Strength-based Nursing Practice For Safe Transition Of Care

Components of Strength-based Nursing Practice

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 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 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.

Transfer of Care and its Key Components

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 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 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.

Effective Patient Education for Safe Transition of Care

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).

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.

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. 

References:

Ahh.com.au 2019. Quality Domestic cleaning and house-keeping Sydney. [online] Ahh.com.au. Available at: https://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: https://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: https://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.

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: 19^th 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.

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