Developing a Nursing Care Plan

Running Head: Nursing Assignment
Nursing Care Planning
Name of the Student
Name of the University
Authors Note

Nursing Care Planning1
Table of Contents
Introduction.................................................................................................2
Discussion...................................................................................................2
Background..............................................................................................2
Stages of Care Planning...........................................................................3
Evaluation of Care Planning.....................................................................8
Conclusion...................................................................................................8
Recommendation........................................................................................9
References................................................................................................10
Appendix................................................................................................10
Introduction
Nursing models and theories aim to enhance the quality of patient
centred care with the quality of life. The nursing legislatives of The

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National Health Service (NHS) are also focused on serving health and
social care provision to every individual in United Kingdom. The
legislatives and policies of NHS help to ensure rights of having quality
healthcare services with nominal expenses of the common people. NHS
policies evaluate the care plan and stages of care planning which helps to
recognise the service structure of a hospital or healthcare settings. There
are different nursing care models such as Roper, Logan and Tierney
Models, Orem’s self-care model, Johnson’s Behavioural model which help
to provide better services with the person-centred treatment. Involvement
of multidisciplinary teams and different additional facilities should be
incorporated in the care provision of a healthcare setting. The essay will
focus on the recommendations of the care planning for better nursing
care provision with the reference of the Mid Staffordshire National Health
Service (NHS) Foundation Trust Public Inquiry as case study (Smith and
Chambers, 2019). The objectives of this assignment are to design a
nursing care planning with proper policies and legislation to obtain the
optimum quality of care with needs assessment and up gradation of the
skills of nursing staffs. The report focuses on the care planning of elder
care patient in a hospital care setting to avoid the similar undesired
circumstances which was recognised in the Mid Staffordshire hospital after
the enquiry was taken place (Smith and Chambers, 2019).
Discussion
Background
In 2007, Julie Bailey started a campaign against the trustee or the
administrators of the Stafford Hospital as her mother died during the
treatment. The mortality rate in the emergency department was much

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higher than the usual. A full-scale official investigation was conducted in
(2008), and due to inquiry, many loopholes in the clinical settings were
recognised. The mortality rate among the emergency patient was
elevated during 2005 to 2008. The commission of Robert Francis QC (the
commission was assigned for the investigation) detected different
negative sides of healthcare setting in Stafford Hospital. The affected
families took legal steps with Ms Bailey against the hospital. According to
the inquiry commission, the management of the hospital preferred poor
strategies for healthcare provision. The Nursing and Midwifery Council
took actions against the alleged nurses and nursing leaders of the hospital
(Hayes, 2017). As many reports such as discrimination during patient
care, carelessness during the treatment of critical patients in Intensive
Care Unit (ICU), medication errors and multiple errors related to handover
process were observed in the inquiry (Hollnagel and Braithwaite, 2019).
Poor work culture and working environment were identified as after full
length investigation. The inquiry reported that around 290
recommendations were proposed by which were failed in various aspects
of the selected healthcare system (Hollnagel and Braithwaite, 2019). The
policies failed in the leadership strategies, conundrum of culture,
management of working force and implementing multidisciplinary teams
and maintenance of the legislative policies in the service provision to the
patients in critical care. Stafford Hospital scandal was an eye-opening
instance in the healthcare industry of United Kingdom. In this incident,
nursing plans and stages of care planning were also breached along with
the NHS policies (Powell, 2019).

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Stages of Care Planning
Healthcare services can be differed according to the provision of
services such as primary, secondary and tertiary care in two different
areas of care (acute and chronic care) to check effectiveness of the care
provision (Peate, 2017). This assignment aims to design a nursing care
plan for elderly patient care in acute care setting. There are four stages in
the nursing care process such as assessment, planning, implementation
and evaluation (Stonehouse, 2017.). Every care process should involve
four core components of the nursing models which are the person, the
environment, health of the patient and nursing (Cuthbert and Quallington,
2017). The nursing care plan should involve different nursing theories to
provide better services to different patients from various healthcare
context (Kitson, 2018). The stages of care planning should involve a
logical and systematic flow from initial assessment to the final evaluation.
Purpose of the care planning underlies with the legal documentation,
showing accountability to the records of the patients and continuity of the
care plan (Ballantyne, 2016.). A successful assessment procedure involves
good communication, methodical approach of detailing and better
interpretation (Hogston and Marjoram,2011). During the assessment a
patient should not be asked any question which will affect his or her
aesthetic culture and personal preferences by maintaining ethics (Östlund
et al., 2018). Patient’s detail should be collected from verbal, nonverbal
and written records. An effective planning consists determination of
problems, risks and prioritised them with analysing the physical,
psychological and social condition of that person (Howatson et al., 2015).
Initiation and termination of the shifts, duration of handovers, comparison

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of care plans associated with the patients and continuous monitoring are
considered as the significant aspects of implementation of a care plan.
Evaluation of care plan combines both observational and documental
evidence. Documents for evaluation can be recorded by tools, lab reports
and regular documentation by nurses (Drummond and Simpson, 2017).
In the Mid Stafford Hospital (2008) responsibility of the nurses and
health workers was lost during provision of care and patients lay striving
for hunger and thrust, hygiene of patient’s ward was neglected
(Hutchison, 2016). Late responses from the nurses and attendants led to
some unexpected mishaps, in this assignment some issues for the elder
patient in a hospital setting will be addressed. The issues, which will be
analysed in this context, are fall and pressure injuries, nosocomial
infection, immediate admission and transfer of a patient from one unit to
another, depression among the patients, aggressive behaviours of nursing
staffs, inadequate workforce for treating critical patient, erroneous service
provision (Smith and Chambers, 2019).
To prevent fall risks and pressure injuries among older patient in the
older adult wards the cause of frequent falls and injuries should be found
out with the help of surveillance camera and medical records of the
admitted patients (see Appendix)(Hoffman
et al., 2017). The person
centred care approach allows patients to involve whoever they want in the
treatment procedure. This approach involves financial and psychological
aspects of the patients and therefore the patients can get better
services and provision of care. The patients are hemiplegia or
neurological disorder or have balance problems should be monitored by
attendants or assistant in Nursing (Peate and Wild, 2018). Medications