Evaluating Care Plan Effectiveness

Introduction

In nursing care, the nurses by analysing and identifying the needs and demands of the service users through diagnosis of their health are to develop a care plan to ensure their well-being. In this assignment, the nursing care of patient named Roy will be explained and in this process, the steps of nursing to be followed and nursing model to be used in identifying his key needs will be discussed. Moreover, the way shared decision in care and care plan for Roy to be established will also be discussed. For those seeking nursing dissertation help, it is important to consider how detailed analysis and structured care planning can contribute to comprehensive research. The case study mentions that Roy is a 60-year old individual, who has suffered two heart attacks and is experiencing Rheumatoid Arthritis, Type-2 diabetes and feet neuropathy with risk of developing vascular disease in the leg (youtube.com, 2018).

Whatsapp

Key stages of nursing process

The APIE is a problem-solving process that is used for directing nursing individuals in systematic manner to resolve health problems in patients The AIPE stands for assessment, planning, intervention and evaluation of nursing care (Wilson et al. 2018). In Assessment phase, the diagnosis of patient’s health is executed to identify their clinical needs and demands (Spirgien and Brent, 2018). This, in Roy’s case, the nurses are to perform physiological and psychological diagnosis and examination of the patient to determine the demands and needs of care to be fulfilled to deliver holistic support. In Planning phase, based on the systematic clinical assessment of the patient the nurses identify potential intervention to be included to care for the patient in their care plan so that patient’s health complications are effectively managed and resolved (Harries et al. 2020). Thus, in Roy’s case, the nurses are to develop care plan based on the diagnosis of his current health complication to deliver appropriate care for his health enhancement. In the case study, Roy mentioned that he avoided taking diabetes care seriously which led to his greater deterioration in health apart from other health condition. Thus, the nurses while arranging care plan for Roy are required to focus on including intervention in improving his type-2 diabetes and its associated risks apart from his other health complication.

In Implementation phase, the care plan is implemented through appropriate care initiative from the nurses along with active participation of the patients. The nurses require ensuring the intervention addresses the needs of the patients and are practicable including referral of patent in need of specialist care (Delves-Yates, 2018). Thus, in Roy’s case, the nurses to successfully implement the care plan are to ensure the determined healthcare intervention is effectively practised through collaboration with specialists and the patient actively implements the care intervention in their everyday life such as uptake of medication, involve in exercise and other. In evaluation phase, the nurses are to examine the extent to which the care goals are met through intervention and the adjustment in care plan to be made for more enhanced care of the patient (Hertz and Santy-Tomlinson, 2018). Thus, in Roy's case, the nurses are to analyse the extent of care goals reached with the implementation of the current care plan and determine the further adjustment in care and changes in intervention to be needed by Roy to ensure his enhanced well-being.

Nursing Model

In order to effectively care for Roy, a nursing model is to be followed by nurses to ensure his holistic well-being. The Ropert-Logan-Tierney Model is a theoretical nursing model developed on the basis of activities of daily living (ADLs) of individuals to holistically assess their health needs and provide thorough care to ensure patient’s well-being. The 12 ADLs focussed on the model of care are maintaining safe environment, breathing, communication, eliminating, eating and drinking, personal hygiene and dressing, body temperature control, mobilising, expressing sexuality, working and playing, sleeping and dying (Williams, 2017). The benefit of using the model is that it offers ability to the nurses in providing holistic care by considering important components of everyday life (Stonehouse, 2017). Thus, it would be effective to arrange care for Roy as effective understanding of his overall health needs can be made to determine the aspects in which care approaches are to be made to improve his overall health. However, the limitation with using Ropert-Logan-Tierney Model is that it often leads the nurses misunderstand the appropriate condition of activities of living of the patients in turn leading them to fail in creating effective care plan (Gaut, 2016).

The case study of Roy mentions that he is suffering from rheumatoid arthritis and feet neuropathy due to long-term impact of inappropriately controlled type-2 diabetes. As asserted by McWilliams and Walsh (2017), rheumatoid arthritis (RA) leads people to experience tenderness and increased pain in the joints. This is because in RA the body’s immune system targets and destroys the linings in the joints creating increased stiffness that makes individuals face mobility issues. As argued by Vale et al. (2017), in feet neuropathy the patients experience pain, weakness and numbness along with picking feeling in the legs. This is because of the impact of increased blood sugar level in the blood that damages the nerves leading to the feet. Thus, according to Ropert-Logan-Tierney Model, the mobility efficiency is Roy is analysed where he informed that he is feeling pain and hindrance to walk out of his health condition indicating he requires support regarding movement.

The working and playing are key parts of everyday living as working helps to enhance the mental health of the individuals and allows them to earn finances in supporting their living whereas playing improves and develop social skills (Hickish and Roberts, 2019). As per Ropert-Logan-Tierney Model, Roy's working and playing efficiency are assessed as long-term health condition often renders individuals to develop physical and mental inefficiency to work and play. This is because of long-term suffering from various complications of diseases and increased intake of different clinical intervention to manage health (Williams, 2017). In Roy’s case, he expressed no working and hindered playing activities out of increased pain and mobility issues due to RA and feet neuropathy. He mentioned his long-term health condition of type-2 diabetes and double heart attack along with intake of long-term care for the health conditions has made him think that he would never be able to perform normal work and play with his grandchildren as wished. Thus, nursing during care is to focus on enhancing the working and playing efficiency of Roy. (Refer to Appendix 1)

The patients are required to have good quality sleep as it helps to effectively repair and heal the body along with develops peace of mind for the individuals (Delaney et al. 2018). As per Ropert-Logan-Tierney Model, the sleeping activity of Roy is assessed as long-term health condition often leads individuals to have poor sleep. This is because of anxiety and depression regarding their ailing health condition (Okun et al. 2018). The case study mentioned no information of sleeping activity of Roy but he is found to have clinical anxiety regarding his long-term health which may interfere with his sleeping efficiency due to which the nurses while offering care are to consider the importance of the health aspect. Thus, the health assessment of Roy informs that anxiety and pain management are the two key aspects of care currently required for him. In order to deliver care to Roy based on his assessed health condition; the person-centred care approach is to be used. This is because it promotes trust between nurses and patients making the nurse experience ease in delivering support to patients to enhance their health.

The four principles of person-centred care are treating people with respect, compassion and dignity; provide coordinated care and support to people; provide personalised care and allow service users in recognising and developing abilities to led independent life (Louw et al. 2017). The use of Ropert-Logan-Tierney Model influence nurses to deliver person-centred care to the patients. This is because the activities of living specific to the patients are assessed by nurses and based on the facts specific personalised care intervention are included to deliver care to the individual (Williams, 2017). As mentioned by Stonehouse (2017), use of nursing model like Ropert-Logan-Tierney Model informs nurses about the aspects of care to be maintained to meet principles of person-centred. This is evident as the model allows holistic assessment to identify and manage all hindered activities of living of the patient, in turn, trying to promote their independence of care.

Principle of shared decision making

The shared decision making is one of the key components of patient-centred care which is a process where clinical professionals and patients work collaboratively to develop care decision and select intervention to the provided care as per preferences and values of the patient (Slade, 2017). The principles of shared decision-making include care options for patients to be effectively explored, different choices to the patients for care to be provided and collaborative decision making between patient and health professional (Montori et al. 2017). As asserted by Montori et al. (2017), presence of different choices in effective shared decision-making makes the approach beneficial. This is because different choices of care intervention allow patients to have scope to choose one over another intervention by shared communication with nurses regarding specific care appropriate for them. As argued by Kon et al. (2016), inability to explore risk and benefits of care during shared-decision making helps nurses and patients ineffectively explore the strength and limitation of the interventions. This leads the nurses and patients unable to understand the consequences of the care intervention being provided in turn avoiding smooth care delivery to be established out of effective knowledge of importance as well as limitation of each care.

The benefit of shared decision-making in care is that it allows both patients and health professionals understand the components and aspects important to each of them (Pieterse et al. 2019). Thus, it would promote compliance in care as the patients receiving care would understand the reason behind the specific care being wished to be delivered to the individual by the healthcare staff (Grad et al. 2017). Therefore, in Roy's case, the shared decision-making would lead him to understand the importance of medical and clinical intervention made for him, in turn, making him show enhanced compliance in accepting the care. As commented by Boss et al. (2016), shared decision-making in care is beneficial as it helps health professionals to tailor the treatment as per needs of the individual. This is because during discussion in shared decision-making in care the health professionals are aware of the needs of the patients and effectively understand the intervention to be provided to link it in fulfilling their care needs.

The barrier to shared decision-making is time constraints as increased amount of time is required in framing the discussion to decide care through sharing of knowledge between nurses and patients which may not always be available (Farrelly et al. 2016). In Roy's case, he may be unwilling to spend extra amount of time taken in making shared decision for care, in turn, creating barriers towards the establishment of care approach. As argued by Giacco et al. (2018), lack of interest of the patients and their hindered health condition creates barriers in shared decision-making for care. This is because without interest and hindered health condition that renders them inability to communicate creates difficulty in sharing information of care and making decision. In Roy’s case, he is seen to show unwillingness to talk much with the health professionals regarding his care out of lack of knowledge of medical terms showing his lack of interest creating barrier for share decision-making.

In Roy's case, out of two aspects of care that are anxiety and pain management it is seen that he currently reports more hindrance with mobility issues our of pain in legs compared to anxiety. Thus, the proposed care plan will be focussed towards pain management for Roy. The care goal for Roy will be to resolve his pain in the legs out of rheumatoid arthritis and feet neuropathy to promote his mobility. A SMART goal is mentioned in the appendix regarding the care plan. The hot and cold massage is to be provided to Roy for his pain management. This is because it creates an analgesic impact on the legs of patient making them feel numbing effect and avoid perception of pain along with it reduces swelling out of RA and feet neuropathy (Vaghasloo et al. 2020; Shinde and Varadharajulu, 2017). Roy is to be administered nonsalicylates as it impacts to lower inflammation and pain in RA by inhibiting synthesis of prostaglandins which causes increase perception of pain (Erhardt et al. 2019). In controlling pain regarding feet neuropathy, Roy is to be provided gabapentin and pregabalin. This is because they are effective to reduce burning or stabbing perception of pain in neuropathy patients (Kaul et al. 2018). (Refer to Appendix 2)

Order Now

Conclusion

The above discussion informs that Roy who is 60 years old has double heart attack, rheumatoid arthritis along with type-2 diabetes which has caused him feet neuropathy and risk of vascular neuropathy. The AIPE process mentions that patients health is to be assessed based on which care plan for Roy is to be made and it is to be implemented with his participation and finally evaluated to determine adjustment regarding in his care to ensure his effective well-being. The assessment through Ropert-Logan-Tierney Model informs pain perception has reduced his mobility. Thus, a care plan is framed to resolve the health issue to promote his health.

Take a deeper dive into Techniques and Challenges in Steganography with our additional resources.

References

Boss, E.F., Mehta, N., Nagarajan, N., Links, A., Benke, J.R., Berger, Z., Espinel, A., Meier, J. and Lipstein, E.A., 2016. Shared decision making and choice for elective surgical care: a systematic review. Otolaryngology--Head and Neck Surgery, 154(3), pp.405-420.

Delaney, L.J., Currie, M.J., Huang, H.C.C., Lopez, V. and Van Haren, F., 2018. “They can rest at home”: an observational study of patients’ quality of sleep in an Australian hospital. BMC health services research, 18(1), p.524.

Delves-Yates, C. ed., 2018. Essentials of nursing practice. Sage.

Erhardt, D.P., Cannon, G.W., Teng, C.C., Mikuls, T.R., Curtis, J.R. and Sauer, B.C., 2019. Low persistence rates in patients with rheumatoid arthritis treated with triple therapy and adverse drug events associated with sulfasalazine. Arthritis care & research, 71(10), pp.1326-1335.

Farrelly, S., Lester, H., Rose, D., Birchwood, M., Marshall, M., Waheed, W., Henderson, R.C., Szmukler, G. and Thornicroft, G., 2016. Barriers to shared decision making in mental health care: qualitative study of the Joint Crisis Plan for psychosis. Health Expectations, 19(2), pp.448-458.

Gaut, M.M., 2016. The Tree of Life Model of Faith-Based Living: A Practice Model for Faith Community Nursing. International Journal of Faith Community Nursing, 2(2), p.10.

Giacco, D., Mavromara, L., Gamblen, J., Conneely, M. and Priebe, S., 2018. Shared decision-making with involuntary hospital patients: a qualitative study of barriers and facilitators. BJPsych Open, 4(3), pp.113-118.

Grad, R., Légaré, F., Bell, N.R., Dickinson, J.A., Singh, H., Moore, A.E., Kasperavicius, D. and Kretschmer, K.L., 2017. Shared decision making in preventive health care: What it is; what it is not. Canadian Family Physician, 63(9), p.682.

Harries, H., Giles, L., Condon, L. and Williams, M., 2020. Objective structured clinical exam: how clinical nurse educators can support internationally educated nurses. Nursing Management, 27(3).pp.20-45.

Hertz, K. and Santy-Tomlinson, J., 2018. Fragility Fracture nursing: holistic care and management of the orthogeriatric patient (p. 158). Springer Nature.

Hickish, D. and Roberts, D., 2019. The nurse-led model of hospice care. International journal of palliative nursing, 25(3), pp.143-149.

Kaul, I., Amin, A., Rosenberg, M., Rosenberg, L. and Meyer III, W.J., 2018. Use of gabapentin and pregabalin for pruritus and neuropathic pain associated with major burn injury: a retrospective chart review. Burns, 44(2), pp.414-422.

Kon, A.A., Davidson, J.E., Morrison, W., Danis, M. and White, D.B., 2016. Shared decision making in intensive care units: an American College of Critical Care Medicine and American Thoracic Society policy statement. Critical care medicine, 44(1), p.188.

Louw, J.M., Marcus, T.S. and Hugo, J.F., 2017. Patient-or person-centred practice in medicine?-A review of concepts. African journal of primary health care & family medicine, 9(1), pp.1-7.

McWilliams, D.F. and Walsh, D.A., 2017. Pain mechanisms in rheumatoid arthritis. Clin Exp Rheumatol, 35(Suppl 107), pp.94-101.

Montori, V.M., Kunneman, M. and Brito, J.P., 2017. Shared decision making and improving health care: the answer is not in. Jama, 318(7), pp.617-618.

Montori, V.M., Kunneman, M. and Brito, J.P., 2017. Shared decision making and improving health care: the answer is not in. Jama, 318(7), pp.617-618.

Okun, M.L., Mancuso, R.A., Hobel, C.J., Schetter, C.D. and Coussons-Read, M., 2018. Poor sleep quality increases symptoms of depression and anxiety in postpartum women. Journal of behavioral medicine, 41(5), pp.703-710.

Pieterse, A.H., Stiggelbout, A.M. and Montori, V.M., 2019. Shared decision making and the importance of time. Jama, 322(1), pp.25-26.

Shinde, S.B. and Varadharajulu, G., 2017. Effect of therapeutic exercise programme in adults with early rheumatoid arthritis. Indian J Physiotherapy and Occupational Therapy, 11(3), pp.77-80.

Slade, M., 2017. Implementing shared decision making in routine mental health care. World psychiatry, 16(2), pp.146-153.

Spirgiene, L. and Brent, L., 2018. Comprehensive geriatric assessment from a nursing perspective. In Fragility Fracture Nursing (pp. 41-52). Springer, Cham.

Stonehouse, D., 2017. A support worker's guide to models of living and nursing. British Journal of Healthcare Assistants, 11(9), pp.454-457.

Vaghasloo, M.A., Aliasl, F., Mohammadbeigi, A., Bitarafan, B., Etripoor, G. and Asghari, M., 2020. Evaluation of the efficacy of warm salt water foot-bath on patients with painful diabetic peripheral neuropathy: A randomized clinical trial. Complementary Therapies in Medicine, 49, p.102325.

Vale, T.A., Symmonds, M., Polydefkis, M., Byrnes, K., Rice, A.S., Themistocleous, A.C. and Bennett, D.L., 2017. Chronic non-freezing cold injury results in neuropathic pain due to a sensory neuropathy. Brain, 140(10), pp.2557-2569.

Williams, B.C., 2017. The Roper-Logan-Tierney model of nursing. Nursing2019 Critical Care, 12(1), pp.17-20.

Wilson, B., Woollands, A. and Barrett, D., 2018. Care Planning: A guide for nurses. Routledge.

Sitejabber
Google Review
Yell

What Makes Us Unique

  • 24/7 Customer Support
  • 100% Customer Satisfaction
  • No Privacy Violation
  • Quick Services
  • Subject Experts

Research Proposal Samples

Academic services materialise with the utmost challenges when it comes to solving the writing. As it comprises invaluable time with significant searches, this is the main reason why individuals look for the Assignment Help team to get done with their tasks easily. This platform works as a lifesaver for those who lack knowledge in evaluating the research study, infusing with our Dissertation Help writers outlooks the need to frame the writing with adequate sources easily and fluently. Be the augment is standardised for any by emphasising the study based on relative approaches with the Thesis Help, the group navigates the process smoothly. Hence, the writers of the Essay Help team offer significant guidance on formatting the research questions with relevant argumentation that eases the research quickly and efficiently.


DISCLAIMER : The assignment help samples available on website are for review and are representative of the exceptional work provided by our assignment writers. These samples are intended to highlight and demonstrate the high level of proficiency and expertise exhibited by our assignment writers in crafting quality assignments. Feel free to use our assignment samples as a guiding resource to enhance your learning.