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These models provide a deeper context for applying the principles of the APIE, taking into account the necessity to generate patient-centred care planning and goals that are achievable and measurable with respect to the status of the patient (Flagg, 2015).Similarly, planning should take into consideration the ability of the patient to self-care, a crucial aspect of everyday function and wellbeing (Orem, 1985).
Therefore, to ensure adherence to practice standards and professional codes of conduct, the implementing process in the APIE scheme should balance the need for nurse-led therapies and strategies to promote individual wellbeing and empowerment in self-care.
Furthermore, the APIE problem-solving approach emphasizes the need for suitable implementation of a plan, but wider roles of nurse and the patient need to be considered to deliver personalised care.
Nurses may involve other members of the care team in decision-making at this point in order to maximise the potential benefits to the patient.
Furthermore, a combination of personal experience and evidence-based guidance can be used to inform the optimal planning approach, suggesting that nurses need to apply critical thinking and a combination of intuition and guidelines in formulating appropriate care goals (Blais et al., 2006).
Accordingly, nurses have a duty to support and promote patients in self-care activities and should facilitate these activities wherever possible as part of the care planning process.
Care plans should include highly structured and clear stages and steps that may be taken to achieving a specific goal, which may be followed by patients, nurses and other care professionals, as needed (Blais et al., 2006).However, the APIE approach focuses more precisely on the role of nurse-led interventions and overlooks the importance of supportive nursing roles during the implementation process.In addition to nurse-led interventions, patients should be supported and educated to promote self-care (Wilkinson and Whitehead, 2009).These goals should be patient-centred, recordable, observable, directive, understandable, credible and time-related regarding available resources (Hayes and Llewellyn, 2010).However, planning within the problem-solving APIE approach may be limited without consideration of additional models of nursing, including the activities of living model by Roper, Logan and Tierney (1985) and the self-care model of nursing by Orem (1985).Underlying any care decision is the need to identify the source of the problem and then to develop a suitable approach to addressing this problem.To assist in decision-making, it is recommended that nurses adopt frameworks or models of problem-solving and care planning (Johansen and O’Brien, 2016).Therefore, the initial stage of the APIE can be considered a valid approach to gathering data to inform care planning of the individual patient.Only once a systematic and comprehensive assessment phase is complete is it possible to engage in effective care planning.This includes the core components of respect and dignity of the patient, which should be preserved at all times, as well as the delivery of culturally-sensitive care (NMC, 2018).Indeed, nurses who are compassionate and considerate of other cultures and patient beliefs are more likely to develop strong therapeutic relationships, which have been shown to promote adherence to treatment plans and improve outcomes (Hagerty and Patusky, 2003).