Ccm Model In Nursing

Q1. “The nation is recognizing the emerging high prevalence of multiple chronic conditions and the related implications for prevention, treatment and challenges for the nursing profession”.

With reference to the above statement and the relevant literature, discuss your understanding of chronic illness and its impact on the role of the nurse.

Chronic illnesses are defined as long term conditions, which do not resolve spontaneously, that can be treated but not cured (Dowrick et al., 2005; HSE, 2008a). They are the leading cause of morbidity and mortality worldwide, with an estimated 38 million deaths (62 % of all deaths) in 2009. This will rise due to an increased population (9 billion by 2040) and increased longevity (World Health Organisation,

It was developed by Wagner and his colleagues as a framework for guiding specific quality improvement strategies (Bowen et al., 2010; Fiandt, 2006). The goal of CCM is for productive encounters between patients and their healthcare professionals leading to care which is safe, effective, timely and patient focus, efficient and equitable (Institute of Medicine,2001; Wagner et al., 2001). The CCM consists of six core concepts (Appendix 1). Components related to the clinical practice level are: delivery system design, decision support, clinical information systems, self-management supports, and healthcare organization, leadership and community resources are related to the large health system. Chronic disease management can be centred on individual aspects or on the model as a whole, however, it is important to keep all components in mind (Bowen et al., 2010; Fiandt,

It enables understanding of how pain is affecting the person. It supports a change in conversation for some patients, from a “seek, fix and cure” approach to a “cope, control and manage” approach. The Cognitive Behavioural Model of Pain (Appedix 2) and the Cognitive Behavioural Model of Pain Related Fear (Appendix 3) demonstrate how certain psychological factors also affect chronic pain. Fear related to chronic pain furthers pain related disability (Zale et al., 2014). Clinical intuition alone does not always match the right treatment to the right patient. Stratified care approaches seek to improve this by adopting a more systemic management style. The ‘STarT Back’ approach is an example of this. It uses a simple tool to match patients to the most suitable treatment. This has been shown to considerably reduce disability from back pain, decrease time off work, and financial savings by effective utilisation of resources (Hill et al., 2011). The IMPaCT study demonstrates how this concept can be introduced into primary care, where patients may first present to a healthcare provider (Foster et al., 2014). These tools are beneficial to healthcare staff in meeting the challenges posed by chronic