Nursing Report: Communication and Assessment in Aged Care Nursing

This report delves into the application of person-centred care (PCC) within the context of aged care nursing. It examines communication strategies, identifying barriers and proposing solutions to enhance patient interaction and information gathering. The report analyzes the integration of assessment tools with PCC, highlighting the importance of tools for assessing age-related factors, alcohol-related disorders, fall risks, pain levels, and anxiety. It further explores the strength-based nursing (SBN) approach, detailing its principles and effectiveness in empowering patients through problem-solving. The report uses evidence-based research to evaluate the effectiveness of the strategies, and concludes with recommendations for improving communication and assessment practices in nursing care for elderly patients.

Nursing

TABLE OF CONTENTS
INTRODUCTION ..........................................................................................................................1
QUESTION 1 ..................................................................................................................................1
Communication based on the person-centred approach in nursing .......................................1
Communication barrier identified by Robyn..........................................................................1
Identified communication barriers addressed by Robyn........................................................2
Implementation of person-centred approach..........................................................................2
QUESTION 2 ..................................................................................................................................2
Integration of assessment tools with PCC .............................................................................2
Assessment required to be conducted:...................................................................................2
Pain assessment tools: ...........................................................................................................4
QUESTION 3 ..................................................................................................................................4
Strength-based nursing approach (SBN) for assessment of patient ......................................4
Principles of SBN: .................................................................................................................4
Effectiveness of strength-based approach used by Robyn for empowering max with problem
solving approach.....................................................................................................................5
CONCLUSION ...............................................................................................................................5
REFERENCES................................................................................................................................6

INTRODUCTION
The assignment will be focused on and aged service an emergency team, nurses interview
of patient called Max. It will make use of communication strategies and investigation of
strategies via evidence-based research. (McCormack, 2017). It will analyse the assessment of
older patient named Max through various holistic approaches. The document will include
strength-based evaluation by providing care to an elderly aged patient named, Max. The report
will also analyse the health coaching and advantages it provides to max.
QUESTION 1
Communication based on the person-centred approach in nursing
Person centred nursing care (PCC) make it easy for the nurses to provide care services
with efficiency. This strategy analyses the requirements of patient via communication and then
focuses on treatment plan. It helps in raising accuracy of information processing and develops
mutual respect (Butterworth, 2012). The old age patient can reduce their frustration, stress and
dissatisfaction by communicating with health professionals (Bernoth & Winkler, 2016)). Robyn
is a registered nurse of aged care service in emergency. She is responsible for assessing health
status of her patient Max. He is old and thus age-related factors affects the methods of nursing
care. From the conversation of Robyn and Max it is observed that communication strategy needs
to be effective and nurses need to focus on overcoming challenges to improve patient health
outcome.
Communication barrier identified by Robyn
The first challenge which is addressed by nurse is physical and perceptual barriers.
Robyn interacted with Max via face to face communication. She did not make any perception
regarding Max at the time of interacting. Instead, she interacts with Max for acquiring
knowledge. Robyn ask him details like if he smokes, drinks or is facing difficulty in movement.
After knowing the details, she did not criticise Max at any point. This attempt made easy for
patient to communicate with nurse. Usually with people of old age gets easily frustrated when
others point out or assess their habits or actions. Robyn manages this very well (Kogan, Wilber
& Mosqueda, 2016).

Identified communication barriers addressed by Robyn
To overcome the emotional barriers Robyn started conversation with humour when Max
indicated that he can see her name on name-plate. In order to enhance the emotional
connectivity, the nurse asked him questions regarding his family and daily routine activities
without exceeding the personal space of patient. During assessment of Max nurse did not allow
language and gender barriers to affect their conversation. Robyn greets Max when she entered
room and started conversation only after taking his permission. It gave satisfaction to old man
that nurse gave him respect. She was comfortable and confident during communication.
Implementation of person-centred approach
However, there were instances where the undertaken nursing approaches could have been
in a better state. This is especially when she enquired about walking aids, then she could have
explained that whether Max even need to use them or the benefits he can acquire from its use.
Max have responded positively during conversation as a way of motivating him to develop an
effective understanding of PCC practice and its benefits. This could have encouraged him to ask
more questions to resolve any of his doubts existed in his mind (Person-centred prevention and
care, 2015).
QUESTION 2
Integration of assessment tools with PCC
The age factor is one of the most critical elements for assessment. The nurses use
assessment tools to develop better understanding over health status of patient. It was interpreted
that robyn did not perform these assessment tools which was important in improving his health
condition.
Assessment required to be conducted:
1. Assessment of growing age factors:
With older age there is strong possibility that patient undergo serious health issues like
dementia, cognitive impairment and other psychological confusions (Greatrex‐White & Moxey,
2015). Max had history of psychological stress. He also claimed that he was in severe depression
and is dealing with it alone. For detailed assessment of age related factors such as cognitive
impairment nurses also use tool such as mini mental state examination (MMSE). This tool helps
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in analysing patient health and mental status with the help of set of questions which assist in
documenting response of patient towards the nursing care and treatment methods.
Rationale: If Robyn had used this tool, then probably she could have analysed the
symptoms and intensity of Alzheimer's disease. This could help Max in improving his health
condition related cognitive impairment. Depression and loneliness are one of the most common
factors which affect the individuals in old age (Bernoth & Winkler, 2016).
2. Assessment of alcohol related disorders: When Max informed Robyn that he used to
consume alcohol on daily basis then it was assessed by nurse that Max could have faced severe
hazards of drinking. Alcohol use disorder identification test (AUDIT). This test could have
identified that if Max requires not using alcohol or he has mild dependency on alcohol. The
alcohol withdrawal tool is effective for this assessment. It determines the high intensity leaving
alcohol.
Rationale- The nurse must have assessed the checkpoints of this tool such as nausea,
agitation, paroxysmal sweat, headache, tactile or visionary disturbances and anxiety. These
checkpoints help nurses to conclude that either alcohol addiction withdrawal is minimum or
severe. Further the nurses can provide necessary drugs for managing the symptoms. This
assessment help Max to avoid the risks associated with the alcohol consumption.
3. Assessment of risk of fall and the level of pain: Due to knee injury and difficulty in moving
might create risk that Max may fall. Robyn must have identified these risks so that they can be
minimized. The nurse could have used Ontario modified stratify tools for screening the risk of
falling (Franklin & Melville, 2015). With the help of this tool nurses identify and assess
possibilities such as patient might have any history of fall or factors like visionary disturbances,
confusion that can cause the fall (Risk screening & assessment, 2018).
Rationale- Robyn asks various questions related to movement of patient. She also
demonstrated that how Max can use technique when he is sitting so that pain gets reduce. But the
assessment could have been made more effective and valid by using pain assessment tools such
as verbal or graphical rating scale (Wu & et.al. 2015). A numerical pain level scale can also be
used by Robyn.
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4. Anxiety assessment: There are various patients who faces problems like anxiety and
depression due to depressive hospital environment. It has been observed that Max has admitted
that he faces serious consequences of depression so Robyn must have used hospital anxiety and
depression scale tool (HADS). In this tool questionnaire to assess the psychology of patient is
used.
Pain assessment tools:
The PCC approach for Max could have been improved if Robyn had used these tools.
The communication provided her details of assessment but with these tools impact of treatment
strategies is verified and nursing care can be improved.
QUESTION 3
Strength-based nursing approach (SBN) for assessment of patient
This assessment strategy in providing PCC can be considered as an effective approach. It
is defined as a nursing approach which is used to promote health by empowering the patient with
strength and hope (Feeley & Gottlieb, 2000). It focuses on evaluating the parameters which
affect the health of the individual (Gottlieb, 2014). This approach together analyses the
challenges that prevents the recovery of patients.
Principles of SBN:
This concept implements following principles.
Partnership: The most important principle of SBN is to ensure that patient is actively engaged in
health care practices and decision making (Moyle, 2014)). This can be achieved by making
effective communication. For instance, the psychological state of Max can be known only after
interacting with him.
Assessment of inner strength and weakness: For a quick recovery, it is required that Robyn
clearly identifies the strength of Max. For instance, she could have interacted with Max
regarding this and get to know his feeling. This is basically to know his views and the way in
which this injury will affect his life in the future. The role of his family and his expectations
from nurses can help Robyn in developing a better understanding towards Max (DiCenso, Guyatt
& Ciliska, 2014).
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Explanation of health capacities: herein, the capabilities of Max are essential to be considered.
For instance, the assessment could have explored more details with questions about knee
replacement and if his work will get affected from it or what changes he could face after getting
treated. It could have helped Robyn in solving his queries related to his life style.
Effectiveness of strength-based approach used by Robyn for empowering max with problem
solving approach
To encourage Max for quick recovery and console him for such a temporary pain, in the
treatment procedure, Robyn must have explained him the changes that he may experience to be
aware of the changes. To empower him with strength, problem solving approach is also needed
to be used (Glen, 2017). For instance, when Max informed about difficulty during motion, then
Robyn could have explained him the way of sitting on the chair to minimize the pain. The same
problem-solving concept can be used in other aspects as well. This is basically in context to
withdraw alcohol that can in turn reduce his stress and show him the path of dealing with anxiety
and depression.
CONCLUSION
From the above report it has discussed various strategies related to communication and
identified alternate strategies that Robyn can have used in enhancing the interview. The report
has also demonstrated that nurses can increase the quality of communication by using various
assessment tools. All the questions have been answered by using evidence-based research. It can
also result in creating a sense of dissatisfaction among the patients with a special concern of
those who are in their old age (Cox. 2001). Hence, nurses focus on eliminating challenges of
communication and use various tools and strategy that can lead to more productive assessment.
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REFERENCES
Books and Journals
Bernoth, M., & Winkler, D. (2016). Healthy ageing and aged care. OUPANZ.
Butterworth, C. (2012). How to achieve a person-centred writing style in care plans.
Nursing Older people, 24(8). 216
Cox. A. (2001). BSW students favour strengths/ empowerment-based generalist practice.
Families in Society, 82. 305 1.3.
DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-Based Nursing-E-Book: A Guide to
Clinical Practice. Elsevier Health Sciences.
Feeley. N. & Gottlieb.N. (2000). Nursing approaches for working with family
strengths and resources. Journal of Family Nursing. 6. 9 24.
Franklin, N., & Melville, P. (2015). Competency assessment tools: an exploration of the
pedagogical issues facing competency assessment for nurses in the clinical
environment. Collegian. 22(1). 25-31.
Glen, S. (2017). Problem-based learning in nursing: A new model for a new context. Macmillan
International Higher Education.
Gottlieb, L. N. (2014). CE: Strengths-based nursing. AJN The American Journal of
Nursing. 114(8). 24-32.
Greatrex‐White, S., & Moxey, H. (2015). Wound assessment tools and nurses' needs: an
evaluation study. International wound journal. 12(3). 293-301.
Kogan, A. C., Wilber, K., & Mosqueda, L. (2016). Person‐centered care for older adults with
chronic conditions and functional impairment: A systematic literature review. Journal of
the American Geriatrics Society. 64(1). e1-e7.
McCormack, B. (2017). Negotiating Partnerships with Older People: A Person-Centred
Approach: A Person-Centred Approach. Routledge.
McCormack, B., & McCance, T. (Eds.). (2016). Person-centred practice in nursing and health
care: Theory and practice. John Wiley & Sons.
Moyle, W. (2014). Principles of strengths-based care and other nursing models. In W. Moyle,
Parker & M. Bramble (Eds.), Care of older adults: a strengths-based approach
Wu, X. V., & et.al. (2015). A systematic review of clinical assessment for undergraduate nursing
students. Nurse Education Today. 35(2). 347-359.
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Online
Person-centred prevention and care. 2015 [Online] Accessed through <
http://healthliteracycentre.eu/person-centred-prevention-and-care/>
Risk screening & assessment. 2018 [Online] accessed through
<http://www.cec.health.nsw.gov.au/patient-safety-programs/adult-patient-safety/falls-
prevention/falls-prevention-in-hospitals/risk-screening>
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