|Categories:||Nursing Nursing management|
Nursing assessment is a crucial component of the nursing process. It creates a leeway for a caregiver to understand their patient. Nursing practice defines this as the process of information gathering on a person's physiological, sociological, psychic as well as spiritual state for the purpose of adequate treatment at a healthcare facility. It can also be defined as the systemic and continuous collection substantiation organization and documentation of a patients health and compare it to typical norms (Radhakrishnan). Nursing assessment is a continuous process throughout the various stages of nursing. A number of patient interviews and observations are made, consideration of the signs and symptoms they are exhibiting is done, verbal and non-verbal cues from the patient are obtained and assessment of vital signs and physical wellbeing is conducted. It also focuses its attention to the cultural and social ties the individual identifies with. These include race, occupation and religion among other things. The most important aim of the evaluation is to create a large scope for the scientific analysis of the patient in the making of an all-inclusive care plan. Thus making every single intervention that is put forth is most credible and also befitting to the circumstances. This paper is a two-base project on nursing care.
The basis of patient treatment is the same, but there are variations based on the uniqueness of each situation. Persons who have learning disabilities attract the same kind of help as any other patient. Nonetheless, the caregiver must factor in some of the learning limitations in their treatment for effectiveness. In a bid to make the assessment process easier and more definitive for both the patient and the caregiver, several models have been developed. One of these models is the eclectic model of reflective and evidence-based care by Moulster and Griffiths (Ames). This method which combines several aspects that were previously in use has created a good base for the assessment of patient care. They include: Orems self-care model, the tidal model, an ecology of health model as well as the patient-centered nursing care model. It advocates there is no singular model that is adequately sufficient to cater to the needs of both patients and nurses effectively. It is additionally embedded on the key elements of being person-focused, evidence-centered, and outcome-attentive and reflective (Radhakrishnan).
Clinical governance has since improved following the implementation of the eclectic model that is reflective and evidence-based. It enables health organizations become continuously accountable for improving the quality of the services they provide this is in addition to safeguarding the interest of those whom they serve by affording very high standards of care. The person based care individual are given allows for them to be treated with best practice use and this means that in addition to their individual care being top notch the services they get are of good standards. The overall effect is thus improvement of health standards (Ames)
The combination of various models into one gives the eclectic model the advantageous use. It combines various useful techniques that create a hybrid that is better than each of them being applied singularly. This creates a best practice mechanism, which not only benefits the patient but also the care giver. The nurse gets comprehensive and verifiable assessment from the patients using an application of the eclectic methods and therefore caters for the patient as they rightfully deserve. The patient on the other is presented with an environment where they can get better and can be treated in a dignified manner, characteristic of the specialized care they receive (Davis).
The use of the eclectic model has seen outcomes becoming easier to measure as compared to previously used models. From the nurses diagnosis of the patient, they are able to create a profile that puts a spotlight on the needs of the patient in their entirety. The expected results that are at that point set are practical. They reflect the efforts of the caregiver at the time of the intervention basing on a scheme of evidence-based practice. More so, they are clear and concise to avoid any misrepresentation of expectations. They are bound within time limits and this dispels any vagueness. Furthermore, this eclectic approach allows these goals to be set by both the patient and the nurse. This inclusiveness allows a higher probability of realization of the stipulated objectives. As a result, it creates a way to identify hurdles in goal attainment and the contingency measures to be taken in case of deviations.
In addition to the eclectic approach increasing the measurability of outcomes, it also stages a better platform to measure the effectiveness of these strategies. The use of this model reduces confusion of role boundaries for nurses, avoiding the occurrence of never events in the course of caregiving. In their line of work the interaction between nurses and patients creates a certain amount of emotional attachments. They may at times feel obliged to keep patients in for longer times in anticipation of their conditions changing in the future. The setting of valid goals in relation to the care timelines and various interventions defuses these concerns. The nurses are able to establish meaningful insight on timelines and expected results in their care plans. These pre-determined outcomes to be attained create a control to measure how well the nursing regimen accorded to the patient has worked. This in the long run reduces their caseloads and promotes accountable care practices.
It as well avoids an approach where all members with disability are put into one particular group or class. All visible variations that are observable and deducible from a patient are taken into consideration. Patients are not treated as one homogenous group. It would be unfair to treat an individual suffering from autism the same as somebody with kyphosis. Their individual based treatment is bound to be more beneficial than if treated uniformly. It strongly concentrates on what the patient needs and all resolutions are developed with the pointers that are received from the patient. This ensures that the care they receive is specialized for them exclusively while also aligned to top care giving principles.
Regardless, there have been some shortcomings with the use of this model. It being a hybrid model creates a number of challenges. One it is difficult to find an appropriate strategy mix that is agreeable to every stake holder. There may be disparity in the identification of strategies to incorporate. For instance, in violent individuals, it may be difficult to decide which intervention may be best suited to get them back on track. While one professional may want to use psychodynamic another may have preference to cognitive behavior therapy. Additionally, this may result in taking lengthy times to develop and implement such a model which may be detrimental to the patients health.
The mixology of elements incorporated in this model may sometimes be complicated even for the most intelligent of individuals. It is known that many workers in the medical field have high levels of training but this may not cushion them from making mistakes. The use of the Moulster model has been recently gathering steam. Just as it was noted during the piloting of this regimen, many nurses did not have the appropriate know how to fully exploit this model and this hampered with its utility.
Despite its numerous challenges, the Moulster model is applicable for the Alan case. This is because any intervention should be centered on him. They should look at Alan holistically and try to find out what has triggered his recent behavioral flare up. His record shows an individual who has been physically active and happy in this facility for more than fifteen years up until recently. Furthermore, his behavior has moved from attacking the staff to even hitting his roommates. The eclectic model of reflective and personal care nursing would provide an in-depth analysis of his person. First looking at his conditions and what changes he has made in the recent past and the effects that his actions have had on others. The various modus operandi that the staff has used to mediate his habits and why they have failed can be scrutinized. They could also find out the triggers of this behavior. This approach may give a lee way to also understand his physical health and whether his condition is being aggravated or he may be coming down with something else. (Gulanick)The assessment made by the nurse may be blind sighted and not be suitable for the needs Alan has at the time. It foci is more on the environment that surrounds Alan over Alan himself. The nurse gives off an impression of being retired and does not at all mention Alan and how he can be made better in any way. He attributes his behavior to attention seeking while not trying to understand the possible triggers of the behavior. The recommendation to shove him over onto the next team is only a transfer of the problem and not a solution by any means. His needs are not satisfactorily stipulated due to the lack of sufficient responsiveness of the staffers to his desires. The summative assessment is biased towards one factor and this could be detrimental. However an appropriate intervention may work to remedy the state of affairs for both the patient and the nurse.
An intervention refers to the treatment and actions that a nurse gives to their patient in order to help them attain the goals that have been set for them. (Patients)The mediations used on a patient play major role in how effective they will be receptive to treatment and more so the overall effect it will have on not only the individual but the care giver and their family members. Interventions are based on not only the assessments that have already been made but also those that are emerging. It is also not worthy that these individual may be prone to maltreatment and harassment both in the social settings and also in care homes.
Behavioral change is one of the factors that affect the kind of intervention that may be used on a person with learning disabilities. Some individuals may become erratic aggressive or even violent. While the possible triggers for these problems may not be immediately identified, it is necessary to put in place interventions to protect the person and those around him. These interventions must focus on the individual. Attention must be on the patient and they must feel supported in the undertaking of the intervention. The individual must also be involved in the assessment of what intervention is suitable. It is also helpful for the individuals family to be involved too. This creates a platform under which the patient can be supported. Consequently, the application of the intervention must be parallel to the severity, rate of recurrence and interval of the behavior. Patients should only receive intervention up till when the threat has been neutralized. Any point beyond this may create more problems than a positive result. (Davis) On the other hand, factors that are triggering the behavior must be looked into. The past and present personal, social and environmental aspects must be critically assessed. This may help create patterns and the things that reinforces of this behavior. Additionally, the caregiver may assess the patient over time and observe any changes. More so they ought to know when to step up the intervention and when it would be prudent to gradually reduce it. Given Allan Bakungas case, a person centered approach would be an appropriate approach for him. His recent changes in demeanor indicate a possibl...
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