Nursing Assignment: Case Analysis Using Patient-Centred Care & Registered Nurse Approaches

Question

Task:
You are supposed to undertake a medical case scenario of a patient and prepare a nursing assignment analyze the patient-centred care along with registered nurse approaches with regards to the selected case.

Answer

Introduction
According to the case study presented in this nursing assignment, Joan Williams is an old aged women living in the countryside of Victoria and has been recently moved to the nursing care home due to the advanced scoliosis that has affected Mrs. Joan’s mobility and increase the risky falls. However, the nursing staff has decided to provide patient-centred care (PCC) to Mrs. Williams that focuses upon the needs of the patients rather than the requirements of the services. Thus, the present study analyses the Patient-centred care along with registered nurse approaches that can be applied within the aged care setting and will help in exploring the benefits received by Mrs. Williams through such and efficient service.

Discussion
The concept of Patient-centred care within Australian Healthcare settings
As stated by Jo Delaney (2018), the PCC (patient-centred care) has been emerging as the primary health care approach that emphasizes upon the partnership among the healthcare professional and patients within the Australian Healthcare settings with acknowledging the preferences, values, promotion of flexibility within the healthcare provisions and seeks in moving beyond the traditional paternalistic approach of healthcare. Thus, in regards to the physical aspects of healthcare, the approach of PCC concedes with the values and beliefs of the patients towards their welfare and quality of life. However, within the Australian Healthcare settings the approach of PCC focuses upon the enhancement of patient’s satisfaction through providing them with quality service as per their needs and requirements. However, the PCC refers to the movement of cultural change that helps in the representation of a fundamental shift towards the thinking about the nursing homes in Australia. The facilities within the changes are not only viewed as the healthcare institutions but also as the person centered homes that offer the long term services for the patients. The principles and the practices within the cultural change movement are influenced by the shared concerns between the consumers, providers and policymakers as about the quality and value of care offered within the traditional nursing care homes (Koren, 2010).

As per the case study given, Mrs. Joan Williams is suffering from Scoliosis which is the sideways curvature of the spine that mainly occurs in the time of the growth spurt before puberty which and affects the mobility of the person. However, the aged person was getting weakened and tired with increasing risk of fall. However, Mrs. Joan has been managed for moving to the nursing homes for treatment and proper care and thus, the nursing department has decide to provide Patient Centred Care for Mrs. Joan that will increase the patient's trust upon the nurses to provide what is best for them along with making the situation essay of the healthcare professional to treat the patients by meeting the individual emotions, practical and social needs that ensures in maintaining the high quality care and life for Mrs. Joan.

The ethical concept with examples and references for delivering PCC to Joan
As per the case study provided, the ethical and legal concept that matches up with the scenario of Mrs. Joan Williams is the Beneficence that addresses the idea of nurse’s action to promote good. As opined by Rosemond, Hanson, Ennett, Schenck& Weiner (2012), the promotion of good is the thought of the doing best of the patients with showing the act of mercy and kindness. Beneficence covers the acts of care and concern of the Registered Nurses, towards their patients, to protect them from any further complications or issues. Examples of beneficence includes situations wherein nurses revives the patients from bad situations by providing the pain medication and lifting the side rails of the patient's bed in the hospital to prevent risky falls of the patients (The Eight Principles of Patient-Centered Care, 2015). Thus, Beneficence is one of the core values of patient-centered care as it helps the nurse to provide best for the patients with understanding their needs and requirements and specifically in the aged care unit. As stated by Mueller, LaVela & Bokhour (2017), the PCC ideals has been penetrated within the Australian Healthcare system and adding to this, the PCC has expanded to encompass the culture shift of service care delivery that begins with the experience of the patients that is entering within the facility.

For providing the best service to the age patient like Mrs Joan, the inductive approach of PCC along with beneficence is implemented within the quality care by the nurses within the nursing home which based upon the five themes such as the needs of effectively communicating with the patients, the need for the continuation of service care, the creation of the a positive environment around the patients, the efficient knowledge of the nurses regarding the patient's health condition of the patients along with their relative role for providing the best quality care for the patients as per the social, emotional and physical needs (Ross, Tod& Clarke, 2014). The Registered Nurse, in an effort to provide person-centered care to the patient, in accordance with the standard 2 of NSQHS, can come up with a personalized care plan, actively including Mrs Joan in the same, so that her confidence in herself is restored (Safetyandquality.gov.au., 2020). Owing to restrictions in movement, the RN can arrange for a wheelchair for Mrs Joans and can teach her the way to operate the same, so that the patient can move about and be physically active, which would help her to cope up with her physical problems. Mrs Joans, owing to her stay alone, has a very unhealthy way of living, which is not good for her age and condition, which needs to be addressed by the RN, with active participation by Mrs. Joans

The role of the registered nurses in rendering care
As opined by Epstein & Street (2011), a registered nurse (RN) refers to that nursing staff who gets graduated from the nursing program and meets the requirements that are outlined by the nation, state, province or else from the similar body for obtaining the nursing license. Thus, for a registered nurse, in contrast with an enrolled nurse, the scope of practice gets determined by the legislation and gets regulated by the professional council or body (Smith, 2016). The duty of care is referred as the obligation which is placed upon the nursing staff to act towards the patients in certain way, while guarding the individual rights of the patients. Judging by the needs of Mrs. Williams, following the specific nursing standard of providing the safe, responsive and appropriate quality of care as per the personal needs and requirements was deemed to be suitable for the concerned registered Nurse.

According to Brownie & Nancarrow (2013), the PCC intervention by the nursing staff are multifactorial that comprises of the element regarding environmental enhancement, social interaction and stimulation opportunities, changes and leadership and management within the nursing faculties, staffing models that helps in the staff empowerments with providing the patients with individualized philosophy of care. The nursing standards help the RN’s as well as the enrolled nurses to understand their job roles, duties and responsibilities as well as act ethically, taking the right decisions for the well-being of the patients.

In accordance with the case study provided, the most relevant registered standard of nursing that matches up with the condition of Mrs. Joan Williams’ is the Nurse delivering the safe, responsive and appropriate quality of nursing practice that will help the patient in achieving the quality of life. As evidenced from the Nursing and Midwifery Board of Australia - Professional standards. (2020), the RNs (registered nursing standard) provides quality and ethical goals directed actions that are based on systematic and comprehensive assessments and are the best possible evidence for achieving planned and agreed results. The RNs incurs certain role in providing the standard practices such as, they provide the comprehensive quality and safe practice for achieving the agreed goals and results that are responsive to the nursing needs of the patients like Joan, they practice within their scope of practice while allocating the practice aspects to the other enrolled nurses, as per the enrolled scope of the nursing practice and the other non clinical and clinical roles, the RNs helps in providing the effective time supervision and directions that ensures the delegated practice to be correct and safe, the RNs practice according to the relevant guidelines, policies, standards legislation and regulations along with using the appropriate processes for identifying and reporting the potential and actual risk-associated issue system where the practices are the below the expected standards. Therefore, according to the above mentioned guidelines, the RNs, uses the practice of providing safe, responsive and appropriate quality of nursing practice for treating Joan for the Scoliosis disorder.

Conclusion
The present study focuses upon the concept of PCC as per the case study provided of Mrs. Joan Williams suffered from scoliosis. The study elaborates the ethical concept of beneficence for RNs to deliver PCC along with the roles of the nurse as per the registered nursing standard of Australia to enhance PCC. The difference between RNs role for duty of care and the Enrolled nurse for EBP is mentioned within the study.

Reference
Brownie, S., &Nancarrow, S. (2013). Effects of person-centered care on residents and staff in aged-care facilities: a systematic review. Clinical Interventions In Aging, 1.doi: 10.2147/cia.s38589

Epstein, R., & Street, R. (2011). The Values and Value of Patient-Centered Care. The Annals Of Family Medicine, 9(2), 100-103.doi: 10.1370/afm.1239Fix, G., VanDeusen Lukas, C., Bolton, R., Hill, J.,

Jo Delaney, L. (2018). Patient-centred care as an approach to improving health care in Australia. Collegian, 25(1), 119-123.doi: 10.1016/j.colegn.2017.02.005

Koren, M. (2010). Person-Centered Care For Nursing Home Residents: The Culture-Change Movement. Health Affairs, 29(2), 312-317.doi: 10.1377/hlthaff.2009.0966

Mueller, N., LaVela, S., &Bokhour, B. (2017). Patient-centred care is a way of doing things: How healthcare employees conceptualize patient-centred care. Health Expectations, 21(1), 300-307.doi: 10.1111/hex.12615

Nursing and Midwifery Board of Australia - Professional standards. (2020). Retrieved 15 March 2020, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

Rosemond, C., Hanson, L., Ennett, S., Schenck, A., & Weiner, B. (2012). Implementing person-centered care in nursing homes. Nursing assignment Health Care Management Review, 37(3), 257-266.doi: 10.1097/hmr.0b013e318235ed17

Ross, H., Tod, A., & Clarke, A. (2014). Understanding and achieving person-centred care: the nurse perspective. Journal Of Clinical Nursing, 24(9-10), 1223-1233.doi: 10.1111/jocn.12662

Safetyandquality.gov.au., (2020). The NSQHS Standards | Australian Commission on Safety and Quality in Health Care. Retrieved 21 April 2020, from https://www.safetyandquality.gov.au/standards/nsqhs-standards

Smith, Y., (2016). Roles of a Nurse. News-Medical.net. Retrieved 21 April 2020, from https://www.news-medical.net/health/Roles-of-a-Nurse.aspx

The Eight Principles of Patient-Centered Care, (2015). Oneview. Retrieved 21 April 2020, from https://www.oneviewhealthcare.com/the-eight-principles-of-patient-centered-care/