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Question: Critical reflect on the Scenario Elderly Abuse. Answer: Experience According to the article by David Lewis dated 27/9/2016, Mr Zdenek Selir who had been diagnosed with stroke and taken to a Gold Coast nursing home died due to lack of close patient monitoring and lack of treatment of pressure wounds. From the family, their kin Mr Selir was not provided with proper care at the Leamington nursing home. The Southport Aged Care Complaints Commissioner agreed with the family that Mr Selir had been neglected and that he had not been monitored closely. The pressure wounds were discovered on the patient only after a family member came to visit the patient in the nursing home and realized a foul smell. On closer observation, it was discovered that Mr Selir had pressure wounds on the back, the lower parts of his buttocks and on the heel. On his buttocks, Mr Selir had developed a pressure wound extending over 15 centimetres. According to the article, Mr Selir had been left in a chair for long without being rotated. Having been diagnosed with stroke, he could no te rotate himself and therefore his blood circulation was impaired. Mr Selir was taken to hospital immediately but then died before he could get any help. It was then that the Aged Care Complaints Commissioner recommended that the Leamington nursing home staff be trained technical on wound management. Feelings From the event, the undeserved death of Mr Selir made feel very sorry for his family who expected appropriate care for their kin in the Leamington nursing home but got the opposite. I felt disappointed with the staff members of the nursing home for failing to rotate the patient while he remained in the fall-out-chair for too long. I was even more disappointed considering that they could not simply realize the foul smell from Mr Selir and take it upon themselves to take him to hospital. The death of Mr Selir was actually disturbing as it occurred as a result of negligence according to me. Evaluation From the patients perspective and that of his family this event had no positive aspect. This is because Mr Selir did not get the required attention at the nursing home. The staff at the facility did not monitor his state and left him to suffer circulation impairment and thus ended up with pressure wounds. Another negative aspect is that the staff did not manage his wounds and did not take him to hospital early enough for wound treatment. From the nurses perspective, the positive aspect from the incident is that they learnt the need to be closely monitoring patients under their care in line with the ACQSHC. It is also positive that they will be provided with special training on wound management as recommended by the Aged Care Complaints Commissioner. The negative aspect of the incident on the nurses perspective was that they felt the guilt of not monitoring the patient. Further, the nurses did not implement fully the ACQSHC and did not take the patient early enough to hospital making to succumb to the wounds. Analysis From the incident, I now understand that there is need as a nurse to ensure that the safety of my patient remains a top priority. I have learnt that healthcare teams must ensure that they carry out a day to day assessment of patients in critical care units to ensure any deterioration in their health is prevented before it seriously affects them as indicated in Khandelwal (2012). I have been able to understand that monitoring a patients progress proactively cannot only inform a nurse on the patient medical needs but can save the patients life. This particular incident has really widened my knowledge especially on the safety standards required in acute care for patients with stroke and those who face the danger of developing gangrene. More particularly, I have realized that gangrene if left to spread can be terminal in a number of patients as also emphasized in Khandelwal (2012). Further, I have discovered that wound management t training is important especially for healthcare provider s in nursing homes for the elderly. To enhance my own learning from this event, I will continuously be reviewing the ACQSHC standards on patient safety under care to ensure that I remain abreast of the latest standards that I should practice as a nurse. I will also be reviewing evidence based nursing materials from best practice institutions and individuals in the field. This will help me understand further, the need for proactive evidence based nursing care. Further, to enhance my learning, I will ensure that I not only engage my own reflection on this event but I discuss the event with fellow nurses on the best way of preventing gangrene in patients that have long hospital stays. According to the Acute Stroke Clinical Care Standards (2015), there is need for nurses caring for stroke patients to be given training and technical support in order for them to provide proper care to these patients. The Australian Safety and Quality Framework for Health Care calls upon nurses to ensure that they improve they improve continuity of healthcare by doing regular updates of patients clinical status and their intended treatment plan in order to avoid negligence as per the case of Mr Selir. There is also a need to minimise healthcare risks during handovers from one health team member to another by preventing misinformation on patients clinical requirements (Howell et al, 2007). Crucial in nursing, is the aspect of the need to provide evidence based care and ensuring that any provided guidelines in caring for patients under best practice are followed to the later to prevent variation in care delivery (Morse Finkelstein, 2009). On safety of patients, healthcare providers sho uld ensure that there is time to time patient assessment so as to protect them from harm that could be caused by a nurses errors in routine healthcare provision. Action Plan From the ACQSHC framework, as a future registered nurse I will take a number of actions to prevent the occurrence of such a death due to negligence, lack of information on care, technical support insufficiency among others. First I will ensure that patients, their families and my fellow health care providers are actively involved in ensuring the safety and quality of care in the acute stroke unit. I will work together with the healthcare team to minimise any risks during handovers from one healthcare provider to another as recommended in Howell et al (2007). Considering the aspect of consumer centred care, I will openly inform the family and patient in case anything goes wrong. In terms of evidence based care, I will ensure that my team of HCPs provides the best services to the patients in the acute stroke unit based on best evidence. I will also use the provided guidelines in caring for patients in order to prevent variation in care delivery according to ACSQHC (2015). In regard to safety, I will ensure that the time to time patient evaluations carried out are used to inform safety actions in order to prevent any harm that would result from errors on the part of the healthcare.. References Acute Stroke Clinical Care Standards 2015. Australian Commission on Safety and Quality in Health Care. Acute Stroke Clinical Care Standard. Sydney: ACSQHC, 2015. Howell, E., Graham, C., Hoffman, A., Lowe, D., McKevitt, C., Reeves, R., Rudd, A. (2007). Comparison of patients' assessments of the quality of stroke care with audit findings.Quality And Safety In Health Care,16(6), 450-455. Khandelwal, R. (2012). Fourniers Gangrene Severity Index as a Predictor of Outcome in Patients with Fourniers Gangrene: A Prospective Clinical Study at a Tertiary Care Center.Journal Of Young Medical Researchers,1(1). Morse, C., Finkelstein, J. (2009). Fundamentals of health care improvement: a guide to improving your patients' care.Quality And Safety In Health Care,18(5), 416-416. Redley, B., Bucknall, T., Evans, S., Botti, M. (2016). Inter-professional clinical handover in post-anaesthetic care units: tools to improve quality and safety.International Journal For Quality In Health Care,28(5), 573-579. Redley, B., Bucknall, T., Evans, S., Botti, M. (2016). Inter-professional clinical handover in post-anaesthetic care units: tools to improve quality and safety.International Journal For Quality In Health Care,28(5), 573-579. Tong, D. (2008). Review: Organized stroke unit care reduces mortality more than other forms of care in patients hospitalized with stroke.Annals Of Internal Medicine,148(12), JC4. Walton, M., Shaw, T., Barnet, S., Ross, J. (2006). Developing a national patient safety education framework for Australia.Quality And Safety In Health Care,15(6), 437-442.