Maximising Health Using the Nursing Process In conclusion, this systematic cyclical approach to care has proved to be beneficial to Mrs Florence Nightingale
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Maximising Health To protect the resident's identity, the resident will be called Mrs Florence Nightingale. Mrs Florence Nightingale has been selected to demonstrate how to maximize health using the nursing process. She is a 77 year's old elderly resident in a private up-market nursing home in an EMI unit, who's unable to self mobilize and is dependent upon a hoist for transferring. She is unable to verbally communicate, or feed her self. Due to her restricted mouth movement, difficulty with swallowing and fear of choking she is only fed in liquid form, which is thickened. She suffers from multiple disorders such as Alzheimer's, CVA (stroke) and is doubly incontinent. Issues focusing on sustenance intake and surrounding issues will be explored in order to maximize the health of Mrs Florence Nightingale. Issues include psychological and social impacts of eating alone, ensuring adequate nutritional intake and adequate mouth care. Through the nursing process the patient's perspective of health is identified in order maximize the patient's health. The nursing process is an organised, systematic and cyclical method of giving goal oriented, humanistic care to patients that's both effective and efficient (Alfaro-LeFevre, R. 1994), it is often supported by nursing models such as Roper, Logan and Tierney model for nursing, based on activities of living and Maslow's Hierarchy of Human Needs etc. It consists of five sequential and interrelated steps - Assessment, Diagnosis, Planning, Implementation and Evaluation - during which you perform deliberate activities designed to maximize long-term results (Alfaro-LeFevre, R. 1994). In the UK the diagnosis stage of the process is omitted, although UK nurses determine a patient's needs or problems, they are not widely regarded as "diagnoses" (Wikipedia 2006). This systematic approach to care is cyclical in nature and can end at any stage if the problem is solved.
Document the amount given and time given. Document signs of dehydration. 4) Prevent oesophageal reflux. Mrs Florence Nightingale should be sat upright throughout the giving of feed to prevent her from choking etc. 5) To develop Mrs Florence Nightingale swallowing abilities. Place 5-10 mls of custard/yoghurt on Mrs Florence Nightingale lips every lunchtime and allow tasting and swallowing, as directed by speech therapist. In relation to goal 2, it is paramount to adhere to infection control policies to minimise the risk of cross infection to the patients. If, area around mouth becomes infected, a reddening of the skin would indicate the infection. This is the body's way of maintaining its own safe environment. The reddening is a rush of blood, containing lots of white blood cells, to the site of infection to begin the fight against the infection (Roper et al 1996). There are methods the nurse can take to maintain a safe environment. Regarding Mrs Florence Nightingale these methods include ensuring all of the multidisciplinary team are fully trained and are up to date with the latest procedure, as well, using equipment properly and adhering to health and safety guidelines and legislation. Also by taking simple measures such as ensuring all hazards are dealt with, e.g. loose carpeting is secured. These six goals are relating to biological aspects of having not being able to feed one self. However, it is important to look at the social and psychological aspects as well as the biological. It has been discovered that Mrs Florence Nightingale was quite a social person and enjoyed spending time with other people. As Mrs Florence Nightingale no longer eats a meal, she is missing out on the social aspect of spending time with other people eating meals.
If the goal has been met then it can be removed from the care plan. If the goal has not been met, the nurse has to establish a reason why. This is the secondary stage of evaluation. At this point the nurse will look closely at the goal. Maybe the goal isn't realistic or measurable. If this is apparent, then new appropriate goals will have to be set. The nursing interventions might not be successful in meeting the goal, if so, new interventions should be set. The patient might not be co-operating with the care plan, therefore not meeting the goals. This situation demands the division of new goals and interventions. The setting of new goals and interventions leads the nurse back to the beginning of the nursing process, and the whole cycle starts again. It is at this evaluative stage that the nurse can look at the effectiveness of the care plan. The goals mentioned in this essay were evaluated three weeks after they were initially established. The goals were evaluated at three weeks because there were concerns about Mrs Florence Nightingale general health. All of the goals were found to be successful in maximising the health of Mrs Florence Nightingale and none of the goals were changed or removed. Throughout the three weeks Mrs Florence Nightingale has maintained adequate levels of nutrition and hydration, showing no signs of malnutrition or dehydration. Also, her mouth has remained in good health, sustaining no problems. Through discussions with Mrs Florence Nightingale multi-disciplinary care team, it was agreed that the care plan was successful and should remain unchanged. In conclusion, this systematic cyclical approach to care has proved to be beneficial to the Mrs Florence Nightingale. The care delivered to Mrs Florence Nightingale has achieved its aim as it has maximised her health.
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