The Importance of Holistic Assessment in Nursing - Essay Example

Running Headers: THE IMPORTANCE OF HOLISTIC ASSESSMENT IN NURSING Your Name: Course: Institution: Instructor: Date: August 7, 2010. Introduction In the nursing process, Assessment is the initial stage whereby the nurse does a comprehensive and holistic nurture assessment according to the needs of the patient. The commonly used frame work is an assessment frame work and which is mostly based on a nursing form, (Harkreader, Hogan, and Ann, 2003). This stage is carried out in order to identify the nursing problems associated with the patient. These problems can either be termed as potential or actual. For instance, a person who have been affected by a road accident and rendered immobile would be assessed as bearing the “potential for impaired skin integrity related to immobility” , (Ruzicka, Sanchez-Reilly, and Gerety, 2007). Assessment also reduces the severity of certain conditions especially chronic conditions and also helps the patient to apply self care thus gaining control over their health status, (Bellack, Edlund, 1992). Another importance of assessment is that it provides full information which is required in developing plans that are important in enhancement of personal health status. Assessment involves a total appraisal of activities of daily living. Every registered nurse must fill a nursing assessment form. The purpose of a nursing assessment include: A well filled nursing assessment form shows the conditions of the patient at the start. It shows how the patient progresses with time, (Ruzicka, Sanchez-Reilly, and Gerety, 2007). Secondly, this form also acts as a tool for communication which gives instructions on how to give better treatments. In addition it is used as a monitoring tool. For instance it can monitor which services are rendered and which are not provided. Lastly, future requirements of the patient can also be assessed using the nursing assessment form, (Reeser, 2010). A nursing assessment consists of physical examination and psychological and social examination, (Christiaens, Abegglen, and Rowley, 2008). Physical examination involves measurement or observations of signs or symptoms e.g. vertigo or nausea which can be measured or observed or which the patient can feel respectively, (Dossey, and Keegan, 2009). On the other hand, psychological examination involves emotional health and intellectual health. Intellectual health consists of measuring concentration levels, checking hallucinations, assessing cognitive role and also assessing the interests and hobbies of the person, (Goodwin, Sener, and Steiner, 2007). On the other hand, emotional health considers how the person feels and his reaction to the feelings. Clients’ perception may also be included in psychological examination. This means their thinking on why they are being assessed and the benefits they will gain in the assessment, (Ruzicka, Sanchez-Reilly, and Gerety, 2007). The assessment is recorded in the clients nursing or medical records. They can be recorded electronically on the medical records or on paper which is made available to healthcare team members. Some of the assessment tools used by the nurses during assessment include: Barthel index (Mahoney and Barthel ,1965), index of independence in activities of daily living( Katz and Stroud , 1963), general health questionnaire, crighton royal behavior rating scale (Wilkin and Jolley,1979)and geriatric mental health state schedule(Copeland, Kelleher and Keller et al,1976) and the Clifton assessment procedures for the elderly(Pattie and Gilleard,1979) A holistic assessment is alienated into five domains. They include: Assessment preferences and background information Occupational and social needs Physical needs Spiritual wellbeing Psychological wellbeing An assessment should cover the above five domains. The spiritual and psychological wellbeing should be attended at the end the reason being that they require total understanding and trust between the two principles i.e. the patient and the assessor, (Dossey, and Keegan, 2009). Assessment preference and background information There is need for the assessor, during the initial assessment to keep record of background information from the clients care record. During other assessments, the assessor only requires to record any changes which could have occurred from the time when the last assessment was carried out, (Goodwin, Sener, and Steiner, 2007). During each assessment, assessment preferences and information should be recorded. In the assessment preferences, the assessor should ensure that he/she has copies of last holistic assessment; know the reason for the assessment, incase of a face to face assessment, he should know whether the patient is in a state of carrying out the assessment and also put in mind the sensitivities of the assessment which include current health and cultural sensitivities. The assessor should also consider whether the patient is willing to carry out the assessment or not and in addition documentation of patients consent to next assessment should be done. Physical domain On physical needs, assessors should make well known to the patient the importance of the assessment which is to ensure that prospective requirements are identified and that not all the listed symptoms are being experienced by the client. Some fears experienced by the patient concerning physical problems should be addressed in the psychological domain, (Goodwin, Sener, and Steiner, 2007). Under this domain, the assessor should describe the problem: basis, intensity, duration, nature, consistency and changes. He should also explain the consequences of the difficulty and how they can affect the patient’s activities. In addition there is need to review whether the treatment provided is helping the patient. He/ she should make certain to further requirement by the patient and try to curb similar anxieties and fears. Spiritual well being This involves assessment outside the patient’s clinical needs. At this juncture, the assessor should have an understanding of the patient’s cultural background as in most cases; ethnic group describes an individual’s spiritual background. The assessor should mind how he/she represents the questions in order to avoid harm or distress. This domain requires an experienced assessor as it’s a sensitive domain and has potential for harm. Different words are used to describe spiritual aspects thus assessors should consider peoples preference thus should be sensitive in this domain. Such word include: belief, faith, religion, personal philosophy and spirituality among others. Occupational and social needs This includes items such as: work and finance, social and recreational, family and management both in the society and at home. Demonstrate an understanding of the Australian Nursing and Midwifery Council National Competency Standards for the Registered Nurse and provide some examples of how they apply when undertaking a holistic nursing assessment. Professional practices for midwives and nurses in Australia are determined by the professional practice frame work. Australia Nursing and Midwifery council was (ANMC) was established in 1992. It was meant to ease a national view to midwifery and nursing regulation, (Christiaens, Abegglen, and Rowley, 2008). This organization works together with the state and NMRAs in order to provide maintainable standards that are responsive, flexible and also effective to the requirement of health care of the Australian community. The major activities carried out by the organization are: Coming up with national standards and promoting them for midwifery and nursing practice in Australia, It also identifies areas which are relevant to midwifery and nursing regulations, (Bellack, Edlund, 1992). Another activity carried out by the organization is to ensure that midwifery and nursing standards meet the requirements of the Australian society. In addition the organization also participates in those practices or projects which see the future development and growth of midwifery and nursing professions. Lastly ANMC also puts in to use mechanisms which help in supporting in statutory regulations of midwifery and nursing professions, (Christiaens, Abegglen, and Rowley, 2008). Australian nursing and midwifery council (ANMC) in partnership with NMRAs has developed standards which should be applied in each jurisdiction. These standards are competent in that they are well researched, frequently reviewed. These standards are put into practice by employers, nurses, midwives and also NMRAs, (Rew, Regina, Johnson, Jenkins, and Torres, 2009). All midwives and nurses must show proficiency to the national standards put forth by ANMC ahead of enrolling or registering and during renewal of their enrollment. The organization also puts forth ethics and codes of behavior together with guidelines which should be implemented by NMRAs. This portrays professional practice framework for Australians midwives and nurses, (Christiaens, Abegglen, and Rowley, 2008). In summary these standards include but not limited to national competency standards: they were adopted in1990s by ANMC, ethics and codes of professional behavior, competency standards for enrolled midwives, nurses and guidelines and position statements, (Goodwin, Sener, and Steiner, 2007). When undertaking a holistic nursing assessment, these standards apply in that nurses and midwives are ale to carry out assessment which is sensitive to the individuals needs, (Bellack, Edlund, 1992). The nurses also accept persons without considering culture race, gender, and religion, mental or physical state. Protection of individual rights and provision of informed decisions is also another application of the national standards to the registered nurses. Fulfillment of duty of care, responding to unprofessional or unworthy practices and considers an individuals culture, belief, values and their dignity while carrying out their duties, (Christiaens, Abegglen, and Rowley, 2008). Conclusion In conclusion, Australian Nursing and Midwifery council, in order to develop a flexible, responsive and effective system of regulation which adheres to the needs of Australian society is in partnership with the NMRAs. Government and other industrial organizations have welcomed this strategy and have promise to give their total support, (Ruzicka, Sanchez-Reilly, and Gerety, 2007). References Barbara Montgomery Dossey, Lynn Keegan. 2009. Holistic Nursing: A Handbook for Practice. 5th Edition. Washington: Jones & Bartlett Publishers: ISBN 0763754293, 9780763754297. Glenda Christiaens, JoAnn Abegglen, and Alanna Rowley. Nursing Students' Perceptions of a Holistic Nursing Conference: Empowerment, Self-Care, and Application to Practice. J Holist Nurs, Jun 2008; 26: 139 - 146. Janis P. Bellack, Barbara Edlund. 1992. Nursing Assessment and Diagnosis. 2nd Edition, New York: Jones & Bartlett Publishers: ISBN 0867204362, 9780867204360. Julie Reeser, RN. Holistic Nursing. Retrieved From < http://www.bellaonline.org/articles/art57577.asp> (Accessed August 6, 2010). Lynn Rew, Regina J. Johnson, Sandra K. Jenkins, and Rosamar Torres. Developing Holistic Nursing Interventions to Improve Adolescent Health. J Holist Nurs, Dec 2004; 22: 298 - 319. Miki Goodwin, India Sener, and Susan H. Steiner. A Novel Theory for Nursing Education: Holistic Comfort. J Holist Nurs, Dec 2007; 25: 278 - 285. Nursing Students' Perceptions of a Holistic Nursing Conference: Empowerment, Self-Care, and Application to Practice Susan Ruzicka, Sandra Sanchez-Reilly, and Meghan Gerety. Holistic Assessment of Chronic Pain Among Elders. American Journal of Hospice and Palliative Medicine, Sep 2007; 24: 291 - 299. Read More