Evaluation Of An Integrated Care Pathway

The assessment process is the back bone to any package of care and it is vital that it is personal and appropriate to the individual concerned. Although studies have found that there is no singular theory or understanding as to what the purpose of assessment is, there are different approaches and forms of assessment carried out in health and social care. These different approaches can sometimes result in different outcomes.

This case study incorporates a common presentation seen by the nurse in clinical practice: community acquired pneumonia with a history of COPD causing an acute exacerbation. Principles of spiritual care are also naturally situated in

Nursing process is a systematic process that involves a continuous cycle of five interrelated phases: holistic assessment of a client, nursing diagnoses, nursing care planning, implementation, and evaluation (Wilkinson et al. 2015). It enables nurses to assess the person’s health status and health care needs, to create plans to meet the identified needs, and to provide and evaluate individualised nursing interventions according to the person’s needs (Luxford 2015). The holistic assessment is the first step of the nursing process that includes the collection of subjective and objective data related to the physical, psychological, social, developmental, cultural, and spiritual status of a client (Wilkinson et al. 2015). This comprehensive approach to nursing assessment is essential because it allows nurses to comprehend not only clients’ health status, but also their routines and needs in order to incorporate their life-styles into the care interventions (Luxford 2015). It ultimately enables nurses to provide appropriate quality person-centred care rather than nurse-initiated care (Luxford 2015). Responsibility for holistic nursing assessment is supported by the Registered nurse standards for practice (2016), ‘Standard 4.1: The registered nurse conducts assessments that are holistic as well as culturally appropriate’ (Nursing and Midwifery Board of Australia [NMBA] 2016, p. 4). This essay will discuss the elements and the importance of holistic assessment in nursing.

The aim of the essay is to demonstrate the process of a patient assessment and care plan formulation in accordance with the assignment instructions. It is based on a case study, which illustrates a patient who has a diagnosis of paranoid schizophrenia, the patient was admitted to a medium secure hospital unit, please see appendix for more details of the case study. The pseudonym Peter will be used to address the patient to maintain confidentiality as required by the Nursing and Midwifery Council(NMC,2008).Firstly the essay will explore the philosophies of CPA; Care Programme Approach and then demonstrate the assessment of a patient with an assessment tool and including the formulation of a care plan.A KGV assessment tool was utilized(Lancashire,1998).In addition,the essay will examine and analyse the strengths and limitations of principles and philosophies which underpin existing service models for instance biopsychosocial model which is applied in mental health care delivery.Subsuently the essay will demonstrate an in-depth analysis of holistic assessment principles within mental health care.Futhermore the essay will analyse collaborative working in relation to planning and

This assignment will explore and critically evaluate the role of the registered nurse in the development of a plan of care that is patient centred. This will involve examining and critically analysing the chosen nursing model in a holistic assessment of the patient and the use of the nursing framework ASPIRE (Barrett, Wilson and Wollands, 2012).

Assessment tools are used in the care planning process to build up a holistic picture of an individual’s needs. When all the details have been recorded an assessment can be made and suitable care and support can be identified. A few of the assessment tools are information from the individual such as diaries, observations, medical histories and checklists.

The policy of person-centred care has become a mainstay of efforts to reform health care in the UK. Government policy is now built around this core concept, a major aspect of which is enabling individuals to participate in decision-making about their care at every level. By concentrating on the individual’s wishes and aspirations and placing them at the centre of a ‘planning circle’ the care team can assist with goal setting to ensure their best interests are maintained and the individual’s preferences are considered.

A problem solving approach is a process of planning care for a patient (McFerran and Martin, 2003) using ASPIRE, based on APIE (Yura and Walsh, 1988); Assessment, Plan, Implementation and Evaluation. ASPIRE is a nursing process which includes six stages: assess, a systematic nursing diagnosis, plan, implement, recheck and evaluate (Barrett et al, 2012). Using a range of assessment tools, some potential risks can be identified although, these tools should be used as guidance for treatment and not used in the decision making process as to who and who does not receive treatment, (National Institute for Health and Care Excellence (NICE), 2011) but through gaining consent during each process, as it should be before any care or treatment (NMC, 2008).

There are many forms I use to assess an individual’s needs. The first bit of the information comes from Derby City Council, which is called a outcome based support assessment. This is what they use to identify someone’s needs and how much care they require. The information on this document is great for Derby City to use, but I also need to do my own and adapt it so it’s easier for a care worker to understand as they are the ones who will be doing the care. It’s important that I read this document before going out to do my own care plan as it gives me a bit of back

Assessment is the initial stage of the nursing process. Roper et al consistently use the term ‘assessing’ to signify that it is an on-going process, and highlights its continuity throughout the patient’s episode of care (Aggleton & Chalmers, 2000). It is divided into two stages to allow for a holistic representation of the patient to be established (Barrett et al, 2009). Effective assessment allows the prompt identification of any changes in a patient’s health status, and if necessary; allows any action to be carried out immediately supporting the delivery of safe, effective care DH (). The formulation of an accurate assessment is a fundamental skill for a student nurse as outlined by the NMC (2004), and so it is important that a holistic approach is adopted for this skill to be achieved. An holistic approach supports the consideration of……..needs,(THEME?) which

Within this case study I am going to use two of the Chapelhow et al. (2005) enablers to discuss and reflect on the care of a patient I have been involved with on placement over a period of 5 weeks. ‘Enablers are the essential and underpinning skills that come together to provide expert professional practice’ (Chapelhow, C et al. 2005, p.2). These include; assessment, communication, documentation, risk, professional decision making and managing uncertainty. The enablers work together to provide a holistic approach to the care of patients in health care settings. I am going to focus on and discuss two of the enablers, linking them both together, which will be assessment and communication as I believe these two enablers can be related most to my patient.

The first stage of the process is assessment. Roper et al (2001) refer to this process as ‘assessing’ indicating an ongoing activity; this encourages nurses to recognise the on-going nature of this initial phase. The assessing stage includes gathering information about a patient, reviewing this information, identifying actual and potential problems and prioritising (Roper et al 2001). Roper et al (2001) explain the importance for assessing, as early as possible in the patient’s stay. Extensive, in-depth information may not be gathered on an initial assessment, however any information obtained contributes towards individualised care (Roper et al 2001). Ambrose and Wittig (1998) explain that the initial assessment becomes a foundation for ongoing assessing and holistic care. Barrett, Wilson and Woollands (2009) concord with Roper et al and Wittig in that assessing is an ongoing process and elaborate on this explaining that assessment should not be confused with admission. They state “an admission tends to be a one-off process when you first meet the patient, whereas assessment carries on throughout your relationship with the patient” (pg22). Assessment enables the nurse and patient to identify actual and potential problems. Although, some problems can be directly related to biological needs, holistic needs must be considered, i.e. psychological state and cultural/social standing

The goal of this assignment is to define the diverse forms of integrated care and to provide evidence on their impact both on the patient and also the future of the registered nurse. An integrated care pathway contains many elements in order to make it function. There must be a clear declaration of the aims, objectives and key elements of care founded by evidence, the best practice available and a consideration of patient expectations. The records, 24-hour care and assessment of changes and outcomes must be monitored. The assistance of communication, good organisation of people’s roles and sequencing the actions of the relatives, multidisciplinary team, and most importantly the patients. For an integrated care pathway to be truly multidisciplinary, it should never be developed by one staff group. At the outset, all staff groups involved in the patient journey should be identified. A typical working group should include doctors, nurses and allied health professionals, with input from administrative and managerial staff where it is necessary. If the pathway exceeds boundaries of care, such as, discharging patients to services outside the hospital or healthcare setting, reps of these groups should be involved with their integrated care plan. It is the integration of health care, social care, and other external agencies such as voluntary groups and private sectors that impact on the patients care and health professional’s quality of care giving. It does not need all

This essay is based on the Case study of a patient named as Mrs Ford. It will be written as a logical account, adopting a problem solving approach to her care. She is elderly and has been admitted onto a medical ward in the hospital, following a stroke. This essay analyses the care that she will receive and focuses on the use of assessment tools in practice. Interventions will be put in place directly relating to the assessment feedback and in line with best practice.

Pneumonia is an illness of the lower respiratory tract in which the lungs become inflamed and congested and alveolar spaces are filled with fluid and cells-polymorphs and lymphocytes (Mandell L.A). It is an inflammatory condition of the lung and it is one of the most serious infections, causing two million deaths annually among the young and elderly. Pneumonia is the largest killer, accounting for 28% to 34% of all child deaths below five years of age in low-income countries and is an important cause of mortality in the elderly in high-income countries (Suárez).