Date: 05/03/2025
Time: 09:30am – 04:30pm
Title: Planning and Monitoring Care/Clinical Judgment and Shared Decision Making
At the start to the lesson we discussed about comprehensive patient assessment. This is gathering essential information about a patient to create an holistic understanding of their physical, mental, emotional and social wellbeing. This assessment is done considering the Roper Logan Tierney activities of living. They include maintaining a safe environment, communicating, breathing, eating and drinking, eliminating, personal cleansing and dressing/hygiene, controlling body temperature, mobilising, working and playing, expressing sexuality, sleeping and dying.
We were later shared in three groups and given a case study to create a care plan for. By creating a comprehensive assessment for the case study I gained an insights on the importance of holistic care where the physical, mental, emotional and social factors interact and contribute to the patient’s wellbeing. Moving forward, I will further explore more on conducting patient assessment to refine my practice. I also plan to engage in reflective practice regularly to assess how I can improve the assessment process, particularly in terms of making patients feel more comfortable and willing to share sensitive information and finally I aim to use the knowledge gained from the assessment to prioritise and personalise care plans ensuring that they align with the patient’s unique needs and goals.
During the later part of the day we discussed about clinical judgment and shared decision making. Clinical judgement is essential in guiding healthcare decisions and this could be influenced by experience, intuition, ethics, research, evidence base, environment, resources, shared decision making and so on. Shared decision-making reinforces the idea that healthcare is not a one way delivery of service but rather a collaborative process between the patient and the clinician. This empowers patients, giving them autonomy in their treatment choices.
Moving forward, as a Nursing Associate I plan to incorporate shared decision making as a standard practice in my clinical interactions and continue to improve my communication skills to ensure that patients fully understand their options and feel confident in their ability to make informed choices.
KSB addressed:
K1: Understand the code: Professional standards of practise and behaviour for Nurses, Midwives and Nursing Associates in ( NMC, 2018) and how to fulfil all registration requirements
K6: Understand and apply relevant legal, regulatory and governance requirements, policies and ethical frameworks, including any mandatory reporting duties to all areas of practice
K13: Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes
K26: Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld
K30: Understand the principles of health and safety legislation and regulations and maintain safe work and care environments
K41: Know your rules, responsibilities and scope of practise of different members of the nursing and interdisciplinary team and own role within it
S1: Act in accordance with the code: Professional standards of practice and behaviour for Nurses, Midwives and Nursing Associates (NMC, 2018) and fulfil all registration requirements
S2: Keep complete, clear, accurate and timely records
S3: Recognise and report any factors that may adversely impact safe and effective care provision
S4: Take responsibility for continuous self reflection, seeking and responding to support and feedback to develop professional knowledge and skills
S6: Act as an ambassador for their profession and promote public confidence in health and care services
S7: Communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive and behavioural health challenges
S14: Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and well-being
S18: Applied knowledge, communication and relationship management skills required to provide people, families and carers with accurate information that meets their needs before, during and after a range of interventions
S19: Recognise when capacity has changed, recognise how a person’s capacity affects their ability to make decisions about their own care and to give or withhold consent
S24: Perform a range of nursing procedures and manage devices to meet people’s need for safe, effective and personal centred care
S30: Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed
S33: Maintain safe work and care environments
S35: Accurately undertake risk assessments, using contemporary assessment tools
S39: Recognise when people need help to facilitate equitable access to care, support and escalate concerns appropriately
S41: Monitor and review the quality of care delivered, providing challenge and constructive feedback when an aspect of care has been delegated to others