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Inter-professional Practice Essay Plan
Describe the context of the incident.ie where were you, dept. setting, your role etc
This report will explore a critical incident that occurred whilst a Student Learning Disability Nurse was on placement within an Adult Community Learning Disability Team, that made her reflect on her beliefs, attitudes and values about interprofessional working and caused the student to question her assumptions or beliefs about other professional groups. This critical incident analysis offers the opportunity to look back at a safeguarding meeting that took place, where self-awareness and skills in critical thinking and problem solving where developed. It will also consider the role of the learning disability nurse within interprofessional working and look at the professional and legal aspects of care, as well as examining the specific knowledge and attitudes needed to effectively assess, plan, implement and evaluate care interventions. In order to respect confidentiality and ensure anonymity in accordance with the Nursing and Midwifery Council (2015), NHS England (2014) and the Data Protection Act (1998), locations and trust names will not be mentioned and the service user involved will have their name changed to ‘John’.
Describe the actual incident.
The incident that took place was whilst the author attended a safeguarding meeting with her co-mentor who was a learning disability nurse. It was this particular nurse that raised the safeguarding concern initially, after visiting a young man who lived independently in a flat and noticed his home environment had a lot of items that created clutter and posed risks to himself and other individuals that lived in the flat as well. The gentleman had a mild learning disability and Asperger’s syndrome, and the nurse was visiting him to complete a nursing assessment after a referral was made from social services regarding his physical health. The nurse managed to complete her nursing assessment, however noted that his appearance was unkempt and there was a lot of clutter in his home that posed risks. The nurse attempted to gain an understanding of what the contents was, and it was established that the young man collects rubbish from the streets and brings it home with him. It is a nurse’s professional duty of care is to safeguard individuals that may be at risk due to of a variety of factors, and in this case it was apparent that he may have lacked the capacity to acknowledge fire and infection control risks. The nurse acknowledged her strengths and limitations within her own profession and identified the need to reach outside of her own discipline as there were risk regarding fire safety, infection control and self-neglect; thus the need to raise a safeguarding alert.
The particular safeguarding meeting that the student nurse attended was a follow up to discuss what progress had been made with the situation and access if risks have changed. The student noticed that there was a good attendance from muti-professional agency’s including social services, healthcare and advocacy; co-location could have been a factor here as two of the professional organisations were permanently based within the same office building. The meeting had a clear structure, where enabled professionals to communicate in an effective way to feedback actions they had completed since the last meeting, which allowed the administrator who was taking minutes to follow the conversation in a helpful way that meant effective notes could be transcribed for record keeping. It was apparent the during discussion everyone had a shared goal and were in agreement with actions that needed to be taken. It appeared that everyone in the room had the opportunity to share their thoughts and ideas, which enabled a holistic outlook on the matter there was a consensus at the end of the meeting.
Use contemporary literature inform and make sense of the incident in light of inter-professional practice.
1500 words 375 words on each point
The author noted that there were four main factors that impacted upon the incident described: that professionals were communicating effectively with each other and in a professional manner, there appeared to be a structure in place that allowed room for sufficient record keeping and co-ordinated and co-location appeared to benefit professional working together.
Benefits of professionalism and open communication:
It is important that healthcare and social care professionals can communicate effectively with each other.
Joint decision making encourages shared risk taking.
Least restrictive practice
It was reported that support workers had visited John at home to try and help him clean his house and discard of rubbish, as well as educating him on why it it an unhealthy way to live, however he refused their entry on numerous occasions, which let to a discussion about Johns capacity. The psychologist had visited and fed back that there may be some psychological attachment issues which is leading to hording and it is something he wanted to explore further. The phycologist also reported that he has not been sleeping either due to his bed being covered with rubbish too, as we know sleep hygiene is important for daily functioning. After discussion, about the current situation it was discussed if he possibly needed to be detained under the mental health act so that he could access treatment and social care could go into his house to clean it.
The first response but due to the circumstances it felt like this kind of action needed to take place, especially if John wasn’t going to co-operate with services. At this point the student realised that a person has a right to not engage with services and treatments, however as he is a venerable adult, it is the duty of care from the professional to protect John and others that live around him.
Benefit of Colocation:
Limited research on colocation. Most research is about rural areas.
Co-location refers to services that are located in the same physical space, for example the same office. Thought health and social care services were not fully integrated with one another, co-location encouraged a partnership between health providers and human services providers. The advantages of co-location is that they can streamline referrals, increase access to care, and increase communication between different providers (RHI Hub, 2016). Co-location can help to reduce transportation barriers for staff, as they are able to travel to one location for meetings, which means a good attendance expected. However, within a community team it is more or less essential that staff care drive due to visiting services users at an array of lactations which could include their home, day centre or hospital.
Even though it was a physical activity that was causing the person risk, professionals need to effectively treat a personas, professionals need to have a understanding of emotional responses, which was why it was good to see that the psychologist was in meeting and had carried out work with the person (Raphael-Grimm, 2014).
Benefit of good record keeping:
The student recognised that there was a good level of co-ordination once the meeting commenced, with every attendee punctual and prepared with their paperwork and notes, which demonstrates professionals practicing effectively (NMC, 2015). Throughout the meeting there was a good level of record keeping and trail of actions being shared and documented, which is an essential part of collaborative practice which can improve patient care, since Prideaux (2011) acknowledges that poor documentation contributes to reduced patient care and delivery. We know that clear and detailed documentation can be used to evidence tasks that have been carried out with what benefit, which lets other staff know about a service users’ experiences, needs or events (SCIE, 2013). There was a good level of communication upon identifying who will carry out the tasks within certain timescales, which ensures accountability.
Benefit for agreeing on the same goal:
The benefit of working together towards the same goal is beneficial for working together and the patient as it demonstrates consistency and agreed plans. It is essential that patients have a consistency in how care is delivered and the approach. There should be a consensus between professional about the most holistic and person centred approach to modify psychological needs of a person (refrence) however (so and so) feels that there is a major gap in clinician’s willingness to embrace their role in reducing a person’s emotional distress (Raphael-Grimm, 2014)
Explain how this will impact upon your future role in your chosen profession.
When the student was informed that the safeguarding meeting was regarding a person’s house due to clutter/hording concerns, she was quite surprised as she associated safeguarding concerns with abuse, neglect or self-harm. This made her reflect on what safeguarding stipulates and how nurses have to be aware of all factors that could pose risks to those they are supporting or accessing, evening if it is irrelevant to the initial reason of a home visit for example. Due to the fact that the student nurse sees herself as being non-judgemental, and wouldn’t like to think she was being discriminative towards how someone lives their live or keeps their house, she is now aware of how someone’s environment can impact their safety and cause a lot of dangers; moving forward she will not hesitate if she has a concern that needs to be raised.
Interprofessional Working in Health and Social Care (2014) - Edited By Judith Thomas, Katherine C. Pollard And Derek Sellman. 2nd edition. Palgrave Macmillan. Basingstoke, Hampshire.
The student felt that she learnt from and about the role of each of the professionals that attended, which would improve collaboration and the quality of care (tinyurl.com/caipe.ipl).
SCIE (2013) Accesses 21st Nov 2016.
RHI Hub (2016)
Art of Communication in Nursing and Health Care, by Raphael-Grimm, Theresa
PUBLISHER, Springer Publishing Company, DATE 2014-10-15
Prideaux, A. (2011). Issues in nursing documentation and record-keeping practice. British Journal of Nursing, 2011, Vol 20, No 22. P 1450-1454.ted. However, within a community team it is more or less essential that staff care drive due to visiting services users at an array of lactations which could include their home, day centre or hospital.
The benefit of working together towards the same goal is benefi