Field Specific Nursing Practice (Adult)
You may need to write 600-1500 words about the specific needs of and goal(s) of care for your service user. One goal is often sufficient, but you may want to introduce a second goal – as long as it is addressing the one problem.
What are the specific care needs of your service user? For example:
Mr. Hughes needs a more detailed assessment of his respiratory status to allow for appropriate interventions and provide a baseline against which the effectiveness of care can be measured……………………………………………………………………………… He will need oxygen to ………………… He needs to be supported in a position that will make it easier for him to maximize his breathing with as little muscular effort as possible. He needs psychological and communication interventions to reduce his anxiety and therefore reduce his metabolic demand for …………… Mr. Hughes requires ………………….medications (You will need to read about this) in order to …………………………………, to improve the effectiveness of the lungs for external respiration.He needs psycho-social interventions to enable him to achieve his aim of smoking cessation to reduce his risk of further respiratory disability.
Make sure you choose-key biopsychosocial needs . When you do this, you will need to cite sources that confirm your choices. You may want to set your goal(s) of care here, e.g:
Mr. Hughes will achieve blood oxygen saturation levels of between…% and…% on ..% oxygen within. Mr. Hughes will be able to speak in whole sentences within ……. Mr. Hughes will understand what care is being given and why and feel able to co-operate in his own care once he has overcome his extreme dyspnoea, within 30 minutes. Mr. Hughes will be able to express his fears and discuss his needs with nursing staff, which combined with improvements in his oxygen saturation levels will reduce his anxiety. (These are more short-term goals)
Once his breathing is stable, Mr. Hughes will feel motivated and supported in planning smoking cessation and other self-help strategies to optimize his respiratory function. (This is a more long-term goal)
Again, for a level 5 assignment, you should be able to cite sources of evidence to support your ideas. Write down your service user’s care needs and, if possible, goal(s) of care
If you write about two main interventions as is asked for in the brief you could group some interventions together (e.g. administration of medications could be a group, or communication and psychological support could be a group) you will have about 550 words for each. If you write about four, then you will have about 400 words for each. Remember that you need to explain why the intervention is needed, what it will do/how it will work to achieve the care goal(s), any particular ways in which it should be done (e.g., 15 litres (l) oxygen via a non-re-breathing mask versus 28% oxygen via a Venturi mask or 2l oxygen via nasal cannulae). Explain which would be most appropriate at this stage, and why. This is your evidence-based rationale for the care you give. So, you need to write concisely. That means fitting in the necessary information in a small number of words, but still writing in full sentences
The first intervention would be to use specific assessment tools to identify Mr. Hughes’ respiratory status in order to identify care needs and priorities, set the care goal/s, plan and prioritize care, and evaluate its effectiveness.
You need to identify what assessment tools would be used and why. Very often, you may have a choice of tools and have to explain why the ones you have chosen are most appropriate (for example, if your patient’s problem is pain, you would use a different set of tools for chronic pain compared with those used for acute pain. It is quite useful when you do this to give an idea of what the reading might be. All your decisions should be justified for use with your service user’s situation with reference to evidence from recent text books (preferably last five years), articles, reputable websites (e.g., GP notebook, British Thoracic Society) You should be able to set the goals of care from this assessment if you have not already done so.
Now start writing about your first intervention/in-depth assessment.
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