What is the nurse’s role in the transitional process and supporting the patient and their family?
This report is an investigation of the effectiveness of coordinating integrated healthcare.” You are required to select a patient with a chronic / long term condition and explore the nurses role in coordinating integrated healthcare.
This will be completed by focusing on addressing LO1 – L04.
Remember that your work will need to be supported with references (Harvard style) and follow the presentation guidelines outlined within your module handbook.
Your report should look polished and professional.
Make sure your report is well presented, with correct information on the title page, numbered pages, and clearly labelled including numbered sections.
Make sure you have followed the structure and style specified in your assignment brief.
Use a formal academic language and be as brief and concise as possible, using supporting evidence.
You must follow the outline within your “Guidance on report writing.” For example:
- Title page
- Contents page
- Abstract /Summary
- Introduction
- Main text
- Conclusion
- Recommendations
- Reference list
- Appendices – including care pathway (flow chart)
Specifically, your report should include a patients journey of care in relation to a focus on the learning outcomes. Refrain from adding any headings apart from the heading outlined above.
A long-term illness -: stroke with deteriorating mental health illness
Learning Outcome Part 1
You are required to complete a report with a content of 3000 words which will contribute to 80% of your module marks.
LO1
Analyze the role of the nurse, other professions, and agencies in integrated health care delivery.
(450 words approximately).
Guidance for LO1 Content
- Define coordinated integrated care delivery, detail the importance, and look at potential obstacles.
- What is the nurses’ role in coordinating integrated care.
- Look at the importance of the role of the nurse in relation to the NMC standards. chronic
- In relation to your chosen topic, look at the role of the other professions who are involved and are integral in the patient’s journey.
- Consider what agencies are involved or could be involved in providing support to the patient and their family. How do these influence and contribute to care delivery?
- What is the role of the nurse in relation to facilitating the transitional care of a patient.
(Things might help, think about a patient you have nursed with a long term condition and with your patient as your focus, discuss the following question which will assist you in building the content for your report
Look at the Five Year Forward View and the influence this has on integrated care delivery?
What does this document discuss in relation to integrating care? How is the nurse’s role influenced by this?
What is the nurse role in relation to coordinating integrated care?
What is the nurse’s role in relation to communication, why is this important in influencing the delivery of care?
What is the nurse’s role in relation to the Nursing and Midwifery Council?
What is the nurse’s role in the transitional process and supporting the patient and their family?
Considering your patient and their long-term condition, think about those professions that would be integral in the care journey of the patient?
Considering your patient and their long term condition, what agencies could support your patient further?)
LO2
Evaluate the physical. psychological and social aspects of care provision including self – care management for people, carers and families. (450 words approximately).
Guidance for LO2 Content
- Look at what self – care is and the importance of this for the patient, the impact on their carers and their family in the prevention of re hospital admission and in providing and promoting quality coordinated integrated care delivery.
- Review the complexities of managing the provision of psychological, cognitive, behavioral, social and physical care needs across a wide range of care settings.
- Consider the agencies that might support the provision of self -care.
- What structured educational programs are available in supporting the patient and their family and or carers.
- Look at the pillars of self -care / house of care model in relation to self – care, how do these models influence self -care of the patient.
(This might help, Think about your chosen patient and their long term condition now discuss the following:-
PHYSICAL aspects of care provision. Consider how this long term condition affects the person physically?
What are the physical constraints?
Does this physical limitation bear any consequences on the social circumstances of your patient?
PSYCHOLOGICAL aspects of care provision. Has your patient any known / diagnosed mental health conditions?
How are they coping with this long term condition?
SOCIAL aspects of care provision. Is your patient able to work? Is your patient retired?
Who do they live with?
What activities are they involved in?
What is self – care management?,
3. Why is self – care management important to the patient and their family / carers?
4. What is the nurses role in relation to supporting the patient / family / carers in self – care management?
5. Discuss the 7 pillars of self – care in relation to your patient and their chosen condition).
. LO3
Appraise models of care delivery when supporting a patient requiring an interagency approach to care provision. (450 words approximately).
Guidance for LO3 Content
- In relation to your chosen topic, review and discuss a model of care delivery in the coordination of integrated care.
- Consider how this model fits in with the delivery of coordinated integrated care.
- Look at the impact of existing health policies for the nursing and social care professions, detailing the influences on organisation and in the delivery of care.
. LO4
Analyse the importance of interdisciplinary, interprofessional and interagency communication and working amongst care providers. (450 words approximately).
Guidance for LO4 Content
- Define what interdisciplinary, interprofessional and interagency working is in relation to coordinating integrating care.
- Analyse and discuss the importance of effective communication amongst healthcare providers.
- Look at the 6c and the NMC standards in relation to this.
- Discuss the importance of communication, team working in the success of integrated working.
- Consider the benefits and complexities of communication within a collaborative forum.
- Consider a communication tool such as SBAR, which will assist in the communication process within teams.
(This might help-: Why is integrated working important in the treatment of this patient?
What are the barriers to teamwork, and how could you overcome them in your setting?
How does poor teamwork affect healthcare settings?
Why is communication important in teamwork, and what are the potential consequences if it goes wrong?
As a nurse, you are tasked with being a leader and also being part of a team. What skills do you require to do this and how could you ensure your team is working efficiently?
In relation to the NMC standards, can you explain what is expected in relation to teamwork?)