The following care plan will be based on a personal experience with a patient who was nursed in a private sector care home. This interaction took place during a practice placement in the care of the elderly area.

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Patient/Client Assessment and Care Plan.


The following care plan will be based on a personal experience with a patient who was nursed in a private sector care home. This interaction took place during a practice placement in the care of the elderly area. The care plan will incorporate the Roper et al (1998) model of nursing based on the twelve activities of living which aims to prevent actual and/or potential complications or problems and to set expected outcomes or goals. The focus of this care plan will be the potential risk of pressure sores. Pressure area care is an excellent example of an area of nursing intervention that benefits from good use of assessment skills, care planning and thorough evaluation following implementation of interventions (Maylor & Roberts, 1999). Moreover, pressure sores pose a very significant threat to the health of compromised individuals. A threat that can be greatly minimised by preventative, therapeutic and assessment based interventions (Rycroft-Malone & McInnes, 2000).

Introduction of subject patient. 

The particular patient was chosen as the subject of this assignment because the student carried out the initial assessment. During this preadmission assessment a good rapport was developed. This made for positive communication. Moreover, the patient had many different and complex needs. Having these different needs would illustrate the benefit and the importance of carrying out a structured and holistic assessment to create a total picture of an individual from which to plan care.    

Through discussion with the subject of this assignment and his sister we agreed the pseudonym Mr X. Confidentiality and privacy were assured and they were both made aware of the nature of the exercise and were quite happy to continue on that basis. It essential that such assurances and permissions are sought before embarking on an assignment such as this (NMC, 2002)        

Mr X is a retired 85-year-old man, who had previously lived with his sister. He had never married. Mr X had enjoyed a long career as an officer in the British Army and had pictures of himself as officer commanding of various military establishments where he had served in the 1940 and 1950’s.  

Mr X used to be a keen golfer and fisherman, although he had not actively enjoyed these activities for many years. His sister took an active interest in her brother’s care and was involved with helping to arrange her brothers care plan. In particular she was a good source of biographical and historical biophysiological information on her brother. The nursing home had a proactive policy of involving family in organising the patient’s care.

Mr X was assessed in a care of the elderly ward of a local primary care hospital prior to his admission to the nursing home.  He had a bad fall at home, which necessitated his initial admission to hospital. His injuries had healed, however his general frailty had increased and it was felt that his elderly sister who was his main carer would no longer be able to cope.

The Roper Logan and Tierney Model of Nursing.

Using Roper et al (1998) model of nursing, a nurse is able to build a profile of a patient based on their individual ability to carry out the twelve basic activities of living, and including the patient’s level of independence/dependence, lifespan and factors influencing each activity such as: biological, psychological, sociocultural, politicoeconomical and environmental. See diagram one. Consequently, a nurse can have a wider perspective of the complexity surrounding a patient’s current health through the identification of actual/potential problems making this model the most popular and widely used throughout the health care services in the United Kingdom (Basford, et al., 1999; Heath, 2000).

The decision to use Roper et al (1998) model of nursing here is not based purely on its popularity in the United Kingdom or further a field. The Roper, Logan and Tierney model has been chosen as it is demonstrably straightforward in its application. The relative ease with which it can be used is a testament to the fact that it is very much drawn directly from real practice and real nurses (Alexander et al, 2000).  Further to its straightforwardness and practical provenance the Roper, Logan and Tierney model also maintains a positive goal orientated approach whilst still placing significant emphasis on the information gathering, assessment stage of the nursing process (Heath H., 2000).

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In a practical sense the model can be incorporated as a framework to allow all the health professionals to coordinate and follow the same criteria of care (NMC, 2002; Wood, 2003; Nettina, 2001). This framework is most often shaped around the systematic approach to nursing. A systematic approach to patients, by which a nurse recognises the complex biopsychosocial needs of a patient. This is key to providing individualised care, based on the uniqueness of the person (NMC, 2002; Redfern, 1996). Individualised care then is provided throughout the systematic nursing process of:-

  • Assessing
  • Planning
  • Implementing
  • Evaluating .

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