Assist program Flashcards
Assist with an Allied Health program
The three-tier health system of Australia:
Primary care:
includes education, prevention, early detection and routine care.
Secondary care:
includes acute diagnostic and treatment service.
Tertiary care:
includes critical care and emergency services.
Primary health care:
the first level of care a client receives.
This care is provided by appropriately trained staff in many different settings.
Primary health care does not only focus on care of clients already identified as being ill or requiring assistance but also includes:
health promotion
illness prevention
advocacy
community development.
‘Primary health care’ is a very broad term that addresses much more than caring for clients once they are in need. Working in the area of primary health care may involve any of the areas identified above and may include vastly different workplaces and work roles. All of these - that is, care of those already in need, health promotion, illness prevention, advocacy and community development combine to provide a holistic approach to health care.
Holistic care:
a person is much more than the sum of the parts for which the Allied Health Assistant is caring.
An AHA should look at the client from a perspective that encompasses all of their life.
This would include considering each client's:
emotional / mental state
education level
work situation
recreation activities
general health
finances
accommodation / housing
family / community situation
culture / religion
communication preferences and abilities
spirituality.
The above factors are determinants of health for everyone. Awareness of issues that may impact upon each client’s ability to understand and participate in treatment will play an important part in the ultimate success or lack of success for any treatment or assistance given to the client as part of their overall treatment plan.
A holistic approach to health focuses on health as a state of wellbeing rather than illness or the absence of disease. AHAs are required to approach clients in a holistic manner, in other words, caring for the whole person while attending to the particular task they have been directed to do. Each client’s lifestyle, environment, circumstances and ability to access services will have as much impact on their health and outcomes of care as the treatment received in a health care setting.
Health promotion:
a large part of primary health care. Along with disease prevention it encourages a focus on health, rather than illness. Health promotion and disease prevention at both individual and community levels is an important part of the work of an AHA
AHAs should be aware of all factors relating to each client’s health. For example, issues such as compliance with treatment regimes or even attending appointments regularly may not be related to a lack of desire to improve but have more to do with a client’s inability to access basic needs such as transport.
The AHA’s role in health promotion for clients will largely be concerned with education related to the particular treatment they are undergoing, however, education will not be effective if time is not taken to talk to and observe the client. Often during times of informal contact, indications may emerge which could suggest other factors that could impact upon the desired outcomes for the client.
Factors which promote health include:
a balanced diet
maintaining the ideal body weight
adequate movement and exercise
adequate sleep, rest and relaxation
adequate elimination of waste
maintaining high standards of personal hygiene
preventing infection
avoiding accidental injury
reducing stress appropriatelyFactors which are detrimental to health include:
smoking
alcohol / drug abuse
dangerous activities
negative eating behaviours
insufficient rest, sleep, exercise
stressful lifestyle
unsafe sexual practices
environmental pollutants
overcrowded living conditions
excessive sunlight.Access and equity:
treat each client with respect regardless of disability, language, culture, religion, age, gender or level of literacy.
Knowledge of access and equity issues that may affect each client means the AHA will be able to identify needs and take steps to ensure that needs are met. This will ensure all clients have access to all of the knowledge and skills required for optimal outcomes.
An AHA using a holistic approach in their work must show respect for each client and relate to them as an individual. AHAs should work in partnership with clients, empowering them to identify their needs to ensure that they can achieve a quality of life that is acceptable to them.
Who needs to be involved in a collaborative effort to achieve the best outcomes for clients?
Client;
Client’s family;
Community;
Health care team.
It may not be possible to achieve goals and targets set for clients if there are detrimental factors present that are not addressed. It is not enough to ensure that clients have the knowledge and skills to reach the desired goals of care. Issues such as the attitudes and values that clients hold will impact on outcomes. Personal values and external factors such as access and equity issues (ability to get to appointments, financial concerns) will contribute to decision making, goal setting and the ability to manage stress.
Evidence based practice:
clinical Expertise
Best research practice
Patient values.
Evidence-based practice means using the best, research-proven assessments and treatments in day-to-day client care and service delivery.
Each health worker undertakes to stay in touch with the research literature and to use it to guide their intervention.
Recently the term ‘Evidence Informed Decisions ‘ has emerged. This reflects a change of focus to acknowledge that research is just one component of the knowledge base required to make fully informed decisions regarding client care. A health care worker’s skills and experience, along with client and professional values are blended with research to make decisions about the goals and strategies to be used in practice.
Evidence based practice values and builds on clinical experience and knowledge of disease processes. It involves conscientious decision making based on:
client characteristics
client situations
available evidence
client preferences.
Giving clients options is an important part of health care, as is respecting each client and encouraging autonomy. Autonomy for clients means that they have the right to make decisions, or express preferences regarding their care without staff trying to influence their decision. The AHA’s role is to make sure that clients are informed about all choices while allowing the client to freely express a preference. Clients have a right to expect that their preferences will be respected if at all possible.
For AHAs, evidence based practice means using knowledge of current research, (that is, the most appropriate information available about client needs and care), and best clinical experience as well as knowledge of client values to determine a course of action regarding individual clients. It is an important part of providing holistic care for clients.
The basic communication process:
A ‘sender’ (person wanting to send a message)
A ‘receiver’ (person the message is communicated to)
The sender thinks of what message they wish to send. They then transmit that message using a variety of methods or strategies. This could include verbal and/ or non-verbal language.
When the message gets to the receiver, it is then ‘decoded’ or translated by the receiver so they understand what has been said.
The receiver then responds to the message they have received.
The goal of communication is a mutual understanding between the sender’s intended message and the receiver’s perceived message.
Some good communication techniques may include:
Face the person when speaking or listening;
Use eye to eye contact;
Speak clearly, at a moderate pace;
Be at the same height level as the person you are speaking to if possible;
Check the person has understood you;
Ask questions to ensure you have received the correct message;
Use appropriate gestures – nod, smile, acknowledge that you have heard the sender’s message;
Use an appropriate level of language for the listener.
AHAs can help ensure successful communication by always:
Being aware of each client’s physical + mental state;
Demonstrating courtesy at all times;
Using constructive communication skills e.g. using an appropriate tone + calm manner, articulating clearly;
Keeping communication short + simple (avoid jargon);
Allowing time for clients to respond;
Avoiding rushing clients e.g. answering for them;
Modifying approach to suit each client’s level of understanding;
Only providing basic information that they feel confident is accurate;
Never giving an opinion about diagnosis or treatment as this is the responsibility of the AHP
Barriers to good communication may include:
Inappropriate choice of words;
Body language that sends a different message to the words used;
Cultural variations – body language or behaviour may vary from culture to culture and may therefore send incorrect messages or be misinterpreted;
Making incorrect assumptions about the message being received;
Not understanding the importance of the message being sent out and therefore not responding appropriately.
Health clients are often in an unfamiliar environment, unwell, and may be anxious, in pain or discomfort and also on medication. All of these things may impact on their ability to listen, comprehend and / or understand what is being communicated regarding their care.
APPs:
The Australian Privacy Principles (APPs) were introduced in 2014 and form part of the Privacy Act 1988 (Cth). They outline how Australian health organisations must handle, use and manage personal information.
All health workers should be familiar with the content of the APPs and in particular the obligation not to disclose information about clients in their care, except when the information is required in the course of their professional duties.
Confidential information is anything relating to a client’s condition and may include:
treatment being given
prognosis
anything about a client’s private life.
Each health facility will have policies regarding the confidentiality of client information. These policies may relate to:
health fund entitlements and fees
payment and records
medical and consent forms
telephone conversations
secure location of written records.
Information about clients must be kept private. Client information should only be shared with a third party if the client has given consent beforehand in accordance with the health facility’s policies. AHAs should direct any requests for information from third parties to their supervisor
Duty of care:
the responsibility which all health workers have to their clients to avoid doing anything which could reasonably be foreseen to risk injuring or harming other people.
If a health worker does do something that is likely to cause another person to be harmed, the health worker has breached their ‘duty of care’.
Some examples of a breach of duty of care include:
Allowing a client to walk on a floor that is clearly wet;
Using broken or unsafe equipment with clients;
Failing to report safety concerns about client to AHP;
Undertaking tasks without adequate training;
Asking a client to mobilise with a walking aid that is different from the one they have been prescribed;
Undertaking therapy with a client when they have reported feeling unwell / dizzy;
Failing to adhere to the AHP’s instructions regarding client care.
Treatment plan:
Formulating a treatment plan is the responsibility of the AHP and may include:
diagnosis
therapy goals
planned interventions
possible ongoing supports required.
A treatment plan is specifically prepared for each client and is written to guide client care. It provides continuity of care from one health professional to the next, and ensures consistency in care.
An AHA may contribute to the ongoing treatment plan by collaborating with the AHP regarding the care that they have provided to clients and the intervention they have completed.
There are many factors to be considered when working with a treatment plan. These factors include:
Accountability – each health worker is accountable for what they do.
Individuality – each care plan is specific to each individual client and may be significantly different from a plan for another client with a similar diagnosis or therapy goals.
Personality of client.
Expectations of client.
Health status of client.
Goals and prognosis of client.
Four basic steps for following treatment plans:
1) Awareness of the treatment plan
2) Preparation of any necessary materials/equipment
3) Minimising of environmental hazards
4) Prepare the client for therapy
Healthy living:
Many community organisations have health and wellbeing policies to guide community workers interactions with clients. Some also employ Lifestyle Workers whose role is to deliver support, education and training to clients to assist them to make informed decisions.
Aims for healthy living:
Look after mental wellbeing;
Maintain a healthy weight;
Promote and encourage daily living habits that contribute to healthy lifestyle;
Drink alcohol drink in safe amounts;
Be physically active (moving more and sitting less);
Support and assist the person to maintain a safe and healthy environment;
Not smoking;
Eat healthy food.
Safety and the Nine Healthy Living practices:
Washing people;
Washing clothes/bedding etc;
Removing waste water/rubbish safely;
Improving nutrition;
Reducing negative impacts of overcrowding;
Reducing negative effects of animals/insects/vermin;
Reducing health impacts of dust;
Controlling living environment temperature;
Reducing hazards that cause trauma
Good mental health:
Good mental health is a sense of wellbeing, confidence and self-esteem.It enables us to fully enjoy and appreciate other people, day-to-day life and our environment. When we are mentally healthy we can:
Form positive relationships Use our abilities to reach our potential Deal with life’s challenges.
2007 survey found how many Australian adults experienced common mental disorders in previous 12months?
one in five (20%) – 3.2 million individuals – experienced one of the common mental disorders in the preceding year. Fourteen per cent experienced anxiety disorders, 6% mood disorders, and 5% substance use disorders. One quarter experienced two or more of these conditions in the year of interest. Prevalence was highest among those aged 16 ‑ 24 (26%) and declined with age, and two thirds of those with depression and/or anxiety disorders had experienced their first episode before the age of 21. An estimated 23% of Australians – around 600,000 people – have severe disorders, as judged by diagnosis, intensity and duration of symptoms, and degree of disability
A mental illness is:
a clinically diagnosable illness that affects a person’s thinking, emotional state or social abilities. It may disrupt their ability to work, carry out daily activities or have satisfying personal relationships.
Symptoms of depression:
Clinical depression is a state of extreme distress where the sufferer feels empty or numb rather than just sad.
A depressed person is unable to enjoy life normally or break out of the depressed state.
A persistent depressed mood may be considered a disorder when it is present all or most of the time, for at least 2 weeks.
In a major depressive episode, someone might also experience:
diminished appetite with weight loss
increased appetite with weight gain
insomnia or increased sleep
agitation or slowed movements
loss of all pleasure and enjoyment
tiredness and fatigue
feelings of guilt and worthlessness
poor concentration
thoughts of death,include suicidal thoughts/plans.
Suicidal thoughts are never normal, and indicate a need for urgent help
Signs of bipolar:
Episodes of unusual highs or irritable mood (mania or hypomania) possibly mixed with depressive episodes.
It is also known as bipolar mood disorder, bipolar affective disorder and previously as manic-depression.
People with bipolar disorder may experience psychotic symptoms such as hearing voices or delusions, which are typically in keeping with their current mood state, for example:
in a depressive episode, the sufferer may believe they have significant physical health problems, reasons to be guilty, or that they are poverty-stricken.
in a manic episode, they might think they have great wealth, special powers or a special mission.
Some people with bipolar disorder do not experience depressive episodes, only the episodes of elation and excitement
Symptoms of schizophrenia:
Symptoms may include:
delusions—a false belief held by a person which is not held by others of the same cultural background
hallucinations—a person sees, hears, feels, smells or tastes something that is not actually there
disorganised thought, speech or behaviour
diminished emotional expression
decreased motivation.
Schizophrenia affects the normal brain function, interfering with a person’s ability to think, feel and act, and is characterised by psychotic symptoms.
It usually presents itself for the first time during adolescence or early adulthood. It can develop in older people, but this is not as common.
Some people may experience only 1 or more brief episodes in their lives. For others, it may remain a recurrent or life-long condition.
Schizophrenia can be diagnosed when at least 2 different types of psychotic symptoms persist for a month, and some degree of symptoms continue for at least 6 months
