Importance of Communication in Providing Care and Treatment to Elderly Patients

This assignment focuses on the importance and effectiveness of communication in providing care and treatment to the elder people and develop a plan of care for their better recovery. It also discusses the SBAR communication model and Roper, Logan and Tierney’s Activities of Living model.

Running head: FOUNDATIONS OF ADULT FIELD OF PRACTICE
FOUNDATIONS OF ADULT FIELD OF PRACTICE
Name of the student:
Name of the university:
Author note:

1FOUNDATIONS OF ADULT FIELD OF PRACTICE
Introduction:
Individuals suffering from severe health problems often witness feeling of anxious
and nervous regarding the difficulty that may occur during diagnosis and treatment for their
health problems (Moore et al. 2018). The feeling of anxious and difficulty may lead the
patient to become aggressive, rude and also silent which will further cause difficulty and
complication for the nursing staffs to provide better care and treatment (Boissy et al. 2016). It
is important to develop better communication with the patient as well as other nursing staffs
to understand the needs and requirements of the patient and develop an effective plan of care
for them (Parry et al. 2016). The assignment will focus on the importance and effectiveness
of communication in providing care and treatment to the elder people and develop plan of
care for their better recovery (Nemeth et al. 2017).
Mrs. Margaret (pseudonym), a woman at her early 60s has been admitted to the
emergency ward as she was witnessing breathing difficulties, with high fever and pain in the
chest and was also having complain of massive cough. She has been witnessing the pain and
high fever for past few days and recently started having difficulty in breathing and also
yellow septum was observed with her cough. She has been earlier diagnosed with Chronic
obstructive pulmonary disease (COPD) and has also been frequently suffering from the
breathing difficulty for past one year (Korpershoek et al. 2016). As she was frequently
suffering from health difficulties, she became nervous and worried about her health and the
pain she has been witnessing. The nursing staff communicates with her in order to develop
better therapeutic relationship in order to understand her condition and fear and also to assess
what treatment process will be better for her condition.

2FOUNDATIONS OF ADULT FIELD OF PRACTICE
Part 1:
It is important for the health care settings and clinics to ensure that their patients are
provided with proper health care attendance and treatment and it involves more than just
accomplishment of procedures and performing diagnoses (Zerhusen et al. 2017).
Communication plays a part of an important component in each and every factor of the health
care and treatment process (Collins Jr et al. 2016). It involves communication related to
sharing information regarding the patent with the another health care facility, or health care
specialist, nursing staffs and other technical specialists, and the communication also involves
how to provide care and treatment to the present as well as the arriving patients, the need for
development and avoid error, every step requires communication as the main factoring the
health care settings (Schuman et al. 2016).
According to Foronda, MacWilliams and McArthur, (2016), the health care
organizations with strong and effective communication and policies related to it is found to
enhance their patients’ health condition, when compared to those health care settings which
have deprived communication practice as they have negative impact on the patient well-being
(Udvardi 2019). Health care specialists along with the health care settings need to understand
the importance of implication of communication in a patient health care to deliver better
recovery (Hemmati et al. 2017). It has been proved to help patient gained trust over their
health care professionals and share their feelings, difficulties, needs and other issues which
has been a very important aspect in planning better care and recovery option for the patient.
As Mrs. Margaret arrived at the hospital, she was assisted with a multidisciplinary
team. She was not in a stable state, and was anxious about her condition (Zerhusen et al.
2017). Communication between the nursing staff and her helped to better asses her condition
and understand her problem and needs of her health condition (Udvardi 2019).

3FOUNDATIONS OF ADULT FIELD OF PRACTICE
The SBAR Four-Part Communications Toolkit
The SBAR communication model is one of the important healthcare methodology which is
divided into four parts which helps in developing healthcare communications (Stewart 2016):
1. Situation (S)
In the part of model, the health care professional and the nursing staff provides
information regarding the present condition of the patient (Duan et al. 2017). In case of Mrs.
Margaret, the health care professional will address and assess her health condition and her
difficulties such as her breathing difficulty, the septum assessment, her past medical record
assessment and her other issues (Renz et al. 2015).
2. Background (B)
In this part of the model, it states that the background of the Patient, and pertinent knowledge
and information regarding the Patient current condition is assessed; for an instance (Duan et
al. 2017)
 In order to provide discharge to Mrs. Margaret, it should be assessed that the patient is
able to move, speak, work on his own and is eating healthy (Parry et al. 2016).
 Also the past medical history of the patient needs to be assess, like how she was
administered her medications, how she was provided care, the difficulties she
witnessed and other treatment details (Stewart 2016).
3. Assessment (A)
In this part of the model, the health care professionals need to assess the patient’s
situation and background of medical status and then pal appropriate interventions in order to
provide better recovery (Renz et al. 2015).

4FOUNDATIONS OF ADULT FIELD OF PRACTICE
 In case of Mrs. Margaret communication will be the first intervention that needs to be
provided to her focusing on her anxiety and nervous state. She has been witnessing
difficulty in cooperating with the health care professionals which was serving as a
barrier in the care delivery process (Boissy et al. 2016).
4. Recommendation (R)
In the portion of the model, the health care professionals will assess the accurate process
and take action on the basis if the assessment to treat the Mrs. Margaret and help her recover
(Stewart 2016).
 In case of Mrs. Margaret, the health care professionals will provide her with care and
compassion achieved from better communication, as she has difficulty in breathing
she will be administered with oxygen therapy and medications related to her severe
health condition (Parry et al. 2016).
 She needs to be monitor throughout the process by nursing staffs to observed her
critical condition, medication uptake, food intake and the outcome of the treatment
that has been provided to her by the health care professionals (Boissy et al. 2016).
Part 2:
Roper, Logan and Tierney’s Activities of Living model is used as an assessment
procedure for the assistance and measurement of the ability of the patient to retain
independence at every particular stage of health care (Holland and Jenkins 2019). The model
is divided in to 12 activities which includes maintaining a safer environment for the patient,
better communication, eliminating, eating and drinking, breathing, controlling body, personal
cleansing and dressing, mobilising, expressing sexuality, temperature, working and playing,
sleeping and dying. These 12 activities have been used as a health care framework in order to

5FOUNDATIONS OF ADULT FIELD OF PRACTICE
better assess, plan, implement and evaluate process for attaining better health care and
treatment for the patient (Williams 2017).
The difficulties that the nursing staff witnesses while assessing Mrs. Margaret was her
lack of ability to mobilise and eating and drinking difficulties (Holland and Jenkins 2019). As
being in the age group of elderly population, Mrs. Margaret has been facing difficulty in
communicating as well as issues with mobilizing and problem with eating and drinking,
which were creating barrier in the care and treatment giving process (Holland and Jenkins
2019). She was not able to move as weakness and her health issues increased her movement
disparity. She needed assistance in getting up, sitting, to get off the bed, she was not able to
perform anything on her own (Williams 2017). As she was witnessing breathing difficulty
and cough due to which she was not eating or drinking anything, also as she previously
suffered from Chronic obstructive pulmonary disease (COPD), she was not allowed to eat or
drink everything. She was restricted to various of eating or drinking habit due to her growing
age (Williams 2015).
The majorly effecting nursing problem for Mrs. Margaret was her breathing difficulty
and cough. As she was not able to breath properly an appropriate amount of oxygen due to
which her body was getting effected. She was getting weaker day by day and also she was
facing other difficulties related to her shortness of breath (Holland and Jenkins 2019).
The nursing process is the assessment and diagnosis of a patient administered in a
health care setting (Weldam et al. 2016). The process involves first aid, primary care,
diagnosis, medication administration and post- surgical care and treatment (Pérez Rivas et al.
2016). In case of Mrs. Margaret, the nursing staffs first needs to provide her with oxygen
therapy as she was witnessing breathing difficulties when she was admitted. The next step is
providing her with medication to drop down her increasing body temperature (Zamanzadeh

6FOUNDATIONS OF ADULT FIELD OF PRACTICE
et al. 2015). In the next step, her mucus secreted from cough needs to be sent for further
diagnosis to observe the reason behind the condition. after diagnosis it was found that she has
been suffering from respiratory tract infection, which was causing her with all the severe
difficulties. She needs to be administered with the nursing interventions in order to bring her
condition to a stable state (Kim and Choi 2015). There are various assessment tools in the
field of nursing which helps the nursing and the health care staff to better asses the patient’s
condition and plan proper treatment plan to enhance their scope of recovery (Udvardi, 2019).
She has been earlier diagnosed with Chronic obstructive pulmonary disease (COPD) and has
also been frequently suffering from the breathing difficulty for past one year. Her Chronic
obstructive pulmonary disease (COPD) should also be focused and provided care and
treatment which will be appropriate for her past health condition as well. Medications also
need to be administered with the assessment that they do not cause any severe com0lucations
when administered with other medications (Korpershoek et al. 2016). Her earlier medication
dosage needs to be studies and the further medication should be provided according to the
combination suitable with the drugs (Weldam et al. 2016).
As mentioned above the patient has been suffering from breathing difficulties and also
has a past medical history of COPD. Apart from that the patient also has been suffering from
high fever, cough and chest pain and in her cough yellow septum has also been observed. By
considering the patient situation, it can be considered that the patient has been suffering from
respiratory tract infection.
The general assessment tool that is used in this case by the nurses is the respiratory
assessment tool which helps identifying the breathing rate of the patient in order to evaluate
the severity of the illness (Des Jardins and Burton 2019).

7FOUNDATIONS OF ADULT FIELD OF PRACTICE
The general assessment tool helps in evaluating the breathing difficulty of the
individual and fro that it can be said that the patient has been suffering from dyspnoea
(Bolzani et al. 2017). In this the patient gasps for the air. As the patient also has cough and
fever, it should also be assessed by the nurses (Ames et al. 2017)
The subjective data that can be assessed according to the condition of the patient is
the shortness of breathing, chest pain, nausea and fever. For the assessment of the subjective
data, the nurse should monitor the patient in regular interval (Kalid et al. 2018). As the
patient has been suffering from chest pain, the nurse should encourage her to change her
position and should suggest her to lay in semi-fowler or fowler position (Phan 2018) Apart
from that, the nurse should provide supplemental oxygen to the patient to deal with breathing
difficulties. For the fever, the nurse should administer antibiotics to the patient.
The objective data that can be assessed by nurse is the cough and the anxiety the
patient has been suffering from (Fain, 2017). In order to deal with that, the nurse should
promote airway clearance which aims to reduce the yellow sputum in the cough of the
patient. In order to assess the cough, the nurse should promote deep breathing and coughing
among the patient (da Silva et al. 2019).
The case study represents the Chronic Obstructive Pulmonary Disease (COPD) of a patient
who is 60 years who was admitted to the emergency ward as she was experiencing breathing
difficulties, high fever, and pain in the chest.
In this case, the nurses are required to set a long term as well as short term goal in
order to support the wellbeing of the patients (Summers et al. 2017). It will improve the
health condition of the patients, improve patient satisfaction and improve the wellbeing of the
patients (Summers et al. 2017). In the current context, the short term goal is to improve the
functional status of the patient by preventing reoccurrence of exacerbations within the

8FOUNDATIONS OF ADULT FIELD OF PRACTICE
support of the medication Theophylline within the next three month (Pyarali et al. 2016).
The rationale behind providing theophylline is that it is very inexpensive medication may
improve the breathing of the patients and prevent the execration of the patient (Bender et al.
2016). However, in order to provide mediation to the patient, it is crucial to consider the side
effects of the medication such as nausea, headache, fast beat, and tremor.
On the other hand, the long term goal is to improve quality of life through
improving symptoms of the patients with the assistance of Long-term domiciliary oxygen
therapy, exercise and restricting high carbohydrate food (Pyarali et al. 2016). The prime
reason behind this therapy is that Caillaud et al. (2016), state that oxygen therapy is crucial to
reduce the hypoxia experienced by the patient .In addition, this therapy is effective in
preventing heart failure in people with severe lung disease like COPD (Summers et al. 2017).
Treatment and implementation:
While the doctor may use many medications to treat the patients, residential care
would be the best treatment for the patient of years (Pyarali et al. 2016). In this current
context, in order to improve the symptoms and prevent the execration of the patient, the
nurses provided theophylline, an inexpensive medication which will improve the breathing of
the patients and prevent execration of the patients (Pyarali et al. 2016). The nurses also
provide oxygen therapy for reducing the hypoxia experienced by the patient. It will reduce
the probability of heart failure inpatient. Moreover, nurses also involve her in mild exercise
for 3 minutes every minute to improve her breathing (Bender et al. 2016). The nurses
amended her dietary routine by adding the high protein, low carbohydrate diet and
eliminating high sodium and fat diet. It will reduce the symptoms of the patients (Bender et
al. 2016).

9FOUNDATIONS OF ADULT FIELD OF PRACTICE
The treatment was implemented for the patient by communicating with another health
professional for making a shared decision (Bender et al. 2016). His family members also
incorporated in this planning so that it can reduce the psychological distress they are
subjected to and provide patient safety and comfort (Bender et al. 2016).. It will also help
nurses to achieve high patient satisfaction and improve the wellbeing of patient since patient
would be empowered and safe.
Conclusion:
In order to conclude, it can be stated that, Communication plays a part of an important
component in each and every factor of the health care and treatment process (Korpershoek et
al. 2016). It is important to develop better communication with the patient as well as other
nursing staffs to understand the needs and requirements of the patient and develop an
effective plan of care for them (Nemeth et al. 2017). Communication held to build trust and
compassion between a health care provider and the patient, which comforts the patient to
share and understand the health condition and treatment. It helps the nursing staff to assess
the exact plan of treatment which will be helpful for the patient (Collins Jr et al. 2016). In
case of Mrs. Margaret communication will be the first intervention that needs to be provided
to her focusing on her anxiety and nervous state. She has been witnessing difficulty in
cooperating with the health care professionals which was serving as a barrier in the care
delivery process. She needs to be provided with comfort and care which can be achieved by
developing better therapeutic relationship by communication. It will be also necessary to
better asses her regarding her difficulties and infection, as she her condition was getting
severe. The health care professionals need to use assessment tools in order to provide
intervention and care appropriate o her health condition.

10FOUNDATIONS OF ADULT FIELD OF PRACTICE

11FOUNDATIONS OF ADULT FIELD OF PRACTICE
Reference:
Ames, N.J., Powers, J.H., Ranucci, A., Gartrell, K., Yang, L., VanRaden, M., Leidy, N.K.
and Wallen, G.R., 2017. A systematic approach for studying the signs and symptoms of fever
in adult patients: the fever assessment tool (FAST). Health and quality of life outcomes,
15(1), p.84.
Bender, B.G., Depew, A., Emmett, A., Goelz, K., Make, B., Sharma, S., Underwood, J. and
Stempel, D., 2016. A patient-centered walking program for COPD. Chronic Obstructive
Pulmonary Diseases, 3(4), p.769.
Boissy, A., Windover, A.K., Bokar, D., Karafa, M., Neuendorf, K., Frankel, R.M., Merlino,
J. and Rothberg, M.B., 2016. Communication skills training for physicians improves patient
satisfaction. Journal of general internal medicine, 31(7), pp.755-761.
Bolzani, A., Rolser, S.M., Kalies, H., Maddocks, M., Rehfuess, E., Hutchinson, A., Gysels,
M., Higginson, I.J., Booth, S. and Bausewein, C., 2017. Cognitive‐emotional interventions
for breathlessness in adults with advanced diseases. Cochrane Database of Systematic
Reviews, (6).
Caillaud, D., Chanez, P., Escamilla, R., Burgel, P.R., Nesme-Meyer, P., Deslee, G., Perez,
T., Paillasseur, J.L., Pinet, C., Jebrak, G. and Roche, N., 2016. Asthma-COPD overlap
syndrome (ACOS) versus" pure" COPD: A distinct phenotype?.
Collins Jr, W.F., Allen, J.M., Huster, K.A., Riley, C.W., Glidewell, P.A., Vanderpohl III, I.J.,
Schuman, R.J. and Mathura, C.A., Hill-Rom Services Inc, 2016. Healthcare communication
system for programming bed alarms. U.S. Patent 9,517,034.
da Silva, L.F.M., Pascoal, L.M., Nunes, S.F.L., de Sousa Freire, V.E.C., de Araújo Almeida,
A.G., Gontijo, P.V.C. and Neto, M.S., 2019. Ineffective Airway Clearance in Surgical

12FOUNDATIONS OF ADULT FIELD OF PRACTICE
Patients: Evaluation of Nursing Interventions and Outcomes. International journal of nursing
knowledge.
Des Jardins, T. and Burton, G.G., 2019. Clinical Manifestations & Assessment of Respiratory
Disease E-Book. Elsevier Health Sciences.
Duan, W., Meng, Q., Hao, G., Wei, S. and Shen, Y., 2017. Application and effect of SBAR
communication model in the application of clinical nursing teaching. Chinese Journal of
Practical Nursing, 33(30), pp.2380-2384.
Fain, J.A., 2017. Reading, understanding, and applying nursing research. FA Davis.
Foronda, C., MacWilliams, B. and McArthur, E., 2016. Interprofessional communication in
healthcare: An integrative review. Nurse education in practice, 19, pp.36-40.
Hemmati, A., Carlson, C., Nayebi, M., Ruhe, G. and Saunders, C., 2017, July. Analysis of
software service usage in healthcare communication services. In 2017 IEEE International
Conference on Software Quality, Reliability and Security Companion (QRS-C) (pp. 565-566).
IEEE.
Holland, K. and Jenkins, J. eds., 2019. Applying the Roper-Logan-Tierney Model in Practice-
E-Book. Elsevier Health Sciences.
Kalid, N., Zaidan, A.A., Zaidan, B.B., Salman, O.H., Hashim, M., Albahri, O.S. and Albahri,
A.S., 2018. Based on real time remote health monitoring systems: A new approach for
prioritization “large scales data” patients with chronic heart diseases using body sensors and
communication technology. Journal of medical systems, 42(4), p.69.
Kim, J.M. and Choi, Y.S., 2015. Effect of practice education using the simulator, critical
thinking, problem solving ability and nursing process confidence of nursing students. Journal
of digital Convergence, 13(4), pp.263-270.

13FOUNDATIONS OF ADULT FIELD OF PRACTICE
Korpershoek, Y.J.G., Vervoort, S.C.J.M., Nijssen, L.I.T., Schuurmans, M.J. and
Trappenburg, J.C.A., 2016. Factors influencing exacerbation-related self-management
behavior in patients with COPD. Journal of Advanced Nursing, 72(Suppl. S1), pp.89-89.
Moore, P.M., Rivera, S., Bravo‐Soto, G.A., Olivares, C. and Lawrie, T.A., 2018.
Communication skills training for healthcare professionals working with people who have
cancer. Cochrane Database of Systematic Reviews, (7).
Nemeth, C.P., Kowalsky, J., Brandwijk, M., Kahana, M., Klock, P.A. and Cook, R.I., 2017.
Between shifts: healthcare communication in the PICU. In Improving Healthcare Team
Communication (pp. 135-153). CRC Press.
Parry, R., Pino, M., Faull, C. and Feathers, L., 2016. Acceptability and design of video-based
research on healthcare communication: evidence and recommendations. Patient Education
and Counseling, 99(8), pp.1271-1284.
Pérez Rivas, F.J., Martín‐Iglesias, S., Pacheco del Cerro, J.L., Minguet Arenas, C., Garcia
Lopez, M. and Beamud Lagos, M., 2016. Effectiveness of nursing process use in primary
care. International journal of nursing knowledge, 27(1), pp.43-48.
Phan, N., 2018. A heart attack in elderly people: The guidebook for relatives and healthcare
professionals.
Pyarali, F., Tewari, P., Pezon, C., Enriquez, C., Labrada, M. and Campos, M.A., 2019.
Reducing COPD Readmissions Using a Standardized Order Set-A Quality Improvement
Study. In B44. COPD: TREATMENT AND OTHER TOPICS(pp. A3269-A3269). American
Thoracic Society.

14FOUNDATIONS OF ADULT FIELD OF PRACTICE
Renz, S.M., Boltz, M.P., Capezuti, E. and Wagner, L.M., 2015. Implementing an SBAR
communication protocol: A quality improvement project. Annals of Long-Term Care, 23(7),
pp.27-31.
Ribble, D.L., Mann, N.A., Lawrence, B.L., Emmons, K.M., Agdeppa, E.D., Hood, M.S.,
Zerhusen, R.M., Lingenfelser, J.P., Dixon, S.A. and Severns, R.S., Hill-Rom Services Inc,
2017. Catheter monitor integration with patient support, hygiene and healthcare
communication systems. U.S. Patent 9,642,967.
Schuman, R.J., Glidewell, P.A. and Roehl, E.E., Hill-Rom Services Inc, 2016. Distributed
healthcare communication system. U.S. Patent 9,299,242.
Stewart, K.R., 2016. SBAR, communication, and patient safety: An integrated literature
review.
Summers, R., Ballinger, C., Bruton, A., Garrod, R., & Leontowitsch, M. (2015). Goal setting
in rehabilitation for people with COPD: Respiratory physiotherapists' perspectives.
Udvardi, A., 2019. The role of linguistics in improving the evidence base of healthcare
communication. Patient education and counseling, 102(2), pp.388-393.
Weldam, S., Zwakman, M., Lammers, J.W. and Schuurmans, M., 2016. Patient perspectives
on the COPD-GRIP intervention, a new nursing care intervention for Chronic Obstructive
Pulmonary Disease patients. Primary care nursing for COPD patients: a biopsychosocial
perspective, p.129.
Williams, B.C., 2015. The Roper-Logan-Tierney model of nursing: A framework to
complement the nursing process. Nursing2019, 45(3), pp.24-26.
Williams, B.C., 2017. The Roper-Logan-Tierney model of nursing. Nursing2019 Critical
Care, 12(1), pp.17-20.

15FOUNDATIONS OF ADULT FIELD OF PRACTICE
Zamanzadeh, V., Valizadeh, L., Tabrizi, F.J., Behshid, M. and Lotfi, M., 2015. Challenges
associated with the implementation of the nursing process: A systematic review. Iranian
journal of nursing and midwifery research, 20(4), p.411.