Question

Clara is a 78-year-old woman admitted two days ago for a resection of her intestines due to a

bezoar. Her postoperative course has been uncomplicated and her surgeon wants her to

ambulate three times per day the length of the hall. Selma, the RN on the post-surgery recovery

unit, has assessed Clara and determined that ambulating her is a task that appropriate for a

nursing assistant.

Selma approaches the nursing assistant, Sue, after report and says: “Sue, I need your

assistance to ambulate Clara. She needs to ambulate once per shift the length of the hall. I’d

like her to ambulate once before lunch and again around 3 pm. I’ve assessed her to be

relatively steady on her feet although she uses a walker at her nursing home. I believe that all

she needs is stand-by assistance when she walks. She should walk from her room to the

nurses’ station and back to her room. Clara has had her morning care and breakfast and is

ready to walk when you have time. When you walk with her, please stay with her the entire time

she is up. If you notice she is having trouble walking, becomes unsteady, light headed or dizzy,

assist her back to bed or into a chair and let me know. Do you have any questions or

concerns?”

Overall, how would you have managed the care for this patient from a leadership and management point of view?         

What should have, would have a nurse do when caring for patient nursing judgement/critical thinking.

Answer 1

Selma RN has mainatined a clear leadership and management quality in assigning the care of her patient to her Nursing assistant Sue.Instruction were clear and would be better if she could explain in detail on fall risk prevention.Eliminate slipping and tripping hazards. Keep the bed at the proper height during transfer and when the patient rises to a standing position. Don't keep the bed in a low position at all times. Check chairs, toilets, and safety grab bars for potential safety problems.all this measures can be explained for the safety of the patient.

Inpatient falls are the most commonly reported adverse event in hospitals. Injury from a fall may have serious physical and psychological consequences, including the need for a surgical intervention, prolonged hospitalization, additional pain, and the fear of future falls.Tasks related to mobility, assisting with bed mobility, helping the patient out of bed to a chair for meals, and providing support with ambulation were designated as the number 1 priority for these bedside care providers. Documentation of distance walked and other out-of-bed activities by either the nurse or the patient care technician appears in the same row in the electronic medical record.