Comprehensive Care Plan for Patient Well-being

Care Plan

Care Plan Care Plan

Importance of person-centred care.

Person-centred care is important as it enables the patients to manage their own health condition thereby improving quality of care and gaining increased satisfaction from care (Haydon et al., 2018). The person-centred care assessment for breathing efficiency of John as mentioned in the care plan is important. This is because it would help the nurses to specifically monitor the oxygen saturation and breathing rate per minute of the patient for deciding when to provide additional oxygen support and when it is to be removed to ensure John reach effective breathing ability within the least time.

The case study of John mentions he is experiencing constipation and has swollen belly along with showing inability to eat. In the care plan, the person-centred assessment of John’s eating and drinking efficiency is important to understand the short-term and long-term eating and drinking goals for the patient is to be set for reaching enhanced well-being for him. Moreover, the person-centred approach of deciding the eating and drinking nature of John is also important to develop the inclusion of diet and drinks that are preferred by the patient and healthy for him which would influence him to follow the diet and drinks which are high in Carbohydrates and protein intake consistent with liver function(British Liver Trust, 2021).

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Analysis of assessment and treatment methods in care plan

In the care plan for John, one of the interventions include providing him soft and low-fat diet and ensuring enhanced nutrient intake. The intervention is important because cirrhosis of liver causes the liver cells to be damaged which lowers its efficiency in removing toxins and producing bile that is the protein which assists in breaking down fat into fatty acids in the body to get the fat digested (Biolato et al., 2019). Thus, the low-fat and soft diet would help the body avoid indigestion of fat in the body along with ensuring smooth bowel movement. In liver cirrhosis, diet chart is important to be implemented. This is because poor nutrition intake is mostly seen in case of liver cirrhosis patients and presence of enhanced diet chart developed by the dietician would create opportunity for the patients to intake adequate nutrient required for their body to cope with the disease (Schiavo et al., 2018). Thus, the diet chart is important for John to develop understanding of the type and amount of nutrient to be taken to remain healthy and cope with the disease.

The care plan mentions that oxygen saturation is to be assessed and oxygen therapy is to be provided for treating breathlessness. The monitoring of oxygen saturation is essential examination in patients with breathlessness issues because it helps the nurses to determine the oxygen level in the blood and determine when action to be taken to normalise the oxygen level in facilitating their breathing ability (Asano et al., 2020). Since John is facing breathlessness, thus oxygen saturation measurement is essential to measure oxygen level in the blood and accordingly take actions. Oxygen therapy helps in improving the oxygen level in the body and minimise respiratory problem by adding extra oxygen in blood (Jeon et al., 2021). Since John is experiencing breathlessness, thus the treatment is appropriate according to his condition to resolve the issue. Thus, the alcohol addiction treatment is effective for John as it would help him avoid worsening his condition of liver cirrhosis along with support him in developing healthy lifestyle.

In the care plan john was referred to Drugs, Alcohol and Liaison teams to support him when is been discharge to stop drink alcohol as the Nice guideline suggests that cirrhotic patients’ needs intervention for total abstinence from alcohol(NICE, 2019). The harmful chemicals present in the alcohol causes further destruction of liver cells in patients with liver cirrhosis due to which alcohol is to be avoided (Roerecke et al., 2019). Thus, the alcohol de-addiction treatment would be effective for John as it would help him avoid worsening his condition of liver cirrhosis along with support him in developing healthy lifestyle. However, in the care plan Mr. John the intervention Discussions on alcohol screening was not tailored according to his needs. Many individuals relapse within weeks of stopping alcohol due to post-acute withdrawal symptom which can last for months. Mr John has alcohol problem for 20years. According to the NICE guideline (2011) John needs to receive proper alcohol and drug addiction treatment, therapists, psychiatrists and other addiction specialists to work with him to address underlying mental health issues. As with alcohol and drug addiction, mental health issues often require long-term attention to sustain recovery. If mental health issues go unaddressed, or if an individual does not know how to properly cope, they can trigger an alcohol or drug relapse.

Role of the student nurse in patient care

In patient care, one of the roles of a student nurse is to chart and record the patient's medical condition and vitals during the care (Nice.org.uk,2021). This is important to help the registered nurses and physicians to review the record and determine the efficiency of the patients in responding to the care as well as changes required in the care for better health improvement of the patient (Rylance et al., 2017). Thus, the student nurse caring for John is to record his medication administration, health vitals, raised health needs and others during the care delivery. The other role of the student nurse is to assist the care of the patients and administer them prescribed medication (Jackson et al., 2021). This indicates that the student nurse caring for John is to act collaboratively with other registered nurses and family members of the patient to deliver him effective care. The importance of working collaboratively with the family of the patients is that it helps the nurses develop an idea regarding the additional needs of the patients that are not mentioned. Moreover, collaborative care of nurses with family of patients provide overview of the success and satisfaction of the care from patient and their family’s perspective and involve the family in shared caring of the patient to ensure continued quality care is provided to the patient (Powers et al., 2019). The significance of working in collaboration with patients is that the nurses are able to establish person-centred care and empower the patients in taking their own care as well as frame care which reaches the patient’s utmost satisfaction. This is because during collaboration the patients discuss their needs with nurses and involve in decision-making regarding the way and nature of care to be provided in their best interest (Vizcaya-Moreno et al., 2018).

Intervention from multi-disciplinary team for care planning

The involvement of the multi-disciplinary team in care helps in the inclusion of expertise from various medical field to provide best quality care to the service users (Cook et al., 2019). The multi-disciplinary team involved in caring for John include dietician, respiratory nurses, hepatologist and others. The importance of multi-disciplinary team is that creates better avenues for service implementation and care delivery for the patients (Suwa et al., 2021). This is evident as the hepatologist by working with the oncologist would be able to determine if the liver cirrhosis in John can turn cancerous. The importance of multi-disciplinary team is that it helps the patients to experience enhanced service coordination and referral process to meet their care goals in an effective manner (Cook et al., 2019). Thus, multi-disciplinary care is important for John to access enhanced referral for his health condition and meet the care goals needed for him to have good health.

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References

Asano, R., Mathai, S.C., Macdonald, P.S., Newton, P.J., Currow, D.C., Phillips, J., Yeung, W.F. and Davidson, P.M., 2020. Oxygen use in chronic heart failure to relieve breathlessness: A systematic review. Heart failure reviews, 25(2), pp.195-205.

Ballard, C., Corbett, A., Orrell, M., Williams, G., Moniz-Cook, E., Romeo, R., Woods, B., Garrod, L., Testad, I., Woodward-Carlton, B. and Wenborn, J., 2018. Impact of person-centred care training and person-centred activities on quality of life, agitation, and antipsychotic use in people with dementia living in nursing homes: A cluster-randomised controlled trial. PLoS medicine, 15(2), p.e1002500.

Biolato, M., Manca, F., Marrone, G., Cefalo, C., Racco, S., Miggiano, G.A., Valenza, V., Gasbarrini, A., Miele, L. and Grieco, A., 2019. Intestinal permeability after Mediterranean diet and low-fat diet in non-alcoholic fatty liver disease. World journal of gastroenterology, 25(4), p.509.

British Liver Trust 2021, Diet and cirrhosis, Available at: https://britishlivertrust.org.uk/information-and-support/living-with-a-liver-condition/diet-and-liver-disease/cirrhosis-and-diet/ [Accessed on: 3 November 2021]

Cook, O., McIntyre, M., Recoche, K. and Lee, S., 2019. " Our nurse is the glue for our team"-Multidisciplinary team members' experiences and perceptions of the gynaecological oncology specialist nurse role. European Journal of Oncology Nursing, 41, pp.7-15.

Duarte‐Rojo, A., Ruiz‐Margáin, A., Montaño‐Loza, A.J., Macías‐Rodríguez, R.U., Ferrando, A. and Kim, W.R., 2018. Exercise and physical activity for patients with end‐stage liver disease: Improving functional status and sarcopenia while on the transplant waiting list. Liver Transplantation, 24(1), pp.122-139.

Ezhumalai, S., Muralidhar, D., Dhanasekarapandian, R. and Nikketha, B.S., 2018. Group interventions. Indian journal of psychiatry, 60(Suppl 4), p.S514.

Haydon, G., Browne, G. and van der Riet, P., 2018. Narrative inquiry as a research methodology exploring person centred care in nursing. Collegian, 25(1), pp.125-129.

Jackson, S., Steven, A., Clarke, A. and McAnelly, S., 2021. Student nurse socialization: A model of professional discourse adoption. Nurse Education in Practice, 56, p.103198.

Jeon, D., Son, M. and Choi, J., 2021. Impact of liver cirrhosis on the clinical outcomes of patients with COVID-19: a nationwide cohort study of Korea. The Korean journal of internal medicine, 36(5), p.1092.

Jeon, D., Son, M. and Choi, J., 2021. Impact of liver cirrhosis on the clinical outcomes of patients with COVID-19: a nationwide cohort study of Korea. The Korean journal of internal medicine, 36(5), p.1092.

McClain, C.J., 2016. Nutrition in patients with cirrhosis. Gastroenterology & hepatology, 12(8), p.507.

Morando, F., Rosi, S., Gola, E., Nardi, M., Piano, S., Fasolato, S., Stanco, M., Cavallin, M., Romano, A., Sticca, A. and Caregaro, L., 2015. Adherence to a moderate sodium restriction diet in outpatients with cirrhosis and ascites: a real‐life cross‐sectional study. Liver International, 35(5), pp.1508-1515.

Nartey, Y.A., Asem, M., Agyei-Nkansah, A., Awuku, Y.A., Setorglo, J., Duah, A., Bampoh, S., Ayawin, J., Asibey, S.O., Ye, W. and Afihene, M.Y., 2019. Nutritional management of cirrhosis patients: A qualitative study exploring perceptions of patients and health workers in Ghana. Clinical nutrition ESPEN, 34, pp.18-22.

NHS 2021, Alcohol support, Available at: https://www.nhs.uk/live-well/alcohol-support/ [Accessed on: 26 October 2021]

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NICE 2020, National Early Warning Score systems that alert to deteriorating adult patients in hospital, Available at: https://www.nice.org.uk/advice/mib205/resources/national-early-warning-score-systems-that-alert-to-deteriorating-adult-patients-in-hospital-pdf-2285965392761797 [Accessed on: 3 November 2021]

Powers, K., Herron, E.K. and Pagel, J., 2019. Nurse preceptor role in new graduate nurses' transition to practice. Dimensions of Critical Care Nursing, 38(3), pp.131-136.

Roerecke, M., Vafaei, A., Hasan, O.S., Chrystoja, B.R., Cruz, M., Lee, R., Neuman, M.G. and Rehm, J., 2019. Alcohol consumption and risk of liver cirrhosis: a systematic review and meta-analysis. The American journal of gastroenterology, 114(10), p.1574.

Rylance, R., Barrett, J., Sixsmith, P. and Ward, D., 2017. Student nurse mentoring: an evaluative study of the mentor's perspective. British Journal of Nursing, 26(7), pp.405-409.

Schiavo, L., Busetto, L., Cesaretti, M., Zelber-Sagi, S., Deutsch, L. and Iannelli, A., 2018. Nutritional issues in patients with obesity and cirrhosis. World journal of gastroenterology, 24(30), p.3330.

Suwa, S., Tsujimura, M., Yumoto, A., Iwata, N. and Shimamura, A., 2021. Multidisciplinary pharmacotherapy collaboration for home‐based older adults with dementia: a study focusing on physicians, pharmacists, and nursing professionals. Psychogeriatrics, 21(5), pp.749-762.

Velázquez, K.T., Enos, R.T., Bader, J.E., Sougiannis, A.T., Carson, M.S., Chatzistamou, I., Carson, J.A., Nagarkatti, P.S., Nagarkatti, M. and Murphy, E.A., 2019. Prolonged high-fat-diet feeding promotes non-alcoholic fatty liver disease and alters gut microbiota in mice. World journal of hepatology, 11(8), p.619.

Vizcaya-Moreno, M.F., Pérez-Cañaveras, R.M., Jiménez-Ruiz, I. and de Juan, J., 2018. Student nurse perceptions of supervision and clinical learning environment: a phenomenological research study. Enfermería Global, 17(3), pp.306-331.


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