Rehabilitation Grand Rounds

NURS 441 Clinical Management of Recovery

Purpose of Assignment
To provide the student an opportunity to integrate previous knowledge from the sciences
to the care of a client with a physical disability. Also, to provide the student with an opportunity
to demonstrate critical thinking and independent judgments in managing care of a client with a
physical disability.

Student Approach to Assignment

For the following rehabilitation grand rounds I report on my patient from the first week
of clinical at RRI. During the presentation I discussed the patients past medical history, the HPI,
the chief reason for needing rehab, the psychosocial and family data as well as relevant home
data. Through observation, I identified the patients capabilities and areas of dependence related
to physical therapy activities and ADLs. I was also able to assess the patient and organize a plan
of care derived from my top nursing diagnoses.

Reason for Inclusion of this Assignment in the Portfolio

This portfolio assignment demonstrates my abilities to plan and implement an individualized
plan of care based upon assessment data and patient needs. The following criteria derived from
the great eights are exemplified:

Nursing Practice
Implements traditional nursing care practices as appropriate to provide holistic health
care to diverse populations across the lifespan.
Example: During my first week of clinical at RRI, I provided traditional nursing care
practices to my assigned patient as well as other patients on the unit. I was able to
take vital signs, perform daily head to toe assessments, and attend therapies
throughout the day. A major component of our nursing care was providing therapeutic
communication. My patient was having difficulties with pain management and
anxiety regarding the transition home and communication and listening to her
concerns was a source of support and comfort.

Communication
Expresses oneself and communicates effectively with diverse groups and disciplines
using a variety of media in a variety of context.
Example: Communication was completed a variety of ways during this clinical
rotation and the following grand rounds presentation. I communicated effectively
when presenting my grand rounds presentation. For this presentation I utilized a
 PowerPoint presentation and videos to enhance learning. I also communicated
effectively with the interdisciplinary staff team and the patient on a daily basis.
Accesses and utilizes data and information from a wide range of sources to enhance
patient and professional communication
Example: Research and data as well as multimedia modalities were utilized in order
to gather and present complete, accurate, and supported data regarding my patient and
her developed plan of care. Nursing interventions were supported using appropriate
rationales and presented during my grand rounds presentation. Interdisciplinary
sources of data were also utilized to enhance my presentation, which included PT and
OT.

Teaching
Provides teaching to patients and/or professionals about health care procedures and
technologies in preparation for and following nursing or medical interventions.
Example: During patient care I provided teaching regarding the importance of early
ambulation and the continuation of PT exercises due to risk of pain, stiffness, and
contracture after knee replacement surgery. I also utilized a educational animation video
that explained the stepwise process for total knee replacement surgery during my grand
rounds presentation.
Uses information technologies and other appropriate methods to communicate health
promotion, risk reductions, and disease prevention across the life span.
Example: An educational requirement for my patient was pain management and
medication administration. Her main complication after surgery and during rehab has
been poorly controlled pain. She frequently requests her PRN and scheduled pain
medication before they are due or able to be safely given. This combined with her
past history of drug and alcohol abuse but her at risk for improper medication
administration at home. These issues were discussed and it was decided that the
patient would use a timed medication dispenser once she returns home to insure
safety.
Evaluates the efficacy of health promotion and education modalities for use in a variety
of setting with diverse populations
Example: Teaching was a major component of patient care during rehabilitation
clinical. My patients priority teaching included proper medication administration,
coping mechanism to control anxiety, and early ambulation and continuation of
exercise to increase mobility in her knees. These interventions were evaluated in my
grand rounds presentation and concept map. A short-term outcome of using her
breathing exercises we taught her to help control her anxiety was met.
Uses information technologies and other appropriate methods to enhance ones own
knowledge base.
 Example: During rehabilitation clinical and while preparing for my grand rounds
presentation I utilized relevant nursing research, medical procedure videos, and
interdisciplinary journals to enhance my knowledge regarding my patients procedure
and plan of care initiated.

Research
Integrates and Applies research-based knowledge from the arts, humanities, and sciences
to complement nursing practice.
Example: Rehabilitation clinical opened my eyes to the importance of
interdisciplinary care. Physicians and nurses play a small role in the recovery of the
patient. In rehabilitation physical therapy, occupational therapy, and speech therapy
play a huge role in the recovery, care, and independence of the patient. During my
product analysis I utilized research from physical therapy research journals.
Rationales for nursing interventions were also based upon nursing, physical therapy,
and occupation therapy research. My research study utilized during my product
analysis compared the use of a standard walker to the use of a wheeled walker to
determine the effect on gait, velocity, and step length.
Shares research findings with colleagues.
Example: During my product analysis and grand rounds presentations my identified
research studies were identified and discussed in a brief literature review format. The
studies purpose, participates, type, methods, outcomes, evaluation, and limitations
were discussed and shared with my fellow nursing students and clinical faulty.

Leadership
Delegates and supervises the nursing care given by others while retaining the
accountability for the quality of care given to the patient.
Example: Delegating care was not a task I had participated in before rehabilitation
clinical rotation. At RRI certain tasks had to be delegated to appropriate personal due
to patient safety concerns. The main example is asking an OT team member to
transfer a patient with an orange safety band from the wheelchair to the toilet. RRI
identified patient transfers as out of the nursing students scope of practice due to lack
of specialized training for the safety of the patient and ourselves. By ensuring this
task was delegated to the appropriate person, leadership qualities were exemplified.