Sample Nursing Paper on Practice Experience: HCAHPS

Describe the importance of holistic assessment when caring for patients with chronic and co-morbid illnesses.

Chronic illnesses confront patients and their caregivers with a restricted and uncertain associated with controlling the disease (Wagner, 492). The effective management of chronic and co-morbid illnesses requires that patients get appropriate medical care as they cope with the illness and the numerous therapies associated with it. According to Wagner (514), “successful chronic illness programs, in contrast to usual primary medical care, organize their systems and work to meet the needs of patients with chronic health problems and to comply with a protocol or guidelines.” For example, the Germans improved how they gave holistic, primary care to patients with chronic illness and co-morbid illnesses by developing structured treatment and teaching programs for patients suffering from diabetes and hypertension. Successful chronic illness care programs rely heavily on non-physician personnel to conduct routine assessments, take responsibility for key preventive tasks like immunizations, and provide most of the counseling and support for self-management (Wagner, 516). These multisession group education programs have been well received by both patients and providers and have resulted in significant weight reduction and improved disease control (Wagner, 517).

Results of My Completed Assessment.

I assessed an older patient, aged 70 named Mary (name changed for confidentiality reasons) who was suffering from hypertension. Hypertension can be defined as a medical condition where an individual’s blood pressure in the arteries is persistently raised. In conducting the assessment, I used the SPICES screening tool. SPICES is an acronym for the common syndromes of the elderly requiring nursing intervention (Wallace, 46). According to Hall (9), “S stands for Sleep Disorders, P stands for Problems with Eating or Feeding, I is for Incontinence, C is for Confusion, E is for Evidence of Falls, and S stands for Skin Breakdown.”

Discuss what you learned about the individual’s level of health from this screening test.

From the results of Mary’s assessment, I was able to note four out of the possible five common indications that require nursing. She had sleeping disorders, problems with eating, evidence of falls, and confusion.

How unusual findings in the screening test can influence the health and safety of the older adult I assessed

The assessment results of Mary revealed one unusual finding. She had an unusual sleeping pattern, which can be categorized as a disorder. Moreover, the disorder made her sleepwalk during the night, which is not safe for an older adult. The evidence of falls on her body indicates that her health was deteriorating from taking many falls.

How screening tests can assist in evaluating a change in a patient’s condition

An initial screening can trigger patients to go for complete assessments. Moreover, since primary care practices and practitioners are so oriented to acute illness, they may not differentiate their clinical approaches to patients with acute and chronic illness, relying instead on patient-initiated visits, relief of symptoms, normalization of aberrant physiological measures, and assurance that there is no urgent medical crisis (Wagner, 513). This is not the proper way of dealing with patients. Instead, primary care practitioners should be educated on not only how to conduct screening tests using the SPICES screening tool, but also on how to distinguish between acute and chronic illnesses. By doing so, primary caregivers will be able to detect an illness at an early stage and note a change in condition.



Works Cited

Wagner, Edward H., Brian T. Austin, and Michael Von Korff. “Organizing care for patients with chronic illness.” The Milbank Quarterly (1996): 511-544.

Wallace, Meredith, and Terry Fulmer. “Fulmer SPICES: An overall assessment tool for older adults.” AJN The American Journal of Nursing 107.10 (2007): 45-46.

Hall, Geri R, M.L Henderson, and M Smith. Assessing the Elderly. New York, N.Y: Lippincott Williams & Wilkins, 2001. Print.