Question:Discuss Roper Logan and Tierney model of reflection. What activities make the r-l-t model of nursing? Which factors affect the activities?

Introduction
Roper Logan and Tierney model of reflection(r-l-t) goes by the name of its developer, Nancy Roper, Logan and Tierney. The r-l-t model of nursing was built in 1980, considering the work of Nancy Roper in 1976.The model is developed on 12 activities of living to make a living. The Roper Logan and Tierney model of reflection is used as an assessment tool during patient care. As a nurse practitioner, the model must be applied to evaluate the patient’s relative independence compared to future independence in daily activities required for a living. The patient’s independence is considered a continuous process that begins from absolute dependence to absolute independence. It assists in deciding which interventions will accelerate increased independence and which in-progress support is required to cancel out continuing dependency.

12 activities of daily living mentioned in the Roper Logan and Tierney model of reflection
As per the Roper Logan and Tierney model of reflection, there are 12 activities to be performed for daily living.The 12 daily living activities must be considered a cognitive approach while assessing a patient. It must not be as a checklist on paper; instead, it must reflect the approach of the nurse practitioner while assessing the patient.The activities will help the nurse practitioner to have a deeper understanding of the organization of care, the model and its implementation. The assessment of the sufferer must be done during their ingress, and their dependence and independence must be viewed when making care plan and during evaluation. By going through the difference in the continuous dependence and independence process, the nurse can judge the improvement within the patient and accordingly make alterations to the care provided based on the findings.

The 12 activities forming the daily activities in a patient’s life as per the Roper Logan and Tierney model of reflection are:

1. Eating and drinking
2. Mobilizing
3. Maintaining a safe environment
4. Dying
5. Communicating
6. Expressing sexuality
7. Breathing
8. Eliminating
9. Sleeping
10. Personal cleansing and dressing
11. Working and playing
12. Controlling body temperature

Elements affecting activities of living

Along with the above 12 activities, Roper Logan and Tierney model of reflection also consider five elements that help provide a holistic view of the model.As per the proponents of this model, failure to observe these elements may make the result of the assessment full of flaws and incomplete. Hence, it is suggested that nurses use these elements while using the model to assess the patient. In addition, the elements will help enhance the understanding of the r-l-t model of nursing.</

The below-mentioned are the elements that influence an individual and have an impact on their dependence and independence level. Biological factor:The factor manages the consequence of the total health of present injury and illness and the dimension of the patient’s anatomy and physiology.

Physiological factor: The factor considers the consequence of emotion, spiritual beliefs, ability to understand and cognition. As per Roper Logan and Tierney model of reflection, it is all about knowing, hoping, believing, thinking and feeling.

Socio-cultural factor: The factor considers the consequence of the community and culture on the patient experience.The factors include expectations and values determined by status, culture and class. The socio-cultural factors may also relate to expectations, beliefs, and values possessed by the patient for themselves and others being affected by the dependence and independence of the patient or by the people associated with the patient’s daily activities.

Environmental factor:Roper Logan and Tierney model of reflection suggests considering the influence of the environment on the 12 daily activities mentioned previously.It also recommends considering the impact individuals make on the environment.

Politico-economic factor: The factor considers the influence of the government, politics and economy on all. Concerns related to availability and access to benefits, government policies and programs, availability of funding (public and private),funding, state of war, conflicts, political reforms, government targets, and interest rate are all related to the present factor.

Pros and cons of the Roper Logan and Tierney model of reflection
It is vital to apply the Roper Logan and Tierney model of reflection in a hospital or any medical department. The benefit of applying the model is that it helps to maintain stability in the caring style received by patients. It helps to bring consistency in the care patterns and treatments.The model can also lessen the conflicts among the team members in a medical setting.The definition and rationale behind the Roper Logan and Tierney model of reflection help healthcare professionals to better understand the logic of care.Comparing the model with another model of reflection, it is self-explanatory and uncomplicated. The model is flexible, concentrates on the individual and has an easy application.

Though the model has wide application, nurses have faced too many difficulties while using the model. Many of these difficulties arise from a lack of knowledge of the application of the model. Prioritizing the activities of living differently is another weakness of the model. Nurses are not always sure about the difference in the relevance of the 12 activities when comparing their habits with the patient.Another disadvantage is the lack of a universal measure of the extent of the 12 activities and their link to the patient’s health.

Evaluating Roper Logan and Tierney model of reflection
The r-l-t model of nursing is extensively applied in nursing practice across the UK and Ireland. The model assesses the patient’s potential to carry out the 12 activities concerning their life, dependence, and independence level. Roper Logan and Tierney model of reflection helps to evaluate the care provided to the patients.There is a mutual agreement between the nurse, patient and family before adopting the care plan.So, the goal of a care plan must be clear and precise.Roper Logan and Tierney model of reflection helps to assess the goals of the care plan and decide whether the goals have been achieved or require certain changes.The r-l-t model of nursing gives a systematic and logical channel for delivering care, motivating the team to provide the best primary care and continue with it.

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