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 ward for periods. The programme group was multidisciplinary and expanded from the early programme days to include more registered nurses and support staff although a core group remained constant over the period of the programme. The Director of Nursing worked with the programme group in relation to the practice development work. Registered Nurses Grade Non Registered Care Workers 3 CNM11 x 1 6 Staff Nurse x 2 Areas Of Work • Healthcare Assistants • Physiotherapy Assistant • Occupational Activity Assistant • Support staff 2 Internal Facilitator CNM11 Staff Nurse Programme Achievements from both sites In Falcarragh Community Hospital formal data collection as part of the PD programme took place at two timescales including observations of care, environmental observations and patient narratives, PCNI/PCCI and CAI. In St Patrick’s the data collection process took place over three timeframes. As well as the formal data collection, a continual process of analysis from group process evaluation, discussion among the participants of the PD group and also at individual ward level has contributed to the ongoing work of the programme in both sites. The action planning and achievements from the programme in both sites were very similar in many respects and the following is an overview. Communication The development of resident group meetings led by nursing and healthcare assistants is now established in both sites. This was identified as a need after dialogue with residents through narrative work. This provided a method to involve residents in a more meaningful way in their care. This was a positive achievement for residents, families and staff; the process was also a positive learning and personal growth experience for the facilitators of the meetings which included registered nurses and healthcare assistants. A formal process was agreed by the PD groups where the information collected at the resident group meetings which are 57
The implementation of a model of person-centred practice in older person settings held on a regular basis is documented, solutions sought and feedback provided to the residents and all the staff. In St Patrick’s there has been a long standing resident committee established with an independent chairperson, the development of smaller resident group meetings on each of the individual wards has further enhanced this process of communication. In both sites it was found that the information collected at these meetings contributed to and provided more evidence to support implementing change in other ways by bringing to the fore issues such as, choice around meal times, the exploration of more meaningful activities for residents, getting to know the residents likes and dislikes and issues they wanted to highlight. One of the residents in St Patrick’s, through the resident group meeting, expressed a wish to try to return to live in her own home. A process was put in place with the resident which was facilitated by the CNM, a participant on the PD group and MDT to explore if this was possible. This was progressed over a long period, although it was not possible for the resident to return on a permanent basis because of many different reasons. The resident was at the centre of the decision making process and all efforts were made to meet the person’s needs. Action planning as a result of consultation with residents in Falcarragh Community Hospital through the resident group meetings included the following: • Excursions to areas of interest in the local community that are meaningful for the resident. • Going out shopping both locally and travelling to Letterkenny. • Having ‘fish and chips’ for tea. • The establishment of a hairdressing salon in the hospital, a similar service was established in St Patrick’s. • The attendance of regular chiropody service for the residents. • The expansion of social activities based on resident’s choice and requests. Person-centred language activity was explored by the participants in both groups over the two years. This resulted in raised awareness of using person-centred language, the participants facilitated this through active learning activities and work based learning, such as, role play, developing listening skills and observing. There 58
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