In this section guide the reader through your assignment journey by:

Identifying the topic: State what you are going to discuss (this should link to the learning outcomes) CORONARY HEART DISEASE

One short paragraph re-prevalence of LTC (CORONARY HEART DISEASE) and impact on NHS/quality of life – this justifies your choice of LTC (setting the scene)

The context you have nursed the patient in – hospital/community/primary care/secondary care etc.

What has brought them into your care? i.e. an acute exacerbation/bi-annual review with case manager/increase in symptoms etc Present the background here and present your patients signs and symptoms that made them seek help at this point.

Articulate a succinct history, ‘like a bedside handover’, presenting clinical manifestations…….(CASE STUDY ABOUT PATIENT)

THIS IS AN EXAMPLE

Peter has Heart failure,62yrs, lives alone/recently bereaved/married etc smokes, unable to work/retired etc…. he presented in hospital, he could have presented with an array of problems for example, short of breath, fatigue, weakness, oedema/swelling, low mood/anxiety, persistent cough, admits to not understanding his medication and/or taking his medication etc, etc etc

Give a very brief overview of normal A&P (your chosen Long Term condition) then link this to: –

· Changes that have occurred to the structures/function – this is the pathophysiology part, Then…….

· Link the pathophysiology to your patient symptoms/how they presented (clinical manifestations/signs/symptoms) this then creates some analysis and demonstrates a deeper level of understanding allowing you to fully meet with the LO and to demonstrate that you understand why they have these signs and symptoms.  

· Sticking with the example above; Peter presented with oedema, cough and low mood/not coping. Explain/link the pathophysiology to the cough/oedema etc, why is this happening?

What is the nursing process – a holistic and systematic way to assess patients etc.

Where does care planning fit in with this? Why is it important, who is involved? (nurse, patient, MDT approach to care delivery is needed).

For this section, a clear and concise overview of the importance of a systematic approach (APIE) to nursing care delivery is required. Discussion relating to how this can impact on the management of your case studies disease with focus on self-care strategies. The importance of MDT and family in promoting self-care strategies needs to be included. What are self-care strategies?

Planning and delivering care for patients involves a collaborative approach, this includes the patient, carers, family, nurse, MDT etc, the focus is on individualised care, holistic care, person cantered care, patient focussed care/Link with the evidence that supports why we do this. Link in with care planning for patients with LTC’s and SMART goal setting…

Ensure you say why this is an issue and note the impact

What two problems are you focussing on?

Problem/SMART GOAL/Nursing interventions/Patient self-care strategies…….

THIS IS AN EXAMPLE

Peter has Heart failure,62yrs, smokes, unable to work…. he presented in hospital, he could have presented with an array of problems for example, short of breath, fatigue, weakness, oedema/swelling, low mood/anxiety, persistent cough, admits to not understanding his medication and/or taking his medication etc, pick two problems that you can focus on.

This is the section where you justify why you are doing what you are doing for the patient in relation to the nursing actions, use the evidence from the latest guidance and evidence-based articles to support your actions. For example, why do we restrict fluids in patients with CHD, who says we do and what is the guidance regarding the amount? How does this affect your patient and what needs to be put in place to ensure this is happening, i.e. fluid charts/measuring cups

A paragraph to explain the importance of empowering and including the patient in their care planning and management will cover the self-care actions section. Mention shared-decision making. The impact self-empowerment has on patient’s recovery time is well researched in the field of LTC.

THIS IS AN EXAMPLE

Sticking with the example: Plan the care for your problem, what will you do as a nurse, what does Peter agree too? For example, you will educate and advise, you will refer to smoking cessation etc, Peter may well agree to keeping a smoking diary where he can identify times and triggers that make him smoke more, Peter may well agree to smoking cessation as well as nicotine replacement etc. You need evidence to support your nursing actions and Peters self-care actions too.

Summarise key points of your discussion/ Do not introduce new evidence/facts

Apply APA 6th Edition