Integrating Practice System and Healthcare Management

Week 3 NRSG139: INTEGRATING PRACTICE 1 ASSESSMENT IN HEALTH WARNING This material has been reproduced and communicated to you by or on behalf of A ustralian Catholic University in accordance w ith section 113P of theCopyright Act 1968(Act). The material in this communication may be subject to copyright under the A ct. A ny f urther reproduction or communication of this material by you may be the subject of copyright protection under the A ct. Do not remove this notice Acknowledgement of Country In continuing ACUs commitment to Reconciliation and in line with Aboriginal and Torres Strait Islander tradition, it is customary to acknowledge country as we pass through. Today we acknowledge and pay our respects to the First Peoples, traditional custodians of the lands and waterways The Turrabuland Jagerapeople in Brisbane, The Wurundjeri people in Melbourne, The Wathaurong people of Ballarat, The Gurringaipeople in North Sydney, The Darugpeople in Blacktown, and The Ngunnawal people from Canberra and we thank them for their continued hospitality. We acknowledge and celebrate the continuation of a living culture that has a unique role in this region. We also acknowledge Elders past and present as well as our emerging leaders of tomorrow and thank them for their wisdom and guidance as we walk in their footsteps. School of Nursing, Midwifery and Paramedicine2| Unit learning outcomes On successful completion of this unit, you should be able to: 1. Demonstrate beginning skills in explain the difference between critical thinking, clinical reasoning and clinical judgement; 2. Demonstrate developing skills in assessment of physical, psychosocial, and cognitive health across the lifespan; (GA1, 3, 9) 3. Conduct nursing health assessment interviews at a beginning level; (GA8) 4. Reflect on their learning within a professional portfolio to evaluate effective learning and self-care strategies for themselves and others; (GA4, 10) 5. Perform peer evaluation using effective communication skills. (GA10) School of Nursing, Midwifery and Paramedicine3 Graduate Attributes On successful completion of this unit, you should have developed your ability to: GA1demonstraterespectforthedignityofeachindividualandfor humandiversity GA3applyethicalperspectivesininformeddecisionmaking GA4thinkcriticallyandreflectively GA8locate,organise,analyse,synthesiseandevaluate information GA9demonstrateeffectivecommunicationinoralandwritten Englishlanguageandvisualmedia GA10utiliseinformationandcommunicationandotherrelevant technologieseffectively. School of Nursing, Midwifery and Paramedicine4 1.Maintaining a safe environment 2.Reflective Practice Introduction to Gibbs reflective cycle 3.Introduction to Healthcare Terminology Outline of this Lecture School of Nursing, Midwifery and Paramedicine5 Part 1 Maintaining a safe environment W ARNING This material has been reproduced and communicated to you by or on behalf of Australian Catholic University in accordance with section 113P of theCopyright Act 1968(Act). The material in this communication may be subject to copyright under the Act. Any further reproduction or communication of this material by you may be the subject of copyright protection under the Act. Do not remove this notice Maintaining a Safe Environment Healthcare environments can be hazardous to both you and patients Risks to you (as nurses) slips, trips, infections, physical injuries from patients etc. Risks to patients falls, infections, medical errors (e.g. medication errors) etc. There are simple steps you can take to keep both you and patients, safe School of Nursing, Midwifery and Paramedicine7| Prevention of Back Injury W hy do you think nurses are at risk of back injuries? Nursing is a physical job, involving moving, bending and twisting Over time these actions can wear away at your back Most facilities have a no lift policy, meaning you are not to physically lift people There are devices and mechanical lifters to assist with moving people Avoid moving out of mid-range i.e. reaching, bending Raise the bed to interact with a patient! School of Nursing, Midwifery and Paramedicine8| https://search.creativecommons.org/search?q=injury Avoiding Slips and trips Slips and trips are common injuries for both healthcare staff and patients How can these be avoided: Wear correct footwear Clean up water/liquid spills immediately Do a scan of any room for hazards such as cords across walkways or dropped items that can be a slip hazard Do the same in the praclabs to ensure your safety and to make safety a habit School of Nursing, Midwifery and Paramedicine9| This Photoby Unknown Author is licensed under CC BY Avoiding sharps injuries Sharps injuries are also called needle stick injuries These are common injuries in healthcare because of the use of needles and other sharps Sharps injuries can result in HIV/hep B/hep C infection How to avoid: Once you generate a sharp you are responsible for the correct disposal Sharps go into a sharps bin, not the general waste Take a sharps bin to the bedside for immediate disposal Never re-cap a used needle!! Report unsafe practice such as inappropriate disposal School of Nursing, Midwifery and Paramedicine10| Management of fatigue Fatigue is a common result of shift work (and study) W hen you are tired you are more likely to make errors and poor decisions You will know what works for you to mange fatigue but here are some general tips: Get enough sleep Know your signs of tiredness and take rest breaks Schedule enough time for assessments Dont combine full time work and full time study School of Nursing, Midwifery and Paramedicine11| Patient falls prevention Patient falls prevention is a major concern in healthcare and is written into the National Safety and Quality Standards W hy would falls be an issue? Older patients at risk of falls and injury from falls Effects of medication Unsure environments, slips and trip hazards Poor patient sleep = fatigue & unsteady Disorientation to area Bed rest and muscle wasting W hat can nurses do to prevent patient falls? Assess patients for falls risk Know effects of medications Observations esp. BP School of Nursing, Midwifery and Paramedicine12| NSQHS, 2019 Infection Prevention and Control Patients and healthcare workers are at risk of infections from healthcare Infection prevention incorporates: Standard precautions: oHand hygiene 5 moments oSharps Management oCleaning & W aste Management oAseptic Technique oCough etiquette oAppropriate PPE Transmission-based Precautions oContact oDroplet oAirborne School of Nursing, Midwifery and Paramedicine13| ACSQHC (2019) In Summary Injuries, accidents and infections in healthcare can be prevented Be aware of your surroundings, be alert for risks and minimiserisks where possible Simple steps you can take include: Perform hand hygiene, Adjusting the patients bed appropriately before attending to care, and after care episode Patient non slip socks, Getting patient to sit in edge of bed before they stand up, W iping a wet floor, Following infection control PPE guidelines Scan any room for hazards School of Nursing, Midwifery and Paramedicine14| Part 2 Reflective Practice WARNING This material has been reproduced and communicated to you by or on behalf of A ustralian Catholic University in accordance w ith section 113P of theCopyright Act 1968(Act). The material in this communication may be subject to copyright under the A ct. A ny f urther reproduction or communication of this material by you may be the subject of copyright protection under the A ct. Do not remove this notice "The unexamined life is not worth living". Socrates, in Plato, Dialogues, Apology Greek philosopher in Athens (469 BC -399 BC) 16| This Photoby Unknown Author is licens ed under CC BY-SA-NC School of Nursing, Midwifery & Paramedicine What is Reflection? Reflection is a tool you can use to assist you in shaping your nursing practice, and to help you make meaning out of tricky situations Reflection Systematic, logical and deliberate deep thinking (Daly, Speedy, & Jackson, 2017). Reflection proposes ways to make meaning out of complex situations (Mann et al 2009). Reflection is part of the NMBA Registered Nurses Standards for Practice it is essential to reflect to be an effective nurse School of Nursing, Midwifery & Paramedicine17| What is Reflective practice? NMBA RN standards and reflection Standard 1.2 develops practice through reflection on experiences, knowledge, actions, feelings and beliefs to identify how these shape practice (NMBA, 2016) Critical thinking and self awareness are essential for effective nursing practice Gibbs Reflective Cycle is a tool you can use to structure your reflection and to develop as a professional School of Nursing, Midwifery & Paramedicine18| NMBA, 2016 Gibbs reflective cycle School of Nursing, Midwifery & Paramedicine19| 1. Description 2. Feelings 3. Evaluation 4. Analysis 5. Conclusion 6. Action Plan Stepping through the Gibbs reflective cycle Description: W hat happened? Describe what happened, keep focused on your description; dont make judgements or draw conclusions. Feelings: W hat were your feelings and how did you react? Keep focused on your emotions, dont be tempted to analyse yet, W hat was good and bad about the experience? Evaluation: Think about your initial feelings and reactions in order to get to the heart of what really concerned you (positive and/or negative) about the experience. By doing this, you should be able to identify and attend to key issue/s which will allow you to move on to critical analysis. You can also compare your evaluation to other people's experiences via academic literature. School of Nursing, Midwifery & Paramedicine20| Stepping through the Gibbs reflective cycle Analysis: What sense did you make of the experience? Critically analyse what was going on. What themes seem to be emerging from your analysis? How do these compare with your previous experiences? Can you challenge any assumptions now? Make use of knowledge/ideas from outside your experience to develop and inform your analysis, e.g. experts, literature, clinical papers, reviews, discussion papers. How do these compare with your experience? Conclusions: What have you learnt from reflecting on this experience? What have you learnt about: yourself, your self-awareness, your practice? What have you learnt that you would recommend for practice in general? What skills do I need to develop? Action plan: What would you do differently and what new learning is required What would you do if this type of situation arose again? What steps will you take, based on what youve learnt, to develop your future skills? How will you decide if your practice has been improved? School of Nursing, Midwifery & Paramedicine21| Peer review -giving and receiving constructive feedback A peer is a colleague of the same profession, grade, or setting (Rout & Roberts, 2008). Feedback is about providing information with the intention of narrowing the gap between actual and desired performance. Reciprocal giving and receiving (Philippakos, 2017) In order to give feedback to a peers practice you need to have knowledge of what good practice is School of Nursing, Midwifery & Paramedicine22| This Phot oby U nk nown Aut hor is lic ens ed under C C BY-SA-NC Peer review -giving and receiving constructive feedback Peer review in nursing: Peer review is an organisedeffort whereby people critically appraise, systematically assess, monitor, make judgements, determine strengths and weakness and review the quality of practice of a peer, to provide evidence to use as the basis of recommendations by obtaining the opinion of their peers (Rout & Roberts, 2008). School of Nursing, Midwifery & Paramedicine23| This Phot oby U nk nown Aut hor is lic ens ed under C C BY-NC-NDThis Photoby Unknown Author is licens ed under CC BY Peer assessor feedback form 24|Criteria for providing useful and structured feedback Always describe the behavior and its effects upon others. Avoid judgment or interpretation. Respectfully ask the individual if they would like some feedback. Dont impose feedback on others. Constructive feedback should occur at the earliest opportunity. Consider the readiness of the individual to receive the feedback at this time. Constructive feedback is specific and justifiable (can be rationalised). Avoid generalisations, vague language, and opinions. Consider both the needs of the receiver and the provider. Is feedback at this time necessary and appropriate? Is the way in which the feedback is being provided, suitable? Focuses on the behavior (which receiver can adjust) and may include suggestions on how to change the behavior. Avoid language that focuses on the person rather than the behavior. Requires receiver validation of understanding. Lack of receiver validation may equate to lack of understanding or misunderstanding. May be more effective of several individuals provide the feedback. Feedback from too many individuals may be overwhelming or confronting. Must always be provided in a respectful, empathetic manner Avoid dogmatic, dominating verbal and non-verbal styles of communication. Peer Review and Feedback Template [modified from Australian Nursing Standards Assessment Tool Summative] PEER ASSESSOR FEEDBACK 1. What has the student done well in conducting the interview? 2. What strategies can the student use to advance their skill in conducting interviews? 3. Any further comments? Peer Reviewer Signature: Date: Academic Assessor Signature: Date: Adapted from: Australian Nursing Standards Assessment Tool Summative (2016). www.ansat.com.au School of Nursing, Midwifery & Paramedicine In Summary Reflection is a required skill for nurses A tool such as Gibbs Reflective Cycle can assist in learning to reflect Peer review nursing team to provide feedback on practice and to build capability in teams You will be practicing using the peer review tool in your praclabs School of Nursing, Midwifery and Paramedicine25 Part 3 Introduction to Healthcare Terminology WARNING This material has been reproduced and communicated to you by or on behalf of A ustralian Catholic University in accordance w ith section 113P of theCopyright Act 1968(Act). The material in this communication may be subject to copyright under the A ct. A ny f urther reproduction or communication of this material by you may be the subject of copyright protection under the A ct. Do not remove this notice Healthcare Terminology Healthcare Terminology is also called medical terminology It is a way of communicating some terms in healthcare with other healthcare team members Abbreviations are also used in healthcare and each facility has an approved list of acceptable abbreviations Nurses need to limit their use of terminology when communicating with patients so that the patient isnt excluded from the conversation. School of Nursing, Midwifery and Paramedicine27| Healthcare Terminology Healthcare terminology has some basis in Latin or Greek words There is more information in the LEO Workbook and a matching exercise to help get you used to some familiar terms The matching exercise uses words that you may need for your OSCE assessment School of Nursing, Midwifery and Paramedicine28| ht t ps : / /www. s om eec ards . c om/us erc ards/v iewc ard/ MjAx My 0xY zY wOW F hMjI wMD EzN 2E0/ ?t agSlug=nurs es-week In Summary Healthcare Terminology is an important part of communicating within healthcare teams It is not used for communicating with patients because they may now know the language, and this excludes them from the conversation School of Nursing, Midwifery and Paramedicine29|https ://www.phys io-pedia.com/Communication_in_Healthcare References Australian Commissi on on Safety and Quality in Healthcare. (2019) Guidelines for the Preventi on and Control of Infection in Healthc are. https://app. magic app.or g/#/ guideline/Jn37kn Australian Government, National Health and Medical Research Council AG. Cultural competency in health: a guide for policy, partnerships and participation. Canberra (AU): The Council; 2005. Arnold, E., Boggs, K., & Dummitt, J. (2016).Interpersonal relationships : Professional communication skills for nurses(Seventh ed.). Baca, M. (2011). Professional boundaries and dual relationshi ps in clinical practice.The Journal for Nurse Practitioners,7(3), 195-200. Brascoup, S., & Waters, Catherine,B.A., M.A. (2009). Cultural safety: Exploring the applicability of the concept of cultural safety to aboriginal health and communi ty wellness.Journal of Aboriginal Health,5(2), 6-41. Retrieved from https://search. proquest.com/ doc view/1138537303?accountid= 8194 Daly, J., Speedy, S., & Jackson, D. (2017).Contexts of nursing: An introduction. Elsevier Health Sciences. Dean, E. (2017). Cultural competency.Nursing Management (UK),23(9), 11. Retrieved from https://search. proquest.com/ doc view/1875835510?accountid=8194 Dempsey, J., Hillege, S., & Hill, R. (2014).Fundamentals of nursing and midwifery : A person-centred approach to care(Second Australian and New Zealand ed.). Denny, E., Earle, S., & Hewison, A. (Eds.). (2016). Sociology for nurses. John W iley & Sons. Drechsler, J., Gilbert, M., & Malone, B. (2013).Diversity and cultural competence in health care a systems approach(1st ed.). San Francisco: Jossey-Bass. Eliason, M. J., & Chinn, P. L. (2017). LGBTQ cultures: W hat health care professionals need to know about sexual and gender diversity. Lippincott W illiams & W ilkins. School of Nursing, Midwifery and Paramedicine30 References Estes, M. E. Z. (2016).Health assessment and physical examination 2e. Cengage Learning. Forbes, H., & Watt, E. (2016).Jarvis's Physical Examination and Health Assessment 2e. Elsevier Health Sciences. Gast, L., & Patmore, A. (2012).Mastering approaches to diversity in social work(Mastering social work skills). Philadelphia, Pa.: Jessica Kingsley. Germov, J. (Ed) (2014). Second opinion. An Introduction to Health Sociology (5th ed). South Melbourne: Oxford University Press. Hill, R., Hall, H., & Glew, P. J. (2017). Fundamentals of Nursing and Midwifery: A Person-Centred Approach to Care. Levett-Jones T. (2018). Clinical Reasoning: Learning to think like a nurse. Pearson: Frenchs Forest Macionis, J., and Plummer, K. (2012),, Sociology: a global introductiones, 5th edn. New York, Pearson Prentice Hall. (Chapter 5) https://www.humanrights. gov.au/fac e-facts-cultural-di versi ty Mann, K., Gordon, J., & MacLeod, A. (2009). Reflection and reflective practice in health professions education: a systematic review.Advances in health sciences education,14(4), 595. Nursing and Midwifery Board of Australia (2016) Registered Nurse Standards for Practice. 14 January from: http://www. nur singmi dwif eryboar d.gov. au/ Codes-Gui deli nes-Statements/Pr ofessional-standar ds. aspx Nursing and Midwifery Board of Australia (2018) Code of Conduct for Nurses. Accessed 14 January from: http://www. nur singmi dwif eryboar d.gov. au/ Codes-Gui deli nes-Statements/Pr ofessional-standar ds. aspx University of Edinburgh. (2021). Reflection Toolkit Gibbs Reflecti ve Cycle. https://www.ed.ac. uk/r eflecti on/ref lec tor s-toolki t/ref lecti ng-on-experience/ gibbs-ref lec ti ve-cycle School of Nursing, Midwifery and Paramedicine31 Image References "Lawyers For Injury San Luis Obispo California"by Injury Lawyers San Luis Obispois licensed with CC BY 2.0. To view a copy of this license, visit https://creativecommons.org/licenses/by/2.0/ This Photoby Unknown Author is licensed under CC BY-NC-ND Homer Simpson Thinking by Unknown Author is licensed under CC BY-SA-NC https://www.someecards.com/usercards/viewcard/MjAxMy0xYzYwOW FhMjIwMDEzN2E0/?tagSlug= nurses-week This Photoby Unknown Author is licensed under CC BY-SA-NC Sharps Bin https://www.alphamedicalsolutions.com.au/sharps-container-with-clip- lid/?gclid=Cj0KCQiAgomBBhDXARIsAFNyUqP8bZNQnHS4idsbI7mdUDD4vtStjKoEZ_vDDlvj9-D7G- PiV4n50OUaAjGxEALw_wcB Tired Nurse: https://wp.nurse.com/wp-content/uploads/2018/09/Nurse-tired-iStock- 907591258.jpg?_ga=2.90483802.1180462374.1612917910-1591698992.1612917909 NCSQS Logo: https://www.safetyandquality.gov.au/standards/nsqhs-standards Communicaitongraphic: https://www.physio-pedia.com/Communication_in_Healthcare School of Nursing, Midwifery and Paramedicine32