The Implementation of a Model of Person-Centred Practice In Older ...

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The implementation of a model of person-centred practice in older person settings 1 Listening to a patient 6.55 6.57 (1) 6.44 (2) Intimacy 2 Reporting a patient’s condition to a nurse 6.42 6.35 (4) 6.37 (3) Technical 3 Sitting with a patient 6.34 6.30 (5) 6.34 (4) Intimacy 4 Consulting with a nurse 6.32 6.23 (7) 6.25 (8) Technical about a patient 5 Involving a his/her care patient with 6.27 6.26 (6) 6.28 (7) Intimacy 6 Being honest with a patient 6.18 6.18 (9) 6.14 (10) Intimacy 7 Instructing a patient about 6.10 6.00 (11) 6.08 (11) Technical self-care 8 Giving reassurance about 6.03 6.06 (12) Technical clinical procedures 9 Being with a patient during a clinical procedure 5.91 5.88 (12) 5.98 (13) Intimacy 10 Measuring the vital signs of a patient 5.90 ---- 5.82 (15) Technical 11 Observing the effects of medicine 5.88 ---- 5.80 (17) Technical 12 Explaining a clinical procedure to a patient 5.76 ---- 5.82 (15) Technical 13 Keeping relatives informed 5.73 ---- ---- Technical 14 Providing privacy patient for a ---- 6.55 (2) 6.55 (1) Intimacy 15 Being cheerful patient with a ---- 6.37 (3) 6.31 (5) Intimacy 16 Getting to know a patient as a person ---- 6.23 (7) 6.31 (5) Intimacy 17 Exploring lifestyle a patients ---- 6.06 (10) 5.97 (14) Intimacy 18 Being neatly dressed with a patient ---- ---- 6.24 (9) Technical Table 4.10 The Ranking of the Caring Dimensions Index items 141
The implementation of a model of person-centred practice in older person settings RESIDENT NARRATIVES AND OBSERVATIONS In total across the 3 time points, one hundred and eighty (180) periods of observation and sixty (60) user narratives were collected. The process used for analysing these data sets is set out in Appendix 2. Four key categories were identified from across all data sets and each of these categories are operationalised through a number of themes. In the presentation of the data analysis, the key categories will be introduced and the themes will be discussed and illustrated with data extracts. Category 1 = Choice Themes • Choice - “Is it facilitated” Meal and mealtimes • Family - Visiting Roots • Activity/Boredom - Lack of stimulation and meaningful activities The theme of choice was a significant theme across the data sets and indeed it is something that featured in the work of the programme groups across the participating sites. The data demonstrate that over the period of the programme, residents were provided with a greater range and number of choices. Specific activities (such as resident and family groups) were initiated and established in the majority of settings as methods of enabling more choice for residents. However, the data also reflects a range of challenges and ongoing issues in the development of person-centred care environments that facilitate choice for older people. A key question that was in particular reflected from the analysis of the observation notes, was “is choice facilitated”? “Some evidence of choice, however there is poor evidence in the notes to show that it is continuously reviewed” (observation note) “Evidence of strong knowledge among staff of the individualised preferences of the resident, however, no evidence of formal structures of handover of this information” (observation note) “Well it depends on my experience, it’s a tough life being a patient … As regards my control, they’d say they are scared in case I’d go to the toilet on my own in case I’d have a fall and that way. Two years ago I had a fall and they are still referring to that 142
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