NURS 3020 Health Assessment - Week 2 Discussion

NURS 3020 Health Assessment – Week 2 Discussion

NURS 3020 Health Assessment – Week 2 Discussion : Caring and Ethics in Your Practice

Some things in nursing never change. Caring has been the basic work of nurses from the genesis of nursing.

Caring and nursing are inextricably intertwined. For example, caring is defined as, “feeling and exhibiting concern and empathy for others; showing or having compassion” (The Free Dictionary by Farlex, 2015, para. 2). Nurse is defined by Merriam-Webster (2018) as, “a person who cares for the sick or infirm” (para. 3). As these definitions demonstrate, caring is a feeling that also requires an action.

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The theory of the ethics of care has evolved over time between obligation-based ethics and responsibility-based ethics. The former asks, “What obligation, if any, do I have to this person?” In the latter, responsibility-based ethics, the relationship with others is a given. The only question is how to best meet the responsibility for effective care.

According to the Code of Ethics for Nurses, “Optimal nursing care enables the patient to live with as much physical, emotional, social, and religious or spiritual well-being as possible” (American Nurses Association, 2015, p. 2).

Caring is an essential part of patient care. There are four phases of caring. They are attentiveness, responsibility, competence, and responsiveness. Caring requires the nurse to put aside personal biases and prejudices to effectuate the four phases of caring. The four phases of caring suggest that good care demands more than just good intention; good care. It is a practice of combining activities, attitudes, and knowledge of the situation.

To Prepare for NURS 3020 Health Assessment – Week 2 Discussion

Review the Week 2 Discussion Rubric provided in the Course Information area.

Review Chapters 7–10 and 12–16 in the course text.

Review, this week’s Resources.

Review this week’s Writing Resources and Program Success Tools.

Consider types of caring techniques and strategies that can be used during a health assessment.

Think about a time when you had the opportunity to encourage a patient to comply with a health promotion activity, and whether you did so successfully or not.

By Day 3 of NURS 3020 Health Assessment – Week 2 Discussion

Post a substantive 2-paragraph response (at least 350 words) to one of the options below. Develop and post cohesive paragraphs, and use evidence to support your ideas.

Cohesive paragraphs

Evidence

What caring techniques/strategy can you use during the health assessment of a patient to encourage the patient’s adherence to a treatment plan?

Describe an instance in your practice when you successfully encouraged a patient to comply with a health promotion activity. If you have not successfully encouraged a patient to comply with a health promotion activity, how might you have done so based on what you know now?

By Day 7 of NURS 3020 Health Assessment – Week 2 Discussion

Read two or more of your colleagues’ postings for the Discussion question.

Respond to at least two of your colleagues in one of the following ways:

Expand upon the proposed technique(s).

Suggest an alternative technique to encourage adherence to a treatment plan.

Ask a clarifying question about a colleague’s proposed technique or strategy, or about the instance when your colleague successfully encouraged a patient to comply with a health promotion activity.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you have learned and/or any insights you have gained as a result of the comments your colleagues made.

Provide a Discussion entry on three different days of the week. See the Discussion Rubric for more information. NURS 3020 Health Assessment – Week 2 Discussion.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

NURS 3020 – Health Assessment Assignment Paper

A health assessment is a plan of care that identifies the specific needs of a person and how those needs will be addressed by the healthcare system or skilled nursing facility. Health assessment is the evaluation of the health status by performing a physical exam after taking a health history. It is done to detect diseases early in people that may look and feel well.

Evidence does not support routine health assessments in otherwise healthy people.^[1]

Health assessment is the evaluation of the health status of an individual along the health continuum.^[2] The purpose of the assessment is to establish where on the health continuum the individual is because this guides how to approach and treat the individual. The health continuum approaches range from preventative, to treatment, to palliative care in relation to the individual’s status on the health continuum. It is not the treatment or treatment plan. The plan related to findings is a care plan which is preceded by the specialty such as medical, physical therapy, nursing, etc.NURS 3020 – Health Assessment Assignment Paper

Health assessment has been separated by authors from physical assessment to include the focus on health occurring on a continuum as a fundamental teaching.^[3] In the healthcare industry it is understood health occurs on a continuum, so the term used is assessment but may be preference by the specialty’s focus such as nursing, physical therapy, etc. In healthcare, the assessment’s focus is psychological but the intensity of focus may vary by the type of healthcare practitioner. For example, in the emergency room the focus is chief complaint and how to help that person related to the perceived problem. If the problem is a heart attack then the intensity of focus is on the biological/physical problem initially.

Health Assessments in Primary Care

A health assessment is a set of questions, answered by patients, that asks about personal behaviors, risks, life-changing events, health goals and priorities, and overall health.

Health assessments are usually structured screening and assessment tools used in primary care practices to help the health care team and patient develop a plan of care. Health assessment information can also help the health care team understand the needs of its overall population of patients. Health assessments can vary in length and scope. They can be completed during office visits or between office visits, either on paper or computers. Health assessment questions may be asked about patients of all ages, including children and adolescents.

Some common health assessment questions ask about:

Tobacco use.
Stress.
Healthy eating.
Physical activity.
Sexual practices.
Sedentary behaviors such as sitting and watching TV or playing computer games.
Alcohol usage.
Addictive behaviors such as gambling or drug use.
Violence, bullying or physical abuse.
Depression or anxiety.
Emotional and social support.
Safety issues such as wearing a seat belt while driving.
Overall health or well being.

Health Assessment

Health assessment is important and often first step in identifying the patient’s problem. Health assessment helps to identify the medical need of patients. Patients health is assessed by conducting physical examination of patient.

A health assessment is a plan of care that identifies the specific needs of a person and how those needs will be addressed by the healthcare system or skilled nursing facility. Health assessment is the evaluation of the health status by performing a physical exam after taking a health history. There are different from diagnostic tests which are done when someone is already showing signs and/or symptoms of a disease. The major health assessments are Initial Assessment in which determine the nature of the problem and prepares the way for the ensuing assessment stages. Focused Assessment, which expose and treats the problem. Time-Lapsed Assessment, which ensure that the patient is recovering from his malady and his condition has stabilized. Emergency Assessments focus on rapidly identifying the root causes of concern for the patient and assessing the airway, breathing and circulation (ABCs) of the patient.

Regular assessments are performed by hospital staff during your hospital stay. These assessments are undertaken to explore your medical, physical, psychological and social needs. Assessments help to find the cause of your illness and check your ability to do day-to-day tasks. Assessments help to keep you safe by identifying areas of risk or deterioration in your health. They are particularly valuable for older people, who may decline more rapidly when they are admitted to hospital.

In hospital, assessments may include a list of questions or tasks that staff members will ask you to complete. These are used to work out whether there is a problem and to measure your progress once you have started treatment.

Definition of a health assessment in hospital

Assessment is a broad term that is used to describe a process of measuring your health and ability to perform everyday skills during a hospital stay.

Assessments can involve a set list of questions or tasks that staff members will ask you to perform. These are used to help work out whether or not there is a problem. Assessments are often repeated in order to help measure your progress and identify your ongoing needs. This helps make sure you get the best care in hospital and helps with planning for when you leave hospital.

For some assessments you need to answer questions, for others you need to perform certain tasks. Staff may also want to talk to your family, carers and your GP, to understand more about your needs.

Purpose of health assessments in hospital

Regular assessments of patients by hospital staff help to identify problems quickly. If health issues are not picked up early, they can get worse. This can mean a longer hospital stay or more severe health problems later.

It is important for you and your family to participate in the assessment process and to tell staff if you have concerns.

Your healthcare team in hospital is always checking your health and ability to do everyday skills. Part of its role is to identify and diagnose problems that will impact on your quality of life. Your healthcare workers look at your medical issues and they also investigate your social, physical, and psychological health.

Ongoing assessment by hospital staff means they can also recommend the best care plan for you when you are discharged from hospital, and put you in contact with services that can support you outside of hospital.

Tips for participating in a health assessment in hospital

When answering assessment questions, remember your privacy will be respected. Hospitals and hospital staff are not allowed to share information about you and your health without your consent (except when medically or legally necessary).

Examples of the types of questions that a person may be asked during a hospital health assessment include:

Before the illness or injury that brought you to hospital, did you need someone to help you on a regular basis?
In general, do you see well?
Do you take more than three different medications every day?

Examples of tasks that a person may be asked to perform if they are able include:

standing or walking with or without assistance
drawing a clock and other memory and thinking tests.

It is important to:

be open and honest when answering assessment questions
tell staff what matters to you and if you have any concerns
perform assessment tasks to the best of your ability.

Tell hospital staff straightaway if you

feel very unwell
don’t understand why you are being asked questions or are performing tasks
are in pain during an assessment.

You may be asked the same types of questions many times during your stay, such as when your health changes or you are moved to a different ward. Answer each time to the best of your ability.

You may need ongoing assessments for other problems while in hospital. Some assessments are done routinely and some are performed as a precaution.

During your hospital stay it’s important that you and your family and carers tell hospital staff if you have any concerns about your health or about your ability to do activities.

Health assessments are utilized by nurses to evaluate patients’ medical status. During this process, nurses must make certain that patients understand how important health assessments are for their current and future well being. The information collected via health assessments also assists care giving organizations in improving community health conditions, identifying potential areas of concern within the public health sector and developing health policies which can improve patient outcomes across multiple settings.

Importance of Health Assessments

Health assessments are important for a number of reasons, but two key benefits are that health assessments help health leaders target high-risk conditions specific to their communities and identify early signs of disease when, at first glance, a patient may appear to be healthy. Early identification is beneficial for health care providers, because it helps nurse leaders develop a more accurate understanding of the community that they are serving as well as identify potential causes of a disease afflicting large numbers of the population. As of late, electronic health records have been used to improve health assessment analysis, allowing caregivers to discover hidden trends, share research, identify under served conditions and evaluate performance.NURS 3020 – Health Assessment Assignment Paper Once assessments are complete, caregivers can leverage collected data to develop key initiatives that will help improve the overall health of the community, such as educating on the dangers of smoking, the importance of wellness plans and effective methods for managing stress.

Role of the Nurse Leader in the Health Assessment Process

Although nurse leaders may occasionally give health assessments, their primary responsibility is to organize and manage the health assessment process as well as the caregivers administering assessments. They may also provide training to younger nurses that lack experience with assessments. Nurse leaders continue their training and leadership throughout the process as they assist their peers with analysis and identification techniques as they sift through data to determine current health concerns and those that may be developing among st the community. To optimize their efficiency, nurse leaders should expand their comprehension and expertise in the collection and analysis of data and diagnostic formulation, as these skills are important for helping to identify potential health concerns and in managing the health assessment process as a whole.

Upon identifying potential risks, nurse leaders then pursue actions to alleviate the conditions or behaviors afflicting the patients and/or community population. Some of these actions may include following up with patients, developing community presentations on how to minimize health risks, and developing health policies or a community health improvement plan. As a whole, health assessments have an important role in maintaining and improving individual and community well being. Through health assessments, nurse leaders and the medical community are able to identify potential areas of concern within a specific region. Once risks have been identified, nurse leaders help develop and implement initiatives to maintain and improve the current and future health of their respective communities.

The Physical Examination and Health Assessment

About Health Assessments

Many people who visit the doctor or healthcare provider’s office wonder: “What are they doing?

What are they looking for?” During a physical examination, there are many things that your healthcare provider may be looking for as they are gathering cues and clues, during the short time you are in the office. Some of the clues are based on the spoken information that you provide, or they may be based on physical examination findings.

During a health assessment, diagnosing an illness, disorder or a condition is like a puzzle. Diagnosis often includes laboratory studies, radiology studies to look at certain organs, and the physical exam itself. This process is called data collection. Before modern technology, it was important for healthcare providers to perfect their physical examination techniques, because x-ray machines, scanners, and echo cardiograms were non-existent.

In a physical examination, there are many things that your healthcare provider can find out by using their hands to feel (palpate), stethoscope and ears to listen, and eyes to see. Findings that are present on the physical exam may by themselves diagnose, or be helpful to diagnose, many diseases. The components of a physical exam include:

Inspection

Your examiner will look at, or “inspect” specific areas of your body for normal color, shape and consistency. Certain findings on “inspection” may alert your healthcare provider to focus other parts of the physical exam on certain areas of your body. For example, your legs may be swollen. Your healthcare provider will then pay special attention to the common things that cause leg swelling, such as extra fluid caused by your heart, and use this information to help them make a diagnosis. Common areas that are inspected may include:

Your skin – to look for bruising, cuts, moles or lumps
Your face and eyes – to see if they are even and “normal”
Your neck veins – to see if these are bulging, distended (swollen)
Your chest and abdomen (stomach area)- to see if there are any masses, or bulges
Your legs – to see if there are any swelling
Your muscles- to check for good muscle tone
Your elbows and joints – check for swelling and inflammation, if any deformities are present

Palpation

This is when the examiner uses their hands to feel for abnormalities during a health assessment. Things that are commonly palpated during an exam include your lymph nodes, chest wall (to see if your heart is beating harder than normal), and your abdomen. He or she will use palpation to see if there are any masses or lumps, anywhere in your body.

Percussion

This is when the examiner uses their hands to “tap” on an area of your body. The “tapping” produces different sounds. Depending on the kind of sounds that are produced over your abdomen, on your back or chest wall, your healthcare provider may determine anything from fluid in your lungs, or a mass in your stomach. This will provide further clues to a possible diagnosis.

Auscultation

This is an important physical examination technique used by your healthcare provider, where he or she will listen to your heart, lungs, neck or abdomen, to identify if any problems are present. Auscultation is often performed by using a stethoscope. The stethoscope will amplify sounds heard in the area that is being listened to. If there is an abnormal finding on your examination, further testing may be suggested.

The neck: When your doctor or healthcare provider is listening to your neck, they are often listening for a “swishing” sound in your arteries. This may suggest that there is a narrowing of the arteries, which would increase the sound of blood flow.
The Heart: Normally, your heart produces a “lib-dub” sound, when the heart valves are opening and closing during the flow of blood. Your healthcare provider will listen to see if your heart is beating regularly, or if there are any murmurs (extra sounds with every heart beat). Heart murmurs may be “innocent”, meaning they are normal, and non-life threatening, or they may signify a problem may be present. To diagnose this, your healthcare provider may listen with their stethoscope to many areas around the heart, instead of just one area, and suggest further testing, if necessary.
The Lungs: Your doctor or healthcare provider may listen to your lungs with their stethoscope, anywhere on your back (posterior), or on the front of your chest wall (anterior). He or she may be able to tell if air is moving to the bottom of your lungs, by listening to the airflow in and out of your lungs with each breath. These are called normal lung sounds. If there is a blockage, constriction or narrowing of your lung tubes, or fluid in your lungs, this can be heard by the examiner.
The Abdomen: The abdomen will be examined using a stethoscope, to listen for any “swishing” sounds of blood through the arteries near your stomach (such as the aorta), or abnormal bowel sounds.
Other locations: Auscultation may be used anywhere your healthcare provider wants to listen

The Neurological Examination:

During a physical examination by the health care professional, a neurological examination may be performed. This can be very brief or more detailed depending on concerns and findings. In general the physical examination is divided into 4 parts; cranial nerve assessment, motor function assessment, sensory function assessment, and assessment of reflexes.
Cranial nerve assessment: There are 12 cranial nerves and these arise from the brain. Each nerve has its own function and the assessment of the nerves is done by evaluating each function. For example, testing the gag reflex with the tongue depressor is testing the 9th and 10th cranial nerves.
Motor function assessment is checking a person’s gait, muscle strength and coordination. The test where a person is asked to touch their nose then the finger of the examiner, with eyes open then with eyes closed is an example of how coordination may be evaluated.
Sensory function assessment is checking sensations such as pain, temperature, position sense, crude and fine touch along certain pathways. A test that may used to evaluate this is asking the person to close their eyes and then using a wisp of cotton, ask the person if they can feel the cotton brushed on the skin.
During a physical examination, testing reflexes helps to assess the status of the central nervous system, this indicates whether the pathway from the spinal cord to the area stimulated and back is intact. The briskness of response is evaluated.

Components of a Complete Health Assessment

A complete and holistic health assessment includes the:

health history
physical, psychological, social and spiritual assessment
consideration of laboratory and diagnostic test results
review of other available health information.

First impressions

Assessment begins as soon as you meet your patient. Perhaps without even being aware of it, you’re already noting such aspects as their skin color, speech patterns and body position. Your education as a nurse gives you the ability to organize and interpret this data. As you move on to conduct the formal nursing assessment, you’ll collect data in a more structured way. The findings you collect from your assessment may be subjective or objective.

Group dynamics

When evaluating the assessment data, you’ll start to recognize significant points and ask pertinent questions. You’ll probably find yourself starting to group related bits of significant assessment data into clusters that give you clues about your patient’s problem and prompt additional questions. For instance, if the data suggest a pattern of poor nutrition, you should ask questions that will help elicit the cause, such as:

Can you describe your appetite?
Do you eat most meals alone?
Do you have enough money to buy food?
On the other hand, if the patient reports frequent nausea, you should suspect that this may be the cause of his poor nutrition. Therefore, you’d ask questions to elicit more information about this symptom, such as:
Do you feel nauseated after meals? Before meals?
Do any of your medications upset your stomach?

History

The nursing history requires you to collect information about the patient’s:

biographical data
current physical and emotional complaints
past medical history
past and current ability to perform activities of daily living (ADLs)
availability of support systems, effectiveness of past coping patterns and perceived stressors
socioeconomic factors affecting preventive health practices and concordance with medical recommendations
spiritual and cultural practices, wishes or concerns
family patterns of illness.

Biographical data

Begin your history by obtaining biographical data from the patient. Do this before you begin gathering details about his health. Ask the patient their name, address, telephone number, birth date, age, marital status, religion and nationality. Find out who the patient lives with and get the name and number of a person to contact in case of an emergency. Also ask the patient about their health care, including the name of their general practitioner and any other health care professionals or members of the inter professional team they have contact with, for example an asthma nurse specialist or social worker.

If the patient can’t give accurate information, ask for the name of a friend or relative who can. Always document the source of the information you collect as well as whether an interpreter was necessary and present.

Performing a Community-Based Assessment

A Community Assessment, also called a “Community Needs Assessment,” is a process of collecting, analyzing and reporting information about the needs in a community as well as its strengths and assets. The purpose is to identify unmet community needs and plan ways to meet them.

A community assessment should be driven by community leaders and organizations, and actively involve community residents. An assessment can raise awareness about unmet community needs, can identify and prioritize areas for change, and can help your community to act on its own behalf. An assessment also builds skills around research, leadership, collaboration, and community involvement.

In this workshop, participants learn how to organize, plan, and implement a health assessment of their communities. Participants learn how to plan an assessment, how to identify and map community assets, and how to collect and analyze data for their assessment. They also learn how to identify and engage community collaboration in the assessment process. At the conclusion of the workshop, participants establish long-term goals to understand and promote the health of their community.

Re-Employment Health Screening

Many of the large organizations in this country undertake per-employment health screening. This is a simple step undertaken during recruitment, (after interview and offer of post in accordance with the Equality Act 2010), that benefits both employee and employer.

The first and, for many the only, stage of per-employment screening is the completion of a Health Questionnaire. This asks questions about an individual’s medical history, any current health problems and the previous work-health relationship.

Completed in minutes and sent confidentially to our headquarters in the Ashley Ainslie Hospital, this information is then assessed by a qualified nurse with years of experience in Occupational Health. The nurses can assess if there will be any health issues for the person in their prospective post and any adjustments that need to be considered. For example – considering restrictions in manual handling for people with back or shoulder problems, noting the importance of regular breaks for someone with diabetes or making allowance for people with regular hospital appointments as per the Equality Act 2010.

Further action may be recommended, such as advising a workplace assessment be undertaken or informing you of any immunizations or health surveillance needed in the future.

On occasion, further information may be sought, either by a simple telephone call to the potential employee, by requesting a report from their GP or Specialist or by asking them to attend an appointment with one of our Occupational Health Doctors. In any of these cases HR will be kept informed that there will be a delay in our response as to the candidate’s fitness for the job while we await further information, though the reason for this delay will remain confidential.

Health Assessment and Screening During Adolescence

The “medical checkup,” like hot dogs and apple pie, has become an American tradition. Adolescents have checkups requested by schools, summer camps, sports teams, employers, parents, and, less frequently, themselves. At such times, a cursory chat between the teenager and health professional, followed by a quick physical examination, is unlikely to detect the most prevalent and significant health problems of young people today. The very nature of such an interaction may even serve to alienate the teenager from the health care system or provider. Alternatively, if properly focused and thorough, a checkup may not only uncover important areas of disease or dysfunction, but also should initiate a meaningful dialogue and relationship between the adolescent patient and health professional. A checkup generally occurs when an individual feels well and visits a medical professional without complaint or a checkup may be had in conjunction with medical attention to a specific problem. In either case, the primary purpose of a checkup is health assessment and screening.

Health screening has been defined by the World Health Organization as “. . . the presumptive identification of unrecognized disease or defect by the application of tests, examinations, or other procedures which can be applied rapidly.” The purpose of health screening is to detect a problem (or problems) before it would usually become apparent or before medical attention is sought, with the intent of initiating treatment at an earlier and more optimal time, so as to prevent or favorably alter its course and consequences. Screening is not in itself diagnostic.

Psycho-emotional and health assessment tools

Objectives

A psycho-emotional monitoring package and a family resilience evaluation will help to reveal coping resources and critical areas in the patient and his/her family. These tools will allow tailored information provision according to the patient’s preferences and attitudes as well as the development of personalized self-management action plans. This process will greatly improve the personalisation of decision support tools that will be delivered by the WP5 and will lead to better and more efficient decision support tools for physicians smart recommendations for the patients. In consequence, this work package will provide ICT based instruments to assess the psycho-emotional status of the patient and to evaluate the resilience in his family. A generic health enquiry tool will be developed that serves that purpose. In addition, support for the integration of off-the-shelve sensors and medical devices will be incorporated in the platform to assess relevant vital signs and parameters related to lifestyle. NURS 3020 Health Assessment – Week 2 Discussion. NURS 3020 Health Assessment – Week 2 Discussion.