An Exploration of a Needs Orientated Approach to Care Planning

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An exploration of a needs orientated approach to care planning

The purpose of this assignment is to explore a needs orientated approach to care planning, through the use of a problem solving approach to care, and a nursing model. It aims to show an understanding of what both a problem solving approach to care, and a nursing model are; and to establish how various key elements of both are implemented in practice. The following citation by the Department of Health (DH) (2009) identifies what is intended by the process of care planning; Personalised care planning is essentially about addressing an individual’s full range of needs, taking into account their health, personal, social, economic, educational, mental health, ethnic and cultural background and circumstances.

In order for the care planning process to be effective the need for both a problem solving approach to care and a nursing model is fundamental. The problem solving approach which will be discussed within this assignment follows the format of Assess, Plan, Implementation and Evaluation (often referred to as APIE) developed by theorists; Yura and Walsh in 1967. APIE offers a structured, systematic approach to nursing practice through the use of the methodical care planning stages highlighted above (Barrett et al, 2009). Nevertheless, broad literature research suggests that this process lacked effectiveness in meeting the holistic needs of the individual and so, the process was adapted to include two further stages known as; Systematic Nursing Diagnosis and Recheck to produce the acronym ASPIRE (REF). However, these amended stages will not be discussed widely within this assignment, and so the process of APIE will be referred to throughout.

The nursing model developed by Roper, Logan and Tierney (RLT) in 2000, is one of several extensively criticised models commonly used in practice; to enable the facilitation of a holistic approach to care. The purpose of a nursing model is defined by Barrett et al as; Models give direction to the nurse about the patients and their needs and define nursing roles derived from the views, beliefs and values about people, health, the environment and nursing (Barrett et al, 2009 p.42).

As previously identified, RLT are keen to adopt an holistic approach to care as oppose to other models which only take into account a patients needs from a medical perspective. The RLT model has been acknowledged to reflect the current realities of healthcare within the United Kingdom (Barrett et al, 2009), consisting of five underlying concepts; Activities of Living, Lifespan, Independence-dependence continuum, factors influencing AL’s and individuality which (Roper et al, 2000) clearly state are interrelated with one another to emphasise the importance of holism. Pearson et al, along with many other nursing authors, highlight the significance of agreeing on a nursing model to be used together with the problem solving approach to develop an individualised care plan efficiently. Pearson et al (2005 p.84) indefinitely state; ‘the ‘process’ cannot happen without an agreement on nursing’ as, whilst APIE provides the systematic framework as to how the care plan should be devised, the nursing model effectively identifies what should be considered at each individual stage (REF).The Royal College of Nursing (RCN) also supports the utilisation of a nursing model alongside a problem solving approach, in identifying that; It facilitates consistent, evidenced-based nursing care, and necessitates accurate, up-to-date care documentation (RCN, 2011).

This assignment will also discuss how the RLT model and the problem solving approach are used to meet the biopsyhosocial needs of an individual, and also the strengths and limitations of using RLT’s model and a problem solving approach in relation to developing a care plan. An exploration of how the...
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