Pre-activity Health Screening Case Study

2076 words (8 pages) Nursing Case Study

12th Feb 2020 Nursing Case Study Reference this

Tags: health and social care

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When an inactive person decides to participate in physical activity for the first time, there is a risk of possible major coronary problems. Sharkey and Gaskill (2007) state that inactive people who decide to start an activity are five times more at risk during vigorous exercise. The risk of engaging in exercise varies by the type of exercise and intensity, which a person participates in. This would mean the individual with cardiovascular problems is more at risk of having coronary problems. Sharkey and Gaskill (2007). As suggested by NHS Choices (n.d.) the risk can be dramatically reduced when completing a pre-activity health screening.

Pre-activity health screening is a tool used mostly by exercise professionals. It refers to the process of collecting information about an individual’s medical history and health status Heaney and Goodey (2012, p.136). This normally involves completion of a physical activity readiness questionnaire (PAR-Q). In addition physiological measures would also be done like height, weight, body mass index (BMI) body-fat percentage and waist-to-hip ratio (WHR). These are necessary to identify any further potential risks factors a person has relating to coronary heart disease(CHD)Heaney and Goody (2012)

The American College of Sports Medicine (ACSM) cited in Heaney and Goodey (2012, p.139) recommended that people are categorized into low, medium and high-risk factors. For example, primary risk factors are those at the highest risk, this includes hypertension, cigarette smoking and those with high-cholesterol levels. Secondary risk factors are those classified as medium risk. For example, diabetes type one and two obesity and physical inactivity. Furthermore, the non-modifiable risk factors are classified as low risk. This would include men over 45 and women over 55, in addition to gender and a family history of heart disease.

Another important factor is customer care, Sinka, I. (2012) suggested that if a fitness company wants to offer their services to a customer, then the customer needs to believe the service is worth taken part in. Not only does a pre-activity health screening ensure that the correct exercise programmes are offered, but also helps to understand and meet the customer needs. Furthermore, It is necessary for health and safety reasons. Completion of a pre-activity health screening demonstrates that health, and safety is always being considered. Similarly, as suggested by Jason Wamala pre active health screening reduces the risk against potential legal liability to the organization and employees. The open University (2008)

Do Daisy’s results from the health screening – physiological measurements fall into healthy ranges.

The results show a number of risk factors that are likely to lead to the development of cardiovascular disease. Daisy is 55 years-old sources from ACSM, 2006; Woolf-May, (2006) cited in Heaney and Goodey (2012, p.139) implies that Daisy is at risk to coronary heart disease genetic or lifestyle factors cause plaque to be build-up in your arteries as you age. By the time you’re middle-aged or older, enough plaque has built up to cause signs or symptoms. National heart and lung Institute (n.d.)

Blood pressure tends to rise with age this could indicate part of the reason why Daisy has a resting blood pressure of 160/100 millimeters of mercury (mmHg), this indicates that Daisy has high blood pressure referred to as stage two hypertension. The Open University (2008) suggested that high blood pressure greater than 140/90 mmHg can dramatically increase your risk of developing cardiovascular disease such as heart attack or stroke. Marie Toms suggested that it may be worth retesting Daisy more than once The Open University (2008). National heart and lung Institute (n.d.) suggested that blood pressure did not stay the same throughout the day. It is a lot lower while you sleep and rise when you wake up. Blood pressure tends to rise when you’re excited, nervous or active. If your blood pressure is above average most of the time, you’re at risk to CHD.

Daisy’s resting heart rate is ninety six beats per minute (bpm), the average bpm should be between sixty to one hundred bpm, NHS, (n.d.). However, Daisy is within the guidelines yet still at risk. NHS (n.d.) states that the resting heart rate is the number of beats in one minute when the body are at a complete resting state so the more your heart beats the more strain you put on your heart.

Looking at Daisy’s body mass index (bmi) which is 29.01, this indicates that Daisy has an increased health risk. Using the guidelines from Sharkey and Gaskill (2007, p.242.), indicates that Daisy has a desirable BMI of between nineteen to twenty five. Sharkey and Gaskill (2007) also suggested that having a higher than desired BMI puts Daisy more at risk of atherosclerotic heart disease and hypertension. Since Daisy is inactive, and the results from the BMI indicate she is overweight NHS, (n.d.) suggested that these are 2 factors that have an increase risk of hypertension

waist to hip ratio of 0.9 would indicate that Daisy has she is above average 0.86(study guide) this would indicate Daisy is more at risk In particular, heart disease, high blood pressure and diabetes develop when the inflammatory effects of that mass of fat hit your blood vessels Sharkey and Gaskill (2007) This would indicate why this individuals body fat percentage is so high, 25 for women is average so 33 percent is bad. The excess weight can put you at increased risk of heart disease, stroke and type two diabetes.

To conclude Daisy needs to make some big life changes to avoid being at risk of CHD. For example, exercise regular to help her lose weight, lower her BMI and WHR. In addition to lowering her risk factors to CHD.

Outline how physical activity could have a positive effect on Daisy’s health.

Daisy is overweight and is bordering obesity with a BMI of 29.01, Sharkey and Gaskill (2007) suggested that obesity along with lack of activity has been suspected to have a link between coronary artery disease (CAD), hypertension and type two diabetes. For example, an increase level of blood lipids (fat) in the body increases insulin resistance. This means that the insulin-resistant cells can’t take in glucose. Glucose levels then rise, which results in the release of more insulin, this in turn increase’s blood pressure causing possible hypertension and type two diabetes. Sharkey and Gaskill (2007)

For example, a study was published by Morris and raffle (1954) cited in Sharkey and Gaskill (2007, p.17.) Showing a link between inactivity and CAD, the bus drivers were tested along with the conductors. The conductors were more active then the bus drivers and were shown to have a 30 percent lower risk of CAD then the bus drivers. It is also suggested by NHS (n.d.) that inactivity increases the risk of hypertension by thirty-five percent. The result published by (Morris and raffle) would suggest that physical activity would benefit Daisy and lower her risk to hypertension and CAD.

In addition, People with very high blood pressure are three times more likely to experience CAD and four times more likely to get congestive heart failure then others. Sharkey and Gaskill (2007). Research has shown that physical activity can reduce blood pressure, in middle-aged and older women and Any inactive person engaging in exercise has a 60 percent lower risk of heart attack. Sharkey and Gaskill (2007). It is suggested that regular physical activity help prevent CHD by increasing the efficiency of the cardiovascular system, and example would be increased blood volume and decreased blood pressure.

Daisy also runs her own business, which suggested Daisy may be under stress. Sharkey and Gaskill (2007) suggested that stress is associated with heart disease and hypertension. To conclude daisy needs to include some regular moderate activity may minimize the effects of stress and more importantly reduce the risk from cardiovascular disease.

What legislation governs health and safety in a sports and fitness facility, and how might these relate to this incident? (250 words/13 marks)

Health and safety requirements are supported by tort law. This is a wide area of law covering areas such as negligence and occupier’s liability. For example, Heaney and Goody (2012) negligence in tort law concerns situations where a person suffers injuries due to carelessness, forgetfulness or thoughtlessness due to the results of another person. This would mean that person has breached their legal duty to take care. It would make them liable to that person for negligence.

An example would be Susan the 14-year-old daughter of Alistair, the father and daughter are fully aware of the health club’s policy relating to no under-16s, and every member has to complete a gym induction and health screening. The father owes a duty of care to his daughter, as he should be competent to understand the policies that the gym has in place. In addition, Goodey, J (2008) p152) suggested that an occupier may not be liable for injuries to a child if accompanied by someone competent enough to look after them.

Furthermore, statute law refers to the act of law made by parliament, this includes the health and safety at work act 1974 (HASWA 1974). For example, HASWA 1974) cited in Heaney and Goody (2012) 153 an employer must undertake all necessary measures to ensure visitors to their premises are not exposed to risks of health and safety.

There is the management of health and safety at work regulations 1999 (MHSWR 1999) MHSWR 1999) cited in Heaney and Goody (2012) state that management running a health and safety facility are required to conduct a risk assessment to ensure the welfare of employees and visitors.

Consequently, the fact Susan was still able to access the gym after claiming to be using the pool only may indicate that the employer has not taken all the necessary measures that fall under (HASWA 1974) and (MHSWR 1999).

Discuss whether or not Alistair and his 14-year-old daughter Susan would have a case for a claim for negligence against the facility.

There are many factors to consider that explain why Susan may not have a claim for negligence against the facility. One consideration may be that it falls within the occupier’s liability act 1984 cited in Goodey, J (2008

p.151) states that a person who controls the premises is responsible for allowing or preventing access to visitors. It can be argued that Susan gained access to an unauthorized part to the facility. Therefore, the duty of care expected of the facilities owner was not met. This would be due to insufficient security measures to prevent unauthorized access to non gym members and people under the age of sixteen. However, Alistair is Susan’s father so already has a duty of care toward his child. Alistair is already a member of the gym, he has participated in an induction and health screening. Alistair is aware of the facilities policy that under sixteen’s are not allowed within the gym area therefore, Alistair has been a regular user with the facility. You would therefore expect Alistair to have a higher standard of competence. In addition, Susan is fourteen years old, it is thought that age fourteen they would have some awareness. (Heaney and Goody (2012)

Susan went on to use a piece of gym equipment inappropriately, which highlights the cause of her injury. You could argue that the instructor supervising the gym at the time breached the duty of care for inadequate supervision. (Heaney and Goody (2012) However, the gym instructor would assume that all members in the gym at the time would have met the gym requirements and completed the induction and health screening. In addition, the instructor’s response to the accident was immediate and appropriate, as a result would indicate that the facility takes its duty of care seriously.

To conclude the majority of Susan and Alistair’s own negligence may have contributed to her injuries. Therefore, it would be suggested that Alistair and his 14-year-old daughter Susan would not have a case for negligence against the facility.

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