Developing Advanced Assessment Skills

Description

This book will help you to develop some of the essential assessment skills that are needed to support patients with long-term conditions in secondary and primary care settings. You may be at the beginning of your career, or you may be an experienced practitioner who is moving into long-term conditions care. At whatever level you may be, this book will give you some guidance on how to use appropriate assessment tools and to reflect on your experience from practice.Supporting patients with long-term conditions is not solely the domain of nursing. This book is intended to be suitable for a range of practitioners who are interested in developing their assessment skills further. However some examples have been given from a nursing perspective.The exercises throughout the book have been designed to encourage you to reflect on your practice and draw from the wide range of evidence that is available to support your development. You can work through them at your own pace and return to chapters that you need to learn more about.

Sujets

• Médecine
• Medical diagnosis

Informations

• Publié par: M&K Publishing
• Date de parution: 15 novembre 2011
• Nombre de lectures: 0
• EAN13: 9781907830181
• Langue: English

Extrait

Developing Advanced Assessment Skills:
Patients with long-term conditions

Edited by Ann Saxon and Sue Lillyman
Developing Advanced Assessment Skills: Patients with long-term conditions
Ann Saxon and Sue Lillyman (editors)
ISBN: 978-1-905539-18-5
First published 2011
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London, W1T 4LP. Permissions may be sought directly from M&K Publishing, phone: [phone], fax: [phone] or email: [e-mail]
Any person who does any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Notice
Clinical practice and medical knowledge constantly evolve. Standard safety precautions must be followed, but, as knowledge is broadened by research, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers must check the most current product information provided by the manufacturer of each drug to be administered and verify the dosages and correct administration, as well as contraindications. It is the responsibility of the practitioner, utilising the experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Any brands mentioned in this book are as examples only and are not endorsed by the publisher. Neither the publisher nor the authors assume any liability for any injury and/or damage to persons or property arising from this publication.
To contact M&K Publishing write to:
M&K Update Ltd · The Old Bakery · St. John’s Street
Keswick · Cumbria CA12 5AS
Tel: [phone] · Fax: [phone]
[e-mail]
www.mkupdate.co.uk
Designed and typeset by Mary Blood
Printed in England by H&H Reeds, Penrith
Other Health & Social Care books from M&K include:
The Management of COPD in Primary & Secondary Care
ISBN: 978-1-905539-28-4
Issues in Heart Failure Nursing
ISBN: 978-1-905539-00-0
The Clinician’s Guide to Chronic Disease Management for Long-term Conditions:
A cognitive-behavioural approach
ISBN: 978-1-905539-15-4
Nurses and Their Patients:
Informing practice through psychodynamic insights
ISBN: 978-1-905539-31-4
Spiritual Assessment in Healthcare Practice
ISBN: 978-1-905539-27-7
Perspectives on Death and Dying
ISBN: 978-1-905539-21-5
Research Issues in Health and Social Care
ISBN: 978-1-905539-20-8
Identification and Treatment of Alcohol Dependency
ISBN: 978-1-905539-16-1
Preventing and Reducing Aggression & Violence in Health and Social Care:
A holistic approach
ISBN: 978-1-905539-57-4
The ECG Workbook 2/e
ISBN: 978-1-905539-77-2
Contents
List of figures and tables
Contributors
About the editors
Acknowledgements
Introduction
Chapter 1
Developing competence and skills in the care of long-term conditions
Ann Saxon and Sue Lillyman
Chapter 2
Supporting people with long-term conditions
Sue Lillyman and Ann Saxon
Chapter 3
Assessment of patients with long-term conditions
Sue Lillyman
Chapter 4
History-taking and clinical assessment
Ann Saxon
Chapter 5
Assessment of patients with chronic respiratory disease
Ann Saxon and James Bethel
Chapter 6
Assessment of patients with chronic heart failure
Ann Saxon and Sue Lillyman
Chapter 7
Assessment of patients with diabetes mellitus
Ann Philp and Ann Saxon
Chapter 8
Assessment of patients with musculoskeletal pain
Mary Drodz and Gail Parsons
Chapter 9
Assessment of patients with multiple sclerosis
Amanda Andrews and Sue Lillyman

Index
List of figures
5.1 Chest palpation
5.2 Chest percussion
6.1 Visual analogue scale (VAS) for degree of breathlessness
7.1 Foot pulse examination
8.1 Knee examination
9.1 Neuron
List of tables
3.1 Examples of objective and subjective data
4.1 The SOAPIE model
4.2 The SOCRATES assessment
6.1 New York Heart Association (NYHA) system of classification
9.1 Sensory and motor function of the cranial nerves
Contributors
Amanda Andrews (Senior Lecturer)
Birmingham City University
James Bethel (Senior Lecturer)
University of Wolverhampton
Mary Drozd (Senior Lecturer)
University of Wolverhampton
Sue Lillyman (Senior Lecturer)
University of Worcester
Gail Parsons (Advanced Nurse Practitioner Orthopaedics)
The Dudley Group of Hospitals NHS Trust
Ann Philp (Head of Recruitment, Retention and Employability)
University of Wolverhampton
Ann Saxon (Principal Lecturer)
University of Wolverhampton
About the editors
Ann Saxon SRN NDN Cert MA (ed) BSc (Hons) Health Science RNT
Ann is a principal lecturer at the University of Wolverhampton. She has been a qualified nurse for over 30 years, specialising in community nursing. She was instrumental in setting up the first PG Cert Case Management for people with long-term conditions in partnership with Birmingham City University. Her research interests are patients’ experiences of case management and service evaluation.
Sue Lillyman SRN RM MA(ed) BSc (Nursing) DPSN PGCE RNT
Sue is a senior lecturer at the University of Worcester. She has over 30 years experience as a nurse and nurse educator. She was the route director for the PG Cert Case Managers programme in partnership with the University of Wolverhampton. Her research interests are patients’ experiences of case management, service evaluation and caring for older adults.

Acknowledgements
The authors would like to thank all those who contributed to the development of this book, in particular Hilary Kemp and Barbara Mason, and their families and friends who have always supported their endeavours. We would also like to thank the publishers, M&K Update, and Maria for her editorial skills.
Introduction
This book will help you to develop some of the essential assessment skills that are needed to support patients with long-term conditions in secondary and primary care settings. You may be at the beginning of your career, or you may be an experienced practitioner who is moving into long-term conditions care. At whatever level you may be, this book will give you some guidance on how to use appropriate assessment tools and to reflect on your experience from practice.
Supporting patients with long-term conditions is not solely the domain of nursing. This book is intended to be suitable for a range of practitioners who are interested in developing their assessment skills further. However some examples have been given from a nursing perspective.
The exercises throughout the book have been designed to encourage you to reflect on your practice and draw from the wide range of evidence that is available to support your development. You can work through them at your own pace and return to chapters that you need to learn more about.
Chapter 1
Developing competence and skills in the care of long-term conditions
Ann Saxon and Sue Lillyman
Key areas
Meeting patient needs and models of care
Self-assessment of strengths and weaknesses
Reflective journals and learning contracts
Resources and developing skills
Introduction
It is estimated that 17.5 million people in the UK report living with a longterm condition (Department of Health, 2005). As we live longer, with better medical provision and living conditions, this is expected to rise to 18 million by 2025 (Department of Health, 2008) in people aged over 65 in England. It is currently around 15 million for this age group. Our ageing society has also been affected by the baby-boom generation of the post-war era and increased life expectancy. The Department of Health (2008) stated that:
Long-term conditions are those conditions that cannot, at present, be cured, but can be controlled by medication and other therapies. The life of a person with a long-term condition is forever altered – there is no return to normal.
Common conditions include:
• Coronary heart disease, heart failure, stroke, transient ischaemic attacks and hypertension.
• Diabetes.
• Chronic obstructive pulmonary disease and asthma.
• Epilepsy.
• Cancer.
• Chronic kidney disease.
• Multiple sclerosis and motor neuron disease, Parkinson’s disease, dementia, schizophrenia and depression.

Exercise 1.1
List the most common conditions your patients present with.
How does your list compare with above list?
Meeting the needs of people with long-term conditions
People may be at risk of developing a long-term condition or chronic illness due to a variety of factors. First there is genetic makeup, for example some people are susceptible to motor neuron disease or certain types of cancer. And it could be the result of lifestyle. For example, people who are obese could develop diabetes and people who smoke could develop chronic obstructive pulmonary disease. However, genetic make-up and lifestyle are not the only factors. Many causes remain unknown.
Once people are diagnosed with a long-term condition then care must be provided and coordinated to help the person live with that condition. The UK Government (Department of Health, 2005; cited by Baines, 2008) identified that the care needs of patients with long-term conditions should be divided into three levels:
Level 1 : This is aimed at encouraging people to self-manage and self-care. They estimated that 70–80 per cent of this patient group would be in this category.
Level 2 : Level 2 involves the support of a multidisciplinary team (MDT) approach and includes people with single or multiple conditions. These patients are at risk of complications of their conditions and require some pr