Domiciliary Care for National Safety and Quality Health Service

Question: Discuss about theDomiciliary Care for National Safety and Quality Health Service. Answer: Introduction The National Safety and Quality Health Service (NSQHS) Standards were developed to provide and maintain safety and quality standards in health service provision and protect public health in Australia. Each of the ten standards contains a standard, a statement of intent, a statement of context and a list of key criteria. Assessment of the health service organisations is done by a three point rating scale: Not Met, Satisfactorily Met and Met with Merit (National Safety and Quality Health Service Standards | Safety and Quality. (2017). Mrs Julia Brown has undergone a laparoscopic cholecystectomy and has a history of T2DM, OA and toe amputation. This essay aims to choose two standards from the NSQHS Standards and apply them in a domiciliary scenario with reference to Mrs Julia Brown. The patient has undergone a laparoscopic cholecystectomy, which is a common, minimally invasive surgical procedure to remove gall bladder from the body. She is being prescribed IVABs via a PICC line and requires constant monitoring of the wound area, assessment of vital signs and provision of general education about her condition. Considering the type of surgery and her history of Osteoarthritis and toe amputation NSQHS Standard 3 and 10 have been chosen, which are Preventing and Controlling Healthcare Associated Infections and Preventing Falls and Harm from Falls respectively. Large numbers of patients suffer from health care related infection, at least half of which can be prevented with appropriate measures and actions. Further, patients who undergo invasive procedures and are on a wide range of antibiotics are posed with a risk of acquiring antibiotic resistivity with prolonged exposure to certain microorganisms that can eventually prove to be fatal for the patient (Percival, Suleman, VuottoDonelli, 2015). Several core and developmental actions are provided in the Preventing and Controlling Healthcare Associated Infections Standard. The patient has undergone cholecystectomy and thus has an incision and suture in the abdomen. If there is a breach in the first line of defence that is the skin the patient is at high risk of acquiring an infection. However, as compared to a hospital environment there is a lesser risk of coming in contact with infectious microorganisms at home. The stewardship of antibiotics is the primary goal of nursing care (Twigg, Duffie ld Evans, 2013). The nurse must abide by appropriate antibiotic stewardship program with proper access to therapeutic guideline of the antibiotic used. Regular reviewing of the antibiotic effectiveness and resistance, if any must be done. The nurse must assure that clean and hygienic environment in the house is maintained by all the members of the family. Transmission-based disinfection and sterilisation and appropriate use of protective equipment by all family members must be ensured. Policies, procedure and protocols must be followed while using invasive devices (Sievert et al., 2013), in this case needles and other devices used in peripherally inserted central catheter for administration of intravenous antibiotics. Regular wound dressing must be done following aseptic techniques and control measures to minimise the risk of infectious agents. Fall prevention is often one of the less prioritized topics in provision of nursing care to patients. However, studies show that older adults above the age of 65, and more frequently women fall and incur injuries and losses from the same. Further, this statistics increase many folds in domiciliary care due to old age, lack of precaution, chronic diseases and cognitive impairments and may result in fractures or tissue damage or brain injuries (Miake-Lye, Hempel, GanzShekelle, 2013). In this regard, Preventing Falls and Harm from Falls Standard provides substantial guidelines and prevention programs to be implemented as a part of nursing care practice. Nurses play a key role in educating the family and the patient about the prevention of fall and the measures to be taken as such. The criteria to achieve this standard include assessment of the risk factors associated, preventing falls and injuries from falls and proper communication with patient and her family. Considering that the conc erned patient belongs to a age group at high risk of sustaining falls, it is mandatory to provide timely access to equipment and devices available to prevent such falls. Further, the nurse must screen the patient and the household environment though a screening tool or through clinical judgement procedure to assess the overall fall risk of the patient and identify appropriate strategies to prevent such risks (Coppedge, Conner Se, 2016). Conclusion Considering the patient condition and priorities several care plans aimed to manage the post-operative complications of laparoscopic cholecystectomyin home-based scenario must be adopted, with main focus on infection and fall prevention. Further, care must be provided to reduce breathing troubles, risk of aspiration, impaired mobility and acute pain, which are common symptoms of post-operative cholecystectomy. References Coppedge, N., Conner, K., Se, S. F. (2016). 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