Roper Logan Tierney Model of Nursing Assignment

Running head: NURSING CARE
Role of Adult Nurse in Adult Care Setting
Name of the Student
Name of the University
Author Note

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To provide effective care to the patient, the nursing and multi-disciplinary team will
follow the Roper Logan Tierney Model of Nursing which is a theory of nursing care based on
activities of daily living (Williams, 2017). Using this model of care, the adult nurses and the
multidisciplinary team will process one daily activity that is critical in restoring the health of
the patient. To comply with the NMC Code of Conduct of confidentiality, a pseudonym Mrs
Burst will be used to discuss the patient in this essay (Nursing & Midwifery Council (NMC),
2015). The Author will discuss the health need, the role of the nurse and a discussion to
clarify on how effective communication and teamwork is essential in care delivery. This
narrative refers to an 89year old woman who was admitted due to aspiration pneumonia and
Lower respiratory tract infection (LRTI). Her medical history showed she had three strokes in
the past, urinary tract infection, high cholesterol, Asthma and type 2 diabetes. Before she was
admitted to hospital, she was staying alone with four times package of care. Patient stayed in
hospital for more than four weeks because she was waiting for placement to a rehab centre
while she recovers.
According to the Nursing and Midwifery Council 2018, the very first priority of the
nurses should be to assess the patient upon and get a complete picture of the patient’s current
and future care needs (Shepherd 2017). With higher competency in nursing skills, the nurses
can recognise the pertinent changes to prioritize their interventions accordingly to ensure the
highest standards of health care delivery to the patient (Wighus and Bjørk 2018). The nurses
can employ a structured assessment including physical examination to complete the
inspection and assessment of the patient’s required level of care (Bani-issa et al. 2019). On
the basis of this assessment, clinical judgement on the nursing interventions should be made
by the health care professionals and nurses (Standing 2017).
A similar assessment of Mrs Burst, was done to outline the healthcare services and
multi-disciplinary team formation to provide patient-centered care to her. She has been

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diagnosed with lower respiratory tract infection and infection. The medical history of the
patient includes type-2 diabetes, 2 stroke incidents, urinary tract infection, high cholesterol
levels and asthma. Analysing the medical history, it is evident that the patient requires the
standard intervention of the multi-disciplinary team to work together and address patient care
and safety.
Upon conducting a thorough aphasia assessment of the patient’s current health status,
a package of care was determined specifically for Mrs Burst. This care package included
professionals from different fields to provide disease-specific care to the patient. The
Mississippi Aphasia Screening Test (MAST) and Western Aphasia Battery-Revised (WAB-
R) were used the two screening tools, used for determining the language skills of the patient
(Nursi et al. 2019; Clark et al. 2019).
One of the interventions determined for Mrs Burst is SALT (Speech and Language Therapy)
taken care of by a speech and language therapist. From the health assessment of Mrs Burst, it
was evident that she was suffering from aphasia and was at a risk of chronic condition owing
to her medical history of two strokes. From the health assessment of Mrs Burst, it was evident
that she was at high risk of suffering from chronic aphasia due to a medical history of two
strokes. Aphasia is a condition of the impaired ability of speech production, which is resulted
from brain damage. This communication is a disorder is common in older patients who have
suffered from a stroke in their past. Stroke incidents can lead to injury or damage to the
language parts of the brain, disability the person’s capability to understand words and
communicate effectively. As the patient had a past history of 2 strokes, it can be determined
that the patient is at high risk of attaining chronic aphasia (Stahl et al. 2018). To improve this
condition and treat aphasia, speech and language therapy is recommended, for which the
professional has been assigned. The therapist will increase the speech activity of Mrs Burst
and reduce any signs of impairment with the help of short and less intensive sessions of

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speech and language therapy. In this case study where communication problem has been
identified as a significant challenge, the SALT intervention will help in assessing the extent
of the difficulty by taking into consideration a range of factors like how sounds are produced
and whether the patient demonstrates competency to understand spoken language. However,
before performing the intervention, the therapist will assess the aspects of language the
patient is having difficulty with and then decide the interventions to improve the social,
language and speech skills of Mrs Burst.
The patient is also taken care of by a physiotherapist, who is part of the multi-
disciplinary team. The patient is referred to the physiotherapist by the doctor, as Mrs Burst is
evidently old and requires physical therapy from a profession to address mobilization and
pain issues. The physiotherapist can provide effective treatment by the means of exercise
prescription to help Mrs Burst retain her physical stability, functionality and mobility.
The patient is having a high cholesterol level and is suffering from type-2 diabetes.
Type- diabetes in an 89-year old patient requires extensive care from diabetes professionals
to help meet the medical needs. Moreover, the care plan devised for type-2 diabetes along
with high cholesterol levels requires a highly patient-particular diet, given at regular intervals.
To accomplish this aspect of care, Mrs Burst is assisted by a dietician, who can achieve all
such patient-centered care plans and improve the patient’s health while she is at the
rehabilitation center.
Moreover, as the patient is living alone in a rehabilitation center with such an
extensive list of medical history, she requires to be assessed by a mental health nurse.
Neurological and mental health disorders are common in older adults who have suffered from
a range of diseases and are living without any support from family members. According to
the World Health Organization factsheet (2017), the population of older adults will double by
the end of 2050 and mental health disorders will account for 6.6% of this population’s

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disability (Who.int 2017). Even in the situation, where the patient is kept away from their
family members, the patient develops depressive symptoms that require intervention from a
mental health nurse. Mrs Burst has been living in the rehabilitation center for four weeks
now, and thus, requires to be assessed by a nurse to ensure a healthy mental health status.
Roper Logan Tierney model of nursing developed in 1976 by Nancy Roper (Williams
2017). This model is based upon the activities of daily living and is widely used in the United
Kingdom. This model is evolved from the work of Virginia Henderson, one of the first
modern nurses. According to Virginia, it is imperative that a nurse assists the sick individual
and assess the activities, which contributes to the recovery of health. Thus, this model of
nursing was initially meant to be used for effectively assessing the changes in patient’s life
post admission in a hospital or rehabilitation center (Williams 2017). However, in recent
times, this particular model of nursing is used to plan activities for the patient to increase
their independence and raise their standard of life.
According to the health assessment of the patient, it is revealed that Mrs Burst is
diagnosed with lower respiratory tract infection and aspiration pneumonia. To further support
the independence of Mrs Burst and increase her quality of life, a particular activity of living
needs to be emphasized by the multi-disciplinary team. The nurses along with other
professionals from the multi-disciplinary team need to provide their services keeping in mind
the central diagnosis that the patient is receiving. The basic activity of living from the Roper
Logan Tierney Model of nursing that the nurses need to ensure suitable mobility of the
patient Mrs Burst. The nurses have to ensure proper nursing intervention to enhance the
patient’s ability to recovery and improve her body functionality. Further attempt on
enhancing the patient’s ability to mobilise was performed by the physiotherapist with specific
intervention of hydrotherapy, where the patient is helped to carry out exercises in warm
water. The hydrotherapy intervention, in which exercises are carried out in shallow & warm

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water helps to support and relax the joints and muscles of the patients, while the resistance
from water helps them to get physically stronger gradually (Iliescu et al. 2019).
In the nursing profession, effective communication is imperative in providing the best
patient-centered care. With the help of active communication skills, the nurses can relay
critical information effectively to their peers and exchange information between patient, their
family members and other caregivers. However, in adult nursing care, the involvement of the
multidisciplinary team to provide all aspects of professional care is required to ensure the
highest standards of patient care and safety. This situation demands professional
communication and team collaboration to achieve the highest standards of patient care and
safety. The adult patient communicates with more than one professional in a single day,
including technicians, physicians and nurses from different backgrounds. Effective
communication skills when integrated into clinical practice can help these sets of
professionals to relay critical information. In the event where a lack of effective
communication skills are observed, several reasons arise to negatively influence the patient’s
safety and increase its risk. A few of these reasons include unclear orders from peers,
misinterpretation of information, overlooked changes in the patient’s status chart, lack of
critical information passed on to the current nurse taking care of the nurses. One of the major
issues caused due to nominal communication skills is medication errors, which can cause
severe injury to the patient and can even lead to patient death. The patient, Mrs Burst,
requires professionals from multiple disciplinary, such as mental health nurses, doctors, a
physiotherapists, a speech and language therapist and a dietician. Effective communication
between these professionals will ensure that the patient’s care needs are met with
collaborative efforts from the multi-disciplinary team.

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Conclusion
An adult health nurse is a professional nurse who has received additional training and
education to deal with older patients in an adult care setting. The primary aim of an adult
health nurse is to promote the health of the patient, prevent health, restore health and
facilitate activities that support the health of the individual. Adult nurses work in
collaboration with a multi-disciplinary team to address the holistic care need of the patient,
but around a central aim of curing a specific disease of the patient. In such cases, it is
important that effective communication skills are displayed by the professionals involved in
the care plan for the patient. With a lack of communication, critical information is not
effectively relayed between the professionals leading to professional misconduct such as
medication errors. Thus, with effective communication, the nurses and multi-disciplinary
team can increase the standards of patient care and safety.

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