Nursing Assessmen Assessment

However, only 10% of nurses actually complete accurate inspections of the skin during their initial physical assessments of the patients (Lahmann et al., 2010). As a result, patients who are at risk of developing pressure ulcers are often overlooked by nursing staff.

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.

I am pleased to state that I have been a registered nurse for forty years. At this moment, I continue working in nursing while pursuing my Bachelor of Science in Nursing degree. My intended month of completion is October 2012. My experience in nursing education has motivated me to continue my education and pursue a Masters degree in a nursing related field commencing in 2013. Thus, in terms of my career planning, my education is a crucial part to my professional development. Extending and deepening one's education, especially within the career field of one's choice, can only bring upon additional professional opportunities as well as opportunities for personal growth. My career planning includes building upon my decades of experience in obstetrics, my particular area of specialty, expertise, and passion, with the assistance and addition of higher education. I believe in terms of career planning, my strengths include foresight, preparation, internal motivation, and focus.

Nurses need to realise what they are looking for when performing skin assessments for patients. A study conducted by Thoroddsen et al (2013), found that out of 45 patients that had pressure ulcers only 27 were correctly recorded in the patient’s records.

An interdisciplinary team of professional staff is a necessity to overcome the issue of pressure ulcer development among patients. Relevant stakeholders would include a nurse, nurse aide, dietitian, and a hospitalist. The primary responsibilities of the nurse consist of completing and documenting skin and risk assessments, monitor progress and/or changes in medical/skin conditions, report patient problems to the hospitalist, and work with the wound team

While University Hospital is already on the brink of completely preventing pressure ulcers I would still recommend implementing all of the current practices but also add new additions to the team. Currently, we have a wound care team that diligently treats at risk and affected patients. Adding a nutritionist into the team to guarantee treatment from within along with prescribed medications. This will make the team and the strategies multidisciplinary. In addition to that, each treatment should be customized for each patient in regards to cost options and best treatment for their health. The project would also have to be performed repetitively without error to ensure that it is actually helpful. Patients’ skin should continue to be examined thoroughly in common places where ulcers could arise, the standardized pressure ulcer risk assessment should be used, and the proper care should be distributed once evaluated. The team should continue to record its progress and also provide company update emails to inform the facility, as well as send the appropriate data to the higher ups for public posting.

This piece of work will be based on the pre-assessment process that patients go through on arrival to an endoscopy unit in which I was placed in during my second year studying Adult diploma Nursing. I will explore one patient’s holistic needs, identifying the priorities of care that the patient requires; I will then highlight a particular priority and give a rational behind this. During an admission I completed under the supervision of my mentor I was pre-assessing a 37 year old lady who had arrived to the unit for an upper gastrointestinal endoscopy. During the pre-assessment it was important that a holistic assessment is performed as every patient is an individual with unique care needs as the patient outline in this piece of work has

Pressure ulcers are a good way for the BSN prepared nurse to teach and educate RNs with an associate degree or diploma and other healthcare staff involved in patient care. This can be accomplished by introducing evidence-based practice information to them. They can be taught how to use to the Braden Scale effectively. They can teach others how to correctly stage and document pressure ulcers. Another important factor is stressing the importance of positioning, pressure-relieving devices, skin care and protection, and nutrition (Agency for Healthcare, 2009).

King’s Theory of Goal Attainment was proposed in the 1960s and published in 1981. It was derived from her conceptual system which presented in 1968, and incorporates the concept of self, perception, growth, development, time, interaction, communication, role, and coping. The Theory of Goal Attainment is a practice methodology based on the nurse and patient setting goals together, and the nurse assisting the patient to meet these goals they set for their health (Caceres, 2015). These interactions between the nurse and patient are the process in which the professional relationship develops, mutual goals are set, and actions are planned to achieve these goals. It is an interaction-transaction process and is based on the nursing

According to the Agency for Healthcare Research and Quality (AHRQ), 2.5 million patients are affected by pressure ulcers and incur costs anywhere from $9.1 billion to $11.6 billion per year in the United States (AHRQ, 2014). As of October 1, 2008, the Centers for Medicare and Medicaid Services (CMS) will not reimburse hospitals for cases in which the pressure ulcer was acquired after admission (CMS, 2008). Because of this high cost, the number of patients affected each year, and insurances no longer reimbursing hospital acquired pressure ulcers (HAPU), an accurate skin assessment upon admission is critical to reduce costs, ease pain in patients, and lower incidences of pressure ulcers. This paper will address what leadership and management skills and functions are required of a wound care nurse who identifies a problem with the accuracy of skin assessments on newly admitted patients.

Summary: The patient was involved in a motorcycle accident in which his bike fell onto and injured his left leg. When the nurses assessing the patient could not detect a pulse in that leg, an ominous sign of circulatory failure. The physician when notified chose to dismiss this fact and discharge the patient. The patient would return soon after with worsening symptoms that would require emergency surgery. Should the nurses have initially pressed for further action, treatment?

Lily was a 65 year old lady with stage 5 CKD, she had recently begun hemodialysis treatment three times a week as an inpatient and had been responding well to treatment. During dialysis treatment on the morning of the first day, Lily’s observations showed that she was: tachycardic, hypotensive, tachypnoeaic, had an oxygen saturation level of 88% and was becoming confused and drowsy. It became apparent that Lily had become hypovolaemic. The hypovolaemic shock seen in this patient was of a particular critical nature due to the fact that her dialysis treatment had moved her rapidly through the first two stages of shock with her compensatory mechanisms failing very quickly (Tait, 2012). It was also much harder to identify the early signs of

We must view the patient holistically and want to help them achieve their health goals. By keeping King’s theory in the back of our minds, we can be sure to include all parts in our assessments. Personal, Interpersonal and Social systems are what makes a person, whole. Everything around us affects us. By forming a quality committee, we are able to assess the patient through each of these concepts and use our findings to better create plans of care to help reach quality outcomes. Ultimately, the patient and the nurse work together to form a relationship, and it is through that relationship that trust is built, goals are achieved, and outcomes are obtained. This is patient care. This is nursing.

Prevention and management of pressure ulcer is of significant worry in health acre system. The appropriate nurses knowledge of wound care help in prevention srtetgy. The prevention and treatment techinques that mostly to assess the nurses' knowledge about pressure sores and effect on practical decision amking skills and uses of different devices.The

For the purposes of this discussion, I have selected King’s Theory of Goal Attainment and Peplau’s Theory of Interpersonal Relations. On a broad perspective, both theories aim at explaining the interaction processes that happen between a nurse and her patient. Imogene King’s basic assumption of her theory is that the nurse and the client communicate information, set goals mutually, and act to attain those goals. The same can actually be said with Peplau’s theory wherein she states that nursing is an