Individualised Approaches to Health & Wellbeing
For the purpose of this essay, it will be explaining and exploring the systematic nursing diagnosis process and the nursing model that is used in conjunction with this. When using a systematic nursing diagnosis, this can aid a nurse in being able to identify a patient’s individual needs from a nursing perspective (Barrett et al, 2012). Systematic nursing diagnosis can help give the nurse direction and time to reflect on a patient’s individual needs (Barrett et al, 2012). There are several nursing models that are widely used within nursing practice, but for the purpose of this essay, it will be using Roper Logan and Tierney’s (R.L.T) model of nursing. Choosing a systematic framework enables nurses to provide a consistent and accurate care relating to the individual patient, this approach to creating care plans is the most widely used within Europe and the United Kingdoms nursing practice (Barrett et al, 2012). This essay will help to identify the strengths and weaknesses of the systematic nursing diagnosis, whilst using R.L.T nursing model of care, and by analysing a care plan created for a fictional patient who had being admitted to hospital with a chest infection and exacerbation of her C.O.P.D (chronic obstructive pulmonary disease) (see appendix 1).
Part of systematic nursing is to use assess, planning, implementation and evaluation (A.P.I.E). Aggleton and Chambers (2000) say that Yura and Walsh (1967) argued that nursing should involve a problem-solving process. Aggleton and Chambers (2000) say that A.P.I.E helps nurses to identify the causes of a patient’s problems, plan a solution to the problem, take steps to alleviate their issues and then be able to reflect on what has happened. Barrett et al (2012) say that systematic nursing diagnosis helps to offer a nurse direction and gives them quality time to reflect on a patient’s issues and develop a nursing diagnosis, but this is not to be confused with a medical diagnosis. Moving away from the medical model approach, it can help to recognise the patient as an individual and address their problems beyond the extent of their physical care and medical diagnosis to help give a more holistic approach (Brooker and Waugh, 2013). Aggleton and Chambers (2000) say that the nursing diagnosis is different from having a medical diagnosis, as it helps to place emphasis on the individual person as a whole, by looking at their health in relation to their environment and whole personal health and not just focusing on the patient’s illnesses or disease. Using RLT’s model of Activities of Living, along side APIE and using the systematic nursing diagnosis, helps a nurse to give the patient holistic care using the biopsychosocial approach.
ASSESSMENT: The assessment stage of APIE is a key stage in the assessment process. Having a comprehensive assessment is the first part of the nursing process and gives a solid foundation when giving individualised care, and making it person centred (Armstrong and Mitchell, 2008). During the first stage of the assessment, the nurse should gather all biographical information about the patient, then confirm with the patient that all their details are correct, also during this process the nurse will be able to collect a baseline of information about the patient’s present health to continue the assessment correctly (Brooker and Waugh, 2013). An effective assessment is able to give the nurse a view of the patient’s background, such as their family history, their next of kin, lifestyle, and the illness or injury that can be affecting them at that time (Dougherty et al, 2015). To be able to make an accurate assessment, is not an easy process. Using RLT’s AL’s alongside APIE, can encourage a nurse to use a systematic approach when assessing a patient as an individual, and can then take into account the patients, physical, psychological, social and emotional needs (Delves-Yates, 2015).