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For the purpose of this assignment and in accordance with the nursing and midwifery council (NMC) code of confidentiality, all names and locations mentioned during this assignment have been altered to comply with the NMC code of confidentiality. (NMC 2009)
Miss Q, an 84 year old elderly Female, came onto the Accident and Emergency department of a hospital based in Greater Manchester due to a fall that occurred an hour previously whilst she was taking rubbish out. During the night, she was transferred to the Orthopaedic ward diagnosed with a fractured neck of femur. As part of her treatment Miss Q was scheduled to undergo a procedure known as Thompson’s Hemiarthroplasty to correct the fracture.
Before the admission Miss Q’s health was described as generally good with a history of angina thyroid and hypotension. Despite her age she was able to complete tasks of daily living with minimal assistance and lived happily alone. Every other day her daughter would visit to aid her with cleaning, this continued during her stay in hospital. During Miss Q’s time on the orthopaedic ward she encountered a vasovagal episode which led to the need for an ECG which came up normal.
During Miss Qs stay on the orthopaedic ward a care plan was developed around the Roper, Logan and Tierney model of nursing (Appendix 1) and modified to encompass the changes in her individual needs before and after the surgery. According to Pearson et al (2005) `The care plan is both a statement of the transaction agreed upon by the nurse and client and a guide to the nature of the interactive process to be engaged in while nursing takes place`. (McEwan & Wills 2011) The individualised care plan that was utilised for Miss Q (Appendix 2) involved the input from the whole multi-disciplinary team involved in her care on the orthopaedic ward. This included; the orthopaedic surgeons, the doctors, the nurses and the auxiliary nurses.
The Roper, Logan and Tierney model of nursing care consists of 5 concepts; Activities of daily living (ADL) including; maintaining a safe environment, communicating, breathing, eating and drinking, eliminating, personal hygiene, controlling body temperature, mobilising, working and playing, expressing sexuality, sleeping and dying. (Holland et al. 2003), lifespan (divided into 5 stages; infancy, childhood, adolescence, adulthood and old age), the dependence/independence scale, factors influencing ADL and individuality in living. (McKenna et al 2008) The RLT model provides a way of planning care around a more holistic, defined by the Oxford Dictionary as `characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of a disease` (Oxford Dictionary 2011) base that encompasses the psychological, sociocultural, environmental, politicoeconomic factors that can influence an individual’s daily living alongside biological factors. `The Roper model for nursing offers a framework for nurses to be able to ensure that this individuality is taken into account when undertaking nursing care and planning`. (Holland et al 2003) (RCN 2011)
The nursing process is known to be a comprehensive system of classifications that describes and categorizes actions, therapeutic approaches, and ideas performed by nurses within all types of specialties and health care settings. It is defined as `a systematic method of planning, delivering, and evaluating individualised care for any clients in health or illness`. It is used to aid health professionals in developing appropriate plans of care and recovery that differ for the patient’s individual needs.
The nursing process consists of 4 approaches for the following categories; assessment, planning (development of an action plan), implementation (delivery of the actual care) and evaluation (determining the effectiveness of the care delivered). (Habermann 2005) These