Background Low Level Laser Therapy Low level laser therapy LLLTalso known as "cold" laser therapy, refers to a wide variety of procedures involving several laser types and treatment methods. LLLT uses red beam or near infrared nonthermal lasers with a wavelength between and nanometers and from five to milliwatts. In contrast, lasers used for surgery typically use watts.
Introduction The aims of this assignment are to provide a needs orientated approach to care using a nursing model alongside a nursing process in order to create a framework. A nursing model is used to determine what is important and relevant to providing individualized care Barrett, Wilson, Woollands This will be discussed in detail providing evidence of strengths and weaknesses of the model.
The nursing process that will be discussed will be APIE which is assess, plan, implement and evaluate. A nursing process is a systematic approach which focuses on each patient as an individual ensuring that the patients holistic needs are taken into consideration.
These include physical, social, psychological, cultural and environmental factors. The nursing process is a problem solving framework for planning and delivering nursing care to patients and their families Atkinson and Murray It will also discuss an example of a care plan done for a fictional patient Mabel Dunn and evaluate and discuss how the nursing plan and the nursing process have created a plan of care and how effective this was or was not.
Care planning is a highly skilled process used in all healthcare settings which aims to ensure that the best possible care is given to each patient. The Nursing and Midwifery council state that care planning is only to be undertaken by qualified staff or by students under supervision.
It provides a written record accessible to all health professionals where all nursing interventions can be documented. Care planning is extremely important as it enables all staff involved in the care to have access to relevant information about the patients current medical problems and how this affecting them in relation to the 12 activities of living as well as any previous medical history.
Although a vast majority of hospitals now use pre-printed care plans it is important to remember that not all the questions on them will be relevant to all patients.
An example of this would be that activity of breathing may not have any impact on a healthy young adult be would be a major factor for an elderly man with COPD.
Barrett et al It is important that a nursing process is used and it is set out in a logical order, the way in that the nurse would think this helps minimize omissions or mistakes.
Assessment Assessment is a fundamental nursing skill required to gather all the information required about the patient in order to meet all or their needs Hinchliff, Norman and Schober The initial assessment untaken by nurses is to gather information regarding the patients needs but this is only the beginning of assessing as the holistic needs of the patient including physical, physiological, spiritual, social, economic and environmental needs to be taken into consideration in order to deliver appropriate individualized care Roper, Logan and Tierney When using the 12 activities of living ALs for assessment it gives a list a basic information required but must not just be used as a list as the patient will respond better to questions asked in an informal manner and when just part of the general conversation.
RLT state that although every AL is important some are more important than other and this can vary between patients. It is important for nurses to obtain appropriate information through both verbal and non-verbal conversation patients are more likely to give correct information but without jumping to conclusions or putting words into their mouths.
Information can be gained from the patient, the patients family and friends as well as any health records Peate I, During this process of gathering information it is important to find out what the patient can do as well as what they cant.
A full assessment needs to consider how the patient was before they became ill or hospitalized in relation to their medical diagnosis as well as how the patient was dealing with it, how they are now, what is the change or difference if any, do they know what is causing the change, what if anything they are doing about it, do they have any resources now or have they have in the past to deal with the problem barrett et al.
RLT state that there are 5 factors that influence the 12 activities of living which are biological, psychological, sociocultural, environmental and politicoeconomic, these may not all have an effect on each patient but all need to be taken into consideration.
The more information gained in the assessment process the easier the other steps will follow. RLT suggest that assessing is a continuous process and that further information will be obtained through observations and within the course of nursing the patient.
At the end of the initial assessment the nurse should to identify the problems that the patient has.
The Nursing and Midwifery Council NMC states a nurse is personally and professionally accountable for actions and omissions in practice and any decisions made must always be justifiable.
There are many benefits to using a nursing process it is patient centered and enables individualized care for each patient. It also gives patients input into their own care and gives them a greater sense of control it is outcome focused using subjective and objective information which helps and encourages evaluation of the care given.
It also minimizes any errors and omissions. When I carried out the assessing stage on mabel I did this using the 12 activities of living as suggested by Roper et al but this was used too much like a checklist.
If using ASPIRE rather than APIE the next stage would be systematic nursing diagnosis where a nursing diagnosis is established which differs from the medical diagnosis but the two do overlap Barrett et al The nursing diagnosis takes into account the medical diagnosis as well as the holistic needs of the patient considering their biopsychosocial and spiritual needs Hinchliff et al and the effect these may have on the patient and how they deal with their illness.
|Mass-customisation and self-reflective frameworks: As a consequence of this wider participation, tertiary educators are now engaging with increased numbers of culturally and economically diverse learners in distributed ICT environments that they, the educators and learners, are often unfamiliar with.|
The next part of the systematic diagnosis is to establish baselines of where the patient is now in relation to the 12 als and their illness and set goals accordingly in collaboration with the patient in a way in which they understand Barrett et al Planning The next stage of the nursing process is planning this is where all the information gained in the assessment part to plan the care of the patient.
The planning stage of the process is where achievable goals need to be made through discussion with care givers and the patient or the patients representative.
The plan of care is to solve the actual problems the patient has and to prevent potential problems from becoming actual ones, it also aims to help the patient cope with their illness in a positive way and to make them as comfortable and pain free as possible RLT Individualised care aims to have the best possible outcome for the patient by educating the patient and involving them in their care.
There are disadvantages to providing individualized care one of these being the time it takes to write the care plan which is why core care plans are often used but Roper et al say that these can be used effectively when used appropriately such as in post-operative care.
Although when using core care plans it is important not to standardize care as patient react differently to illnesses and treatments. Faulkner Suggests that one of the benefits of using a core care plan is that potential problems can be foreseen.
The more information gathered in assessment the easier the plan of care will be.6th Western Conference on Behavioral Health and Addictive Disorders.
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