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Using Grim's Framework Of Reflection On The Healthcare Quality Strategy

1642 words - 7 pages


The aim of the Healthcare Quality Strategy (HQS) is to deliver excellent healthcare to the citizens of Scotland, and in the process brand NHS Scotland as a world leader in healthcare (Scottish Government, 2010). A key ambition of the HQS is to provide compassionate and person-centred care which encompasses the needs of service users, therefore, allowing their values to direct decisions (Scottish Government, 2010). A HQS improvement intervention is the prevention of pressure ulcers (PU). This essay will demonstrate how I was involved in this improvement intervention by applying my skills of compassion, person-centred care and teamwork. I have chosen Gibb’s (1988) framework to ...view middle of the document...

I felt self-aware of how I was communicating with Elspeth, particularly in relation to her dysphasia. Being self-aware facilitates nurses to identify their strengths and weaknesses, supporting them to become more compassionate, person-centred, and capable of building enhanced relationships with service users (Miller, 2008); traits I knew were imperative to facilitating the aims of the HQS.
Since, I had previous experience of preventing PU, I felt confident about being involved in Elspeth’s care. However, my mentor, whose supporting role is to guide me in my practice (Royal College of Nursing, 2007), explained that confident nurses are not necessarily the most skilled (Luhanga, Yonge and Myrick, 2008) and; therefore, I could still benefit from enhancing my knowledge.

The positive aspect of my experience was being part of a team which quickly assessed Elspeth and successfully prevented her from developing PU; thus achieving the aforementioned Scottish Government (2010) HQS improvement intervention. Moreover, I delivered compassionate and person-centred care, which encouraged Elspeth, to have direct involvement in her own care; therefore, also achieving a quality ambition of the HQS.
The Scottish Patient Safety Programme (*) identifies that an individual’s risk of developing a PU is a principle driver associated with prevention. Whiteing (2009) re-iterates the importance of early risk identification, declaring that prompt recognition of those at risk is a fundamental determinant in prevention. Hence, NHS Quality Improvement Scotland (QIS) (2009) recommend that all individuals should be assessed within 6 hours of their admission to hospital. The most common tool for assessing the risk of PU is the Waterlow tool (Watret and Middler, 2012). However, Chamanga (2010) discusses how this assessment tool does not come without criticism; hence NHS QIS (2009) declare it is imperative that such assessments are not used as a standalone tool and should be used in addition to nursing judgement. Additionally, NHS Dumfries and Galloway (*) instigated Active Patient Care (APC) as a strategy to reduce the prevalence of pressure ulcers. APC involves regularly checking a patient’s skin integrity, repositioning needs and nutritional needs. In order to facilitate the Scottish Government (2010) HQS aim of involving individuals in their care, I explained the purpose of the Waterlow and APC tools to Elspeth; thus actively involving her in the process. The National Institute of Health and Clinical Excellence (NICE) (2005) also discuss the importance of verbally providing information to individuals who are vulnerable to PU, suggesting that it can facilitate prevention.
The inability of a person to move and re-position their body can increase the chances of friction, pressure and shear; three extrinsic causes associated with PU development (Elliot, 2010). Hence, the RCN (2005) discuss the importance of using appropriate pressure relieving...

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