Introduction
This essay aims to explore how a nursing associate can utilise the Roper-Logan-Tierney (RLT) nursing model to deliver patient-centred care, focusing on maintaining a safe environment in a hospital setting for Florence, a patient who has sustained a right fractured neck of femur following a fall at home. Patient safety is a cornerstone of nursing practice, particularly for vulnerable individuals such as older adults with mobility impairments and acute injuries. By applying the RLT model, which emphasises a holistic approach to care based on activities of living (ALs), this essay will discuss how nursing associates can address Florence’s needs while ensuring her safety. The discussion will cover the relevance of the RLT model, specific ALs such as maintaining a safe environment and mobility, and the integration of patient-centred principles to promote recovery and well-being. Key arguments will be supported by evidence from academic and authoritative sources to provide a comprehensive understanding of the topic within the context of contemporary nursing practice in the UK.
The Roper-Logan-Tierney Model and Patient-Centred Care
The Roper-Logan-Tierney model, developed in the 1980s, provides a framework for nursing care that focuses on 12 activities of living (ALs), ranging from breathing to working and playing (Roper et al., 2000). Unlike other nursing models, the RLT framework is uniquely grounded in the concept of maximising independence by assessing a patient’s ability to perform ALs and identifying areas where support is required. For Florence, a patient with a fractured neck of femur, this model offers a structured approach to tailoring care that prioritises her individual needs while addressing safety concerns. Patient-centred care, as defined by the NHS, involves treating patients with dignity, respect, and compassion while involving them in decisions about their treatment (NHS England, 2019). Combining the RLT model with patient-centred principles enables nursing associates to create a care plan that not only addresses physical recovery but also respects Florence’s autonomy and personal preferences.
The model’s holistic focus is particularly relevant for older patients with complex needs, as it considers both physical and psychosocial factors. For instance, Florence’s fall may have impacted her confidence as well as her mobility, necessitating emotional support alongside physical rehabilitation. A nursing associate can use the RLT model to assess Florence across all ALs, ensuring that care is comprehensive and tailored. This approach aligns with the Nursing and Midwifery Council (NMC) standards, which emphasise the importance of safe, effective, and compassionate care (NMC, 2018).
Maintaining a Safe Environment Using the RLT Model
One of the key activities of living in the RLT model is “maintaining a safe environment,” which is critical for Florence given her recent fall and subsequent injury. Falls are a significant concern in hospital settings, with the National Institute for Health and Care Excellence (NICE) reporting that falls are the most common patient safety incident in UK hospitals, particularly among older adults (NICE, 2013). For Florence, the risk of further falls is heightened due to pain, limited mobility, and potential disorientation in an unfamiliar environment. A nursing associate must therefore conduct a thorough risk assessment to identify hazards and implement preventive measures.
Specific interventions might include ensuring that Florence’s bed is at an appropriate height, providing non-slip footwear, and keeping essential items within reach to avoid unnecessary movement. Furthermore, the use of assistive devices such as bed rails (where clinically appropriate) and call bells can enhance safety while promoting a sense of security. The nursing associate should also collaborate with the multidisciplinary team, including physiotherapists and occupational therapists, to develop a mobility plan that minimises risk while supporting recovery. Importantly, these interventions must be explained to Florence in a clear, reassuring manner to ensure she feels involved in her care, thereby upholding the principles of patient-centred practice (Kitson et al., 2013).
Addressing Mobility and Independence
Another relevant AL in the RLT model is “mobilising,” which is directly impacted by Florence’s fractured neck of femur. This injury often requires surgical intervention, such as a hip replacement or internal fixation, followed by a prolonged recovery period involving pain management and rehabilitation (Royal College of Physicians, 2016). A nursing associate plays a vital role in supporting Florence’s mobility while preventing complications such as pressure ulcers or deep vein thrombosis, which are common risks associated with immobility (NHS England, 2019).
Patient-centred care in this context involves working with Florence to set realistic goals for mobility, taking into account her pain levels, physical capabilities, and any pre-existing conditions. For instance, encouraging small, supported movements early in recovery can prevent muscle atrophy while reducing the risk of falls. The nursing associate must also ensure that Florence understands the importance of adhering to weight-bearing restrictions and using mobility aids as prescribed. By involving Florence in these decisions and providing regular encouragement, the nursing associate fosters a sense of control and autonomy, which is essential for psychological well-being (Holland et al., 2008).
Holistic Care and Communication
Beyond physical safety and mobility, the RLT model encourages nursing associates to consider other ALs, such as “communicating” and “expressing emotions,” to provide holistic care. Florence may experience anxiety or frustration following her fall, particularly if it represents a loss of independence. Effective communication is therefore essential to build trust and ensure that her concerns are addressed. A nursing associate should use active listening and empathetic responses to understand Florence’s feelings, offering reassurance and involving her family or caregivers where appropriate (NMC, 2018).
Moreover, cultural or personal factors may influence Florence’s perception of care, and these must be respected to deliver truly patient-centred support. For example, if Florence has specific preferences regarding privacy or assistance with personal care, these should be accommodated wherever possible. This approach not only enhances her dignity but also contributes to a safer emotional environment, reducing stress that could otherwise impact her recovery (Kitson et al., 2013).
Conclusion
In conclusion, the Roper-Logan-Tierney model provides a robust framework for nursing associates to deliver patient-centred care to Florence, a patient with a right fractured neck of femur following a fall at home. By focusing on key activities of living such as maintaining a safe environment and mobilising, nursing associates can address both the physical risks and emotional needs associated with Florence’s condition. Interventions such as fall prevention strategies, tailored mobility plans, and empathetic communication ensure that care is holistic and aligned with patient-centred principles. The integration of the RLT model with evidence-based practices, as supported by sources like NICE and the NMC, underscores its relevance in modern nursing. Ultimately, this approach not only promotes Florence’s safety and recovery in the hospital but also sets a foundation for her long-term independence and well-being. The implications for practice are clear: nursing associates must continue to adopt structured, individualised care models to meet the complex needs of vulnerable patients, ensuring safety remains a priority in all aspects of care delivery.
References
- Holland, K., Jenkins, J., Solomon, J. and Whittam, S. (2008) Applying the Roper-Logan-Tierney Model in Practice. 2nd ed. Churchill Livingstone.
- Kitson, A., Marshall, A., Bassett, K. and Zeitz, K. (2013) What are the core elements of patient-centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. Journal of Advanced Nursing, 69(1), pp. 4-15.
- National Institute for Health and Care Excellence (NICE) (2013) Falls in older people: assessing risk and prevention. NICE.
- NHS England (2019) Patient Safety Strategy. NHS England.
- Nursing and Midwifery Council (NMC) (2018) The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. NMC.
- Roper, N., Logan, W.W. and Tierney, A.J. (2000) The Roper-Logan-Tierney Model of Nursing: Based on Activities of Living. Churchill Livingstone.
- Royal College of Physicians (2016) National Hip Fracture Database Annual Report. Royal College of Physicians.
