NMC - Nursing Midwifery Council Person-Centred Care Planning Questions and Answers 1 — Questions and Answers
Question 1: A patient with newly diagnosed heart failure is overwhelmed by the amount of information given. To apply a person-centred approach to their care planning, what is the nurse's most appropriate initial action?
- Provide a comprehensive set of leaflets and schedule a follow-up appointment for one week later.
- Focus on the most critical medical instructions, such as medication adherence, to ensure immediate safety.
- Ask the patient, 'Of all the things we've discussed, what feels most important to you right now?' and start planning from there. (Correct answer)
- Develop a detailed daily care plan for the patient to follow strictly to avoid confusion.
Correct answer: Ask the patient, 'Of all the things we've discussed, what feels most important to you right now?' and start planning from there.
Person-centred care planning begins by identifying the individual's own priorities, values, and concerns. Asking what is most important to the patient respects their perspective and empowers them to engage in the planning process, making it a true partnership as required by the NMC Code. This approach allows the nurse to tailor subsequent information and planning to the patient's immediate needs, reducing their feeling of being overwhelmed.
Question 2: Which of the following statements best describes the nature of a person-centred care plan according to NMC principles?
- It is a static document created on admission to guide all clinical tasks.
- It is a 'living document' that is regularly reviewed and updated in partnership with the individual. (Correct answer)
- It is a medical record primarily focused on the diagnosis and treatment pathway.
- It is a formal agreement designed by the multidisciplinary team for the patient to consent to.
Correct answer: It is a 'living document' that is regularly reviewed and updated in partnership with the individual.
The NMC expects care plans to be dynamic and responsive to a person's changing needs, preferences, and goals. It is an ongoing process of collaboration, not a one-time event. Regular reviews with the patient are essential to ensure the plan remains relevant and effective, truly reflecting the 'person-centred' approach.
Question 3: A nurse is planning care for a patient who has been assessed as lacking the mental capacity to make decisions about their treatment. To adhere to person-centred principles and the Mental Capacity Act 2005, the nurse must:
- Follow the standard treatment protocol for the patient's condition without further consultation.
- Make a decision based solely on what the patient's family thinks is best.
- Act in the patient's 'best interests', considering their previously expressed wishes and involving those close to them. (Correct answer)
- Wait for the patient to regain capacity before creating any care plan.
Correct answer: Act in the patient's 'best interests', considering their previously expressed wishes and involving those close to them.
The Mental Capacity Act (2005) requires that any action taken for a person who lacks capacity must be in their 'best interests'. This is a key principle that involves a holistic assessment, including considering the person's past and present wishes, consulting with family and carers, and weighing all relevant circumstances. This ensures the person remains at the centre of the decision-making process, even when they cannot consent themselves.
Question 4: A nurse is caring for an older adult who repeatedly states, 'I just want to be able to tend to my garden again.' In the context of person-centred care planning, how should the nurse primarily interpret this statement?
- As a personal hobby that is secondary to their clinical needs.
- As an unrealistic goal that should be gently discouraged.
- As a key personal goal that should inform the objectives of the care plan, such as improving mobility and managing fatigue. (Correct answer)
- As a sign that the patient needs a referral to a social prescribing service.
Correct answer: As a key personal goal that should inform the objectives of the care plan, such as improving mobility and managing fatigue.
Person-centred care planning is about understanding what is truly important to the individual beyond their clinical diagnosis. This statement represents a meaningful personal goal. The nurse should use this as a central point around which to plan care, setting clinical objectives (e.g., physiotherapy for mobility, energy conservation techniques) that directly contribute to achieving what matters most to the patient.
Question 5: To facilitate effective person-centred care planning with a patient who is deaf and communicates using British Sign Language (BSL), what is the most appropriate action for a nurse to take?
- Use written notes to communicate complex information.
- Ask a family member who can sign to interpret the discussion.
- Arrange for a qualified and impartial BSL interpreter to be present. (Correct answer)
- Speak slowly and clearly so the patient can lip-read.
Correct answer: Arrange for a qualified and impartial BSL interpreter to be present.
The NMC Code requires nurses to communicate clearly and ensure people receive information in a way they can understand. For a BSL user, written notes may not be appropriate as BSL has a different grammatical structure to English. Using family can compromise confidentiality and accuracy. The gold standard is to use a professional, impartial interpreter to ensure accurate and effective communication, enabling the patient to fully participate in their care planning.
Question 6: Which of the following is a core principle of 'shared decision-making' within person-centred care, as promoted by the NMC?
- The nurse presents the single best treatment option and persuades the patient to agree.
- The nurse and patient work together, sharing information and expertise to jointly agree on a plan of care. (Correct answer)
- The patient makes the final decision, and the nurse's role is solely to implement it.
- The multidisciplinary team decides on the best course of action and then informs the patient.
Correct answer: The nurse and patient work together, sharing information and expertise to jointly agree on a plan of care.
Shared decision-making is a collaborative process and a cornerstone of person-centred care. It involves the healthcare professional providing evidence-based information about options, benefits, and risks, and the patient sharing their personal values, preferences, and goals. Together, they work as partners to make a decision, which is a key requirement of the NMC Code's theme to 'Prioritise people'.
NMC - Nursing Midwifery Council Person-Centred Care Planning Questions and Answers 1
A patient with newly diagnosed heart failure is overwhelmed by the amount of information given.
To apply a person-centred approach to their care planning, what is the nurse's most appropriate initial action?