...Systematic Approach to Care through Effective Person-Centred Care Planning. The NHS places a strong emphasis on delivering person-centred care to patients. Patient-centred planning was adopted as national government policy in 2001 via the “Valuing People” paper and more recently as part of the “Valuing People Now” document (DOH,2009). Person-centred planning is now promoted as a key method in delivering the personalisation objectives of the Governments “Putting People First” programme for social care (DOH, 2007). The Coalition continues this commitment towards personalisation of care with its “Capable Communities and Active Citizens” document (DOH, 2010). One key area to ensure that care is delivered in a systematic person-centred way is through effective care planning that involves the patient in the process as a key stake holder. Several systematic models to nursing care are available that will facilitate practitioners in ensuring that all needs of the individual are identified and met. This essay will define what is meant by the term “person centred care”, will explore the systematic nursing models of care delivery and will highlight good practice in constructing person-centred care plans. This will be done using examples of an original care plan (constructed by the author for a real patient whose name has been changed) - and will draw upon information and evidence from a range of contemporary sources. It is appropriate in the context of this essay to firstly define...
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...THE CASE FOR A MODEL OF CARE Contemporary health care systems are constantly challenged to revise traditional methods of health care delivery. These challenges are multifaceted and stem from: 1. novel pharmacological and non-pharmacological treatments; 2. changes in consumer demands and expectations; 3. fiscal and resource constraints; 4. changes in societal demographics in particular the ageing of society; 5. an increasing burden of chronic disease; 6. documentation of limitations in traditional health care delivery; 7. an increasing emphasis on transparency and accountability, 8. evidence based practice (EBP) and clinical governance structures; and 9. the increasing cultural diversity of the community. These challenges provoke discussion of the necessity of developing services around a model of care. What do we mean by a model of care? Ambiguity exists in the literature, with the terms, model of care, nursing model, philosophy, paradigm, framework and theory often used interchangeably, despite referring to diverse, yet parallel concepts (Tierney 1998). In their recent review of the literature, the Queensland Government (Australia) reported that they found no consistent definition of ‘model of care’ (Queensland Health 2000). They concluded that a model of care is a multidimensional concept that defines the way in which health care services are delivered (Queensland Health 2000). More specifically, Davidson and Elliott...
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...Crystal L. Watkins 201420-HAS-4383- Quality Improvement in Healthcare Dr. Jessica Sapp Eastern Florida State College August 3, 2014 Abstract Quality improvement is one of the most important topics within businesses for the past twenty years. This is mainly true for health care, as the debate continues on how our current American system should be restructured. The current health care reform is aimed at decreasing costs and guaranteeing access to all Americans. It cannot be allowed to put the quality of care at risk. Quality improvement has become the main element to strategic planning within the health care domain. A strategic concept can help save our healthcare business in more way than you think. This cannot be effectively applied unless quality improvement can be accurately defined, measured, evaluated, and monitored at all times. Through such analysis a hospital can choose how to narrow resources toward those quality improvement projects which will effect a customer’s perceptions of service quality the most. The purpose of this research paper is to establish a concept by which to approach the issue of quality improvement, define the numerous components of quality improvement that exist in health care, and understand how these elements will affect one another. Quality improvement is a hard topic to have success in within this century. I have chosen to speak to do my research on quality improvement within a hospital. Hospitals are always trying to improve their quality...
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...Chapter 17- Evidence-based practice in therapeutic health care Objective: What evidence-based practice is About a 5-step approach to evidence-based practice To discuss evidence hierarchies and evidence quality To apply the evidence to current practice To provide a case study for a therapy question To provide a case study for a diagnostic question Key terms: Clinical practice guidelines Evidence-based practice Randomised controlled trial Systematic review Evidence-based practice: the use of best research evidence, along with clinical expertise, available resources and the patient's preferences to determine the optimal management option in a specific situation. Randomised controlled trail: a clinical trail where participants are randomly assigned to groups in order to receive different interventions. This randomization removes many of the effects that may bias the true result. Systematic review: a comprehensive identification and synthesis of the available literature on a specified topic. Clinical practice guidelines: systematically developed statements that assist the health professional and the patient to make decisions about what is the appropriate health care in specific circumstances. Critical summaries (systemic reviews and clinical practice guidelines) now provide practitioners with readily accessible access to research evidence. The availability of theses documents on the web means that patients have almost as much access to the 'critical...
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...Systematic Review Analysis: “A systematic review of nurses’ inter-shift handoff reports in acute care hospitals” 2013 Outline: A) Introduction. B) Article Analysis. C) Conclusion. Thesis: The present paper provides the analysis of the systematic review “A systematic review of nurses’ inter-shift handoff reports in acute care hospitals” by Poletick & Holly (2010). The influence of this review on clinical practice is discussed. The article “A systematic review of nurses’ inter-shift handoff reports in acute care hospitals” by Poletick & Holly (2010) provides the systematic review of the handoff reports between and among the nurses which ensure the quality exchange of information for the improved health care service. The continuity of care is the major concern for nurses, and the procedure of patient care transfer should take that into account. The objective of the review was stated clearly and mentioned the appraisal and synthesis of the qualitative evidence related to the nursing handoff report. Moreover, the authors aimed at recommending the improvements which would facilitate and enhance the information transfer. by reviewing the qualitative studies which dealt with the real experience of nurses with their inter-shift handoff reports. As the authors admit, this is likely to contribute to the improvement of the patient care. The conclusion on the potential...
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...Sam is a recently graduated health professional, who during his time at university has been taught about evidence based practice (EBP). His first experience of implementing the five steps of EBP, asking an answerable question, acquiring the evidence, appraising the evidence, applying the evidence and assessing the process Liamputtong (2010), will be critically analysed in this essay. An encounter of qualitative and quantitative approaches to research, and how Sam can apply the evidence generated from a quantitative approach to evidence based clinical practice will be detailed below. Evidence based practice can be defined as clinical decisions for individual patients derived from the most appropriate evidence available (Facchiano & Snyder, 2012). It is a nurse’s care of duty to use appropriate clinical practice that will best suit the needs of the patient. Implementation of EBP based on an understanding of research findings is a requirement of competency standards for Australian and New Zealand nurses and midwifes (Borbasi & Jackson, 2012). Sam noticed conflicting practices while watching a routine wound clean; tap water was used instead of saline solution by one of his fellow nurses. This made Sam begin to think about what evidence there was to support using water, or if the nurse should have used saline instead. Sam decided to research this topic further, which comprised of him asking a targeted question that he could then translate into research. The clinical question...
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...practice nurse is employed as a British Heart Foundation (BHF) Heart Failure (HF) nurse and is based in secondary care. Along with networking with a wide range of health care practitioners providing a seamless service between primary and secondary care her role also involves evidence-based care to clients with chronic heart failure (CHF). CHF is a complex syndrome that results from a structural or functional cardiac disorder that impairs the ability of the heart to function as a pump. This results in the heart not being able to pump enough blood to meet metabolic demands of the body (Clinical Resource Efficiency Support Team (CREST), 2005). The most common cause of HF is coronary artery disease, hypertension and valvular disease. It is a chronic condition, which may fluctuate, and result in repeated hospital admissions. The incidence and prevalence of heart failure is on the increase and with the current ageing population it is likely to continue along this trend. It is currently the most common cause of hospital admission in clients over the age of 65 years and accounts for 1 - 3 % of the National Health Service’ expenditure, the majority of which is associated with inpatient care (CREST, 2005). The Nursing and Midwifery Council (NMC, 2010) defined specialist practice as “...the exercising of higher levels of judgement, discretion and decision making in clinical care” and requires that specialist practice nurse is competent in clinical assessment and diagnosis in their area...
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...Nursing Process The nursing process is a systematic and organized way nurses are required to give care to patients at a hospital setting. Nursing process follows a simple rule flexible rule by using the acronym ADPIE, it stands for accessing, diagnosing, planning, implementing, and evaluating. The purpose of the nursing process is to build on nurse’s critical thinking skill, allow for nurses to think outside the box and most importantly to provide excellent services to patients every time. Accessing in terms of nursing process refers to the gathering of information about a patient, objective information (directly from the patient) or subjective information (from family, friends and electronic health record). The next stage of the nursing process is the diagnosis, the nurse takes the information from the assessment, analyzes the information and through critical thinking process the nurse creates an intervention. The next phase is the planning, the nurse prioritize which diagnoses need to be focused on. A nursing diagnosis is different from a medical diagnosis because the nursing diagnosis focuses on the problem that results in the disease process and medical diagnosis focuses on the disease process alone. According to American Nurses Association the planning phase is based on the assessment and diagnosis, the nurse sets measurable and achievable short- and long-range goals for this patient that might include moving from bed to chair at least three times per day; maintaining...
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...INTRAPARTUM AND IMMEDIATE POSTPARTUM CARE 2012 A collaboration of the Department of Health and the Philippine Obstetrical and Gynecological Society 1 The mention of specific product brands is not meant to suggest that they are endorsed or recommended by the Department of Health (DOH) and the Philippine Obstetrical and Gynecological Society (POGS) in preference to other products of a similar nature that are not mentioned. All reasonable precautions have been taken by DOH and POGS to ensure that the information contained in this publication is accurate. However, this guideline is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the guideline lies with the end user. In no event shall DOH and POGS be liable for damages arising from its use. 2 ii MESSAGE The primary aim of MDG 5 is to reduce by three quarters by between 1990 an 2015, the maternal mortality ratio,especially among less developed countries. The Philippines is among those with high maternal mortality rate (MMR). In 2006, our MMR was 162 deaths/100,000 live births, however, the Family Health Survey in 2011 showed that the MMR has increased to 221 deaths/100,000 live births. It is therefore important that we mobilize our efforts together to avert further deaths of our pregnant mothers. The Philippine Obstetrical and Gynecological Society (Foundation), Inc. (POGS) stood up to the challenge of World Health Organization (WHO) in 2011 to...
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...nursing care to patients and their families with complex healthcare needs” (Practice- Registered Nurse n.d.). One of the standards set forth by TX BON is “the maintenance of health, or prevention of illness”. Leininger’s theory says when an individual’s cultural expectations are not met or overlooked can delay progress or lead to worsening health. A nurse is not able to maintain health or prevent illness if he/she is faced with the obstacle lacking cultural knowledge and awareness. Therefore, nurses must approach each patient encounter uniquely with what is learned through literature and from clinical experiences in developing a nursing care plan. Another scope of practice defined by TX BON is the supervision and...
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...Introduction When one thinks about the historical developments in nursing research and research utilization, the statement is indeed true… that nursing has evolutionalized. This brief journey into historical research has been described by LoBiondo – Wood and Haber (1998) as ‘the systematic compilation of data, resulting from evaluation and interpretation of facts regarding people, events and occurrences of the past’ History is where we come from, who we are, and where we are going. History may not always repeat itself exactly, but knowledge of history can serve as a guide to avoiding pitfalls or mistakes similar to those in the past (Rees and Howell, 1999) Developments covered will include the work of Florence Nightingale, the development of the Nursing Science Journal and the Agency for Healthcare Research and Quality (AHRQ), the identification and development of the first nursing diagnosis conference and the development of the Healthy People 2010. Florence Nightingale is best known as the person who founded modern nursing. She chose nursing despite the disapproval of her family. Her choice to rebel against the traditional woman’s role as a wife and mother helped her as she started her initial research role by focusing on the patient’s physical and mental wellbeing and promoting a healthy environment. She is noted for her collection and analysis of soldier morbidity and mortality data during the Crimean War. The research enabled her to change the attitudes of the military and...
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...Levels of Health Promotion Health promotion is essential in keeping society and individuals healthy. Health promotion empowers communities and individuals for healthy living through education. The primary goal of health promotion is prevention. Nurses are key in health promotion and will be seen in diverse settings as health promotion evolves the nursing profession. There are three levels to health promotion that are utilized to optimize health. Definition of Health Promotion The World Organization (WHO) defines health promotion as “the process of enabling people to increase control over the health and its detriments, and thereby improve their health”. Health promotion is an efficient way to preserve health and wellness. Health promotion assists people in taking command of and better their health. The actions of health promotion are geared toward disease prevention and injury before it happens and also supports maximum health and quality of life for the individuals who are injured or living with a disability or illness. The population as a whole is regarded in health promotion. Health promotion is evidence based. Evidence base research increases our knowledge about root causes and factors that influence health and the best strategies for health promotion. The success of health promotion involves multiple sectors (school, workplace, and parishes) to participate. Evidence shows multiple strategies are the most effective with health promotion (Jackson et al 2006). ...
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...Levels of Health Promotion Health promotion is essential in keeping society and individuals healthy. Health promotion empowers communities and individuals for healthy living through education. The primary goal of health promotion is prevention. Nurses are key in health promotion and will be seen in diverse settings as health promotion evolves the nursing profession. There are three levels to health promotion that are utilized to optimize health. Definition of Health Promotion The World Organization (WHO) defines health promotion as “the process of enabling people to increase control over the health and its detriments, and thereby improve their health”. Health promotion is an efficient way to preserve health and wellness. Health promotion assists people in taking command of and better their health. The actions of health promotion are geared toward disease prevention and injury before it happens and also supports maximum health and quality of life for the individuals who are injured or living with a disability or illness. The population as a whole is regarded in health promotion. Health promotion is evidence based. Evidence base research increases our knowledge about root causes and factors that influence health and the best strategies for health promotion. The success of health promotion involves multiple sectors (school, workplace, and parishes) to participate. Evidence shows multiple strategies are the most effective with health promotion (Jackson et al 2006). ...
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...Integrated Approach to Care of Common Genitourinary Problems Student’s Name Institution Integrated Approach to Care of Common Genitourinary Problems This approach will incorporate techniques for care and treatment for the infected persons. Genitourinary infections are diseases that are caused by either virus, bacteria or even parasites that are transmitted during sexual association with an infected partner (Barlow, 2011). Efforts or attempts to develop a comprehensive approach to care for people with common genitourinary infections will have to analyze several features of the problem. The first characteristic of this problem is that there is a rapid increasing prevalence rate for people with genitourinary infections (Gross, 2011). The second aspect of this problem that will be included in the integrated approach is that. Genitourinary infections are not caused by bacteria alone, parasites and bacteria also cause these diseases too (Iannini, 2003). We also need to understand the risk factors associated with untreated genitourinary infections as most of these infections do not have symptoms during certain stages (Markos, 2003). The last characteristic of this problem to incorporate is the impact of genitourinary infections on costs and healthcare utilization. To develop an integrated approach to care for patients with common genitourinary infections, I formulated three elements for a comprehensive approach to addressing this problem. I identified them...
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...Comparing Jean Watson’s Theory of Human Caring And The Neuman Systems Model Jayanna Volm Concordia University Comparing Jean Watson’s Theory of Human Caring And The Neuman Systems Model Nursing frameworks and conceptual models are imperative as a foundation for nursing practice. These frameworks provide recognition, understanding, and the ability to manage phenomena in which nursing comes into contact. These frameworks also provide the nurse with a systematic approach to interventions and goal attainment. The purpose of this paper is to compare Neuman Systems Model to Jean Watson’s Theory of Human Caring. According to Alligood and Tomey the Neuman Systems Model is classified as a nursing conceptual model. “Nursing conceptual models are concepts and their relationships that specify a perspective from which to view phenomena specific to the discipline of nursing. Different conceptual models provide various perspectives or frameworks for thinking critically and making nursing decisions” (Alligood & Tomey, 2010, p. 223). The nursing conceptual models are comprehensive and define the metaparadigm according to their framework. Tourville and Ingalls categorize the Neuman Systems Model as a systems model. They define a systems model of nursing as viewing “the person as a multidimensional being who reacts continually to a world of stressors” (2003, Systems Model, para. 1). Systems may be organizations, communities, businesses, or social structures. Within the large...
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