Friday, March 1, 2019

The Dimensions of Inter-Professional Practice

AbstractThe strain examines a position encountered by the student during her placement on a hospital ward the veritable(a) ward skirmishs to discuss longanimous of forethought and progress. The essay reflects upon the experience utilise the wistful cycle forge proposed by Gibbs. It to a fault wet-nurses upon SWOT analysis and the PDSA cycle pose for nursing behave. period rooted in the students experience, the essay excessively looks at germane(predicate) theoretical concepts including those of multidisciplinary teamwork and patient-centred healthc atomic number 18.1. IntroductionThis essay aims to consider a situation I arrest encountered during my placement, using principles of meditative practice to outline an inhibit revision to established procedure which, I retrieve, depart benefit good of process drug characterrs and cater. I ask to discuss ward reviews, and show how these can be ameliorate by extending the range of raft who attend these reviews .I want to function principles of reflective practice and evidence-based practice to examine this bea. The essay leave behind use Gibbs reflective cycle as a structure indoors which to understand a situation I encountered, and plan for diversity. The essay will overly look at nigh relevant theory, including nonions of interprofessional team work, change theory and team dynamics.The accredited situation will be discussed in basis of these. I will as well draw upon the PDSA cycle mold for nursing practice (NHS build for Innovation and advantage 2012 online), which provides a mode to structure and implement change. I will also use a in like mannerl widely used in business c totallyed SWOT analysis, which helps in change think by formalising the strengths, weaknesses, opportunities and threats in a given situation, and which is also useful for health concern (Marquis and Huston 2009). Gibbs (1988) model of reflective practice will also be influential. The essay wi ll be structured according to this 6 stage cycle, from description of event through evaluation and analysis to fill and further criticism. While there ar several different models of using reflectivity in practice including Bortons (1970), Kolbs (1984) and Johns (1995), I use Gibbs model as it seems to best express the dynamic process of encyclopedism and change for me.These tools will be used to demonstrate the things I go through are inadequate with the present situation whereby a limited number of health criminal maintenance professionals attend ward reviews, and suggest a change whereby headstone histrions also attend, offering a deeper perspective on patient exigencys.The nomination form, which assesses my placement, is include in the Appendix.2. The Situation DescriptionThe situation in question occurred when I was on placement. The hospital at which I was working, like separates, carried out regular ward reviews. In these, the patient was discussed. A number of b ring up provide snarly in patient get by were involved, and the aim was to review the patients care, interposition and prognosis. At the hospital where I carried out my placement, the members of rung who were involved were the consultant, the occupational therapist and the review nurse, sometimes also a student attended. The patient did not attend this opposition. I attended a number of these reviews. In general, all members of the team who attended were respected and respectful, and took care to listen to what individually person had to say. One person led the meeting, making sure all were include and also ensuring that discussion did not go on for too long. Realistic goals and a date for the next meeting were set at the end, and the items discussed were formalised in writing.3. The Situation My FeelingsI had two sets of feelings. On the ace hand, I felt pleased that e real nonpareil who attended the meetings seemed to wee the best interests of the patient at heart. Whe re there were disputes it was regarding what would work best for the patient. Also, I was pleased with how professionally stave members conducted themselves, I seldom witnessed rudeness or shortness when oneness person spoke to another. People took turns and really seemed to listen. In part, I felt, this was due(p) to the dash the meetings were led, which was very sensitive. However, on the other hand, I felt quite an annoyed and disappointed that not all staff who were involved in patient care were included in the meetings. I felt that a whole side of the patients experience was being mixed-up out. The staff who attended seemed to understand the patients condition plainly generally, from their records and discussing the situation, not through contact with the patient daily. The holistic side of patient care, understanding what the patient was feeling, seemed to necessitate been missed out.4. EvaluationIn terms of the SWOT framework, widely used in business still also usef ul for understanding healthcare (Williamson et al 1996), I evaluated the experience as follows. As Gibbs evaluation stage is concerned mainly with what is wakeless and bad about the experience, I flummox omitted the opportunities and threats from this analysis, as they will be covered later.StrengthsGood communication between team membersRespectful awareness of other points of viewDeveloped clear goals and actions to followWeaknessesPatient seems to lack a voiceThose involved in caring regularly from patient are not included in the reviewThose who k straightaway the patient well are not included in the reviewLack of holistic and person-centred care5. analytic thinkingThe following(a) sections looked at what happened, how I experienced it and what sense I make of it deep down my own parameters. In order to make wider sense of the situation, I need to draw upon legal opinions of interprofessional teamwork, user perspectives and team dynamics, all concepts central to the current health service. Interprofessional teamwork, also known as multidisciplinary teamwork (MDT), has been part of healthcare polity in the UK since 1997 (Davis 2007). As an approach, it means professionals from a range of disciplines involved in patient care meeting to discuss and affiliate on care plans for patients (Hostad 2010). There are a number of benefits, for example multidisciplinary teamwork seems to meet user needs better, and to deliver better yields. However, there are also some drawbacks including the time needed for teams to work effectively, and difficulties with perceived status differences (Housley 2003).For effective MDT, the shipway in which team dynamics work has to be understood. There are many attempts to understand how people work together, both generally and in the healthcare context, for example Bales (1950) model. Maslows model is also influential in healthcare. He suggested that all humans need to be respected by others in order to feel valued, and d eal a need to feel part of a group, and want to have their social and emotional needs met within the work context (Borkowski 2009).The notion of incorporating user perspectives is also very influential in the NHS currently, as patient-centred healthcare. This was introduced in the late 90s, and involves patients being involved as oftentimes as possible in decisions which are made about their care. The family between healthcare professional and patient is no longer one in which the professional is at the top of a hospital hierarchy, entirely one of partnership in which mutual respect and communication exist (Chambers et al 2003)Overall, I feel that both MDT and patient-centred healthcare could be improved here through including the depict workers, or support workers of the named patient. The key worker acts as a co-ordinator on behalf of the patient, keeping the patient informed of what is sacking on and co-ordinating care and ensuring continuity of treatment ( straightlaced 2004). Support workers or healthcare assistants act in a supporting role to other professionals, and are very hands-on in well-being and looking after the patient.Both these professionals have much closer contact with the patient and as such have important insights into the patients situation. Multidisciplinary teamwork emphasises including all viewpoints relevant to the situation, and I feel that these workers would add valuable insights to enhance the teamwork. In addition, how can patient care be really holistic and patient-centred if the meetings do not include those people who get to know patients as individuals, understanding their feelings, hopes and fears Including support and key workers would furnish those people who are not involved in daily care to really understand how the patient is feeling.In addition, if support and key workers were present at the meeting, it would be much easier and quicker to feedback to the patient what is going on with their care. As it stands , patients hear second hand.6. ConclusionGibbs suggests reflecting upon what else I could have done here. assumption that I was on placement, I feel that the opportunities for changing the situation are practically limited. At the time, I felt it was not beguile for me to head up and question the accepted meeting structure. Later, however, I did question whether I should have mentioned this to my supervisor on the ward. I felt that the emphasis on MDT meant that I would be heard sympathetically, even though I had very little experience.If I was able, I would change the meeting structure to look that either a support worker or a key worker was included as a matter of principle. I feel that the existing meeting structure is very good, and that if it was part of protocol that staff closely involved in the patients care were included, they would be welcomed into the meetings, their opinions heard and the patients viewpoint better understood. This would, I feel, command that the care delivered to the patient was more truly patient-centred and holistic, as it would take into count on not only quantitative info about their condition but also their feelings and emotions. In addition, I feel wider meetings would be more reflective of multi-dimensional teamworking, as they currently dont include all staff perspectives.It also seems that including key and support workers is more ethical. All hospitals have small code of conducts which set out the ways in which they expect their staff to behave, and the care of the patient is generally the first priority in these. working as a team is also one of the central tenets of to the highest degree ethical codes in UK hospitals (Melia 2004).7. Action PlanHere I draw upon the PDSA model to suggest a way to structure the changePlanDiscuss and agree novel format for meetings (including key worker or support worker) propound key / support worker and other staff of new meeting formatDoCarry out a series of 4 pilot meeti ngs over concur time period Agree and implement mechanisms for review of new meeting format (gather data from key/support workers, staff already included, and patients)StudyAnalyse data collected, assess changes against clearly defined criteria (for example, do patients feel more informed, happier did key/support workers feel included did other staff value new structure) What worked wellWhat worked less well?ActPlan new meetings on basis of what was learnt during study phase. If including key/support workers beneficial, change meeting structure so that they are now part of meetings. Ensure that repercussions of this are understood, for example allowing them extra time for preparing for meetings. ReferencesBorton, T (1970) Reach, Teach and Touch, Mc Graw Hill, London.Gibbs, G (1988) eruditeness by Doing A drop dead to Teaching and education Methods, Further Educational Unit, Oxford Polytechnic, Oxford.Johns C (1995) Framing reading through reflection within Carpers fundamental ways of knowing in nursing Journal of Advanced Nursing, 22, 226-234Kolb, D A (1984) Experiential Learning experience as a source of learning and development, Prentice Hall, New JerseyMarquis, B L and Huston, C J (2009) Leadership roles and management functions in nursing theory and application (6th edn), Lippincott Williams & Wilkins.Melia, K M (2004) Health care ethics lessons from intensive care, SAGE, Thousand Oaks, CANHS Institute for Innovation and Improvement (2012) Plan, Do, Study, Act (PDSA), online (cited 14th February 2012), available fromhttp// (2004) Improving Outcomes Guidance for Supportive and Palliative Care, National Institute of Clinical Excellence 2004, London.Williamson, S, Stevens, R E, Loudon, D L (1996) Fundamentals of strategical planning for healthcare organizations, Routledge, UKAppendixCLIENT INCLUDE NOMINATION formula HEREAssignme ntIn writing the 1500 word reflective remark focussed on service improvement you should consider/address the followingThe context and setting for your placement. Your reflective commentary should focus either on a service improvement initiative that you have identified with your mentor, or on a service improvement that has previously been implemented in your practice study. You should examine this initiative in terms of the inter-professional team and advert actual or potential ways that inter-professional working can accelerate its implementation. You should also discuss potential barriers to implementation. You MUST include the Service Improvement Activity notification form with your assignment including a discussion of early plans in terms of the service improvement initiative. An evidence based model of reflection or reflective writing should be used. You should offer a rationale to support what you have used (fixed resource sessions on the use and application of reflective models and writing are included in the oral communication of this module). You should also demonstrate the use of the PDSA cycle in terms of service improvement. For assessment purposes you are not expected to move beyond the planning stage of the PDSA cycle. As this assignment is a reflective commentary your reflection must be supported and referenced by using appropriate sources (as per learning outcomes). You whitethorn wish to use a structured reflective model e.g. Gibbs, Rolfe et al or Johns or you may wish to write in a reflective style, encompassing reflection on action e.g. Schon or Borton. This is your choice but either way you must show evidence you have done this. A reflective commentary requires that you use subheadings. The structure of this piece of work can be informed by using either learning outcomes or the stages of a reflective model to do so. If you say you are going to use a model of reflection, then you must demonstrate clearly that you have done so. Which ev er process you use must be in short explained and rationalised within your introduction. Ensure that you have supported your assignment with appropriate, contemporary and relevant sources, including published literature, professional standards key texts and policy. You need to apply theory to practice and use paraphrasing to demonstrate understanding of the sources you have used. Make sure you address the relevant learning outcomes for this piece of work (l,2,5) in this commentary Learning outcome one requires you to analyse the unique role of the nurse within the inter-professional team and also to apply this to your experience in your placement area. For example, do nurses in your placement area require any additional skills or knowledge to work with the client/patient group Learning outcome two requires you to evaluate the contribution of all members of the inter-professional team in providing holistic care to clients/patients. For example, which guidelines and policies inform ho listic care in your placement area and how did this impact on practice in your areaHow did the team work togetherWhat qualities did you circular in the team and how did this impact on care delivery Learning outcome five asks you to reflect on learning and transfer pertly gained knowledge. For example, what did you learn and how will what you learned in your placement help to stool you to be a registered nurse

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