Carry out an assessment of a patient and present a plan of care of a specific problem that the patient has encountered.

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The purpose of this essay is to carry out an assessment of a patient and present a plan of care of a specific problem that the patient has encountered. The model chosen to guide the care plan is the Roper, Logan and Tierney's 'Elements of Nursing'. This will enable me to develop my skills in assessment, problem-solving and planning care.

I will describe and explain the nursing model and provide an rationale for my choice. An overview of the assessment process will be given followed by an introduction and history of the chosen patient. An assessment of the patient will be carried out using the model to identify any problems the patient may have or encounter. Then a plan of care will be detailed relating to a specific problem identified in the assessment. Finally, I will reflect on the process of carrying out a care plan and discuss the nurse/patient relationship.


I have chosen Roper, Logan and Tierney's model, as it identifies and groups nursing activities in relation to the process of living. The model believes individuals carry out a series of daily activities that are fundamental to normal functioning. The philosophy of care is based on living, not illness. (Walsh 1999). The model views individuals holistically and shows awareness of cultural environmental, political and economical factors. (Roper et al 1996). It emphasises on prevention and helps patients with problems relating to activities of living. The model consists of two parts, 'A Model for Living' and 'A Model for Nursing'. The Model for Living has five interrelated elements, twelve activities of living lifespan, independence-dependence continuum, influencing factors and individuality. (Roper et al 2001).

The activities are based on the idea of basic human needs and can be used as the criteria for assessment. (Roper et al 1996). Lifespan influences the individual's behaviour in each activity of living, as each person has a lifespan from birth to death such as childhood and adolescence. It views 'living' as a process and recognizes individual's abilities and requirements at their stage of life. (Roper et al 2001). The dependence-independence continuum identifies the patient's status, as it is subject to change during illness and incapacity. Dependence is assessed at each activity acknowledging need for nursing intervention. (Roper et al 1996). The influencing factors, which are physical, psychological, sociocultural, and environmental, and politicoeconomic, provide a structure enabling a full account to be taken of the circumstances of the patient. (Walsh 1999).

The Model for Nursing contains the same elements as the Model for Living apart from individuality, where it is replaced with individual nursing. (Tierney 1998). The model will help me to provide systematic care and the knowledge gained by using the model will give me greater insight into problems affecting patients.


Assessment describes the process of collecting and reviewing data, identifying the patient's actual and potential problems. It is the initial stage of the nursing process, followed by planning, implementation and evaluation and is a continuous and ongoing activity. (Murray and Atkinson 2000). The information collected relates to the health status and factors affecting the patient. This information can come from sources such as the patient, family, significant others, health care professionals and health records. (Heath 2000a).
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The assessment enables nursing care to be planned and implemented, prioritising the patients problems. (Alfaro-Lefevre 2002). It requires to be reviewed frequently to reappraise problems as the patients condition changes. (Heath 2000b), (Rowe 1999).

Subjective and objective information are gathered during the assessment. Subjective information is reported from the patient concerning their thoughts and feelings. Objective information is observed and measured by the nurse such as temperature and pulse. (Alfaro-Lefevre 2002).

My preceptor and I discussed a suitable candidate, on which to carry out an assessment. Due to the ward having very few admissions, we decided ...

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