Collaborative Nursing Practice
Collaborative Nursing Practice
Collaborative Care
In order to improve the quality of patient care and ensure that the goals of care are being achieved, many settings are using the collaborative care delivery model. The collaborative “approach involves teams of health professionals working together to provide more coordinated and comprehensive care to clients,” (Kearney 2008). An interprofessional team can consist of nurses, physicians, care technologists nutritionists, counselors, physical therapists, educators, care givers and the patient. These members work together for the common purpose of enhancing the wellness of a particular patient.
Case Study Subject
The subject patient is a 53 year old obese female presenting with a stage IV pressure ulcer on the sacrum. The ulcer exhibits severe tunneling and purulent foul smelling drainage. History includes left total knee replacement approximately four weeks ago, hypertension, gout, chronic kidney disease, depression, obesity, and coagulopathy secondary to post-operative warfarin therapy. Patient stated she was unable to participate regularly in post-operative physical therapy due to a painful flare-up of gout. She also states she has not eaten in two days due to nausea and diarrhea from antibiotics.
The Nursing Process and Collaborative Care
Based on nursing assessment the salient nursing diagnoses for this patient are:
1. “Impaired tissue integrity related to mechanical destruction of tissue secondary to pressure” (Carpenito, 2009, p. 326) as evidenced by deep sacral wound.
2. “Impaired physical mobility related to restrictions” (Carpenito, 2009, p. 326) secondary to pain.
3. “High risk for infection related to exposure of ulcer base to fecal/urinary drainage” (Carpenito, 2009, p. 326).
According to NANDA (1990), “a nursing diagnosis is a clinical judgment about individual, family, or community responses to actual or potential
Collaborative Care
In order to improve the quality of patient care and ensure that the goals of care are being achieved, many settings are using the collaborative care delivery model. The collaborative “approach involves teams of health professionals working together to provide more coordinated and comprehensive care to clients,” (Kearney 2008). An interprofessional team can consist of nurses, physicians, care technologists nutritionists, counselors, physical therapists, educators, care givers and the patient. These members work together for the common purpose of enhancing the wellness of a particular patient.
Case Study Subject
The subject patient is a 53 year old obese female presenting with a stage IV pressure ulcer on the sacrum. The ulcer exhibits severe tunneling and purulent foul smelling drainage. History includes left total knee replacement approximately four weeks ago, hypertension, gout, chronic kidney disease, depression, obesity, and coagulopathy secondary to post-operative warfarin therapy. Patient stated she was unable to participate regularly in post-operative physical therapy due to a painful flare-up of gout. She also states she has not eaten in two days due to nausea and diarrhea from antibiotics.
The Nursing Process and Collaborative Care
Based on nursing assessment the salient nursing diagnoses for this patient are:
1. “Impaired tissue integrity related to mechanical destruction of tissue secondary to pressure” (Carpenito, 2009, p. 326) as evidenced by deep sacral wound.
2. “Impaired physical mobility related to restrictions” (Carpenito, 2009, p. 326) secondary to pain.
3. “High risk for infection related to exposure of ulcer base to fecal/urinary drainage” (Carpenito, 2009, p. 326).
According to NANDA (1990), “a nursing diagnosis is a clinical judgment about individual, family, or community responses to actual or potential
References: Eley, D., Del Mar, C., Patterson, E., Synnott, R., Baker, P., & Hegney, D.. (2008). A nurse led model of chronic disease care: An interim report. Australian Family Physician, 37(12), 1030-2. Retrieved August 21, 2009, from ProQuest Health and Medical Complete. (Document ID: 1617588311). Carpenito-Moyet, Lynda Juall (2009). Nursing care plans & documentation : Nursing diagnoses and collaborative problems (5th ed.). Philadelphia: Wolters Kluwer Health / Lippincott Williams & Wilkins. Firman, Julie. (1991). Case Management: Quality Care Today. Hospital Materiel Management Quarterly, 12(3), 22. Retrieved August 21, 2009, from ProQuest Health and Medical Complete. (Document ID: 488623). Flynn, A., & Mangione, T.. (2008, January). Five Steps to a Winning Project Team. Healthcare Executive, 23(1), 54-55. Retrieved August 22, 2009, from ProQuest Health and Medical Complete. (Document ID: 1409863201). Kearney, A.. (2008, March). Facilitating interprofessional education and practice. The Canadian Nurse, 104(3), 22-6. Retrieved August 21, 2009, from ProQuest Health and Medical Complete. (Document ID: 1459601381). NANDA Nursing Diagnoses. Philadelphia: North American Nursing Diagnosis Association, 1990. The Collaborative Partnership Approach to Care: A Delicate Balance (rev. reprint). (2006, February). The Canadian Nurse, 102(2), 8. Retrieved August 21, 2009, from ProQuest Health and Medical Complete. (Document ID: 992838421).