Engagement

Means coming to know the client Key emphasis: Clientcentered Client as expert Client as unique individual Steps: Elicit clients understanding of his/her experience, the clients story Using Gordons framework as an assessment guide, collect data via interview & physical assessment (see attached form)

Heath Promotion Clinical Decision-Making Model Salience and Area of Mutual Pattern Meaningful Outcomes Recognition Focus Salience means Steps: Means together with the client relevant identify envisioning and issues of meaningful articulating concern significant desired outcomes both Pattern recognition short and longmeans identifying term the relevant particulars of your client situation and how the particulars fit together to form the big clinical picture Steps: research your clients diagnosis(es) using your resources (e.g., Medical Surgical text) consider similarities and differences and identify salient data create clusters of data that form a theme

Course of Action Means the doing and what needs to be done in relation to focus Steps: delineate your nursing actions integrate your theory & research

Gordons Functional Health Patterns

HEALTH PATTERN HEALTH PERCEPTION HEALTH MANAGEMENT PATTERN NUTRITIONAL METABOLIC PATTERN DEFINITION
perceived pattern of health and well being and how health is managed food and fluid consumption relative to metabolic need and indicators of local nutrient supply

ASSESSMENT (exemplars)
Reason for admission Primary Diagnosis Code Status IV therapy Diet Swallowing Weight loss/gain General appearance skin color/texture/intactness oral mucus membranes Output characteristics of urine/stool perspiration GI losses Foley catheter & other tubes Energy level Activity level TPR BP Peripheral pulses Respiratory status O2 therapy Edema rest/activity pattern demeanor feelings expressed/underlying

ELIMINATION PATTERN

excretory function (bowel, bladder, and skin)

ACTIVITY EXERCISE PATTERN

exercise, activity, leisure, and recreation

SLEEP - REST PATTERN SELF PERCEPTION SELF CONCEPT PATTERN

sleep, rest, relaxation self-concept pattern and perceptions of self (body comfort, body image, feeling state), selfconception and self-esteem sensory perceptual and cognitive pattern

COGNITIVE PERCEPTUAL PATTERN ROLE - RELATIONSHIP PATTERN SEXUALITY REPRODUCTIVE PATTERN

aids: e.g. glasses, hearing aid, oriented to time/person/place pain support systems family relationships

role engagements and relationships

satisfaction and dissatisfaction with sexuality pattern, describes reproductive patterns

age appropriate

COPING - STRESS TOLERANCE PATTERN VALUES BELIEF PATTERN

general coping patterns and effectiveness of patterns in terms of stress tolerance values, beliefs (including spiritual) or goals that guide choice of decisions

coping mechanisms life changes experienced

discharge plans client concerns/questioning

Mandle, C.L. (2002). Health promotion and the individual. In C.L. Edelman & C.L. Mandle. Health promotion throughout the lifespan. Toronto: Mosby.

Engagement

Health Promotion Clinical Decision-Making Model Salience and Area of Mutual Pattern Meaningful Outcomes Recognition Focus

Course of Action