Support for Nursing Care Plans

Our nursing care plans can impact patient readmission rates. In our scope of practice we assess our patients for patterns of human responses. We use that assessment to create a nursing regimen that can help with health behaviors and coping.

Addressing these issues would make a difference in readmissions rates according to a recent study. A study of HSCT patients at The James discovered that psychosocial factors can impact risk of readmission.

In the latest issue of The Cancer Connection there was a brief on readmission rates. Our very own Dr. Ashley Rosko, MD, senior author of the study, remarked:

“Just like we assess potential impact and risks of a patient’s co-morbidities before pursuing a stem cell transplant, we saw a need to evaluate psychosocial vulnerabilities to identify those patients at the highest risk for complications and develop interventions to ensure the smoothest recovery possible.”

The most common identified risk factors included: poor health behaviors (16 percent) and poor coping history (13 percent).

“We need to help our patients better cope with the chronic stress of a cancer diagnosis and treatment so that they are less likely to have setbacks in care due to additional illness,” adds Rosko.

These issues are within Nursing’s scope of practice. A quick look at NurseLabs nursing interventions for coping suggests the following nursing interventions and rationale:

Interventions Rationales
Set a working relationship with the patient through continuity of care.  An ongoing relationship establishes trust, reduces the feeling of isolation, and may facilitate coping.
Assist patient set realistic goals and identify personal skills and knowledge. Involving patients in decision making helps them move toward independence.
Provide chances to express concerns, fears, feeling, and expectations. Verbalization of actual or perceived threats can help reduce anxiety and open doors for ongoing communication.
Use empathetic communication. Acknowledging and empathizing creates a supportive environment that enhances coping.
Convey feelings of acceptance and understanding. Avoid false reassurances. An honest relationship facilitates problem-solving and successful coping. False reassurances are never helpful to the patient and only may serve to relieve the discomfort of the care provider.
Encourage patient to make choices and participate in planning of care and scheduled activities. Participation gives a feeling of control and increases self-esteem.
Encourage the patient to recognize his or her own strengths and abilities. During crises, patients may not be able to recognize their strengths. Fostering awareness can expedite use of these strengths.

This sounds like Relationship-Based Care – see the patient as a person, not an object. This is Nursing.