A laparoscopic appendectomy is a significant surgical procedure to remove the appendix. Compared to open appendectomy, this variant is better because it uses a few small incisions to perform surgery, which contributes to a shorter recovery time. However, it does not mean that this procedure does not require specific attention. 23-year-old Nicole’s scenario is used to comment on the most significant issues. Thus, the principal purpose of this paper is to address postoperative risks, present sources of research evidence to guide Nicole’s care, and explain the importance of involving Nicole in her care. Furthermore, it is reasonable to comment on the concept of the scope of practice and describe how the quality and safety of Nicole’s care depend on leadership.
Postoperative Risks
Even though a laparoscopic appendectomy has essential advantages that have been mentioned above, it, as a surgical procedure, results in a few risks. While Bui et al. (2017) argue that in Australia, older patients experience more dangerous outcomes, it does not mean that Nicole wily avoid the following health problems. Firstly, it refers to a wound infection that can occur following surgery. According to Güler, Karabulut, Çaliş, and Şengül (2020), this adverse outcome can increase rehospitalization rates. At the same time, the researchers admit that this morbidity is “seen less frequently in complicated appendicitis patients who underwent laparoscopic surgery” (Güler et al., 2020, p. 2). The second dangerous outcome relates to postoperative bleeding that can result in the effusion of much blood. Thirdly, it is also necessary to mention small bowel obstruction is considered a long-term adverse effect of appendectomy.
When it comes to a risk assessment, it is rational to develop a prevalence rate. Since it is challenging to state which negative consequence can be more dangerous for Nicole and other patients, it is more reasonable to draw attention to the frequency of risks. Even though small bowel obstruction is a severe condition that prevents the intestinal contents from moving along the length of the intestine, it is less dangerous for Nicole. It is so because the prevalence rate of this complication is 0.2% (Poonawala & Poonawala, 2020, p. 54). At the same time, bleeding is not also a widespread phenomenon among patients how have experienced a laparoscopic appendectomy. Al-Azzawi, Al-Abboodi, Fasullo, and Najuib (2018) state that the incidence rate of this health condition is 0.5% (p. 3). Finally, Güler et al. (2020) have found that 6.9% of laparoscopic appendectomy patients suffered from postoperative wound infection (p. 4). Consequently, this information means that wound infection is the most widespread risk for people who had undergone surgery operations.
Sources of Research Evidence to Guide Nicole’s Care
Since Nicole can be subject to the risks above, it is reasonable to use specific sources of research evidence to guide her care. Firstly, it seems rational to consult the BMJ Learning website because it offers medical education for doctors and other health care professionals. Consequently, this resource gives insightful information on how to provide care to Nicole and what service she needs. It is so because the website contains materials that allow medical personnel to gain knowledge that “helps them directly improve care for patients” (BMJ Learning, n.d., para. 13). Another significant advantage of this source relates to the fact that it publishes its evidence-based works online, which means knowledge is disseminated on a real-time basis. Secondly, Cochrane is also a useful resource since it sspecializesiin n distributing evidence among both doctors and patients. According to its official website, the resource covers more than 130 countries, which means that it is possible to find specific information for a particular region (Cochrane, n.d.).
Thirdly, EBSCO Health is one of the largest medical databases in the world. It gathers much general information, which allows it to distribute specific knowledge to institutions, corporations, public libraries, and others. Furthermore, this resource represents a “collection of leading health care journals and magazines,” which allows caregivers to gain necessary knowledge (EBSCO Health, n.d., para. 2). Finally, it is reasonable to draw attention to South Australia-based JBI. This organization develops and disseminates evidence-based knowledge and training pprogramsaimed at improving patient outcomes and health care practice (Jordan, n.d.). Thus, these four websites are the most useful resources to identify research evidence that is useful to provide Nicole with the necessary care.
Importance of Involving Nicole in Her Care
Another significant aspect is to contribute to Nicole’s involvement in care because this fact implies a few essential benefits. Also known as participation, the term involvement means that a patient has the right and possibility to influence the process of health care delivery. There is no doubt that this phenomenon results in benefits because patients feel that their feelings are respected. Furthremore, Tobiano, Marshall, Bucknall and Chaboyer (2016) stipulate that participation of this kind improves health care safety and quality. It is so because when individuals freely express their feelings and emotions, caregivers have an opportunity to offer a treatment method according to them. Thus, it is not a surprise that both Australian and international “policy and research recognize the positive influence of patient participation in advancing health care quality and patient safety” (Redley et al., 2018, p. 15). At the same time, Mahapatra (2017) insists on the fact that it is necessary to encourage patient involvement because it improves behavior outcomes.
Since it is challenging to overestimate the necessity of patient participation, one should consider how it is possible to promote it. According to Tobiano et al. (2016), dialogue and knowledge sharing are the most suitable ways that contribute to higher patient involvement. The means of communication make it possible to improve patient safety and service quality significantly. This information indicates that it is reasonable for caregivers to enhance their social skills since this fact has the potential to make a difference for the whole health care system.
Concept of the Scope of Practice
As has been just mentioned, Nicole’s caregiver must have a specific competency that refers to communication. In addition to that, the requirements relate to both soft and hard skills, and the scope of practice describes the latter ones. According to the Nursing and Midwifery Board of Australia (2020), this scope helps health care professionals identify whether they are responsible for performing specific actions. Consequently, the scope of practice is used by caregivers to determine and assess their own activity. This concept is significant because it results in the fact that health care professionals deal with their direct responsibilities and are not distracted by trivia. That is why it is necessary to consider how medical establishments contribute to the fact that their employees abide by the scope of practice.
According to the Australian Commission on Safety and Quality in Health Care (n.d.a), medical organizations determine the scope of clinical practice for health care professionals. The same establishments provide individuals with access to best-practice guidelines and support them to use evidence-based materials (Australian Commission on Safety and Quality in Health Care, n.d.b). Consequently, if a nurse doubts whether it is necessary to perform a particular task, they should consult the guidelines to find an answer. As for Nicole’s case, her registered nurse should be educated on how to provide care to postoperative patients. Thus, the concept of the scope of practice should be applied here to ensure that the patient receives adequate care that is necessary for her recovery.
Impact of Leadership on Quality and Safety of Care
Nurse leadership is a significant phenomenon in the health care industry. It is so because every shift exposes medical professionals to numerous challenges that should be successfully overcome. It relates to the fact that nurses “make decisions, delegate, act as role models, and influence colleagues” (Major, 2019, p. 39). If a person wants to achieve positive results in each of the domains above, it is reasonable to develop leadership skills. Furthermore, Major (2019) stipulates that a good leader should considerthea bigger picture and draw attention to individuals.
In addition to that, numerous scientific articles demonstrate that leadership has a direct connection to patient outcomes. One of them, the study by Wong, Cummings and Ducharme (2013), lists all the possible benefits that can arise if nurses exercise effective leadership strategies. On the one hand, this phenomenon contributes to decreased patient mortalitybehaviorur problems, medication errors, patient falls, inadequate pain management cases, and others (Wong et al., 2013). On the other hand, the number of positive outcomes includes increased patient satisfaction that is caused by a higher quality of care (Wong et al., 2013). It is so because when nurses have superior leadership skills, they know how to make their patients follow treatment requirements or change their behavior.
The information above stipulates that every medical professional should invest their efforts in leadership development. However, one should state that it is not an easy process, and that is why individuals require assistance from senior staff members and health careorganizationss. It refers to training opportunities, educational programmes,s and mentorship at the workplace (Major, 2019). At the same time, relevant scientific articles that can found in the databases mentioned above are also suitable for nurses to gain the required knowledge. That is why it is possible to suppose that if Nicole’s caregiver follows an effective leadership strategy, the patient will be likely to recover fast.
Conclusion
Nicole has experienced a laparoscopic appendectomy and requires specific care. It is reasonable to explain risks that she can witness, including wound infection, bleeding, and small bowel obstruction because ignoring them can expose the patient to stress. The most suitable research evidence on the case under consideration can be found in the BMJ Learning, Cochrane, EBSCO Health, and JBI sources. It has also been mentioned that it is significant to involve Nicole in her care because this fact usually contributes to better patient outcomes. Furthermore, the scope of practice is an essential resource because it results in the fact that the patient receives the necessary care. Finally, it has been described that suitable nursing leadership is another phenomenon that can improve Nicole’s health outcomes.
References
Al-Azzawi, Y., Al-Abboodi, Y., Fasullo, M., & Najuib, T. (2018). The morbidity and mortality of laparoscopic appendectomy in patients with cirrhosis. Therapeutic Advances in Gastrointestinal Endoscopy, 11, 1-4.
Australian Commission on Safety and Quality in Health Care. (n.d.a). Action 1.23.
Australian Commission on Safety and Quality in Health Care. (n.d.b). Action 1.27.Web.
BMJ Learning. (n.d.). About BMJ Learning.
Bui, H. T., Pho, J., Kwok, M., Cheng, M., Beath, A., & Chan, S. T. F. (2017). Risk factors and consequences of conversion in laparoscopic appendectomy. Advances in Laparoscopy, 1(1), 5-10.
Cochrane. (n.d.). About us.
EBSCO Health. (n.d.). About us.
Güler, Y., Karabulut, Z., Çaliş, H., & Şengül, S. (2020). Comparison of laparoscopic and open appendectomy on wound infection and healing in complicated appendicitis. International Wound Journal, 1-9. doi:10.1111/iwj.13347
Jordan, Z. (n.d.). Who are we?
Mahapatra, S. (2017). Impact of participation onbehaviorr outcomes in health care service. Benchmarking: An International Journal, 24(4), 1082-1098.
Major, D. (2019). Developing effective nurse leadership skills. Nursing Standard, 34(6), 61-66.
Nursing and Midwifery Board of Australia. (2020). Decision-making framework for nursing and midwifery [PDF document].
Poonawala, A., & Poonawala, N. (2020). Assessment of small bowel obstruction in patients following appendicitis: An institutional based study. International Journal of Medical Research Professionals, 6(1), 54-57.
Redley, B., McTier, L., Botti, M., Hutchinson, A., Newnham, H., Campbell, D., & Bucknall, T. (2018). Patient participation in inpatient ward rounds on acute inpatient medical wards: A descriptive study. BMJ Quality & Safety, 28(1), 15-23.
Tobiano, G., Marshall, A., Bucknall, T., & Chaboyer, W. (2016). Activities patients and nurses undertake to promote patient participation. Journal of Nursing Scholarship, 48(4), 362-370.
Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: A systematic review update. Journal of Nursing Management, 21, 709-724.