The importance of non-technical skills in the management of the acutely deteriorating patient
it is patient case:
Mr Williams Case History (Acute)
Mr Williams is a 61-year-old male who has been referred to the community physiotherapy service by his GP. The GP referral letter explains that Mr Williams has Multiple Sclerosis, and a recurrent urinary tract infection (UTI) and recent possible aspiration. He has low tone in his upper, lower limbs and thorax. He has restrictive thoracic movement in particular extension. Recommendation for moving and handling included hoisting from bed to chair or wheelchair, assisted drinking and to cough post-swallow.
On arrival: Mrs Williams, reports that her husband is currently very tired, has a weak cough and has been sleepy since yesterday. He became quite chesty 2 days ago, when he had a drink of tea and thickened soup. She had called the GP yesterday but he has not improved overnight.
Healthcare Providers Information:
GP diagnosis: Multiple Sclerosis, UTI, (status – acute deterioration following recent aspiration pneumonia to be determined by the learner).
Condition: acute deterioration (developing sepsis secondary to pneumonia)
MRSA: unknown at present
Urinary catheter: in situ
Allergies: None known
MS Medication: (Interferon Beta 1a, for relapsing MS, and Tizanidine to reduce muscle spasms). Tazocin recommenced (25.09.2015)
The Question is:
Using a critical examination of the relevant literature discuss the importance of non-technical skills (e.g. situational awareness, decision-making, team management, leadership, communication and teamwork) in the management of the acutely deteriorating patient (Mr Williams).
PLEASE IDENTIFY THESE POINTS:
• Critically evaluate relevant literature to include Government policy initiatives underpinning evidence-based practice.
• Synthesise the analysis of research findings in order to make judgements about their contribution to the clinical evidence base.
• Develop reasoned arguments in order to critically evaluate clinical decisions relating to case management/physiotherapy interventions.
• Engage effectively in debate, arguing and evaluating a variety of viewpoints in a professional manner to produce detailed and coherent arguments in relation to case management/physiotherapy interventions.
Critically reflect on their experience of implementing best available evidence in relation to case management and physiotherapy interventions in order to suggest solutions to the problems of implementing research findings into clinical practice.