Assessment Tools - Essay Example

Introduction In order to expand the abilities of nurses to assess as well as evaluate clients in various stages and states of health illness, stress and life, nurses should have the knowledge in assessment tools. The purpose of this paper is to provide the student with the opportunity to examine assessment tools which can be used in order to evaluate on-physical measures, and apply the Watson’s Theory of Human Caring which integrates the mind-body-spirit dimensions. Assessment Tools TENETTI TEST This assessment tool is simple, and it can be used in adult population or elderly patients. It is an easily administered test which measures the patient’s gait and balance. The Tinetti test is scored based on the ability of the patients to perform specific tasks. This assessment tool is a task performance exam which can be completed for 10-15 minutes. The scoring of the Tenetti Assessment Tool can be done on a three point ordinal scale with range of 0 to 2. The most impairment is represented by 0 score, while a 2 would represent independence of the patient. In order to form three measures the individual scores are combined; an overall gait assessment score, an overall balance assessment score as well as gait and balance score. For the gait component, the maximum score is 12 and for the balance component the maximum score is 16 points. Twenty-eight points is the maximum total score. Patients who scored below 19, in general, are at high risk for falls, patients who scored 19-24 indicate that the patient has a risk for falls. In a study of 15 patients by having a physician and a nurse test the patients at the same time, interpreter reliability was measured. On over 85% of the items agreement was found, and the items that differed never did so by more than 10% and these results indicate that Tinetti Assessment tool has good inter-rater reliability (Lewis, C., 1993; and Tinetti, M.E., 1986). MOBILE INTERACTION FALL CHART (MIF) The Mobile Interaction Chart (MIF) is a flow chart used for the identification of older people who are prone to falling. It includes the observation of mobility level and ‘Stops Walking when Talking,’ the ‘DiffTUG, a test of vision and a rating of concentration. Having these complete details of observation makes valid information for the assessment. It is designed in order to evaluate older people living in residential areas and could be applied to older males and females, 65 years old and above. This assessment has been applied by the Department of Community Medicine as well as rehabilitation Physiotherapy and Geriatric Medicine (Sweden) and tested to be quick, easy and requires no expensive facilities. This tool could help nurses to deliver good and quality health care even in the residential areas where they deal with numerous older people in the absence expensive facilities and available resources. PJC-FRAT TOOLS Peter James Centre Fall Risk Assessment Tool also known as PJC-FRAT, is a new instrument which is designed in order to obtain a baseline fall risk assessment. This PJC-FRAT is used in a sub-acute rehabilitation setting and have been tried to male and female patients, 38-99 years old (average 80 years). It is a long term process that could be used by a team. It can identify intervention that will prevent the patients from falling. According to Strudwick (2006) in terms of convenience and simplicity, this multidisciplinary tool is close to ideal since it can be easily incorporated to the nurses’ workflow and can be fitted into the routine duties without difficulty. Watson’s Theory of Human Caring Patient-nurse interactions are involved in this theory. A phenomenon which is intrinsic to the core of nursing in 10-1tem “carative factors” framework was initially conceptualized by Watson. The framework was changed over time, from carative to “caritas,” as the theory’s merging elements which means love and caring, were transformed into deep interpersonal caring. Its framework tenets include humanistic-altruistic values; presence of faith-hope; cultural congruence; formation of trusting relationships; promotion of teaching-learning; environments which supports holistic principles of nursing; as well as presence of an existential-phenomological- spiritual force. Its elements suggests abandoning ego or self in order to achieve health through spiritual connection and these connections, in turn access potential healings. Nurses make healthy outcomes possible by helping remove the blocks of healthy energy, in healthcare settings. To help patients acquire harmony in body, mind as well as spirit is the goal of holistic nursing. By introducing partnership of the caring person/nurse and the patient/the one being cared, nurses can help the patients, according to Watson in finding meaning in their existence (DiJoseph, J. and Cavendish, R., 2005) Application of Tools in the Vulnerable Population and Self Awareness Dealing with patient falls is a great challenge for health care providers such as nurses. Experts figure that the annual rate of fall in the US by the year 2020, both in Health care setting across the board as well as the community at large will reach 17,293,000 per year and cost an estimated $ 85.37 billion (Strudwick, D., 2006). Conducting fall assessment requires reliable assessment tools that could help nurses offer safety and health care costs. Based on the Watson Theory, Nurses should consider clinical knowledge in order to apply general principles to have the best practice of caring for older people particularly in preventing falls and deal with injuries from falls. The use of the Tenetti Test could eliminate the financial burden of the poor elderly that belong to the uninsured and underinsured. This tool can be applied based on the needs and environment of the patients such as the residential setting. Nurses should consider providing the highest quality of care and improved safety for patients they are entrusted with. References Articles Using the Downton Index to Predict those Prone to Falls in Stroke Rehabilitation (1996). American Heart Association. DiJoseph, J. BS, RN and Cavendish, R., PhD, RN, CPN. (July/August 2005). Expanding the Dialogue on Prayer Relevant to Holistic Care. Holistic Nursing Practice. Vol.19, No.4. Lewis, C. (1993). Balance, Gait Test Proves Simple Yet Useful. P.T. Bulletin. 2/10:9 & 40. Strudwick, D. RN, BSN, LHRM. (Oct. 9, 2006). Nursing Spectrum, Career Management Magazine Articles: Before the Fall Preventing Falls and Harm from Falls in Older People, Commonwealth of Australia. (April, 2005.) Tinetti, M.E. (1986). Performance-Oriented Assessment of Mobility Problems in Elderly Patients. JAGS. 34:119-126. Read More