care planning & reflection presentation
TRANSCRIPT
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Care Planning & Reflection Care Planning & Reflection
Rana Saadaldeen Rana Saadaldeen
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Learning outcomes Learning outcomes KNOWLEDGE& UNDERSTANDINGKNOWLEDGE& UNDERSTANDING
K1 discuss the Nsg. Process & its application to Nsg. Practice.K1 discuss the Nsg. Process & its application to Nsg. Practice.
K2 select& discuss appropriate evidenced based Nsg. Interventions required in the K2 select& discuss appropriate evidenced based Nsg. Interventions required in the planning & achievement of negotiated, pt. centered outcomes.planning & achievement of negotiated, pt. centered outcomes.
K3 describe Orem’s Model of Nsg.K3 describe Orem’s Model of Nsg.
INTELECTUAL QUALITIESINTELECTUAL QUALITIES
I1 Apply a recognized model of Nsg. As a framework to the planning, implementation& I1 Apply a recognized model of Nsg. As a framework to the planning, implementation& evaluation of care.evaluation of care.
I2 Identify factors that impact upon the effectiveness of outcomes of care.I2 Identify factors that impact upon the effectiveness of outcomes of care.
I3 Explain different Models of Reflection that can be applied to the Reflective processI3 Explain different Models of Reflection that can be applied to the Reflective process ..PROFESSIONAL/PRACTIXCAL SKILLS PROFESSIONAL/PRACTIXCAL SKILLS
P1 Demonstrate the ability to set person-centered goals\outcomes.P1 Demonstrate the ability to set person-centered goals\outcomes.
P2 Develop an individualized care plan that identifies the clients desired outcomes.P2 Develop an individualized care plan that identifies the clients desired outcomes.
P3 Demonstrate the ability to evaluate the outcomes of care in relation to set objectives, & P3 Demonstrate the ability to evaluate the outcomes of care in relation to set objectives, & measures the degree to which goals have been achievedmeasures the degree to which goals have been achieved . .
TRANSEFABLE/KEY SKILLSTRANSEFABLE/KEY SKILLS
T1 Apply the principles of goal setting within a multidisciplinary context.T1 Apply the principles of goal setting within a multidisciplinary context.
T2 Use Reflection to help determine whether to maintain, adapt or discontinue the plan of care. T2 Use Reflection to help determine whether to maintain, adapt or discontinue the plan of care.
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TASKTASKWithin this unit you are required to complete a Within this unit you are required to complete a group task on care planning. This is a group task on care planning. This is a developmental piece of group work that developmental piece of group work that requires you to build weekly on previous weeks requires you to build weekly on previous weeks work. work.
At the end of the unit you will have completed a At the end of the unit you will have completed a care plan with your small group and you will care plan with your small group and you will (with your group, represent a full care plan as (with your group, represent a full care plan as one final piece of work. one final piece of work.
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The nursing process and its application to nursing practiceThe nursing process and its application to nursing practice
It is essential to note that Conditional to registration as a Nurse is the ability to:-It is essential to note that Conditional to registration as a Nurse is the ability to:-1-1- Undertake and document a comprehensive, systematic and accurate nursing Undertake and document a comprehensive, systematic and accurate nursing
assessment of the physical, psychological, social and spiritual needs of the patients, assessment of the physical, psychological, social and spiritual needs of the patients, clients and communities. clients and communities.
2-2- Provide a rationale for the care delivered which takes account of social, cultural, Provide a rationale for the care delivered which takes account of social, cultural, spiritual, legal, political and economic influences. spiritual, legal, political and economic influences.
3-3- Evaluate and document the outcomes of nursing and other interventions” Evaluate and document the outcomes of nursing and other interventions” (DoH 2000a).(DoH 2000a). Nursing Models ?! Purpose ?Nursing Models ?! Purpose ? The purpose of a The purpose of a Model of NursingModel of Nursing is to provide a framework for nurses to apply all is to provide a framework for nurses to apply all
the stages of the nursing process in practice. (Help nurses organize their thinking the stages of the nursing process in practice. (Help nurses organize their thinking about nursing\ Understand nursing from a particular view point\ Engage in their about nursing\ Understand nursing from a particular view point\ Engage in their practice in an orderly and logical way).practice in an orderly and logical way).
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The Nursing ProcessThe Nursing Process
Assessment(Collecting information)
Evaluation
(feedback)
Implementation
(apply the plan)
Planning (nurse & pt. set a plan (goals) to Assist with
solving a problem
Nsg. Diagnosis (clinical judgment to
Actual & potential Health problems)A systematic approach to nursing
Which comprisesa series (or cycle) of steps
(Or stages) which, most commonly,Are referred to as Assessing
Planning, implementing,& evaluating.(R.L.T 1990)
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NURSING AS A PROFESSION NURSING AS A PROFESSION
Profession can be defined as:Profession can be defined as:
The possession of a unique The possession of a unique body of knowledgebody of knowledge, provision of an , provision of an altruistic service to societyaltruistic service to society, and , and autonomyautonomy in the sense of in the sense of control over their work and work conditionscontrol over their work and work conditions
The main attributes of a profession:The main attributes of a profession:
1-1-a systematic& organized knowledge base a systematic& organized knowledge base
2-2-Public service & altruism (doing things for the benefit of others Public service & altruism (doing things for the benefit of others rather than self).rather than self).
3-3- Codes of ethics & regulation of professional conduct. Codes of ethics & regulation of professional conduct.
4-4-high levels of reward.high levels of reward.
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Why use the nursing process and models?Why use the nursing process and models? AUTONOMY-----AUTONOMY----- “having the free will to select and act according to one’s “having the free will to select and act according to one’s inclinations with independent thought and control over choice” (Wilkinson 1997). inclinations with independent thought and control over choice” (Wilkinson 1997).
Nursing Models help us to be autonomous through :Nursing Models help us to be autonomous through :
** providing a framework for applying the nursing process. providing a framework for applying the nursing process.
** providing Evidence based care (means making clinical decisions which are based providing Evidence based care (means making clinical decisions which are based upon best available evidence). upon best available evidence).
ACCOUNTABILITY---- ACCOUNTABILITY---- “Being accountable means answering for your actions “Being accountable means answering for your actions
It is an integral part of professional practice concerned withIt is an integral part of professional practice concerned with
1-1- Weighing up the interests of patients in complex situations Weighing up the interests of patients in complex situations
2-2- Using professional knowledge, judgment and skills to make a Using professional knowledge, judgment and skills to make a decision decision
3-3- Accounting for the decision made (UKCC Guidelines for Accounting for the decision made (UKCC Guidelines for Professional practice 1996) Professional practice 1996)
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RE-CAP “ REVISION”RE-CAP “ REVISION”
AssessmentAssessment First stage of an ongoing, cyclical & multistage process. First stage of an ongoing, cyclical & multistage process. Involves collaboration with the patient to identify their actual and potential Involves collaboration with the patient to identify their actual and potential
problems. problems. Involves the collection of data from a variety of sources. Involves the collection of data from a variety of sources. An effective assessment depends upon:- An effective assessment depends upon:-
– Identifying appropriate/relevant sources Identifying appropriate/relevant sources
– Pulling together information from these sources.Pulling together information from these sources.
Skills Involved: Skills Involved: Active Listening \ Observing and Monitoring \Responding Active Listening \ Observing and Monitoring \Responding appropriately to cues \Asking relevant, yet sensitive questions \ Conducting a appropriately to cues \Asking relevant, yet sensitive questions \ Conducting a thorough physical examination \Accurately recording, cataloguing, integrating thorough physical examination \Accurately recording, cataloguing, integrating & analyzing. & analyzing.
What Information is Integral to an Assessment?What Information is Integral to an Assessment?
Subjective and objective information about:-Subjective and objective information about:-
Physical health \Psychological well-being \Social health \ Spiritual needs \Cultural Physical health \Psychological well-being \Social health \ Spiritual needs \Cultural needs needs
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Nursing diagnosisNursing diagnosis What Does Nursing Diagnosis Involve?What Does Nursing Diagnosis Involve?
Making a "decisive statement concerning the clients needs"Making a "decisive statement concerning the clients needs"(George 1995: 21)(George 1995: 21)
"A statement that describes the actual or potential health problems of a client based "A statement that describes the actual or potential health problems of a client based on a holistic assessment" (Weber 1991).on a holistic assessment" (Weber 1991).
(Refers to a health problem \Based on objective and subjective assessment data \ A (Refers to a health problem \Based on objective and subjective assessment data \ A short & concise statement of nursing judgment \ Condition for which the nurse can short & concise statement of nursing judgment \ Condition for which the nurse can independently prescribe \Can be validated by patient ) .independently prescribe \Can be validated by patient ) .
(Hogston and Simpson 2002. p.1 )(Hogston and Simpson 2002. p.1 )
Nursing Diagnosis Some Key Points?Nursing Diagnosis Some Key Points?
Differs from medical diagnosis\ Nursing focuses on whole unique person \Not just Differs from medical diagnosis\ Nursing focuses on whole unique person \Not just on illness or disease \ Is the end product of nursing assessment \Is dependant upon on illness or disease \ Is the end product of nursing assessment \Is dependant upon an accurate and comprehensive assessment \ Forms the basis for subsequent care an accurate and comprehensive assessment \ Forms the basis for subsequent care planning activities and therapeutic interventions planning activities and therapeutic interventions
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What is the Relationship Between Nursing Diagnosis & Patient Problems?What is the Relationship Between Nursing Diagnosis & Patient Problems?
Actual Problems - arise from the assessment Actual Problems - arise from the assessment
Potential Problems - could arise as a consequence of the actual problem Potential Problems - could arise as a consequence of the actual problem
For Example:- For Example:-
– Actual Problem: Pain as result of fractured ribs Actual Problem: Pain as result of fractured ribs
– Potential Problem: Chest infection, due to poor ventilation as a result of Potential Problem: Chest infection, due to poor ventilation as a result of inadequate chest movements due to experienced pain. (Hogston and Simpson inadequate chest movements due to experienced pain. (Hogston and Simpson 2002.)2002.)
Nursing Diagnosis Characteristics:Nursing Diagnosis Characteristics:
** Is the end product of nursing assessment Is the end product of nursing assessment
** Is dependant upon an accurate and comprehensive assessment Is dependant upon an accurate and comprehensive assessment
** Forms the basis for subsequent care planning activities and therapeutic Forms the basis for subsequent care planning activities and therapeutic interventionsinterventions
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Multidisciplinary care and the concept Multidisciplinary care and the concept of teamwork within nursing practiceof teamwork within nursing practice
The Multidisciplinary Team (Interprofessional and interdisciplinary) : The Multidisciplinary Team (Interprofessional and interdisciplinary) : A team made up of professionals from different disciplines working together to A team made up of professionals from different disciplines working together to
achieve the same goal.achieve the same goal. A Team can be defined as” a small number of people with complimentary skills A Team can be defined as” a small number of people with complimentary skills
who are committed to a common purpose, performance goals & an approach for who are committed to a common purpose, performance goals & an approach for which they hold themselves mutually accountable”. which they hold themselves mutually accountable”.
**Teamwork relates to a group of people working together to achieve a common Teamwork relates to a group of people working together to achieve a common goalgoal
Teamwork is sustained and improved when:Teamwork is sustained and improved when: ** each team member respects the differences and strengths of others. each team member respects the differences and strengths of others. ** Good teamwork is built on respect and trust for each other. Good teamwork is built on respect and trust for each other. ** Must know their own role and the boundaries of that role. Must know their own role and the boundaries of that role. ** Each member of the team needs to have an understanding of the teams goals Each member of the team needs to have an understanding of the teams goals ** Each valuing the contribution they make and those made by others Each valuing the contribution they make and those made by others ** Effective care is the consequence of effective teamwork Effective care is the consequence of effective teamwork (Semple and Cable 2003) Semple, M.and Cable, S. (2003) The New Code (Semple and Cable 2003) Semple, M.and Cable, S. (2003) The New Code
of Professional Conduct. Nursing Standard. 17(23): 40-48.of Professional Conduct. Nursing Standard. 17(23): 40-48.
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What is teamwork and what maintains it:What is teamwork and what maintains it:
Working within a team however provides support to members in making Working within a team however provides support to members in making challenging decisions challenging decisions
Team members can also provide objective feedback on situations, have the Team members can also provide objective feedback on situations, have the benefit of differing perspectives and ideas to a common solution. benefit of differing perspectives and ideas to a common solution.
Barriers to effective teamwork can be classified into three categories:Barriers to effective teamwork can be classified into three categories:
1- Internal Team Dynamics 1- Internal Team Dynamics
2- External Influences2- External Influences
3- Individual Behaviour 3- Individual Behaviour
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Individual Behavior Individual Behavior External InfluencesExternal Influences Internal Team Internal Team DynamicsDynamics
1-TIME1-TIME 2- NON-COOPERATION 2- NON-COOPERATION BY INDIVIDUALBY INDIVIDUAL
3- CRITISISM WUTHIN 3- CRITISISM WUTHIN THE TEAMTHE TEAM
4- RULES & 4- RULES & REGULATIONSREGULATIONS
5-COMPETITION\ SELF-5-COMPETITION\ SELF-INTERESTINTEREST
6-POOR 6-POOR COMMUNICATIONCOMMUNICATION
7-LACK OF 7-LACK OF COMMITMENTCOMMITMENT
8-RESOURCES 8-RESOURCES
9- GROUP SIZE\ 9- GROUP SIZE\ STRUCTURESTRUCTURE
10-PHYSICAL WORK 10-PHYSICAL WORK SETTINGS SETTINGS
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Individual Behavior Individual Behavior External InfluencesExternal Influences Internal Team Internal Team DynamicsDynamics
11-AUTHORITY 11-AUTHORITY STRUCTURESSTRUCTURES
12- TRAINING12- TRAINING 13- ORGANIZATIONAL 13- ORGANIZATIONAL CULTURE CULTURE
14-ROLE AMBIGUITY 14-ROLE AMBIGUITY 15-CAREER 15-CAREER ASPIRATIONSASPIRATIONS
16- SKILLS \ EDUCATION 16- SKILLS \ EDUCATION \ KNOWLEDGE \ KNOWLEDGE
17- ATTITUDES & 17- ATTITUDES & BELIEFS BELIEFS
18-MOTIVATION 18-MOTIVATION
19- TOO MUCH\ TOO 19- TOO MUCH\ TOO LITTLE LEADERSHIPLITTLE LEADERSHIP
20-ORGANIZATIONAL 20-ORGANIZATIONAL GOAL \ STRATEGY GOAL \ STRATEGY
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Care Planning TaskCare Planning Task This week you need to complete the following steps of the care This week you need to complete the following steps of the care planning group work task:planning group work task:
Each small group will be given a specific profile\early next week.Each small group will be given a specific profile\early next week.The Ulster University care plan template must be used for the The Ulster University care plan template must be used for the completion of this group work.completion of this group work.
Firstly, using a holistic approach, conduct a nursing assessment for Firstly, using a holistic approach, conduct a nursing assessment for your patient using the patient profile specified for your group. You your patient using the patient profile specified for your group. You then need to identify: then need to identify: - 2 actual patient needs/problems of high priority- 2 actual patient needs/problems of high priority- 2 potential patient needs/problems of high priority- 2 potential patient needs/problems of high priorityThese need to be written as nursing diagnoses. These need to be written as nursing diagnoses. For example, one nursing diagnosis may be (potential problem) For example, one nursing diagnosis may be (potential problem)
John is at risk of falling due to poor mobility and requires the John is at risk of falling due to poor mobility and requires the assistance of 1 when mobilizing assistance of 1 when mobilizing
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Goal statementGoal statement
STEP THREE IN THE nursing PROCESS: PLANNING/SETTING GOALS WITH A CLIENT.STEP THREE IN THE nursing PROCESS: PLANNING/SETTING GOALS WITH A CLIENT. Prioritize problems/diagnosesPrioritize problems/diagnoses Formulate expected outcomesFormulate expected outcomes Choose nursing strategiesChoose nursing strategies Develop a care planDevelop a care plan
Indicates the absolute desired outcome of the planned nursing careIndicates the absolute desired outcome of the planned nursing care ..Types of Goals Types of Goals
• • Short term goalsShort term goals are expected to be achieved in a relatively short period of time, usually less than a week. are expected to be achieved in a relatively short period of time, usually less than a week. • • Long term goalsLong term goals are expected to be achieved over a relatively long period of time, usually weeks or months. are expected to be achieved over a relatively long period of time, usually weeks or months.
Goals statements provide four purposesGoals statements provide four purposes 1-1- They provide direction for nursing interventions. They provide direction for nursing interventions.
2-2- They provide a time span for planned activities. They provide a time span for planned activities. 3- 3- They serve as criteria for evaluation of progress toward goal/outcome achievement. They serve as criteria for evaluation of progress toward goal/outcome achievement. 4-4- They enable the patient and nurse to determine when the problem/need has been met They enable the patient and nurse to determine when the problem/need has been met /addressed/addressed
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Outcomes/Goals Outcomes/Goals
• • State how, what, when, and where.State how, what, when, and where. Outcomes/Goals in Outcomes/Goals in
• • Actual diagnosis the goal is to Actual diagnosis the goal is to restore health responses and prevent restore health responses and prevent complications. complications.
•• Potential the goal is to prevent the Potential the goal is to prevent the problem from occurring or maintain problem from occurring or maintain present level of functioning.present level of functioning.
Just as it was essential to validate Just as it was essential to validate the diagnosis with the client, it is the diagnosis with the client, it is necessary to work with the client to necessary to work with the client to set health-related goals. What is seen set health-related goals. What is seen as a priority by the nurse may not be as a priority by the nurse may not be seen important to a client and the seen important to a client and the reverse can be true. Either reverse can be true. Either the clientthe client (or his/ her family if the client can not (or his/ her family if the client can not participate) participate) should be involved in should be involved in picking the goals and discussing the picking the goals and discussing the methods to achieve them.methods to achieve them.
Nursing goals are simply the antithesis Nursing goals are simply the antithesis of the nursing diagnostic statement of the nursing diagnostic statement with a reasonable time frame. In other with a reasonable time frame. In other words, words, diagnostic statements are diagnostic statements are "problems" (negative"problems" (negative).).
Goals are "positive" (turn the nursing Goals are "positive" (turn the nursing diagnostic statement around).diagnostic statement around).
If the nursing diagnosis is "Risk for If the nursing diagnosis is "Risk for Infection r/t..." for instance Infection r/t..." for instance then the then the
goal statement might be "Client will goal statement might be "Client will not experience infection throughout not experience infection throughout hospital stay AEB clear lung sounds, hospital stay AEB clear lung sounds, afebrile, WBC count between 5,000 afebrile, WBC count between 5,000 and 11,000, wound site well and 11,000, wound site well approximated with no purulent approximated with no purulent drainage."drainage."
Goal statements always begin with Goal statements always begin with "The patient/ client will..." and have a "The patient/ client will..." and have a specified time element.specified time element.
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MACROS CRITERIA
M---MEASURABLE&
OBSERVABLEA---ACHIEVABLE&
TIME LIMITED.C---CLIENT CENTERED.
R---REALISTIC.O---OUTCOME
WRITTEN.S---SHORT.
THINK ABOUT
IS IT CLEAR?IS IT LINKED TO THE NSG. DX.?WHEN POSSIBLE DOES THE PT.&\ OR FAMILY AGREE THAT THIS IS THE FOCUS OF CARE?
WRITING A GOAL STATEMENTWRITING A GOAL STATEMENT
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HowHowOnce the problem list is complete,Once the problem list is complete,
look at each problem and ask the question,look at each problem and ask the question, "Will this problem get better?“"Will this problem get better?“
YESYES Then your goal willThen your goal will be for the problembe for the problem
to resolve or show signs to resolve or show signs of improvement of improvement within the reviewwithin the review
period period acuteacute setting, setting,
the the review periodreview period may be as may be as shortshort as next shift,as next shift,
next day or next next day or next weekweek
NONO
Can we keep this Can we keep this from gettingfrom getting any worse, any worse,
or developingor developing complications?"complications?"
YesYes Then your goal willThen your goal will
be forbe forthe problem tothe problem to
intervene and preventintervene and preventor minimizeor minimize
complications.complications.
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PLANNING AND OUTCOMESPLANNING AND OUTCOMESo What are the goals for this What are the goals for this
client? client? o What do I want to accomplish? What do I want to accomplish? o How are my goals related to How are my goals related to
what the client wants to what the client wants to accomplish? accomplish?
o What are the expected outcomes What are the expected outcomes for this client? for this client?
o What interventions are to be What interventions are to be used? used?
o Who is the best-qualified person Who is the best-qualified person to person these interventions?to person these interventions?
o How much involvement can the How much involvement can the client and family or significant client and family or significant others have at this time? others have at this time?
o How much involvement does the How much involvement does the client wish to have at this time?client wish to have at this time?
SETTING GOALS WITH A CLIENTSETTING GOALS WITH A CLIENT
There are three parts to a correctly There are three parts to a correctly written goal statement. To remember written goal statement. To remember the three parts of SETTING GOALS the three parts of SETTING GOALS WITH A CLIENT one can use GTT WITH A CLIENT one can use GTT the abbreviation for drop. the abbreviation for drop.
G = Goal statement is written as " The G = Goal statement is written as " The client will . . .'client will . . .'T = Time for evaluating goal T = Time for evaluating goal achievement is part of the statement:achievement is part of the statement: " ...by noon today..." " ...by noon today..."T = Tool for measuring goal T = Tool for measuring goal achievement is part of the statement:achievement is part of the statement: "...as measured by..." "...as measured by..."
One example of a short term goal One example of a short term goal statement would be;statement would be;
"The client will show involvement in "The client will show involvement in her own post-operative recovery by her own post-operative recovery by noon today as measured by turning noon today as measured by turning side to side, deep breathing and side to side, deep breathing and coughing every hour."coughing every hour."
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Writing Goals/OutcomesWriting Goals/Outcomes
Be sure that at least one outcome clearly demonstrates resolution of the problem cause. Be sure that at least one outcome clearly demonstrates resolution of the problem cause.
Be sure the outcome is appropriate to the nursing diagnosis. Be sure the outcome is appropriate to the nursing diagnosis.
Be sure that each outcome has all the necessary components. Be sure that each outcome has all the necessary components.
Be sure the outcome is valued by the client and the family. Be sure the outcome is valued by the client and the family.
Be sure the outcome is congruent with the total treatment plan. Be sure the outcome is congruent with the total treatment plan.
Be sure each outcome is stated in terms of client responses and not nursing activities. Be sure each outcome is stated in terms of client responses and not nursing activities.
Be sure the outcomes are phrased in positive terms. Be sure the outcomes are phrased in positive terms.
Be sure that each outcome addresses only 1 behavioral response. Be sure that each outcome addresses only 1 behavioral response.
Be sure the outcomes describe a client behavior or response that demonstrates the Be sure the outcomes describe a client behavior or response that demonstrates the desired improvement, resolution or prevention of the nursing diagnosis. desired improvement, resolution or prevention of the nursing diagnosis.
Be sure the outcomes are observable, measurable, and have a time factor. Be sure the outcomes are observable, measurable, and have a time factor.
Be sure the outcomes are specific and concrete. Be sure the outcomes are specific and concrete.
Be sure the outcomes are realistic and achievableBe sure the outcomes are realistic and achievable .. North American Nursing Diagnosis AssociationNorth American Nursing Diagnosis Association (NANDA). (NANDA).
Nursing Outcomes Classification (NOC) developed at the University of Iowa. Nursing Outcomes Classification (NOC) developed at the University of Iowa.
Nursing Interventions Classification (NIC) developed at the University of IowaNursing Interventions Classification (NIC) developed at the University of Iowa
Need help with writing Nursing interventions!Need help with writing Nursing interventions! PermalinkPermalink
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CARE PLANNING TASK\ CONT.CARE PLANNING TASK\ CONT.
BUILDING ON YOUR GROUP WORK IN THE BUILDING ON YOUR GROUP WORK IN THE PREVIOUS WEEK & CONTINUING TO USE ULSTER PREVIOUS WEEK & CONTINUING TO USE ULSTER
UNIVERSITY CARE PLAN DOCUMENTATION UNIVERSITY CARE PLAN DOCUMENTATION COMPLETE BY COMPLETE BY
DEVELOPING GOAL STATEMENTS TO ADDRESS DEVELOPING GOAL STATEMENTS TO ADDRESS THE 4 NSG. DIAGNOSIS YOU HAVE SELECTED THE 4 NSG. DIAGNOSIS YOU HAVE SELECTED
WITH REFERENCE TO EACH OF THE ACTUAL & WITH REFERENCE TO EACH OF THE ACTUAL & POTENTIAL NEEDS\ PROBLEMS ULREADY POTENTIAL NEEDS\ PROBLEMS ULREADY
IDENTIFIED.IDENTIFIED.USE MACRO CRITERIA USE MACRO CRITERIA
GOOD LUCK GOOD LUCK
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IMPLEMENTATION IMPLEMENTATION
1-Assessment(Collecting information)
Evaluation
(feedback)
4-Implementation
(apply the plan) Is where theIs where the
care is delivered andcare is delivered and
the actions are carried outthe actions are carried out..
3-Planning (nurse & pt. set a
plan (goals) to Assist
with solving a problem
2-Nsg. Diagnosis (clinical judgment to
Actual & potential Health problems)
The Nursing ProcessA systematic approach to nursing
Which comprisesa series (or cycle) of steps
(Or stages) which, most commonly,Are referred to as Assessing
Planning, implementing,& evaluating.(R.L.T 1990)
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IMPLEMENTATIONIMPLEMENTATION
The “The “DoingDoing “ phase of the “ phase of theNursing Process;Nursing Process;
the initiation of designed nursing the initiation of designed nursing care plans into action toward achieving thecare plans into action toward achieving the
goal & expected outcomegoal & expected outcomeThis step encompasses most of the This step encompasses most of the physical carephysical care
teaching, support and teaching, support and
coordinationcoordination
•The nurse has alreadyThe nurse has already been workingbeen working
closely with her/ his client:closely with her/ his client:establishing rapport, establishing rapport, assessing, discussingassessing, discussing
•client’s need identified( Dx)client’s need identified( Dx)
•Client's goals are establishedClient's goals are established
Now that the client's goalsNow that the client's goals
are establishedare establishednursing actions are selected thatnursing actions are selected that
move those goals forward.move those goals forward.(planning)(planning)
ActionsActions are specific toare specific to
a particular goal;a particular goal;each goal has its own list each goal has its own list
of nursing actions.of nursing actions.Accompanying each nursing Accompanying each nursing
Intervention isIntervention is a statement of its scientific rationale.a statement of its scientific rationale.
interventions should interventions should Also be measurableAlso be measurable
realistic, & should berealistic, & should be documenteddocumented
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WRITING THE NURSING
INTERVENTIONACTIONS
DOING SOMETHING
A VERB IN STATEMENT
INSTRUCTIONS TO HOW ACHIEVE “ OUTCOME OF CARE.
RATIONALE(EVIDENCE-BASED PRACTICE ) DRIVEN FROM PROFESSIONAL
KNOWLEDGR& UNDERSTANDING.
WHAT DO WE NEED TO ACHIEVE THIS
GOAL\ OUTCOME ?
HOW?WHAT DO WENORMALLY DO?
START WRITING WITH VERBS
(OBSERVE, HELP, MONITOR,DISCUSS,…)
PRIORITISE NSG. INTERVENTIONS ACTIONS
(LOGICAL FORMAT; STEP BY STEP EASY TO FOLLOW &
SUCCINCT”BRIEF”)
CHECK FOR GUIDANCEFROM MOST UP-TO-DATE
NSG. LITERATURE( THE USE OF EVIDENCE)
PROVIDE A RATIONALE FOR CARE(A REASON
“ EVIDANCE BASED” FOR PROVIDING THECARE)
ALWAYS ENSURE THATALWAYS ENSURE THAT
THE NURSING INTERVE-THE NURSING INTERVE-
NTIONS REFLECT THENTIONS REFLECT THE
PRIORITIES OF THE PT.PRIORITIES OF THE PT.
AT THE GIVEN TIME.AT THE GIVEN TIME.
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THE LINK BETWEEN THE THE LINK BETWEEN THE OUTCOME/GOAL OUTCOME/GOAL STATEMENT AND THE STATEMENT AND THE NURSING INTERVENTIONS. NURSING INTERVENTIONS.
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SO WHAT DO WE MEAN BY EVIDENCED BASED SO WHAT DO WE MEAN BY EVIDENCED BASED PRACTICE?PRACTICE?
Evidence-Based Practice (EBP) requires that decisions about health Evidence-Based Practice (EBP) requires that decisions about health care are based on the best available, current, valid and relevant care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, evidence. These decisions should be made by those receiving care, informed by the tacit (understood, not necessarily researched) and informed by the tacit (understood, not necessarily researched) and explicit knowledge (gained from research) of those providing care, explicit knowledge (gained from research) of those providing care, within the context of available resources. within the context of available resources.
WE DO NOT CARRY OUT INTERVENTIONS BECAUSE THEY WE DO NOT CARRY OUT INTERVENTIONS BECAUSE THEY HAVE ALWAYS BEEN CARRIED OUT TO MEET THIS GOAL, HAVE ALWAYS BEEN CARRIED OUT TO MEET THIS GOAL,
WE DO THIS BECAUSE THE EVIDENCE SHOWSWE DO THIS BECAUSE THE EVIDENCE SHOWS THIS IS THE BEST WAY FORWARD. THIS IS THE BEST WAY FORWARD.
AS PROFESSIONALS WE MUST BE ABLE TO STAND OVER OUR AS PROFESSIONALS WE MUST BE ABLE TO STAND OVER OUR PRACTICE AND JUSTIFY OURPRACTICE AND JUSTIFY OUR DECISIONS.DECISIONS.
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CARE PLANNING TASK\ CONT.CARE PLANNING TASK\ CONT.
For this section of the unit, you need to For this section of the unit, you need to complete the following steps as part of your complete the following steps as part of your care planning group work activity:care planning group work activity:
Based on the Based on the evidenceevidence available:- available:-
1- 1- Plan the nursing interventions required to Plan the nursing interventions required to meet the 4 goals you had set last weekmeet the 4 goals you had set last week
2-2-You must provide a rationale for You must provide a rationale for allall of the of the specified nursing interventionsspecified nursing interventions
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EvaluationEvaluation 55thth stage in NSG. PROCESS stage in NSG. PROCESS
1-Assessment(Collecting information)
4-Implementation
(apply the plan) Is where theIs where the
care is delivered andcare is delivered and
the actions are carried outthe actions are carried out..
3-Planning (nurse & pt. set a
plan (goals) to Assist
with solving a problem
2-Nsg. Diagnosis (clinical judgment to
Actual & potential Health problems)
5-Evaluation
EVALUATION IS MAKING
A JUDGEMENTON HOW
EFFECTIVE THE NURSING
INTERVENTION HAVE
BEEN IN ACHIEVING THE
DESIRED
OUTCOME/GOAL.
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HOW DO WE EVALUATE CARE?HOW DO WE EVALUATE CARE? WHAT DID THE NURSES DO TO EVALUATE NURSING CARE? WHAT DID THE NURSES DO TO EVALUATE NURSING CARE? HOW WAS CARE EVALUATED?HOW WAS CARE EVALUATED?
THE PROCESS OF EVALUATION IS CONCERNED WITHTHE PROCESS OF EVALUATION IS CONCERNED WITH CHECKING WHETHER THE CHECKING WHETHER THE NURSING INTERVENTIONSNURSING INTERVENTIONS
HAVE BEEN EFFECTIVE IN HAVE BEEN EFFECTIVE IN REACHINGREACHING THE THE DESIRED PATIENT’S GOAL SETDESIRED PATIENT’S GOAL SET. .
KEY SKILLS AND ACTIONS NEEDED TO MAKE AN EVALUATION KEY SKILLS AND ACTIONS NEEDED TO MAKE AN EVALUATION ARE:ARE:
** QUESTIONING THE PATIENT, THE PATIENTS FAMILY/FRIENDS, QUESTIONING THE PATIENT, THE PATIENTS FAMILY/FRIENDS, OTHER NURSES, AND OTHER HEALTHCARE PROFESSIONALS.OTHER NURSES, AND OTHER HEALTHCARE PROFESSIONALS.
* * OBSERVING.OBSERVING. ** MEASURING. MEASURING. ** COLLABORATING/ LIAISING. COLLABORATING/ LIAISING. ** RECORDING AND REPORTING . RECORDING AND REPORTING . ** RE-ASSESSING. RE-ASSESSING.
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WRITING WRITING THE THE
EVALUATIEVALUATIONON
THE EVALUATION SHOULD NOT BE A “STORY”.
IT SHOULD BE A
CONCISE RECORD
OF THE
EFFECTIVENESS OF
NURSING CARE, A
ND
SHOULD ALSO
SPECIFY IF THE
GOAL IS M
ET, OR
BEING M
ET
SHOULD NUMBER EACH NURSING
DIAGNOSIS, AND NUMBER EVALUATION TO CORRESPOND WITH THIS.
A NURSE HAVE TO
MAKE DECISIONS
AND WRITE THE
EVALUATION,
MAY NEED TO
INVOLVE OTHERS IN
MAKING THE
EVALUATION
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““IF GOALS IF GOALS ARE NOT ARE NOT
MET, WHY MET, WHY NOT?”.NOT?”.
THE NURSING THE NURSING INTERVENTIONS WERE INTERVENTIONS WERE
NOT CARRIED OUT NOT CARRIED OUT EFFECTIVELY, OR THEY EFFECTIVELY, OR THEY
WERE NOT THE CORRECT WERE NOT THE CORRECT INTERVENTIONS TO INTERVENTIONS TO
ACHIEVE THE GOAL SET? ACHIEVE THE GOAL SET?
THE GOAL THE GOAL SET WAS SET WAS
NOT NOT ACHIEVABLACHIEVABL
E OR WAS E OR WAS UNREALISTIUNREALISTI
C?C?
THE REGISTERED NURSE SHOULD FEEL
AUTONOMOUS IN HIS/HER DECISION
ON THE EFFECTIVENESS OF
CARE. IN COLLABORATION
WITH THE MULTIDISCIPLINARY TEAM, PATIENT AND
FAMILY
PERHAPS THE PERHAPS THE PATIENT’S PATIENT’S
CONDITION CONDITION HAS CHANGED HAS CHANGED SIGNIFICANTLSIGNIFICANTL
Y?Y?
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John is 23, and has been admitted with acute abdominal pain in his right lower John is 23, and has been admitted with acute abdominal pain in his right lower quadrant. He states that the pain is “stabbing” and “sharp”. He rates the pain as quadrant. He states that the pain is “stabbing” and “sharp”. He rates the pain as
scoring 8 on a scale of 0-10 (0 being no pain and 10 being the worst pain possible”. scoring 8 on a scale of 0-10 (0 being no pain and 10 being the worst pain possible”. He is married with one child aged 3 months, and is the only person who is currently He is married with one child aged 3 months, and is the only person who is currently earning an income within the household. He is very anxious about being in hospital earning an income within the household. He is very anxious about being in hospital as he has never been in hospital before. John has also just been informed that he will as he has never been in hospital before. John has also just been informed that he will
have to go to theatre for bowel surgery, and must now fast for theatre. have to go to theatre for bowel surgery, and must now fast for theatre. JOHN HAS
SHARP PAININ HIS
RIGHT SIDE AS A RESULT
OF A SUSPECTED
APPENDICITIS
JOHNS PAIN WILL
BEREDUCED TO
WHAT HEFEELS IS
AN ACCEPTABLE
LEVEL. ??
NURSE WILL:1-ASSESS JOHNS PAIN
USING PAIN SCALE 3-4 HOURLY,
RECORDING TYPE, LOCATION AND
EXPERIENCE OF PAIN 2-ADMINISTER PRESCRIBED
ANALGESIA AS APPROPRIATE
ASSESSING PAIN IS ESSENTIAL TO HELP ESTABLISH JOHN'S PERCEPTION
OF THE PAIN EXPERIENCED SO THAT A BASELINE
CAN BE ESTABLISHED.A PAIN SCALE IS A USEFUL
TOOL FOR PATIENTS TO BEABLE TO COMMUNICATE
THEIR PAIN (WOODS 2004). oUNRELIEVED PAIN CAN LEAD
TO FURTHER COMPLICATIONS, FOR EXAMPLE, RED
UCED MOBILITY, ANXIETY, SHALLOW BREATHING
(LEADING TO POTENTIAL CHEST INFECTION),
AND RAISED HEART RAT (ALEXANDER ET AL., 2006).
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CARE PLANNING TASK\ CONT.CARE PLANNING TASK\ CONT.
For this section of the unit, you need to complete For this section of the unit, you need to complete the remaining steps of your care planning group the remaining steps of your care planning group
work activity:work activity:
1-1-Explain the methods and process you would Explain the methods and process you would adopt to evaluation the patient's progress and adopt to evaluation the patient's progress and the effectiveness of the nursing interventions. the effectiveness of the nursing interventions.
2-2-Then identify the strengths & weaknesses of the Then identify the strengths & weaknesses of the care plan you have developed. care plan you have developed.
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Revisiting Reflection, and Developing your skills Revisiting Reflection, and Developing your skills of Reflecting on your experiencesof Reflecting on your experiences
Reflection means ... the throwing back of thoughts and memories, Reflection means ... the throwing back of thoughts and memories, in cognitive acts such as thinking, contemplation, meditation and in cognitive acts such as thinking, contemplation, meditation and any other form of attentive consideration, in order to make sense any other form of attentive consideration, in order to make sense of them, and to make contextually appropriate changes if they are of them, and to make contextually appropriate changes if they are
required. required. (Taylor, 2001, p3)(Taylor, 2001, p3)
Reflection is the process that we consciously undertake to gain Reflection is the process that we consciously undertake to gain further understanding and add meaning to our daily lives. further understanding and add meaning to our daily lives. Reflection is associated with learning that has occurred through Reflection is associated with learning that has occurred through experience and is an activity that helps you make sense of and experience and is an activity that helps you make sense of and learn from situations.learn from situations.Reflection, therefore is a means of assisting us to think, to explore Reflection, therefore is a means of assisting us to think, to explore our thoughts and feelings and to work through an experience, in our thoughts and feelings and to work through an experience, in an attempt to gain new understandings, fresh insights and self an attempt to gain new understandings, fresh insights and self awareness awareness
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Reflection encourages the uncovering and interpretation of Reflection encourages the uncovering and interpretation of actions, thoughts feelings and behaviours all of which are present actions, thoughts feelings and behaviours all of which are present during and following an experience.during and following an experience.The purpose of reflective practice is to enable practitioners toThe purpose of reflective practice is to enable practitioners to
• • Assess Assess •• Learn Learn •• Understand Understand Through tried experiences AND then as a consequence take the Through tried experiences AND then as a consequence take the
appropriate steps to improve practice. (Johns 1995) appropriate steps to improve practice. (Johns 1995) Reflection as a thoughtful process is required within nursing to Reflection as a thoughtful process is required within nursing to
ensure that the nursing care that is given is required by that ensure that the nursing care that is given is required by that individual, planned individually and evaluated appropriately. individual, planned individually and evaluated appropriately.
Reflective practice therefore is a means to encourage nurses to be Reflective practice therefore is a means to encourage nurses to be thoughtful in their care, seeing patients as unique individuals.thoughtful in their care, seeing patients as unique individuals.
In being Reflective, provide us with the desire to engage in In being Reflective, provide us with the desire to engage in nursing interventions that facilitate more quality interactions nursing interventions that facilitate more quality interactions with patients and others. with patients and others.
Reflection create the opportunity to modify and change practice Reflection create the opportunity to modify and change practice as required by the changing needs of the individual or situation as required by the changing needs of the individual or situation
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ThinkThink
of the situation where all of the of the situation where all of the patients have to be bed bathed, out patients have to be bed bathed, out of bed and have their breakfast all of bed and have their breakfast all
before 9am because the ward round before 9am because the ward round starts then. Or every patient having starts then. Or every patient having their temperature, pulse and blood their temperature, pulse and blood
pressure recorded at 10am.pressure recorded at 10am.
Ask yourself:Ask yourself:
• • Of what benefit are these nursing Of what benefit are these nursing interventions and routine practices interventions and routine practices
to all of the patients?to all of the patients?•• Do the tasks get completed much Do the tasks get completed much
more quickly?more quickly?•• Is it easier to standardize nursing Is it easier to standardize nursing care and provide the same care to care and provide the same care to
all patients?all patients?•• Is this routine, ritualistic care Is this routine, ritualistic care
safe? evidence based? respectful of safe? evidence based? respectful of individuals need?individuals need?
Reflection is an active process and Reflection is an active process and not a random process, undertaken not a random process, undertaken without thought. without thought.
When we as nurses are thinking When we as nurses are thinking about our practice and are critical about our practice and are critical of it, we start to ask very of it, we start to ask very fundamental questions such asfundamental questions such as
• • What are we doing?What are we doing?• How is it being done?• How is it being done?• Why are we doing it this way?• Why are we doing it this way?• Does it need to be done?• Does it need to be done?• Is this the best way to do it? If not, • Is this the best way to do it? If not, what other way is there?what other way is there?
Schon (1991) and Boud et al (1998) Schon (1991) and Boud et al (1998) suggest that Reflection helps suggest that Reflection helps integrate theory and practice, integrate theory and practice, encourages more critical 'thinking' encourages more critical 'thinking' and as such creates professionals and as such creates professionals who are more critical 'doers'. who are more critical 'doers'.
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Reflection Reflection 'in''in' action occurs when the nurse working with a patient recognizes a action occurs when the nurse working with a patient recognizes a new situation and thinks about this situation in the midst of continuing to act on new situation and thinks about this situation in the midst of continuing to act on it, that is, she/he is 'thinking whilst doing'.it, that is, she/he is 'thinking whilst doing'.
Reflection Reflection 'on''on' action however is retrospective. That is, looking back on the action however is retrospective. That is, looking back on the experience to discover and appreciate the knowledge used in the situation and experience to discover and appreciate the knowledge used in the situation and the need for further knowledge. Schon (1983)the need for further knowledge. Schon (1983)
Schon refers to these two times, viewing reflecting 'in action' as being associated Schon refers to these two times, viewing reflecting 'in action' as being associated with thinking whilst acting - that is 'thinking on your feet'. with thinking whilst acting - that is 'thinking on your feet'.
GuidedGuided reflection; reflection; reflection is a personal process that helps develop reflection is a personal process that helps develop further understanding, usually resulting in a change in behaviour , further understanding, usually resulting in a change in behaviour , learner needs to work with a supervisor. Johns (1995)learner needs to work with a supervisor. Johns (1995)
Gibbs' Reflective Gibbs' Reflective CycleCycle(1988)(1988) When engaging in reflection, When engaging in reflection,
it is important that you: it is important that you:
Are spontaneous. Are spontaneous.
Express yourself freely. Express yourself freely.
Are open to ideas. Are open to ideas.
Choose a time to suit you. Choose a time to suit you.
Are prepared personally. Are prepared personally.
Choose a reflective method (Taylor, 2001) Choose a reflective method (Taylor, 2001)
FUTURE ACTION
REFRAME
DESCDIBTION
THOUGHTS\FEELINGS
EVALUATION
ANALYSIS
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Using Taylor’s Model of ReflectionUsing Taylor’s Model of Reflection
Taylor's model of reflectionTaylor's model of reflection is derived from the work of is derived from the work of HabermasHabermas (1972). In (1972). In his work, Habermas suggested that knowledge can be categorized as technical his work, Habermas suggested that knowledge can be categorized as technical (the interest of work) , practical (interaction) and emancipatory (power).(the interest of work) , practical (interaction) and emancipatory (power).
These are areas of interest that humans consider as important from which These are areas of interest that humans consider as important from which knowledge can be gained and interpreted. These human interests according to knowledge can be gained and interpreted. These human interests according to HabermasHabermas are based on and linked to parts of human existence. are based on and linked to parts of human existence.
Taylor adopted Habermas work and developed a reflective framework. She Taylor adopted Habermas work and developed a reflective framework. She identified three types of reflection as being:identified three types of reflection as being:
1- Technical Reflection-1- Technical Reflection--This type of reflection has the potential for creating -This type of reflection has the potential for creating opportunities for nurses to think critically in order to improve work practices, opportunities for nurses to think critically in order to improve work practices, particularly procedures and policies, through systematic questioning.particularly procedures and policies, through systematic questioning.
This systematic questioning is carried out within the steps of assessing, This systematic questioning is carried out within the steps of assessing, planning, implementing and evaluating the whole procedure.planning, implementing and evaluating the whole procedure.
The outcome of the technical reflection can be immediate The outcome of the technical reflection can be immediate
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2- Practical Reflection-2- Practical Reflection---- is a means by which we as nurses can interpret and --- is a means by which we as nurses can interpret and understand human interactions through systematic questioning.understand human interactions through systematic questioning.
It is a means to help you gain greater insight into the meaning of lived It is a means to help you gain greater insight into the meaning of lived experiences and to improve your communication with others within the clinical experiences and to improve your communication with others within the clinical environment. Having gained new insights and a raised awareness of the environment. Having gained new insights and a raised awareness of the interpersonal basis of human experiences, this in turn creates more interpersonal basis of human experiences, this in turn creates more opportunities for change. opportunities for change.
3-3- Emancipatory Reflection Emancipatory Reflection ---- Taylor suggests that through the process of ---- Taylor suggests that through the process of emancipatory reflection, nurses are in a better position to critique personal, emancipatory reflection, nurses are in a better position to critique personal, political sociocultural and economic features and constraints that are political sociocultural and economic features and constraints that are impacting on their work lives. impacting on their work lives.
In this type of reflection, practitioners are able to examine the delicate and In this type of reflection, practitioners are able to examine the delicate and clever powers and circumstances that hold practitioners back from achieving clever powers and circumstances that hold practitioners back from achieving desired goals.desired goals.
The systematic questioning used within emancipatory reflection provides The systematic questioning used within emancipatory reflection provides practitioners with a greater ability to identify the problem or issue encountered practitioners with a greater ability to identify the problem or issue encountered in their practice setting and the restrictions and limitations faced. These are in their practice setting and the restrictions and limitations faced. These are crucial steps in the process of creating changes in attitudes, behaviours andcrucial steps in the process of creating changes in attitudes, behaviours and practices. practices.
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Practical Reflection-Practical Reflection-
In using practical reflection the intended outcomes are to help you
• gain a greater understanding of the interpersonal basis of human experiences• increase your potential for knowledge generation• enhance your opportunities for interpretation of the lived experiences within the environment that it is set (context) without bias and prejudice (subjectivity)• strengthen your opportunity to affect change as a result of your increased awareness of the nature of communication within professional practice (Taylor, 2001).
The process of practical reflection:
Experiencing----- retelling a practice story so that you experience it again in as much details as possible.
Interpreting----clarifying and explaining the meaning of a communicative action situation.
Learning ------creating new insights and integrating them in into your existing Learning ------creating new insights and integrating them in into your existing awareness and knowledge. awareness and knowledge.
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TASKTASK Using the process of practical reflection detailed below (Taylor’s model),
reflect on your experience of the team work within the care planning group that you have just been involved in.
Remember
Within each piece of reflective writing you need to clearly identify• what learning has occurred ?
show how this learning is linked to the theory related to the issue being reflected on.
In addition you must clearly indicate the model and type of reflection you have used to help guide the reflection.
This must be submitted online using the assignment drop box. The This must be submitted online using the assignment drop box. The submission date for this task is -----------submission date for this task is -----------
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SummarySummary The Nursing Process is a five stage, cyclical framework for The Nursing Process is a five stage, cyclical framework for delivering nursing caredelivering nursing care
2. The planning phase of the nursing process involves setting goals 2. The planning phase of the nursing process involves setting goals to address the nursing diagnosis, and identifying the nursing to address the nursing diagnosis, and identifying the nursing interventions required to meet these goals. interventions required to meet these goals. 3. Goal statements should be linked to the nursing diagnosis, be 3. Goal statements should be linked to the nursing diagnosis, be clearly written, be agreed with the patient, and meet the clearly written, be agreed with the patient, and meet the MACROS criteria.MACROS criteria.
4. Nursing interventions are the evidence-based actions required 4. Nursing interventions are the evidence-based actions required to achieve the goals set. to achieve the goals set.
5. Nursing interventions must be written in a clear, logical, step-5. Nursing interventions must be written in a clear, logical, step-by-step sequence, and have a rationale for their basis. by-step sequence, and have a rationale for their basis.
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6. Evaluation should include the following steps:
a. Review the goal statement and ask ‘are we achieving this goal’?
b. If you are achieving the goal then say so. If not, identify the reasons.c. Evaluate what has been successful about the care – you will want to ensure that this successful element is maintained within the care plan.
d. In some cases where the goal may have been achieved, you can discontinue the care in this area.
e. If the goal has not been achieved, check the nursing interventions. Are they still appropriate or do they need revision? You may wish to add or subtract from the plan of nursing interventions. You must show that the nursing interventions have been reviewed. What aspects of the nursing interventions may have been counterproductive to achieving the goal? Perhaps the outcome needs to be modified. Was the goal set too ambitious? If so, rewrite the goal statement in collaboration with the patient, family and multidisciplinary team.
f. Always question the review date. You may need to review this outcome more often. Maybe you had a short term goal that needed to be a long term goal.
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According to Taylor (2001) reflection is a means to create understanding that According to Taylor (2001) reflection is a means to create understanding that helps us recognize the impact of our nursing actions and therefore provides us helps us recognize the impact of our nursing actions and therefore provides us with opportunities to improve our professional skills. with opportunities to improve our professional skills.
Therefore when you reflect on any experience you do not simply see more, you Therefore when you reflect on any experience you do not simply see more, you do however seedo however see differently differently and as such you therefore and as such you therefore act differentlyact differently..
Reflection is an active process and not a random process, undertaken without Reflection is an active process and not a random process, undertaken without thought.thought.
Nursing actions without though reduces opportunity to provide quality Nursing actions without though reduces opportunity to provide quality individualized care.individualized care.
The process of reflection on practice is not easy- but rewarding as it provides The process of reflection on practice is not easy- but rewarding as it provides new insights, new knowledge, and opportunities to alter practice to enhance the new insights, new knowledge, and opportunities to alter practice to enhance the outcome. outcome.
Reflection is a valuable means to help us understand the different types of Reflection is a valuable means to help us understand the different types of knowledge which is rooted within everyday nursing practice.knowledge which is rooted within everyday nursing practice.
Taylor’s model of reflection is one framework that provides nurses with a Taylor’s model of reflection is one framework that provides nurses with a reflective approach to their work reflective approach to their work
• • It is important to remember technical, practical and emancipatory types of It is important to remember technical, practical and emancipatory types of reflection identified but Taylor can be used in different aspects of your clinical reflection identified but Taylor can be used in different aspects of your clinical work.work.