Management of a Service User with Chronic Obstructive Pulmonary Disease
Assignment Brief
Analysis of the nursing assessment undertaken to identify your service user’s problems/needs
Evidence-based nursing care assignment
The module will be assessed by the submission of a 4,000 word written care study.
The care study will be based on a chosen service user selected from clinical placement
Your assignment should include:
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An analysis of the nursing assessment undertaken to identify your service user’s problems/needs
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A discussion of the decision-making processes involved in planning person-centred nursing care, to include consideration of related pathophysiology and pharmacology
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A critical discussion of the implementation of this plan of care, to include aspects of interprofessional working
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An evaluation of the evidence base for the care delivered
Structure of essay (general guide)
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Introduction (200 words approx.)
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Analysis of the nursing assessment undertaken to identify your patient’s or service user’s problems/needs (900 words approx.)
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Discussion of the decision-making processes involved in planning person-centred nursing care, to include consideration of any related pathophysiology and pharmacology (900 words approx.)
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Critical discussion of the implementation of this plan of care, to include aspects of interprofessional working (900 words approx.)
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Evaluation of the evidence base for the care delivered (900 words approx.)
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Conclusions (200 words approx.)
Assessment
Analysis of the nursing assessment undertaken to identify your service user’s problems/needs
Things to consider:
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What nursing frameworks tools, guides or protocols did the nursing team use to provide an holistic assessment of the service user?
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What key problems/needs, actual or potential, were identified as a result of this assessment?
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How did the findings from this assessment inform the plan of care?
Planning
Discussion of the decision-making processes involved in planning person-centred nursing care, to include consideration of related pathophysiology and pharmacology
Things to consider:
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Discuss the decision-making in relation to planning their care i.e. any identified priorities / key considerations?
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What considerations need to be made in terms of pathophysiology (consider only one condition) when planning their care? e.g. signs / symptoms which may indicate improvement / deterioration etc.
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What considerations need to be made in terms of pharmacology (select only one drug) when planning their care? i.e. in monitoring its effectiveness or noting for adverse side effects?
Implementation
Critical discussion of the implementation of this plan of care, to include aspects of interprofessional working
Things to consider:
- What knowledge or evidence informed the decision-making process? i.e. why you did x instead of y etc.?
- What contribution did (or could) other members of the interprofessional team make (or have made) in relation to the service user’s care
Evaluation
Evaluation of the evidence base for the care delivered.
Things to consider:
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Was the evidence that informed the decision-making appropriate / relevant / applicable to your service user? If not, why not, and how might it be improved?
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How did the healthcare professionals accommodate the service user’s preferences when they were planning their care? Could this have been improved?
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What recommendations would you make as a result of your learning from undertaking this care study.
And Finally…
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Consider service user’s informal permission / consent
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Confidentiality – NMC code and data protection
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Anonymise assessment tools using Trust logos
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Higher marks are awarded for analysing and critiquing the care, rather than just describing it. Do check the marking grid in the module handbook
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References and appendices are not included in the word count
Sample Answer
A Care Study on the Management of a Service User with Chronic Obstructive Pulmonary Disease (COPD)
Introduction
This care study explores the assessment, planning, implementation, and evaluation of evidence-based nursing care for a service user with Chronic Obstructive Pulmonary Disease (COPD). The purpose is to demonstrate how holistic nursing assessment identifies patient needs and guides clinical decision-making in the delivery of person-centred care. COPD is a progressive respiratory condition characterised by airflow limitation that is not fully reversible, commonly caused by smoking and environmental exposure to irritants (NICE, 2019).
The service user, referred to as Mr T to maintain confidentiality in line with the NMC Code (2018), is a 68-year-old man admitted to a respiratory ward following an acute exacerbation of COPD. The care study draws on evidence-based nursing practice, integrating clinical assessment tools, pharmacological management, and interprofessional collaboration to promote recovery and improve long-term self-management.
By analysing the nursing assessment, decision-making process, and implementation of care, this essay demonstrates the importance of evidence-informed practice and reflective evaluation. The ultimate goal is to provide safe, effective, and person-centred nursing care that supports optimal health outcomes for patients living with chronic respiratory diseases.
Analysis of the Nursing Assessment Undertaken to Identify Service User’s Problems and Needs
Nursing assessment is the foundation of effective care planning and delivery. For Mr T, an initial holistic assessment was undertaken using the Roper-Logan-Tierney Model of Nursing (RLT) (Roper et al., 2000), which focuses on twelve activities of living. This model supports nurses in identifying how illness affects a patient’s ability to carry out daily activities such as breathing, mobility, nutrition, and communication. A structured framework ensured that Mr T’s physical, psychological, and social needs were explored comprehensively.
On admission, Mr T presented with severe shortness of breath, productive cough, and fatigue. Vital signs were recorded using the NEWS2 (National Early Warning Score 2) system, which revealed oxygen saturation of 86% on room air, a respiratory rate of 28 breaths per minute, and a heart rate of 102 bpm. These findings indicated hypoxaemia and tachypnoea, suggesting acute respiratory distress. Baseline arterial blood gases (ABG) showed elevated carbon dioxide levels, confirming type 2 respiratory failure, consistent with acute COPD exacerbation (O’Driscoll et al., 2017).
During the assessment, Mr T appeared anxious, explaining that his breathlessness worsened even during rest. The nurse used open-ended questions to gather subjective data and employed the COPD Assessment Test (CAT) to measure symptom severity and its impact on daily living. The CAT score of 28 indicated severe COPD symptoms. The nurse also reviewed Mr T’s smoking history, medication compliance, and previous hospital admissions, which helped identify potential risk factors for deterioration.
Continued...
