NVQ evidence

X12

Tracy was a three-year-old girl who had broken her tibial plateau. She had already been put in a caste but, due to this being made of plaster of Paris, this had disintegrated and was no longer Secure and fit for purpose. It required replacing.

Tracy was a company by her mother and her elder brother. Her mother had limited insight and very mild learning disabilities.

(Background. This unit's emphasis is on the actions of the worker when assisting another with their role. To begin with, I started procedure on my own because Tracy seemed calm and did not show any signs of distress. However, when she started to have her plaster removed, she began screaming and kicking so I asked Mark, one of the staff nurses to come and undertake the task while I helped.)

[GENERAL NOTES FOR THE WHOLE PROCEDURE]

• I ensured that the procedure was carried out within the correct manner and in the correct order [X12.2.2]
• Throughout the procedure, I tried to ensure that Tracey was supported appropriately by asking him if he was ok and if different procedures within the overall procedure were acceptable to him [X12.2.5].

Before Tracey became distressed

I checked to see what was required in Tracey's casualty card, which was an above-knee full cast made of plaster of Paris.

I went into the plaster room and prepared it by making sure it was nice and tidy and that all the resources that I needed were ready:-

· Three rolls of plaster of Paris casting tape

· A role of padding

· A fully functioning plasters saw

· A bucket of tepid water

I ensured that the sheet on the couch was clean. [X12.1.1]

I went up Tracey and introduce myself to her and her mother and brother giving my designation and that I needed to change her cast. I checked her name, date of birth and hospital number against her name band.

• To ensure that the correct person received the correct care.[X12.1.2]
• To ensure that Tracey and her family were aware of my designation and its limitations.

I took Tracey and her family into the plaster Room and insured that there was seating arrangements for her mother as well as her brother. I ensured that her brother had a book to read so that he had something to do while we were other taking the procedure.

I first explain to Tracey that I need is to take the plaster off. As Tracy was so young, I enlisted the help of her mother to gain Tracey's consent which I obtained [X12.1.3]

I washed and dried my hands thoroughly and applied latex gloves and apron. Tracey asked me why i was wearing these. I explained i didn't want to get my uniform dirty.[X12.1.5, X12.1.6, X12.2.1 X12.2.3]

I asked her mother if she had had a previous cast to which her mother had said yes. I also asked her if she had had this saw used to remove this to which her mother said yes.

I asked if Tracey wanted to use the toilet before I commenced the task. Her mother said that Tracey had just been to the toilet so we were ready to commence the task. [X12.1.8]

To minimise Tracey's distress, I showed her the saw and explained the low risk of hurting her in a manner that was applicable to her. I also explained that she needed to stay in really still whilst I and took the procedure and that her mother would help by holding her legs still. I turned the saw on which she looked at with interest. Her mother and I held her legs still and I said that when I started to cut the plaster it will be very noisy and a bit shaky. I started to cut the plaster. I heald the saw firmly with two hands, ensureing that i did not drag it along the cast, making a cust along the side of the caste, so it could be removed safely. [X12.2.7].

I stayed nice and calm as not to distress Tracey by my body language or tone of voice. Tracey started to kick and scream. So I called Mark in to co-ordinate the procedure. [x12.2.6]

Mark then took over and cut the plaster off and applied a new one after having calmed Tracey down. This is not very easy as she was very anxious. Her mother, who was holding her, did some diversion of therapy with her which helped also. I supported Tracey's leg when was needed and helped to explain what was going on, when required.

I asked Tracey if she was comfortable to which she said she was. [X12.1.10]

When we had finished, I explained to Tracey's mum that it was important to be observant of any changes in the colour of Tracey's toes. If they became blue for example or cold, or should she staff experiencing disproportionate amounts of pain, she should bring Tracey immediately to the accident and emergency department [X12.3.1 X12.3.4].

I also reiterated that this plaster was not a weight-bearing plaster nor should it be got wet . Her mother asked when would the plaster be changed. As well as prescribing a replacement plaster, the doctor had also prescribed that Tracey should attend the accident and emergency clinic in three days' time. I explained this to Tracey's mum. I asked Tracey's mum if she had any more questions. She had none. I checked to see that Tracey was comfortable. She was. She was also a lot calmer due to there diversion role therapy that her mother had undertaken during the procedure. I showed Tracey and her family to the accident and emergency reception where she could book an appointment for the clinicI asked tracey's mother if she understood and she said she did. [X12.3.6].

Tracey's mothere reported that her partner was waiting in the top car park and it would be better for him to come to the a and e entrance which would facilated putting Tracey in the car. i faciliated the sues of a telephone so she could use it to contact her partner so she could do this. {X12.3.7]

When Tracey had left, I recorded that She had left the deparment and signed and dated it. [x12.3.9]

I returned to the plaster room and threw away Tracey's old cast in a yellow clinical waste bag. I also threw the rappings of the caste in a black non-clincial waste bag. i ensured that the saw blade had been cleand, was sharp and was stored awy safely with the leand wonad arround the machine safely. [X12.2.11, X12.2.12]

I certify that this is my own work
Alan P Jack

I whitnessed Alan carry out this activeties

posted by alanpjack  # 11:10 PM