Delegation and Skill


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Pat Alexander
Director, Herts Handling Training Limited
(P17, Friday, NZI 4 Room, 12-1)

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Delegation and Skill

  1. 1. Auckland Conference 2012 Challenging workplace boundaries Pat Alexander MSc PGDip PGCE MCSP CMIOSH MIfL
  2. 2. Aims of workshop Analyse handling skills required for delegated therapeutic tasks Identify existing staff skills Devise alternative strategies if necessary
  3. 3. UK Physio Guidance on Treatment handling (2008) physios must not use or condone unsafe systems of work- extra staff or equipment must be considered treatment goals must be realistic and achievable or may need to be reconsidered management responsibility to ensure staff safety is compatible with patient progress and support staff in rehabilitation issues
  4. 4. UK Physio Guidance on delegation (2008) physio must be clear if it is delegation or guidance principles of duty of care and risk assessment apply in physio must be working within professional scope to be covered by Public liability insurance physios have duty of care to assistants/others as well as patients physio must ensure they are up to date with current good practice
  5. 5. UK Physio – guidanceDelegation, guidance and advice (cont) no profession can dictate to another person how they must handle a patient aim must be to prevent harm to handlers whilst ensuring best possible outcome for patient giving advice and delegating tasks is normal/essential part of physio. Clarity about position of physio should make this easier.
  6. 6. UK OT - Delegation andguidance to others (2006) Does person have sufficient skill/ knowledge of manual handling respect other person’s policy guidance to formal/paid carers (not training - this is employer’s responsibility) guidance to supervisor of team capability of family/unpaid carer OTs are not able to “dictate” method of handling to other professions-but allow balance where rehabilitation can progress, even with use of equipment
  7. 7. Benner levels of competence Novice- adheres to rules, little experience, inflexible behaviour Adv. beginner- limited perception, place advice in context Competent- gaining perspective, standardised procedures Proficient- holistic view, faster decision making, uses deviations from norm Expert- no longer needs to analyse, enormous experience, intuitive grasp, advanced problem solving
  8. 8. Possible alternatives The task could be simplified/altered to suit the competence of available staff Other staff could be found who possess the correct level of expertise The therapist could educate the available staff to enable them to function at higher level The therapist could visit the child more often
  9. 9. Child size A Babies and very small children 0-2 years, estimated weight range 3-10 kg B Pre-school 2-4 years, estimated 11-20 kg C Young Children 4-7 years, estimated 21- 25 kg D Older children 7-12 years, estimated 26-35 kg E Teenagers 3-16 years, estimated 36-40 kg F Almost Adults 16-18 years, estimated 41+ kg
  10. 10. Levels of Functioning (from FIM)7 Complete Independence (timely, safely)6 Modified Independence (extra time, devices)5 Supervision (cueing, coaxing, prompting)4 Minimal Assistance (performs 75% or more of task)3 Moderate Assistance (performs 50-74% of task)2 Maximal Assistance (performs 25-49% of task)1 Total Assistance (performs less than 25% of task)