Handout - IP - Unit 1 v20240901 PDF

Copyright Gateway College Copyright Gateway College 1.1 INTRODUCTION T...

Copyright Gateway College Copyright Gateway College 1.1 INTRODUCTION TO THE HEALTH CARE SYSTEM IN BRITISH COLUMBIA AND INTRODUCTION TO PRACTICE CANADA Unit 1: Workplace Settings and Contexts Copyright Gateway College. All right reserved. THE EVOLUTION OF HEALTH CARE INTRODUCTION SYSTEM - CANADA  Canada’s national health insurance system  Canada’s Health Care System – an  Medicare interlocking set of 10 provincial and 3 Copyright Gateway College Copyright Gateway College  Medicare uses provincial/territorial and territorial health insurance plans. federal taxes to pay for all medically  Medicare provides access to universal, necessary health services for all permanent comprehensive coverage for medically residents. necessary hospital and physician services. CANADIAN HEALTH CARE IN THE PAST 1 CANADIAN HEALTH CARE IN THE PAST 2  In the first part of the twentieth century, The Great Depression individuals in Canada were expected to pay Families struggled to feed, clothe, and Copyright Gateway College Copyright Gateway College  the entire amount of bills. house their members and could not possibly  There were no “set fees.” pay their medical bills.  Those who could not afford to pay had to  Many ill and disabled people depended on find charity services through community family members and neighbours to provide agencies such as the Victorian Order of care. Nurses, the Red Cross, and local churches. 1 CANADIAN HEALTH CARE IN THE PAST 3 CANADIAN HEALTH CARE IN THE PAST 4  These hardships inspired Canadians to  By 1961, all 10 provinces and 2 territories create a prepaid medical and agreed to provide coverage for inpatient Copyright Gateway College Copyright Gateway College hospitalization insurance plan. hospital.  In 1947, under then-Premier Tommy  By 1972, all provinces and territories Douglas, Saskatchewan was the first extended their insurance plans to also province to introduce a public insurance cover medical services provided outside plan that covered the costs of hospital hospitals. services. THE MODERN HEALTH CARE SYSTEM 1 THE MODERN HEALTH CARE SYSTEM 2 Five Criteria (Health Insurance Plans)  The federal Public Health Agency of Canada acts as a focal point for disease Copyright Gateway College Comprehensiveness Copyright Gateway College 1. prevention and control and for emergency 2. Universality response to infectious disease. 3. Portability 4. Accessibility 5. Public Administration THE FEDERAL ROLE 1 THE FEDERAL ROLE 2  Administering the Canadian Health Act  Transferring tax money to the provinces and providing provincial funding. and territories to share the cost of Copyright Gateway College Copyright Gateway College  Providing direct delivery of health care medically necessary health care services. services to specific groups, such as First  Ensuring that the provinces and territories Nations people, Inuit, Canadian Forces and provide the same quality and type of care. RCMP.  Developing and carrying out government policy and programs that promote health and prevent disease. 2  HEALTH CARE CHALLENGES AND THE PROVINCIAL/TERRITORIAL ROLE TRENDS 1  The provincial or territorial government Challenges 1 finances and plans its health care services, Many rural or remote areas facing severe Copyright Gateway College Copyright Gateway College  following the five basic principles outlined short ages of physicians, nurses, and other in the Canada Health Act. health care workers.  Financial issues  Aging of the “baby boomer” generation HEALTH CARE CHALLENGES AND HEALTH CARE CHALLENGES AND TRENDS 2 TRENDS 3 Challenges 2 Additional Services Long waiting lists that are common for The provinces and territories provide Copyright Gateway College Copyright Gateway College   surgeries, diagnostics, or medical coverage to certain people, such as seniors, procedures children, and social assistance recipients.  High cost of new technology  These benefits include prescription drugs, dental care, vision care, medical equipment and appliances. HEALTH CARE CHALLENGES AND HEALTH CARE CHALLENGES AND TRENDS 4 TRENDS 5 Private Insurance Trends 1 Many Canadians, either through their Alternative care in clinics Copyright Gateway College Copyright Gateway College   employers or on their own, are covered by  Primary health care centres private health insurance, and the level of  Community health centres service provided varies according to the  Home care plan purchased. 3 HEALTH CARE CHALLENGES AND HEALTH CARE CHALLENGES AND TRENDS 6 TRENDS 7 Trends 2 Trends 3 The number of acute care hospitals and The Provincial and territorial governments Copyright Gateway College Copyright Gateway College  acute care hospital beds decreased from are now focused on two areas: 1995 to 2000, whereas postacute or hospital  Health Promotion and disease prevention alternative services provided in the home  Home Care and community have grown. HEALTH PROMOTION AND DISEASE HEALTH PROMOTION AND DISEASE PREVENTION 1 PREVENTION 2  Health promotion refers to strategies that Government policy promotes health and improve or maintain health and prevents illness. Copyright Gateway College Copyright Gateway College independence.  Immunization programs  Disease prevention refers to strategies that  Prenatal and parenting classes prevent the occurrence of disease or injury.  Information campaigns to reduce drinking  There are 12 key determinants for a during pregnancy, unsafe sex, and tobacco person’s health. use and to encourage healthy eating and physical activity HEALTH PROMOTION AND DISEASE PREVENTION 3 HCA REGULATION IN BC Government policy promotes health and  Care aides and community health workers are frontline care providers in a variety of institutional prevents illness. Copyright Gateway College Copyright 2010 Gateway College and community settings.  Efforts to improve housing, decrease  These include: poverty, monitor safe drinking water, and  Home support agencies - Community/Home Care protect the environment  Residential care facilities - Assisted Living - Group Homes  Long Term Care Facilities  Acute Care - - Hospitals - - Clinics 4 BC CARE AIDE & COMMUNITY HEALTH BC CARE AIDE & COMMUNITY HEALTH WORKER REGISTRY WORKER REGISTRY – MANDATE  To be eligible to work as a HCA in any publicly funded  To protect vulnerable patients, residents and health care setting in BC, applicants must be registered clients Copyright 2010 Gateway College Copyright 2010 Gateway College with the BC Care Aide & Community Health Worker Registry. Registrants must be a graduate of a HCA  To provide a database of credentialed program in BC. The registration requirements for (“registered”) care aides and community health Graduates of HCA programs outside BC and workers who are eligible for employment in Internationally Educated Health Care Professionals are publicly funded organizations and settings. currently under review.  To create a common process for employers in  After graduation, students are eligible for a registration number to be qualified to work in British Columbia. reporting and investigating patient, resident and client abuse complaints.  Care planning, coordination and delivery of services are centered on the client and their Copyright Gateway College Copyright Gateway College unique needs and preferences. 1.2 MODELS OF CARE – CREATING COMMUNITY,  The client participates in decisions ACTUALIZING PERSON-CENTRED regarding their care and their CARE decisions/choices are respected to the extent possible. MODEL OF CARE PERSON-CENTERED CARE  A ‘model of care’ is a multifaceted concept,  The move is from the model of care, where which broadly defines the way health an individual receives the care determined Copyright Gateway College Copyright Gateway College services are delivered. It can therefore be by a professional, to one that has person applied to health services delivered in a centred planning at its heart, with the unit, division or whole of District. individual firmly at the centre in identifying what is personally important to deliver his or her outcomes" 5  STANDARD OF CARE 1  A standard of care is a medical or psychological treatment guideline, and can Copyright Gateway College Copyright Gateway College be general or specific.  It specifies appropriate treatment based on scientific evidence and collaboration 1.3 STANDARDS OF CARE between medical and/or psychological professionals involved in the treatment of a given condition. STANDARD OF CARE 2 STANDARD OF CARE 3  Diagnostic and treatment process that a  In legal terms, the level at which an clinician should follow for a certain type of ordinary, prudent professional having the Copyright Gateway College Copyright Gateway College patient, illness, or clinical circumstance. same training and experience in good standing in a same or similar community would practice under the same or similar circumstances. STANDARD OF CARE 4 STANDARD OF CARE 5  A physician also has a "duty to inform" a  A recipient of pro bono (free) services patient of any material risks or fiduciary (either legal or medical) is entitled to Copyright Gateway College Copyright Gateway College interests of the physician that might cause expect the same standard of care as a the patient to reconsider a procedure, and person who pays for the same services, to may be liable if injury occurs due to the prevent an indigent person from being undisclosed risk, and the patient can prove entitled to only substandard care. that if he had been informed he would not have gone through with the procedure, without benefit of hindsight. 6  NURSING DIAGNOSIS  A nursing diagnosis is a statement describing a health problem that is treated Copyright Gateway College Copyright Gateway College by nursing measures. 1.4 LONG TERM CARE  It includes physical health and psychosocial ASSESSMENT (HOW IT IS DONE health. AND OUTCOMES)  Most Canadian nurses use nursing diagnoses from the North American Nursing Diagnosis Association (NANDA). MEDICAL DIAGNOSIS  A medical diagnosis is the identification of a disease or condition by a physician. Copyright Gateway College Copyright Gateway College  Example  Cancer  Pneumonia 1.5 WORKING IN FACILITIES –  Bipolar disorder CHALLENGES AND  Stroke OPPORTUNITIES.  Heart attack  AIDS  Diabetes FACILITY ACUTE CARE  A health care facility is a building designed  Health care that is provided for a relatively or established for the delivery of specific short time (usually days to weeks) and is Copyright Gateway College Copyright Gateway College care, treatment, and support services. intended to diagnose and treat an  Inpatient – patients who are assigned a bed immediate health issue. and admitted to stay in the facility overnight or longer  Outpatient – patients who do not stay overnight in the facility 7 SUBACUTE CARE (CONVALESCENT CARE) LONG-TERM CARE  Health care or rehabilitation for people  Health and support services provided over recovering from surgery, injury, or serious the course of months or years to people who Copyright Gateway College Copyright Gateway College illness. cannot care for themselves.  Hospitals and complex care or continuing  A chronic illness is an ongoing illness, slow care facilities provide subacute care. or gradual in onset, that usually grows worse over time. RESPITE CARE REHABILITATION SERVICES  Temporary care of a person who requires a  Therapies and educational programs high level of support, care, and supervision. designed to restore or improve the client’s Copyright Gateway College Copyright Gateway College independence and functional abilities. PALLIATIVE CARE MENTAL HEALTH SERVICES  Both palliative and hospice provide end-of-  Services for people with mental disorders life care – an approach to care that (such as schizophrenia, bipolar disorder, Copyright Gateway College Copyright Gateway College emphasizes patient goals, relief of pain, and addictions) suffering, and quality of life. 8 RESIDENTIAL FACILITY SUPPORTIVE HOUSING FACILITIES  A residential facility is a facility that  Residential facilities where people live in provide living accommodations, care and their own apartments and are provided Copyright Gateway College Copyright Gateway College support services. support services. GROUP HOME RETIREMENT RESIDENCES  A group home is a residential facility in  A retirement residence is a facility that which a small number of people with provides accommodation and supervision Copyright Gateway College Copyright Gateway College physical or mental disabilities live together for older adults. and receive supervision, care, and support services. LONG-TERM CARE FACILITIES ISSUES AND CHALLENGES 1  The facilities provide accommodations, 24-  Working in a structured team environment. hour professional nursing care, and support Meeting multiple needs and demands. Copyright Gateway College Copyright Gateway College  services to clients who cannot care for  Doing many tasks in a short period of time. themselves at home but do not need  Respecting your scope of practice. hospital care.  Working in shifts. 9 ISSUES AND CHALLENGES 2  Dealing with people in distress Making the facility feel like a home. Copyright Gateway College  Copyright Gateway College  Respecting the client’s privacy and dignity  Maintaining professional boundaries 1.6 ASSISTED LIVING – GOALS, PHILOSOPHY, APPROACHES (How these might also be applied in other contexts.) GOALS PHILOSOPHY  Assisted living residences offer three key  The philosophy of assisted living is to components to adults who require regular provide housing with supports that enable Copyright Gateway College Copyright Gateway College help with daily activities: residents to maintain an optimal level of  Housing independence. Services are responsive to  Hospitality services residents’ preferences, needs and values,  Personal assistance services and promote maximum dignity, independence and individuality. APPROACHES 1 APPROACHES 2  Providing supervision or assistance with Support Services activities of daily living. 24-hour monitoring and emergency Copyright Gateway College Copyright Gateway College   Monitoring of resident activities to help to response services ensure their health, safety, and well-being  Social / recreational programs  Assistance may include the administration  One or two daily meals or supervision of medication, or personal  Housekeeping and laundry care services. 10  HOME CARE 1  Home Care is health care and support services provided to people in their places Copyright Gateway College Copyright Gateway College of residence, including private homes, licensed residential care facilities and 1.7 WORKING IN COMMUNITY- homes, and assisted-living facilities. BASED SETTINGS (Challenges and opportunities) HOME CARE 2 HOME CARE – SERVICES AND FUNDING  Support workers have a central role within  Support workers provide most support home care. services for home care. Copyright Gateway College Copyright Gateway College  Assist with personal care, activities of daily  All Provinces and territories offer the living (ADLs), childcare, transportation, following: and home management.  Client Assessment  Case coordination and Management  Nursing services  Support services for eligible clients HOME CARE SERVICES HOME CARE - CHALLENGES  Personal care services  Working on your own Home support services Taking direction from different health care Copyright Gateway College Copyright Gateway College    Nursing and professional services professionals.  Ancillary support  Maintaining professional boundaries  Providing for client safety  Providing for your personal safety 11  COMMUNITY DAY PROGRAMS - COMMUNITY DAY PROGRAMS CHALLENGES  The program is a daytime program for  Working closely with a team and a people with physical or mental health supervisor Copyright Gateway College Copyright Gateway College problems or for older adults who need  Working in a structured environment assistance.  Meeting multiple needs WORKING DIRECTLY FOR CLIENTS - WORKING DIRECTLY FOR CLIENTS CHALLENGES  Clients may hire their own support workers  Clarifying the terms of employment if they need a service that is not provided Establishing work limits Copyright Gateway College Copyright Gateway College  by the local agencies.  Knowing scope of practice limits DEFINITION  Procedure – a way of doing something, especially the usual or correct way. Copyright Gateway College Copyright Gateway College  Policy – a set of ideas or plans that is used 1.8 AGENCY/FACILITY/EMPLOYER as a basic for making decisions. STANDARDS, POLICIES, AND  Standard – a level of quality or PROCEDURES achievement, especially a level that is (Purpose and Function) thought to be acceptable. 12 PURPOSE 1 PURPOSE 2  Identify and establish long- and short-range  for employees to improve their own organizational goals that are feasible and performance and that of the organization. Copyright Gateway College Copyright Gateway College acceptable to those affected. This motivational plan should meet the  Cover all aspects of employees' roles, including the selection and effective use of talent. needs of both the staff and the institution.  Delineate an organizational structure that  Establish an effective two-way system of establishes duties, responsibilities, and communication to keep employees fully authority. informed of all changes that will affect  Clearly define each individual's position and expected contribution. them. CONFIDENTIALITY 1  Confidentiality is respecting, guarding, and using discretion with personal and private Copyright Gateway College Copyright Gateway College information about a client. 1.9 IMPORTANCE OF MAINTAINING  All agencies require that all staff sign an CLIENT/RESIDENT/FAMILY oath of confidentiality. CONFIDENTIALITY  Providing for privacy and confidentiality shows respect for the client and protects the client’s dignity. CONFIDENTIALITY 2 CONFIDENTIALITY 3  All employers have strict guidelines about  Be very careful when transporting the confidentiality of charts and client confidential documents. Copyright Gateway College Copyright Gateway College information.  Concentrate on what you are doing and  Only health care team members involved in remind yourself of the importance of your the client’s care have access to confidential task. information. 13 PRIVACY ACT  All provinces and territories have legislation that protects the privacy and Copyright Gateway College Copyright Gateway College confidentiality of clients’ health information. 1.10 REPORTING AND RECORDING – WHEN, WHAT, HOW REPORTING VERBAL REPORTING IN A FACILITY  A support worker needs to report and  Support workers report their actions and record its actions and observations. observations to the charge nurse. Copyright Gateway College Copyright Gateway College  A verbal report is the spoken account of  Reports must be prompt, thorough, and care provided and observations made. accurate. VERBAL REPORTING IN A COMMUNITY SETTING RECORDING  Usually the support worker calls its  Recording is documenting care and employer if something out of the ordinary observations. Copyright Gateway College Copyright Gateway College occurs.  When recording on a document or form, communicate clearly and thoroughly.  Employers usually have their own policies for recording.  Follow the guidelines and employer’s policies. 14 RECORDING TIME TERMINOLOGY AND ABBREVIATIONS  The 24-hour clock Is used to document care.  In health care, medical terminology and Using a four-digits number for time. abbreviations are used to communicate Copyright Gateway College Copyright Gateway College  effectively and clearly.  0100 = 1:00 a.m.  Use a medical dictionary to constantly look  1300 = 1:00 p.m. up meanings of words. METHODS OF CHARTING RECORDING IN A FACILITY  Narrative charting  In an acute care setting, you most likely SOAP Charting will document care on graphic sheets, flow Copyright Gateway College Copyright Gateway College  sheets, and progress notes.  PIE charting  In a long-term care setting, you will likely document on ADL checklists of flow sheets. RECORDING IN THE COMMUNITY  Every agency and case manager keep separate client charts in their Copyright Gateway College Copyright Gateway College organizations.  Most agencies have forms called client care task sheets that support worker carry with 1.11 LEGAL IMPLICATIONS OF them to every assignment. THE WRITTEN WORLD 15 CHARTS 1 CHARTS 2  A chart (a record) is a written account of a Charts provide the following: client’s condition or illness and responses Communication Copyright Gateway College Copyright Gateway College  to care.  Currency  The chart is a permanent, legal record of  Accountability care provided from admission to discharge  Continuity of care or record.  Funding DOCUMENTS USED IN CHARTS LEGAL IMPLICATIONS 1  Data forms  The client chart is a confidential document.  Assessment forms Home assessment forms The support workers are ethically and Copyright Gateway College Copyright Gateway College    Care plans legally bound to keep client information  Progress notes  ADLs checklists and flow sheets confidential.  Task sheets  Graphic sheets  In a legal case, you may need to testify  Other flow sheets regarding what you wrote on the chart.  Summary reports  Incidents reports  Kardex LEGAL IMPLICATIONS 2  Be careful to observe guidelines on accessing, reporting, and transporting Copyright Gateway College Copyright Gateway College information. 1.12 ORGANIZING WITHIN THE WORK ENVIRONMENT Managing time effectively 16 TO DETERMINE YOUR PRIORITIES SETTING SMART GOALS  What do I value most in life?  Your goals should be SMART: What gives me satisfaction? Specific Copyright Gateway College Copyright Gateway College    Measurable  What principles do I want to live my life by?  Achievable  Realistic  Timely PLANNING YOUR LIFE AND YOUR WORK  Goals are easier to achieve if you spend some time planning at the start of each Copyright Gateway College Copyright Gateway College week.  Daily planning and scheduling are important to meeting goals. 1.13 USE OF WORKPLACE  Give each task a time limit. TECHNOLOGY (COMPUTERS) COMPUTER INFORMATION 1 COMPUTER INFORMATION 2  Using a computer is easier, faster, and  Computer information is easy to access, so efficient. the client’s right to privacy must be Copyright Gateway College Copyright Gateway College  The recordings are more accurate, legible, protected. and reliable.  Follow the ethical and legal considerations relating privacy and confidentiality. 17