Roper Logan and Tierney Care Planning

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Exploring a Needs Orientated Approach to Care Planning
This assignment will investigate a needs orientated approach to care, critically discussing the nursing process. It aims to show an understanding of what a nursing model and the nursing process is, looking in detail at the relationship between this nursing process and the Roper, Logan and Tierney (RLT) model of nursing. This essay will explore how the nursing model and process is implemented in practice, considering how the RLT model assists nurses to adapt a problem-solving technique when developing care plans for individuals. Strengths and limitations of the RLT model and the nursing process, in relation to developing care plans, will be critiqued along with the effectiveness of Multidisciplinary teams (MDT) using the approach to meet public health needs. To support this discussion, throughout this assignment an example of a formative care plan I devised during this module for a fictitious patient, Annie Laine (See Appendix A) will be utilised, along with knowledge that I have gained throughout the programme surrounding this subject. By exploring each stage of the nursing process, an understanding of how the RLT model is used by the nurse and MDT to ensure patients receive quality care, will be demonstrated. Aspects of the RLT model will be explored, when discussing each separate stage of the nursing process. The stages will be critiqued in depth and analysed, and the care plan I devised using the RLT model and the nursing process, will again be used as reflective material to support the discussion. For years nurses understood that the best form of nursing was carried out based on intuition, empathy and instinct (Aggleton and Chalmers 2000). This approach to nursing care and planning has been extensively criticised. Many nursing authors called for a more systematic approach to care, focusing on the needs of the individual also looking at the psychological, physical and behavioural aspects of the patient. In 1967 Helen Yura and Mary Walsh published a book “The Nursing Process” where four stages were identified; assessment, planning, implementation and evaluation, creating a problem solving process which ensured nurse and patient interaction. This enabled the nurse to produce a plan of care individual to the patients needs (Aggleton and Chalmers 2000). These four stages are a circular problem solving approach which is a continuous process, whereby the patient will be assessed and reassessed until each problem is solved. (Kenworthy, Snowley and Gilling 2002) The RLT model of nursing is a framework based on the activities of living the patient under-takes which guides the care of patients in an extensive range of circumstances (Roper, Logan and Tierney 2001). Pearson, Vaughan and Fitzgerald (2005) suggest that applying a nursing model provides a continuation of care through support, illustrating to other members of the MDT the goals they are hoping to achieve. The RLT model is centred around the individual. There are twelve activities of daily living which the RLT model is based around, how each individual is able to perform each activity of living and how they live life is considered (Roper et al 2001). There are also four other significant sections that make up the model. These four sections are used by nurses to enhance the care patients receive by enabling cares to meet individual needs (Roper et al 2001). They guide the nurse and MDTs to see the patient holistically and provide holistic care for each individual, acknowledging the patient as a person and not labelling them as an illness or condition. By providing such guidance, the nursing model helps to ensure a standard of care is achieved within the care setting. Nursing models encourage nurses to gain an understanding of individual needs and underpin practice with evidence based theory; therefore a nursing model cannot be implemented effectively, without using the four stages of the nursing...
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