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 Other areas of improvement in all the units include: • Art work done by the residents is now displayed throughout the units on the walls • Signage was changed to facilitate the residents • Entrance areas to the units were enhanced and made more welcoming • Throughout the units changes were made to improve and enhance the environment • Residents were facilitated to personalise their bed areas if they wished • Sitting rooms were made more homely • Development of a quiet room • Development and enhancement of existing enclosed garden spaces In St Brigid’s Hospital the internal doors were locked to prevent residents with cognitive impairments wandering out of the building. The programme group identified the need to address this issue. An action plan was developed involving the residents’ family members, risk management, senior management both within the hospital and at a higher level with the HSE. The aim was to improve residents’ freedom of movement around the building, thus restoring their dignity and rights. The objectives were to: • explore process and timescale for opening doors throughout the building. • to include individualised risk assessments and guidelines for staff • facilitate learning sessions to support residents, staff and families plan for the changes to the environment to be delivered • establish a process for ongoing review monitoring for sustaining the changes involving all the key stakeholders This culture change challenged staff; it raised issues around accountability for the safety of the resident. Staff, residents and family needed education and reassurance in relation to the new systems in place. Opening the doors within the hospital has been phased in and proposals submitted to the finance department for funding to change some of the external doors. Residents now have much more freedom to mobilise throughout the building and the feedback from ongoing observations of care indicate that it is now a more homely welcoming environment. The project very clearly identified that introducing change can be slow and needs to be planned well involving all stakeholders at every stage of the process. 49
The implementation of a model of person-centred practice in older person settings Issues in relation to improving communication and teamwork amongst staff were identified from observations of care, the PCNI and PCCI along with evaluation data on programme days in all three units. Action plans were developed to address the issues highlighted. Named programme participants took on the responsibility of leading the groups. For some participants this was the first time they ever were involved in chairing a group. Action plans were developed from auditing current practice, using questionnaires, feedback from staff meetings along with observations of care. Throughout the programme, progress has been made in improving communication and developing teamwork in the management and delivery of care. Some achievements include: • Regular unit meetings were established involving all care groups • Daily communication meetings where staff are updated on ongoing issues. This takes place for an agreed time every morning with the lead person rotating each day. • Introduction of a communication book for staff at unit level • Quarterly Newsletter • Re establishment of the social club • Bi annual staff well being weeks • Implementing reflective practice and problem solving frameworks in everyday work • Development of protocols on giving and receiving feedback in the units • Implementation of clinical supervision for staff Developing person-centred care was as much about staff as it was about the residents. Across the three units the programme participants in consultation with all staff, identified what the staff wanted. A five day programme of events was organised for staff covering areas such as: • talks on health care issues relevant for staff with experts offering advice and support to staff • relaxation, and beauty therapy sessions offered to staff throughout the day; social outings and in-house events • The staff well being weeks have evaluated very positively in particular in relation to staff morale. These events are now incorporated into the yearly planner with events organised bi-annually. 50
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