Question:
Discuss about the Kyneton District Health Services.
Community health services are essential in local regions to encourage and support residents to remain healthy and prevent transmission of disease in the community. It plays a key role in meeting health care needs of uninsured people and the community health workers play an active role in meeting the unique needs of the communities. They are involved in creating connections between health care system and people at risk of disease, managing care for vulnerable group, determining health insurance plan and collaborating with health care providers to understand community health needs (Payne et al., 2017). This essay provides a detailed discussion on the function of Kyneton District Health service and the type of service provided by the service along with typical patient population covered by the service. It also compares the role and responsibilities of the nurse in the practice setting and the type of support available for LGBTI person in the community health setting.
Kyneton District Health (KDH) Service is part of the Macedon Range community and it provides local health service to around 42, 000 people living in Shire and surrounding area. The core vision of KDH is to provide positive experience during care to all patients and keep track of their performance on a regular basis (Kyneton District Health Service :: Home, 2017). KDH also work in partnership with the Cobaw Community health service where staffs provide variety of community health service to residents living across Macedon Shire (Cobaw Community Health Service, 2017). A wide array of service is provided by KDH such as acute services, allied health service, care in home, maternity care, surgical service and urgent care centre. In the area of acute services, KDH supports local hospitals to provide variety of specialty services. The pharmacy department, the North West Dialysis service, radiology and pathology service are also part of the acute care service at KDH. The Macedon Range Community nursing team also delivers other care programs such as district nursing, pose-acute care, transition care program, hospital in the home, palliative respite care and life limiting illness care. The community nursing team plays a great role in chronic disease management, medication management, pain management, wound care and developing care plans (Kyneton District Health Service :: Acute Services, 2017).
KDH is mainly serving the residents living at the Macedon Ranges Shire Council. The council is located in central Victoria and has a population of about 47, 512 people according to 2016. The review of the population profile at Kyneton district has revealed that there are low proportion of pre-schoolers in the district and high percentage of people at post retirement age. Hence, considering the age structure of the community, the demand for age based service is high. Therefore, My Aged Care is also a part of the care program of KDH that provides the best service to meet the health needs of older people in the community. Another important service of KDH is the Treehouse program, which is an innovative social program that helps to provide health care service at home to people living with chronic or life limiting illness. This has helped many people to become independent and return to meaningful activities in life (Community profile | Kyneton District | profile.id., 2017).
Kyneton District Health Service has been able to achieve their vision because of the contribution of nurses in the community setting. With the support of the KDH community nursing team, KDH has been able to provide health care service at home and other services like palliative and respite care. The district nurses have the responsibility to treat and manage health of people of all ages and they provide quality support to patients by visiting their home. One of the advantages of the district nurse is that they are qualified and well-trained in their work thus bringing efficiency in the service. The nurses also have the duty to respect patients, engage them in decision making, maintain privacy and confidentiality of patient’s information and advocate for the care of patient (Kyneton District Health Service :: Care in Your Home, 2017). These role and responsibility are similar to the NMBA standards of registered nursing practice as it mentions about engaging in therapeutic and professional relationship and providing safe and responsive quality nursing practice. Hence, the responsibility of the district nurse to advocate for patient is similar to NMBA standard 6 which states that registered nurse must delegate and implement ethical goal directions actions (Nursing and Midwifery Board of Australia – Registered nurse standards for practice, 2017).
The registered nurse at KDH has been found to cover a variety of roles such as pain management, chronic disease management, medication management and many other roles. Although other collaborative partners like health care professional and regional health care partners also plays a key role in providing community care, however majority of service is provided by district nurse. Their experience and expertise has helped in successfully integrating wide variety of service and their main focus is to deliver the best care to patient (Kyneton District Health Service :: Home, 2017). This responsibility has been fulfilled by building effective therapeutic relationship patients. Research literature has also given lot of evidence regarding building therapeutic relationship with patient. For instance, Sherwood & Zomorodi, (2014) has defined that respect, genuineness, empathy, active communication, trust and confidentiality are the underlying principles of therapeutic relationship and these values are also a professional responsibility of nurses working at KDH. The core purpose of therapeutic relationship is to support people in a way to promote healing and enhance functioning in patient. The district nurse at KDH have gone a step ahead to fulfill this requirement by going to the home of chronically ill patients to provide care (Kyneton District Health Service :: Care in Your Home, 2017). The success of the district nurse in building capacity is also dependent on level of support provided by the Kyneton District Health Service. This is also explained by Bridges et al., (2013) as the study showed that nature of organizational setting can affect nurse’s capacity to build and sustain therapeutic relationship with patient.
Complexity and moral dilemma is inherent in nursing practice and relational aspects of nursing care are also critical to overcome such dilemma. KDH has emphasized on reducing the ethical dilemma for nurses and this is evident by their claim that they ensure that patient’s right to privacy and confidentiality of information will be ensures and all their staffs will properly handle all personal and health information of patient. All staffs at the community health service are committed to store patient’s information in a secure manner and comply with all standards of the Health Records Act 2001 in Victoria. The privacy principles provided in the Act guides staff to collect, use and store information in a secure manner (Kyneton District Health Service:: Privacy of Patient Health Information, 2017).
Research evidence has also given idea about the growing issues related to information security and privacy in health care setting. Erickson & Millar, (2005) has explained that advocating for patient’s right to privacy and confidentiality is the key role of nurse, however there is a need to renew this commitment because privacy issues has increased within the health care environment. Although all nurses are aware of their duty to respect patient’s confidentiality, however challenges for nurses in maintaining confidentiality arises because of the development of advanced technology and new demands in health care. Health Insurance Portability and Accountability Act is one of the national legislation standards that protect patient’s right to confidentiality of information. In case of KDH, the Health Record Act 2001 was a reference for staff to maintain confidentiality standards. Feo et al., (2017) recommended that maintaining integrity of nurse-patient relationship is the most crucial element to comply with patient’s privacy and confidentiality requirement in health care or community setting.
The review of roles and responsibilities in the KDH community health service also gives the idea that it is the responsibility of carers to obtain all information to manage and attend to client whenever required. Any concerns or issues experienced by the client are also communicated to the Macedon Ranges Community Nursing staff. Ensuring professional relationship with clients and being respectful to all people involved in care is also a key responsibility (Kyneton District Health Service :: Care in Your Home, 2017). The review of community nurse role also clarified regarding the difference in their role compared to hospital nurse. For example, the hospital nurses have a single focus of attending to hospitalized patients in health care setting, however community nurse have multiple role as they are designated to provide to population of specific regions. Another important difference is that clinician is the main medical authority who directs hospital nurse, however the community nurse get medical autonomy to take decision, plan and implement nursing care measures for patients. The nursing team at KDH also gets the liberty to take decision of shifting patients between home and hospital based on their changes in symptoms. On the whole, it can be concluded that community nurse like those recruited at KDH play a role not just in providing care inside hospital, but they also engage in community awareness and preventive health role. They have the resilience skill and ability to manage health care issues of diverse population (Fooladi, 2015). Hence, nurses play a crucial role in the success of community health care program.
The KDH community health service is one of the community health services available in Victoria to serve the people residing at Macedon Ranges community. By entering into partnership with Cobaw Community Health service, KDH has also played an influential role in serving the health care needs of LGBTI (lesbian, gay, bi, transgender, intersex) community. They respect the diversity present in Victoria’s community and hence have implemented specific care program for LGBTI community. They are responsive to the health needs of LGBTI community by working under the values of compassion, integrity, respect, commitment and equity (Cobaw Community Health Service, 2017). Their flexibility is the main strength that has enabled them to be innovative in service provision for LGBTI. Some of the relevant health and human services available in Victoria for the health and well-being of LGBTI groups includes general health care service, aged care service, mental health service, LGBTI inclusive service, alcohol and drug service and sexual health service (Lesbian, gay, bisexual, transgender and intersex health, 2017).
The presence of such health care service and support for LGBTI Victorians is also necessary because this group faces discrimination which affects their physical and mental health and eventually experience poorer health outcomes compared to other Victorians. Mental health, general health, alcohol and other drug service are common health care service for this group because there are many evidence regarding the impairment in health in these areas. LGBTI people experiencing systemic discrimination and stigmatization are found to suffer from emotional distress, anxiety and depression. Family rejection and being rendered homeless also increases mental health issues and increase the risk of suicide attempts too (Friedman 2014). The research literature by Russell & Fish, (2016) also highlights about mental health problem in LGBTI youth. They are at high risk for compromised mental health because of negative experience in society. Due to social acceptance issues in society, LGBTI youth are mainly diagnosed with mood disorder, anxiety disorder and substance use disorder. In such situation, several community based treatment and therapy are essential for them. The focus on developing mental health service by KDH and Cobaw community health service is the right approach to address health care disparities in LGBTI group.
One of the influential LGBTI specific health care project that has been implemented in Victoria is the Healthy Equal Youth project which had the main purpose of improving the mental health of LGBTI youths. The Victorian government has arranged funding programs to promote mental health and well-being in this group. This will act as an effective step to reduce the suffering of LGBTI people and give them equal rights in society (Lesbian, gay, bisexual, transgender and intersex health, 2017). Taking such kind of responsibility for the disadvantaged section of the society is also a necessary component of community health service. Experience of stigma and discrimination has been a reason for poor mental health as well as poor access to mental health care for this group (Russell, & Fish, 2016). The identification of stigma as a barrier for LGBTI in accessing health care service is also demonstrated by Whitehead, Shaver & Stephenson, (2016) as the study showed that experience of stigma and fear of disclosing sexual orientation drives many people away from health care service. This affects the health care utilization rate in this group. In such situation, local agencies and community health agency hold an important responsibility to prevent illness and address health issues in the group. KDH has implemented specific health service for this group, however it is recommended that they focus on implementing those interventions that decrease stigma and increase LGBTI group intention to disclose their identity to health care providers. Such approach will be beneficial in increasing the health care utilization rate and improving health outcomes in this group.
Social issues and family violence is a major problem for LGBTI people. Cobaw’s support for LGBTI group is also evident from the commitment that they will protect all clients exposed to violence and provide inclusive health care service specific to health needs of this group. Cobaw staff collaborate with KDH staff to ensure that their clients get access to safe and inclusive care. Their specific goal for promoting health and well being of LGBTI people is to provide information to them about LGBTI service, value and respect the diversity of this group and appropriately train the staff to provide necessary care to this group (Cobaw Community Health Service, 2017). Hence, as a community health service, it can be said that KDH is taking step in the right direction to ensure that all people irrespective of their sex, gender and race get the equal right and access to health care in the community. The importance of their inclusive service is that LGBTI people will never feel uncomfortable while revealing their sensitive information to the staffs. They have the right environment and values to ensure that clients never have a bad experience with them. Such approach is critical to provide the right support to this group because research has showed that LGBTI people are discriminated by the health care staffs too. Hence, when primary health care service cannot serve the health needs of LGBTI people, community health service like KDH can act as the right means of support for this people.
The essay summarized the service and roles and responsibilities of staffs working at the KDH community health service in collaboration with Cobaw community health service to illustrate how promote health and well-being of Victorian community. The strength and weakness of its service and staff action has been evaluated with support from relevant research evidence. There focus on respecting the diversity in the communication is also evidence from the implementation of inclusive service for LGBTI people. In the future, they can contribute in a significant way to make LGBTI people feel safe and develop trusting relationship with health care providers in Victoria.
References
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Cobaw Community Health Service. (2017). Cobaw Community Health Service. Retrieved 18 November 2017, from https://www.cobaw.org.au/
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Erickson, J., & Millar, S. (2005). Caring for patients while respecting their privacy: renewing our commitment. Online journal of issues in nursing, 10(2).
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Fooladi, M. M. (2015). The Role of Nurses in Community Awareness and Preventive Health. International journal of community based nursing and midwifery, 3(4), 328.
Friedman, M. (2014). The psychological impact of LGBT discrimination: How the LGBT community is being harmed each and every day. Brick by Brick.
Kyneton District Health Service :: Acute Services. (2017). Kynetonhealth.org.au. Retrieved 18 November 2017, from https://www.kynetonhealth.org.au/index.php/our-services/acute-services/
Kyneton District Health Service :: Care in Your Home. (2017). Kynetonhealth.org.au. Retrieved 19 November 2017, from https://www.kynetonhealth.org.au/index.php/our-services/community/
Kyneton District Health Service :: Home. (2017). Kynetonhealth.org.au. Retrieved 18 November 2017, from https://www.kynetonhealth.org.au/
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Lesbian, gay, bisexual, transgender and intersex health. (2017). Www2.health.vic.gov.au. Retrieved 19 November 2017, from https://www2.health.vic.gov.au/about/populations/lgbti-health/understanding-lgbti-health
Nursing and Midwifery Board of Australia – Registered nurse standards for practice. (2017). Nursingmidwiferyboard.gov.au. Retrieved 19 November 2017, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx
Payne, J., Razi, S., Emery, K., Quattrone, W., & Tardif-Douglin, M. (2017). Integrating Community Health Workers (CHWs) into Health Care Organizations. Journal of Community Health, 1-8.
Russell, S. T., & Fish, J. N. (2016). Mental health in lesbian, gay, bisexual, and transgender (LGBT) youth. Annual review of clinical psychology, 12, 465-487.
Russell, S. T., & Fish, J. N. (2016). Mental health in lesbian, gay, bisexual, and transgender (LGBT) youth. Annual review of clinical psychology, 12, 465-487.
Sherwood, G., & Zomorodi, M. (2014). A new mindset for quality and safety: the QSEN competencies redefine nurses’ roles in practice. Nephrology Nursing Journal, 41(1), 15.
Whitehead, J., Shaver, J., & Stephenson, R. (2016). Outness, stigma, and primary health care utilization among rural LGBT populations. PloS one, 11(1), e0146139.
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