Needs & Organizers - Nursing Presentation PDF

Overview of all Needs & Organizers Melissa Hoffman F2024 Created by: Diane Browman, Olesia Koretski, Judy Sabiston, Patricia Lawrence 1  Objectives Identify what are the basic human needs Outline Maslow’s Hierarchy o...

Overview of all Needs & Organizers Melissa Hoffman F2024 Created by: Diane Browman, Olesia Koretski, Judy Sabiston, Patricia Lawrence 1  Objectives Identify what are the basic human needs Outline Maslow’s Hierarchy of Needs theory Identify why an understanding of human needs is important to nursing Identify some characteristics of the needs Recognize the nursing role in clients with needs Describe the JAC nursing framework of needs Examine 10D need for comfort State priority problems (nursing diagnosis) based on the needs framework 2  AC a J p tu k l n ce wor Co me Fra NURSING NURSIN ABILITIES G PROCES S CARING HEALTH & NEEDS ILLNESS DEVELOPMENT ENVIRONME NT 3  Needs Theory A theoretical framework that nurses use to promote the health of an individual & families 4  NEEDS THEORY As a nurse, you will help people: Satisfy their basic needs, assist clients to meet their needs Reduce threats to fulfilling a need E.g. prevent complications 5  Basic Human Needs Are essential to health & survival of all people Could be physical &/or psychosocial need Can be met or unmet A person whose needs are met may be considered as being healthy, while a person who has one or more unmet need(s) is at an increased risk for illness Examples of human needs? 6  How can you determine the client’s needs? ASSESSMENT Collecting data Interview & head-to-toe assessment Validating data Objective & subjective data should be congruent (agree) v.s. incongruent (disagree) Clustering data Body systems (e.g. neurological, cardiovascular) Needs framework Analyzing data Formulating a nursing diagnosis (priority problem)7  Why Is It Important To Understand The Needs? Nurses assess & plan health care for individuals All people have the same basic needs, however each person’s needs are modified by that person’s health & culture 8 Abraham Maslow’s Hierarchy of Needs Maslow is the most well-known needs theorist Ranked the needs on five (5) levels in an ascending order from simple physical needs or physiological needs to more complex ones known as hierarchy of needs Many nursing programs/textbooks are based on Maslow’s hierarchy of needs Most types of nursing care are prioritized using the same hierarchy 9 Maslow’s Hierarchy of Needs: Key Concepts Needs are common to all people regardless of age, sex, race, social class, & state of health (well or ill) Maslow found that people who satisfy their basic needs appropriately are healthier, happier, & more effective than those whose needs are not met Basic needs are transcultural (across all cultures) The perception of a need may vary according to learning & standards of the culture 10 Maslow’s Hierarchy of Needs 1. Physiological 2. Safety & Security 3. Love & Belonging 4. Self-Esteem 5. Self-Actualization 11 Maslow’s hierarchy of needs 12 13  Maslow’s Hierarchy of Needs Everybody has a set of needs that need to be gratified Starts with the most basic needs Once the needs on one level have been gratified, they can move on to the next level of needs The ultimate gratification of all the levels leads to self- actualization 14  Needs Needs must be met at the foundation of the hierarchy before working toward meeting higher- level needs Example A hungry person will not be concerned about learning Clients in pain may not be concerned about personal appearance or relationships with others until pain relieved 15  Maslow’s Physiological needs THESE NEEDS ARE CRUCIAL FOR SURVIVAL They take precedence over higher-level needs Air Food Water Shelter Rest Sleep activity Temperature maintenance  Question Of all the physiological needs which one is the most essential? a. Food b. Water c. Elimination d. Oxygen 17 What Can A Nurse Do To Satisfy Patients’ Physiological Needs? 18 Maslow’s Safety & Security Needs Physical & psychological aspects Feel safe in both physical environment & in relationships Adequate shelter, free from harm, danger, fear & anxiety Characteristics of safety include: Predictability Stability Familiarity 19 What Can You, The Nurse Do To Satisfy Patients’ Safety Needs? 20  Maslow’s Safety & Security Needs cont’d Clients entering the healthcare system often fear the unknown & may have significant emotional security needs Nurses can Allow as much independent decision making & control as possible Explain new, unfamiliar procedures & treatments Encourage spiritual practices that are a source of strength & support 21 Maslow’s: Safety & Security: Spirituality A client who is ill may find comfort in spirituality Nurses can help clients meet their spiritual needs by: Assisting them to worship services Providing reading Contacting the client’s clergy person or the chaplain of the institution 22  Maslow: Safety & Security: Shelter The nurse should inquire about a person’s shelter Helps the person to feel safe Should provide warmth necessary to maintain adequate body temp Some clients are homeless: be alert when interviewing clients (clients may be embarrassed or ashamed) 23  Maslow’s Love & Belonging Needs People need to feel that They have meaningful relationships with others They belong They give & receive affection People need to have that feeling of acceptance Acceptance From Whom? 24 Maslow’s Love & Belonging Needs: cont’d We need social interaction Hospitalized clients are often separated from friends & family Persons confined to home may lack social contacts People who believe that their love & belonging needs are unmet often feel lonely & isolated They may suffer from both physical & emotional withdrawal, or they may become overly demanding & critical Be on the alert! 25  Maslow’s Love & Belonging needs The person at this level will seek to find: Friendships Affection from others Intimacy (both Having supportive & physical and communicative emotional) family interaction Sense of roots 26  Who Is At Risk For Unmet Love & Belonging Needs? What can you the nurse do to satisfy patients’ love & belonging needs? 27  Maslow’s Esteem Needs The individual needs both Self-Esteem and Esteem from others Self-Esteem: An appreciation of one’s own personal worth Esteem from others: Concern about how others perceive you 28  Maslow’s Esteem Needs If the needs are met: It leads to an overall self-confidence, self- worth, the feeling of being useful & necessary If the needs are not met: Can lead to inferiority & helplessness 29 What Type Of Clients May Have Altered Levels Of Self-esteem? What can a nurse do to help satisfy their need for self esteem? 30  Self - Actualization The innate need to develop one’s maximum potential Even if all the other needs are met, some people may never reach the level of self- actualization ___________________________ 31  According to Maslow A Self-Actualized Person Is: Highly creative, flexible, spontaneous, courageous, willing to make mistakes Open to new ideas Self-confident & has self-respect Has low degree of self-conflict Does not need fame 32  Cont’d Highly independent, desires privacy, can appear to be remote & detached Is realistic & objective about life Has a clear view of right & wrong Possesses humility (has a modest view of their own importance) & listens to others 33  Nursing & Needs Knowledge of the theoretical bases of human needs assists nurses in responding therapeutically to a client’s behaviours & in understanding themselves and their own responses to needs Clients entering the health care system generally have unmet needs The hierarchy of needs is a way to plan individual care 34  Important point Theoretically, the basic physical needs must be satisfied before the higher psycho-social level needs emerge. This is true in general, but the order in which needs are felt & become important to an individual is different from person to person & from situation to situation 35  Virginia Henderson (1960s) Nursing researcher developed a conceptual model for nurses based on needs common to all individuals Needs Model of Nursing Care is based on 14 needs: 36 37  JAC Needs Framework These 14 “needs” have been modified to form the JAC needs framework Definition of each need - refer to: 1. “Needs & Organizers: Formulating Nursing Diagnoses” – Posted on LEA 2. “10D Core Concepts” Keep this document handy as you will need it through out the program 38  JAC Needs and Organizers NEED ORGANIZER Comfort Pain, Anxiety, hygiene, temperature, body alignment, sensory deprivation, sensory overload, effects of illness and hospitalization Rest Lack of meaningful or purposeful activity, changes in comfort which may interfere with rest Sleep Changes in the quality and/or quantity of sleep Safety Due risk of infection or injury 1.Related to environment: mechanical, thermal, electrical, chemical, biological 2.Related to altered body structure or function: musculoskeletal, neurological, integument, immune, cellular function 3.Related to developmental abilities 39  JAC Needs and Organizers (cont’d) Need Organizer Activity Increased mobility, decreased mobility, decreased activity tolerance Nutrition Altered ability to: ingest, digest, absorb Altered nutritional requirement, metabolism, fluid & electrolyte balance Elimination Altered Fluid output: urine production/excretion, gastric losses Bowel excretion: diarrhea/constipation Oxygenation Altered Ventilation: ineffective airway clearance, ineffective breathing pattern, impaired gas exchange Tissue perfusion: blood vessel changes, blood pressure abnormalities, decreased cardiac output, decreased oxygen carrying capacity of blood 40  JAC Needs and Organizers (cont’d) Need Organizer Self esteem Altered Self worth, Identity, Body image, Role Social Altered interaction Communication, Patterns of interaction Sexuality, valuing and goal of life 41  Learning Needs Client’s can have learning needs based on any of the JAC framework needs They can be identified by the nurse or client, Examples:  Knowledge Deficit: indicates that the patient does not know enough about an issue thus creating a potential unmet need  Health Seeking Behavior: related to any need, or an issue such as parenting, or coping with an illness 42  JAC Needs Framework by semester 1. Comfort 1, 2 2. Safety 1, 2 3. Activity 2, 3 4. Nutrition 2, 3, 5 5. Elimination 3 6. Oxygenation 4 7. Rest 4 8. Sleep 4 9. Self-Esteem 4 10. Social Interaction 3 11. Learning 1 43  JAC Needs Framework As per JAC, a nursing diagnosis is: A problem or concern of the client, stated as an unmet need due to one or more of the factors identified as an organizer 44  JAC Needs Framework NURSING DIAGNOSIS STATEMENT: Unmet (or potential) need for ___ need ___, Due to ______ organizer _____________, Related to ___reason __ (no medical diagnosis) 45  NEED: Comfort A condition of physical and psychological ease that allows the client to have a sense of control & readiness for action 46  NEED: Comfort’s organizers Pain Anxiety Hygiene Temperature Body alignment Sensory deprivation Sensory overload Effects of illness and hospitalization 47  NEED: Comfort - Pain Any pain causes __________________ Fear of pain can be as bad or worse than the pain itself Unmet need for comfort due to pain related to right knee swelling 48  Let’s Try An Other Example Unmet need for COMFORT (need) due to BODY ALIGNMENT (organizer) related to FEAR OF MOVEMENT Unmet need for COMFORT (need) due to INABILITY TO PERFORM HYGIENE (organizer) related to FATIGUE Can you think of your own? Relate it to your clients from your week in clinical 49 50