P A C E Emergency Department Origin NIPEC Recording Care Project - - PowerPoint PPT Presentation

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P A C E Emergency Department Origin NIPEC Recording Care Project - - PowerPoint PPT Presentation

Apr 27, 2023 331 likes •710 views

Care Planning P A C E Emergency Department Origin NIPEC Recording Care Project SINCE 2009.. Improve the standards of nurse record keeping practice in the region Recording Care ...... Whats the point? Why Keep Records I I Int

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Care Planning

Emergency Department

P E A C

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Origin

NIPEC Recording Care Project SINCE 2009…….. Improve the standards of nurse record keeping practice in the region

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Recording Care...... What’s the point?

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Why Keep Records

I I Int ntegral ral par art o t of p f pra ract ctice ice Evidence of partnership with people in our care Communication Support delivery/continuity of care Evidence clinical judgement/decisions Identifies risks

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Requirement

Co-production – being person centred Regulatory – NMC Legal - Improves accountability and provides evidence Employer - Policies

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What it’s not.....

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What it is.....

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CARE PLAN

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What is a Care Plan

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It is..

A written record of the ‘care planning process’.

This process identifies the persons needs , plans the nursing intervention to achieve the desired outcomes and evaluates the effectiveness of delivered care.

Care planning – Action Care plan – Recording

Can be viewed as a negotiated contract laying down both parties’ responsibilities

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Care plan should..

be Person-centred Involve person in decision making be in Partnership be Collaborative enable Information Sharing be Regularly Reviewed

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Caution….

Over reliance – not questioned Difficultly to keep updated as person changes Constant revision costs time Not always individual Not flexible Reduced critical thinking

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Is there a better way

The development of the way forward to improve the quality of care planning within the nursing profession began January 2014

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START NOV 2014 CARE PLANNING SUMMIT – January 2015 Presentation to EDoNs April 2015 Meetings June, July and August 2015 Product PACE Pilot September 2015 Presentation to EDoNs Nov 2015 Larger Pilot Feb-April 2017 Presented to CNO/ EDoNs July 2016 PROCESS OF PLANNING ROLLOUT

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What did the literature tell us

Highly skilled Dynamic process Variety models underpin care plans Ongoing reflection required Complex/ inflexible Difficult to understand Safety issues Record keeping not reflective of delivered care Involving person and family

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Current practice

  • Nursing process
  • Models
  • Care pathways
  • Care bundles
  • Clinical assessment tools
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PACE – What's possible

Passive recipients PARTNERSHIP Paternalistic EMPOWERMENT Informed of care INFORMED CONSENT Comprehensive ‘it wasn’t recorded it wasn’t done’ SIMPLICITY FACTUAL/CONCISE

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PACE

PERSON ASSESSMENT

PLAN OF CARE

EVALUATION

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When to record

P – commencement of record and during their time in

the department A - Depending on the need - ongoing care/episodes of care/emergency & critical care C - Following assessment of needs E - After a plan is in place and the action has been carried out or if unable to be carried out

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Champions

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Champions Role

WHAT HOW

Motivator

Educator

Facilitate/ Mentor Embed Change culture Evaluator/ Feedback Role model Good practice Promote awareness

Resource Embracing barriers/

Monitor

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Educator

 Train their peers, tailoring this to their area of practice.  Can be formal or informal. Run short sessions or work with staff during the shift.  Work through resource pack.  Feedback on the resources and possible development of new materials such as posters, leaflets.  Guide to other resources  Become familiar with NIPEC site with resources and tools for practice improvement

PACE

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Embracing Barriers

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BARRIER ENABLER New approach – increase time to record Given adequate time from nurse leaders Inadequate training preparation Adequate training preparation

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BARRIER ENABLER Lack of explanations of change/expectations Given adequate explanation Lack of feedback to department level Facilitate feedback to department level. Misunderstanding of PACE Training/Resources Reluctance from patient Explanation

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BARRIER ENABLER Lack of training/ preparation at all levels Lack of awareness Support from NIPEC Attendance at training workshops. Involvement of department champions to cascade Resource pack. Training audit tool

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BARRIER ENABLER Fear -not writing enough/change of entire style Training/on going support at ward level Fear of legal/professional repercussions Addressing these issues Revalidation Staff attitudes - sceptical Communication / Discussion Challenging department environment Creative thinking to current processes Staff levels Appropriate reporting Understanding

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Resources

  • Resource pack
  • NIPEC website http://www.nipec.hscni.net/
  • NIPEC microsite

http://www.nipec.hscni.net/resource- section/improve-record-keeping/

  • NMC Code
  • Standards document
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