An audit of Individual Care Plan (ICP) in Dublin North City and County (DNCC) child and adolescent mental health service (CAMHS)

AimsThe objectives/aims of the Audit include: 1.To standardize and implement ICP for service users attending DNCC CAMHS team in accordance with the established policy.2.To achieve greater involvement of service users/parents in ICP.3.To standardize and improve treatment of care involving all members of one team.BackgroundEvery patient should have a care plan. Each care plan has a set of needs and goals. These are agreed between the service user and key worker and are assessed and measured frequently. Consultation with each service user/parents, as far as practicable is important. Specification of treatment and care required in accordance with best practice should be recorded. Identification of the necessary resources should be recorded and discussed with service user and key worker. Records kept in one composite set of documentation, and a signed copy should be made available to the service user/parents.MethodFirst Cycle commenced 15th October 2019. 166 files were selected from CAMHS team. Data were collected from clinical records from time of admission into CAMHS service to the time of audit. The audit report was prepared on the 6th December 2019, and intervention discussed at the multidisciplinary team meeting and wider DNCC CAMHS academic meeting. Second Cycle 23rd March 2020. 30 files randomly selected and audited. Data were collected by Dr Uchechukwu Egbuta, Mr Cillian Howley, Dr Anitha Selvarajoo, under supervision of Dr Muhammad Iqbal and Dr Diana Meskauskaite.Method of data input/analysis is IBM SPSS.ResultFor each ICP, the following were looked at: Files with ICP, Identifiable key worker, Formulation, Goals, Action plan, Copy of ICP to young person/parents, Next Review Date, Projected discharge date.Overall compliance shows 62% in first cycle, and 68% in second cycle after intervention.There was a 6% quality improvement of ICPs in terms of overall compliance in applying the various components of ICP.ConclusionEach service user should have an individual care plan. Each individual care plan should be measured regularly. To develop a therapeutic individual care plan, a formulation of the case from history taking is essential looking at the bio-psychosocial model and should be service user focused. Care plans are part of clinical governance, therefore continuous re-audit every three months was recommended. The follow-up audit will be carried out by the multidisciplinary team members.

Model of organization of nursing care for a patient after appendectomy

The aim of the study was to determine the relevant aspects of the organization of nursing care for the patient after appendectomy based on an analysis of its problems, using a formalized assessment method. The existing problems of patients caused by the operational intervention were analysed. Results. Based on analysis of existing problems of patients caused by operative intervention for removal of worm-like process using formalized assessment method, nurse of surgical department has possibility to build individual (personal) program of patient care. Conclusion. Further study is needed on the use of formalized assessment of the existing problem of patients who are involved in the operational intervention in order to identify and treat possible complications in a timely manner and to draw up an individual care plan.

Resilient Software Architecture Platform for the Individual Care Plan

The individual care plan (ICP) is a metamorphic being. The only steady reality that it maintains is its final objective, stated and explained in the previous chapter where the ICP is thoroughly introduced and debated. It is a fantastic beast, better described as a system of systems that is severely polymorphic due to its coverage both in level of care as well as sources of data to handle. Patient monitoring generates large volumes of data. There is the evident need of an advanced approach that can deal with these huge amounts of healthcare data extracted from various sources such as the wearable sensors, medical, and nursing records that are currently called big data. The purpose of this chapter is to introduce and discuss the software platform that is adequate to develop and deploy the system paying attention to the needs of high-availability, sensitive information security; service-level agreements for multiple healthcare interoperability; law and ruling conformance; as well as other technical and ethical aspects.

The Individual Care Plan as Electronic Health Record

The idea of the need for healthcare planning, whether in the individual or collective dimensions, is consensual among all health professionals. Despite this consensus, as well as a discourse that values teamwork, planning focused on health professionals has prevailed. Due to the current circumstances, particularly those resulting from changes in the epidemiological profile of the population, a new way of planning individual healthcare is required that must meet the following criteria: be of an individual nature, integrate the active participation of the citizen/family caregiver, be focused on care in the course of life, safeguard interdisciplinarity, assist in decision making about care, and be able to record decisions about care.

Establishing Individual Care Plans for Rehabilitation Patients: Traces of Self-Targeting in the Norwegian Universal Welfare State

Several countries have introduced devices for coordination of complicated individual cases across care, health and welfare services. This study examined one such device: the individual care plan (ICP), introduced in Norway in 2001 to enhance user involve­ment and coordination across sectors and service providers. Despite strong political imperatives, however, ICPs have remained significantly underused. To understand why, this study investigated the experiences with ICPs among staff in municipal coordinating units, tasked with organising rehabili­ta­tion efforts and case­workers in local labour and welfare services. In focus groups, participants discussed the fictitious vignette of a patient with traumatic brain injury, a person clearly within the ICP target group. They praised ICPs for advancing the rehabilitation process but acknowledged that they were applied too rarely. Through abductive-retroductive recontextualisation, this study identified a practice of de-facto self-targeting: in some municipalities, patients had to request ICPs themselves. We argue that this mechanism may have emerged from ambiguous propensities of rehabilitation, simultaneously emphasising needs and potentials, and ultimately from ambiguities in the Norwegian welfare model balancing universalism and local autonomy.

Blood conservation and transfusion in anaesthesia

Over the last three decades, avoidance of allogeneic transfusion in order to decrease adverse events within the recipient has become a part of clinical care. Although the main driver was an avoidance of transfusion-transmitted disease, other immunological consequences have been noted, and it is widely regarded as desirable to avoid the use of allogeneic component transfusion unless there is an essential physiological need. Of course this attempt at decreasing allogeneic blood component use has a potentially beneficial effect of blood component supply, leading to decreased use within the surgical specialties, while allowing increased use in clinical cases where there is currently no alternative to the transfusion of allogeneic components, such as those cases who have received chemotherapy and marrow suppression. The development of an array of techniques and treatments to decrease dependence of blood component transfusion has led to a care pathway that attempts to treat preoperative anaemia, minimize operative blood loss, and withhold allogeneic transfusion in the postoperative period according to clinical need. Many questions remain about the appropriate level of haemoglobin depending upon the comorbidities suffered by the patient, which is why patient blood management has gained popularity, as each patient deserves an individual care plan according to need.

Zdravstvena nega odojčeta sa hidrocefalusom / Case of infant with hidrocefalus by nursing proces

Modern methods of treatment of neonatal hydrocephalus, still does not give satisfactory results. The treatment of children with hydrocephalus requires intensive monitoring, emergency diagnosis and therapy. Preventing complications in the pre and postoperative period is vital for the quality of life of these children. This requires a high level of knowledge, greater commitment, maturity, responsibility and ability of nurses. By implementation of methods of medical care precess, nurse can notice the condition and care needs, definie nursing diagnosis and goals of care and genuine individual care plan. Based on an evaluation of the results of the work, it can be concluded that the nursing actions are most effective in addressing the problems of children with hydrocephalus. It also allows the nurse to assess their expertise and competence. Evaluation of accomplished, can give directions and guideline for improvement of the quality of work. Improving and developing the health care process brings the ability to improve the work of nurses.