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Child and Family Nursing Practice

Asthma is considered one of the most significant non-communicable disorders that have increased the health care burden. Asthma increases the respiratory complications that increase the rate of morbidity by increasing complication for the patient (Dharmage et al., 2019). Furthermore, 75% of the adult population gets affected by asthma that directly increases complication for asthma. There are the different factor that leads to the increase asthmatic complication that includes variable airways obstruction, airways hyperresponsiveness and airways inflammation (Lenney et al., 2018). The essay will discuss the different aspect of the case study in a different section and provide the nursing care plan to assist the patient. The case study is related to a 5-year-old boy admitted to the emergency department with the complaint of exacerbation of asthma and this is his third admission.

Issue of Child and Family Nursing Practice

One of the major issues that have been identified after evaluating the case study is the lack of Renee understanding the asthma condition. Parents are considered to be a major participant in paediatric care and their knowledge concerning the different aspect of the disorder plays a major role. The lack of understanding concerning the disorder can increase health-related complication for the patient due to neglecting behaviour toward triggering factor.

In paediatric care family participation in the care is considered to be one of the important aspects that help the health care professionals to improve the care. The Family knowledge and understanding should be compatible to assist the patient the need and it helps the patient to be protected concerning any triggering factor. The patient participation helps the child to feel comfortable and participate in the care. Family-centred care is considered to be important to reduce the chances of complication that can occur due to a lack of understanding of the family (Hill et al., 2017).

Family-centric care is the new face of the paediatric care and it is preferred due to the decrease recovery time with the better health status of the patient. Parents are expected to be integrating into the care and understand different aspect of the care that is needed to be considered during the care of the child. The knowledge of the parents is important as they are a major source of the treatment and medication administration. The need of the child and the right concerning the health should be accurately balanced by the parents to maintain the good health status of the patient (Arabiat et al., 2018). Doctor-parent is considered to be an essential part of the paediatric care and the coordination of these two individuals are important to deliver quality care to the patient. The paediatric understanding is not enough to handle and improve the complication faced by thus parent participation is important to assist the complication of the parents. The communication and interaction of the parents are important with a health care professional to understand and implement necessary measure to reduce the issue with parent health (Konstantynowicz et al., 2016).

Nursing Goal

The goal in healthcare is important to frame the care accordingly that aim to improve the health of the patient concerning the set goal. The nurse should always set the goal before the treatment to utilize their clinical skills and principle to deliver the quality care that helps them to achieve the goal. The goal should include different aspects that include specificity, measurability, timely, realistic and attainability (Stanek, 2017). The case study indicates the issue from the parent end when it comes to asthmatic condition thus the goal of the issue is to improve the parent’s understanding concerning the asthmatic condition of the child and possible precautions that are important.

Nursing Intervention

Educational intervention is the preferred nursing intervention as it will assist the parents to understand and improve their knowledge concerning the different aspect of the asthmatic condition. This was also supported by one of the article presented by Neuharth-Pritchett et al. (2015) by adding that educational intervention to aware the parents regarding the different aspect of the patient disorder that is important help the child during care. Educational interventions cover all the different aspects that are expected to be important concerning the care procedure. Moreover, the study presented by Kennedy et al. (2017) describe that educational intervention is important to teach the parents in the paediatric care concerning the different risk factor and precaution that are necessary to reduce complication. The educational intervention covers different aspects like risk factor of the asthmatic condition, the prognosis of the disorder, precaution important and complication with the disorder.

Evaluation of Child and Family Nursing Practice

The evaluation process is important to identify the impact of the intervention over the individual that help to analyse the accuracy of the intervention concerning the observed issue. Evaluation processes include different aspects that are included to evaluate the current condition of the participant like feedback, questionnaire and self-evaluation (Leoni-Scheiber et al., 2019). The feedback will be conducted to understand the parent perspective regarding the educational intervention so that improvement can be done. 

Issue of Child and Family Nursing Practice

The error in the medication administration is the second issue that was observed in the case study and it requires urgent attention as it can increase complication for the patient. The reluctance behaviour of the patient concerning the spacer is the reason behind the not using spacer for drug administration by Renee.

The respiratory discomforts in the asthmatic patient increase the complication of the patient and drug administration through spacer is important to increase the reach of the medication. The spacer is considered to be important for drug administration as it targets the large drug participle by creating an aerosol cloud that is necessary to increase the time for the user to inhale the fine particle. The spacer is especially important for the paediatric patient as the medication inhalation is an issue that decreases the effectiveness of the drug (Anderson et al., 2018). Different spaces are utilized for the drug administration thus there is need to choose the convenient spacer concerning to improve the drug delivery that is important to improve the condition of the patient. The patient should utilize the spacer in the drug administration so that a small amount of drug can be effective to reduce the complication face by the patient. The different aspects that need to be considered while choosing the spacer include its thickness, area and material that should be suitable for the patient to improve the participation in the intervention (Jain & Dhanraj, 2016).

Nursing Goal

Goal to care is important to improve the care and it included the entire group of participant that is connected in the care. The nurses are expected to set the goal to accurately frame the treatment process that is necessary to deliver the quality of care to the patient. Setting the nursing goal helps the nurses to work as per the standards and principles to attain the goal that is related to better health outcome of the patient (Wittenberg et al., 2016). The goal for the issue related to the administration error is to help the parent to improve the understanding concerning the use of a spacer in the drug administration.

Nursing Intervention

The nursing intervention that can address the administration error is inhalation technique training that will help the patient to improve the use spacer in the medication. The training will help them to understand the importance of spacer and right technique to use the spacer during the drug administration. The training will help them in improving the activities that are necessary for the management of asthma by improving individual skills and self-esteem (Rahmati et al., 2014). The training session will include both theoretical and practical classes that help them to understand and assist the patient in the drug administration by utilizing the spacer. The pharmacist can help the patient as well as family to understand the importance of the inhalation technique in the training that will improve the use. Patient and family understanding concerning the spacer will help to increase the use that directly reduces the chances of complication (Nguyen et al., 2018).

Evaluation of Child and Family Nursing Practice

The evaluation process is necessary to understand the accuracy of the intervention that will help to improve the intervention concerning the health status of the patient. The evaluation of the process help to identify the gap in the intervention concerning the health of the patient that needs to be addressed to improve the quality of care. Evaluations help the nurse to judge the potential of the intervention to treat the issue that is important to improve the health of the patient (Ojewole, 2018). The evaluation will be conducted by interviewing the patient and the family concerning their understanding related to the inhalation technique and the use of a spacer.

Conclusion on Child and Family Nursing Practice

The essay has discussed the two that has been identified in the case which needs to be urgently addressed to improve the patient health status. One of the identified issues is the poor understanding of the Renee concerning the asthmatic condition that can be dangerous. This issue can be addressed by educational intervention to improve understanding and feedback can be used for the evaluation process. Another issue that needs urgent attention is the lack of use of a spacer in drug administration that increases the chances of complication. Training session for inhalation technique will be helpful to improve the knowledge concerning the use followed by interviewing as an evaluation session.

References for Child and Family Nursing Practice

Anderson, G., Johnson, N., Mulgirigama, A., & Aggarwal, B. (2018). Use of spacers for patients treated with pressurized metered dose inhalers: Focus on the ventolin mini spacer. Expert Opinion on Drug Delivery, 15(4), 419 430. https://doi.org/10.1080/17425247.2018.1437414 

Arabiat, D., Whitehead, L., Foster, M., Shields, L., & Harris, L. (2018). Parents’ experiences of family centred care practices. Journal of Paediatric Nursing, 42, 39–44. https://doi.org/10.1016/j.pedn.2018.06.012 

Dharmage, S. C., Perret, J. L., & Custovic, A. (2019). Epidemiology of asthma in children and adults. Frontiers in Pediatrics, 7(246), 1-15.

Hill, C., Knafl, K. A., & Santacroce, S. J. (2017). Family-centered care from the perspective of parents of children cared for in a pediatric intensive care unit: an integrative review. Journal of Pediatric Nursing, 17, 30531-30536. https://doi.org/10.1016/j.pedn.2017.11.007

Jain, A., & Dhanraj, M. (2016). A clinical review of spacer design for conventional complete denture. Biology and Medicine, 8(5), 1-5. https://doi.org/10.4172/0974-8369.1000307.

Kennedy, S., Bailey, R., Jaffee, K., Markus, A., Gerstein, M., Stevens, D. M., & Mitchell, H. (2017). Effectiveness of evidence-based asthma interventions. Pediatrics, 139(6),1-10. https://doi.org/10.1542/peds.2016-4221 

Konstantynowicz, J., Marcinowicz, L., Abramowicz, P., & Abramowicz, M. (2016). What do children with chronic diseases and their parents think about paediatricians: A qualitative interview study. Maternal and Child Health Journal, 20(8), 1745–1752. https://doi.org/10.1007/s10995-016-1978-0 

Lenney, W., Bush, A., Fitzgerald, D. A., Fletcher, M., Ostrem, A., Pedersen, S., & Zar, H. J. (2018). Improving the global diagnosis and management of asthma in children. Thorax, 73(7), 662–669. https://doi.org/10.1136/thoraxjnl-2018-211626 

Leoni-Scheiber, C., Mayer, H., & Müller-Staub, M. (2019). Relationships between the Advanced Nursing Process quality and nurses' and patient' characteristics: A cross-sectional study. Nursing open7(1), 419–429. https://doi.org/10.1002/nop2.405

Neuharth-Pritchett, S., & Getch, Y. Q. (2015). The effectiveness of a brief asthma education intervention for child care providers and primary school teachers. Early Childhood Education Journal, 44(6), 555–561. https://doi.org/10.1007/s10643-015-0751-0 

Nguyen, T. S., Nguyen, T., Van Pham, T. T., Hua, S., Ngo, Q. C., & Li, S. C. (2018). Pharmacists' training to improve inhaler technique of patients with COPD in Vietnam. International journal of chronic obstructive pulmonary disease13, 1863–1872. https://doi.org/10.2147/COPD.S163826

Ojewole, F. (2018). Evaluation of the nursing process utilization in a teaching hospital, Ogun State, Nigeria. Journal of Nursing and Midwifery Sciences, 4, 97-103. https://doi.org/10.4103/JNMS.JNMS_13_17.

Rahmati, H., Ansarfard, F., Ghodsbin, F., Ghayumi, M., & Sayadi, M. (2014). The effect of training inhalation technique with or without spacer on maximum expiratory flow rate and inhaler usage skills in asthmatic patients: A randomized controlled trial. International Journal of Community Based Nursing and Midwifery, 2, 211-219.

Stanek, S. (2017). Goals of care: a concept clarification. Journal of Advanced Nursing, 73(6), 1302–1314. https://doi.org/10.1111/jan.13243 

Wittenberg, E., Ferrell, B., Goldsmith, J., Buller, H., & Neiman, T. (2016). Nurse communication about goals of care. Journal of the advanced practitioner in oncology7(2), 146–154. https://doi.org/10.6004/jadpro.2016.7.2.2

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