Discuss about the Emergency Departments to Improve Compassion.
A client assessment is the basis for outlining interventional strategies that can promote health outcomes. Prior to undertaking the assessment a health care professional must be must aware of the professional standards. These include informed consent of the patient, maintaining of privacy of the patient, advocating for patient’s right, and engaging in formal communication with the patient. A nurse is to be aware of the obligation to communicate with the patient in simple and clear language and avoid using medical terminologies. Further, correct body language is essential for making the communication proper in addition to appropriate facial expressions. A nurse is to be an active listener, understanding and acknowledging the concerns of the patent. Two-way communication is important and a nurse must provide and take feedback at different stages of care delivery (Brown et al. 2017). Maintaining these standards ensure that the care service delivery is of optimal standard, and the guidelines outlined by the respective committees are maintained.
Health reforms are moving rapidly towards a patient-centered model. Within the patient-centered model of care lies the need of the patient having a more active and empowered role. Therapeutic interpersonal relationships have been understood to be the most crucial component of care interaction that promotes better health outcomes. Positive clinical experiences are enabled for the patients when nurses focus on delivering comprehensive care. The sole manner in which such a relationship can be enabled is to acknowledge the cultural, ethical and spiritual concerns of the patient and outline interventions based on these. A nurse must incorporate the preferences of the patient into the care plan so that there are negligible chances of non-adherence to the plan. Further, human dignity is to be upheld by a nurse who is required to cater the diverse needs of patients coming in from various backgrounds. Care is also to be provided irrespective of the social class, economic background, race, culture, ethnicity, gender, age and personal attributes. An unbiased care is the cornerstone of maximal recovery of patients presenting with different health needs (Thorne and Stajduhar 2017).
An open disclosure is the open discussion carried out between the patient and/or the family members, and the healthcare professionals in charge of patient care, regarding the incidents that have occurred in due course of care delivery that can cause harm to the patient. It is a formal discussion between the two parties and acts as the two-way communication where information is exchanged. An open disclosure can take place in a single meeting or over multiple meetings. One must note that an open disclosure is not a one-way provision of information, and the care professionals must have an active role in this process (safetyandquality.gov.au 2013).
The elements of open disclosure are:
Open disclosure is the way healthcare professionals are responsible for communicating any adverse incidents to the patients that could cause them harm. It is therefore based on ethical principles that clinicians are to abide by. Open disclosure is a patient right and it is known to be anchored by professional ethics. It is ethical to inform the patients and their family members about any inappropriate incident that might have a negative impact on the lives of the patients. Health care environment is mostly conducive to identification of errors in care delivery process. A response is thus required that can be based on suitable ethics framework having public health ethics approach. The underlying concept is to avoid further harm to the patients as a continuum of the incident that has occurred (safetyandquality.gov.au 2013).
The National Safety and Quality Health Service (NSQHS) Standards is a set of ten distinct standards that provide a clear guideline regarding the level of care that care consumers are to expect from the different health service organizations in Australia. The standards are also known to play a crucial role in the accreditation arrangements which commenced in January 2013. The standards ensure that the health care services incorporate risk management, clinical governance, and incident notification and investigation systems.
Open Disclosure is mandated in the NSQHS Standards precisely Standard 1. As per the Standard 1, health care services are to give increased attention on governance for safety and quality. As organizations are to- “implement governance systems to set, monitor and improve the performance of the organisation and communicate the importance of the patient experience and quality management to all members of the workforce”. Criterion 1.16 of the Standard 1 entails the implementation of the open disclosure process. Actions for health service organisations must involve an open disclosure that is consistent with the national open disclosure standard. The organizations are to take the responsibility of providing training to the clinicians so that they can successfully implement the open disclosure processes (safetyandquality.gov.au 2013).
Effective partnerships in healthcare have been well documented. The partnership in healthcare addresses the appropriate and acceptable needs of the healthcare consumer. In practice, the partnership between the care provider and the consumers rests upon the integration of patient needs into the care continuum. The four basic features of effective partnerships are communication, coordination, collaboration and integration. Proper communication entails involvement of each party and exchange of information in a two-way manner. It is also pivotal that each entity is well informed about the related actions in care delivery. Coordination is related to how each partner works for the actions to be taken with mutual understanding. Collaboration is the cohesive work done by the partners. Lastly, integration is to be instilled in that the partners are to work together with common goals. Working as a single agency requires focus on mutual goals and objectives, and each partner is responsible for promoting a shared vision (Pomey et al. 2015).
As per the Communication and Behaviour Support for Nurses – Practice Package outlined by the NSW government, and the and Behaviour Support for Nurses Appraisal, nurses are to abide by certain guidelines that enable them to support people with disability for promoting efficient and consistent best practice. The guideline is based on four domains, one of which is communication and behavior support. Healthcare professionals are to engage in an effective communication with the patient and family members so that they express and receive messages with the help of signs, symbols and behavior. Communication between clinicians and patients is to be supported by written information that acts as an evidence-based piece. It should also cater to the needs of the patients in a comprehensive manner. All information has to be given out in a culturally sensitive manner acknowledging language barriers. It should also be provided in formats easily accessible to people. The common challenges to communication might be health problems and social interaction.
The first effective communication skill was that an interpreter was included in due course of the communication. An interpreter is helpful for addressing language barrier between the two parties. It ensures that adequate information is passed on to the patient and family members within the stipulated time. The fact that the Senior Medical Specialist apologized to the patient was noteworthy. This formed the basis of a strong relationship between the two as the dignity of the patient was maintained. Further, the clinician was frank in providing information, enabling two way communications. The changes that were brought about in the ward were communicated to the patient through a letter from the CEO. This was again a good approach since a formal communication was made (Blais 2015).
Norouzinia et al. (2016) outlined the barriers in effective communications in healthcare. Communication is noted to be a multi-factorial phenomenon, multi-dimensional and dynamic process, related to the health care experiences of the consumers. While effective communication holds a prime place in the care delivery process, the barriers or challenges in effective communication are also understood. Barriers to effective communication can be classified under four broad categories. These include factors common between clinician and patient, clinician related factors, patient related factors and environmental factors. The factors common between the clinicians and patients include colloquial language differences, cultural differences, and gender differences. Clinician related factors include excessive work load, lack of time, and shortage of shortage of knowledge. Patient related factors include family interference, patient’s inability to understand care professional’s duty, physical pain and discomfort. Lastly, the environmental factors include hectic environment of the care unit, lack of resources for care delivery and unsuitable environment.
The National Boards regulating registered health practitioners in Australia has outlined a proper definition of social media that they refer to in their policies and procedures. Social media is referred to online and mobile tools used by individuals for sharing opinions, experiences, information, videos and images, and encompasses applications and websites enabled for social networking. The most common sources of social media include social networking sites like Facebook and LinkedIn, WOMO, True Local, blogs (personal, professional and those published anonymously), and microblogs like Twitter. Further, social media also includes content-sharing websites like YouTube and Instagram, together with message boards and discussion forums (nursingmidwiferyboard.gov.au 2017).
An enrolled nurse is required to follow certain requirements in regards to use of social media. A nurse is to use the social media and other electronic communication means for the purpose of professional and personal communications. Nurses are to have the adequate knowledge of how to handle different social media platforms and understand the information exchanged. Nurses must also understand that social media can benefit the healthcare delivery process in different manner, encompassing promotion of timely communications, fostering of professional connections, and patient education.
Social media has a huge potential to strengthen the relationship between the patient and the care provider, and provide valuable information to care consumers. The nurses are given an opportunity to interface with other professionals from across the domain. Nurses have the role in imparting clinical information across the care continuum for enabling better health outcomes. Nurses must also engage in exchange of information between professionals who might have different opinions on a particular topic. They must have complete awareness of the possible consequences of disclosing patient-related information through social media. This relates to maintenance of patient confidentiality and privacy. Further, nurses are responsible for being mindful of the relevant federal and state laws, employer policies and professional standards. Nurses must also report any discrepancy in following the guideline. In case a nurse finds a fellow nurse breaching the policies, suitable actions are to be taken through reporting to the concerned authority (acn.edu.au 2018).
Dementia is a global epidemic and is mostly common among the aged group of population of the low and middle income countries where adequate access to social protection, social services, support and care are limited (Kessler and Bromet 2013). According to the World Health Organisation (2017), the risks of developing dementia increases with age and the main age bracket of population who are prone towards developing dementia include people belonging to the age group of 75 to 84 years of age. The main success in initiates to reduce the risk factors of dementia include increasing education about the disease prognosis, proper monitoring through population based research programmes and adequate access along with coverage of the proper social and health care interventions.
The non-pharmacological interventions that will be suitable for the client in the case study include occupational activities. According to Oliveira et al. (2015), tailored activities program (TAP) is the best suited occupational activity for reducing the behavioural and psychological symptoms of dementia (BSPD). TAP mainly focus on the decreasing the unwanted behaviours associated with dementia. In case of the client of the case study, the principle TAP will encompass providing proper assistance to the client in accomplishing his interests and roles and exploring his abilities. This assistance in accomplishing his roles will help to reduce depression thereby reducing the severity of dementia (Oliveira et al. 2015).
According to Grand, Caspar and MacDonald (2011), integrated multidisciplinary approach in order to diagnose and manage dementia is extremely important under clinical practise settings because no single healthcare specialist alone has the capability to manage the range of complexity associated with dementia like cognitive, emotional, physical and social problems. The suitable multidisciplinary team in order to provide comprehensive dementia care to the client in case study include social service agencies, neurologist, neuropsychologists, geriatricians, nurse practitioners, nutritionists and physical/occupational therapists (Grand, Caspar and MacDonald 2011).
Communication in the early stage includes speaking directly to the patient in order to know how he is feeling while taking time to listening to his feeling. Communication in the middle stage include engage the person in one to one conversation in a quiet place having minimal distraction while maintaining eye contact. Communication in the late stage mainly target towards use of touch, sound and aroma as the source of communication while approaching the person (patient) from the front so that he can quickly identify the person who is interested to converse with him (Alzheimer’s and Dementia Caregiver 2017)
The skills that assist information giving in case of dementia care is generation of interactive approach while promotion of the audiovisual facts via the means of power point presentation and poster presentation in order to increase the awareness about dementia (Alzheimer’s and Dementia Caregiver 2017).
According to the Nursing and Midwifery and Board Australia (2017), it is the duty of the nurse to assist student for the informed decision-making. It is also the duty of the nurse to advocate patients or clients in the domain of privacy, confidentiality and while helping clients with impartial, honest and accurate information.
Mrs. Price is to be reassured and supported after the fall for reducing risks of further similar incidents. Since the patient is an elderly person, care is to be given to provide emotional support apart from physical support. She needs to be explained the need of residing at the unit for achieving better health outcomes. She is to be assured that she can meet with her husband under desirable circumstances. The patient is further to be assisted with maintaining proper hygiene as she is old. Measures are to be taken by the nurse for avoiding further falls. These include installing hand rails in the room and bedside rails. The floors are also to be made free of slippery substances and other maximal space is to be enabled for free mobility (Hill et al. 2015).
Mrs. Price is to be invited for a discussion regarding the event that has been conveyed to her. This would enable a face-to-face conservation important for better results. Any errors made on the health care unit’s part are to be duly acknowledged, and assurance is to b given that such incidents would not occur in future. Suggestions are to be taken from the family member to understand the preferences and values of the patient which can be included in the future care plan. This would ensure that a comprehensive care is given to the patient through providing social support in addition to support for health promotion (Black 2016).
Nursing documentation is integral to proper clinical communication and patient outcomes. Firstly, the documentation has to be objective, factual and client centered. This is to be based on the assessment carried out by the nurse and the perception of the need of the client. Further, documentation is to be relevant and accurate, and must have sufficient details of the care. Documentation also needs to be current for being of good quality. All information is to be recorded soon after it has been collected. Lastly, documentation has to be logical, sequential and organized. Information has to maintain a chronological manner for having decisions, actions and responses in a suitable manner (Kearney-Nunnery 2015).
The complete team meeting procedure consists of eight valuable steps. These are identification of the team; meeting on the stipulated time; agreement on the ground rules; discussing meeting agenda; exhibiting meeting roles; solving issues; recording action step; imparting key information (Black 2016).
It is important for students to know the progress they have made in due course of learning at the respective institutors. Feedback is the elementary part of effective learning as it helps students in understanding the needs of future improvement they need to consider. Effective feedback supports students to bring positive changes in their leaning patterns, and aids in transition to higher learning levels. Feedback holds the potential to improve a student’s self-awareness, confidence and enthusiasm for learning. In addition, feedback containing advice is more likely to motivate students to act upon their learning needs. Nurses can improve their practice if feedback is professionally delivered and effectively received. A nurse can be receiving feedback from the seniors, peers, and patient population within the environment of a nursing home. Feedback from seniors motivates the professional to make improvements in practice. It is also essential for professional growth. Peers can provide feedback that increases motivation and self-confidence. Patients also provide feedback that can lead to practice improvement. Constructive feedback can be asked from the seniors, by establishing a strong rapport with them (Cherry and Jacob 2016).
Nursing homes are committed to ensure that the staff is given support for effective debriefing. Debriefing is to be carried out through small group or one-to-one discussions. Staff should have regular formal opportunities to debrief at staff meetings. The general procedure includes contacting the manager or supervisor, incident reporting, taking legal measures, debriefing with other individuals if appropriate and examining the work practices. The debriefing process must be allowing the professionals to express what they did, what they saw, and how they felt (Schmidt and Haglund 2017).
References
Alzheimer’s and Dementia Caregiver. 2017. Communication and Alzheimer’s. Access date: 24th April. Retrieved from: https://www.alz.org/care/dementia-communication-tips.asp
Australian Open Disclosure Framework. (2013). [ebook] Available at: https://www.safetyandquality.gov.au/wp-content/uploads/2013/03/Australian-Open-Disclosure-Framework-Feb-2014.pdf [Accessed 24 Apr. 2018].
Australian Open Disclosure Framework. (2014). [ebook] Available at: https://safetyandquality.gov.au/wp-content/uploads/2013/03/Australian-Open-Disclosure-Framework-Feb-2014.pdf [Accessed 24 Apr. 2018].
Black, B., 2016. Professional Nursing-E-Book: Concepts & Challenges. Elsevier Health Sciences.
Blais, K., 2015. Professional nursing practice: Concepts and perspectives. Pearson.
Brown, D., Edwards, H., Seaton, L. and Buckley, T., 2017. Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems. Elsevier Health Sciences.
Cherry, B. and Jacob, S.R., 2016. Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.
Grand, J. H., Caspar, S., & MacDonald, S. W. (2011). Clinical features and multidisciplinary approaches to dementia care. Journal of multidisciplinary healthcare, 4, 125.
Hill, A.M., McPhail, S.M., Waldron, N., Etherton-Beer, C., Ingram, K., Flicker, L., Bulsara, M. and Haines, T.P., 2015. Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial. The Lancet, 385(9987), pp.2592-2599.
Kearney-Nunnery, R., 2015. Advancing Your Career Concepts in Professional Nursing. FA Davis.
Kessler, R.C. and Bromet, E.J., 2013. The epidemiology of depression across cultures. Annual review of public health, 34, pp.119-138.
Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M., and Samami, E. 2016. Communication Barriers Perceived by Nurses and Patients. Global Journal of Health Science, 8(6), pp.65–74.
Nursing and Midwifery and Board Australia., 2017. Code of Professional Conduct for Nurses in Australia. . Access date: 24th April. Retrieved from: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/FAQ/Registration-as-a-nurse-and-a-midwife.aspx
Nursingmidwiferyboard.gov.au. (2017). Nursing and Midwifery Board of Australia – Social media policy. [online] Available at: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Policies/Social-media-policy.aspx [Accessed 24 Apr. 2018].
Oliveira, A.M.D., Radanovic, M., Mello, P.C.H.D., Buchain, P.C., Vizzotto, A.D.B., Celestino, D.L., Stella, F., Piersol, C.V. and Forlenza, O.V., 2015. Nonpharmacological interventions to reduce behavioral and psychological symptoms of dementia: a systematic review. BioMed research international, 2015.
Pomey, M.P., Hihat, H., Khalifa, M., Lebel, P., Néron, A. and Dumez, V., 2015. Patient partnership in quality improvement of healthcare services: Patients’ inputs and challenges faced. Patient Experience Journal, 2(1), pp.29-42.
Schmidt, M. and Haglund, K., 2017. Debrief in Emergency Departments to Improve Compassion Fatigue and Promote Resiliency. Journal of Trauma Nursing, 24(5), pp.317-322.
Social Media Guidelines. (2018). [ebook] Available at: https://www.acn.edu.au/sites/default/files/social_media/acn_social_media_guidelines.pdf [Accessed 24 Apr. 2018].
Thorne, S. and Stajduhar, K., 2017. Rebuilding the Roots of Patient-Centred Care. Nursing leadership (Toronto, Ont.), 30(1), pp.23-29.
World Health Organisation. 2017. The Epidemiology And Impact Of Dementia Current State And Future Trends. Access date: 24th April. Retrieved from: https://www.who.int/mental_health/neurology/dementia/dementia_thematicbrief_epidemiology.pdf
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