Clinical and Professional Practice Portfolio - Book Report/Review Example

Reflective Clinical portfolio Department Learning Theory In Kolb’s learning theory, there are four importantstages. Firstly the learner must experience a concrete new situation. The situation may also involve re-interpreting an already existing experience. This stimulates an observation and reflection on the experience with importance being particularly placed on any inconsistencies with existing knowledge. This is followed by abstract conceptualization ideas and finally active experimentation (McLeod, 2013). On the Honey & Mumford questionnaire, my learning style involves a great deal of reflection and consideration of possible consequences of actions taken. I take a step-by-step approach while solving problems and express my ideas in a manner that is simple and direct. I also believe in following laid down procedures while working in teams and actively seek the assistance of others in understanding new ideas. I believe this is very important for me as a learner and will help me greatly on this programme. More importantly are the skills of organised critical thinking and adherence to procedure which are necessary not only in the course but also the clinical profession which handles lives. Feedback A very important aspect of the learning process is feedback. It not only assists learners in understanding issues but also offers a clear guidance on how and what should be done better. Wide consensus in literature points at a strong association between feedback and learning achievement. With feedback, learners are able to gain more confidence, increase self-awareness and be more willing to learn. Feedback therefore improves learning and at the same time enhances student performance in assessments. In delivering bad news to a patient I will begin by setting the stage for the conversation through mental preparation of the patient. I will consider privacy, involve the patient’s significant others, ensure the patient is ready and manage any potential constraints to effective communication. It is also important to assess the patient’s perception of the situation and obtain their invitation so as to effectively disclose their diagnosis information (Baile et al, 2000). An important aspect is ensuring the patient gets sufficient information and also adequately responding to their emotions so that the process of breaking bad news is not impacted negatively. Finally I will also go an extra mile to assist the patient develop a strategy to handle the bad news going forward. Reflective Practice. Description is the first step in the Gibb’s cycle of reflective learning; the person should be asked to describe the experience in as much details as possible. The individuals should then be permitted to express their thoughts and opinions on the experience in a free manner. Evaluation is the third stage and here the individual should be encouraged through feedback to be objective in their approach. After evaluation, individuals should also be allowed and assisted to draw conclusions on the situation by using collected information to think further. The final stage is action and here it is important to develop action plans to be used with similar situations in the future. Professional clinical health practice is both a science and an art and thus practitioners often be required to work across domains such s health services, improvement and protection. Reflective practice has been identified as an important aspect of professional development in healthcare considering the unique situations that characterise the procession. Professionals are thus encouraged to always reflect as part of their professional practice. Reflecting on experiences enables learning from situations and therefore improving both individually and professionally. Learning encompasses social, emotional and cognitive aspects. Whereas cognitive aspects can be measure easily, social and emotional elements are quite difficult to measure. Reflective practice could significantly enhance development of all the learning dimensions (Jayatilleke and Mackie, 2012). Professional Identity A professional is a person who follows a particular career to earn a living. Professionals typically exhibit certain competencies, stills, training and educational knowledge necessary for the kind of job they are engaged in. it is the therefore very important for practitioners in the health sector to posses strong professional skills and identify with their professions so as to give quality service. Professional identity allows workers reflect not only their perception of work but also how others see their work and what they think of others. From my professional identity chart I score high on compassion, teamwork, ethics and adherence to laid down procedures. I think I can increase my professional identity scored by gaining more self-awareness and being reflective in my work. By Working closely with patients, documenting, sharing and inquiring for instance I will be able to integrate practice and learn a lot in different cultural settings. Reflective practice will particularly help develop my professional identity by permitting interweaving of personal, cultural and professional experiences. Professional Conduct Standards help promote professionalism and service quality in any profession. The HCPC has set the below standards of conduct, performance and ethics that must be kept by registrants. Act in the best interest of service users Uphold and respect confidentiality Maintain high standards of personal conduct Provide important information on their conduct an competences Always be up to date in terms of professional knowledge and skills Act within limits of accessible knowledge, skills and experience and make referrals where necessary Ensure proper and effective communication Efficiently supervise any tasks you assign to other persons. As much as possible seek informed consent in care provision. Maintain records that are accurate Must fairly and safely handle the risk of infection Be honest and of high integrity Ensure any advertisement done is accurate. As a professional in healthcare I think the standard are very important to service delivery. I will therefore strive as much possible to comply by being open to learn new ideas on a daily basis while following the laid down procedures. In making decisions, I will always ensure to be sufficiently informed so as to act in the best interest of clients. For any situation beyond my knowledge base, skills and competence level I will consult a significant others so as to make informed judgement. Confidentiality The 1997 Caldicott principles regarding usage and transafer of patient information are s below. The purpose for use of confidential information must be justified Use the information only in situations of absolute necessity Use just the minimum required information Access should strictly be a need-to-know basis Every person must know their responsibilities The law must be understood and complied with. Principles of the Data Protection Act 1998 Data must beprocessed fairly and lawfully Data should be processed for limited purposes Data should be processed in adequate and relevant amounts that are not excessive Processed should be accurate and up to date where need be Should be kept just for the period of necessity Processing should be in line with the rights of the subject Security of the data should be ensured No transfer of personal information outside EEA countries without adequate protection. The Freedom of Information Act of 2000 makes provisions for disclosure of any kind of information in custody of public authorities or held by people offering service t the authorities. It therefore amended the data Protection Act 1998 and Public Records Act 1958 for the same purpose. In the NHS or laboratory settings, confidentiality is particularly important as a lot of patients’ personal information is collected to aid delivery of quality care. It is important therefore that everything possible is done to comply with the standards of confidentiality while at the same meeting the needs of individuals in terms of healthcare. Informed consent is important as well as upholding high standards of professional and ethical conduct as the low protects not only the privacy of information but also rights of patients to privacy. Continuing Professional Development The HCPC has a major role of protecting the public through setting of standard of education, training, professional conduct, skill requirements and performance & ethics for registrants. It also keeps a register of professionals that have satisfied and complied with the set standards. HCPC also approves programmes to be completed by professionals for registration and takes appropriate actions when registered professionals fail to consistently meet standards. The professions regulated by HCPC are as below; Art therapy Biomedical science Chiropody Clinical science Dietetics Occupational therapy, Hearing aid dispensers Paramedics Surgery Physiotherapy Orthoptists Psychiatry, Prosthetics Radiography Social work Speech and language therapy. CPD is of particular important for healthcare professionals as it enhances continued learning and accumulation of up to date knowledge. It enables professionals to relevantly and effectively respond to the ever changing healthcare environment and continue offering quality service even with the constant changes. It enables them give the best of service to users consistently retain the capacity of servicing, practising safely, professionally, with efficiency and in compliance to legal & ethical considerations of the fast evolving scope of practice (HCPC, 2008). Ethics and Clinical Governance. Considering ethics in research is necessitated by the fact that research not only collects information but is touches on safety, welfare, dignity and rights of participants. Everyone involved in research must therefore hold the principle of ethics central. There often will be overlaps between ethics and practice especially in the healthcare field and as such researchers must be very careful to comply with standards and more importantly serve the best interest of society. Clinical governance is guided by five important principles. Transparency principle ensures organisations are managed in an open manner for the public benefit. Probity requires of the management and clinical employees to carry out their work in an ethical and legitimate manner. Accountability principle holds professionals responsible for actions taken both to the public or institution. Open, no-blame culture principle demands a system based approach to improving quality and finally patient centred care dictates that patients, service users and the general community are involved in every aspect of care. These principles ensure that service is given in a safe, efficient manner and with emphasis on quality ultimately improving patience care (Stuart and Barnes, 2005). Informed Consent Informed consent refers to permission given by a patient agreeing to receive service. It can only be valid where it is given voluntarily, with sufficient information and where the consenting person has capacity for decision making. Unless there is sufficient necessity for treatment without consent, professionals should always obtain the patients’ informed consent before treating. A number of exceptions are permitted in which treatment can proceed without the patient’s consent. In an emergency situation where the person is considered unable to consent due to lack of capacity, treatment may go ahead to save their life. in the event of an operation it is obvious that a patient may require additional procedures to treat life threatening problems that may not be included in the original consent. Treatment without consent may also be warranted when the patient suffers severe mental health e.g. those with dementia, schizophrenia and others. Such patients do not have the capacity to consent. Capacity in this respect means the individual understands the information provided and is capable of making informed decisions based on the information. Lack of capacity may include cases of mental health, inability to read, in emergency situations where they cannot talk and for children (NHS, 2014). Equality and Diversity. Equality promotion aims at enhancing fair& equal treatment of persons without any favour with regard to their unique needs. Equality can be effectively attained by eliminating prejudice and discrimination that is based on race, ethnicity, skin colour, class, religion or socio-economic status. Diversity on the other hand when used with equality requires the recognition of both group and individual differences so as to treat persons as individuals and place positive value on diversity in the workplace. Considering the diversity in our society, there is a need to for appropriate and sensitive response especially in the healthcare settings. Consumers of healthcare come with differences in gender, religion and sexuality. They come from different religious, age and socio-economic backgrounds. Some are disabled and some are not able to communicate effectively but must be treated as humans. Implementing measures to attain equality and diversity in healthcare environment promotes fair treatment of staff and patients hence enhancing quality. It ensures the rights of individual patients for instance are observed regardless of their status, cultural or socio-economic background. Health and Safety Including Risk Assessment and COSHH In the Health and Safety at Work Act 1974 employers have responsibilities as follows; Provide updated information to employees, contractors and all visitors regarding risks and hazards they may face as well as measures being implemented to avert the same and emergency procedures should be followed. Have timely consultations with employees on matters of health and safety in the work place. Avail clear guidelines to ensure all employees know just what is expected of them Regularly offer free training on safety and healthy in the work place which is relevant and current. Offer sufficiently appropriate supervision to all new employees who are inexperienced. Regularly perform risk and health assessments so as to ensure employees’ safety is protected while working. Have in place a policy on health and safety of workers and clearly document your commitment to safeguard the welfare of employees in terms of health and safety. Have a first aid box that is sufficiently stocked with a person appointed to take care of the first aid issues. Have enough safety signs and emergency exits in the premises The duties and responsibilities of employees in terms of their health and safety are as below; Proactively take charge of own safety and health as well as for others Co-operate with employers in ensuring legislations on safety and health care complied to. Adhere to provided instructions and information provided through trainings Report potential serious safety risks in the workplace to the employers for action. Report any shortcomings in the workplace safety standards for employers to improve. The basic steps of safe lifting and handling are as follows. 1. Size the load up and ensure to check overall conditions 2. Ensure your balance is sufficient 3. Bend with your back straight 4. Hold the load firmly with fingers and palms of your hand 5. Using your body weight, start moving the load and then lift using legs to push it up. 6. Ensure arms and elbows remain close to the body when lifting the load 7. The load should be carried close to the body and ensure not to twist your body 8. Ensure to sufficiently see where you are going 9. While lowering, just bend your knees. If you have to deposit on a bench, start by placing on the edge and then push to the desired position. In doing that your hands and feet must be clear. Infection Control Methicilinin-resistant Staphylococcus aureus or MRSA is a bacteria causing infections in different body parts. Owing to its antibiotic resistance MRSA is a very tough staphylococcus aureus when it comes to treatment. MRSA causes mild skin infections such as boils and sores and can also cause very serious infections in lungs, urinary system and entire blood stream. The bacterial can be spread through contact with infected persons or objects containing the bacterial cells. At the personal level, individuals can help slow down or even completely eliminate infections through observing hygiene standards. Firstly it important to ensure frequent hand washing, staying home when sick and washing hands immediately after sneezing, coughing or even using tissues. While coughing or sneezing it is also use a tissue, sneeze in ones hands or turn away from others. Minimise touches with the mouth, eyes & nose as well as sharing of cutlery. In the setting healthcare, standard infection control measures include hand hygiene and use of protective equipment such as gloves, aprons and gowns, footwear and protective masks for the head and nose. Needles and syringes should also not be reused while disposal of wastes should be effectively carried out. Professionals should ensure to disinfect after handling patients and also ensure patients observe personal hygiene to avert spread of infections (NHS, 2010). Hand Hygiene Very many persons die around the world on a daily basis due to infections that are acquired in the process of receiving health services. The main transmission for pathways in the healthcare setting is hands. Decontamination of hands therefore significantly protects both the healthcare workers and patients from disease causing germs. Before and after touching patients the healthcare workers should aseptically decontaminate hands. Other situations that call for hand decontamination in the healthcare setting are after touching the surroundings of patients and before carrying out aseptic procedures. Also wash after exposure to body fluids such as mucous, blood and saliva. Washing of hands should be done using a lot of soapy water to cover all the surfaces of hands followed by rubbing of palms. A lot of water should also be used to rinse the hands after which a single use towel is used to thoroughly dry hands. Ensure to use the towel to turn water of to avoid exposure to germs after washing. Patient Centred Care It is appropriate to use a chaperone when seeing patients especially when carrying out intimate examination such as on breasts, private parts and the rectal area. Such examinations may cause discomfort for the patient and therefore having a chaperone adds a layer of protection for both parties. Use of chaperones helps acknowledge the vulnerability of the patient, offer emotional support and reassure, assist during the examination, undressing and help in interpretation. Advance decision refers to a decision by any person to reject certain treatment types in the future. This decision allows family members, care givers and health care professionals the kinds of treatment one may not want at a future time. They are able therefore to understand the person’s wishes if for some reason he/she is rendered unable to communicate the decision by the time. The medications being rejected must be named in advance and the situations for which the medications should not be used clearly set out. Quality Standards Published by NICE 1. Persons worrying about the possibility of dementia can discuss with knowledgeable or expert others about diagnosis options 2. Dementia patients, involving their care providers have the choice and control of decisions regarding their support and care. 3. Dementia patients should participate in the review of their health needs and preferences following change of circumstances. 4. Dementia patients should be enabled to in their own daily leisure based on their interests and choices. 5. Dementia patients should be enabled to develop and nurture relationships. 6. Persons with dementia should be enabled to access necessary services for welfare both mentally and physically. 7. Persons with dementia must live in houses that meet their unique needs. 8. Persons with dementia should have an opportunity to influence designing, planning and assessment as well as own service delivery. 9. Dementia patients should have access to independent advocacy services. 10. People having dementia should be enabled to participate and be involved in contributing to communities. Structure of NHS Records of any visit to an NHS service by a patient are created and kept. The implication of this is that patient’s medical information is safely available in their GPs, dentist or any other hospital they have ever been treated. It is a requirement for all GPs to offer online records to their patients. Emphasis is placed on accuracy of the information, storage of all necessary information about the patient and more importantly assurance of high standards of privacy of the information held. Blood Pleasure Hypertension is a medical condition characterised by elevated blood pressure in the arteries. It is also referred to as high blood pressure and can result in organ damage and illnesses like heart attack, kidney problems, aneurysm etc. symptoms include severe headaches, nausea, dizziness, vision problems, pains in the chest, blood stains in urine, fatigue and irregular heartbeat. Risk factors include obesity, diabetes, stress, low levels of vitamin D and chronic kidney disease. Hypotension is also known as low blood pressure and is the opposite of hypertension. It is mainly caused by conditions that disrupt the ability by the body to regulate blood pressure. Dehydration and severe shock are some of the causes. Hypotension may also be naturally mediated especially when the heart does not communicate properly with the brain. Bibliography. 1. Clandinin D. J. and Cave M. T. (2008). Creating Pedagogical Space for Developing Doctor Professional Identity. Med Educ. 42(8):765-70. doi: 10.1111/j.1365-2923.2008.03098.x 2. HCPC (2008). Your Duties as a registrant: Standards of Conduct, Performance and Ethics. Available at: http://www.hcpc-uk.org/assets/documents/10003B6EStandardsofconduct,performanceandethics.pdf 3. Jane Stuart and Jacqueline Barnes. (2005). Conducting Ethical Research. National Evaluation of Sure Start. Available at: http://www.ness.bbk.ac.uk/support/GuidanceReports/documents/165.pdf 4. NHS (2014). Consent to Treatment. Available at: http://www.nhs.uk/conditions/consent-to-treatment/pages/introduction.aspx 5. NHS (2010). NHS Professionals: Standard Infection Control Precautions. Available at: http://www.nhsprofessionals.nhs.uk/download/comms/cg1_nhsp_standard_infection_control_precautions_v3.pdf 6. Nishamali Jayatilleke and Anne Mackie. (2012). Reflection as Part of Continuous Professional Development for Public Health Professionals: A Literature Review. Journal of Public Health. Available at: http://jpubhealth.oxfordjournals.org/content/early/2012/10/16/pubmed.fds083.full 7. Walter F. Baile at al. (2000). Spikes-A Six-Step Protocal for Delivering Bad News: Applicatio to the Patient with Cancer. The Oncologist. Available at: http://theoncologist.alphamedpress.org/content/5/4/302.full 8. Saul Mcleod. (2013). Kolb-Learning Styles. SimplyPsychology. Available at: http://www.simplypsychology.org/learning-kolb.html Read More