The growing numbers of older people are living with the chronic health and their condition are being advert to hospitals with their actual care needs (Boltz and et. al., 2014). There are so many approaches which have been made to bridge the practice gap between the palliative and curative models of care. In present report, Port Haven Care Homes are considered. In this, the role of nurse has been discussed to optimise the functional outcomes.
Role of nurse in enacting coordination, supervision and delegation of quality and safe functional care
It is essential for the nurses to consider the intensity of pain so that proper medical services can be delivered to the patients. According to the study Achterberg and et.al (2013), it can be said that around 35 million people with dementia are living all across the world among which 50% people experience higher pain. However, even after knowing the fact, several patients are not treated properly. As per the study, the most promising aspect is the use of stepped treatment approaches that leads the nurses to adopt diverse behavioural intervention while noticing clear symptoms. Pain in dementia is analysed on the basis of changes in behavioural aspects and it is also one of the reasons that leads helps in analysing health complications. It is also analysed that educational and organizational shortcomings sometimes impede the quality of care and pain management aspects.
In care homes, the registered nurse has huge roles and responsibilities towards patients which they are accountable to fulfil on regular basis. In day-to-day life, they have to maintain the activities which are performed by other nurses. In order to deliver quality of services they have to make proper coordination with doctors (Bray and et. al., 2010). From the view point of Bodenheimer, (2008), the responsibility of registered nurses is that they have to maintain record of all individuals, monitor the patients on regular basis and many more. Sometimes they have to consult with other service health care provider to provide best services to patients. It is their responsibility to stay up to date that what new technology so that better services can be delivered. With the help of new technologies the nurse can provide best care services to families and patients and at the same time challenges and complexities can be reduced accordingly. Through this, they will support the doctors who are involved in the care of patients.
However, the study developed by Allan and et.al, (2009), states that falls are termed are the major causes of morbidity in dementia; hence it is crucial for the nurses to ascertain all such risk factors that exists and that can enhance issues related to falls in older people. In such study, 179 participants (over the age of 65) were recruited from outpatient clinics. In the study, a multi factorial assessment of baseline risk factors was performed to record all the incidents related to falls. However, according to multivariate analyses, significant potentially modifiable predictors are considered major symptoms of orthostatic hypotension. Thus, in terms of conclusion it can be said that there should be appropriate management of such symptoms; hence suitable strategies can be made accordingly. At the same time, randomised controlled trails can also be conducted for the purpose of adopting suitable management of dementia.
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Changes are coming in the role of nurses; hence they have to handle a lot of activities multiply. They have to perform different duties so that patient will feel happy. The level of supervision which has been provided by nurse should be appropriate (Bystedt, Eriksson and WILDE‐LARSSON, 2011). The supervision is provided in two ways such as direct and indirect. In direct supervision, the nurses are personally present and observe patients and provide them with proper services. In indirect supervision, registered nurses are on site and they make contact with others and provide reasonable access to the patients. The Nursing and Midway Board of Australia undertakes several functions which are set by the Health Practitioner Regulation National Law and which are also essential to be followed by the registered nurses. NMBA has framed various laws registration standard as well as for professional codes and also set up the guidelines. They are providing recommendations while assuming that there is a shared responsibility between employers, department of health and human services, professional bodies and many more (Choo, Hutchinson and Bucknall, 2010). Delegation and supervision is always the core responsibility of registered nurse and midwives.
According to Anderson and et. al. (2012), nurses must have to develop suitable care coordination according to the Patient- Centred Medical home in which there should be direct communication among nurses and patients. The study states that care coordination is essential for the nurses because that aids the nurse to become more responsible and efficient about the service care aspects. Thus, in this respect it can be said that registered nurses should focus on delivering quality care to the patients so that complex health aspects can be managed accordingly. However, on the other hand according to Antonelli and et.al (2008), care coordination activity services are important because that aids the patients to manage all service aspects in the best way. Proper coordination is essential so that health problems can be discussed suitably and according to that specific action can be taken.
According to Boltz and et. al., (2014), critical nurse have to work on shift also and assess proper medical treatments. As per view point of Ramirez, the critical nurse has to proper monitor the hygiene condition and nutrition food given to the patients. However, according to Beddoes and et.al. (2016), it can be said that dementia brings many changes in health aspects of a person and at the same time it leads to alter the behavioural changes in the physiological aspects. It also depicts that nurses are required to emphasize on proper delivery of services so that patient’s care dimensions can be managed accordingly. The study also confronts that measuring vulnerability to functional decline is crucial at the time of selecting appropriate participants in research and health service evaluation. The research work has come up with the final outcomes that showcase the validity of adoption of proper intervention in health care perspective.
According to Beth Anne Scahwamberger, it is depicted that registered nurse has to work in both place i.e. in hospitals and clinics. Their shifts are entirely dependent upon the patients and co-workers. These nurses have to arrive before doctors and set the clinic.
The Activities of daily living, this term is used in healthcare in order to provide self-service to the patients.
- Bathing and showering
- Grooming and personal hygiene which include brushing, combing etc.
- The patients have to move from one place to another while performing their activities in a proper manner. In short, it can also be considered as the functional mobility.
- Self-feeding does not include any cooking or chewing activities.
- The nurse has to measure individual ability while performing the activities daily.
The aim of care homes is to build existing theories which is related is related with the supportive care in order to support the older people. Bernstein and Remsburg (2007), the nurses should be updated with their technologies in order to provide proper services to the services users (Harrington and et.al., 2012). In delegation, it involves transfer of authority in which a competent person has to perform a specific activity. In Port haven care homes, the registered nurse provides better services to patients so that they can meet with their requirements.
Patient health status – The nurse is required to be update with the status of patients. Through this, they can provide proper treatment to them.
Level of knowledge – The knowledge of nurse should be high. They should have confidence skills to serve the best quality of services to the patients.
Monitored and communicate – whatever outcomes are there they have to monitor in a proper way and analyse the results properly. With the help of this, they can get best results and improve services also (Lyons, 2014). They are required to communicate with patients in an appropriate manner to know about their problems. It helps the patients to properly tell about their problems to nurses.
Legislative requirements – The Nursing and Midwifery Board of Australia has provided the legislative requirements which have to be properly performed. Through these the services will be provided in proper ways.
There are five rights of delegation considered by nurse such as; right activity, circumstances, person, communication, supervision and evaluation. In health and care homes, there are many people who are suffering from many diseases and nurse has to take care of them properly (McHugh, Berez and Small, 2013). In care homes, there are also nurses who are non- registered and sometimes they are providing services. The registered nurse are playing essential role as compare with non registered staff. The following are the some list which explains the duties and responsibilities of registered nurse.
- They observe and record the behaviour of patients.
- They coordinate with the physicians and other health care professionals for making proper care plans.
- If they have to provide emotional and psychological support to patients then they have to create harmonious environment.
- They have to carry out requisite treatment and medication.
- Check the stock on regular basis for which they have to maintain the inventory level and place the order if required.
- Maintain the hygienic and healthy environment which should be comply with the health care procedures.
According to Antonelli, Stille and Antonelli (2008), working environment plays an essential role in offering standard services to services users. These nurses are working in different areas but unregistered staffs are not working in different areas (Australian Nursing & Midwifery, 2016). There mind is prepared to work for a long period of time even in holidays also. They spend most of time in walking, standing bending or lifting. If any patients are suffering from diseases then they are supposed to work closely in proper manner. They also assume that there role is clinical nurse manager, labour and delivery, patient’s educator, chief care nurse and many more.
As per report of Bureau of Labour Statistics, it has been shown that between year 2012 and 2022, there will be growth in employment opportunities.
There are some responsibilities of professionals and recipients towards delivering best quality of services to patients. Beddoes-Ley and et. al., (2016), the responsibilities of professionals is to provide proper guidance to nurse; proper training should be given to them so that they can also be updated with the new latest technologies (Registered Nurse Responsibilities, Duties and Job Prospects, 2017). They have to also evaluate outcomes so that proper decisions can be taken. They have also to notify in timely manner if they are unable to perform their activities in ethical form or due to other reasons. Through this, the other people will come to know these problems. Instead of them other people can provide proper services to customers (Resnick and et. al., 2013). Through this, it will maintain reputation of care homes in the global competitive market.
Risk factors of dementia
The following are the risk factors which are associated with health issues of patients.
Behavioural factors – In this, there are many patients who are suffering from various risks such as, taking alcohol, tobacco, nutritional choice and many more. The nurse has to understand their problems in an appropriate manner to provide them with proper treatments.
Psychological factors - In these, the factors include high blood pressures overweight and many more; however at the same time, motivation and attitudes and beliefs is also included in this. The patient needs motivation from their families to get well soon (McHugh, Berez and Small, 2013).
Impact of dementia on patients
In the country there are many people who are suffering from dementia. This disease’ has huge impact on people social, psychological function etc. In this, there are lot of people who describe that due to this disease they are losing the confidence and are not able to cope with the challenges (Alzheimer’s Australia, 2016). In this, the individual become frustrated, feels stressed, suffer from pain and many more. If this situation occur than nurse have to take care of the people properly.
In this disease, people are not able to do work properly (American Nurses Association, 2012). In this older people suffer from this disease and the registered nurse has to properly take care of them. They have to support them and make proper conversation so that their issues can be resolved. It is responsibility of nurse in order to provide them with best services.
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According to Bystedt, Eriksson and WILDE‐LARSSON (2011), dementia also occurs when brain is damaged by other disease. It has been observed that dementia brings several changes in the attitude and behaviour of the person and at the same time it also affects the mental stability of the patient experiencing dementia. Dementia is associated with varied risks and challenges and weight loss can occur even when the normal intake of food is maintained. Memory loss is one of the problems that appears in the case of dementia; however at the same time problems also arise due to wasting of muscles. For instance- when the patient becomes bedridden, it leads to development of bed sores and at the same time it also brings several other issues in the body and muscles.
It has been concluded from the above report that role of registered nurse is important as compared with non-registered staff. They are providing better services to patients. Nurses are also required to focus on the daily activities of the patients. In care homes, registered nurses have to perform their duties in appropriate manner to deliver best quality of services to patients.
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