Care Planning Processes in Healthcare Practice

This document discusses the care planning process in healthcare practice, including different models of assessment, theoretical perspectives, and the legislative and regulatory framework. It also includes case studies to review the challenges of developing care plans to meet individual needs.

Care Planning Processes in
Healthcare Practice

Table of Contents
INTRODUCTION...........................................................................................................................1
PART 1............................................................................................................................................1
Compare the different models of assessment and their implementation in healthcare..........1
Discuss the application of theoretical perspectives to the care planning process in a healthcare
setting.....................................................................................................................................2
Review how the legislative and regulatory framework that supports equality and diversity is
reflected in the assessment and care planning process...........................................................3
Evaluate the influence of different theoretical perspectives on models of planning and
assessment used in the workplace..........................................................................................4
PART 2............................................................................................................................................5
A. Develop two case studies of individuals in your care to provide a critical review of the
challenges of developing care plans to meet the needs of the individual........................................5
Case 1.....................................................................................................................................5
Case 2.....................................................................................................................................8
Discuss responsibilities and duties of own role in promoting person centred care planning in
reference to the individuals in the two case studies created.................................................10
Demonstrate your own contribution to the care planning process and the use of care plan in
setting...................................................................................................................................11
Review the application of the risk assessment process in promoting person-centred planning
in own workplace.................................................................................................................11
Critically review the challenges of developing care plans that meet the needs of individuals
and their required outcome...................................................................................................11
Discuss the barriers to implementing care planning in the setting.......................................11
Review the benefits of the use of care plans in ensuring the needs of the individual are
prioritised..............................................................................................................................12
B. Two records of observation of your practice in promoting an individual’s holistic wellbeing
through effective communication when implementing plans of care in your workplace..............12

Demonstrate your own contribution to the care planning process and the use of care plan in
setting...................................................................................................................................12
Demonstrate the promotion of an individual’s holistic wellbeing through effective
communication when implementing a plan of care in own workplace................................12
Review aspects of the care planning process in terms of its impact on the individual, family
and/or carers, including a discussion of how the individual and their family have contributed
to the evaluation of the care process.....................................................................................12
Explain the barriers to implementing care planning in the setting and discuss the strategies
used to overcome barriers to effective planning...................................................................13
Conclude with an overall review of the benefits of the use of care plans in ensuring the needs
of the individual are prioritised............................................................................................13
C. Reflective account.....................................................................................................................13
CONCLUSION..............................................................................................................................13
REFERENCES..............................................................................................................................14

INTRODUCTION
Care planning process refers to evaluating actual health problem to make decision of providing
treatment. It includes setting desired set of interventions to carry out clinical steps in correct
sequence to address particular disease effectively. However, it has been analysed that care plan
should be establish by following desired codes of practices and ethical principles to deliver
effective care (Doenges, Moorhouse and Murr, 2016). It is necessary to consider all the
healthcare legislations and required health models to provide appropriate medical facilities in
proper manner. It is required to focus to assessment of specific disease carefully which facilitate
to make accurate decision regarding treatment. In context of this assignment, it is based on two
case studies to analyse their respect problems and responsibilities of health professionals. This
project will focus on different models and theoretical perspective regarding care planning in
healthcare. It will also include legislative and regulatory framework along with influence of
theoretical perspectives on models of planning & assessment in healthcare settings. The care plan
for specific case studies and observation records related them are given below.
PART 1
Compare the different models of assessment and their implementation in healthcare.
The different models of assessment include tools which can be used to assess specific health
problem with its causes in order to make treatment decision. It includes using specific
assessment model that is favourable to evaluate actual medical condition an individual, it is
necessary to carry our accurate diagnosis of health problem which facilitate to establish accurate
decision of treatment (Kaakinen and et. al., 2018). However, it is suitable to formulate effective
nursing interventions in order to make patient disease free. There are various assessment models
that can be used by nursing staff in which some of them are given below.
The Culturally competent community care (CCCC): This nursing model includes the
criterion of in which nurse is required strive for achieving the capability of working with family
and individual in cultural context. It includes some of elements which should be consider while
diagnosing the patient such as awareness of one’s own cultural worldview, attitude towards
cultural differences, knowledge of various cultural practices & worldviews and cross cultural
skills.
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Family cultural heritage assessment tool (FAMCHAT): The FAMCHAT can be defined as an
assessment tool in which questions were asked to patient in order to examine their ethnic,
cultural and religious heritage. It can be utilised for analysing the health traditions of an
individual which helps to formulate more accurate nursing interventions for their wellbeing
(Martin and et. al., 2016). However, this diagnosing model is helpful about practices and
procedures to which patient is fond of doing them according to which the inappropriate aspects
can be determined to correct with providing treatment respectively.
Assessment, communication, cultural negotiation and compromise, establishing respect and
rapport, sensitivity, safety (ACCESS model): This can be described as an overall combination
of important factors which should be followed while diagnosing the health problem. It includes
maintaining respect and safety for patient along with making effective communication with them
to establish appropriate nursing care plan for making them disease free. However, it is necessary
to focus on cultural negotiation and assess real issue carefully for providing appropriate
treatment respectively.
The process of cultural competence in the delivery of healthcare services model: The model
of cultural competency is used for assessment of an individual to evaluate their health problem in
effective manner. It is favourable to increase patient’s health care seeking behaviour and
facilitate more effective testing as well as screening. Moreover, it is helpful to avoid chance of
occurring drug complications and greater adherence for medical advice respectively.
Discuss the application of theoretical perspectives to the care planning process in a healthcare
setting.
The theoretical perspectives refer to methods that are helpful to understand actual condition of an
individual by evaluating health problem for carry out care planning effectively. It includes
number of theoretical perspectives from which specific and suitable one option can be used by
nursing staff in terms of formulating appropriate care plan to make patient disease free.
However, it consist the criterion of using specific one approach to be followed in order to deliver
effective care facilities (Townsend and Morgan, 2017).
Functionalism: This can be considered as functionalist perspective which states that health is
known as vital to stability of the society. It includes the criterion that illness can be known as a
sanctioned form of deviance. However, it has been analysed that patterns of expectations are
responsible to state about correct behaviour for ills person and for those who is taking care of
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them. Meanwhile, it includes the fact that patient also has some of roles and responsibilities
regarding their treatment method. They can make enquiry about their condition and followed
clinical practices along with providing suggestions for gaining more suitable treatment.
Conflict perspective: This includes the problems and issues related to healthcare system
including social problems that are rooted in capitalist society. It includes the fact that social
conflicts may occur due to limited availability of health services. Basically, it is observed that
health disparities and inequalities are present due to which some of people cannot gain desired
health services (Delaney, 2018). However, it is necessary to make sufficient availability of
medical facilities along with removing the threat of societal inequalities for few of citizens.
Moreover, the health professional should maintain equality while providing health services and
care by ensuring their every needed person get desired medication effectively.
Symbolic interactionism: The symbolic interactionism states that health and illness are
considered to be both constructed in social manner. It includes the fact that bad behaviour
towards specific discriminated community is responsible for converting into sick behaviour.
However, it has been analysed that the discriminated behaviour of society is accountable to
develop many of physical health problems among some of people because they will not desired
resources to fulfil their basic needs, they remain uneducated, unemployed and poor due to which
they develop physical as well as mental health problems between them. Moreover, care
professional should provide appropriate care services by making effective care plan for wellness
of sick people.
Review how the legislative and regulatory framework that supports equality and diversity is
reflected in the assessment and care planning process.
The legislative and regulatory framework includes set of rules and regulations which are required
to be followed by medical practitioners while dealing with patients. It includes legislations which
encourage professionals to perform on correct way during conducting clinical procedures and
activities (Nelson and Staggers, 2016). The regulatory frameworks play an important role to
restrict medical professionals for misusing their knowledge and power along with directing their
efforts to correct directions. However, the consideration of legislations is suitable to encourage
professionals for making accurate decision and reduce chance of occurring drug errors or other
clinical mistakes. Some of legislative and regulatory frameworks are given below.
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Health and Social Care Act 2012: This legislation provides guidelines in regards to establish
effective structure of healthcare organisations to provide medical services for people properly. It
includes the guideline for professionals that they must take responsibility of their patient
regarding both positive and negative outcomes. However, they are responsible for patient
outcomes and take responsibility for relevant complications which encourage them perform more
effective in clinical settings.
The Care Act 2014: According to this act, it has been analysed that it has main principle to
improve the independence and wellbeing among citizens of the country. It includes providing
instructions for local authorities to enhance the availability of services to improve health
condition of people (McCormack and McCance, 2016). Meanwhile, it is observed that local
authorities are required to make sure that developing of health needs should be reduced and
prevent severe health problems among citizens.
The Equality Act 2010: The equality act can be defined a legislation which exist to eliminate
the factor of discrimination from society. It includes removing discrimination for people while
they are seeking for education, employment and health services. However, equality act instruct
care professionals to provide treatment facilities in equal manner so that everyone get health
services immediately to maintain their health condition.
The Data Protection Act 2018: The data protection act plays an important role to maintain
confidentiality of patient data which is essential in healthcare settings. It is so because a minor
medical issue may develop a major social problem for an individual from which they may suffer
lifelong. However, it is very important for medical practitioners to maintain privacy of patient
records by carefully handling the relevant information (Edelman, Mandle and Kudzma, 2017). It
is mandatory to share data of specific patient to only few of professional that are associated with
respective cases and working on it for wellbeing of them.
Evaluate the influence of different theoretical perspectives on models of planning and assessment
used in the workplace.
The theoretical perspectives are favourable to understand the actual cause of specific health
problem according to which effective decision of treatment can be established. It includes
evaluating actual reason behind sick behaviour of an individual for which specific nursing
interventions can be established for welfare of patient. However, it has been analysed that
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models of planning are helpful to formulate more effective as well as efficient nursing care plan
which facilitate to improve patient health condition.
On the other hand, it involves considering evidence based plan, person centred care, quality
standards, ethics etc. which facilitate to prepare appropriate care plan. It is necessary to establish
number of nursing interventions for providing appropriate treatment. Meanwhile, it consist the
criterion of using evidence based practices which are effective treat specific health problem and
reduce risk of complications (Brown, 2018). The ethical principles are helpful to avoid wrong
attempt and mistakes along with dealing with an individual with respect & dignity. Moreover,
effective models can use for evaluating actual health issues along with providing appropriate
treatment in order to make people disease free accordingly.
PART 2
A. Develop two case studies of individuals in your care to provide a critical
review of the challenges of developing care plans to meet the needs of the
individual.
Case 1
The patient named Mrs P lives with her husband on a farm who was admitted to emergency
department with problem of diarrhoea and moderate dehydration following bowel resection two
weeks earlier remove carcinoid tumours. She is 68 years old and has history of diarrhoea before
two and a half year which a significant weight loss. However, the give patient become
increasingly homebound and lost her independency as she is depend mostly for care on her
husband who suffer from problem of Tourrett’s syndrome and depression. The patient has
present critical status that her youngest daughter have attempted suicide before some time which
also impact negatively on health of Mrs P.
PATIENTS MEDICAL INFORMATION
Relevant conditions, diagnosis and latest test results:
The given patient has problem of carcinoid tumours due to which the emergency of diarrhoea
and moderate dehydration takes place. It has been diagnosed that due to presence of carcinoid
tumours in small intestine, the problem of diarrhoea occurs.
Significant past medical history:
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The given patient has past history of diarrhoea which results into potential weight loss due to
which Mrs P become home bound and depends on her husband.
Current medication:
The current medication provided to the select patient is Xermelo (telotristat ethyl) along with
somatostatin analog (SSA) therapy to treat the problem of diarrhoea.
Date of planned review of medications:
The date planned for reviewing medication is next day that is 24th May, 2020. It is helpful to
evaluate effectiveness of given medication to understand improvement and analyse need if
changing the medication if no positive sign can be found.
Allergies: No allergy
KEY ACTION POINTS
Guideline or intervention
 It is required to assess the bowel sounds and movement including frequency and
consistency to provide appropriate medicine.
 It is required to monitor I & O and weight to avoid relevant complications.
 The diet adjustment is must to avoid heavy food items and provide high fibre eatable
products for patient.
 It includes encouraging providing adequate fluid intake and small & frequent food items
(Stanhope and et. al., 2019).
 It is necessary to monitor the electrolytes, administer IV fluids, antidiarrheal agents and
stool differences, laxatives, enemas as indicated.
OTHER RELEVANT INFORMATION (if appropriate)
Other support services e.g. local authority support, housing
The other support for patient is her husband who was available all the time for taking care of his
wife.
Identification of whether the person is themselves a carer (formal or informal) for another person
Mrs P was not herself a care provider and she is a married housewife lives with her husband on
their farm.
Anticipatory care plan agreed: YES /NO/N/A
 N/A
Anticipatory drugs supplied: YES / NO/ N/A
 No
Emergency care and treatment discussed: If yes, please specify outcome:
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YES / NO
 Yes, the emergency treatment was
discussed with family of patient and
then with senior doctor in charge to
make further decisions regarding
wellness of them.
The outcome of discussion with family is to
make them informed about treatment given to
patient by taking their approval whereas
discussion with senior doctor and team is
favourable to provide treatment more
effectively for wellness of patient.
Date of assessment: 23rd May, 2020 Date of review(s): 24th
May, 2020
Any special communication considerations:
The patient is not bale to understand English language and her husband help her to communicate
with nursing staff and doctor. The lack of English language is a problem but it had not develop
any big issue for medical practitioners due to support of patient’s husband who known English
language very well.
Any special physical or medical considerations (e.g. specific postural or support needs or
information about medical condition – patient needs at least x mgs of drug before it works, etc.):
The special need of patient is mentally depressed due to which counselling was provided to make
her stable emotionally and mentally.
SIGNATORIES (if appropriate and / or possible)
Patient signature: P. Johnson
Date: 25th May, 2020
Carer (if applicable) signature: Peter
Date: 25th May, 2020
Named accountable GP signature: Dr. Brown
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Date: 25th May, 2020
Care Coordinator signature (if applicable): Oliver
Date: 25th May, 2020
Case 2
The patient named Mrs Beryl Brown was admitted to emergency department while her daughter
saw her lying in front of the toilet. She is 85yaers old woman. Her daughter was thinking that
patient was lying like that for overnight. She was diagnosed with the problem of right sided
stroke which has left her with moderate weakness in her left leg and arm. However, the diagnosis
procedures and methods also results into other problem of vascular dementia for patient that was
overlaid on a pre-existing diagnosis of Alzheimer’s diseases.
PATIENTS MEDICAL INFORMATION
Relevant conditions, diagnosis and latest test results:
The given patient was diagnosed with the problem of right sided stroke and vascular dementia
which is required to be treated earlier to avoid further complications.
Significant past medical history:
The significant medical history of selected patient is Alzheimer’s disease from which they were
suffering since last 3 years.
Current medication:
The current medication provided to patient is heparin which is known as an anticoagulant that
has a function to dilute blood clots. It can be consider as a kind of blood thinner which facilitate
proper supply of blood to brain which avoid problem of stroke.
Date of planned review of medications:
28th May, 2020
Allergies: No allergy
KEY ACTION POINTS
Guideline or intervention
 It is required to evaluate overall body condition of patient including their brain, skin,
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hands, legs etc.
 It includes the criterion of changing the position of individual within every 2 hours.
 It consists to pro extremities in functional position by use footboards at the time of
flaccid paralysis (Frow, McColl-Kennedy and Payne, 2016).
 Elevate arm and hand along with placing the pillow under axilla to abduct arm.
 It is necessary to encourage patient to assist for movement and exercise to facilitate
movement in weaker side.
 It is required to provide medication for stroke and vascular dementia to make patient
disease free.
OTHER RELEVANT INFORMATION (if appropriate)
Other support services e.g. local authority support, housing
The other support is patient’s daughters who provides support to doctors by providing details and
take care of her mother.
Identification of whether the person is themselves a carer (formal or informal) for another person
Anticipatory care plan agreed: YES /NO/N/A
 N/A
Anticipatory drugs supplied: YES / NO/ N/A
 N/A
Emergency care and treatment discussed:
YES / NO
 Yes
If yes, please specify outcome:
The discussion with family for informed
consent regarding treatment and discussion
with team members associated case to establish
effective care plan to make patient wellbeing
as soon as possible.
Date of assessment: 27th May, 2020 Date of review(s): 28th
May, 2020
Any special communication considerations (e.g. patient is deaf or language communication
differences):
No, there is not special consideration of communication as patient and her daughter are capable
to communicate in English with doctors.
Any special physical or medical considerations (e.g. specific postural or support needs or
information about medical condition – patient needs at least x mgs of drug before it works, etc.):
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The counselling is need because of dementia to improve patient condition for gaining her
cooperation in treatment process.
SIGNATORIES (if appropriate and / or possible)
Patient signature: Beryl Brown
Date: 28th May, 2020
Carer (if applicable) signature: Anthony
Date: 28th May, 2020
Named accountable GP signature: Dr. William
Date: 28th May, 2020
Care Coordinator signature (if applicable): Hannah
Date: 28th May, 2020
Discuss responsibilities and duties of own role in promoting person centred care planning in
reference to the individuals in the two case studies created.
Considering the both case studies, it has been analysed that the care professionals has a role to
follow person centred care approach for every patient while providing treatment to them. The
duties of medical professionals include following principles of person centred care including
dignity, compassion, respect, coordinated care and treatment (Laverack, 2019). They have a
responsibility to consider code values of person centred care such as individuality, independence,
privacy, partnership, choice, dignity, respect and rights of patients in given cases of P. Johnson
and Mrs Beryl Brown.
.
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Demonstrate your own contribution to the care planning process and the use of care plan in
setting.
My contribution is to remain careful and honest during addressing the specific health problem by
ensuring that evidence based clinical practices must be used. It is necessary to follow all the
ethical principles to provide effective care for welfare of patients (Borkowski, 2016). However,
my responsibility is to involve patient and their family members to establish person centred care
plan in given both cases to deliver appropriate services for their wellbeing.
Review the application of the risk assessment process in promoting person-centred planning in
own workplace.
Risk assessment is an important task to assess factors which may develop complications in future
to remain prepared to deal with them immediately for saving patient. In context of given cases of
P. Johnson and Mrs Beryl Brown, The risk assessment is useful to evaluate forthcoming
problems in promoting person centred care plan to set strategies to deal with risky situations.
Care professionals can proactively and reactively work to either prevent the incident or to
minimise the damages.
Critically review the challenges of developing care plans that meet the needs of individuals and
their required outcome.
The challenges occur when a patient is allergic then medication should be prescribed very
carefully and regular monitoring is must to ensure that given drug is suitable with no side effects
of body. It includes other challenge regarding fear of patient which results into lack of
cooperation and internal & moral strength which is important to execute care plan for wellness of
people (Huber, 2017).
Discuss the barriers to implementing care planning in the setting.
In context of given cases, it has been analysed that lack of communication and
miscommunication between care practitioners become a barrier to implement care planning
effectively. It includes that low comfort level of patient with doctors is also considered to be a
barrier for apply care plan in proper manner as they do not cooperate as much as required.
11

Review the benefits of the use of care plans in ensuring the needs of the individual are
prioritised.
Care plan is beneficial because it is establish for specific individual for their specific medical
needs that is favourable to make them wellbeing soon. It is beneficial to direct efforts of nursing
staff to provide correct care services at right time (Crowell and Boynton, 2020).
B. Two records of observation of your practice in promoting an individual’s
holistic wellbeing through effective communication when implementing
plans of care in your workplace
Demonstrate your own contribution to the care planning process and the use of care plan in
setting.
My contribution is to maintain respect & dignity along with using person centred approach to
deliver appropriate care for patient in given cases of P. Johnson and Mrs Beryl Brown. It
includes the responsibility to make effective communication with patient to analyse their choice
about treatment and prepare appropriate care plan to make sick individual disease free (Sitzman,
2018).
Demonstrate the promotion of an individual’s holistic wellbeing through effective
communication when implementing a plan of care in own workplace.
The holistic care can be promoted with the help of maintain effective communication with the
help of appropriate use of communication methods. It is necessary to use technology to share
accurate information between care professionals to avoid clinical mistakes and drug errors which
facilitate to implement care plan effectively.
Review aspects of the care planning process in terms of its impact on the individual, family
and/or carers, including a discussion of how the individual and their family have
contributed to the evaluation of the care process.
The patient and family plays an important role to provide information about actual care needs of
an individual according to which effective care plan can be formulated (Abel-Smith, 2018). Care
professionals gain an idea about favourable interventions and medication for particular patient to
make plan of acre and deliver appropriate treatment for making them healthy.
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Explain the barriers to implementing care planning in the setting and discuss the strategies used
to overcome barriers to effective planning.
The barrier for applying care planning includes fear factor of patient and lack of cooperation in
healthcare settings which impact on treatment process as well as respective outcomes. It is
necessary to develop mutual understanding with an individual via effective communication to
make them comfortable and increase moral strength which reduces fear to overcome this barrier
and implement care plan properly (Sligo and et. al., 2017).
Conclude with an overall review of the benefits of the use of care plans in ensuring the needs of
the individual are prioritised.
Care plan is helpful to carry out clinical procedures in correct sequence and it facilitate to not
forget small things like changing positions in 2 hours, avoid some of food items etc. It is helpful
for nursing staff to follow instructions of specialist effectively which provide support to make an
individual disease free as soon as possible.
C. Reflective account
Considering the above information, I have analysed that involvement of patient and their family
members is effective in terms of improving accuracy of care plan to address actual care needs of
an individual. It is favourable for medical professionals to fulfil overall needs of patient to make
them completely well. However, the team work is very important to provide appropriate
treatment with the help of using correct leadership style for making clinical decisions regarding
better health of patient. Meanwhile, the planning process requires extra careful working to assess
actual requirements of patients to formulate number of interventions to improve health condition
of a person.
CONCLUSION
From the above project, it has been concluded that care planning is very important to provide
care services effectively. It includes assessing actual needs and requirements of an individual to
make accurate decision of medical treatment for their wellbeing. However, it is necessary to
follow ethics and legislations which provide support to efforts in correct manner. Moreover, it is
observed that considering legislations and person centred care is helpful to reduce chance of
clinical problems and improve patient outcomes.
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REFERENCES
Books and journals
Abel-Smith, B., 2018. An introduction to health: policy, planning and financing. Routledge.
Borkowski, N., 2016. Organizational behavior in health care. Jones & Bartlett Publishers.
Brown, M.M., 2018. Transitions of care. In Chronic Illness Care (pp. 369-373). Springer, Cham.
Crowell, D.M. and Boynton, B., 2020. Complexity leadership: Nursing's role in health care
delivery. FA Davis.
Delaney, L.J., 2018. Patient-centred care as an approach to improving health care in
Australia. Collegian, 25(1), pp.119-123.
Doenges, M.E., Moorhouse, M.F. and Murr, A.C., 2016. Nursing diagnosis manual: Planning,
individualizing, and documenting client care. FA Davis.
Edelman, C.L., Mandle, C.L. and Kudzma, E.C., 2017. Health promotion throughout the life
span-e-book. Elsevier Health Sciences.
Frow, P., McColl-Kennedy, J.R. and Payne, A., 2016. Co-creation practices: Their role in
shaping a health care ecosystem. Industrial Marketing Management, 56, pp.24-39.
Huber, D., 2017. Leadership and nursing care management-e-book. Elsevier Health Sciences.
Kaakinen, J.R. and et. al., 2018. Family health care nursing: Theory, practice, and research. FA
Davis.
Laverack, G., 2019. Public health: power, empowerment and professional practice. Macmillan
International Higher Education.
Martin, R.S. and et. al., 2016. The effects of advance care planning interventions on nursing
home residents: a systematic review. Journal of the American Medical Directors
Association, 17(4), pp.284-293.
McCormack, B. and McCance, T. eds., 2016. Person-centred practice in nursing and health
care: theory and practice. John Wiley & Sons.
Nelson, R. and Staggers, N., 2016. Health Informatics-E-Book: An Interprofessional Approach.
Elsevier Health Sciences.
Sitzman, K., 2018. Caring science, mindful practice: Implementing Watson’s human caring
theory. Springer Publishing Company.
Sligo, J. and et. al., 2017. A literature review for large-scale health information system project
planning, implementation and evaluation. International journal of medical informatics, 97,
pp.86-97.
Stanhope, M. and et. al., 2019. Public Health Nursing E-Book: Population-Centered Health
Care in the Community. Mosby.
Townsend, M.C. and Morgan, K.I., 2017. Psychiatric mental health nursing: Concepts of care in
evidence-based practice. FA Davis.
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