1. Caring for the patient with COPD
Topic: Caring for the patient with COPD Develop Competencies and objectives * 4 and a
GEM model. Please see included instructions Working With Homebound Elderly Diabetics
Name Institution Working With Homebound Elderly Diabetics Competencies are behaviors
which encompass the skills, attributes and knowledge that are requisite in the successful
performance of a job. The competence of an individual not only requires the aptitude and
intelligence, but also in the individual characteristics that lie underneath which may include
the habits, the traits, the social roles and self image same as the environment that is around
the individual which empowers them to adequately perform a stated job, role or respond in
a situation (La Rocca, n.d.). The process of competency modeling is designed to determine
the specific competencies that influence the high performance and success of a given job.
Competency modeling identifies the core competencies and how they are applied to
improve or enhance performance of a job. The prevalence of diabetes has continued to rise
over the years and even among the older population, the problem has not abated. The rise
of diabetes among the older population presents a challenge especially to homebound
diabetics who require a flexible and unique approach in the management of the disease.
There are numerous challenges that present to caregivers of the aged and therefore there is
a necessity to carefully and by design adopt very clear methods and approaches in the
management of this class of diabetes patients. The challenges include the difficulty in
spotting some of the symptoms, the impaired physiological functioning challenges that the
aging process brings about in the patients which could include disabilities, the mental
capacities or cognitive impairment of the patients brought about by age, the environment in
which they are confined which may be in the presence of family members or other
guardians. Elderly patients are susceptible to frailty as well as sickness which also make it
harder for the caregivers. Their diet management is also a challenge and the complications,
also associated with their age can arise. Additionally, they may also suffer from social
challenges, depression and limited economic means as well as co-existing health problems.
In regard to the discussion above, there is a need to ensure that the professionals who are
working with the homebound diabetes patients are well briefed on their job and roles in the
provision of services. The following are the competency statements that are relevant in the
practice of nursing in regard to the caregivers of this category of patients. This competency
model focuses on the knowledge, the skills and the interventions that are required for the
nurses who are specifically working with the homebound elderly diabetics. The model is not
in itself an independent model, rather, it should be applied in collaboration with the other
2. models that focus on the core competencies of the nursing field. Competency Statements: 1.
Professional Responsibility and Accountability: Demonstrates professional conduct;
practices in accordance with legislation and the standards as determined by the regulatory
body and the practice setting; and demonstrates that the primary duty is to the client to
ensure consistently safe, competent, ethical nursing care (Nursing & Midwifery Council,
2004). 2 Ethical Practice: Demonstrates competence in professional judgments and practice
decisions by applying the principles implied in the code of ethics or ethical framework for
registered nurses and by utilizing knowledge from many sources. Engages in critical inquiry
to inform clinical decision making, which includes both a systematic and analytic process
along with a reflective and critical process. Establishes therapeutic, caring, and culturally
safe relationships with clients and health care team members based on appropriate
relational boundaries and respect (College of Nurses of Ontario, 2009). 3 Provides Nursing
Care with Clients: Within the context of critical inquiry, relational and caring approaches,
uses multiple sources of knowledge (knowledge from nursing science, health sciences, other
related disciplines, practice knowledge, clients knowledge and preferences, and factors
within the health care setting) to consistently provide individualized nursing care for
people of all ages and genders in situations related to: Health promotion, prevention and
population health; Altered health status including acute and chronic health Conditions and
rehabilitative care; and Hospice, palliative and end of life care. 4. Ethical Practice:
Demonstrates competence in professional judgments and practice decisions by applying the
principles implied in the code of ethics or ethical framework for registered nurses and by
utilizing knowledge from many sources. Engages in critical inquiry to inform clinical
decision making, which includes both a systematic and analytic process along with a
reflective and critical process. Establishes therapeutic, caring, and culturally safe
relationships with clients and health care team members based on appropriate relational
boundaries and respect œCollege of Nurses of Ontario, 2009) . Objectives of the Competency
Statements Professional Responsibility and Accountability: Demonstrates professional
conduct; practices in accordance with legislation and the standards as determined by the
regulatory body and the practice setting; and demonstrates that the primary duty is to the
client to ensure consistently safe, competent, ethical nursing care (Nursing & Midwifery
Council, 2004). Objectives “ Demonstrates critical inquiry regarding to novel knowledge
and new technologies that change or enhance the practice of caring for homebound
diabetics. “ Participates in the analysis, development, implementation and evaluation of
methods, practice and policy that guide the home based care of diabetics. “ The
professional is accountable and assumes responsibility for his/her actions, omissions and
decisions. “ Exercises professional judgment in the application of policies, procedures and
in the practice of the care in the absence of agency policies and procedures. “ Protects the
clients by recognition and reporting of the unsafe practices which compromises the staff
and clients and as well challenges unclear orders, decisions or actions made by fellow
health care members who interact with the homebound diabetics. Ethical Practice:
Demonstrates competence in professional judgments and practice decisions by applying the
principles implied in the code of ethics or ethical framework for registered nurses and by
utilizing knowledge from many sources. Engages in critical inquiry to inform clinical
3. decision making, which includes both a systematic and analytic process along with a
reflective and critical process. Establishes therapeutic, caring, and culturally safe
relationships with clients and health care team members based on appropriate relational
boundaries and respect œCollege of Nurses of Ontario, 2009) . Objectives “ To establish and
maintain a caring environment that helps homebound diabetics’ patients to achieve their
most optimal health, manage their diabetic condition or a dignified death. “ Establish and
maintain appropriate the professional bounds with the patients, families and the health care
team members with a critical distinction between their social relationships with their
professional interactions. “ Respect and preservation of the right of the homebound
diabetic by observing the code of ethics or ethical framework. These include observing code
on the safe, compassionate, competent and ethical care, informed decision making, dignity,
privacy and confidentiality and being accountable for the actions. “ Acceptance and
provision of care for all patients without discrimination whilst respecting the different
health conditions, diagnosis, beliefs and health practices. “ Shows an understanding of the
ethical and legal considerations related to maintain client confidentiality in regard to their
diabetic condition. “ Lends assistance to the diabetic patients to make informed choices and
use their inner strength to modify the practices inorder to enhance the care and health
promotion of diabetics. “ Application of knowledge in the provision of care to homebound
diabetics for their psychological needs to prevent the development of complications.
Provides Nursing Care to Clients: Within the context of critical inquiry, relational and caring
approaches, uses multiple sources of knowledge (knowledge from nursing science, health
sciences, other related disciplines, practice knowledge, clients knowledge and preferences,
and factors within the health care setting) to consistently provide individualized nursing
care for people of all ages and genders in situations related to: Health promotion,
prevention and population health; Altered health status including acute and chronic health
Conditions and rehabilitative care; and Hospice, palliative and end of life care. Objectives “
Selects educational materials and information sources consistent with the patient’ s age,
literacy level as well as the cultural and/or ethnic background. “ Promotes the safe
management of homebound diabetics across the lifespan. Specialized Body of Knowledge:
Draws on nursing knowledge and ways of knowing, along with knowledge from the
sciences, humanities, research, ethics, spirituality, relational practice and critical inquiry as
well as demonstrating competence in the provision of nursing care (College of Nurses of
Ontario, 2009). Objectives “ Assesses the impact of the existing social, economic, and
cultural aspects/circumstances. “ Assesses local and regional communities to establish
effective support networks for patients with diabetes “ Inculcates cultural competence in
all aspects of the encounter with the patient and the healthcare providers. “ Acknowledges,
seeks remedial assistance and assists others in the rapidly deteriorating conditions of
diabetic patients which could affect the health and well being of the patient. “ Avoids or
minimizes the interference of personal values, beliefs as well as positional power on the
assessment of the diabetics as well as care. GEM Modeling The GEM model for homebound
diabetic patients is effective in minimizing the physiological decline of homebound elderly
diabetics and reducing the mortality as well as minimizing the need for long term care. This
model helps in preventing the functional decline of patients who are suffering from diabetes
4. which is reversible and greatly helps them to be independent and promote self management
thus helping the patient to live independently from the community. The GEM model stands
out as a stellar multidisciplinary management of negotiated goals whose achievement is
confined to a specific timeframe. There are five components of a GEM model as Gallo et. al
(2000) suggests;
