Care Planning for Older People in Inpatient Settings


Presentation (Elaboration), 2015
7 Pages

Excerpt

Table of Contents

INTRODUCTION

OBJECTIVES

WHY DO WE CARE PLAN?

WHAT MAKES A GOOD CARE PLAN?

CARE PLAN FORMAT

ROLE OF THE NAMED-NURSE

THE FRANCIS REPORT

CARE PLANNING FOR PEOPLE WITH DEMENTIA

WHEN SHOULD CARE PLANS BE REVIEWED?

MULTIDISCIPLINARY CARE PLANS

REFERENCE LIST

INTRODUCTION

Following a recent CQC inspection, it has been highlighted that care plans should not just be present and in-date (which is audited for ICP purposes); but their contents should reflect quality (which is not presently audited for ICP purposes) and as named-nurses we are responsible for this.

As a result, there is now a demand for us to have a greater focus on the quality of our written care plans; ensuring that interventions are listed exhaustively and in detail.

The ICP audit is currently being reviewed, and will soon include measures which will help to identify and qualify the quality of our care plans within the audit.

OBJECTIVES

- To discuss the reasons for writing care plans; whilst exploring what constitutes a good care plan, working in groups to write examples.
- To explore the role of the named-nurse in the care planning process.
- To explore the findings the Francis Report which relate to care planning and discuss the impact that these will have on the way we write care plans.
- To provide an informal forum for staff to discuss any issues or suggestions they may have about how to improve the standard of care plans within the hospital.
- To raise the confidence of staff in writing care plans, through being provided with an opportunity to refresh on the basics.

DISCUSSION - A relative of yours has been admitted to hospital. What would you expect or want from the nursing team?

WHY DO WE CARE PLAN?

- To act on assessment and identified needs.
- To inform patients and carers of what can be expected.
- To ensure consistency of care.
- To guide practice safely.
- To maintain standards.
- To identify interventions aimed at promoting independence and supporting/empowering the patient in having a fulfilled life.
- To identify who is responsible for interventions and when they should be delivered.
- To identify the strengths and weaknesses of the patient.
- To identify what can be realistically achieved.

WHAT MAKES A GOOD CARE PLAN?

- Include patient (if appropriate) in the care planning process.
- Involve family and carers when formulating care plans.
- Include the care co-ordinator in the writing of care plans (particularly with reference to discharge plans).
- Individualised and patient-specific interventions.
- It should be readily accessible and visible to those involved in the provision of care.
- Jargon-free and written in language which will not alienate other professionals or the patient (where possible).

CARE PLAN FORMAT

Nursing care plans are usually written under three different headings or areas; the first describes the “problem”, the next details the “goal”, and the final one explains any “interventions” which can be used in order to meet the desired outcomes. Once a care plan has been written, it must be evaluated regularly and changed accordingly, in order to ensure that it continues to meet the needs of that patient (Barry, 2002).

According to the University of Lincoln (2010) it is also useful to consider the following acronym when writing care plans:

- S – specific
- M – measurable
- A – achievable
- R – realistic
- T – time limited.

GROUP ACTIVITY – Case studies. In groups devise a care plan(s) for any specific need(s) you can identify for the patient in your case study. Groups will present their care plans after coffee (20 minutes).

COFFEE – (15 minutes).

GROUP ACTIVITY – Present care plans to the rest of the group (10 minutes per group).

ROLE OF THE NAMED-NURSE

The main purpose of the named nurse is to co-ordinate the delivery nursing care for the patient from the point of admission to the point of discharge; therefore, patients are able to identify one nurse who is consistently and specifically responsible for their overall nursing care. This provides the named nurse with the opportunity to “maximise the therapeutic value of the nurse-patient relationship” and increase levels of trust and nurse-patient collaboration, whilst also developing an extensive knowledge and understanding of that patient (North East London NHS Foundation Trust, 2008).

The named nurse will play a key role in the development of the therapeutic relationship, whilst also leading in the assessment, planning, implementation and evaluation of the nursing care delivered to their patients (Cornwall Partnership NHS Trust, 2009).

THE FRANCIS REPORT

After the severe failings of Mid-Staffordshire Hospital in providing safe care for their patients and the dire consequences of these failings, including the deaths of patients, a public inquiry was commissioned; evidence collected during the inquiry indicated that nurses had failed to make “adequate or proper” care plans (The Francis Report, 2013a, 1.186).

Care plans provide a means of protecting the patient from the risks of inappropriate treatment by providing specified guidance on how to meet the needs of the individual (The Francis Report, 2013b, 11.46).

CARE PLANNING FOR PEOPLE WITH DEMENTIA

The Francis Report (2013c) suggests that people with dementia should have an “ongoing personalised care plan” that “addresses their individual needs”; where possible the patient should be included in the care planning process and there should be a named professional “assigned to operate the plan”. These care plans should be reviewed at an agreed frequency whilst considering any changing needs of the patient. Such care plans should cover “activities of daily life” including “toileting skills”, “environmental modifications” and the need for specialist aids, “physical exercise”, “cognitive stimulation”, “pharmacological interventions”, mental state.

NICE (2006) states that care plans should consider issues arising from diversity, such as gender, age, religion, ethnic background and personal care. They should identify “specific needs” of the person with dementia arising from “ill health, physical disability, sensory impairment, communication difficulties, problems with nutrition, poor oral health and learning disabilities”. Care plans should “accommodate the preferences of people with dementia”, including diet, sexuality and religion.

WHEN SHOULD CARE PLANS BE REVIEWED?

- When the needs of the patient change.
- When a review date was pre-determined.

[...]

Excerpt out of 7 pages

Details

Title
Care Planning for Older People in Inpatient Settings
Course
Care Planning
Author
Year
2015
Pages
7
Catalog Number
V476713
ISBN (eBook)
9783668965287
Language
English
Tags
care, planning, older, people, inpatient, settings
Quote paper
Timothy John Whittard (Author), 2015, Care Planning for Older People in Inpatient Settings, Munich, GRIN Verlag, https://www.grin.com/document/476713

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