Fundamentals of Nursing and Midwifery 2e

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C H A P T E R

Implementing person-centred care

LEARNING OUTCOMES

After completing this chapter, the learner should be able to accomplish the following: 1. Distinguish between nurse- or midwife-initiated, doctor(medical)-initiated and collaborative interventions 2. Describe variables that influence the way a plan is implemented 3. Use eight guidelines for implementing care 4. Use ongoing data collection to determine how to safely and effectively implement a plan of care 5. Explain why a comprehensive and continuous assessment is necessary after implementing interventions.

KEY TERMS

collaborative interventions delegation doctor-initiated interventions

evidence-based practice nurse- and midwife- initiated interventions policies

procedures protocols standing orders supervision

I MPLEMENTING PERSON-CENTRED CARE is the fourth phase in the process of delivering and evaluating care. This process involves the nurse or midwife working in partnership with the person and family to implement the planned care identified in the previous chapter. The purpose of implementing care is to assist the person to achieve their iden- tified health goals: promote health, prevent disease and illness, restore health and facilitate coping with altered functioning. Implementing person-centred care is based on the information collected during the health assessment phase, which leads to the identification of health problems and the planning of care. Recall Claire, the 18-year-old with Type 1 diabetes since she was 9 years old, who was admitted with a diag- nosis of ketoacidosis. In Chapter 17 you developed a plan of care based on the data gathered from your health assessment. In this chapter the care you planned will be

implemented. Claire’s condition has stabilised and she will be continually monitored to gauge her responses to the care given. At this point, her care may be modified as her condition or responses to care change. Critical thinking questions will be posed, and reflective points included, to encourage you to focus on the issues of implementing care to address Claire’s health problems. Through this activity you will continue to strengthen your clinical reasoning skills as the basis for thoughtful practice. Person-centred planned care is best implemented when the person is able and willing to participate and have maximum opportunities to provide self-care. Involving family members and other support people in planning care will further enhance the successful implementation of the plan of care. Table 18-1 outlines the relationships and the role responsibilities involved in successfully implementing a plan of care. During

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