A structured reflection using Rolfe et al.’s (Cited by Morrissey and Callaghan 2011) three-stage reflective model is applied to guide this annotated bibliography.
Stage 1
I have chosen the topic “promoting health and equality for marginalised groups “specifically in the area of end stage dementia care from the school research matrix (School of Nursing and Midwifery 2013). As a general nurse I became interested in this topic having worked in the residential setting where I observed first-hand staff neglecting a geriatric patient whom had end staged dementia. End stage dementia is characterised by severe short-term and long-term memory loss, the inability to communicate and dependant on other individuals for activities for daily living (Santakruz,
…show more content…
At this stage of dementia the optimal care requires balancing polypharmacy, geriatric syndromes, frailty, delirium, fall risk, incontinence and behaviour disturbances all to which this patient was not obtaining (Ganguli, 2005). These requirements are very relevant to nursing practice as the side effects must be managed and the nurse has the responsibility to ensure that. Polypharmacy can increase the risk for adverse side effects and geriatric syndromes. Throughout my time in that placement I noticed the use of the SPICES tool which asses sleep disorders, problems eating and drinking, incontinence, confusion, evidence of falls and skin breakdown was not used effectively or often enough thus neglecting the patient’s needs (Fulmer, 2007). As this patient was elderly it intern increased her morbidity and mortality risk (American Geriatric society, …show more content…
This emphasizes the importance of engaging with the concerns of the practitioners on their experienced professional judgements even when no evidence of mistreatment is taken seriously and acted on. There were little limitations to this study. The amount of participants in the research were moderately low which may conclude to work demands and time pressures resulting in little availability to participate, also with this being a distressed issue, induvials may be reluctant to take part in. Also other key groups were not included in the study such as family members who are essential in understanding their relatives and monitoring their care that is given by staff (Tadd et al.,
In thinking about whether one is enabled or encouraged to enact person-centred care in the workplace is a twofold response. In ones role of leisure and health officer, one of the parameters of agreed employment was that one would be able to work as a person-centred officer in the role. Therefore, one is encouraged to empower people with dementia to ...
...tion with the outside world and loss of their life style. Communities need to be educated on dementia so that as to include and create activities they can join in. The residential homes decision makers need to monitor the cares’ behaviour as they and address issues within their working environment to improve and keep everything up to standard. The government need to implement and review their policies to make ensure quality care in residential homes. According to United Kingdom Health and Social Care (UKHCA), (2012) and The National Institute for Health and Care Excellence (NICE), have been working on introducing new guidance which will help dementia patient to get more funding to live in their own homes and avoid living in residential home which is a positive move as people will still enjoy the comfort of their homes and receive excellent care.
Furthermore, they have introduced a human rights approach, which is to respect diversity, promote equality help to ensure that everyone using health and social care services receives safe and good quality care. Human rights approach will help to apply the principle of promoting equality. The CQC have a process in which you answer five key questions to consistently integrate human rights into the way they regulate, which healthcare providers must work alongside. They also have equality objectives which were introduced in 2017, the objectives are, person-centred care and equality, accessible information and communication, equal access to pathways of care and to continue to improve equality of opportunity for our staff and those seeking to join CQC, as well as patients. Also filling in a safeguarding adults review, which is a process for all partner agencies to identify the lessons that can be learned from complex or serious safeguarding adult’s cases, where an adult in vulnerable circumstances has died or been seriously injured because of abuse or neglect. At winterbourne view residential home, abuse and neglect had been made clear to the public eye and could clearly be identified, although no staff logged it as a safe guarding adult
It aims to co-operate with people with dementia, their families, carers and a wide range of stakeholders (Glasgow Dementia Strategy, 2016). The number of people in Scotland with dementia stands at around 70, 000 as of 2015 with a projection of 156% rise over the next 38 years (Alzheimer’s society, 2016). National and local level Policy has therefore reflected a need to respond to this and plan for the future (Glasgow Dementia Strategy, 2016). Following the Scotland’s national dementia Strategy (2010) the Glasgow strategy aims to encourage and strengthen communities to ensure that over time, there is capacity to support people affected by dementia so they can enjoy the best possible quality of life. This policy also follows the Alzheimer’s Scotland (2016) policies on dementia awareness and health models to ascertain the best possible life for those impacted by dementia. This new Glasgow strategy provides an opportunity to raise awareness and combat stigma this is to ensure that Glasgow is a dementia friendly place to live for people affected by dementia (Glasgow Dementia Strategy,
Mollie is the patient in our case study. Mollie lives with her daughter and son in law, both in their 70’s. A home health aide assists Mollie five days a week for three hours each day. At age 94, Mollie is an older adult, considered to be part of a vulnerable population, at risk for hearing, visual and mobility deficits. This at risk population can experience changes in cognitive or physical status making the activities of daily living difficult to perform (Meiner, 2011). As people like Mollie age, gradually becoming less able to function independently, their grown children, potential caregivers, may be preoccupied with the demands of their own lives and not prepared to care for an older
On 10/4/16 I was working the detail located at ORMC 1431 SW 1st Ave, Ocala, FL at approximately 1900.
Due to an ageing population , The Francis Report recommends the introduction of a new status of nurse, the “registered older persons nurse”. One of the illnesses linked in with this is dementia, and multiple factors relating to dementia are having an impact on how nurses are trained and their deliverance of services. In 2013, the Royal College of Nursing (RCN) began a new development program to transform dementia care for hospitals. There aim is to develop skills and knowledge related to dementia, the roles of all those who are involved, understanding the development of action plans that identify key changes.
The idea of a being a nurse has always been a driving force in my life. Throughout my Licensed Vocational Nursing Program I had my first encounters with sick people and the hospital setting. Observing my mentors I witnessed the difference they made in peoples lives. In my Registered Nursing Program I had the privilege of doing clinical rotations at The Veteran Affairs Hospital in Fresno, California. It was here that it was most profound that nurses not only heal the physical ailments of a patient but also those of the mind and spirit. I looked forward to spending time with the patients and listening to their histories while providing care. Through these experiences grew my personal philosophy of nursing. Nursing
I am currently in placement in a care home which provides long term care for elderly individuals. Following the Data Protection Act 1998, in order to preserve confidentiality, for the purpose of this activity the resident shall be referred to as Grace. Having assessed a number of residents needs I came to the conclusion that this individual would benefit most from this activity. The reasons for which I will outline below. Grace is an 87 year old female resident with a current diagnosis of mixed type dementia. Grace’s diagnosis of mixed dementia has resulted in a decline in her cognitive ability, especially her memory recall. This has also resulted in Grace being deemed to be a vulnerable adult and she has been placed on an Adults with Incapacity Act 2000 declaration. In order for Grace to be treated with a person-centred holistic care approach, I will work with Grace to develop a scrap book containing pictures and stories about her life. The aims of the activity are; to engage Grace in a mentally stimulating activity which provides for all of her dimensions of health and needs which are; Physical, psychological, social, societal, emotional and spiritual. (WHO, 2011)
Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Elderly who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. Elderly who take over-the-counter medications, herbs, and supplements without consulting their physician are at risk for adverse reactions associated with polypharmacy. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients who continue to take medications which have been discontinued by the physician. There is a great need for nursing interventions regarding polypharmacy, including medication reviews also known as “brown bag”. As nurses obtain history data and conduct a patient assessment, it is essential to review the patients’ medications and ask open-ended questions regarding all types of medications in which the patient is taking. In addition, the patient assessment is also an opportunity for the nurse to inquire about any adverse reactions the patient may be experiencing resulting from medications. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.
Developing confidence, and competence is a challenge faced by novice nurses (Morrell & Ridgway, 2014). Over the course of my nursing degree developing, and maintaining confidence in my clinical practice has always been a personal challenge. During my preceptorship placement, I have the opportunity to continue to cultivate my confidence, and prepare to begin my practice as an independent graduate nurse. In the reflection, I will discuss how I have gradually become a confident practitioner through my experiences in my clinical placement, and especially those in my preceptorship placement.
I certify that this assignment is my own work in my own words. All resources have been acknowledged and the content has not been
Innovation can be defined as a process for inventing something new or improving on an idea that already exists. In the past weeks, the course on Innovation in Nursing has motivated nurses to be strong critical thinkers, evidence-based practitioners, and innovative leaders in their specialty of practice and education. The following paragraphs will briefly discuss and elaborate on the eight learning outcomes listed in the syllabus.
The following essay is a reflective paper on an event that I encountered as a student nurse during my first clinical placement in my first year of study. The event took place in a long term facility. This reflection is about the patient whom I will call Mrs. D. to protect her confidentiality. Throughout this essay I will be using LEARN model of reflection. I have decided to reflect on the event described in this essay since I believe that it highlights the need for nurses to have effective vital signs ‘assessment skills especially when treating older patients with complex medical diagnoses.
“The ultimate value of life depends upon awareness and the power of contemplation rather than upon mere survival” (Aristotle, n.d.)