NUR3117A Community Nursing Plan of Care Management, Individual Writing Assignment NUS, Singapore

• This individual written assignment aims to consolidate the student’s learning by linking theory to clinical practice in the community. The community assessment experience provides students with real life physical and cognitive experiences, assesses community needs and identifies key health issues.
• Using the findings from your group’s community assessment done, develop strategies, integrating a health promotion model/ theory, to address health/psychosocial issues from a case study in below. Apply your group’s chosen community’s resources and settings to develop individual/family nursing care plan to the issues.

Develop a case study using either from community assessment project interviews or about someone you know who have chronic diseases and address the questions below:

(a) Identify and critically analyse at least 3 key health or psychosocial behaviour/issues affecting the client and/caregiver. Provide evidence from literature to support analysis.

(b) Develop a home care self-management plan for 3 issues that were discussed in above by applying a health promotion model (e.g. HBM, TTM, or CCM). The plan should have specific goals/measurable outcomes and interventions to empower the client/caregivers to self-manage in the home/community. Provide evidences to support your proposed interventions. If your case-study has a patient being discharged from the hospital to home, you can also discuss the anticipated needs in the home that the patient has such as, equipment, services, and referrals.

(c) In the plan, apply how existing community resources can be integrated into the management of care to deliver effective person-centered care in the community. The community area your group chose for the community assessment project will be considered as the community for the case-study.

(d) Discuss evaluation strategy for assessing the measurable outcomes.

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Frequently Asked Questions:

1. A case study can be developed from a resident your group encountered during the community assessment project or you can use your any family member/relative/friends/previous clinical attachment patient (without names) with chronic diseases will be acceptable (please see an example in below). Include caregivers and psychosocial issues.

2. Only assignments submitted in EXAMSOFT will be marked. If you submit the final document into Canvas, it will not be marked and late submission policy will be affected. Please read the steps required to submit your final document: 1. Generate Turnitin report via Canvas and 2. Submit your final document via Examsoft.

3. If you want to use another behavior theory besides HBM, TTM, or CCM, please write an email to your tutor with rationale and confirm with the tutor first.

4. 3 key health or psychosocial behavior issues must include both client and caregiver. Issues can’t be all about caregiver.

CASE- Scenario Example:

Mr Tan is a married 70-year-old, retired Chinese gentleman and lives in a 2-room Flexi Flat with his wife aged 68 years old in Queenstown. They do not have any children. Mr Tan has frequent admissions to the hospital due to multiple episodes of breathlessness. He is a chronic smoker (started in the last 40 years) and he has medical history of hypertension diabetes and hyperlipidemia. In his recent hospital admission, Mr Tan was referred to the Respiratory Medicine department as he experienced persistent shortness of breath despite of inpatient treatment. Mr Tan’s spirometry test suggested of moderate to severe obstruction of airways. His primary diagnosis for admission concluded as Chronic Obstructive Pulmonary Disease (COPD) Stage 2. He was discharged with Salbutamol (Metered Dose Inhaler with Spacer). Prior to discharge, he received patient education on the use and effects of the inhalers, reinforcements of early symptom recognition and management and advice on smoking cessation.