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Patient history and psychology

The objective of this case is always to focus on an aged individual's journey of healthcare in an intensive care hospitalisation. Analysing the existing studies will be used to evaluate the patient care. The study results goal is to show how nursing theory may be applied in actual life. This will assess the multifunctional team's focus on meeting patients' physically, mental, and psychological aspects.

The author is a Specialist Stoma Care nurse with the NHS in Scotland, practicing in a colorectal department of surgery. The stoma nurse plays a unique function within the multidisciplinary approach. Important in the clinical patient care of stoma patients. I enlisted the help of a patient with and who I had built a strong working connection when he was a hospitalized patient to complete the assignment's criteria. I've been in touch with this individual after his release. To safeguard client anonymity, all identities have been altered and no mention to profession has indeed been made in the performances and morality for nursing and midwifery (Vakkalanka et al,2018). The customer shall be referred to as Tom for such purpose of this case study.

Nursing care planning (NCP) and documenting are time-consuming tasks for healthcare personnel(Harris et al,2018). Its efficacy is variable. Nursing care planning tools (NCPT) are evaluated in this study as a technology that assists nurses in their daily job while also assisting residents in their daily lives in the nursing home (Arnold et al,2018). The objective of this systematic review is to find studies that show that NCPT improves user quality of life as a meaningful outcome in long-term care. Nurses who utilise such services and patients who are impacted explicitly or implicitly by NCPT are considered final.

Nursing Healthcare plan takes up a lot of time and money for health professionals. So although Proposed action should be performed as an integrated part of the professional healthcare services and also as a legal obligation, automated or publication devices and licensing requirements should be purchased, staff should be trained, and nurses in long-term people caring must be analysed based on analysis to demonstrate whether their use is justified.

Tom is a former private school headmaster who is 84 years old. He lives on the borders of a small town in a Georgian home. When he retired 20 years ago, he moved here. Tom is married to "Jean," with whom he has been married for 62 years. They have a son and two daughters who all reside within an hour of his house and visit on a regular basis.

Critique care plan

Tom is his wife's principal caregiver after she was diagnosed with Alzheimer's disease some years ago. As her illness has worsened, this position has grown more practical and difficult. He receives just little social work assistance. He is a competent, capable, and fiercely independent guy who organised and paid for his wife's residential care at a local nursing home before his hospitalisation. Tom is still quite busy; he manages his house, drives a car, and is an avid gardener.

Tom has gastroduodenal disease and an enlarged spleen, although none of these conditions has necessitated ongoing therapy. Bendroflumethiazide is being used to treat his moderate hypertension. This follows the British Hypertension Society's guidelines. He does not consume alcoholic beverages or smoke cigarettes. Tom has osteoarthritis, which is relieved by taking paracetamol as needed, but he is otherwise healthy.

Tom went to his doctor earlier last year after experiencing new rectal bleeding and a change in his digestive habits. When Tom's treatment plan for haemorrhoids failed and his problems continued, he was sent to his local hospital. A rectal cancer was verified by a flexibility colonoscopy and histology. In both men and women, colorectal cancer is currently one of the most prevalent cancer (Johnson et al, 2018).

Patients who receive a positive cancer diagnosis undergo further testing to determine the disease's stage(Charalambous et al,2018). The tumour was circumferential and confined to the rectum, according to computerised tomography (CT) and magnetic resonance imaging (MRI) scans, and there was no sign of metastatic infection spread. At the weekly multidisciplinary team (MDT) meeting, his condition was evaluated, and it was decided that he should have a primary surgical complete mesolectal excision (TME).

The tumour, node, and metastasis (TNM) system of categorization is used to classify malignant tumours(Hartley et al,2018). The dukes method is used to classify colorectal cancers. T3 disease, a locally aggressive tumour, was discovered after a pathological and radiographic assessment.

Tom is under treatment for his rectal cancer. However, his increased blood cells count indicate evidence of sepsis. Results are improved by early recognizable proof of sepsis and the quick commencement of proof-based treatment following sepsis acknowledgment, including forceful liquid revival and antimicrobial treatment. Positive strain ventilation and sedation might prompt significant hemodynamic precariousness preceding satisfactory liquid revival(Lamas et al,2020).

Staying away from meds like ibuprofen and nonsteroidal, that inflammatory agents obstruct platelet work for patients who are in danger of creating DIC (spread intravascular coagulation).

By this care plan

  1. The patient will accomplish the accompanying objectives:
  • Ideal Coping
  • Nonappearance of Bleeding
  • Blood Glucose Level Within Targeted Range
  • Nonappearance of Infection Signs and Symptoms
  • Ideal Nutrition Intake
  1. Patient, family or huge other will instruct back or exhibit training themes and focuses:
  • Overview
  • Education on self-Management
  • education on When to Seek Medical Attention

Problem intervention 1

Improve Psychosocial Adjustment to the disease

Recognize, standardize, approve power and intricacy of patient and emotionally supportive network reaction to circumstance(Day et al,2021).

Give a potential open door to articulation of considerations, sentiments and concerns; answer with empathy and consolation.

Decline pressure and tension by giving data about quiet's status and treatment.

Work with emotionally supportive network presence and investment in care; consider giving a journal in serious consideration circumstance (Khanina et al,2020).

Support adapting by perceiving current ways of dealing with hardship or stress; give help in growing new methodologies.

Recognize and standardize trouble in overseeing long lasting way of life changes and assumptions.

Survey and screen for signs and side effects of psychologic misery, uneasiness and despondency.

Consider palliative consideration counsel for objectives of care discussion, assuming the condition is deteriorating regardless of treatment.

Related Documentation

Family/Support System Care

Strong Measures

Problem intervention 2

Start Sepsis Management

Give liquid treatment, for example, crystalloid or egg whites, to increment intravascular volume, organ perfusion and oxygen conveyance (Whitfield et al,2020).

Offer respiratory help, like oxygen treatment, harmless or obtrusive positive strain ventilation, to accomplish oxygenation and ventilation objective; stay away from hyperoxemia.

Acquire societies preceding starting antimicrobial treatment whenever the situation allows. Try not to defer for lab brings about the presence of high doubt or clinical markers.

Oversee intravenous expansive range antimicrobial treatment quickly.

Execute hemodynamic observing to direct intravascular support in light of individual designated boundaries.

Decide and address hidden wellspring of disease forcefully; carry out transmission-based insurances and separation, as demonstrated.

Related Documentation

Contamination Management

Disease Prevention

Disconnection Precautions

Adjustment Measures

Problem intervention 3

Advance Stabilization

Screen for indications of liquid responsiveness and over-burden; think about liquid change and diuretic treatment (Storozuk et al,2019).

Expect utilization of vasoactive specialist to help micro perfusion and oxygen conveyance; titrate to reaction.

Screen research centre worth, demonstrative test and clinical status patterns for indications of disease movement and different organ disappointment.

Evaluate adequacy of and potential for de-acceleration of the antimicrobial routine day to day (Samransamruajkit et al,2018).

Give fever-decrease and solace measures.

Screen and oversee electrolyte lop-sidedness, like hypocalcaemia.

Use lung defensive ventilation measures, for example, low volume, inspiratory strain, ideal positive end-expiratory tension, to limit the gamble of ventilator-incited lung injury; guarantee minute volume requests.

Get ready for strong treatment, like corticosteroid treatment, coagulopathy the board, CRRT (ceaseless renal substitution treatment), hemofiltration and cardiovascular help gadget (Dash et al, 2020).

Related Documentation

Fever Reduction/Comfort Measures

Liquid/Electrolyte Management

Lung Protection Measures

Problem intervention 4

For Recovery

Energize pneumonic cleanliness, for example, hack upgrade and aviation route leeway strategies, that might incorporate utilization of impetus spirometry, profound breathing and hack.

Energize early restoration and active work to streamline utilitarian capacity and movement resilience, as well as limit wooziness(Iaboni et al,2018).

Advance energy preservation; limit oxygen interest and utilization by changing climate, diminishing feeling, keeping up with normothermia and treating infection (Howick et al, 2019).

Advance liquid equilibrium, nourishment admission, rest and glycaemic control to keep up with tissue perfusion and upgrade safe reaction(Finlayson et al,2018).

Related Documentation

Action Management

Aviation route/Ventilation Support

Rest/Rest Enhancement

Problem intervention 5

Advance and Optimize Nutrition Delivery

Play out a wholesome evaluation; incorporate a sustenance centred actual test.

Decide calorie, protein, nutrient, mineral and liquid prerequisites.

Start early enteral sustenance support. Note: Enteral is liked over parenteral because of physiologic advantages, for example, upkeep of stomach respectability and capacity, decrease of contamination chance and arrangement of stress ulcer prophylaxis (Choupoo et al, 2021).

Upgrade protein admission, except if contraindicated.

Consider post pyloric versus gastric cylinder taking care of for patient at expanded hazard of goal(Kim and Park, 2019).

Advocate for and change mixture rate, detailing or volume in light of taking care of resistance and clinical status (e.g., hemodynamic strength); limit pointless interferences.

Expect the requirement for a promotility specialist assuming that diminished gastric purging or deferred inside motility is suspected (Abe et al,2018).

Screen sustenance conveyance to guarantee safe practices (e.g., affirmation of cylinder arrangement, tube patency, prescription conveyance, head of bed height, oral consideration) ( Donnelly et al, 2018).

Related Documentation

Sustenance Support Management

Issue intervention

Advance and Optimize Nutrition Delivery

Play out a nourishing evaluation; incorporate a sustenance centered actual test.

Decide calorie, protein, nutrient, mineral and liquid prerequisites.

Start early enteral sustenance support. Note: Enteral is EDUCATION

CPG-Specific Education Topics

Outline

depiction

signs/side effects

Self-management

movement

liquid/food admission

vaccinations

disease counteraction

post sepsis disorder

supplier follow-up

VTE anticipation

When to seek medical attention

unsettled/deteriorating side effects

VTE side effects

General Education Topics

General education

Affirmation, progress of care

Direction to mind setting, schedule

Advance consideration arranging

Demonstrative tests/methods

Diet alteration

Narcotic medicine the board

Oral wellbeing

Medicine the board

Infection appraisal process

Safe drug removal

Tobacco use, smoke openness

Treatment plan

Wellbeing education

Call light use

Hardware/home supplies

Fall counteraction

Hurt counteraction

Disease counteraction

Mdro (multidrug-safe organic entity) care

Individual wellbeing data

Assets for help

Along with care plan for Sepsis treatment, the patient needs a nursing intervention for hypertension.

Nursing intervention for hypertension

Decide the patient's underlying degree of understanding about hypertension and how to oversee it (Scales et al,2018).

Assist the patient with embracing way of life changes to keep a sound weight; increment work out; decline salt in the eating regimen; eat natural products, vegetables, entire grains (basically grain), and more fish; drink negligible liquor (something like one glass each day); limit red meats and lessening pressure (Gamel et al,2020).

In a healthcare system, particularly in hospitals depends on team effort. In a normal inpatient unit, a team of health experts collaborates to provide excellent treatment and a positive patient experience (Xyrichis et al 2018) Interprofessional is the system where various medical workers from relevant skill areas working together, with patients, relatives, to achieve the best level of care. Coordination of care among nurses, chemists, and other specialties has grown increasingly crucial as healthcare delivery becomes more integrated (Zivkovic, 2018). I could help to remove bottlenecks in patient care by refocusing our activities through the prism of interprofessional. Partnership working is the technique of addressing patient safety from such a collaboration view in its most basic form. And it is very important because it have various benefits;

  • To improve more care about serious patient
  • It reduces the medical gaps
  • Treatment should be faster than previous
  • Eliminate extra cost and inabilities
  • Improve the team working environment 

Communication and cooperation skills are critical to provide a quality health care, according to public health professionals. Community nurses can enhance patient care, avoid clinical mistakes, improve productivity, and raise quality of care once all clinical and nonclinical employees interact successfully. Communication is essential at every stage in health-care system. The requirement for simple, and better communication is constant present a nurse or a specialist near the patient, whether there's a clinic effectively communicating clinical information with some other doctors as well as nurses, specialists, and other hospital workers evaluating how to handle existing and upcoming patients (Moore et al,2019). To that purpose, here are few popular methods through which hospitals and health organisations can do their better communicate

  • Transferring patient information
  • Share their research paper
  • Do collaboration with others
  • Use of telemedicine

Decision making both in public health and clinical procedure very is crucial (Howick et al 2018). Many decisions are taken in the presence of uncertainty since health indicators are unpredictable. This study looks at two types decision making: those made in favour of patients through clinicians and those made jointly by clinicians and patients. Whenever deciding on our ongoing health care, there have factors to consider.  Decisions will be influenced by the cost, time, and consistency of medical therapy(McVeigh, 2020). There are few things to put in mind when make a decision for a critical care patient

  • Know the appropriate knowledge of the patient’s health.
  • Decisions must be followed the personal values.
  • How much time needed.
  • Possibility of recovering.
  • Keep in mind what are options if this is failed.
  • How much risk is included?
  • And also estimate the costs.

In this case study of Tom who is an old man and suffering with various problem like Diverticular disease, enlarged prostate, Cancer, Alzheimer and various older age-related issue. Tom admitted in a hospital, for doing a surgery. His increased white cell count indicated evidence of sepsis So, in all medical conditions have some risk factors and here I discussed about the management of risk factors of Tom’s case as well as a critical patient’s risk factors in healthcare system. The method that involves to identifying the risks that might affect an organisation and its patient, personnel, or anybody else inside this institution is known as risk management. Risk managers should prepare to deal with a wide range of challenges in a variety of situations. They asses the safety for patients, how they feel safe and recovered from an emergency. It affects every aspect of a health system's ecology, including clinical and protocols to do an operation and also the profit margins of a hospital (Foreman, 2020). Healthcare organisations may become more reactive in risk management only with right kind of people, procedures, and technologies, that will help them create resistance for potential challenges (Dash et al 2019) Unified risk management systems are the cornerstone of an effective care risk management programme. Here I mentioned how technology might help healthcare firms improve risk management programmes;

  • Improving Patient care quality: Improvement of patient care is a great concern among the hospital and home (Long et al,2018) 
  • Allow for easier compliance: It's more straightforward to remain in consistence with complex medical services prerequisites for repayment, supplier quality assessments, and more when one has programming that merges your dangers as a whole and data into one area, tracks each progression of an activity plan, and consequently circles back to the proper gatherings(Coelho-Junioret al,2022)
  • Consistency: Integrated system removes functional silos and provides a unified methodology.
  • The quantity of suppliers is reduced:Healthcare businesses can reduce the number of vendors, by using a singular, unified development platform, which is growing more important as security flaws as well as other second risks become more prevalent.
  • Procedures should be simplified:Modern technology gives the access of doing everything in a simple manner that helps to a patient in various way 

Conclusion

Tom is an elderly patient with multiple health complexities. He has been detected with rectal cancer and his increased white cell count indicated evidence of sepsis. Thus, he should immediately be followed by a critique care plan for checking the progression of sepsis. Although whereas many patients' diagnoses are the same, their physical, emotional, and spiritual demands are not (Queiroz et al, 2019). Planning a customised plan for the patient can provide comprehensive nursing home care, yet different studies have demonstrated that the must-have document 'nursing care plan' is misused for a variety of reasons. It might be due to an increase in workload, a staffing deficit, or an increase in paperwork. The examination, diagnosing, scheduling, treatments, and evaluation steps are included with this concise nursing care plan (CNCP). A nurse merely needs to tick mark the appropriate region in this CNCP. It is unnecessary to develop long patient care plans. This CNCP eliminates a lot of paper work and saves time.

The Critique care plans and patient care has piqued policymakers' curiosity. However, empirical research reveals that there is still a lack of detail about the nature of care plans and care planning at the ground level, as well as a lack of analysis of their expected impact on procedures, expected outcomes, and factors that could affect benefit. The suggested type of patient care, as well as the model of the process by which treatment plan affects outcomes, provide a valuable foundation for future policy creation and assessments. Empirical research is needed to evaluate how well existing care plans can be characterised using these characteristics, as well as the factors that influence which patients and providers employ certain types of care plans.

References:

Abe, T., Ogura, H., Shiraishi, A., Kushimoto, S., Saitoh, D., Fujishima, S., Mayumi, T., Shiino, Y., Nakada, T.A., Tarui, T. and Hifumi, T., 2018. Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: the FORECAST study. Critical Care, 22(1), pp.1-12.

Arnold, M.H., Kerridge, I. and Lipworth, W., 2020. An ethical critique of person-centred healthcare. European Journal for Person Centered Healthcare, 8(1), pp.34-44.

Charalambous, A., Wells, M., Campbell, P., Torrens, C., Östlund, U., Oldenmenger, W., Patiraki, E., Sharp, L., Nohavova, I., Domenech-Climent, N. and Eicher, M., 2018. A scoping review of trials of interventions led or delivered by cancer nurses. International Journal of Nursing Studies, 86, pp.36-43.

Choupoo, N.S., Das, S.K., Saikia, P., Dey, S. and Ray, S., 2021. How Robust are the Evidences that formulate Surviving Sepsis Guidelines? An Analysis of Fragility and Reverse Fragility of Randomized Controlled Trials that were referred in these Guidelines. Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine, 25(7), p.773.

Coelho-Junior, H., Marzetti, E., Calvani, R., Picca, A., Arai, H. and Uchida, M., 2022. Resistance training improves cognitive function in older adults with different cognitive status: a systematic review and Meta-analysis. Aging & mental health, 26(2), pp.213-224.

Dash, S., Shakyawar, S.K., Sharma, M. and Kaushik, S., 2019. Big data in healthcare: management, analysis and future prospects. Journal of Big Data, 6(1), pp.1-25.

Day, C.B., Bierhals, C.C., Mocellin, D., Predebon, M.L., Santos, N.O., Dal Pizzol, F.L., Fuhrmann, A.C., Aires, M. and Paskulin, L.M., 2021. Nursing Home Care Intervention Post Stroke (SHARE) 1 year effect on the burden of family caregivers for older adults in Brazil: A randomized controlled trial. Health & Social Care in the Community, 29(1), pp.56-65.

Donnelly, S., Begley, E. and O’Brien, M., 2019. How are people with dementia involved in care-planning and decision-making? An Irish social work perspective. Dementia, 18(7-8), pp.2985-3003.

Finlayson, K., Chang, A.M., Courtney, M.D., Edwards, H.E., Parker, A.W., Hamilton, K., Pham, T.D.X. and O’Brien, J., 2018. Transitional care interventions reduce unplanned hospital readmissions in high-risk older adults. BMC health services research, 18(1), pp.1-9.

Foreman, E., 2020. Nursing the sepsis patient-part 1. Veterinary Nursing Journal, 35(8), pp.242-245.

Gamel, W., Genedy, A. and Hassan, H., 2020. Impact of puerperal sepsis self-care nursing guideline on women's knowledge and practices. American Journal of Nursing Research, 8(2), pp.132-141.

Harris, T., Kerry, S.M., Limb, E.S., Furness, C., Wahlich, C., Victor, C.R., Iliffe, S., Whincup, P.H., Ussher, M., Ekelund, U. and Fox-Rushby, J., 2018. Physical activity levels in adults and older adults 3–4 years after pedometer-based walking interventions: Long-term follow-up of participants from two randomised controlled trials in UK primary care. PLoS medicine, 15(3), p.e1002526.

Hartley, S., Raphael, J., Lovell, K. and Berry, K., 2020. Effective nurse–patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance. International Journal of Nursing Studies, 102, p.103490.

Howick, J., Moscrop, A., Mebius, A., Fanshawe, T.R., Lewith, G., Bishop, F.L., Mistiaen, P., Roberts, N.W., Dieninyt?, E., Hu, X.Y. and Aveyard, P., 2018. Effects of empathic and positive communication in healthcare consultations: a systematic review and meta-analysis. Journal of the Royal Society of Medicine, 111(7), pp.240-252.

Iaboni, A., Cockburn, A., Marcil, M., Rodrigues, K., Marshall, C., Garcia, M.A., Quirt, H., Reynolds, K.B., Keren, R. and Flint, A.J., 2020. Achieving safe, effective, and compassionate quarantine or isolation of older adults with dementia in nursing homes. The American Journal of Geriatric Psychiatry, 28(8), pp.835-838.

Johnson, S.B., Butow, P.N., Kerridge, I., Bell, M.L. and Tattersall, M.H., 2018. How well do current measures assess the impact of advance care planning on concordance between patient preferences for end-of-life care and the care received: a methodological review. Journal of pain and symptom management, 55(2), pp.480-495.

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