Service Users at the heart of inter-professional working
por micky mallon
1. While on placement I attended a conference day with different seminars on different care of children and young adults. The speakers came from all health backgrounds from health visitors, incontinence nurses, also marketing companies designing and making equipment and resources for disabled children and young people. The whole conference was designed to help each department come together to help the patient to have the best life they could. I was able to see first hand the way they came together to listen to each others seminar and add their information to help.
2. interprofessional training events
3. Effective team working can have a positive effect on patient safety
4. Regular mandatory training is esential
4.1. give staff option of online elearning or face to face for some mandatory training
4.2. Regular mandatory training is important as professionals skills and knowledge is kept up to date regularly whether its training or online training, they are still refreshing their memories on what is expected.
5. Legislation
5.1. Throughout the last 50 years inter-professional working has been underpinned in many pieces of legislation that promote working together as professionals to benefit the well being of the patient and the team providing their care.
5.2. Modernising Social Services (1998)....breaking down the 'berlin wall' between professionals!
5.3. There have been many different legislations throughout the past years which have all all been made to try promote relationships between service users and professionals to make patient centred care paramount, one of the main legislations which she mentioned is the Health and Social Care Act 2003.
5.4. Mental Capacity Act (2005)
5.4.1. Does the patient have capacity to make decisions about their care?
5.4.2. DOLS assessment
6. MDT's to meet regularly to discuss the care of their service users
6.1. This is also helpful for if you are unsure of the best route to take with somebody's care. Discussing this with other professionals can give insight into other options you may not have thought of yourself
6.2. Ensure all avenues are being explored
6.3. Enables different professionals to take responsibility for different aspects pf care and raise concerns others may not have thought of.
6.4. Different opinions from different professionals.
6.5. They can discuss all possible outcomes, review how things are going so far, and if there any changes that need to be made
6.6. Review care plans, check to see if anything has changed, what the plan is going to be put in place.
6.7. Review patients on going progress.
7. Professionals to research the roles of other professionals to find out how their services can be used to improve the care of their service users
7.1. Shadowing someone of another profession to see how they work. To understand the part they play in someone's care.
7.2. working with different professionals during your training as a student
7.2.1. As a student midwife I am currently undertaking short placements on different nursing wards where I have observed the roles of many different professionals such as adult nurses, specialist nurses, ODPs, anesthetists, doctors/consultants, healthcare assistants, physiotherapists etc and how these have positively affected patient care and made recovery much quicker.
7.3. Professionals could also set time aside to work with other professionals
7.4. Working together as health professionals allows for the development of education knowledge and understanding around the roles of other health professions. Knowledge and understanding leads to empowerment, therefore supporting more effective engagement across MDT's thus leading to a more consistent and coordinated provision of care.
8. Professionals to identify gaps in knowledge and seek relevant training to address these
8.1. Professionals can also seek advice from other professionals who may already have the knowledge you require.
8.2. Attending relevant training and further enhancing knowledge can increase confidence with professionals and ensures the service users get the highest standard of care.
8.3. Be aware of the training available and make your line manager aware of any courses you would like to attend
8.4. Ward based training courses run by staff members with experience in that area or co-ordinated by staff members using reps from companies appropriate to that wards speciality
8.5. To ensure competency before undertaking any task. Seek further training and get help if assistance is required.
8.6. Professionals should ensure to take responsibility for their individual professional development, seeking to attend training courses not necessarily focused solely on their particular area of work. In addition managers should endeavour to support staff members in attending such session.
9. Professionals to access regular training to increase their knowledge and understanding in order to improve the quality of care delivered to their service users
9.1. Inter-professional training courses- able to learn how each profession can work together in certain situations.
9.2. Regular mandatory training is vital for all professionals as it will keep skills and knowledge up to date and keep on improving the quality of care that is given to patients and families, professionals should be given time to do training or online training.
9.3. Through this professionals can then forward this up to date knowledge to those they care for in order to help them make informed choices, therefore delivering person-centered care.
10. All healthcare professionals be aware of their scope of practice and only work within this scope
10.1. All healthcare professionals should only work within their scope of practice to ensure full safety of the patient in care, this provides the patient with the best care possible.
11. Discuss pro's and con's of treatments e.g. medication and side effects
11.1. This should be done using terms the patient understands (no jargon) and simplistic terms as then the patients gets a full understanding of whatever the health professional is telling them. This then encourages patient centered care as when the patient fully understands the care that can be given to them, the patient then has a choice.
12. Effective written and verbal communication, and extensive and relevant documentation of care given, concerns noted and patient/service user preferences and requirements.
12.1. open and accesable to all staff who need acess to the patients notes
12.2. Notes comply with NMC, HCPC, BMA standards
13. Evidence based practice which is based on service user preferences and values, clinical expertise, and the best available research evidence.
13.1. Provides the most up to date and effective care
13.2. The most common definition of Evidence-Based Practice (EBP) is from Dr. David Sackett. EBP is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” (Sackett D, 1996)
13.3. EBP is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values. The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology. (Sackett D, 2002)
14. Person centred and individualised care, (no decision about me without me).
14.1. Do they have capacity?
14.1.1. Always ask questions, never assume.
14.1.2. Gillick Fraser principles, just because the person is under 18, doesn't mean they cannot make there own decisions on there care
14.2. Involve people in their own care
14.3. Taking the time to read records and treating patients as individuals. it is important that we read what has been documented by other members of the team.
14.3.1. Agree care plans they find achievable and fitting - helps ensure compliance.
14.3.1.1. Have a short term goal and a long term goal that can be agreed with the patient and worked on together.
14.4. Involve family, friends and carers with consent of the patient, as these are the people who know the patient best
14.4.1. only if patient wishes family to be involved
14.5. Make sure any care decisions is based completely around the patient and involve the patient in their care as much as possible
14.6. Make sure that patient is always involved in the care they're receiving as they have a choice. Patient having capacity to make their own decisions.
14.6.1. Keep the patient updated in regards to their care.
15. Inter-professional and inter-agency collaboration
15.1. Right care in the right place. Ensures information in passed through to relevant agencies eg home care for continuous care
15.2. Refer to the correct agency straight away to avoid delays in patient care - research/look into where is the correct place to refer the patient to
15.2.1. For example this could include agencies such as PALS, smoking cessation, mental health services, physiotherapy, breastfeeding support services, outreach, homecare, sexual health services, family partnership etc and general referrals to other professionals such as consultants and so on. The trust intranet provides information on when to appropriately refer someone and who to. It is important to be aware of the different services/agencies available in the area you practice in so that we can then recommend these to service users if interest.
15.3. Communicate appropriately and quickly when necessary to collaborate information with the interprofessional and interagency teams.
16. Service users working alongside professionals to plan their care
16.1. Informed consent should always be given
16.2. Informed consent
16.3. Assessment done to find out the patients OWN short term and long term goals, what does recovery look like for them?
16.4. If the patient has a good understanding of their care then they will be able to provide you with more information to help you help them
16.5. make sure documentation is clear and precise.
16.6. Reevaluation when needed to adapt and change
16.7. Communication between the service user and the professionals is paramount, they need to have an understanding of what is actions are to be taken
16.8. Providing care that is respectful and responsive too patients individual needs and values, and making sure that all patients needs help shape clinical decisions to create an individualised care plan
16.9. It is important that professionals always make sure the patient/service user has thoroughly understood the conversation relating to their care and help to overcome any barriers that may be restricting this thorough understanding, e.g jargon.
16.10. Allowing patients to be involved in their care and do as much for themselves as they are able. This allows them to retain their independence due to the close working between them and the health professionals.
16.10.1. Also by health professionals enforcing patient involvement this can help encourage a patient to take responsibility and be independent (to an extent, depending on the circumstances/ situation) with their care knowing they have support from health professionals.
16.11. Patients are able to give informed consent to the care they're receiving, by doing this professionals need to make sure patients understand everything that has been said as things can get misinterpreted by professionals using jargon.
16.12. Along with gaining informed consent, you should always identify yourself to the patient, for example stating you are a student nurse etc.
17. Team building
17.1. This can provide a better working environment. colleagues may develop better and positive relationship which may enhance support when dealing with difficult situations.
17.1.1. Better atmosphere for the patient and possibly better care.
17.2. By getting to know our colleagues and understanding their role we can provide optimum care for patients. Team building also enables us to feel comfortable to be able to approach different members of the multi-disciplinary team.
17.3. In inter professional working, each colleague has specific roles and their own goals which contribute to achieve an end goal
18. Conflict resolution
18.1. Be aware of personal boundaries, non-verbal communication and the environment that your in. can things be removed to prevent the patient harming themselves?
18.1.1. Why are they presenting this behaviour?