The COVID-19 pandemic brought many serious challenges to the clinical workplace, and was a catalyst to novel approaches to the way in which we practice medicine. These challenges include extreme numbers of critically ill patients overwhelming many intensive care units, how to maintain the flow of communication between clinicians, patients and their families, and how to prevent the spread of infection working on quarantined units in personal protective equipment. The Royal Brompton and Harefield Hospitals deployed a series of digital solutions to try to address some of those challenges and a series of case studies describes their clinical application in three clinical domains: communicating with families, clinical communication between clinicians and the delivery of clinical education.
Nursing assessment addresses health promotion, prevention of illness, and the nursing care of ill people. It identifies immediate and future responses to potential and actual health problems of the cardiovascular patient. Care planning aims to address problems with collaborative goals identified by the cardiovascular patient. A physical examination is an essential part of comprehensive nursing assessment providing a wealth of information about the patient. The early detection of clinical deterioration is a key component in the care quality and safety agenda. The initial assessment in an acute care setting reviews the reason for seeking care and determines adequate ventilation and perfusion to identify the need for early intervention. Recognition of deterioration using appropriate track and trigger tools outlined in hospital policies allows nurses to identify the need for escalation of care. Timely management of deterioration of patients in emergency situations is facilitated by effective communication with specialist teams with intensive care skills. A comprehensive, holistic assessment using a patient-centred approach is completed after the initial assessment to gather further data for care planning. Nurses use their clinical knowledge and reasoning to make judgements that identify problems that are responsive to nursing care.
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