Examine how and why nursing care is practiced in a person-centred manner



Assignment synopsis: the student is required to discuss a given and completed nursing assessment. The nursing assessment will describe a patient/client who encompasses more than one field of nursing.

Summative Assessment Scenarios

A CAMHS Case Study- Molly
Molly is a 13 year old girl who lives at home with her Mum (Lucy) and her pet dog (Frank). Molly has never met her Dad. Molly?s Mum works as a care assistant in the nursing home in the next village, and also works three evenings a week in the local pub in order to make ends meet, leaving Molly to do the majority of the cooking, the shopping and the house work.
Molly often eats a lot of take away food as she does not enjoy cooking, and has around 4 take away meals a week. She struggles with her sleep as she misses her Mum and worries that her Mum will be cross with her if she has not managed to do the house hold chores. Molly is struggling at school as she is always feeling tired, and all but two of her friends have slipped away from her as she does not have time to socialise with them after school.
Last year, Molly?s maths teacher asked the students to take their height and weight, and then manually calculate their BMI. He then wrote all the BMI results on the board. Molly?s BMI was the highest in the class (she scored 33), and a gang of girls have been teasing her relentlessly as a result. They shout ?fatty? at her in the corridor, throw food at her, and recently weakened the legs on her science stool, so that when she sat down the stool collapsed. Molly has not spoken to anyone about this; she is worried about burdening her remaining friends, she is not close with her teachers and does not want to worry her Mum.
Molly has started spending her break times sitting in a toilet cubicle as she wants to avoid the bullies. Six months ago, Molly scratched herself with her nails when she was feeling particularly stressed, cutting her arm. She was surprised to find that this made her feel better, as it helped her forget her problems for a moment. She then began experimenting with cutting, using her maths compass to cut her arms and legs when she felt upset or helpless. Molly is now finding that she has to cut deeper and deeper in order for cutting to help her, and has recently began using razors as they are sharper, and the cuts are more precise.
Molly is ashamed of the cuts on her arms and her legs. she has begun wearing long sleeve tops to hide the scars, even though it is summer. The gang of girls have also been teasing her about this. Molly wants the scars to go away, but does not know how to stop cutting herself. Last week, one of the girls tried to pull up Molly?s sleeves, and Molly hit out, striking her in the face. Molly has been suspended as a result.
Lucy is aware that Molly has been suspended from school, she is very angry with Molly and has forbidden her from leaving the house during the day.
Molly is spending all day alone in the house, watching TV. She is starting to wonder about the purpose of her life, and feels that no one would miss her if she was no longer around. She has hidden an old kitchen knife under her bed ?just in case? things become worse.
Molly finds that she spends most of her day thinking about death, and has been keeping a diary about her thoughts and her worries. She is beginning to worry that there is something seriously wrong with her.
Molly decides to talk to her Mum about how she is feeling, and shows her Mum her diary. Molly?s Mum is very upset and worried about Molly, and takes her to the GP the next day. The GP immediately refers Molly to the adolescent CMHT, and you have been asked to meet Molly and complete the initial assessment.

2. Abdul has moderate learning disabilities and complex needs. He is 26 years old and lives in his family home with his parents and a younger brother and sister. Abdul has spastic quadriplegia and is demonstrating the characteristic signs of arthritis and tendonitis.
Abdul is unable to walk, sit up unaided or control the movements of his limbs or hands. He experiences muscle spasms resulting from the pain and/or stress of the tightness experienced by his spasticity. Abdul spends his day in a wheelchair which he is reliant upon others to maneuver.
He is also reliant upon others to maintain his continence, wash, dress and feed him.
Abdul has some intentional language. He speaks in short sentences of about 3-4 words. Sometimes his communication will be a mixture of English and Urdu. Abdul?s parents family first language is Urdu, and his Mother, who is his main carer speaks little English.
Abdul experiences a number of physical health needs, including:

? Epilepsy: Abdul typically has absences as well as myoclonic seizures. Within the last 12 weeks he has had two episodes of tonic clonic seizures that have progressed to status epilepticus for which he was hospitalised as an emergency on each occasion.
? Abdul has a BMI of 16.5, and this has been decreasing across the last 14 months.
? Abdul suffers constipation. Although a bulk-forming laxative is indicated , Abdul is unable to take this due to swallowing difficulties
? Abdul suffers frequent occurrences of bronchitis, and twice in the last 12 months had bronchial pneumonia.
? Abdul has a history of pressure sores on his ankles, with the sore taking a very long time to heal. Currently one of his ankles is beginning to show characteristic signs of redness prior to breaking down.
Abdul has been admitted to hospital because of a bronchitis. You have been asked to meet with Abdul and complete the initial assessment.

Assignment synopsis: the student is required to discuss a given and completed nursing assessment. The nursing assessment will describe a patient/client who encompasses more than one field of nursing. Word count: 2500 words.

Learning Outcome Assignment Criteria and comments Marks available
A clear introduction is given, sign-posting content and demonstrating appropriate structure and flow of discussion.

Examine how and why nursing care is practiced in a person-centred manner

Define and critically discuss the importance of person-centred care in the management of a service user?s condition to achieve optimum concordance and health improvement.

Appraise the clinical reasoning and decision-making processes within person-centred nursing practice and relate to evidence-based practice.
Combines the information from the nursing assessment to generate a person-centred patient /client nursing diagnostic statement, identify actual or potential health needs.
Critically discuss the priority of needs and concerns on which the given Nursing Diagnosis are ordered in constructing the plan of care and identify how the concept of Person-centred care informs the priority of needs.
Identifies short-term and intermediate person-centred goals to be achieved by the service user before being ?discharged? from care.

Analyse the nursing practice underpinning the clinical judgment about individual, family or community responses to actual or potential health needs / life processes Critically discuss how the nurse supports the service user to give direction to their care as they identify what they hope to achieve

Collect and combine all of the information and identify nursing actions and interventions with supporting rationale by analysing the information obtained to identify the relevance of a specific intervention for the service user.

Evaluate the similarities and differences in delivering person-centred care across the lifespan with adult, child, mental health and learning disability nursing Critically discuss any similarities or differences that may exist on actions and interventions across adult, mental health, child or learning disability nursing.


Demonstrate evidence-based practice through the use of contemporary research and literature Literature should be within the last 10 years, academic e.g. research papers, policy documents and professional guidance e.g. Nursing and Midwifery Council, the National Institute for Health and Clinical Excellence.
Academic skill Students must ensure the work reflects level (4, 5, 6 or 7) expectations as described in Kingston University SEEC Level descriptors. A range of contemporary and/or seminal references with accurate use of Faculty system of referencing. Clear logical structure; academic presentation; grammar and spelling accurate; adheres to Faculty policy on word count (2500 words max.) and plagiarism. Confidentiality and anonymity must be maintained at all times to protect the identity of client, their families, carers, heath care settings and professionals involved.

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