PRIORITIZING

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Prioritization of Care for Multiple Patients

Care Plans

You are assigned to care for three patients on the day shift, 7:00 a.m. to 3:30 p.m. The shift routine includes breakfast trays at 8:00 a.m., lunch trays at 12:00 p.m., routine vital signs are completed at 8:00 a.m. and 12:00 p.m. Assessments are completed on all Patients at 8:30 a.m. You need to identify the priorities for each Patient and the priorities for the group of Patients you are caring for on the shift. You are working as a team on the floor and your team members include the RN (who has your patients as well as 6 others) and a Nursing Assistant who is assigned to help on the floor as needed.

The Patients you are assigned to care for are:

Patient 1: Surgical

1. Going for OR @ 1000 for bowel resection

1. Admit @ 0700

1. Preop checklist to be done

1. EKG and CXR to be done (both are done off the floor)

1. IV of 1000 mL LR @ 100 mL/hr, to be started (LPN’s do not start IV’s at this facility)

1. Pre/post op teaching to be done

Patient 2: New Diabetic

1. 1500 calorie ADA diet

1. Blood glucose @ 0700 – 1100 – 1630 – 2100 (NA’s can’t take accu √)

1. 0730 – NPH 20 units Humulin insulin with Regular 8 units Humulin insulin

1. Begin diabetic teaching

1. Up ad lib

1. Shower

Patient 3: Low back pain & cardiac decompensation

1. VS qid

2. Ambulate length of hall with assistance bid

3. BRP with help

4. 1000 cal Low Na diet

5. I & O

6. K-pad to back

7. Enema this AM

8. Cares with assistance

9. PT 1100 (therapy)

10. Lanoxin 0.125 mg qd @ 0900, √ AP

11. Naproxen 250 mg bid @ 0900 and 2100

12. Misoprostal 200 mcg qid 0900 – 1300 – 1700 – 2000 with food

Student: _______________________________Date: ____________________________ Clinical Worksheet for Multiple Patients (Patient 1)

PN Student

Time periods:

10A

11A

12P

Initials:

Room: ____

Staff: _______

Age: ____

Doctor: _______

Diagnosis:

Medical: _______________

Surgical: _______________

Nursing: _______________

Allergies: _____ Diet:_____

Activity: _______________

HD:______ P.O.D.:_______

Clinical Worksheet for Multiple Patients (Patient 2)

PN Student

Time periods:

10A

11A

12P

Initials:

Room: ____

Staff: _______

Age: ____

Doctor: _______

Diagnosis:

Medical: _______________

Surgical: _______________

Nursing: _______________

Allergies: _____ Diet:_____

Activity: _______________

HD:______ P.O.D.:_______

Clinical Worksheet for Multiple Patients (Patient 3)

PN Student

Time periods:

10A

11A

12P

Initials:

Room: ____

Staff: _______

Age: ____

Doctor: _______

Diagnosis:

Medical: _______________

Surgical: _______________

Nursing: _______________

Allergies: _____ Diet:_____

Activity: _______________

HD:______ P.O.D.:_______

Prioritization/Assignment of Care Patient 1

Priority for Care/ Maslow’s Hierarchy Of Needs

Patient #1:

Rationale:

Patient #1:

Rationale:

Patient #1:

Rationale:

Assigned tasks to the Nursing Assistant

Patient #1:

Rationale:

Tasks referred to the RN

Patient #1:

Rationale:

Prioritization/Assignment of Care Patient 2

Priority for Care/ Maslow’s Hierarchy Of Needs

Patient #2:

Rationale:

Patient #2:

Rationale:

Patient #2:

Rationale:

Assigned tasks to the Nursing Assistant

Patient #2:

Rationale:

Tasks referred to the RN

Patient #2:

Rationale:

Priority for Care/ Maslow’s Hierarchy Of Needs

Patient #3:

Rationale:

Patient #3:

Rationale:

Patient #3:

Rationale:

Assigned tasks to the Nursing Assistant

Patient #3:

Rationale:

Tasks referred to the RN

Patient #3

Rationale:

Revised from assignment developed by Anoka Technical College Nursing Program, Minnesota

Title	Prioritization of Care for Multiple Patients
	Put X in box to correspond with the SLO (s)	Put X in box to correspond with the Competency (s)	Knowledge/Practice/Ethical Comportment
			K	P	E
Student Learning Outcome(s)	Patient Relationship Centered Care		Communication Skills
			Nursing Process
			Learning Needs
	Informatics/Technology		Documentation
			Informatics
	Nursing Judgment/Evidence Based care	X	Prioritization	X	X
			Nursing Judgment	X	X
	Professional Identify and behaviors	X	Professionalism
			Ethical/Legal	X	X
	Quality Improvement		Patient Care Concerns
			Systems
	Safety		Patient Complications
			Safe Nursing
	Teamwork and Collaboration		Communication
			Conflict Recognition
	Managing Care of the Individual Patient	x	Managing Care of the Individual Patient	x	x
			Assign/Monitor	X	X

Where should this assignment be used:
Classroom	X
Clinical Setting	X
Independent Study	X
Online/Web Based	X
Skills Lab	X
Simulation	x

Revised from Linda Caputi © (What type of assignment is this?)
Patient Care Assignment	Non Patient Care Assignments
Patient Care The assignments are related to the student while providing patient care in the clinical setting. Example: Concept mapping care for one or multiple patients.	Thinking Focused Assignments encourages critical thinking and clinical reasoning and teaches students to think like a nurse.	Patient Focused The student focuses on specific aspects of patient care such as safety, falls, diabetes, other diseases, etc.	Systems Focused Assignments help the student understand the clinical world, the nurse’s work therein, and the effect of the system on the nurse and the patient. Example: How the system completes medication administration from order to delivery to patient.
x	x	x

Assignment: Prioritization of Care for Multiple Patients

Name:

The student will complete the assignment for organizing and prioritizing care to 3 patients. The assignment will be graded with the rubric below.

Rubric for Grading Assignment
Criteria	Satisfactory (_2_points each)	Needs Improvement (_1_ points each)	Unsatisfactory (_0_points each)
NURSING JUDGMENT/EVIDENCE BASED CARE-PRIORITIZATION OF CARE COMPETENCY NURSING JUDGMENT/EVIDENCE BASED CARE-NURSING JUDGMENT COMPETENCY
1. Organization of tasks	Organized tasks on worksheets, complete, accurate, easy to read.	Organized tasks on worksheet but misses some of the tasks needed to be accomplished, difficult to read.	Unable to organize tasks on worksheet. Misses tasks, sloppy.
2. Nursing Judgment/Prioritization	Sets priorities accurately and according to Maslow’s.	Needs a few supporting cues to identify priorities accurately.	Unable to set priorities without multiple cues and direction.
3. Nursing Judgment	Gives accurate rationales for priorities	Requires a few supporting cues to give rationale for priorities.	Unable to give rationales for most of the prioriities without multiple cues and direction.
MANAGING CARE - MANAGING CARE COMPETENCY MANAGING CARE - ASSIGN/MONITOR COMPETENCY
4. Managing Time	Organizes patient care within clinical time frame. Productive and organized. Determines what can be assigned to the Nursing Assistant.	Requires assistance to organize care within defined time frame. Disorganized at times. Does not assign duties to the nursing assistant.	Unable to organize care within clinical time frame without multiple cues, direction, and assistance.
PROFESSIONAL IDENTITY AND BEHAVIOR - ETHICAL/LEGAL COMPETENCY
5. Professionalism Ethics/Legal Assign/Monitor	Identified care within scope of practice. Requested assistance for care out of scope of practice of PN.	Needs a few supporting cues to determine scope of practice. Needs prompts to request assistance for care out of scope of practice for PN.	Does not practice within scope of practice of PN without multiple cues and directions given.
Points:
Total Points	/10