Nursing Assignment: GPN Health Assessment for Mr. Pitman's Case Study

This nursing assignment focuses on a case study of Mr. Pitman, an 83-year-old patient who suffered a femur fracture and underwent a hip replacement. The report details Mr. Pitman's GPN health assessment, exploring his activities of daily living, the causes of falls in older people, and the deficits he faced. It highlights the crucial role of nurses and caregivers in providing home-based treatment and support. The assessment includes a review of his eating habits, bathing practices, dressing routines, toileting issues, and mobility challenges, along with nursing care recommendations. The report emphasizes the importance of addressing the patient's psychological and physical health needs through interventions like the SMMSE (Standardised Mini-Mental State Examination) and home services. This comprehensive analysis provides insights into geriatric care and healthcare practices, emphasizing the collaborative approach of nurses and GPs in improving patient outcomes, especially for the elderly population. The report also mentions the risk factors associated with Mr. Pitman like living alone, and the need for psychological support to prevent depression, and the importance of regular exercise after hip replacement surgery.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student
Name of the University
Author Note

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Executive summary
General practice of nursing signifies an occasion for general practice and nursing both in
order to improve the quality of care delivered to patient in general practice. Nurses and GPs
recognise their contribution in the healthcare and observe it as a vital component of the
upcoming general practice. The following part of the report will describes about a patient’s
case study whose name was Mr. Pitman who broke his femur bone accidentally. He faced
numerous problems in doing his everyday work. The nurses or the caregivers plays a crucial
role in the well-being of the patient with proper supports from them. It can be concluded
hereby that both the caregivers and the GPs actively performed their operation in the welfare
of the patient by giving him a home based treatment.

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Table of Contents
GPN health assessment..............................................................................................................3
Activities of daily living.............................................................................................................4
Causes of falls in older people...............................................................................................4
Deficits relating to the Mr. Pitman’s activities of daily living...............................................5
Nursing Care Recommendations................................................................................................7
References..................................................................................................................................9

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GPN health assessment
The full form of GPN is the General Practice Nursing. General practice nursing
suggest great proposals in contributing to the well being provided to Australians through
practice. Considering the upcoming of general practice nursing, nurses and the General
Practitioners (GPs) imagine a future where medicine and nursing are joined together and
perform collaboratively to encounter the vibrant needs of health care. Nurses and the
caregivers’ works together with GPs, not in order to substitute or replace for them, but to
improve the value and increase the excellence of care given to the patients. General practice
future rests on a collaborative approach to health care distribution that can react to, adjust
with and effectively accommodate the varying health requirements of the Australian populace
(Boyle, Saunders & Drury, 2016, p.33). Still, there are some ways to perform before general
practice nursing can achieve this dream. The supports which contain instructions for GPs and
general practice nurses, clearing their role within the general practice squad, clinical
procedures for general practice nursing, medico-legal preparations for general practice
nursing, constant expansion of standards for general practices, and workforce planning for the
registered nurses. Health assessment for the older people is a detailed evaluation of a patient
whose age is 75 years and above. It delivers an organised way of classifying health problems
and circumstances that are possibly avoidable or agreeable to interferences to progress the
quality of life. 707 health assessment describers about the continued health assessment which
lasts more than 60 minutes. The current legal requirements which governs the MBS item
number 707 which permit a practice nurse to help a GP with the health assessments (Bilinski
& Boyages, 2013, pp.3-5 ). Clinicians or the medical practitioners may select MBS item
(Medicare Benefits Schedule) 707 (prolonged) to commence the health assessment for those
person who are aged 75 years and above, depending on the consultation which is determined
by the difficulties of the patient’s performance. The aim of the health aseessemment for the

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aged people 75 years and above is an assessment for the health of the patient and his or her
social, psychological and the physiological functions. The MBS item 707 includes the check
up by the general practitioner to execute a health assessment which lasts for at least 60
minutes. Additionally it includes the detailed information collection of the patient’s history.
After examining all the structures of the patient history a proper health care management plan
should be incorporated for the patient. The services should be provided annually to the
eligible patient. The risk factors which are associated with Mr Pitman is that he lives alone
with a dog, he should socialize himself by communicating with the outside world and with
the other people. He was checked with a psychologist because the age is high and so proper
mental care treatment is needed in this situation. He may feel depressed after the accident so
the nurses or the psychologist should console him and prevent him from going to the level of
depression (Ambrose, Paul & Hausdorff, 2013, pp.51-61). Additionally after the accident he
had gone through a hip replacement. He should do his exercise regularly otherwise it would
be difficult for him to recover. These are the some of the risk factors that are associated with
Mr. Pitman.
Activities of daily living
Causes of falls in older people
According to the case study Mr Pitman is 83 years old. He is an older people. While
going to the bathroom he tripped on a mat suddenly and eventually this causes a breakage in
his left neck of femur. He was admitted to the hospital for the total hip replacement. After the
successful hip replacement surgery he returned home and he was advised to follow up with
the general practitioners. He got cut and wound. Sometimes he experiences tremendous pain
in the body but he is recovering well according to the general practice nurses. Falls are
common for aged people, and eventually some of the causes are deadly. The therapeutic
management and enquiry of patients who are present with falls can be interesting for non-

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specialists, and numerous rules and procedures have been published to support this. The
number of people of the old age is fast growing and this people face immense problems like
Mr Pitman who is 83 years of age. The main area of concern is the health of the elderly
people with numerous psychological and medical problems. Assessment of the sickness
profile in elderly people, and the effect of prolonged situations on functional incapacity and
mental well-being are a crucial part of complete assessment of the elderly people (Clegg,
Young, Iliffe, Rikkert & Rockwood, 2013, pp.752-758). The main reasons that why the older
people are more prone to have a fall are: the prolonged health conditions which includes
dementia, heart disease and the low blood pressure and eventually it causes dizziness.
Impairments like the poor vision and the muscle weakness are the cause for the fall. Sickness
that can affect the balance of the body like labyrinthitis causes the fall of the older people.
Among the older adults like Mr. Pitman the most common cause for accidently slipping or
falling is due to the polished or the wet floors in the bathrooms or the carpets and rugs that
are not properly protected. Accordingly to the case study age is one of the main hazards
for falls. Older people have the maximum risk of serious injury or death which arises from
the fall and the risks or the hazards eventually increase with the age (Halcomb, Salamonson,
Davidson, Kaur & Young, 2014, pp 38). Often falls results from a complex interaction of
precipitating and predisposing issues in a person’s situation. Half to two thirds of falls occurs
inside the patient’s house (Colón-Emeric, Whitson, Pavon & Hoenig, 2013).. Falls are the
important cause of mortality and morbidity in the elder people like Mr. Pitman. Falls can be
avoidable, therefore it is important to understand the risk factors for falls in the elderly
people.
Deficits relating to the Mr. Pitman’s activities of daily living
Eating- Mr Pitman spend his day alone with his dog. He has a daughter who lives
nearby. According to the case study her daughter brings food as evening meal on every day.

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She also brought sandwiches for the lunch. After giving the meals to her father she heads
back home. Due to this Mr. Pitman finds difficult to re-heat the food in the microwave, so he
used to east the cold food. Left over foods or the cold foods should be avoided to the elderly
people like Mr. Pitman. Cold foods or the leftovers can cause numerous health issues like
malnutrition or any stomach irritations or problems. When the foods became cold, many type
of bacteria forms on the surface. So if someone like Mr Pitman do not re-heat those cold
foods then it can cause stomach ache and it can be accompanied by vomit (Pahor et al., 2014,
p.311).
Bathing- After discharging from the hospital Mr. Pitman sometimes found difficult to
get up from his bed. He struggled to reach to the bathroom so sometimes he do not take a
bath. It can cause problem to his skin and affect his health. Bathing should not be avoided
otherwise infections and the skin breakdown can occur. Bathing is sometimes difficult and
very much time consuming for elderly people with disabilities. Cleanliness can help the
patient to recover fast and if cleanliness is one of the issue of the patient then it will be tough
for Mr. Pitman to recover fast from the incident (Whiteford et al., 2014)
Dressing- Mr Pitman was in pyjamas for many days until her daughter came and
changed his clothes. Pyjamas should be changed on a regular basis in the elderly people.
Since Mr Pitman has not changed his pyjamas for many days, eventually it can cause health
hazards to him. He may face difficulties in sleeping. Sleeping in dirty pyjamas can keep him
up at night because he might feel oily or itchy. Allergy can occur in the body for sleeping in
the same old pyjamas. Dust mites may mix with the dead cells of the body causing a
suffocation problem to the patient. Dirty pyjamas contains more bugs and more bugs can
cause serious illness to the patient body (Ungar et al 2013, pp 71).

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Toileting or continence- According to the case study Mr Pitman often feels
constipated. He had problem with his bowel movement. Sometimes he felt incontinent ate
night because he can’t seem to get up from his bed to reach to the toilet. If he had a bowel
movement problem or constipated then he will face several stomach problems frequently and
this will cause him sick. The patient must wear a catheter at night for soundless sleep. He
might lack the voluntary control over defecation and urination. Incontinence can cause stress
in the patient body. Skin infections, rashes and sores can develop from the constantly wet
skin and eventually it can cause urinary tract infection in the patient body (Wagg et al., 2015,
pp.398-406).
Mobility and transferring- According to the case study, Mr Pitman faced a lot of
difficulties while getting up or moving inside the house. He cannot manage to get up from his
bed to reach the kitchen or the bathroom. Eventually mobility and transferring can affect the
health of the patient. This can cause depression in the patient and he may feel depressed all
day long and the symptoms will get worse in the future. He may face mental illness issues in
his day to day life. Weakness, joint problems and sometimes neurological difficulties are the
common conditions in the elderly people (McInnes, Peters, Bonney & Halcomb, 2015,
pp.79).
Nursing Care Recommendations
According to the case study after coming back from hospital it is recorded that Mr.
Pitman is recovering well with the support of GPN. The nurse performed investigations with
Mr. Pitman and it is shown that the patient is coping his daily living activities. GPN
conducted a screening on his mental health through SMMSE (Standardised Mini-Mental
State Examination (SMMSE) | IHPA, 2018). In order to prevent any decline in psychological
and physical health GPN arranges the home services.

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The SMMSE (Mini Mental state examination) which is conducted by the GPN is a
useful technique for classifying the cognitive state of the patients for the clinical study. It was
designed as a screening test for the purpose to evaluate the cognitive deficiency in the elder
people. Nurse plays an important role to deliver care in the general practice (GP). Aged care
assessment team or the ACAT are teams of caregivers or the health professionals who
measures the psychological, physical and medical needs of the older people like Mr. Pitman
and help them to an appropriate levels of support (Aged Care Assessment Team (ACAT),
2018). Assessment which is conducted for the patient showed that the elder person may be
able to remain in home. ACAT may recommend Mr Pitman about the certain health care
packages to remain in the house. They can provide both high and low quality of care to the
patient. It mainly focuses on the residential aged care services. In the case study Mr. Pitman
should get the transition care from the team, as the transition care delivers care for those
elderly people moving from hospital to their home. Home care could be useful for the patient
because sometimes simple tasks like bathing and dressing were tough (Why In-Home Elder
Care is Right for You: Benefits and More, 2018). With the exact support from the care givers
Mr. Pitman can make his life easy and eventually this will allow him to continue living in his
residence. Home care treatment is very much cost effective and comfortable. It is more
personalised and less stressful which is required for Mr. Pitman. The main reason why older
people favour to stay in their residence as it delivers them with a required amount of freedom.
Multidisciplinary team method plays a crucial role in the supervision and delivering care of
the elderly people. It delivers care to the families and the patients and serving them to
familiarise with the illness (Access aged care information and services | My Aged Care,
2018). Additionally, multidisciplinary team can offer a psychosocial counselling to Mr.
Pitman because it will help the patient to reconcile the psychological injuries and reconstruct

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social structures after a critical event or an emergency (Jetten, Haslam, Dingle & Jones, 2014,
pp. 46).

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References
Access aged care information and services | My Aged Care. (2018). Retrieved from
https://www.myagedcare.gov.au/
Aged Care Assessment Team (ACAT). (2018). Retrieved from
http://healthywa.wa.gov.au/Articles/A_E/Aged-Care-Assessment-Team-ACAT
Ambrose, A. F., Paul, G., & Hausdorff, J. M. (2013). Risk factors for falls among older
adults: a review of the literature. Maturitas, 75(1), 51-61.
https://doi.org/10.1016/j.maturitas.2013.02.009
Bilinski, K., & Boyages, S. (2013). Evidence of overtesting for vitamin D in Australia: an
analysis of 4.5 years of Medicare Benefits Schedule (MBS) data. BMJ open, 3(6),
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patients experience?. Australian Nursing and Midwifery Journal, 23(9), 33. Retrieve
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people. The lancet, 381(9868), 752-762. https://doi.org/10.1016/S0140-
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Colón-Emeric, C. S., Whitson, H. E., Pavon, J., & Hoenig, H. (2013). Functional decline in
older adults. American family physician, 88(6), 388. Retrieve from
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Halcomb, E. J., Salamonson, Y., Davidson, P. M., Kaur, R., & Young, S. A. (2014). The
evolution of nursing in Australian general practice: a comparative analysis of

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workforce surveys ten years on. BMC Family Practice, 15(1), 52.
https://doi.org/10.1186/1471-2296-15-52
Jetten, J., Haslam, C., Haslam, S. A., Dingle, G., & Jones, J. M. (2014). How groups affect
our health and well‐being: the path from theory to policy. Social Issues and Policy
Review, 8(1), 103-130. https://doi.org/10.1111/sipr.12003
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smmse
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