Unit-Assignment 2 Template 2 PDF

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This is the distinction level assignment 2...

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Name- Ella Douthwaite BTEC Level 3 National Diploma in Health and Social Care Unit 14: Learning Aim D

Treatment plan for (Amy- Breast cancer) Treatment plan processes and care methods Cycle of Planning

The cycle of planning includes several things, firstly a care plan is made to set out how a service users specific needs should be met and when by, it is a written record of stages arranging treatments and care and notes any services needed or used, ‘Care and support plans are for anyone who needs care of cares for someone else’ (nhs, 2019). A care plan is also used to support those who care for service users by finding ways to make carers job easier. The cycle of planning helps ensure that all aspects of care are being appropriately cared for and supported and there are stages in place designed to make this easier. The cycle is a closed loop and is the same for every service, if the cycle is not complete then the planning wont work properly for the service user. There are steps in place to ensure that the plan is complete. Firstly, Assess the needs of a service user, ‘if a particular assessment is not appropriate for an individual service user, record the fact and the reason on the assessment and keep it with the completed assessment’ ( QCS, 2011) The service user must fully agree to process of an assessment and the results should be shared with them, this assessment should have documents included of the service users needs to help develop treatment or support while identifying the hard and easier parts of the plan, and also what’s not working or what the service user may not agree with. The service user should be able to choose the preferred option of treatment or selected care that they feel is best suitable to them. The next step to mention is to record, each worker who is involved or carries out any action that can contribute to the care of a service user should note this down in the care plan, tis makes it easy for other staff and also the service user to be aware of anything that they have experienced- this can also help determine what is working for the service user and what’s not. ‘ any care or support aim must record what they have done, as well as the result of their action- in terms of meeting the aim, or not’ (QCS,2011) The record should be written in at least once per shift to ensure they are fully updated. Lastly the care plan should be reviewed, a designated person should review each risk assessment with the service user and look for any changes that could improve the standards of care, if there are significant changes that need to be made then a full reassessment should be made to ensure that the assessment is effective at its job. ‘our care and support plan will be reviewed regularly to see what's working and not working, and if it's still the best support for you.’ (nhs, 2019)

Potential care methods and strategies Primary care is a service users first point of contact with a health and social care professional, primary care is usually a continues point of contact throughout treatment, An example of primary care is Amy’s local general practitioner who then referred her to a secondary care centre. Secondary care is a specialist service that can help with specific problems that a primary care provider may only know a limited amount of information about and is often in some sort of medical treatment or medicine. Secondary care is often given and received at a hospital and will normally involve diagnostic tests 1

Name- Ella Douthwaite BTEC Level 3 National Diploma in Health and Social Care Unit 14: Learning Aim D

and specialised equipment that primary care providers may not have access to. This kind of care can be planned such as a surgery or urgent care such as emergency medicine. Tertiary care is a ‘Specialized consultative care, usually on referral from primary or secondary medical care personnel, by specialists working in a centre that has personnel and facilities for special investigation and treatment (johns Hopkins medicine, 2019) Tertiary care normally referred to by a primary or secondary care professional.

Case Study Amy is a 56 year old female who lives in the centre of Norwich, she recently noticed a lump on her breast and was experiencing discharge coming from the nipple. Amy visited her local general practice to have an assessment of her breast. After initial interview, several facts were established about Amy.        

Height is 5’4 ft A mother of two twins, both 21 years of age Smoker- around a pack a day Suffers from mild depression- on medication to help maintain it no mobility problems worried about her family’s reaction to diagnosis widow Vegetarian

Assessing the care needs of (name in case study) . Needs Physical

Care needs After diagnosis of breast cancer Amy has noticed swelling and discharge coming from the nipple of the breast, this can make everyday tasks difficult, Amy also needs help with her nicotine addiction as the cigarettes are effecting her physical health. After diagnostic and treatment surgery Amy will need to spend time recovering and therefore need to take time off work, she will need a carer to help with everyday tasks as she no longer has her husband to take care of her and he children have day jobs.

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Outcomes to be achieved After surgery at the Norfolk and Norwich university hospital, Amy should be seen by a physiotherapist to help with everyday movements during recovery, this will help her recover her mobility slowly and safely after surgery. Amy will also be visiting her local general practitioner who will offer advice and medication to help her slowly quit her smoking addiction.

Name- Ella Douthwaite BTEC Level 3 National Diploma in Health and Social Care Unit 14: Learning Aim D

Care method used: Secondary care while in hospital for her surgery and physiotherapy, tertiary care would be used for the oncologist for the breast cancer and primary care for the help to quit smoking.

Intellectual

As Amy is experiencing depression she often tries to combat her mental illness by sleeping, but she has been experiencing sleeping problems this can effect her intellectually because she could be having problems concentrating, she may also feel as though she’s not fully aware of everything happening around her as it can be very overwhelming when you’re dealing with a serious problem.

Amy should visit her local GP and ask about any medication she could be prescribed to help, which in turn may help her concentration. Amy should be shown her care plan to help her understand exactly what’s going on, with who involved which may help to put her mind at rest slightly, the nurses and doctors should also be telling her exactly what they’re doing as well to help update her. Care method used: Primary care would be used in terms of her GP helping her with sleeping problems and also providing her with more information about her cancer. Specialised secondary care will also be used when oncologists are involved to deal with the cancer

Emotional

Amy could be experiencing stronger symptoms of depression since diagnoses linked to her fears and worries about her cancer, she is also worried about how she will take care of herself and how her family will react to the diagnoses as she doesn’t want anyone to treat her any differently. 3

Outcomes to be achieved Amy should be given support from her GP and a specialised therapist who can help maintain her depression

Name- Ella Douthwaite BTEC Level 3 National Diploma in Health and Social Care Unit 14: Learning Aim D as well as suggesting techniques to help her family understand, she may also be referred to support groups who could help her feel more comfortable talking about her cancer.

Care method used: Primary care from he GP and secondary or tertiary care from a therapist.

Social

Amy is affected socially because she’s not able to do all of the things she did before diagnosis as she has to attend a lot more doctors appointments, she also may feel uncomforted leaving the house as she’s experienced hair loss from the chemotherapy. Amy is also disengaging herself from friends and family

Outcomes to be achieved Amy should be given support to control her disengagement and support to arrange appointments to allow time for friends and family.

Care method used: Primary care from her GP to help with personal confidence.

Treatment plan for (Amy) The overall aim and purpose of the treatment plan 4

Name- Ella Douthwaite BTEC Level 3 National Diploma in Health and Social Care Unit 14: Learning Aim D A treatment plan is a document, which is extremely important in the care of a service user; the treatment plan will follow the service users journey throughout care and will constantly be edited to suit the service users needs. The service user must be at the centre of the plan and all ideas and changes to any treatment or are needs to be discussed with the service user and the service user must have control over what he/she wants to happen unless they lack capacity; in which case the plan and any changes must be in the best interest of the service user. Personalised support to Amy specifically in her treatment plan is essential, this can include her likes and dislikes as well as care approaches she may not agree with and may cause her a lot of stress, This is because she safety and wellness of Amy is the main priority of a treatment plan. The overall aim of a treatment plan is to support the managing or curing of the cancer Amy is experiencing, In Amy’s case, the treatment plan will support how she will be receiving a partial mastectomy which involves removing the part of the breast that has the cancer, followed by sessions of chemotherapy to remove any left over cancerous cells, the side effects of the treatment will be noted in the treatment plan and monitored as her treatment develops. Considering Individual Needs Every service user has there own unique set of individual needs that will need to taken into consideration when caring for them. The kind of care provided will differ between who is receiving it but they should all be cared for with the same level of respect and care; for example, children will need to be talked to differently then adults because they wont understand anything that’s happening to them. Another example is culture and religion, this is because in some religions some adaptations need to be made such as offering vegetarian meals, or how Jehovah witnesses feel its wrong to receive blood transfusions so adaptations should be made to avoid using one as much as possible. Respecting these individual needs is important because it means that everybody is equally being respected and everyone has the same opportunities. In Amy’s case, its important to respect her individual needs such as how she has depression, that means that staff need to respect that some days Amy could be struggling more than others, another example is how she is a vegetarian so should Amy find herself staying at hospital during a meal time she is given a vegetarian option. Action to be taken There are several different treatment options for somebody with cancer depending on the stage and kind of cancer it is. 1. Amy was diagnosed with cancer on the 15th march, she was given a formal consultation with an oncologist who has described and explained the treatments and options available for Amy. Amy has agreed to the partial mastectomy and has had the benefits and side effects fully explained to her. A date will have been set for an appointment with a specialist breasts nurse to discuss advice and support before the surgery all about the recovery and the practical and emotional aspects of the surgery. 2. The date for the surgery has been set for the 6th April at 1pm at the Norfolk and Norwich University Hospital; this will be after the paper work, consultation and pre-surgery tests to ensure she is safe to have the surgery at this time. Amy has chosen a partial mastectomy as this is the most appropriate choice as been informed and suggested from the oncologist, this involves removal of the cancerous tissue inside the breast as well as some normal tissue around it, this surgery usually takes up to 3 hours and is done under general anaesthetic meaning Amy will be unconscious and not feel any of the surgery, to start the surgery a ‘During the operation, a horizontal or diagonal cut is made across your breast so the tissue can be removed (www.nhs.co.uk, 2018) . Recovery for this surgery is normally around 4-6 weeks, Amy will be discharged from hospital on the 9th April . 3. During Amy’s 3 day recovery period in hospital her bandages will be changed frequently by nurses and she will also be visited by a physiotherapist in order to assign exercise for Amy to do everyday to help her recover 5

Name- Ella Douthwaite BTEC Level 3 National Diploma in Health and Social Care Unit 14: Learning Aim D which she should attempt at least 1-3 times a day. The reason for these exercises is intended to help improve her arm movement they can also help with pain and lowering stiffness. A doctor may also visit Amy to prescribe medication to help with pain and also anti-depressants should Amy need it. 4. Amy will also be treated with chemotherapy, ‘after surgery when there is a risk that cancer cells could have spread to another part of the body’ (cancerresearchuk.org, 2017) this will eliminate more risk of the cancer spreading or coming back, it will also help to put Amy’s mind at rest, chemotherapy will involve having blood tests firs to ensure that the patient is safe for Chemotherapy, these will be done before every cycle of treatment. Amy will need to be in hospital to receive this treatment, as it will be given through a drip straight into the bloodstream. The chemotherapy will take around 3-6 months, they are given in cycles of around 8, the body needs time to recover between rounds of cycles, for example Amy’s cycle will last 4 weeks, meaning she will have treatment from the 1st, 2nd and 3rd of may but will have nothing else until the 1st 2nd and 3rd of June. 5. Lastly, once all treatment has successfully been followed Amy will have follow up doctors appointments every 3 months, this will ensure that the cancer has not returned and Amy isn’t experiencing any unusual symptoms after the surgery, however the longer she is cancer free, the fewer appointments she will need, after around 1 year cancer free she will only need to attend appointments once a year including mammograms.

Validity and reliability of sources of information The treatment plan was sourced was credible resources well known for their reliability, for example the NHS website was used for a large percentage of my research, this is government funded association meaning it has the most reliable information, another website I used for a lot of my research was cancer research UK, this is credible because it is one of the biggest charity’s for cancer and there for is well trusted by a lot of people.

Professional responsibilities 

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Maintaining confidentiality of information and discussions on a need to know basis is ensuring that information about a service user is full confidentiality and is only shared it needed, only those who are involved in the treatment plan should know, these include Amy’s confidential documents such as medical records and personal information. They should be stored on a computer, which is password protected or paper copies should be locked away. Considering the service user’s choices and preferences intends to make sure that service users make their own decisions and aren’t forced into any treatment that they don’t want or understand, however they should be fully informed on all options so they can make a informed decisions. Giving praise and encouraging independence and support is about how important encouragement during treatment is essential as for people such as Amy, she may need the encouragement to allow her to see how worth it, it is. Respecting the service user and their personal worth and dignity is essential as its about maintaining dignity and respect throughout treatment as its when service users could feel the most vulnerable, for example Amy may feel extremely weak and vulnerable as treatment commences such as chemotherapy and loosing her hair which could result in a lack of confidence. Maintaining a positive relationship and showing a sensitive manner is important in treatment because it makes sure that staff are always there for the service user when they need it and so they don’t feel alone, its important because they feel like nurses actually understand what they’re gong through. Being aware of the service users needs means to be aware of any specific and personal needs, for example dietary and religious requirements such as vegetarians and people needing a quiet place to pray. Using anti-discriminatory practice is important because it ensures that everybody gets treated equally with the same level of respect regardless of the differences. 6

Name- Ella Douthwaite BTEC Level 3 National Diploma in Health and Social Care Unit 14: Learning Aim D  Respecting individual differences and identity is about making sure that carers respect all religions, beliefs and views etc, this makes sure that everybody has equal rights.

Reviewing care needs and overcoming problems – A service users treatment will need to be reviewed throughout the treatment, this is because circumstances change and things may have changed. Firstly service users ability may worsen or it may get better, another note is that services that a service user has been using may not be adequate for their needs anymore, or they may need them more often, this is important to review as it could mean that the level of care is not as high as it should be. Thirdly services may not be helping as no positive change has happened since starting to use services, for example in Amy’s case, her depression medication should be reviewed as if it hasn’t made a positive difference then they should try something else. Overcoming potential barriers, these barriers could depend on the nature of the disorder, Firstly, some service users may struggle to take tablets so liquid forms or in some cases having the medication as a drip could work, however having a drip isn’t the most practical option as it would have to be done in a hospital. Another example is medication can cause side effects, such as chemotherapy; Amy will have to understand that it’s the best medication for her cause, however she could experience vomiting and hair loss’ You may experience anything from slight to complete hair loss as a result of chemotherapy’ (breastcancernow.org, 2017) Another issue could be that surgery’s get cancelled, as more urgent patients need them, this can be an issue for people such as Amy with cancer as the cancer could spread. A big barrier some patients have is the waiting times to see a specialist consultant as these can sometimes take weeks. ‘operations may be cancelled because of a lack of ward beds, equipment or theatre staff.’ (nuffieldtrust.org.uk, 2018)

The outcome of the plan on the overall health and wellbeing of (name individual)

Needs Physical

Explain how the plan would improve health and wellbeing overall Amy could experience benefits such as her arm muscles could have less pain, she will also see positive changes in how the plan will help her learn exercises for her after surgery.

Intellectual

The plan will help Amy understand fully what will be happening in the future but also it will help put her mind at rest as she learns more about her disorder.

Emotional

Amy may benefit as her depression may become milder as her disorder is treated fully as she will feel the relief of it being primarily over and it will help her see how strong she is.

Social

Socially the plan will help Amy see when she will be needing a...