William's Complex Health Condition and Multidisciplinary Approach

Introduction

For the last decade, multidisciplinary healthcare bodies have embraced the 'complex patient' model more often because there has been a rise in hospital admission with significant underlying issues and demanding health needs (Edmans & Preston 2016). It requires an approach the applies delicate balance between the professionals’ consideration and involvement of patients. In this assignment, I will use an assessment on Willian to Anxious and frightened; Vomiting, hypotensive and becoming less responsive; Acute and continuous abdominal pain to investigate how a cooperative hospital staff provides efficient, high-quality care to patients with such like conditions. healthcare dissertation help can offer valuable insights into how to manage such cases effectively. It will be identifying and considering social, environmental, and physical elements that impact health conditions. The responsibility of a nurse working together with other departments to give information from their participation will dwell more when contemplating how a challenging patient informs assessment, decision making, intervention, and clinical reasoning choices. All the activities that take place will be revolve around the patient and the benefits obtained through the personalized patient care approach. The paper looks into the condition and holistic impact on William, clinical reasoning and prioritization of care for William, and lastly, highlight the lessons that have been learnt from the case study and various activities that took place to ensure quality of life for the patient is improved.

Condition and holistic impact on William

William, a widowed man, has a past medical history of alcohol abuse. The 45-year-old man lives alone. Unfortunately, eleven years ago, a road traffic incident wiped his entire family of a wife and two children. For six years, his general practitioner had managed his alcohol dependence, and his GP had recently diagnosed him with liver cirrhosis. He works as a local senior barrister in a busy, stressful practice, and his employer pays him highly. His employer does not know William has an alcohol dependency issue. His parents and sister, who live a distance away, give him much support but are unaware of his condition.

William had stress for many days because the anniversary of his death was fast approaching and this causes him to have regression of alcohol intake. However, recently he contacted his with symptoms of vomiting, fever, and abdominal pain. He is referred to hospital as a patient with emergence where an ambulance takes him and he gets admitted. He goes straight into a Medical Assessment Unit where he administered with antibiotics, intravenous fluids, antiemetics, and analgesia and monitoring take place. The healthcare professional lay a plan to undertake an CT- Scans, urgent Abdominal Ultra sound, Amylase, and Liver function Tests. Further, they recommend that a Gastroenterology should undertake an assessment on him and recommend further treatment as it may be required. The suspicion of the doctors is that he is infected with Pancreatitis. William is interrogated and his history is recorded and the MTD uses it to make a concreate plan for his treatment.

Clinical reasoning and prioritization of care

Approaches & interventions used for William’s case are the best because they address the much-needed personalized care. Like the Patient and Public Involvement Policy, the present clinical suggestion puts the patient as the primary people for the goal-setting process to make goals unique in meeting patients' needs as an occupational being (Edmans & Preston 2016). The recommendation agrees with embracing narrative and interactive reasoning at this point to permit patients to showcase their motivations by picking specific goals that match their occupational needs and capabilities (Edmans & Preston 2016). The importance of change of power can mobilize service user accountability, participation, and transparency with increased commitment and understanding (Edmans & Preston 2016).

According to William, he is an adult at risk with safeguarding concerns because his condition puts restrictions on making decisions by himself. The conditions he is in prevents his capability to speak his emotions and needs (Edmans & Preston 2016). Thus, the Mental Capacity Act 2005 suggests that care available to patients in this condition, in the best interest together with MDT, caregivers, and families to protect these individuals (Edmans & Preston 2016). The policy will work well with the Deprivation of Libert Safeguards (DoLS) to ensure a holistic approach. In addition, in challenging cases like Jack's, a social worker must decide the services applicable for William to meet his needs under the Care Act 2014 (Edmans & Preston 2016).

Hobson (1996,2006b) indicates that a professional's involvement should rise in such a situation to give the patient the time of participation at every level according to their cognitive ability. As a result, the nurse has to recognize their therapeutical importance when attending to their patients (Hobson, 2006b). Doing so helps build trust and rapport with the patient to encourage maximum performance and involvement from William. Therefore, this aid in graded decisions will assist in making important decisions by negotiating and co-producing to enhance autonomy, empowerment and remain focused on the patients. The model of designing SMART goals with William could involve a conversation specifying episodic situations of past roles and interests (Hobson, 2006b). Regarding this information, the nurse will note the section beneficial to apply them in enhancing QOL and rise locus of control (Hobson, 2006b). The model will use the professional standards and skills of an OT in activity assessment to understand the issues and needs of the chosen activities and areas that the nurse can grade to guarantee William works successfully in tasks given (Hobson, 2006b).

Regarding William's interest in being it will be important that he is put in an environment where the immediate goals of enjoying meaningful occupations to improve QOL. Joyce & Warren (2016) suggest that enjoyable activities can be comprehensive and essential at every capability level when graded, with the advantages of drawing on occasional memories of memorable events from the past. According to William, his capability could motivate him to verbally express this to his nurse or other people him giving way for social interaction (Edmans & Preston 2016). Past studies in dealing with patients with similar conditions to William describe horticulture activities have proven to be viable for cognition. They have also been confirmed to be effective as they increased the QOL from the personal meaning discovered during the exercise, achieving a sense of fulfillment and well-being on his health and mental status. Joyce & Warren (2016) suggest that dealing with psychology can get an influence from intervention with a touch of routine integration, effective time management, promotion of intrinsic motivation, and volition to some ADLs.

At this stage of gathering information, it is essential to recognize that doctors had declared William was Anxious and frightened; Vomiting, hypotensive and becoming less responsive; Acute and continuous abdominal pain William cannot make decisions any personal decisions, and he needs a caregiver, family, or hospital staff to make decisions on his behalf, thereby burdening these people (Edmans & Preston 2016). It is also important to note that therapists best recommend carrying out the conversations with the patients for a maximum gathering of information from the patient (Edmans & Preston 2016). Therefore, the Addenbrooke's Cognitive Examination-III (ACE-III), approved by the Department of Health, will be embraced by the Mental Health Nurse and the OT to examine any future cognitive decrease(Edmans & Preston 2016). The standardized tool adopts a bottom-up method that focuses on cognition with minimal influence; scientists mention that it meets required standards of reliability and validity for analyzing dementia patients closely (Edmans & Preston 2016). Clinicians should always stay alert for early symptoms of alcohol addiction to prevent a patient from getting to an advanced stage like William. Further, an approved model is essential at this level (Edmans & Preston 2016). It is because the stage of cognitive impairment discovered will assist explain intervention efficiency.

Using the intervention requires that an analysis take place where it identifies preparation area that are challenging like musculoskeletal, sensorimotor, and neuromuscular body systems which prevents the completion of the tasks (Possin, Boeve & Aarsland, 2015). The recommendation by Nagle, Cook, & Polatajko (2002) is that there should be a graded approach to ensure a safe limit and environment for William which is seen as risks for engaging where identification of the harmful will be undertaken

Information obtained above will help care givers to have a favorable environment with things that interest him. William will go to this environment and modify the number of states an approach that leads to conservation of energy which directly addresses William’s ability level, reduced Anxious and frightened; Vomiting, hypotensive and becoming less responsive; Acute and continuous abdominal pain and pain levels (Edmans & Preston 2016). Neuropsychiatric elements that affect William on sequencing, planning, communication of speech require that there is need for Speech and Language Therapist (SLT) who can work together with the nurse to ensure that the problems are solved professionally using the best approaches (Royal College of Occupational Therapists. 2017). When brought on board, the SLT will be required to monitor the language skills and communication changes for him to provide guidance and assistance through the use of gestural, visual, and physical prompts that will allow him to continue participating in William’s communication preference methods (Royal College of Occupational Therapists. 2017). SLT will be also be required to collaborate with the nurse in ensuring the alcohol addiction that affects his natural setting engagement is addressed.

Another interesting activity that makes the approaches good for William is how the unique skills and expertise for the STL and nurse will be coordinated and work together to help one another to ensure effective services are delivered (Lepore, Hughes & Blount, 2019). Descriptive and interactive reasoning approaches used all through the interventions, allow the nurse to freely interact with William and feel how he perceives the whole intervention. William is required to focus on himself and not worry of his level of alcohol addiction (Lepore, Hughes & Blount, 2019). It could be important if a macro approach is adopted as it assists in obtaining information that will shape further decision-making.

On the course of discharge process, a case conference can take place to bring a care manager from the hospital to make decision whether there is need for the community team to come and visit the facility for information from the MDT on William’s well-being and health (Lepore, Hughes & Blount, 2019). The case conference could be an opportunity through which the PT and nurse will give advice on the task to allow continuation of participation with safe occupations (Lepore, Hughes & Blount, 2019). Also, the SLT will get an opportunity of advising on management and adopting the effective communication approach that could correct the levels cueing for William. After a short period of reviewing and monitoring Jack’s participation in this kind of meaningful participation, the nurse can make an inquiry from the hospital about the graded activities to understand whether there is need for change or they are manageable (Lepore, Hughes & Blount, 2019). Through this the nurse is able to undertake an evaluation on William’s response to the intervention and other occupational outcomes (Lepore, Hughes & Blount, 2019).

Conclusion

From accounts above, there is a clear demonstration of how services can involve uses and be based on client practice are manageable when it comes to patients with complex conditions and deemed as mentally incompetent. Also, using the collaborative multidisciplinary approach team is of much help when it comes to awareness of the various complexities that a patient like William has and also the occupational needs that may arise. The group of professionals easily address the problems they are facing through evidence-based assessment to ensure the quality of life for patients is enhanced and his needs comprehensively addressed. I have been able to gain deep knowledge about initial assessments through which patients are observed and their needs established for the start of the occupational interventions. Further, there are some of the standardized and functional assessments that I have come to understand how they function and the value they create to the patients. Besides I now understand the difference between assessments and how they can be applied in different patients according to the needs that arise. The application of Mini-Mental State Exam (MMSE), Montreal Cognitive Assessment (MOCA), Behavioral Assessment of the Dysexecutive Syndrome (BADS) and Addenbrooke's Cognitive Examination-III (ACE-III) is one areas that have come to understand how it works and its importance. Lastly, the significance of evidence-based approaches and its role in clinical medicine is one thing that I have come to understand better.

References

Edmans, J., & Preston, J. 2016. Occupational therapy and neurological conditions. John Wiley & Sons, Inc.

Hobson, S. 1996. Being client-centred when the client is cognitively impaired. Canadian Journal of Occupational Therapy, 63(2), 133-137.

Hobson, S. J. G. 2006. Using a client-centred approach with older adults. Client-Centered Practice in Occupational Therapy: A Guide to Implementation, 91.

Joyce, J., & Warren, A. 2016. A Case Study Exploring the Influence of a Gardening Therapy Group on Well-Being. Occupational Therapy In Mental Health, 32(2), 203-215. doi: 10.1080/0164212x.2015.1111184

Lepore, M., Hughes, S., & Blount, E. (2019). Measuring Outcomes to Evaluate Dementia Programs and Interventions. Presentation, National Alzheimer’s and Dementia Resource Center.

Nagle, S., Cook, V.J. & Polatajko, H. 2002. I’m doing as much as I can: occupational choices of persons with severe and persistent mental illness. Journal of Occupational Science, 9(2) 72-81.

Pluye, P., Légaré, F., & Bujold, M. 2015. Toward an interprofessional shared decision-making support tool for primary care patients with complex care needs: A participatory systematic mixed studies review. PROSPERO.

Royal College of Occupational Therapists. 2017. Professional Standards for Occupational Therapy Practice. London.

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