Nursing Practices for Juvenile Idiopathic Arthritis and Asthma Patient: A Case Study

This essay discusses the nursing practices and strategies for Liam, a 15-year-old boy suffering from Juvenile Idiopathic Arthritis and Asthma. It covers the patient care team, barriers to care goals, and identifying effective strategies for quality care services. The essay also emphasizes the importance of self-management and teamwork in delivering proper care to the patient.

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Table of Contents
INTRODUCTION 3
TASK 1 3
Patient Care Team 3
Patients barrier to care goal 4
TASK 2 5
Nursing practices 5
Identifying strategies 6
CONCLUSION 7
REFERENCES 8
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INTRODUCTION
Juvenile idiopathic arthritis (JIA) refers to a common type of arthritis in kids and teenagers which can cause joint pain along with inflammation in ankles,
elbows, knees and others. It has also impact on individual body which can create negative health impact (Hechler et. al., 2021). It is considered complex, so there is
need to delivery proper care and treatment with combination of partnership treatment, when combined with other morbities (Schenck et. al., 2018). In this essay, Liam a
15-year-old boy, suffering from two chronic conditions in JIA and asthma, as well as onset of additional mental problems. Here, Liam has history of Juvenile Idiopathic
Arthritis along with Asthma. Liam has attended Westtown Hospital four times within last month. Liam has referred to the regular paediatrics rheumatologist in Sydney.
Liam also have MRI before appointment. Liam lives with his mother and having step father and step brother and sister. Liam’s father and mother are not able to enough
care for him anymore. They decided to transport Liam to multiple medical appointments and therapy session which includes monthly medical appointment within
Sydney, local fortnightly physiotherapy and General practitioner according to requirement, pediatrician appointment quarterly. I will discuss about his care teams,
which involve Liam’s care and barriers to deliver his care goals. Also, I will explain the quality care which can be provided through the service of effective nursing
staff and adequate strategy which can be effective to deliver the quality care services to patient for their health improvement.
Patient Care Team
Being a complex patient, Liam has been diagnosed with many ailments. Liam’s case demands many people which may include healthcare professionals, different
healthcare premises, organizations and family. Here, healthcare professional may includes doctor, General Practitioner, paediatrician, therapist, physiotherapist and
other nursing staff to care and delivery medication. Healthcare premises may includes hospital and therapy premises and paedtrician premises or clinic. Organisation
may includes hospital and others (Agris et al., 2018). Further, with a primary objective of Liam attaining core goals for both of his chronic conditions. Moreover, he
should be helped with the new start of mental health conflicts, as he objected to be socially introverted and feels inferior between his friends as he is unable to engage
in various activities with them because of his chronic condition. His mother Erica showed her concern related to his social withdrawal, revealing further self-assurance
to the seriousness of his mental well-being issues.
After the recent asthma exacerbation pain has been experienced by Liam which needed to be diagnosed and ensure about any uncertainty which can be effective and
can cause negative health impact on his health. To ensure about the health concern Dr. Jones has referred Liam for review to his regular paediatric rheumatologist
within Sydney that is located 500km away (Dipasquale, et. al., 2019). This referral was needed to do for getting better visualisation of health impact on Liam for better
treatment (Maschmeyer et. al., 2021).
In this, there is need to ensure about the facilities like proper care, person centred care, ensure about patient safety, healthcare services, proper treatment, medication,
support and help (Bollhalder et. al., 2020). These are some of the effective facilities which can support the patient physical and mentally for their better health
improvement (Mena‐Vázquez et. al., 2021). This may include the healthcare organisation like Accident and Emergency department and regular paediatric
rheumatology (Al-Mayouf, 2018). These healthcare organisations are considered to provide better healthcare services that can be effective and allow to deliver quality
services which can be effective for improvement in health. These professionals are identified as primary care and secondary care.
Here, it is essential to delivery primary care to the patient that may help to deal effectively with Liam health condition. For this, nursing staff can be effective while
delivering primary care to Liam. Here, primary care is defined as the day-to-day healthcare given by a professional such as General Practioner (GP’s) and
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physiotherapists (Sawchuck & Craner, 2017). It is easily accessible and not required of prior referrals. Moreover, Liam’s psychotherapist and GP’s sessions are range
as primary care (How, 2019). Dr. Jones, Registered nursing staff, Liam paediatrician are the healthcare professionals who are having the information and attending
Liam health concern in the primary care group. The radiographic hallmarks refer to primary osteoarthritis which includes the non-uniform joint space loss. This
includes the features of rheumatoid arthritis which are the joint inflammation that includes the osteopenia, bone erosions, space loss, uniform joint along with soft-
tissues swellings (Hayhoe et, al., 2018).
Secondary care is defined as when primary care refers patient for medical treatment to the specialist (Singh & Cleveland, 2021). The secondary care in Liam’s
treatment is physiotherapists and rheumatologist. They are the healthcare professional who can provide further therapy treatment to Liam to achieve better and
improved health. They are the specialist to take care about his worsening health condition (Waite-Jones et. al., 2018). Secondary and other important carers are Liam’s
family members are also involved in his better support and care which can allow Liam to get better improvement in health (Yuwen et. al., 2017). These are some of the
organisation and healthcare service providers who are having the effective role in delivery of healthcare services and treatment to the Liam for his health improvement
(Murphy et. al., 2019)
Medicines
Patients’ barrier to care goal
Healthcare processional is not have high potential to treat patent like Liam who is suffering through different health and not having appropriate knowledge and practice
towards appropriate healthcare treatment there is need to take care by the specialists. Medical condition is one of the potential barriers which is highly effective and
restrict individual to easily meet the patient care goal (Perisetti et. al., 2018). It can also be stated that people in the field are not present in the hospital and other
medical healthcare programs, which causes significant issues and formation of the barrier in the patient's mind. Liam's family and friends may not be able to understand
the field of the studies as well correctly, and therefore, there may be many issues where the barriers prevent the care goals from implementation. Liam is having
difficulty to play due to his medical condition where, he need to get better health treatment to get over the health care issues and get healthy to perform the activity and
other task which care generally performed by other children of his age group. In this, medical condition creates the issue and restrict him to meet the goal (Zhao et. al.,
2018).
Another barrier to the care goals of the company is the lack of health literacy and the team goals. Liam needs the support of his parents, and they have their busy
schedules; he spends most of his time living with his mother and stepfather, who are full time workers, and they also need to care for three children and all are studying
in different institutions/childcare facilities. Moreover, Liam spends alternative weekends and half school holidays with his father and stepmother who live on mixed
farming property 25 km from Westtown with their twin daughters. Busy schedule of his family leads to affecting the health outcomes of the patient as they are not able
to attend appointments for pediatric care (Altiok et. al., 2019). This can be amended by giving health education and planning the numerous appointments related to each
other and giving helpful arrangement times, just as explaining the significance of participation and the outcomes of absence to guardians ( Hantke et. al., 2020). The
doctors also properly mitigate themselves with Liam's family such that they can take care of Liam and make sure he gets his medication at the right time and in the
correct order (Mohapatra et al. 2019).
Self-management like taking responsibility regarding treatment plan, keeping appointment with team and care providers, know about medication and doses, taking
medication at time, following healthcare plan, sharing health related information with provider to make changes accordingly and many more can help implementing
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strategy in such a way that this can be effective and allow to deliver quality benefits to the patient (Connelly et. al., 2019). Self-management can also create difficulty in
getting different issue like not able to implement in regular basis, avoid the care plan or an unwillingness to adhere to medications (Arman et. al., 2019). This can result
from his deficient mental state due to social separation and unacceptance by his friends, similarly as a repulsiveness for the indications of his medications, as the
naproxen prescribed to him has the undesired consequence of headaches and dizziness (Schnall et. al., 2020). In this, there is need to ensure about the better health and
should focus on the self-management which can allow to improve his health (Jabs, 2021).
TASK 2
Nursing practices
As a registered nurse, several skills are required for the maintenance of the healthcare programs Liam (Alfayadh, 2020). Communication skills and Regular follow up
have high importance while deliver proper care to the patient with chronic illness. Communication help nursing staff to communicate with the patient and help to get
ensure about the patient needs and sharing of health-related information in positive way with the other healthcare professional regarding patient health (Clark et. al.,
2017). Regular follow up appointments should be coordinated and actively prescribed to Liam and his family at the clinic, determined to screen his improvement,
positively supporting his endeavours, and recognizing any original difficulty. Further, Medical Jargon must be avoided while talking with Liam and use simple
language while explaining treatment, as miscommunication in view of language prompts opposition – particularly for paediatric patients (Xafis et., al. 2016).
Teamwork and Network should be possessed by the nursing staff to get ensure about delivery of proper care service (Grant et. al., 2017). Working together by
healthcare workers can have positive outcomes in achieving better health of patient. Moreover, the psychological burden carried by Liam and his family because of his
condition and the limits it involves should be soothed. It should be done by, encouraging Liam and his family by enlightening hope in them, and by encouraging them
to express their concerns about the condition and its treatment. Additionally, maintain a comprehensive patient-focused approached which helps Liam how to adapt
with difficult experiences (Kassam-Adams et al., 2015).
Finally, the cost and time for travel for scheduling appointments as Liam's home and distance from medical services suppliers should be considered while arranging his
arrangements. This can be carried out by booking his visits at convenient times events for his family, bundling them together to prevent unnecessarily repeating trips,
and organizing them at standard ranges to allow completing them into their month-to-month schedule. Moving further, Liam’s parents is not stable financially.
Therefore, Liam's family can be aided towards the various financial aid plans given by the Australian government to families and those supporting children, for
instance, the Family Tax Benefit and the Child Care Subsidy (Services Australia, 2021).
Identifying strategies
Liam's shared care goal is to create a working environment where he will be able to get the best treatment possible and at the same time feel secure and comfortable.
The strategies developed and needed for this system state that proper healthcare measures must be introduced and allowed. Liam needs the proper mental and physical
help in medicine such that his ailments are adequately cured (Dash et al. 2019).
There is need to use the strategy of working together. This is the one which can be effective in delivery of better care and support to the patient with JIA and asthma.
Additionally, through this nursing staff may get ensure about the patient healthcare needs and support patient by implement the shared care plan of patient. Here,
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nursing staff should be contact with Dr. Jones and his regular paediatric rheumatologist who have the information about Liam and can help to share the required
information that can be effective and help in implementing the effective shared plan (Bradbury et. al., 2018).
To interact with healthcare organisation with whom patient is connected. This is the effective strategy that is effective and allow Liam to deliver quality care and share
the healthcare information with nursing staff that can allow to use that information while implementing the share care plan. Moreover, the arrangement will spin around
patients’ diagnosis, yet should likewise meet his psychological needs, as well as his pain of JIA and asthma, which cause him extreme torment and limit his mobility.
Lastly, the administration of new medication, like methotrexate, has enormously worked on the usefulness of JIA medicines, even delivering reduction an achievable
objective much of the time (Omura, 2017). The strategies in the field have stated that proper communication protocols need to be established. They are adequately
taken into consideration by Liam in the management of the medical condition (Hahn and Gil Lapetra, 2019).
There is also needed to use the strategy of new innovative treatment and care plan which are highly effective for the patient with JIA and asthma. It is also stated
through the complex system and statement of Liam's shared care health program that proper strategies were introduced and needed to be appropriately maintained to
allow the management of the medical facilities that he will be needing (Pilkington, 2017). Liam's parents need the right self-care management tools and help for the
direction of the services to be stable. This would also allow the management of services and devices to be perfect, thus enabling the benefits to stay correctly (Kamble
et al. 2018). The monitor process would be compact and would allow the management of services to be used correctly, and therefore it would be held by Liam in the
proper order. The chronic conditions of Liam would also be maintained in the correct order such that they are kept in the right order. The collaborative care strategies
would also be formed in such a manner to allow the management of services to be in tune with the requirements of the patients and others likely the same (Linnander et
al. 2017). The communication policies would be devices so that they could allocate them and correctly use them properly. This can have better positive result in
delivery of better and effectively implementation of shared care plan for the patient health improvement (Chiang, 2019). The healthcare program would succeed in this
regard, making it possible for the management to be maintained in the correct order (Meacham et al. 2017).
CONCLUSION
From the above discussion, it can be concluding that care plan is highly effective and should be helpful in delivery of proper treatment to patient suffering from
multiple chronic condition. In this, there is need to make better plan and ensure about the patient care team which have an important role in delivery of healthcare
services. During this, there are some of the barriers like medical condition and self-management which can have impact on the achieving the patient care goals. There is
discussion about the nursing practice which required the effective skills like communication, team working and networking which have role in getting proper care.
There is also discussion about the strategies which are effective to ensure about the effectively implementation of care plan. This may include the programs, innovation
and several organisations which can be effective in ensuring about the implementation of shared care plan for delivery of better healthcare treatment for better and
improve health of patient.
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