Review and assess the management of health and safety.
According to Health and Safety Executive (2008), Health and Safety is the protection of workers from harm or ill health by appropriate precaution and provision of satisfactory work environment.To implement the accountable, adaptable and aggressive standards towards the organization`s goal and to motivate employees to work towards achieving this goal , our organization used the strategy of adding value and sense in ways of communicating information towards the employees.
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In our multidisciplinary team are people having some disabilities and come from different culture and background. To keep a good two-ways communication between staff and visitors (families, friends, relatives, inspectors),before searching for answers or documents in the office, the information are provided using video and audio-posters, sign& symbols, picture, boards. This is intended to increase the understanding and performance of employee full potential in benefits of the organization regarding new changes occurred in place.
A simple way of using quotes to proper body hygiene and stop spreading infection, by showing how to wash your hands as an understanding way in which our health or hygiene might put a risk the persons we support or other people at work. Pictures on the meniu board, showing what next meal will be as a easier way to choose one of them for people having hearing, speaking disability. Safe handling of infected or soiled linen and clinical waste by using a labeling colored code or shape of bags, bins, box. Some time the lack of time, lack of enthusiasm or lack of confidence to take responsibility due lack of motivation in learning process of changes can create conflicts between team members. To eliminate this barriers, ensuring compliance with the law, employer make sure that signs are posted that inform of dangers, temporary diversions, hazardous operations or anything that might affect general safety. A mandatory thing in regard to health and safety is to ensure the legalisation in force are followed and completed such as fire exits labelled health and safety policy clearly shown to all employees in the workplace.
Everyone in their workplace had to provide protection, using protective equipment provided pursuant to requirement under the Health and Safety Act, for securing his health and safety while working and co-operate with line manager or colleagues to comply with the provisions of care. To eliminate or minimize the risks can occur in workplace, employer must suited to their particular situation –workplace- in order to achieve desired safety outcomes and preventing accidents for poor safety and health management.
Allocation of responsibilities for health and safety done at every level within the organisations. Communicate effectively providing information about hazards, risks and outlining preventative measures,ensuring competencies means that an employer should have access to knowledge regarding health and safety regulations, skills and experience.
Health and safety is everyone responsibility, wild dispensed throughout the hierarchy some roles take more responsibilities than others. Specific responsibilities will be given to specific persons at specific level, all individuals have to control their responsible areas. Health and Safety responsible employee have to check and control all the safety equipments and make sure that all the standards meant for Health and Safety controlled and maintained by employees and all the employees working according to tasks assigns.
Periodical reviews and audits should be implemented from within an organisations Health and Safety department and externally from the HSE. Ensuring all employees keeps up to date in training and health and safety, use of safety audits, hazard checks, seminar and training. This will help to maintain and improve the ability to manage risks by learning from experience.
Health and safety priorities in health and social care setting
In our Rehab Home the management has the responsibility of protecting everybody in the work setting against health and safety issues that may occur during their duties, visit or living setting .Specially for employees start from training and basic regulation such as cleaning to avoid infection spreading, food poisoning or contamination ; making sure that the equipments are working and are kept in designated area; trained to used fire extinguishers in case of fire and to use of first aid kit things that are critical helpers in case of accident and hazards what can occurs.
Any new employee or new patient in our Rehab Home, changes in equipment used or changes in technology with direct implication on health and safety indicate the need for training and appraisal .The training will help staff to carry out their duties efficiently by acquiring skills and knowledge required by the workplace and affect in positive way the life of patients in our setting. An important fact of health and safety at work is managing time and this is affecting our workers too. When working overtime occurs because of shortages staff, sicknesses or annual leave, the errors are increased by omitting some important tasks .A poor management in work planning and correct prioritization lead to disorganization and chaos which lead to stress and ineffectiveness for everyone in workplace patients and multidisciplinary team.
HSE said that stress is it not a disease but can lead to one when is going for a long period of time or if is excessive. To reduce the stress and increased the work related performance in Rehab Home our team manager done a risk assessment which identified the problems which have led to stress : lack of information and communication, working alone, using inadequate equipment or not using personal protective equipment , confusion about each member of staff role , team working. Some of those barriers were eliminated by involving staff in mandatory training, supervision, and additional mentoring. Were made a one to one supervision to identify the reason which involves sick leave and find modalities to reduce the shortness of staff and overtime work.
In the last century health practices were considered a hazardous environment. Because of not application of basic principles of hygiene and infection, many factors appear to have lead to this situation, patients coming from wild areas, sore pressures by staying longer immobile in beds, infections transmitted by pets were other influencing factors. Using sterilizing equipment to reduce cross infection and meet best practice standards, making strong control of following infection control policies decreased over the time spreading of infection in health care setting.
An example of infection control is Methicillin-resistant-Staphylococcus Aureus known as MRSA, an antibiotic resistant organism which occurred lately in our Rehab Home too. Patients having regular checking in hospitals, visitors, inadequate use of drugs, misuses of PPE are the main causes which enable Rehab Home to keep this infection under control. Been known since 1960s, MRSA has an epidemic began in Kettering Hospital in 1990. NINSS report for 1997-1999 done after checking 96 English hospitals.
The Safety, Health and Welfare at Work (Biological Agents) Regulations from 2013(S.I. No.572 of 2013) sets minimum requirements for protection of workers from health risks associated with biological agents in the workplace. A list of biological agents, classification and containment measures and levels are provided in relevant Code of Practice.
The Health and Safety requirements impact on patients
Care plans are a form of patient-friendly ‘roadmap’ that records the relevant information about patients, and should enable all professionals to develop a knowledge of patient social, psychological and physical wellbeing of individual and those are the main reasons why communicating correct information on individual health and safety in accordance with the law enables professionals to deliver care and planned throughout information provided by organization.
Care planning is a process which never completed until the individual in care is discharged from the setting or die. In this order the care plan needs to be re-evaluated, to have continuity and daily update made, as patient status changes. Care planning is the most important aspect of holistic care even though it is highly underestimated and often neglected. More often a nursing assessment is based on the medical side of the patient rather than the holistic approach.
Risk is the chance or probability that a person will be harmed or will experience health effect if exposed to a hazard, property or equipment loss. The Health and Safety Executive is responsible for ensuring by putting in place health and safety strategies of work. The Management of Health and Safety at Work Regulations 1999 (the Management Regulations) has the main requirement on employers to carry out a risk assessment.
Risk Assessment is part of Risk Management and is part of organizations insurance that will not expose people to unnecessary risk, offer and keeping up to date staff training and up keeping of their skills. Management of health and Safety at work regulations 1999 makes sure that employers carry out risk assessments and appoint a competent person to assist the employer in Health and Safety, and to establish procedures and provide training and information to employees. Workplace (Health, Safety and Welfare) Regulations 1992 ensure that employer provide adequate and appropriate welfare facilities for employees while they are at work.
In making a risk assessment we take in consideration factors that influence the level of risk such as: the level of exposure to a hazardous thing or condition; how is it exposed and the degree of effects in condition of exposure. A risk assessment process has to: Identify the hazards; Decide who might be harmed and how; Evaluate the risks and decide on precaution; Record your findings and implement them; Review your assessment and update if necessary.  Needs assessments as part of risk assessment, used to determine what is missing between the fact situation and what is want or what ‘ought’ to be. For example, in our Rehab Home we have to do assessment of long-term medical and psychosocial care needs and services for a patient who refused regularly to take his medication and must be made to determine if there are adequate services provided. That will determine us on expanding/ trained/enhancing/ installing the lacking professional services. Our mental health setting support individuals who have complex needs because of the co-existence of disability, physical illness or social problems and their main problem is refusing medication.
Certain needs are postulated to be ‘universal’ in humans generally (Maslow, 1954), each area or group of the individual will have more specific types of need. As an example, elderly people with dementia may have specific and unique needs related to their disabilities but their range of general needs is the same as everyone else’s (Murphy, 1992).There is an issue of mental health needs and the assessment has many opinion and has been wild researched in the UK, special after introduction of legislation (National Health Service and Community Care Act 1990) which tend to generate more coordinated and comprehensive service provision by social services and the National Health Service. Basically the monitoring involves review of practices, auditing of risks and threats, updating the procedures and policies, and learning from experience. An organization can only be effective if it takes note of past threats and develops strategies that can minimize recurrence.
In the health and social care settings, difficulties may arise when trying to implement ant-discriminatory practices. These problems may interfere with staff or with patients making them think they might be being discriminated against, put the service users in situation to feel unworthy and lower their confidence and self esteem. As a professional when this happening, it is our duty to challenge our colleague. It is important that when implementing anti-discriminatory practise because there are different factors that could affect different people. Is it vital the care that patients receive, and should be met at a higher standard and not given by judging service users background, upbringing, race, culture, religion and even sex. If some of the staff member is it make responsible for the care may treat patients differently or having a problem with the person’s views the management has to take act of it and offer extra training and counselling to staff involved. Compliance in healthcare, used to assure that the service is handled in the most ethical fashion in accordance with legal requirements. In our health care setting every individuals has their own rights to be treated fairly. The rights are based upon on the principles of care value base, such as: promoting anti-discriminatory practice, maintaining confidentiality, promoting and supporting individuals rights to dignity, needs (which is included physical, emotional, environmental, social, cultural, mental health, spiritual etc) choices, preferences, independence and safety, equality, diversity and human rights, acknowledging an individual’s personal beliefs and identity, protecting individuals from abuse, promoting effective communication and relationships and providing individualized patient care.
The main concern of the principles is to ensure that service users and careers are treated with respect and to protect the safety of service users. Service users by law are allowed to access their records – Data Protection Act 1998 & Freedom of Information Act 2000, therefore clients should be allowed to read information and contribute to the development, review of their care plans. Service users need to know who you need to share their information with and why. Their consent is important or else the confidentiality policy will be breached, but in cases where if information is withheld it could put the individual at risk then information needs to be passed on.
The law made our nursing homes to be part of the only sector of the entire health care industry to have an explicit statutory requirement for providing what is now called “person-centred care”. Patient centred care is the right care, the highest quality care and the most cost effective care for that one patient.
References :
Coles, C. (1996) Approaching Professional Development; Journal of Continuing Education in the Health Professions. 16; 152-158.
Curtis, K. (1999) The Physical Therapist’s Guide to Health Care. New Jersey; SLACK Inc.
Maslow, A. H. (1954) Motivation and Personality. New York: Harper & Row.
Springer, K., & Murphy, G. L. (1992). Feature availability in conceptual combination. Psychological Science, 3, 111-117.
Shortell, S. & Singer, S. (2008) Improving Patient Safety by Taking Systems Seriously; The Journal of the American Medical Association. 299(4); 445-447.
Links:
http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4060875.pdf, accesed 30.03.2014
http://www.nice.org.uk/niceMedia/documents/wphealth_goodpractice.pdf , accesed 24.03.2014
http://www.hse.gov.uk/pubns/priced/hsg220.pdf, accesed 24.03.2014
http://www.compactlaw.co.uk/free_legal_articles/health_and_safety.html, accessed 15.04.2014
http://www.hse.gov.uk/statistics, accessed 15.04.2014
http://www.hse.gov.uk/, accessed 22.04.2014
http://www.direct.gov.uk/en/Employment/HealthAndSafetyAtWork/index.htm, accessed 22.04.2014
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