Assessment 2 Shared Care Plan

Assessment 2 Shared Prudence Intent:

Risk Level: High

Definite updated by (RN) 3/3/2020

Original Author (RN). 3/3/2020

Medical Summary:

Liam’s has JIA (polyarticular) which was diagnosed senility 8. Liam homogeneitys increasing indisposition levels in the joints, especially R wrist, which was fractured in a cycling cloman 3 years gone. He besides homogeneitys increasing disquiet in his shoulders and flexures balance the definite 6 months. Erica homogeneitys that anterior to this extreme exacerbation Liams’ symptoms entertain been polite controlled with established medications elapsed his definite flare up span years gone.

Liam has totalergic Asthma diagnosed senilityd 10. His original triggers are clay and pollen. Liam had 4x attendances at the Westtown Regional Hospital A&E office definite summer. Three intelligent exacerbations were associated with abundant clay storms in the area (currently in parching) and once succeeding substance laagered to abundant amounts of clay suitableness aiding his farther inculpate deity onto a deal in the supply yards.

Exoteric delivery 3/3/20XX
On evidence R influence, R shoulder and L flexure entertain moderate turgescence and are ardent to the affect. Liams complains of 4/10 indisposition on change-of-place of these joints. Liam homogeneity having to interpretation his Asthma reliever medication at meanest once per week coercion the definite 2-3 months.

Liams’ dowager Erica has eliminateed concerns in homogeneity to his exoteric subjective foothold. She states that she believes Liam is graceful increasingly socially secondary and is not attributpotent attributpotent attributpotent participating as actively in the skill of his JIA or Asthma as he has in the elapsed. She states that his year advisor has besides been in affect as he is displaying lowly trial in arrange which is quenched of part as he is usually a cheerful student. Liam was partially loth to engsenility in discourse in-reference-to skill and tenor of either of his stipulations.

Patient Prudence Team:


Personal Support Team:

Mother- Erica Smith
Step father- John Smith

Father- Michael Taylor
Step dowager- Annie Taylor
Patient’s prudence goals (continuous and counteractive)


• “I am disgusted of sensibility incongruous – I lawful omission to be recognized enjoy completesingle else”.
• “I omission to be potent to delineate weekend joke anew. Total the other guys in my year look to delineate bigwig on the weekends I’m the uncommon single quenched”.


• “I am very disturbed abquenched Liams’ subjective vigor and omission to demonstrate a diplomacy to discourse this manifestation ASAP”
• “We omission to secure to the specialists to criticism his JIA an Asthma skill. We scarcity to secure to the ground of what has caused his Asthma and JIA to secure worse balance the definite 6 months”
• “We scarcity to end up with a meliorate intent coercion organizing and managing total of Liams’ appointments and the notification we assent-to from them – we look to lawful be reacting when man go evil-doing these days”

Patient’s self-skill tools:

• Consult paediatric rheumatologist and paediatrician ASAP.
• Eliminate a intent coercion stelderly increased enthusiasm and repay to team joke (hockey).
• Eliminate diplomacy coercion competing train-based tasks when JIA/Asthma flares.
• Attend counselling/psychotherapy
• Eliminate a diplomacy coercion substance recalcitrant at train, and settlement (x2) in-reference-to medications and trigger identification (with minimal supervision).
• Erica, Michael and Liams to eliminate intents coercion medication superabundance, 1-1 interval and medical response intents coercion twain households in the adventure of an intelligent exacerbation of Asthma or JIA.

Patients barriers to prudence goals


Team Goals: (continuous and counteractive)

• Devise a intent/coercion despatch betwixt total appropriate specialists (unobservant of colony) including the interpretation of an electronic vigor annals.
• Eliminate collaborative prudence diplomacy coercion Liams monthly occurrence conferences (including Liam and parents) complete 2 months coercion 6 months.
• Foster Liams’ recalcitrant skill of twain continuous stipulations (with minimal parental supervision).
• Monitor effectiveness of visible and subjective interventions closely balance the present 6 months with monthly clinic visits (prudence coordinator). Appropriate team members to collaborate and amend intents as indispensable.

Adapted from: Patient Centred original Prudence Institute (2020) The basic person-centred prudence intent – Providence Medical Group Southeast, Availpotent at:

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