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  • Subject Name : Nursing

Patient Safety and Clinical Quality in Complex Nursing Care

Description of Nursing Care Plans

Nursing care plans are an essential component of patient care and assistance as they ensure that the patient receives adequate care with clinical considerations for efficient management of the condition and speedy recovery(Kristensson et al.,2018 )In the course of this assessment, I had developed two different care plans for patients Thi Minh Tran and Nicholas Noble. While creating the nursing plan, I was a little concerned as both the patients had distinct needs and required comprehensive care. As a nursing student, as I have been taught how to work and develop nursing care plans, I was also a little confident that by putting in an adequate amount of effort, I will be able to draft a complete care plan for the patients to address their needs. While drafting the care plan, I paid special attention to the patient vitals, ongoing medication, and assessment reports.

Reflection on Nursing Care Plans

For both the patients, I had clear and distinct goals that aimed at their overall beneficence and management of the health condition. The suitable health outcomes for the patient, Mrs. Thi Minh Tran included management of airway and respiratory rate. The care plan of this patient also includes management of circulation and the oxygen saturation levels of the body. Management of glucose pertaining to the history of diabetes has also been included. Since the patient possesses a history of falls, fall risk assessments, VIP score monitoring has also been included for the optimisation of health condition in the patient. Management of UTI and diet have also been included. For Mr. Noble, the primary goals are the management of his cardiovascular health for which ECG monitoring and development of fluid balance chart have been done.

VIP monitoring has also been considered for the overall management of the health condition of the patient. These care plans aimed to achieve management of the presenting health conditions in patients with short term and long-term goals to promote their health. The harm/risks to the patients were included in the care plan, for instance, the fall risk assessment was included for the MrsThi Minh Tran. Fall risk assessment serves as a tool to identify the contributory factors towards the fall risks of an individual (Flood et al., 2018). Similarly, for Mr. Nicholas Noble, the major risk of the health condition was exacerbation and development of pulmonary problems with the history of COPD and CO2 retention; therefore, care planning has been done in consideration of same.

Respiratory distress serves as a marker of health deterioration and was therefore given the highest priority for management in the patient (Janse et al., 2016). The specific needs of the patient that were addressed based on the clinical charts to ensure the highest quality care. Timely management of the assessments and the care needs of the patients were addressed as per the care plan to assure maximum health benefits (Lowe, 2018). The care plan was designed based on high quality peer-reviewed literature. It is essential to consider intervention and management strategies from sources of high trust and reliability so that the patient’s beneficence is ensured and the health risks are minimized (Janse et al., 2016).

Further, to minimize discrepancies, the plan was aligned with literature and the policies to ensure the highest quality and minimize the risks (Walker &P aliadelis, 2016). The care plan did not involve the engagement of the family members and friends of the patients. However, it involved the assistance of several health care professions from different teams. The resources used for the development of the care plan were taken from reliable sources like peer-reviewed research articles and government websites to ensure maximum care safety (McNamara et al., 2017).

If these sources were not reliable, the patient’s safety would have been risked as the interventions and the care management strategies would not be appropriate to implement, which would have made me a highly irresponsible carer and could be considered as a breach of the code of conduct established by the nursing and midwifery board of Australia regarding the patient’s health and beneficence (Walker &Paliadelis, 2016).

Influencing Factors for Nursing Care Plans

The care plan was influenced by several internal as well as the external factors. I was able to develop care plans to ensure effective management of the clinical considerations associated with the patient for the improvement of their physical health and wellbeing. This was possible due to my knowledge concerned with the subject and my clinical reasoning abilities. However, I was not able to include a holistic perspective towards the care needs. The care was not person-centered and focused only on the physical improvement of the health condition with no mention of psychological support for the patient due to my limitations. Also, the lack of effective communication was the influencing factor which hindered me in understanding the psychosocial needs of the patients.

Improvement in Nursing Care Plans

To improve my ability to draft and develop care plans for the patients in future, I will develop holistic care plans to address both physical as well as psychological needs of the patients. I plan to do this is to work on my competence and communication skills (Eklund et al., 2019). By inclusion of effective communication, I will be able to provide holistic care to the patients for their overall beneficence. For older patients, this is even more critical as they often require additional psychological support for complete recovery (Walker &Paliadelis, 2016). The primary benefit of the development of communication for holistic care for patients is that it assists in understanding the care needs of the patients more effectively (Delaney et al., 2018). However, potential risk includes development of unintentional bias for the patient (Lowe, 2018).

Involvement of patient in the care ensures the development of an understanding of care needs and improvement in their delivery for the highest quality care and experience in the care setting.

Learning Regarding Nursing Care Plans

I will focus on developing care plans with a holistic approach that address both the physical and psychological needs of the patient. I will do this by promoting communication and rapport building with the patients. This will help me in addressing their care needs more effectively (Reubenj et al., 2017). By application of this improvement strategy, I will be able to develop strong interpersonal relationships with the patients. This will assist in enhancing communication and provide an opportunity to understand the care needs of the patient more effectively and assist me in developing care plans that are inclusive of all the needs, cultural aspects, perception and beliefs of the patient.

The action plans that will be effective for this improvement implementation include, first, development of competence and rapport building. This will ensure that the patient requirements are met and there is trust in the carer-patient relationship (Powers, 2019). The second plan will be to include the family and friends of the patient. The friends and family are primary carers of the patient and can ensure beneficence and their inclusion in care plan also enhances participatory recovery and management of the health condition (Lowe, 2018). The third plan will be to gather knowledge and learn about efficient care plan making from literature, senior, and my tutors. so that I develop care plans that are complete, comprehensive, and can ensure complete care of the patient.

References for Nursing Care Plans

Delaney, L. J. (2018). Patient-centred care as an approach to improving health care in Australia. Collegian, 25(1), 119-123.https://www.sciencedirect.com/science/article/pii/S1322769617300422

Eklund, J. H., Holmström, I. K., Kumlin, T., Kaminsky, E., Skoglund, K., Höglander, J., ... &Meranius, M. S. (2019). “Same same or different?” A review of reviews of person-centered and patient-centered care. Patient Education and Counseling, 102(1), 3-11.https://www.sciencedirect.com/science/article/abs/pii/S0738399118306232

Flood, K. L., Booth, K., Vickers, J., Simmons, E., James, D. H., Biswal, S., ... & Bowman, E. H. (2018). Acute care for elders (ACE) team model of care: A clinical overview. Geriatrics, 3(3), 50.https://www.mdpi.com/2308-3417/3/3/50

Janse, B., Huijsman, R., De Kuyper, R. D. M., &Fabbricotti, I. N. (2016). Do integrated care structures foster processes of integration? A quasi-experimental study in frail elderly care from the professional perspective. International Journal for Quality in Health Care, 28(3), 376.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931912/

Kristensson, J., Andersson, M., &Condelius, A. (2018). The establishment of a shared care plan as it is experienced by elderly people and their next of kin: A qualitative study. Archives of Gerontology and Geriatrics, 79, 131-136.https://www.sciencedirect.com/science/article/abs/pii/S0167494318301766

Lowe, M. (2018). Ethics and the Care of the Elderly. In Geriatric Medicine (pp. 283-293). Springer.https://link.springer.com/chapter/10.1007/978-981-10-3253-0_19

Mc Namara, K. P., Breken, B. D., Alzubaidi, H. T., Bell, J. S., Dunbar, J. A., Walker, C., & Hernan, A. (2017). Health professional perspectives on the management of multimorbidity and polypharmacy for older patients in Australia. Age and ageing, 46(2), 291-299.https://academic.oup.com/ageing/article/46/2/291/2498696

Powers, J. S. (2019). Risk assessment-focused interdisciplinary outpatient palliative care consultation for elderly veterans. Group, 2(52), 26.http://www.academia.edu/download/59352767/Risk-Assessment-Focused-Interdisciplinary-Outpatient-Palliative-Care-Consultation-for-Elderly-Veterans-PMHCOJ-5-130-120190522-18669-dbk6.pdf

Reuben, D. B., Gazarian, P., Alexander, N., Araujo, K., Baker, D., Bean, J. F., ... & Leipzig, R. M. (2017). The strategies to reduce injuries and develop confidence in elders intervention: Falls risk factor assessment and management, patient engagement, and nurse co‐management. Journal of the American Geriatrics Society, 65(12), 2733-2739.https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.15121

Walker, H., &Paliadelis, P. (2016). Older peoples’ experiences of living in a residential aged care facility in Australia. Australasian Journal on Ageing, 35(3), 6-10.

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