Critically discuss the importance of clinical judgment and decision-making to nurses in clinical practice when caring for deteriorating patients. The assignment should be supported with reference to your clinical practice to illustrate your experiences of clinical judgment and decision-making (CJDM) and supported by relevant literature.

The COVID-19 virus has transformed the healthcare industry, utilizing telehealth more than ever before. Due to the increasing demand for telehealth, you have been tasked with creating a tip sheet for the providers in your clinic. The purpose of this tip sheet is to give the providers the critical information they need for coding and billing telehealth visits without overwhelming them or impacting patient care.

Specifically, on your tip sheet, you should:

• Provide an explanation of telehealth and its associated applications.
• Review privacy requirements when conducting telehealth sessions. Provide 2 requirements and give a brief detail of each.
• Provide 3 examples of documentation needed for a telehealth visit.

Case study 1. Rebecca Brown (Child Study)

Rebecca Brow is 8 years old and is a wheelchair user, following a road traffic accident when she was five years old. Rebecca requires one-to-one personal care due to her physical disabilities, as she sustained a fractured spine in the accident, meaning that she has no movement below her cervical spine (tetraplegia)

Rebecca attends a school for children with additional needs, where she has a designated teaching assistant and also a carer who provides her with personal care during the school day.

Rebecca lives with her parents Sue and David and her older sibling Michael who is 12 years of age. The family lives in an upstairs apartment provided by a housing association, which is small and not ‘wheelchair friendly’.

Sue has a part-time job at a local day nursery but has to stay at home during the school holidays, in order to care for Rebecca and Michael, reducing the family income. David works full-time at a local factory, working long hours for a low wage.

The neighborhood where the Brown family lives is not tolerant of Rebecca’s ‘differences’, and the family has received unpleasant comments as they pass neighbors in the street, causing them to avoid going out whenever possible.

 

Case study 2. Ben Grace (Adult Study)

Ben Grace is fifty-two and has Down’s syndrome and type 2 diabetes. Ben has a learning age of 8 and requires support with all aspects of daily living. Ben lives in a group setting with five other adults who have learning difficulties and who also require additional support. Ben previously lived with his mother, but following her death last year, Ben moved to the residential setting.

Ben has always enjoyed going shopping, but since he has moved into the residence, he prefers to stay in his room which is a concern for the staff, following an incident with some local youths who shouted at Ben when he went shopping with the residents and carers. Recently Ben was refused entry to a local funfair by the manager who stated that Ben’s appearance could prevent other people from wanting to attend.

Ben is refusing to keep to the special diet required to control his type 2 diabetes and staff have found bags of sweets under his pillow when making his bed. His blood glucose levels are unstable, resulting in Ben feeling unwell. Ben has become withdrawn.