Research-Based Practice with Families in Stress Pediatric nurse practitioners in primary health

Nurses often use the aspect of time as an excuse not to conduct a family interview, however, Wright and Leahey (2009) clearly demonstrate how integrating families into patient care does not have to consume a lot of time. Using the Calgary Family Assessment Model (CFAM) and Calgary Family Intervention Model (CFIM), a family interview can be organized and conducted in a less amount of time, and end in a greater understanding of the patient and family. The CFAM contains three major categories including structural, developmental, and functional, which can be used to assess a family or help them address a specific health issue (Wright & Leahey, 2009). The CFIM uses assessments focusing on strengths, meaning that it uses the strengths of each individual family member, and the unit as a whole to provide positive interventions. This allows the interventions to focus on encouraging the family, rather than their deficits or dysfunctions (Wright and Leahey, 2009). During the 15-minute interview, it is suggested to have the entire family present so that the interviewer is able note reactions and collaborate with each family member, thus providing the most acceptable plan of care for the entire family.

Family Assessment The family chosen for this assignment are family friends who agreed to conduct the interview and discuss any health issues they had. Because some of the questions were fairly invasive into their private lives, no names are given. There are five members in the family, and they all participated in the interview. Questions are based on the eleven functional health patterns.

Throughout my 17 years as a pediatric nurse practitioner, I have had the opportunity to work in a variety of settings including a primary care office, a mobile asthma unit, and an asthma specialist office. Each of these experiences has been stimulating, educational, and inspiring.

Since asthma exacerbations in adolescence can lead to emergency room visits, hospitalizations, missed school and diminished health status, there was an evident need for effective asthma management for this population (Quaranta et al., 2014). Unfortunately, these rural adolescents with asthma, and their families, had difficulty determining when their asthma was poorly controlled; and unless the asthma symptoms were disruptive to family life, there was often little motivation for these individuals to seek medical care, thus increasing the risk of poor outcomes (Quaranta et al., 2014, p. 99). According

The attempted strategies will be discussed in their chronological order. First, Evans and his colleagues conducted a study to improve asthma care for minority children (African-American and Latino) in New York City in pediatric clinics serving children from low SES families. The study chose New York City Bureau of Child Health clinics and trained its clinic staffs about National Asthma Education and Prevention Program guidelines to diagnosis, manage, screen, and identify asthma cases in children and provide health education for their families. The authors found that after 2 years of intervention and follow-up, there were improvements in access, continuity, and quality of asthma care provided by clinics with trained staffs. This study demonstrated that professional

Think back to when you were a child and you became ill. All you wanted was the protection and guidance of your mother to take care of you. If you had older siblings, maybe they were the ones that helped make you feel better. Even as we grow older, we rely on our family for support when we are not well. When a family member is ill, it is not just that one person that suffers. When an illness strikes a family member, it oftentimes includes the whole family to deal with the illness also. There are different approaches that a nurse can utilize when dealing with family nursing. Approaches include family as context, as a client, system and a component of society. In this paper, I will discuss where and how these approaches are utilized.

Although, towards the end (July/August) it became dismantled as a result of other projects Yale New Haven residency program adapted. However, open communication remains between the residents and Pediatric Chiefs and the program coordinator. The collaboration provided the pediatric residents and interns’ opportunity to acquire knowledge about Community Public Health Programs. With the primary goal of introducing the residents and interns to a broad range of public health programs they can refer their patients to. This system offered the residents, and interns an introduction to the connection of public health and medicine. With the end result demonstrating the importance of community agencies and medical providers need to partner to address the burden of asthma. The Region had 5 residents/interns come through this reporting period, The residents have reported that given this opportunity to see first-hand how the program works, whether within the home or through individual discussion, that it has helped in aiding to understand the challenges families face as they strive to manage the asthmatic’s symptoms. Furthermore, they describe a broader understanding of the various environmental obstacles families are confronted when managing their asthma. For

The purpose of this paper is to display how such assessment is essential not on an individual basis, but rather on a larger scale in relation to family nursing. Family nursing “centers on the family as a unit of care, addressing family needs in response to a member’s illness or threat to health, rather than focusing on the individual. An understanding of families’ needs at particular developmental stages, how they communicate and function, and an ability to undertake a family assessment is foundational knowledge for family nursing” (St John, 2009, p.6). Often, nurses encounter the families of their individual patients on a daily basis, yet family assessments are not performed. This is because nurses often feel there is little time to engage families effectively, and in fact lack of time, has been identified by nurses as the primary barrier to engaging families (Kaakinen, 2015, p.109). Evidence based practice however, has proven that “a 15 minute, or even shorter, family interview can be purposeful, effective, informative, and even healing” (Wright, 2013, p.264). This 15 minute interview has been adopted in many acute care settings in involves five key components; manners, therapeutic conversation, key questions, commendation, and the genogram. These ideas represent the theoretical underpinning and are a condensed version of the Calgary Family Assessment Model (Wright, 2013). This model is large, but can be customized and adapted to the function of each individual

Asthma triggers and response to medications does not affect individuals in the same ways. Moreover it is not always simple to manage due to its affectability on people on age, sex and ethnic background (Cockett,2003). However, specialist nurse can achieve a successful outcome by ensuring that management plans are tailored to suit each patients/clients needs.

Moreover, the family understands the specifics about the individual's condition and their daily routines. This can help health care professionals to decide if the person is following the proper steps in their therapy. Once this takes place, is the point that health care professionals can make adjustments to reflect changing realities. Those patients, who have their families involved, will be able to receive better care by ensuring that nothing is overlooked. This is the point that physicians will have a more complete picture surrounding their underlying levels of health. (Saleeba, 2009)

The child I helped take care of was a 15-year-old adolescent male. He was brought into the hospital due to an asthma attack. According to his mom, he has had asthma for years and sometimes has more severe attacks causing him to come into the hospital. Throughout this paper, this child’s developmental stages and medical diagnosis will be discussed.

Asthma is a chronic inflammatory disorder of the airways that lead to difficulties in respiration (Kaufman & Kent 2015). It occurs when airways are over-sensitive and easily respond to a variety of intrinsic and extrinsic stimuli such as allergens, smoke, stress, emotions, medication, weather, exercise, and colds or the flu (Kaufman & Kent 2015). These triggers can offset common asthma symptoms including coughing, wheezing, chest tightness, and shortness of breath (Kaufman & Kent 2015). The type of trigger, severity, and timing of an asthma attack is unpredictable and different for everyone. In the case study, Joseph has had episodes of acute exacerbation reducing in severity in the early phases but has not experienced an attack for the last

Respiratory system assessment is the process of evaluating the functioning and condition of a patient’s respiratory system. During assessment of the respiratory system, the nurse takes the patient’s history and perform a physical examination on the patient. The nurse takes the patients data which include personal history, family history, history of current and past respiratory problem, allergy history or reactions to certain drugs, foods, allergens etc., and occupational history. The nurse also objective data of the patient, these data will help her to know the respiratory condition of the patient and factors that predisposes the patient to respiratory problems. The nurse also conducts a physical examination which include inspection, palpation, percussion and auscultation. Findings from the physical examination will help her in making diagnosis and to plan adequate nursing care.

As children grow, so does their need to develop a feeling of self-worth and a sense of self when compared to other children in physical appearance, academics, athletics, and social interactions (Ball et al., 2015, p.208). The effects of asthma can play a direct role on how the child develops in these areas. Factors that affect asthma are being exposed to triggers and the medication management. The child is dependent on parents’ for initial management education of asthma treatment (Silva-Mendez & Barros, 2013, p.1002). The parents’ beliefs about the adherence of medications have shown to have an influence on the child receiving the medication as prescribed (Yilmaz et al., 2012, p. 285). Parents most common concerns were about the amount of medication and the possible long-term effects (Gilchrist et al., 2012, pp.553-554). Often parents’ are aware of their child’s asthma problems but seem hesitant or unwilling to voice their concerns to a physician (Orrell-Valente, Jarlsberg, Rait, Thyne, Rubash, & Cabana, 2007, p.388). The inability to communicate with the physician can leave the parent with a lack of knowledge and preconceived notions: “The lack of knowledge about asthma has been associated with decreased adherence to prescribed treatment plans” (Silva-Mendez & Barros, 2013, p.1003). When inhaled medications are not adhered to, children with asthma have an increased rate of exacerbation (Yilmaz et al., 2012, p. 282).

Nurses are a vital component in patient care. The importance of conducting efficient nursing assessments is critical in order to provide both patient-centered care and safe, effective patient healing. Nurses are often responsible for taking care of patients with very complex disease processes. They frequently provide care to patients with illnesses such as Chronic Obstructive Pulmonary Disease (COPD). According to the Centers for Disease Control and Prevention, in 2014, approximately 6.8 million adults were diagnosed with COPD within the Unites States. The completion of proper assessments and initiation of interventions for these patients are crucial in order to prevent further complications of the illness.