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  • Introduce myself This presentation is based on a case scenario from my past work experience. In the next ten minutes I will focus on the following aspects of nursing roles and responsibilities in the scenario: Accountability Leadership and management Team working Teaching and facilitating
  • Fionapresentation

    1. 1. Developing the roles and responsibilities of the qualified nurse Fiona Lee
    2. 2. Scenario <ul><li>Small residential home for 6 people </li></ul><ul><li>3 support workers, one qualified nurse (Rebecca) </li></ul><ul><li>Problem centres around incorrect distribution of medication </li></ul><ul><li>Result: medication given to wrong service user </li></ul>
    3. 3. Accountability - who is responsible for the mistake? <ul><li>“ Accountability is being personally responsible for the outcome of one’s actions” [RCN, 1981] </li></ul><ul><li>Rebecca alone is accountable for the mistake (no one else can be blamed) [Tilley & Watson, 2004] </li></ul><ul><li>As a professional, Rebecca should act in accordance with the organisation’s policies and procedures </li></ul>
    4. 4. The nurse’s response to the mistake <ul><li>Reporting incident to manager </li></ul><ul><li>Contacting service user’s GP for advice and guidance (or emergency services) </li></ul><ul><li>Complete incident form and nursing notes </li></ul><ul><li>Inform all staff of incident, particularly at hand over to next shift </li></ul><ul><li>Complete risk assessment forms </li></ul>
    5. 5. Management response to the mistake - steps to prevent future errors (short term) <ul><li>Warning notice or memo (in communication book) at time of mistake </li></ul><ul><li>Supervision of Rebecca by her manager (with review meeting) </li></ul><ul><li>Team meeting looking at the mistake and what caused it and learning from it </li></ul>
    6. 6. Management response to the mistake - taking steps to prevent future errors (longer term) <ul><li>Training for home staff (internal or external) (assess training needs first) </li></ul><ul><li>Planning for new policies and procedures is a major part of the management process [Cole, 1996] </li></ul>
    7. 7. Did the team work effectively? Training/education for team – staff encouraged to identify areas where support is needed Lack of support from colleagues Improve understanding of when tasks can be delegated and when not. Failure of delegation Improve induction and on-the-job training of nurses (perceptorship course?) Poor communication Improve understanding of staff roles and expertise and boundaries of practice. [Anciano, 1990] Didn’t follow policies and procedures What can they do to improve? What went wrong?
    8. 8. <ul><li>Effective teamwork is essential to the running of nursing organisations. The Nursing and Midwifery Code of Professional Conduct (2004) states: </li></ul><ul><li>“As a registered nurse you are expected to work co-operatively within a team and to respect the skills, expertise and contributions of your colleagues.” </li></ul>
    9. 9. Conclusion <ul><li>As stated by Burnard (2002): </li></ul><ul><li>“ In order to learn at all, we must be able to reflect on what we do and to undertake some form of critical appraisal.” </li></ul><ul><li>The main areas for improvement here are: </li></ul><ul><li>Improved communication within the home of policies and procedures [NMC, 2004] </li></ul><ul><li>Support for team leaders in delegation skills </li></ul><ul><li>Better awareness among management of where support and education/training is needed </li></ul><ul><li>Main aim should be to ensure such a drug or any other error doesn’t occur in the future which may affect the safety and wellbeing of service users. </li></ul>
    10. 10. References <ul><li>Tilly, S. & Watson, R. (2004) p.118 Accountability in Nursing and Midwifery. Blackwell. U.K. </li></ul><ul><li>Cole, G.A. (1996) Management: Theory and Practice. Aylesbury. U.K. </li></ul><ul><li>Nursing and Midwifery Council Code of Professional Conduct (2004). London. U.K. </li></ul><ul><li>Burnard, P. (2002) Learning Human Skills. An Experimental and Reflective Guide for Nurses and Health Care Professionals. Butterworth-Heinemann. Oxford </li></ul><ul><li>Anciano D. & Kirkpatrick A. (1990) C.M.H.T.’s and Clinical Psychology: The Death of Profession </li></ul>