneventful, and he is transferred to the paediatric unit. Upon transfer to the unit Matt is commenced on regular prophylactic Cefazolin. Within 20 minutes Matt complains of an itch at the site of his IV and across his body.
• What nursing actions may assist you in recognition and management of Matt’s deterioration?
On day two of admission during dressing change, it is noted that there is an unusual amount of ooze with some redness and swelling around the surgical site. A swab is taken and sent to the laboratory. Within 4 hours, the results return, indicating a gram-positive bacterium. Further blood tests are requested for a full septic screen.
• Briefly discuss the role and nursing actions undertaken by the Registered Nurse when caring for Matt and how will these assist in identifying sepsis?
Matt will be transferred to a rural and remote hospital in the nearest town and will require referrals to multidisciplinary teams.
• What considerations need to be made when organising Matt’s transfer to the local rural facility and eventual discharge?
Instructions
To prepare yourself for this assessment, we recommend that you review and complete the following modules in Moodle:
* Module 1 – Introduction to NHPA, Lifestyle Factors and Perioperative Nursing Includes Topic 1A: Introduction to National Health Priority Areas and Topic 1B: Introduction to perioperative nursing roles and care of the patient undergoing surgery.
* Module 2 – Nursing Care of a Person Experiencing an Acute Alteration in Musculoskeletal Health
* Module 6 – Nursing Care of a Person Experiencing Sepsis
Access the Assessment Template that has been provided to you in the Assessment Tab in 
Moodle to complete this assessment. 
You are to support your responses with credible, up-to-date, peer-reviewed citations throughout your paper.
You are to adhere to the referencing style of American Psychological Association (APA) 7th Edition.
To further support your learning utilise the weekly Academic Learning Centre (ALC) sessions. Please see the Moodle page for the scheduled sessions.

Literature and References
In this assessment use at minimum of 10 contemporary references  to support your discussion. You may also use seminal scholarly literature where relevant. Suitable references include peer-reviewed journal articles as well as textbooks and credible websites. When sourcing information, consider the 5 elements of a quality reference: currency, authority, relevance, objectivity, and coverage. Grey literature sourced from the internet must be from reputable websites such as from government, university, or peak national bodies: for example, the Australian College of Nursing or the Australian Association of Social Workers.

Requirements
* Computer access with internet connection
* Utilise the Assessment Template provided to you. The template includes a title page 
where you are to input the required information. The font, font size and headings are appropriate and acceptable. Should you not utilise the template provided you risk a deduction of marks.
* Use a conventional and legible size 12 font, such as Times New Roman, with 2.0 line spacing and 2.54cm page margins .
* Include page numbers on the top right side of each page in a header.
* Utilise formal academic language for the first three questions The fourth question is 
reflective, and you may answer this question in first-person.
* Use formal academic language.
* Use the seventh edition American Psychological Association (APA) referencing style. 
The CQUniversity Academic Learning Centre has an online CQU APA Referencing 
Style Guide.
* The word count excludes the reference list and the questions within the template but 
includes in-text citations. Note. Paraphrasing is preferred.
Learning Outcomes Assessed
* 3. Identify factors associated with the early recognition of deteriorating patients in the acute care environment
* 4. Identify factors associated with the early recognition of sepsis in the acute care environment
* 5. Determine the nursing role in each phase of the perioperative period