"4 modules each of 500 words with APA style reference with in text citation no older than 5years.For module 3 activity 2 a clinical reasoning cycle worksheet (patient from medical surgicalward) needs to be done as well I have attached that as well Purpose: To enable students to develop clinical reasoning, delegation and prioritisationskills.Length and/or format: 500 words per module, total 2000 wordsLearning outcomes assessed: 1, 2, 3, 4, 5, 6 and 9Learning outcomes1. Demonstrate achievement of NMBA Registered nurse standards for practice at the level ofgraduate nurse through the ongoing maintenance of a professional portfolio; (GA5) 2. Evaluate the implications of delegation and supervision of Registered Nurses, EnrolledNurses and unlicensed care workers in relation to differences in scope of practice; (GA4) 3. Use appropriate strategies to manage your transition and responses to the health setting;(GA6) 4. Demonstrate initiative and collaborative clinical reasoning skills and decision making inevidence based assessment, planning, implementation and evaluation of care in complexnursing practice situations; (GA7) 5. Initiate implementation of the care plan for a caseloadrelevant to the health care setting with minimal direction and supervision within a reasonabletime frame; (GA5,6) 6. Prioritise and re-prioritise nursing care based on individual/group needs, acuity andoptimal time for intervention; (GA6)9. Collaborate with interdisciplinary health care team in the development, implementationand evaluation of planned health-care goals. (GA7)Graduate AttributesGA1 Demonstrate respect for the dignity of each individual and for human diversity. GA3Apply ethical perspectives in informed decision making. GA4 Think critically and reflectively. GA5 Demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/orprofession. GA6 Solve problems in a variety of settings taking local and international perspectives intoaccount GA7 Work both autonomously and collaboratively. 2. Are you wanting the answered questions referenced? It depends on the activity. The Module 3 verbal handover for example does not need bereferenced - I want to know what you are thinking, what questions you would ask, and howyou would prioritise your day as a Registered Nurse. Conversely Module 1 activity asks you to 'document your rationales' which is something thatshould be supported with some literature. The Module 2 Case Study component clearly requires some literature support. The Module 4 activity needs only one (or two) brief references that describe different modelsof patient allocation - the rest comes from your own clinical reasoning (i.e. your head).3. How long do the modules need to be? Word limit for each module activities is 500 words (total of 2000 word equivalent over thefour modules).4. Do you want other relevant journal articles uploaded into my eportfolio or just the 4modules? No you do not need to include any extra documentation. Just include the required answers forthe module activities and a reference list for supportive literature used. If you want to includeother things to enhance the product so that you can then use it for a job application or similarthen go for it - but I will only read/assess the Module activities.All Four modules and clinical reasoning cycle worksheet (patient from medical surgicalward) are attached with this doc? Module 1 - Critical Thinking, decision making and professionaldevelopmentThis Module addresses issues such as problem solving, prioritising and putting decisions into actionthrough good communication.? Module OneFile 254.6KB PDF document? Module 2 - Collaborative and Therapeutic PracticeThis module requires you to consider your communication with various members of the multidisciplinaryteam using case studies and scenarios provided.? Module TwoFile 414.5KB PDF document? Module 3 - Provision and Co-ordination of careThis Module looks at assessment and problem solving to care planning. You will need to undertake pre- reading and preparation, and then ask your registered nurse colleagues on clinical to assess your workprior to submission.? Module 3 Activity 2 Verbal HandoverFile 2.5MB Audio file (WAV)? Module 3 - Provision and Co-ordination of CareFile 304.2KB PDF document ? Clinical Reasoning Cycle Worksheet - Module 3 Activity 2File 396.7KB Word document? Module 4 - Professional Practice: Time management, delegation, scopeof practice This Module requires pre-reading (prior to clinical) and then observation of, and interaction with, theregistered nurses on your clinical placement. You will need to discuss delegation with the staff and thenmake some decisions of your own using a case study. It would also be very useful to discuss the scopeof practice of newly registered nurses with your facilitator or preceptor.? Module Four - Professional PracticeFile 179KB PDF documentSOLUTIONModule 1Prioritization is explained as the process of identifying the needs or problems that requireimmediate action. While preparing the care plan the nurse should first address the high- priority diagnoses. The nurse can classify the diagnosis and prioritize into high, intermediateand low (Papastavrou, E., et al. 2014). In the given case scenario there are many clinicalissues which have to be addressed. I will first attend the elderly female post-operative patient who has collapsed. I will assessand monitor the patient’s vital signs and airway. At the same time, I will check if the patienthas any injury due to fall. If there are any complications, I will call for the help, notify themedical office and complete the documentation of assessment findings. I will ask the enrolled nurse (EN) to attend Mrs. Chew. I will instruct the EN to first stop theinfusion and remove the intravenous catheter, elevate the patient’s arm and rest in elevatedposition. Then apply a cold compress. I will instruct the EN to call a specialty nurse forplacing a new cannula at another site. I will instruct the EN to monitor the patient and checkfor any sign of dehydration. I will delegate and assigns the EN to check the vitals of Mr. Smith’s visitor and report anyabnormal findings or irregularity to me. I will suggest the EN make the visitor feelcomfortable. I will delegate Assistants in Nursing (AIN) to look after Mr. Smith’s visitoruntil I visit her. I will delegate an AIN to contact the ward clerk or maintenance to the fix the staff toiletswhich is blocked and is overflowing as it can cause contamination. I will instruct the AIN tomake sure to put “out of order “sign on toilet door so that no one uses it. After attending all the patients, I will meet the surgical consultant to discuss the medicationerror that happened last week.Rationale: According to ANMC guidelines, the nurses should prioritize the care needs and distribute theworkload based on the scope of practice. It helps the nurses to provide safe and effective care.The high priority case in his scenario is the post-operative patient who collapsed and isunconscious after facial surgery. It could be due to impaired breathing or circulation andindicates the necessity of code blue. So I will first attend that patient and check the airway,breathing, cardiac status, vital signs, and circulation and provide immediate care. The secondpriority case is the visitor who has fainted. It is the responsibility of a registered nurse toprovide necessary care to an unconscious patient. The extravasation of an intravenouscatheter in Mrs. Chew’s case can be life-threatening, so before attending visitor, I willsuggest the EN to remove the intravenous catheter of Mrs. Chew and provide necessary careand notify specialty nurse to replace the catheter. After discussing with the SurgicalConsultant, I will check whether the staff toilet has been fixed to prevent contamination(NMBA,2013). ReferenceThe nursing and midwifery board of Australia (NMBA). (2013). Registered nurse standardsfor practice. Retrieved fromhttp://www.nursingmidwiferyboard.gov.au/document/default.aspx?record=WD13%2F10753 &dbid=AP&chksum=ke%2FhMxMHGxnQev5BI%2B0ueQ%3D%3D Papastavrou, E., Andreou, P. and Efstathiou, G. (2014), Rationing of nursing care and nurse– patient outcomes: a systematic review of quantitative studies. Int J Health PlannMgmt, 29, 3– 25. doi:10.1002/hpm.2160Module 21.What factors determine the professional groups on a health care team?The factors that help to determine the professional groups on a health care team are patient’scondition that changes over time and the psychosocial needs of the patient (NSW, 2014). Ahealth care team consists of general practitioners, practice nurses, community health nurses,physiotherapists, occupational therapists, dieticians, psychologists, social workers,podiatrists, Aboriginal Health Workers, health educators.2.Who should lead the health care team?Healthcare is a team effort in which each health care provider plays a unique and special role.The health care teams are usually led by the team member who can manage and coordinateamong the team members. He or she should ensure collaborative practice and propercommunication and flow of information among the team members. Physician and nursemanagers can lead a health care team.However, three out of four patients believe thatpatients receive effective care when a physician leads the health care team.3.Who is the most important member of the healthcare team?Each member of the health care team is equally important. However, a team leader plays acrucial role as he or she is in regular contact with the patient. The leader is responsible forconducting the meeting and ensuring proper flow of information among team members(MND Australia Fact Sheet on Multidisciplinary Teams, 2016).Case Study 1The key issues in this case which are:1.Complications associated with home-based care2.Impact of long-term hospitalization on the patient’semotional well-being Home-based care enables the patients to be with their family and prevents loneliness amongthem; it also enhances the degree of patient autonomy.Some negative impacts of home- based care on the treatment are nurses work alone and do not interact with the physician. Itcreates a communication barrier between the nurse and physician. It influences patient safetyand quality of outcomes.But at the same time, long-term hospitalization affects theemotional well-being of the patient. It separates the patients from their family and friends andmakes the patient more dependent on the nurses. If effects the patient’s cognitive coping andcauses negative consequences such as anxiety, depression, and reduces self-esteem in thepatient (Ellenbecker CH, et al., 2008). A study conducted in 18 patients with chronic low back provided that home-based physicaltherapy program has significantly improved the patient response and outcomes. The home- based rehabilitation program improved the active lumbar flexion and decreased physicaldisability (Sirbu.E, 2016). Home-based care is cost-effective, promotes healing, increasesindependence and reinforces the bond between the client and family members. However,special precautions must be taken to reduce the risk of falls and infection while providinghome care. Therefore, I will suggest the team members that providing home-based occupational therapyand physiotherapy with daily follow-up visits will be beneficial for the Grant and his family. References:Ellenbecker CH, Samia L, Cushman MJ, et al. Patient Safety and Quality in Home HealthCare. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook forNurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr.Chapter 13. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2631/MND Australia Fact Sheet on Multidisciplinary Teams. Retrieved fromhttp://www.mndaust.asn.au/Documents/Information-resources/WEB-MND-Australia-Fact- Sheet-EB3-Multidisciplinary.aspx Dated 23 Oct 2016. Sîrbu, E. (2016). Effectiveness of a home-based physical therapy program in patients withchronic low back pain. Timisoara Physical Education and Rehabilitation Journal, 8(15), pp.12-16. Retrieved 30 Apr. 2017, from doi:10.1515/tperj-2015-0010Module 3Activity 1 What further questions will you need to ask the nurse?A nurse should follow ISOBAR model of assessment during handover. ISOBAR is anacronym which stands for Identification of the patient and staff, situation, and status,observation, background, accountability and risk management. The nurse should askquestions based on ISOBAR model to provide continuity of care irrespective of change inshift or ward (Street, 2011). It helps to deliver adequate care and reduces the risk of adverseeffects or complications. In the give case study, the patient is a 92-year old male who has been admitted to theemergency department due to abdominal pain, and the patient has lost 3 kg weight during thestay in ED. The patient has pneumonia and has a history of gastric ulcers. The patient is onIV antibiotics and got his valves opened yesterday. The patient has to be administered normalsaline ad has to undergo chest X-ray and sputum test. I will use an ISOBAR model and askthese questions to obtain adequate information which helps to provide effective patient care(Scovell, 2010).•Is the patient experiencing pain?If yes, what is the level of the pain experienced by thepatient?•Is the patient on analgesic medications?•Is the patient experiencing any side effects due to antibiotics?•Are there any dietary modifications or fluid restriction recommended for the patient?•Is there any requirement for R/V and procedures?What are the further assessments that the nurse needs to complete?After receiving the handover the nurse should start with a checklist and assess the patient'svitals, respiration rate, blood pressure, heart rate, and urinary output, SPO2, BGL(Malekzadeh, J., et al., 2013). Complete head-to-toe assessment should be done. Conduct anECG test, if required or not performed earlier.Neurological observation should be recorder by assessing patient's cognition, the level ofconsciousness and ability to perform daily activities of living. Perform wound assessment andcheck the skin for breakdown or pressure ulcers it helps to reduce the risk of secondary infection. I will interact with respiration therapist and other members of multidisciplinary tocarry further assessment and obtain adequate data for creating an effective care plan. Clinical reasoning cycle is a process which helps the nurse and other healthcare professionalsto collect the patient’s cues, process the information, understand the patient’s situation orproblem, create a plan and implement the interventions for improving patient’s conditionfollowed by evaluation of outcomes. Effective clinical reasoning skills help the nurse tocreate positive impact on the patient’s health (Henk G Schmidt, et al., 2015).Clinicalreasoning cycle helps to identify the risks associated with patient condition. Patient’s BP.Body temperature, allergy, laboratory reports etc., are some of the cues which help the nurseto diagnose the patient’s condition.Reference: Henk G Schmidt, SílviaMamede (2015). How to improve the teaching of clinical reasoning: anarrative review and a proposal. Medical Education, 49(10), 961. DOI: 10.1111/medu.12775Malekzadeh, J., Mazluom, S. R., Etezadi, T., &Tasseri, A. (2013). A Standardized ShiftHandover Protocol: Improving Nurses’ Safe Practice in Intensive Care Units. Journal ofCaring Sciences, 2(3), 177–185. http://doi.org/10.5681/jcs.2013.022Scovell, S. (2010). Role of the nurse-to-nurse handover in patient care. Nursing Standard,24(20), 35-39.Street, M., Eustace, P., Livingston, P. M., Craike, M. J., Kent, B., & Patterson, D. (2011).Communication at the bedside to enhance patient care: A survey of nurses' experience andperspective of handover. International Journal of Nursing Practice, 17(2), 133-140.Process Case StudyThe patient is admitted in intensive care unitConsider the patient situationafter undergoing abdominal aortic aneurysmWhat current information do you have on thisyesterday. While monitoring the patient thept?nurse finds that patient’s skin is cool and hasWhat new information have you gathered?sweating. The patient has history of hypotension and istaking betablockers. The patient‘s BP was140/80 an hour ago. Collect Cues/Information Now the BP is 110/60 and body temperatureo ·What further cues and information is 38 C. the patient is receiving epidural would be useful? Why?infusion at a rate of 10ml/hr. Further urineoutput, oxygen saturation and pulse shouldbe assessed. The patient has weak pulse,rapid heart rate and reduced urine output. Process Information Patient’s blood pressure is low and the body·What changes do you notice in the cues temperature is slightly high. Patient hasand information provided? hypotension, tachycardia and oliguria. Patient·Which changes are significant for this might be experiencing impending shock. Itpatient and why? could be due to vasodilation caused by·What do you think these changes could epidurals or due to blood loss during surgery.indicate and why?·What could be the outcome of thesechanges?Identify Problems/issues Patient is experiencing hypovolemic and·Given the facts that you have available hypotension due epidural vasodilation. and comparing those to what you think thechanges could indicate/identify one potentialpatient problem/issue. Establish Goals Improve the patient’s hemodynamic status. ·Describe what you want to happen.Improve the patient’s blood pressure and get·Who do you want involved and what do the patient’s urine output back to normal inyou want them to do? the next one hour.·In what timeframe?Notify the physician and get an order toincrease the IV rate of saline solution,colloidal fluids or provide blood transfusion,Receive an order of administering aramine ifTake Actionrequired. ·What nursing actions will you take?Further I will check for parent airways.·What will be your nursing priorities?Measure patient’s urine output hourly.Monitor patient ABG and electrolyte levels.Observe for the sings of impendingcoagulopathy The patient’s blood pressure rises to normalEvaluate Outcomeslevel. ·What do you expect to achieve from thePatient’s urine output should be more thanactions have taken?30mL/hrReflect on Process and new learning Patient’s vitals should be closely monitored·What have you learnt from this exercise? for first 48 hours after the surgery. Module 4The care delivery models help to organize the work while caring for the patients. Theselection of care delivery model depends on the patient needs and availability of competentstaff. It is the responsibility of nurse manager to implement the care models and evaluates itsoutcomes (Jennings BM, 2008). In team nursing model RN acts as a team leader andcoordinates with the group and assigns specific duties based on the scope of practice of theteam members. It is the most common method used in outpatient and inpatient settings. Ithelps to provide comprehensive care and helps to provide collaborative care. It helps to focuson the patient and their needs (Carl-Ardy Dubois, et al.)."