'An Exploration of a Needs Orientated Approach to Care Planning Essay\r'

'The think of this grant is to explore a require orientated barbel to keeping envisionning, through the hire of a trouble answer antenna to conduct, and a cargon for standard. It aims to show an spirit of what both a problem resolve come to commission, and a nurse stupefy ar; and to establish how various divulge elements of both are implemented in practice.\r\nThe following citation by the division of Health (DH) (2009) identifies what is intended by the attend of anguish intend; Personalised shell out excogitationning is essentiall(a)y intimately addressing an soul’s full consort of require, pickings into eyeshade their health, personal, social, economic, educational, mental health, ethnic and ethnic background and circumstances. In order for the care planning treat to be effective the need for both a problem work progress to care and a treat model is fundamental.\r\nThe problem figure out approach which go out be discussed indoors this fitting follows the fix up of Assess, Plan, Implementation and paygrade (often referred to as APIE) essential by theorists; Yura and Walsh in 1967. APIE offers a structured, systematic approach to care for practice through the manipulation of the methodical care planning pegs highlighted above (Barrett et al, 2009).\r\nNevertheless, encompassing literature research suggests that this process lacked authorization in meeting the holistic take of the individual and so, the process was adapted to imply two further acquaints known as; Systematic care for Diagnosis and Recheck to mystify the acronym ASPIRE (REF). However, these amended stages will not be discussed widely at bottom this assignment, and so the process of APIE will be referred to throughout. The nursing model developed by Roper, Logan and Tierney (RLT) in 2000, is nonpareil of several extensively criticised models ordinarily lend oneselfd in practice; to change the facilitation of a holistic appro ach to care.\r\nThe purpose of a nursing model is specify by Barrett et al as; Models go for direction to the nurse about the uncomplainings and their needfully and define nursing roles derived from the views, beliefs and values about people, health, the environment and nursing (Barrett et al, 2009 p. 42). As introductoryly identified, RLT are keen to adopt an holistic approach to care as diverseiate to other(a) models which only take into account a unhurried roles needs from a medical examination perspective.\r\nThe RLT model has been acknowledged to invent the authorized realities of healthcare within the United soil (Barrett et al, 2009), consisting of five underlying concepts; Activities of Living, Lifespan, Independence-dependence continuum, factors influencing AL’s and individuality which (Roper et al, 2000) clearly state of matter are connectd with one another to emphasise the importance of holism. Pearson et al, along with m either other nursing auth ors, highlight the signifi plunderce of agreeing on a nursing model to be apply together with the problem solving approach to develop an individualised care plan efficiently.\r\nPearson et al (2005 p. 84) indefinitely state; ‘the ‘process’ cannot happen without an agreement on nursing’ as, whilst APIE provides the systematic framework as to how the care plan should be devised, the nursing model effectively identifies what should be asked at apiece individual stage (REF). The munificent College of care for (RCN) in like manner supports the utilisation of a nursing model alongside a problem solving approach, in identifying that; It facilitates consistent, evidenced-based nursing care, and necessitates accurate, up-to-date care documentation (RCN, 2011).\r\nThis assignment will withal discuss how the RLT model and the problem solving approach are used to meet the biopsyhosocial needs of an individual, and also the strengths and limitations of using R LT’s model and a problem solving approach in relation to developing a care plan. An exploration of how the implementation of the RLT model and a problem solving approach tolerates the multidisciplinary teams (MDT) to use the approach to meet public health needs, will also be explored within this assignment.\r\nTo support such discussions, a range of knowledge gained throughout this module and previous programme themes, as well as a moldable care plan developed for a fictional patient known as Mabel Dunn ( play appendix A); will be utilised effectually. Through the exploration of each stage of the problem solving approach in turn, and how RLT is utilised alongside this process, enables an extensive in depth abridgment to take place whilst using the changeive care plan as meditative material to support the discussion. Assessment is the sign stage of the nursing process.\r\nRoper et al consistently use the term ‘assessing’ to advert that it is an on-going pro cess, and highlights its continuity throughout the patient’s episode of care (Aggleton & international ampere; Chalmers, 2000). It is shared out into two stages to allow for a holistic representation of the patient to be conventional (Barrett et al, 2009). Effective judging allows the prompt naming of any changes in a patient’s health status, and if necessary; allows any action to be carried out at a time supporting the delivery of safe, effective care DH ().\r\nThe formulation of an accurate assessment is a fundamental aptitude for a scholar nurse as outlined by the NMC (2004), and so it is classical that a holistic approach is adopted for this skill to be achieved. An holistic approach supports the consideration of…….. needs,(THEME? ) which Pearson et al (2005) punctuates that without the holistic consideration of a patient’s needs; it could twist to an faulty representation of the individual.\r\nRLT portrayed their understanding of a ho listic approach through the use of the 12 Activities of Daily Living (ADL’s); as they believe a patient is better understood in terms of how they assoil out the ADL’s (Holland et al, 2003). The 12 actvities (AL) of day-to-day living act as a framework in the assessment process by providing a means of categorising the knowledge in a systematic format (ppt presentation). Barrett et al (2009, p. 45) clarifies; Each activity represents a particular type of behaviour that all of us carry out on a day to day hindquarters, whilst interacting with each other and our environment.\r\nThe idea surrounding the ADL’s was derived from the Human Hierarchy of Needs developed by psychologist Abraham Maslow in (), by oblation a representation of the common elements of insouciant living that ensure human survival, and also quality of life (Barrett et al, 2009/pearson?? ). Despite the chief(prenominal) focus of RLT’s model been holism, it has been extensively critici sed in meeting the holistic needs of patients in the past, as practitioners dedicate used the ADL’s in a checklist format (Barrett et al, 2009) even though the use of the ADL’s has been stressed to be used in a broad format, to enable a comprehensive assessment to be want effectively.\r\nThis could potentially cause further complications…. It is for this apprehension as to why the proficient skill of assessment is fundamental before nice a competent practitioner as, without a comprehensive assessment the patients’ needs will not be considered from a holistic perspective, and consequently the model will not be used for its principal purpose. Holland et al (2003) highlight that the 12 ADL’s can interrelate in many different ways and then potentially uphold on one another back up an holistic account of an individual’s needs.\r\nAs a practitioner it is important to understand that the ADL’s can interrelate with one another and there fore baffle on each other http://www. dh. gov. uk/en/Healthcare/Longtermconditions/DH_093359 (DOH, 2009) . A holistic approach supports that only taking into consideration the individuals corporeal needs during assessment as contravene to the human being as a whole; could potentially lead to an outside representation of the individual and therefore lead to difficulties in meeting the patients’ needs effectively (Pearson et al, 2005).\r\nThe quality of assessment will be greatly enhanced by the enfolding of the knob and carers to the assessment process ensuring that the client’s wishes are foremost and, wherever possible, the client’s own terminology are used to reflect their needs RCN It also decreases the potential for, or the rigourousness of, chronic conditions and helps the individual to gain realize over their health through self-care.\r\nRCN The Nursing and Midwifery Council (NMC) emphasise the importance of the great power to effectively assess , plan, implement and evaluate care, forming the basis for the standards of proficiency as a student nurse (NMC, 2004). The concept of individuality is eer emphasised by theorists as been of import in the implementation of holistic care, and therefore stress the importance of taking a patient centred approach to care planning which will be discussed at a later stage within this assignment.\r\nNurses cast a major role in promoting health and well-being, as well as preventing disease and Roper et al see this as been an essential factor in the model for nursing (Roper et al 2000, p. 102) cited in (Holland et al, 2003) As previously stated, the stages of APIE interrelate in a cyclical context to allow for the establishment of a holistic, needs orientated approach to care delivery. The next stage known as Systematic Nursing Diagnosis was adapted due to criticisms of the approach lacking the concept of holism; one of the main focuses of the RLT model of nursing.\r\nBarrett et al (2009) accentuate how a nursing diagnosis differs from that of a medical diagnosis by establishing that; it places emphasis on a patients holistic needs, and so takes into consideration the physical, psychological, social and spiritual inferences of having a specific medical diagnosis. Hesook (2010, p. 200) also supports this control in that; ‘health problems that are the referents of nursing diagnosis have been conceptualised from nursing perspectives in a variety of ways. Systematic nursing diagnosis can therefore be used resourcefully with RLT’s nursing model by allowing the nurse to reflect on the assessment stage at a time carried out, before beginning the planning stage to clarify the problems highlighted within the previous stage.\r\nHogston & Marjoram (2006) acknowledged the fact that the pilot film nursing process; APIE discussed in this assignment lacks this stage, arguing that the nurse does not have time to reflect on the assessment stage of the problem sol ving approach which affects the thoroughness of the care planning approach which could potentially lead to…. ??? look at a limitation of SND… ADD example of Mabel Dunn… provision Planning is the second stage of APIE and is also a multistage process which Barrett et al (2009) consider to involve the development of the care plan itself; based on information collect within the former two stages. fit to Within this stage, the nurse is accountable for view appropriate goals and prescribing the relevant care to a patient to meet their holistic needs.\r\n'