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Clinical Decision-Making in Nursing; a Person-Centered Approach

Introduction:

During this case study, I had the opportunity to deal with a patient who went by the moniker of Foxy. Following lunch, she saw rashes appearing on both of her arms and scored a score of eight on her news2 evaluation. Foxy is a woman who was born in 1945 and has a history of both high blood pressure and diabetes in her family’s medical history. She is currently 72 years old. Because she lives by herself, her son can only visit her on a sporadic basis. Even though he loves her very much. In order to protect patients’ privacy and maintain compliance with regulations set forth by the Nursing and Midwifery Council (NMC), any identifiable information will be obscured.

Assessment:

In order to collect the information that was required for the evaluation, it was necessary to apply the ABCD approach (Airway, Breathing, Circulation, and Disability) in conjunction with the Head-to-Toe Nursing Assessment tool (Fernandes et al., 2020). This was required so that the relevant information could be obtained. I performed a complete physical examination on Foxy. I checked her vital signs, identified the allergens she was sensitive to, and determined which medications she needed to take. I inquired about her mental health and discovered the source of the aid she sought. With the help of this analysis, I figured out what caused the rashes that emerged in the afternoon after I ate lunch.

Planning:

We applied the Clinical Decision-Making Model to develop a treatment plan that was appropriate for the patient, and we did so in collaboration with Foxy and her child. We discussed the potential allergens that were present in her lunch and devised a plan to exclude them from future meals. In addition, I impressed Foxy with the significance of adhering to appropriate hygiene standards and attending to the requirements of her skincare routine. I overcame Foxy’s resistance to altering her diet by incorporating her kid in the dialogue and asked for his assistance persuading her to make the move (Lee et al., 2022). Her son is very supportive of his mother’s desire to eat healthier. Because of this, I could triumph over the challenge preventing me from making this decision.

Implementation:

Following the most effective techniques supported by evidence, I put the plan into action by modifying Foxy’s lunch so that it did not include the potential allergens. In addition, I took the time to explain to her how the use of antihistamines could assist her in obtaining better control of her rashes. I also highlighted how essential it was for her to maintain appropriate levels of personal cleanliness (Yun & Choi, 2019). Throughout the process, I made it a point to double-check that everything I did was per the legal and ethical standards the NMC set.

Evaluation and Conclusion

The fact that Foxy’s rashes began to improve after specific changes were made to her diet proves that the choice was appropriate. As a result of this decision, the value of providing treatment centered on the patient and the benefits of engaging in collaborative decision-making were brought into closer light. The researchers concluded that involving a patient’s family members in the decision-making process can positively impact the patient’s level of compliance. The model used a systematic approach to make sure that they considered all the relevant data, identified any potential barriers, and implemented evidence-based strategies in order to achieve positive outcomes for the patients (Tomaselli et al., 2020)

The Clinical Decision-Making Model effectively guided the decision-making process, encouraged patient participation, and ultimately achieved a successful resolution to Foxy’s health issue.

Literature Review

The decision to change Foxy’s food and provide antihistamines is in line with the findings of several studies conducted on the management of skin problems and allergic responses. According to the data that Bagnasco et al. (2018) presented, the person-centered approach has also been proven to improve patient outcomes. Other models, such as Roper-Logan-Tierney’s, Neuman’s, and Orem’s, were taken into consideration; however, the Clinical Decision-Making Model was selected because it placed a focus on collaborative decision-making and patient involvement, both of which were crucial in this particular scenario.

References

Bianchi, M., Bagnasco, A., Bressan, V., Barisone, M., Timmins, F., Rossi, S., … & Sasso, L. (2018). A review of the role of nurse leadership in promoting and sustaining evidence‐based practice. Journal of Nursing Management26(8), 918-932.

Fernandes, J. B., Vareta, D., Fernandes, S., Almeida, A. S., Peças, D., Ferreira, N., & Roldão, L. (2022). Rehabilitation workforce challenges to implement person-centered care. International Journal of Environmental Research and Public Health19(6), 3199.

Lee, J. Y., Yang, E., & Lee, K. H. (2022). Experiences of implementing person-centered care for individuals living with dementia among nursing staff within collaborative practices: A meta-synthesis. International journal of nursing studies, 104426.

Tomaselli, G., Buttigieg, S. C., Rosano, A., Cassar, M., & Grima, G. (2020). Person-centered care from a relational ethics perspective for the delivery of high quality and safe healthcare: a scoping review. Frontiers in public health8, 44.

Yun, D., & Choi, J. (2019). Person-centered rehabilitation care and outcomes: a systematic literature review. International journal of nursing studies93, 74-83.

 

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