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1800 results in Nursing

Page 65 of 90

  • 1 - The Model of Interprofessional Practice and Education – 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 11-36

  • Summary

    Learning outcomes

  • Examine the competencies and capabilities required for interprofessional practice.

  • Discuss the relevance of context for working in an interprofessional manner.

  • Explain specific capabilities required in dementia care.

  • Explain the Model of Interprofessional Practice and Education – Dementia.

    • Key terms

  • capabilities

  • competencies

  • dementia

  • evaluation

  • interprofessional

  • interprofessional education (IPE)

  • personhood

    • Introduction

    In 1978, the World Health Organization stated:

    Given that effective health care requires the services of personnel with different competencies, it is essential that trainees should have appropriate experience of such cooperative endeavours and have the ability to work towards a common goal, to communicate and share responsibility.

    As community members, students and/or practitioners, we have all worked in many team environments – for example, the workplace, sport, committees, community services, and group assignments – where people with varying skills and knowledge come together to jointly achieve a goal or provide a service. Within health settings, team practice is common where a group of professionals – for example, nurse, social worker, oncologist, pharmacist and radiographer – manage the care of a specified number of patients as a coordinated group. However, very few of these experiences can be described as interprofessional.

    Respectful working relationships with shared decision making, shared leadership and shared learning are the hallmarks of interprofessional practice (IPP). In addition to specific professional competence, other skills are required: the ability to work collaboratively; to take responsibility for your own actions and the actions of the team as a whole; to take a leadership role or follow the lead of others depending on circumstances; and the ability to provide a consistent service while under pressure.

  • 3 - National and international perspectives: Interprofessional education and collaborative 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 49-62

  • Summary

    Learning outcomes

  • Discuss the drivers and imperatives for changing the way health care is provided.

  • Define interprofessional education and collaborative practice.

  • Discuss how interprofessional education and practice can respond to the imperatives and drivers in changing health contexts.

  • Discuss the relevance of interprofessional education and collaborative practice in the context of dementia care.

    • Key terms

  • collaborative practice (CP)

  • integrated approach

  • interprofessional education (IPE)

    • Introduction

    Many factors have precipitated increased interest in interprofessional education (IPE) and collaborative practice (CP). Demographic changes, in particular an ageing population and increased incidence of long-term health issues, require health care teams to work with people with complex care needs. New models of care and technological advances in diagnosis, treatment and rehabilitation practice require specialised knowledge to provide appropriate, safe and cost effective services. And, despite increasing university places for health professionals, the demand for qualified health professionals continues to exceed supply.

    This chapter will look at the origins of IPE internationally, and the health care environment in which dementia care is to be provided, and ask: What is it? How was it developed? Why do we need it? What does it look like?

    Drivers for changing the way health care is provided

    In 2012, Health Workforce Australia published documentation looking to the future of what would be required for the health workforce in 2025. It articulated the need to develop a health workforce that would work towards new models of health care and, therefore, the need to develop new models of education and training. However, this concept is not new. Indeed Flexner (1910) advocated the need to transform medical education, shifting from an idiosyncratic apprenticeship model to a more rigorous systematic biomedical and educational approach.

  • Introduction to 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 1-10

  • Summary

    Learning outcomes

  • Describe what dementia is in broad descriptive medical terms.

  • Describe the impact of dementia on the Australian population in terms of disability burden.

  • Identify some of the key challenges for individuals and their families and carers throughout the course of the disease.

  • Reflect on the impact of culture and membership of different special needs groups on the experience of dementia.

  • Outline how interprofessional ways of working are needed in the care of people with dementia.

    • Key terms

  • aged care services

  • autonomy

  • communication

  • culture

  • dementia

  • interprofessional

  • neurocognitive disorder (NCD)

  • respect

    • Introduction

    Dementia is a life limiting condition. The needs of people living with dementia are at the forefront of the minds of people concerned with receiving, resourcing, managing, providing and evaluating services for older people. In particular, there is an urgent need for health care teams and service providers to respond in innovative ways (Productivity Commission, 2011) to address the ‘mismatch of professional competencies to patient and population priorities’ and the chronic shortfall in health workforces (Frenk et al., 2010 ; Health Workforce Australia, 2012).

    As people live longer, the shape of society has changed and is continuing to change; creating both benefits and challenges that humanity has not met before. One of these challenges is the increased prevalence of dementia (Productivity Commission, 2011). Dementia embodies our greatest fears: a living death; cognitive decline; lost abilities; increasing dependence; loss of the person as others know them. While acknowledging that a person with dementia and their families require complex care and support over an extended period of years, perhaps there are lessons to be learned by society about what it means to be human and the real priorities of living and dying.

  • 6 - Personal and professional knowledge

  • 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 93-104

  • Summary

    Learning outcomes

  • Articulate the personal and professional attributes that may influence an individual’s practice.

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

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

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

    • Key terms

  • interprofessional

  • personality

    • Introduction

    In Chapter 1 , we identified one key aspect of the Model of Interprofessional Practice and Education - Dementia (MIPPE-D) as being personal and professional knowledge. This capability looks at the practitioner as a whole, as well as the client, and recognises not only the professional knowledge that the individual brings to the situation but also their life skills, empathy and personal experiences.

    What is personal knowledge?

    In the previous chapters of this book, we have emphasised that every client is different and the importance for all health professionals to recognise their client’s journey through life. We have also shown that health professionals need to develop background knowledge and skills to work in a professional and client-centred way.

    However, we must also recognise that each professional will have had personal experiences outside their professional background. These will impact on how they see the world, how they react in situations and their values. They may, therefore, have a wide set of life skills that can be put into practice very effectively.

  • 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.

Page 65 of 90