Roper Logan Tierney Model: Nursing Care Plan Walkthrough

The roper logan nursing model is the assessment framework most UK nursing programmes reach for first, and for good reason: it turns a whole person into twelve manageable, comparable activities of living. Yet it is also the model where students lose the most marks, because a care plan that lists the twelve activities and defines each one reads like a glossary, not a piece of clinical reasoning. This guide walks the framework through one continuous scenario so you can see assessment, planning, implementation and evaluation link up as a single argument. Get that flow right and it stops feeling like a checklist and starts doing what your marker actually rewards.

We are a tutoring service, so everything below is here to help you understand and structure your own care plan. You write and submit your work; we guide the thinking. Along the way we will map the twelve activities to a patient with both physical and psychological needs, touch on where the dependence continuum meets a mental health continuum, and set out the principles of care and the social model of health that examiners expect you to weave in.

The twelve activities of living at a glance

Roper, Logan and Tierney built their model around twelve activities of living (ALs). Each activity is assessed along a dependence to independence continuum, and each is shaped by five influencing factors: biological, psychological, sociocultural, environmental and politicoeconomic. The diagram below shows the twelve activities grouped around the person so you can see them as one integrated assessment rather than twelve separate tasks.

One patient, one continuous care plan

Meet our worked scenario. Mr David Okafor, 68, is admitted with an acute exacerbation of chronic obstructive pulmonary disease (COPD). He was recently bereaved, lives alone in a first-floor flat, and appears withdrawn with low mood on admission. We will hold this one person in view across the whole assess to evaluate cycle, because that continuity is exactly what a strong care plan demonstrates.

Stage 1: Assessment across the activities

Assessment means placing each of the twelve activities on the continuum for this patient today, and noting the influencing factors behind it. You do not write a paragraph on all twelve at equal length. You assess all twelve, then prioritise the activities that carry actual or potential problems.

Activity of living	Assessment for Mr Okafor	Position on continuum
Breathing	Breathless at rest, SpO2 88% on air, using accessory muscles	Highly dependent
Communicating	Withdrawn, short answers, low mood since bereavement	Partially dependent
Mobilising	Breathlessness limits walking; fatigue after a few steps	Partially dependent
Eating and drinking	Reduced appetite, meals skipped at home	Partially dependent
Sleeping	Wakes breathless; ruminating at night	Partially dependent
Working and playing	Socially isolated, stopped attending his club	Dependent on support

Notice that Communicating and Working and playing are where the psychological picture surfaces. Here the dependence to independence continuum runs alongside a mental health continuum: Mr Okafor is not acutely unwell psychiatrically, but his mood sits toward the distressed end and directly reduces his engagement with breathing exercises and mobilising. Naming that link, rather than treating physical and mental needs as separate lists, is a strong-mark move. The social model of health earns its place here too: his isolation, housing and bereavement are shaping his health as much as his lungs are, and the assessment should say so.

Stage 2: Planning and patient-centred goals

For each prioritised problem, set a SMART goal written in the patient's terms and grounded in the principles of care: dignity, autonomy, safety and individualised support. Goals move the patient along the continuum toward independence, however small the step.

Stage 3: Implementation

Implementation is the nursing action for each goal, with a rationale and the evidence behind it. Keep linking back to the activity and the influencing factor you identified.

• Breathing: administer prescribed oxygen and monitor SpO2; teach pursed-lip and controlled breathing; position upright to ease work of breathing.
• Communicating and mood: use unhurried, open questions; screen mood appropriately and refer to the multidisciplinary team; involve him in every decision to protect autonomy.
• Working and playing: discuss a supported discharge, community respiratory support and social prescribing to address the isolation the social model flagged.

Stage 4: Evaluation

Evaluation closes the loop: did the patient move along the continuum toward the goal, and what happens next? This is where weaker assignments simply stop. Strong ones re-assess against each goal, state whether it was met, partly met or unmet, and feed that judgement back into a revised plan. The cycle is iterative, not a single pass.

How to write it up for your assignment

Once the thinking is done, the write-up follows a predictable shape. A tidy structure lets the marker follow your clinical reasoning without hunting for it, and our guide on how to structure a university assignment properly covers the general principles behind the shape below.

1. Introduction: name the model, the patient scenario and the confidentiality point (a pseudonym per the NMC Code). Two or three sentences, no more.
2. Brief rationale for the model: one short paragraph on why this framework suits this patient. Resist the urge to define all twelve activities here.
3. Assessment: the twelve activities covered, prioritised problems drawn out, influencing factors named.
4. Planning, implementation, evaluation: problem, goal, action with rationale, evaluation, for each priority, in that order.
5. Critical reflection: a short paragraph on the model's strengths and limits for this case, referencing the social model of health and the principles of care.

If you want to compare how this care-planning structure sits next to reflective writing, our guide to writing a reflective assignment shows the other half of most nursing modules. For the mechanics of building a case around one patient, our guide on how to write a case study pairs neatly with this walkthrough.

Where students lose marks

• All twelve activities at equal weight. Assess all twelve, but write in depth only on the activities with actual or potential problems. Depth beats coverage.
• Goals that are not measurable. "Improve breathing" cannot be evaluated. Tie every goal to a number, a technique or a timeframe.
• No evaluation. Stopping at implementation loses the final and often heaviest section. Always re-assess against the goal.
• Ignoring the influencing factors. The five factors and the lifespan dimension are what make the model holistic. Leaving them out flattens the whole assessment.
• Physical and psychological needs kept apart. Show where the dependence continuum meets the mental health continuum, as we did with mood and engagement.
• Weak referencing. UK nursing usually expects Harvard or Vancouver, and our rundown of common referencing mistakes students make covers the errors that cost marks most often. Keep it consistent and current.

For broader support across your programme, see our nursing assignment help and our wider academic tutoring services, where subject-specialist tutors guide you through care planning, reflection and referencing in your own voice.

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