3rd year nursing degree, assessment criteria: identify a particular patient group (not individual) living with a long term health condition (rheumatoid arthritis) with a healthcare need (pain management)
locate the assessment within the context of the disease trajectory and care environment (on going condition), explain why pain management health need takes priority in the context of a whole system (holistic assessment) approach to nursing assessment. Demonstrate an understanding of the importance of the nurse patient relationship in relation to Osteoarthritis and pain management. discuss the assessment that would be undertaken for this health need including appraisal of assessment tools use. consider the contribution of patients and families to the assessment of health care needs.
Important inclusions:
holistic assessment - patient as a partner to nurse + family involvement. Patient centered, whole person approach care, 6 c's, extraneous and intrinsic factor, communication and collaboration, how will nurse assess whether treatment/ pain management is effective? include the trajectory model (strauss and glaser 1975, and strauss and corbin 1999) - the model evolves and is not fixed. establish a management plan that is realistic and not too intrusive to patients lifestyle to avoid non compliance. include peer reviewed refs, NICE guidelines, NSF, public health england, karl rogers, RCN etc norm and abnormal observation values, patient education (importance of) the psychological impact of long term health , conditions at diagnosis and in the long term, the cmponents of pain a subjective in the moment experience, types of pain/ definition, effect = raised respiration, Blood pressure, heart rate, facial expressions etc, simple analgesia and possible side effect eg nausea or constipation, importance of considering other medication already being prescribed or over the counter meds - patient education and on going assessment, why do long term conditions challenge society and the NHS - finance and the aging population, self management strategies, department of health 2012 - 1/2 of population over 60 yrs have a longterm condition, expenditure on the over 75 age group is 13x the rest of the population (McKinsey et al 2013, huge rise in predicted health and social care needs - 94% rise by 2022.
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