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1773 results in Nursing

Page 64 of 89

  • Conclusion

  • Dawn Forman, Curtin University, Perth, Dimity Pond, University of Newcastle, New South Wales
  • Book:
    Care of the Person with Dementia
    Published online:
    06 August 2018
    Print publication:
    15 September 2015, pp 171-182

  • Summary

    Learning outcomes

  • Discuss ways in which the interprofessional approach might assist individuals with dementia and carers at each stage of the dementia journey.

  • Discuss ways in which individuals with dementia and their carers can contribute to the work of the team at each stage of the journey.

  • Consider how a big team, consisting of a range of professionals with various roles, might work together, particularly in the middle stages where the person living with dementia is requiring maximum support in the home.

  • Discuss the issues relating to leadership in team care and how the team might resolve these issues in different clinical settings.

    • Key terms

  • dementia

  • evidence-based practice (EBP)

  • leadership

    • Introduction

    Many of the key messages from this book are about how health professionals should work together in the care of people living with dementia. To summarise some of the key points, we will follow Mary as she travels along a dementia journey, and explore some of the many ways in which professionals can work together to help her on that journey.

    Early signs of dementia

    Mary, aged 76, lives alone. Her husband died shortly after he retired some 10 years ago and the couple had no children. Mary used to work in an office, but has lost touch with most of her former workmates now. Her one companion is a much loved dog named Freddie, although there is also a niece who visits from time to time. She has been a patient of her GP for over 10 years. She books a regular monthly appointment for a blood pressure check, repeats of her eight medications when necessary and a bit of a chat. She has quite stable diabetes, for which she is taking oral medication, and every three months she has this reviewed under a chronic disease management plan. She has never brought along her niece to these appointments.

  • 9 - Understanding ethics and dementia care

  • Dawn Forman, Curtin University, Perth, Dimity Pond, University of Newcastle, New South Wales
  • Book:
    Care of the Person with Dementia
    Published online:
    06 August 2018
    Print publication:
    15 September 2015, pp 135-158

  • Summary

    Learning outcomes

  • Understand the importance of the concepts of self and personhood in the context of dementia.

  • Demonstrate knowledge of ethical concepts.

  • Be able to reflect on the impact that cultural understanding may have on giving or receiving dementia care.

  • Understand that relationships are important in caring for others.

    • Key terms

  • autonomy

  • culture

  • dementia

  • ethics

  • palliative care

  • value

    • Introduction

    It can be easy to look at ethics as simply following codes or a set of principles that inl uence what people do. Both of these are important but, in a health setting, particularly one involving dementia care, codes and principles may not be enough because they do not adequately take account of the special situation of someone who needs care, especially those who can be challenging to care for.

    This chapter discusses some key ethical concepts. It also looks at what might be helpful for carers to understand so they may act ethically towards those with dementia. It shows professionals that ethics influences what they do with the information that they have. It is as necessary a part of an interprofessional and evidence-based practice as sound science, good skills or lived experience.

    At a basic level, people need to know about ethics simply to get along with each other, as ethics enters into every interaction that they have with others. In some way or other, at its heart, ethical behaviour must take into account how each person might affect others. This means that people should consider the possible consequences of what they do. But ethics is more than thinking about the possible consequences of actions. Each person needs also to reflect on the reasons for doing things, on what sort of person they want to be and how relationships might be valued and nurtured in even the most challenging care environments.

  • 10 - Environmental and social contexts

  • Dawn Forman, Curtin University, Perth, Dimity Pond, University of Newcastle, New South Wales
  • Book:
    Care of the Person with Dementia
    Published online:
    06 August 2018
    Print publication:
    15 September 2015, pp 159-170

  • Summary

    Learning outcomes

  • Outline principles of sound environmental design that enable maximising abilities and support limitations.

  • Describe the application of evidence-based designs in varying contexts: the home, community, residential care and acute care.

  • Discuss the application of principles of participatory involvement to the design of buildings for people with dementia.

  • Discuss how an interprofessional education and interprofessional practice approach may enhance environmental design and participatory engagement.

    • Key terms

  • environmental design

  • interprofessional education (IPE)

  • interprofessional practice (IPP)

  • knowledge translation (KT)

    • Introduction

    What do the people who provide care to people with dementia share? Values, attitudes, skills - perhaps; but there is one that they cannot avoid sharing - the building that the person with dementia is occupying.

    Environmental design

    It seems fair for me to say, after 30 years of working in the field, that the appreciation of the impact of the building on the success of care is somewhat limited. This is not because we lack information on how to reduce the disabilities experienced by people with dementia by designing enabling buildings.

    In fact, we have the benefit of a reasonably extensive literature on the subject (Fleming & Purandare, 2010; The King’s Fund, 2012; Garre-Olmo et al., 2012 ; Zuidema et al., 2010 ; van Hoof et al., 2010; Verbeek et al., 2009; Calkins, 2009). The findings from this literature can be organised around 10 principles of environmental design (Fleming & Bennett, 2013) and these have been summarised in Table 10.1 .

  • 2 - The journey of dementia

  • Dawn Forman, Curtin University, Perth, Dimity Pond, University of Newcastle, New South Wales
  • Book:
    Care of the Person with Dementia
    Published online:
    06 August 2018
    Print publication:
    15 September 2015, pp 37-48

  • Summary

    Learning outcomes

  • Discuss the course of the disease from health to illness to death.

  • Discuss the importance of acknowledging the social, emotional and spiritual aspects of a person living with dementia.

  • Discuss the significance of the person’s life lived before the onset of dementia.

  • Consider the impact of the journey of dementia on family and friends.

    • Key terms

  • Alzheimer’s disease

  • dementia

  • neurocognitive disorder (NCD)

  • personality

    • Introduction

    The journey of dementia can be described as follows:

  • something is not right;

  • diagnosis;

  • course;

  • transitions;

  • end of life;

  • life stories;

  • the family experience.

    • Mace and Rabins (1981) made four connected statements about dementia:

  • there is damage to the brain;

  • the person is still there;

  • the family is also affected;

  • there are things we can do.

    • This chapter will expand on the first three statements and allude to the last.

    As health or care professionals, we should always remember that people have lived 60 or 70 years before the onset of dementia – it does not define them. Each of us comes in and out of people’s lives in just this small portion. Really we might be a bit important but in the totality we are just a small-bit player.

  • Foreword

  • Dawn Forman, Curtin University, Perth, Dimity Pond, University of Newcastle, New South Wales
  • Book:
    Care of the Person with Dementia
    Published online:
    06 August 2018
    Print publication:
    15 September 2015, pp v-vi

  • Summary

    Over the past decade there has been a signii cant movement towards interprofessional practice (IPP) and education within health care, as a key strategy to increase the effectiveness of health care delivery. Recent studies and systematic reviews have shown that IPP is well received by clinicians, can change their perceptions and attitudes, and is related to improvements in knowledge, skills and collaborative practice. There is a growing body of research showing the positive impact of IPP approaches on healthcare processes, patient satisfaction and clinical outcomes.

    For people living with dementia and their carers, there will be many critical points across the trajectory of disease when they will seek – or be offered - advice, treatment, care and support. The organisation, delivery and quality of the health care they receive, and the important relationships that are formed in the process, can make the difference between a seamless healthcare journey that enhances overall quality of daily life or a fragmented, stressful series of encounters that makes the journey more dificult. Recent international and Australian initiatives in interprofessional dementia care have illustrated the potential benefits of this type of approach to the complex range of needs and issues that occur for people living with dementia and their carers.

  • 4 - Evidence-based practice

  • Dawn Forman, Curtin University, Perth, Dimity Pond, University of Newcastle, New South Wales
  • Book:
    Care of the Person with Dementia
    Published online:
    06 August 2018
    Print publication:
    15 September 2015, pp 63-80

  • Summary

    Learning outcomes

  • Identify the challenges of applying evidence-based practice to health workplaces.

  • Discuss the role of interprofessional education in supporting the translation of evidence into practice within dementia care.

  • Describe the barriers and enablers of knowledge translation and evidence-based practice.

    • Key terms

  • evaluation

  • evidence-based practice (EBP)

  • interprofessional education (IPE)

  • knowledge translation (KT)

  • power

    • Introduction

    The concept of evidence-based practice (EBP) has become the gold standard for health care as it envisions that new and innovative findings (ideas, treatments, technology and methods) will be incorporated into the education of health care teams and thus will lead to improvements in real-world practice with the application of current knowledge. It makes sense that we look to the research literature (peer reviewed and published studies), evaluate what we find, and use evidence in our planning and our ways of doing things. The Oxford Centre for Evidence-Based Medicine (Howick et al., 2011) has developed a hierarchy of likely best evidence with five levels of evidence from strongest to weakest: systematic reviews, randomised controlled trials, cohort studies, case series and clinical/mechanistic reasoning. They link the evidence to whether it is being used for diagnosis, prognosis, therapy and prevention, or economic decision analysis. Eccles and colleagues (1998) used three evidence categories to develop guidelines for the primary care management of dementia: They are:

  • I well-designed randomised controlled trials, meta-analyses or systematic reviews;

  • IIwell-designed cohort or case control studies;

  • III uncontrolled studies or external consensus.

  • 7 - Developing collaborative skills

  • Dawn Forman, Curtin University, Perth, Dimity Pond, University of Newcastle, New South Wales
  • Book:
    Care of the Person with Dementia
    Published online:
    06 August 2018
    Print publication:
    15 September 2015, pp 105-114

  • Summary

    Learning outcomes

  • Review the collaborative skills required for interprofessional practice for people with dementia.

  • Consider how these skills are introduced into the working environment.

  • Discuss the factors that may affect staff resilience and the sustainability of good practice.

    • Key terms

  • capabilities

  • communication

  • dementia

  • interprofessional

  • interprofessional collaboration (IPC)

  • interprofessional teamwork

  • resilience

  • sustainability

  • teamwork

    • Introduction

    In Chapter 1 , we looked at the competencies and capabilities that have been derived by various groups working in this area internationally. We noted that capability tools, to measure whether individuals in teams have these skills, continue to be developed and refined. In this chapter, we revisit these capabilities by asking how these could be introduced into an interprofessional team working with individuals who have dementia and how, with these skills, the team can become resilient to change and therefore can ensure an interprofessional culture that can be sustained by an organisation.

    Interprofessional capabilities

    There are a number of models and interprofessional capability tools that have been developed internationally. Interestingly, the same capabilities (with different emphases according to the country and the environment in which they have been developed) seem to be included in some way in these tools:

  • client-centred;

  • collaborative working;

  • reflection;

  • cultural awareness;

  • organisational competence;

  • leadership skills;

  • communication;

  • role clarification;

  • professionalism;

  • conflict resolution;

  • ethics and values.

  • 1 - Concepts of leadership and management in health services

  • from Part 1 - Introduction
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 2-15

  • Summary

    Learning objectives

    How do I:

  • define management and leadership in healthcare organisations?

  • distinguish between the functions of top-level, middle-level and first-line managers?

  • understand the concept of power and how it is used in management and leadership?

  • determine the skills I would need for effective running of healthcare facilities?

    • Introduction

    Intense debate surrounds the differences between the roles, functions and even superiority of leadership and management (Lease, 2006). Leadership is not something wholly different from management; indeed, it is a component of management and a responsibility of management, especially for senior managers. The present situation in health systems suggests that effective managers need to be effective leaders, and that the most effective leaders are also good managers.

    Definitions

    Most people think they know what management is. However, if they are asked to explain or describe the term management, they will give different answers. Some of them will say that it is a science; others will argue that it is an art; still others will vote for its being a practice. In addition to these answers, they will give examples of successful entrepreneurs like Jack Welch or world-class companies like Apple. It is also tough to explain differences between management and leadership. In many non-English-speaking countries, there is no term for leadership. This suggests that common words like management and leadership could have confused meaning for many of us. Therefore, it is important to discuss the defi nitions and functions of management and leadership.

  • 24 - Successfully managing conflict

  • from Part 5 - Drives Innovation
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 273-282

  • Summary

    Learning objectives

    How do I:

  • recognise the types and origins of conflict in my workplace?

  • determine which is the best approach to managing conflict?

  • develop my skills to be more successful in managing conflict within my workplace?

  • analyse conflict situations and design an appropriate conflict management strategy?

    • Introduction

    Dana (2001) claims that over 50 per cent of voluntary resignations from organisations can be directly attributed to unresolved conflict. Managers need to understand that conflict does not resolve itself; rather, it tends to gather intensity and energy. Gupta, Boyd and Kuzmits (2011, p. 395) have found that ‘employees spend as much as 42 percent of their time engaging in or attempting to resolve conflict and 20 percent of managers’ time is taken up by conflict-related issues’. Managing conflict is one of the prime responsibilities of managing staff and teams. It is critical, then, that managers are able to detect initial symptoms of conflict and adopt the most effective behaviours to resolve it (Vivar, 2006). In this chapter, different types and origins of conflict are discussed, as well as approaches to managing and resolving conflict.

    Types and origins of conflict

    Conflict is best defined as unresolved, protracted disagreements between individuals or groups that negatively impact on staff, organisations and working relationships.

  • 3 - Ethical leadership

  • from Part 2 - Leads Self
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 30-40

  • Summary

    Learning objectives

    How do I:

  • understand the importance of ethics in the health manager’s decision-making process?

  • understand the different perspectives of the four schools of moral philosophy and how they can influence a health manager’s decision-making?

  • understand the concepts of moral courage and whistleblowing?

  • identify the main factors that influence ethical decision-making?

  • identify the eight steps in the decision-making framework?

    • Introduction

    This chapter explores the notion of ethics and ethical decision-making frameworks in leading and managing health services. Chapter 1 outlined the four sets of skills, or functions, that every manager should possess, which are usually summarised under the acronym POLC: planning, organising, leading and controlling. With leadership being one of the four functions of management, it is important to understand both the management and the leadership aspects of ethical decision-making.

    Ethical decision-making

    For managers, ethical decision-making incorporates the development and dissemination of frameworks to assist staff to make decisions in line with the organisation’s direction and values, ensuring current staff understand these frameworks and recruiting staff who will work within the frameworks. For leaders, ethical decision-making is about taking action when it is needed, guiding others in working through difficult and complex decision-making processes and being a role model for other staff.

  • Preface

  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp xix-xxii

  • Summary

    This book is a culmination of over 30 years of studying, practising, researching and observing leadership and management within the Australasian healthcare industry. Over this period, a range of industry and system factors has made working, managing and leading in health services more challenging and complex. These factors include greater scrutiny of the spending on health and the resulting outcomes, which has led to substantial reform initiatives; recognition of the importance of good governance and individual, organisational and system accountability; reliance on technology to support clinical and non-clinical healthcare decision-making; workforce shortages and role substitution; and better understanding of the ways to improve clinical safety and quality, and overall health outcomes. These factors have been driven by greater public interest and political scrutiny of the healthcare system, focused on quality and safety, access and equity, and the roles of the various levels of government and private operators. We have seen funders, regulators and other agencies requiring increasing levels of effectiveness, efficiency and better health outcomes.

    To navigate the complexity of the industry and national and international factors, it is not enough to just be a good manager or a good leader. Being successful as a manager or a health professional requires a combination of both management and leadership skills and aptitudes. Leading and managing health services: An Australasian perspective provides a critical and concise overview of the important skills, aptitudes and content areas required to successfully lead and manage in a wide range of healthcare settings, no matter where you sit in the organisational structure. It provides insights into aspects of healthcare leadership and management applicable to Australasian health systems from highly experienced healthcare managers, leaders and academics.

  • 14 - Influencing strategically

  • from Part 3 - Engages Others
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 162-170

  • Summary

    Learning objectives

    How do I:

  • develop my skills in respect to influencing tactics and strategies?

  • choose key influencing tactics and strategies that might be used in engaging internally in my organisation, as well as outside the organisation?

  • understand the importance of influencing strategically as a leader?

  • help my department and organisation achieve strategic goals through the use of influencing tactics and strategies?

    • Introduction

    Everyone creates influence during their lives. This may be consciously or unconsciously, through communication, actions or behaviours. A person can be influential through who they are or what they do, such as through their creativity, dependency, vulnerability, position and example.

    A critically important element of creating change, growth and renewal in health service organisations is the need for strong and effective leadership, of which influencing skills are an integral part. Healthcare organisations are complex entities with large numbers of internal and external stakeholders. Strategic influence is an important aspect of the leadership and management of these organisations, as leaders and managers rely on the ability to enhance the effectiveness of those working in all parts and levels of the organisations as well as those outside the organisations in the broader system. Healthcare managers can increase their impact and achievements through understanding and applying infl uence, and key aspects of healthcare leadership relate to the processes of influence.

  • 8 - Leadership and critical reflective practice

  • from Part 2 - Leads Self
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 90-102

  • Summary

    Learning objectives

    How do I:

  • improve my ability to reflect on my own practice?

  • use a critical reflection approach?

  • reflect for action, reflect in action and reflect on action?

  • enhance my leadership abilities through reflective practice?

  • choose a reflective technique that works for me?

    • Introduction

    Humberto Maturana (1998) claims that ‘to know with full confidence is the enemy of reflection. Reflection is when what we claim to know has the ability to step back and take another look’. Reflection is not a new concept in the health sciences. Contemporary conceptions of reflective practice are underpinned by the works of John Dewey (1910, 1916, 1933, 1938), Carl Rogers (1951, 1969), Paulo Freire (1995) and Donald Schön (1983, 1987). Today, reflection is a core component of healthcare education and is evident in the governing codes and guidelines that underpin professional practice in many health disciplines in Australasia. References to reflection appear in each health discipline’s code of professional practice or code of conduct, and effective and purposeful reflection is seen to be a core component of proficiency and ongoing professional development. Despite this, students, practitioners and healthcare leaders often struggle with reflection and critical reflective practice.

    This chapter explores what is meant by reflection and critical practice, how to adopt a critically reflective attitude and foster skills in leadership, and how leaders can use critical reflection to support growth and change at personal, team and organisational levels.

  • 13 - Power and political astuteness

  • from Part 3 - Engages Others
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 150-161

  • Summary

    Learning objectives

    How do I:

  • understand the use of power in organisations?

  • identify the main sources of power in organisations?

  • critically analyse the positive and negative aspects of power and influence?

  • understand how political processes operate in organisations?

  • understand the consequences of political activities in organisations?

  • enhance my skills in the various tactics that can be used to shape political outcomes in organisations?

    • Introduction

    Politics is an inevitable feature of organisation life, particularly in large bureaucratic organisations such as hospitals. Political activities arise when there is a lack of consensus about how an organisation should be managed. They are typically employed in an attempt to reconcile these divergent interests, which may be the result of competition for resources within the organisation, the pursuit of personal goals by individuals or a high level of uncertainty within the organisation.

    Traditionally, political activities have been concerned with obtaining, developing and exploiting power to infl uence others in order to achieve desired outcomes (Pfeffer, 1981 ). Consequently, decisions shaped by political activities are not always rational - they do not always produce optimum outcomes, as individuals seek to satisfy their own wants and needs, often at the expense of others (Kumar & Ghadially, 1989). However, more recently, organisational behaviourists have conceptualised organisational politics as the perception that an individual or group is using infl uence and tactics to serve their own personal agenda (Ferris & Kacmar, 1992 ). One person may consider a co-worker’s behaviour to be a typical rational response, whereas another colleague may view the same behaviour as self-serving and highly political. Therefore, what is deemed to be political or normal behaviour ultimately depends on the opinion of the observer.

  • 15 - Networking

  • from Part 3 - Engages Others
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 171-182

  • Summary

    Learning objectives

    How do I:

  • understand the purpose of networking and where it sits on the partnership continuum?

  • use the three levels of networking?

  • learn to appreciate the personal and organisational benefits of networking for leadership development?

  • enhance my skills in networking?

  • overcome the challenges to achieve the potential of intraorganisational and interorganisational networking?

    • Introduction

    Networks, which are defined as groups or systems of interconnected people or things, can be formal and informal in nature and can be applied for different purposes. The capability to network can build influence in groups and organisations to support change or generate new ideas. The process of networking can be seen as a supportive system of sharing information and services among individuals, groups and organisations with a common interest. Networking can be applied at a personal level for career and leadership development, at an intraorganisational level for organisational development, and at an interorganisational level for research, knowledge management, process improvement and relationship development.

    Definitions

    Networking is a key leadership capability. Besides being a supportive system of sharing information, it can develop trust or sharing of turf between partners and is a useful strategy for individuals and organisations in the initial stages of working relationships. It is a useful skill in environmental scanning and managing change.

  • 21 - Negotiating

  • from Part 4 - Achieves Outcomes
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 245-252

  • Summary

    Learning objectives

    How do I:

  • identify a negotiating opportunity?

  • improve my skills in negotiating?

  • plan a negotiation?

  • decide whether I should accept the proposed solution?

    • Introduction

    Negotiation is an important skill for a healthcare manager. According to Mealiea and Latham (1996), many managerial activities, such as budget development, performance appraisal and review, planned change, team-building, complaint-handling and resource allocation require negotiating skills. Other authors have suggested that great leaders need to be great negotiators (Nanus & Dobbs, 1999). This chapter introduces negotiating theory and tactics that can assist readers to develop their skills for use in personal and professional negotiations.

    Concepts

    Once two or more parties agree to enter into a negotiation, they may use either an integrative approach (win–win) or a distributive approach (win–lose). An example of an integrative approach might be the creation of a preferred health service provider relationship, in which the provider wins because they have negotiated a steady cashflow, while the organisation also wins because it has the guarantee of health services of a certain quality at an agreed price. In integrative approaches, the negotiation involves more than one factor. In the example used here, while price would be an important factor, other factors such as volume, availability, quality and mode of delivery would also be included in the negotiation.

Page 64 of 89