Social-Ecological Model Offers New Approach

Running head: SOCIOECOLOGICAL FRAMEWORK MODEL
Development of Care Plan Using Socioecological Framework Model
Name of the Student
Name of the University
Author Note

1SOCIOECOLOGICAL FRAMEWORK MODEL
Introduction
The paper aims for the development of a care plan for the patient mentioned in the
case study provided following the illness trajectory model proposed by Corbin and Strauss.
The case study reviews a woman named Amy, who is recently diagnosed with breast cancer
and receiving the chemotherapy treatment for her condition. The patient have recently moved
from Wisconsin, USA to South Queensland, Australia with her husband Mark and the patient
is new to the treatment therapy, since she only have received the first dosage of the first
round of her chemotherapy treatment previously and is receiving the second dosage of the
round currently. The risk of infection in case of the patients who are receiving the
chemotherapy treatment is very high. Hence it can be considered as the trajectory phase in
case of Amy (Reed and Corner 2015). The goal of the care plan for her is to lower the risks of
chemotherapy associated infections in the patient during her stay at the hospital. The paper
will be focused on the development of the care plan based on a socio-ecological framework
along with discussing the factors that can either facilitate or hinder the achievement of the
goal. There will also be an evaluation of every plan.
Socio-ecological Framework for Care Plan Development
A socio-ecological framework in developing the nursing care plan can be described as
a framework that focuses on various aspects such as individualized care, interpersonal
relationships, organizational care, community support and equipment and other services,
while developing a trajectory care plan for a patient with chronic illness to achieve a nursing
goal (AuYoung et al. 2016).
The Person:
While attempting for management of the infection risks in the patients who are
receiving chemotherapy, it should be remembered the person is most at risk of developing the
infection after seven to twelve days of receiving the chemotherapy (Weycker et al. 2016).

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The care plan will include a regular measurement of the risks of infection in the patient,
promoting her safety by taking care of her food source, hygiene along with her social
interactions. The patient must be prevented from consuming food that have chances to
become contaminated, she should always remember to wash her hands properly along with
maintaining a proper hygiene and she also be allowed for limited social interactions,
especially that involves physical touch. Gardening is one of the hobbies of the patient.
However she must be prevented from continuing that hobby, since it will only raise the
chance of the infection in the patient (Tragust et al. 2015). The patient must also be prevented
from travelling.
The factors that can facilitate the plans are the patient’s strong determination to
cooperate in her own care and the effective of communication ability of the healthcare staff
while explaining the goals and interventions in relation to the patient care plan.
If the healthcare staff was unsuccessful in explaining the actual requirement of the
interventions to be adapted to the patient, then the patient could not be prevented from
resuming her hobby of gardening, it may factor negatively in the achievement of the goal
(Noyce and Simpson, 2018).
The evaluation of the interventions can be done by observing the signs and symptoms
of infections in the patient on a regular basis.
Microsystem- Interpersonal Relationship
The only interpersonal relationship that can be detected in this case study in the one
Amy has with her husband Marc. The care plan involving Marc should be that he must be
encouraged to provide the mental support to Amy along with helping her in following all the
instructions to prevent the risk of infection. The importance of maintaining proper hygiene
around Amy along with the risks associated with it must be explained to Marc in detail. He
must also be encouraged to follow a proper hygiene and be careful while interacting with

3SOCIOECOLOGICAL FRAMEWORK MODEL
Amy, since it will help in lowering the risks of infections in her (Freeman et al. 2015). Marc
should also be taught about the possible signs and symptoms that may be associated with the
infections that may occur in Amy so he will be able to report it immediately, which will be
effective in lowering the severity of a condition.
The positive factor of this intervention of involving the family members of the patient
in direct patient care is that the family members can be considered as reliable to take care of
the patient with the their best effort (Olding et al. 2016). If they understand the importance of
the interventions in promotion of the well-being of their loved ones they are most likely to
co-operate with the healthcare professionals. The concern of the family members about a
patient’s well-being is the main factor that is most likely to facilitate the achievement of the
goal.
The hindering factor in the achievement of the goal will be the inability of Marc in
following the instructions regarding the maintenance of proper hygiene.
The evaluation of the intervention can be made by interviewing Marc about the
measures he takes in maintaining the hygiene in the house and how much he observes Amy
for the signs and the symptoms of the infections.
Mesosystem- The Organisation
Some interventions in regards to the healthcare organization must also be made in
order to promote a better patient care. The healthcare organization must promote the practice
of maintaining proper hygiene around the patient in all the healthcare staffs as a part of
patient care plan. The chemotherapy patients along with all other immunosuppressed patients
must be isolated in a different section of that facility, where they will be subjected to special
care that will involve least risk of infection, such as least human interaction, use of masks as
protection measure from the dust and other aerosolized microorganisms, use of properly
disinfected instruments and equipments when attempting for patient care (Khan, Baig and

4SOCIOECOLOGICAL FRAMEWORK MODEL
Mehboob, 2017). The healthcare organization must also provide the patients with easily
digestible food that made with maintaining a proper hygiene. The patients should be under
continuous observation to detect the sign of an infection at the earliest opportunity possible.
The facilitation factor for these interventions is the proper understandings and the
proper motivation of the healthcare staff in implementing the practices. If all the healthcare
staffs of an organization understands the importance of all the interventions along with the
risks in the patients, they are most likely to co-operate in the implementation to all those
interventions.
The hindering factor can be the increased workload on the healthcare staffs of an
organization. Increased workload make the staffs susceptible to stress, anxiety and finally
burnout (Davey et al. 2019). In that scenario they are more likely to be less careful with their
actions, which may lead to improper monitoring of the patients along with increasing the risk
of infection itself.
The evaluation of these interventions can be made by measuring the rate of infections
developed by the immunosuppressed patients on a yearly basis during their stay at the
healthcare organization.
Exosystem- Community Support
The community support is a very effective in caring for the cancer patients (Chan and
Dickens 2015). The cancer patients faces various challenges in regards to their physical and
mental health and it is always considered to be effective to talk to the other people who has
been gone through the same conditions or are currently going through it. Even though the
patient is currently allowed to make the least interaction with the social community, by
adapting a few safety measures, she can be allowed to interact with this kind of specific
communities. The community members may inform her about the practices and the
interventions they adapted during their own treatment with chemotherapy and how she can

5SOCIOECOLOGICAL FRAMEWORK MODEL
possibly cope with her condition in the best possible way. There are various support
programs in order to provide support to the cancer patients near South Queensland, Australia,
including some programs promoted by the government of the Queensland itself (Qld.gov.au,
2020). Amy should be registered with one of such support programs as a part of the care plan.
The willingness of the patient to interact socially can be considered as the facilitating
factor of this intervention. If the patient hears the experiences of the other people with the
same condition as hers, she will be better informed about her own situation and she can be
prepared accordingly, adapting proper measures to prevent the risks of infections (Johnson et
al. 2019).
If the encounter does not follow proper preventive measures, it will itself be a risk to
the patient’s health in the introduction of the infection. The community interaction should not
involve any physical interaction, such as hand shake or other kind of greetings that involve
physical contact, because that can factor in hindering the success of the intervention.
The evaluation of the intervention can be measured by interviewing the patient about
what she has learned from her fellow members from the community she is now a part of and
how she is implementing their advices.
Macrosystem- Equipment and Other Services
Immunosuppressed patients such as those receiving the chemotherapy are already at a
high risk of developing the nosocomial infections than the other patients by improper
maintenance of the hygiene in the use of equipments and the environment (Westerway et al.
2017). The equipments should be properly cleaned and sterilized before using it to care for
the patients who are receiving chemotherapy. The practice involve use of new syringe while
administering the medications and using masks and gloves when making contact with the
patient. The other equipments that make contact with the patient such as stethoscope, face
masks, catheters and various others, should be properly disinfected before bringing them in

6SOCIOECOLOGICAL FRAMEWORK MODEL
contact with the patient (Cdc.gov, 2020). The other services include keeping the area and
environment around the patient hygienic and contamination free, by cleaning frequently with
the use of disinfectants. All those interventions is considered as being effective in the
prevention of the nosocomial infections in various studies.
The facilitating factor for the success of this intervention is the fact that all the
healthcare staffs are properly informed about the concept of hygiene and its efficacy in
lowering the risks of infections in various patients. The knowledge and understanding of the
healthcare staffs about the importance of maintaining hygiene is more likely to motivate them
in order to promote patient safety.
The hindering factor can be the inefficacy of the healthcare organization in promoting
the practice properly. If the maintenance of the proper hygiene is not widely practiced in a
healthcare organization, the healthcare staffs are more likely to make mistakes while caring
for the immunosuppressed patients only and occasionally, increasing the risk of infection in
the patients instead of lowering them (Alp and Damani 2015).
The evaluation of the intervention can also be achieved by measuring the instances of
the patients developing nosocomial infection in the healthcare facility on a yearly basis.
Conclusion
Hence, it can be concluded from the above discussion that in order to manage the
risks of infection in a breast cancer patient such as Amy, who is new to the chemotherapy
treatment a socio-ecological framework should be used while developing a proper care plan
for the patient. The goal of this plan is to lower the risks of the infection in her. The socio-
ecological framework involve various aspects such as the person, the interpersonal
relationships, the organization, the community service and the equipments and other services.
A care plan addressed to all those aspects is supposed to provide the best outcome in the
patient.

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