CNA345 Nursing Assignment: Strength-Based Care for Joseph's Discharge

This report presents a nursing assignment centered on the case study of Joseph, a patient recently discharged from the hospital, and focuses on applying a strength-based nursing approach to facilitate his transition back home. The report outlines the primary and secondary goals of the care plan, emphasizing the importance of fostering Joseph's physical and mental recovery while ensuring culturally safe care delivery. It delves into the critical components of transfer of care, including the involvement of Joseph's wife and daughter in the decision-making process, patient education, and medication reconciliation. Furthermore, the report examines the legal, ethical, and cultural guidelines that underpin a competent nursing plan, such as the Australian Human Rights Commission's regulations and the principles of non-maleficence and autonomy. The report also explores the concept of culturally safe care, highlighting the significance of trans-cultural nursing practices and the use of interpreters to enhance communication and patient satisfaction. Finally, the report discusses the available support services and a comprehensive care plan to ensure Joseph's safe and effective recovery post-discharge.

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

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Executive Summary:
The report is based upon the application of strength based nursing approach to offer
assistance to the client of the case study Joseph who has recently been discharged from the acute
care unit of the hospital. Joseph and his wife Sophia do not prefer residential-care facilities and
thus the report would discuss the primary and secondary goals to foster physical and mental
recovery to the patient and at the same time impart a culturally safe care delivery.

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Table of Contents
Introduction:....................................................................................................................................3
Transfer of Care:..............................................................................................................................3
Legal and ethical principles involved in decision making:.............................................................7
Culturally safe care:.........................................................................................................................8
Conclusion:......................................................................................................................................8
References:......................................................................................................................................9

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Introduction:
This report is based upon the provided case-study of the client Joseph who has been
discharged from the acute care unit of the hospital recently. The paper intends to critically focus
on the vital components of strength based nursing practice so as to ensure a healthy transition of
care. In addition to this, the report would also discuss the mandatory ethical, legal and cultural
guidelines that form the basis of a competent nursing plan.
Transfer of Care:
Transfer of care broadly refers to the placement of the patient to a different level of care
depending upon the health care needs. Studies have mentioned that transfer of care might elicit a
negative implication on the physical and mental health of the patients as well as their respective
care providers (Shepperd et al. 2013). In this regard, it should be mentioned that the key
components of transfer of care includes the consideration of the patient as well as the family
members in the decision making process. Further, it also involves the process of prescribing
proper medication and reconciliation which in turn forms the fundamental basis of discharge
planning that governs the procedure to carry out effective communication with the general
practitioners (Nursingcenter.com 2019). In close association to the case study, it can be
mentioned that the decision making process would involve Joseph’s wife (Sophia) and his
daughter (Emma), who, in this case is his primary care provider. Research studies have stated
that patients are prone to experience gaps within the transition of care phase which invariably
leads to instances of re-hospitalization. Therefore, it is extremely important to ensure a safe
transition of care. This can be guaranteed with the help of imparting effective patient education
to the primary care providers so as to highlight the patient needs across the cognitive, sensory

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and the physiological domain. In context to the client, the primary goal would constitute
reducing the probability of re-hospitalization and ensuring effective care promotion.
In order to ensure the same, Emma and Sophia would be imparted patient-education that
would critically highlight the present physical health condition of Joseph. Further, the rationale
behind the recommendation of seeking additional services would be briefed to them considering
the dependence of Sophia and Emma on Joseph for the chronic illness condition of Sophia and
disability of Thomas (Emma’s Son). It should be mentioned in this context that, St. George
Hospital runs special programs to offer assistance to the dependent adults (Myhospitals.gov.au
2019). The Care Centre offers a service of health literacy where the care professionals educate
the concerned patients about the significance of shared transfer and associated care. A high
impact awareness is created with the help of establishing an effective therapeutic relationship
that enhances the possibility of acquiring positive patient outcomes and at the same time also
assures complete wellness of the patient.
According to Contemporarynurse,com (2019), the underlying principle of strength based
goal determines the feasibility of acquiring the designed objectives to promote patient wellness.
In this regard, it should be stated that the value 5 of the SNBC emphasizes upon the importance
of promoting self-determination among the patient. It also involves considering and respecting
the patient values and choices while planning the transition. As has already been mentioned in
the case study, Joseph and his wife prefer to stay at their own home rather than shifting to a
residential care facility. However, it is important to consider that Joseph manages the daily
chores because of Sophia’s illness and restricted ability to perform ADL. Further, Emma has a
son who is affected with ASD and largely relies upon Joseph for care and support while at work.
Clearly Joseph on account of his weakness and Delirium would require constant monitoring and

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support to avoid any risks of developing accidental injuries. Hence, it can be said that educating
Joseph and his wife about the importance of availing a residential care nurse would help in
seeking their consent conveniently. The Health and Human service department of NSW offers a
special care program to provide home-based care to the dependable patients (Human Rights for
NSW 2019). The offered services comprise of assisting with medication, assisting with activities
of daily living or taking care of the nutrition routine for the patients. Appropriate knowledge and
access to information would help Joseph and his family to opt for a suitable choice of program. It
can be stated that availing a home-based care support would not only help in improving the
health condition but also ensure a safe and comfortable environment. This would directly reduce
the probability of a risk pertaining hospital readmission.
The second goal would include the maintenance of a clean and secure environment to
avoid risks pertaining to fall and accidents. It would further comprise of seeking assistance to
effectively manage the activities of daily living. The activities of daily living would include
cleaning utensils and clothes and mopping. The goal would require the assistance from a
domestic help service. Therefore, imparting education about the importance of availing the
support would help in seeking consent from Joseph and his family. It should be noted here that
patients are at a high risk of developing infections post discharge from hospital setting.
Therefore, it is extremely important to maintain a clean environment. This not only reduces the
chances of acquiring an infection due to weakness and compromised immunity but also prevents
the chances of fall and injuries related to fall. The value 6 of the SNBC emphasizes on the
maintenance of a clean environment to promote wellness. As stated by Karlsson (2013), the
maintenance of a clean environment helps acquire positive patient outcome due to the promotion
of a feeling of wellness. Also, a clean environment has been witnessed to enhance the capacity of

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self-determination that accelerates the process of recovery (Karlsson et al. 2013). The Absolute
Home Help offers domestic and home care help which covers activities such as cleaning,
cooking meals and washing clothes (Ahh.com.au 2019). Availing the support service would help
in the promotion of a clean and safe home-environment after the discharge.
It should be noted that burden of responsibilities brings with it a series of insecurities that
leads to mental health problems such as anxiety and depression (Pracheth et al. 2013). According
to Taylor (2014), primary care providing patients are often depressed and find it difficult to
socialize because of the obligation towards responsibilities. Anxiety and depression disrupts the
mental wellness of the patients that further delays the recovery process. Psychiatric referral could
largely help in the prevention of depression and anxiety among Joseph because of Delirium. In
this regard, it should be mentioned that the provision 5 of the SNBC states that mental wellness
improves the self-determination ability of the patients to acquire accelerated recovery. The
Mental Health Services by the NSW government offers a wide range of support programs for the
elderly citizens which intends to impart counseling and support services to reinforce positive
mental health (Agedcare,health.gov.au 2019).
Goals Available Measures Available Support Services
Primary Goal 1: Physical
health wellness
Imparting education about
availing home-based support
and care services
Home-based care facilities
guaranteed by the Health and
Human Service (NSW)
Primary Goal 2:
Maintenance of a safe
Availing domestic help
services
Domestic care services offered
by the District Nurses NSW

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environment
Secondary Goal: Mental
Health wellness
Availing professional mental
health support services
Psychotherapist referral and
Community Mental Health
support services

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Legal and ethical principles involved in decision making:
The Australian Human Rights Commission has laid down a set of rules and regulations
that critically govern the decision making process involved in Nursing (Hccc.nsw.gov.au 2019).
Further, the right of the patient to avail equitable service with individualized consent is also
guaranteed by the NSW charter of Rights (Human Rights for NSW 2019). In addition to this, the
Nursing and the Midwifery Board of Australia also comprises a set of ethical standards that
states that Nurses must offer assistance to patients while making a decision through informed
consent and must respect the patient’s right of decision making (Nursing and Midwifery Board
(NMBA) 2018). In addition to this the NMBA guidelines also state that, Nurses must as well
respect patient autonomy, privacy and maintain the confidentiality of patient information. The
ethical principle of non-maleficence states that nursing professionals should mean no harm to the
patients while undertaking a decision. Therefore, while assisting the client, it is mandatory to
comply with the ethical principle of non-maleficence. Also, it is important to respect patient
autonomy in the decision making process. This refers to respecting the patient’s decision and not
imposing a decision on the patients. Therefore, while imparting health literacy to the client and
his wife the ethical principles of non-maleficence and autonomy must be maintained. Further, the
patient rights would also be kept in mind.

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Culturally safe care:
The concept of imparting a culturally safe care is based upon trans-cultural nursing
practice that emphasizes on the importance of valuing the cultural and religious thoughts of the
patients (Betancourt et al. 2014). Imparting culturally safe care subsequently improves the
patient’s level of trust and satisfaction (Grace 2017). For instance, while educating Joseph and
his family who are of Italian origin, an interpreter could help in making the communication
easier. Further, the domestic helper would pay attention to the Italian food preferences so as to
impart a culturally competent service to the users.
Conclusion:
Hence to conclude, it can be said that the paper has effectively discussed the two primary
and one secondary goal that would ensure a safe and healthier transition of care for the patient. In
addition to this the paper has also highlighted the support services and a competent care plan that
can be availed by Joseph and his family for an effective recovery post transition.

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References:
Ahh.com.au 2019. Quality Domestic cleaning and house-keeping Sydney. [online] Ahh.com.au.
Available at: http://www.ahh.com.au/ [Accessed 19 Jan. 2019].
Betancourt, J.R., Corbett, J. and Bondaryk, M.R., 2014. Addressing disparities and
achieving equity: cultural competence, ethics, and health-care
transformation. Chest, 145(1), pp.143-148.
Contemporarynurse.com 2019. Community health nursing in Australia. [online]
Contemporarynurse.com. Available at:
http://www.contemporarynurse.com/archives/vol/16/issue/3/article/2055/community-health-
nursing-in-australia/ [Accessed 19 Jan. 2019].
Grace, P.J. ed., 2017. Nursing ethics and professional responsibility in advanced practice.
Jones & Bartlett Learning.
Hccc.nsw.gov.au 2019. Australian Charter of Healthcare Rights - NSW Health Care
Complaints Commission. [online] Hccc.nsw.gov.au. Available at:
http://www.hccc.nsw.gov.au/Information/Information-For-Health-Providers/Australian-
Charter-of-Healthcare-Rights/default.aspx [Accessed 19 Jan. 2019].
Human Rights for NSW 2019. Human Rights for NSW. [online] Human Rights for NSW.
Available at: https://humanrightsfornsw.org/ [Accessed 19 Jan. 2019].
Karlsson, M.K., Magnusson, H., von Schewelov, T. and Rosengren, B.E., 2013. Prevention
of falls in the elderly—a review. Osteoporosis International, 24(3), pp.747-762.

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Myhospitals.gov.au 2019. St George Hospital NSW | MyHospitals.gov.au. [online]
Myhospitals.gov.au. Available at: https://www.myhospitals.gov.au/hospital/1151C2130/st-
george-hospital-nsw [Accessed 19 Jan. 2019].
Nursing and the Midwifery Board of Australia (NMBA) 2018. Code of Professional Conduct for
the Nurses and Midwives. Access date: 19th Jan 2019. Retrieved from:
https://www.nursingmidwiferyboard.gov.au/
Nursingcenter.com 2019. CEArticle. [online] Nursingcenter.com. Available at:
https://www.nursingcenter.com/cearticle?an=00000446-201408000-00024 [Accessed 19
Jan. 2019].
Pracheth, R., Mayur, S.S. and Chowti, J.V., 2013. Geriatric Depression Scale: A tool to
assess depression in elderly. Int J Med Sci Public Health, 2(1), pp.31-35.
Shepperd, S., Lannin, N.A., Clemson, L.M., McCluskey, A., Cameron, I.D. and Barras, S.L.,
2013. Discharge planning from hospital to home. Cochrane database of systematic reviews,
(1).
Taylor, W.D., 2014. Depression in the elderly. New England journal of medicine, 371(13),
pp.1228-1236.