Nursing Process and Models Flashcards
who developed the idea of the nursing process?
Florence Nightingale
what is the nursing process?
not just treating the disease but looking at the patient holistically and ensuring good sanitation and hygiene
who argued that those who teach control the content of the occupation?
Peplau (1987)
what is a model according to Stockwell (1985)?
a simplified way of organising a complex phenomenon
how is the patient viewed according to the medical model?
as a complex set of anatomical parts and physiological symptoms (Aggleton and Chalmers)
why does the medical model encourage a disease orientated approach to the patient?
emphasises anatomical, physiological and biomedical malfunction as the causes of ill health
what sort of approach should nurses have towards patients?
individualised, holistic, patient orientated approach
what approach should veterinary nurses have?
both disease and patient orientated
what did M Walsh (1997) say about the nursing quest?
if nurses wish to be able to deliver the quality of care that they feel patients deserve, they must know what that care is and how it should be delivered
how many stages in the nursing process?
5
what are the 5 stages of the nursing process?
assessment diagnosis outcome/planning implementation evaluation
what happens during the assessment phase of the nursing process?
information collection/gathering data
what happens during the diagnosis phase of the nursing process?
information interpretation. Stating problems and strengths
what happens during the outcome/planning phase of the nursing process?
setting nursing goals, desired outcomes and planning interventions
what happens during the implementation phase of the nursing process?
performing nursing interventions
what happens during the evaluation phase of the nursing process?
patient’s status and effectiveness of nursing interventions assessed
is one stage of the nursing process more important than another?
no - but assessment is key as this forms the basis of the remainder of the process
when admitting patients what information should be gained?
history (from patient record)
current state
individual needs and routines
during assessment what can wrong information lead to?
wrong action
during assessment what can lack of information lead to?
inadequate action
what is involved in a nursing diagnosis?
making judgements for nursing interventions based on clinical assessment of the patient mobility dehydration feeding/excretion grooming social behavior
what problems must be considered while nursing?
actual problems (those currently happening - pain, difficulty grooming, eating) potential problems (those that could happen and must be monitored and prevented - infection, stress)
what can information gathered during the assessment stage be used for?
formulation of a plan
what are the aims of a nursing plan?
solve problems identified
prevent identified potential problems becoming actual problems
prevent problem treated reoccurring
help the patient be as comfortable as possible even if death is inevitable
help the patient and client cope with those problems tht cannot be solved
what must happen after administration of any treatment?
recording on drug chart and care plan. All entries should be initialed
what do nursing models provide?
the nurse with key pointers regarding patient assessment, goals, interventions and an evaluation appropriate to the individual
what are the 5 aspects of the nursing process?
assessment diagnosis planning implementation evaluation
why are nursing models needed?
nursing process does not: say what to look for in assessment say what form a care plan should take specify appropriate interventions specify what standards evaluation of actions should be made against
what do nursing models provide for nurses?
key pointers regarding patient assessment, goals, interventions and an evaluation appropriate to the individual
what does the logical development of nursing models allow?
adaption to meet specific patient requirements within the care plan
give the 5 main reasons to use a nursing model
consistency of care
less conflict between nurses over care required
incorporates care given by other members of the team
gives direction to nursing care
guides decision making
what are the 3 main models of nursing care?
Orem’s self-care model of nursing
Roper, Logan and Tierney (RLT) model of nursing
The Ability Model
who designed the Ability Model?
Orpet and Jeffery
when was Orem’s model first published?
1971
what is the key element of Orem’s model?
self-care
who does Orem believe should be responsible for patient care?
the patient and their immediate family (owner in veterinary medicine)
according to Orem when should the nurse/practitioner become involved in patient care?
when the patients ability to to achieve the 8 needs is compromised
how did Orem believe an individual meets their self care needs?
through learning rather than instinctively - menaing they could learn how to address their 8 needs
what are the issues with Orem’s model for veterinary practice?
more intervention is often needed - from owner or nurse
teaching is more complex/difficult
what are the 8 universal self care needs according to Orem?
sufficient intake of air sufficient intake of water sufficient intake of food satisfactory eliminative functions activity balanced with rest balance between solitude and social interaction prevention of hazards to life, species functioning and wellbeing normalcy
what does planning/implementation in Orem’s model focus on?
how the patient can achieve universal care needs with the nurse involved only when essential
what does the evaluation in Orem’s model focus on?
ability of patient or family to perform self care improving
how does Orem view the nursing process?
fluid with the nursing history (assessment) as a continuing process as more information about the patient is learned
what are the developmental self care requisites identified by Orem?
intrauterine life and birth neonatal life infancy, adolescence and early adulthood progressive stages of adulthood pregnancy
define self care
ability of each individual to take care of themselves
what term does Orem use to describe assessment of the patient?
nursing history
what is the role of the nurse in Orem’s model?
help others to do for themselves or educate family members to facilitate self-care and only provide health care in cases where the person is wholly unable to do so
who devised the RLT model?
Nancy roper
Winifred Logan
Alison Tierney
what does the RLT model assess?
the patients relative independence and potential for independence in the activities of daily living
when was the RLT model originally devised?
1976
what does the RLT framework encourage with regards to looking at the patient?
a holistic view of the patient not just of the disease process
when was the RLT model first applied in clinical situations to human patients?
1983
why is the RLT model so popular?
its simplistic structure
ease of application to a wide range of clinical settings
what are the 5 parts of the RLT model?
activities of living patient lifespan dependence-independence continuum factors affecting activities of daily living individuality in living
what are the 12 activities of living?
maintaining a safe environment communicating breathing eating and drinking eliminating personal dressing and cleansing controlling body temperature mobilising working and playing expressing sexuality sleeping dying
what are the 4 defined sections of a patients lifespan (human)?
baby/toddler
adolescence
adulthood
senior citizen/OAP
what specialist knowledge is required of veterinary nurses when considering patient lifespan?
prior knowledge and understanding of life stages for each species
what is the dependence-independence continuum?
shows level of competency plotted on a continuum
what does the dependence-independence continuum prompt?
implementation of effective nursing care to allow patient to carry out each activity
what can the dependence-independence continuum be a good tool for?
goal setting and assessment
what are the 4 factors which influence the activities of living?
biological psychological sociocultural environmental politicoeconomic
what is covered by individuality in living?
how patients carry out each activity of living differently (individual differences)
who designed the Ability model?
Hilary Orpet and Andrea Jeffery
what influenced the creation of the Ability model?
RLT and Orem models
what is the assessment phase structured around in the Ability model?
what the animal is able to do or not do by itself - its abilities
what are the 10 abilities of the Ability model?
is the animal able to: eat an adequate amount drink an adequate amount urinate normally defecate normally breathe normally maintain body temperature groom itself mobilise adequately sleep/rest express normal behavior/interact normally
what are the influencing factors of the Ability model?
cultural differences (owner)
owner compliance
financial implications
life stage
what are the 3 key components of the Ability Model?
Ability Assessment Chart
nursing plan
influencing factors
