These are 12 headings, consisting of different behaviours which an individual participates in. It takes into account their personal, social, economic, educational, cultural and mental health needs. After initially discussing this assignment with John patient and the Clinical Nurse Manager both parties agreed that the author could proceed. Mr Valentine attended an appointment with his optometrist who refereed him to the Eye Centre at a local hospital stating that he was suffering from a cataract.
The eye centre is an ophthalmic day case unit which serves both ophthalmic surgical and medical patients. When Mr Valentine was seen at the eye centre by an ophthalmologist consultant, further investigations revealed that he was suffering from a nuclear age related cataract. The treatment deemed appropriate for this condition was a cataract extraction and the insertion of an intra ocular lens under a local anaesthetic.
This treatment was discussed between Mr Valentine and the Consultant and a pre operative assessment was then made in line with Department of Health Guidelines Brooker et al state that the aim of a pre operative assessment is to ensure that each patient receives holistic planning for a safe and dignified surgical experience.
Informed consent was obtained from the patient for a nursing assessment to be made NMC A nursing assessment was used to obtain and record his past and present history in a holistic manner. The following information was taken and recorded. The patient Mr Frederick Valentine, is a Caucasian 79 year old male. Mr Valentine used to be an engineer and worked for the same company for over 50 years. Fred has been a widow for 8 months now and finds it very difficult to talk about his wife.
Fred feels that he is slightly depressed and his doctor has prescribed him some medication for depression which he takes when he remembers. He lives alone in a bungalow rented from the local council and receives a state pension on a weekly basis. He has two daughters whom he has very little contact with. This is due to the eldest daughter living in Scotland and the younger daughter living in Canada. They telephone him occasionally but he has not seen them since their Mothers funeral.
Fred has a dog that he describes as his best friend. Fred suffers with poor mobility and uses a Zimmer frame to walk. Due to this lack of mobility he misses taking his dog for walks. She implored students to support the use of the model through promoting an understanding of these factors as an element of the model.
These factors do not stand alone; they are used to determine the individual's relative independence and requirements to restore independence for each other activities of daily living. Biological- the impact of overall health, of current illness or injury, and the scope of the individual's anatomy and physiology all are considered under this aspect.
An example is how having diabetes mellitus causes the person's nutritional activities to differ from those of a person without diabetes. Psychological- the impact of not only emotion, but cognition, spiritual beliefs and the ability to understand. Roper explained this was about "knowing, thinking, hoping, feeling and believing". One example of the application of this factor would be how having paranoid thoughts might influence independence in communication; another example would be how lack of literacy could impact independence in health promotion.
It could however be debated that this is just a reflection on the model users and not the model itself. Analyzing and understanding the model It is a fact that difficulty often arises among nurses in comprehending the model and this subsequently leads to lack of use. On the contrary, Girot accused Roper, Logan and Tierney on the simplicity of the model which is responsible for its popularity. Similarly, the model lacks testing Fraser, A good model ought to be reliable, valid and well tested according to Reynolds and Cormack.
Conclusion Nursing models gives bearing to nursing care.
The nurse must have knowledge of all five possible influencing factors and the evidence that underpins these, when assessing. Another example is the ADL "death" which does not only apply strictly to the specific last moments of life, but also to the processes perceived to lead up to the eventuality of death, such as loss of independence, periods of ill health, fear of failure to recover, and fear of the unknown. I strongly agree that individuality, while important, is difficult to keep because of outside factors, a concept that was presented by Logan Fey. This will be affected by the other four remaining areas mentioned.
When implementing care for Annie, I felt my lack of experience and knowledge prevented me from providing extensive varieties of care, and incorporating this in the care plan. Assessment enables the nurse and patient to identify actual and potential problems. It is important that the patient and their family are involved, wherever possible in the planning and goal setting process. Frisch and Kelly , explain, nursing is a dynamic practice and all nurses must continually include new assessment information into the implementation of the care plan. This should enable a continuity and consistency of care. It aids with multi-disciplinary team MDT work and communication between health professionals Roper et al
And emphasize the strengths, limitations of Roper-Logan-Tierney Theory and state its value and relevance to the current nursing practice. It aims to show an understanding of what a nursing model and the nursing process is, looking in detail at the relationship between this nursing process and the Roper, Logan and Tierney RLT model of nursing. It aims to show an understanding of what both a problem solving approach to care, and a nursing model are; and to establish how various key elements of both are implemented in practice. Philadelphia, PA: fA davis Co.
Often clinical settings use a list of the activities of daily living as an assessment document, without any reference to the other elements of the model; Roper herself rejected the use of the list of ADLs as a "checklist" as she stated that it was essential not simply to read the title of the ADL, but to base assessment on knowledge of the scope of the ADL as assessed using the 5 key factors. These factors do not stand alone; they are used to determine the individual's relative independence and requirements to restore independence for each other activities of daily living. Goals should always be stated clearly and accurately and need to be observable, measurable and able to be tested, in order for future evaluation. Fawcett, J. Extensive, in-depth information may not be gathered on an initial assessment, however any information obtained contributes towards individualised care Roper et al
The RLT model stresses the importance of a holistic approach to assessing patients, highlighting the necessity of the nurse gathering two types of information from and about a patient, in order to perform a more detailed and holistic assessment Roper, Logan and Tierney
She implored students to support the use of the model through promoting an understanding of these factors as an element of the model. Therefore, a good understanding of the anatomy and physiology of the human body will enable the nurse to provide the patient with an explanation of biological and physical factors that are influencing their AL.