Health Promotion and Care Plans.
Whilst on placement on an adult rehabilitation ward, I had the opportunity to participate in some health promoting activities.
Galli (1978) states that health promotion is an "essentially contested concept". Different people use the term health promotion for different things. For instance, the use of the term by the government when they apply it to screening clinics in primary health care is very different from the holistic and political perception of the World Health Organization: "health promotion has come to represent a unifying concept for those who recognize the need for change in the ways and conditions of living in order to promote health. Health promotion represents a mediating strategy between people and their environments, synthesizing personal choice and social responsibility in health to create a healthier future" (WHO, 1984).
One health promoting activity I participated in was ensuring a safe and effective discharge, in order to prevent readmission. This would of course mean ensuring that a patient is medically fit. However, there are other considerations to take into account, such as where the patient is being discharged to, for example long term or intermediate care in a nursing home, or are they going home? If the patient is returning home, will their care needs be met? Can the patient and/or carer safely utilize equipment that the patient needs to take home? Are there support networks for the patient and/or carer? If there is a condition affecting the patient, the patient and/or carer may need to be educated regarding symptoms, affects and treatments. For
example, one patient on the ward needed to be encouraged to self-care for her colostomy, another patient needed to be encouraged to mobilize with minimal assistance.
Another example of health promotion is the use of a care plan. A care plan would include strategies to improve and promote health and actual and potential problems can be identified and addressed. For example, one problem for a patient could be that they have a urinary catheter. The goal would be to prevent infection. It would be important to educate the patient in catheter care, for example, hand washing techniques and emptying and changing urine bags.
Patient education and consultation, involving the patient in the writing of their care plan reflects current best practice. Patient education is now viewed as an integral part of high quality health care (Walsh, 1997). It is vital that patient’s understand their rights and choices, especially for the elderly, because as a professional nurse one cannot discriminate between people and assume that because the patient is old they do not need to know what is happening to them and treat them as children (Rhonda, 1998).
Nursing care plans are an effective form of communication if written accurately and comprehensively and if all staff read them.
I have written a few care plans, and although I feel they are accurate and comprehensive, I feel that they are time consuming for me to write, as I am not confident in this task. I sometimes have to refer to other care plans written by staff nurses to offer me guidance as to how to word things so that they are clear and concise.
Galli, N. (1978) Foundations and Principles of Health Education. Oxford: Medical Publications.
Rhonda, N. (1998) Contradictions between Perceptions and Practices of Caring in Long Term Care of Elderly People. Journal of Clinical Nursing. Vol. 7, No. 5, pp. 401-408.
Walsh, M. editor (1197) Watson’s Clinical Nursing and Related Sciences. London: Bailliére Tindall.
World Health Organization. (1984) Health Promotion: A Discussion Document on Concepts and Principles. Geneva: W.H.O.
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