Ensuring Best Outcomes

NQF level 5: BTEC Higher National — H1

HND Health and Social Care (Management & Care Practice)

In Course Completion of

UNIT 9: ENSURING BEST OUTCOMES FOR INDIVIDUALS

Submitted this ____________

Submitted to:

Submitted by:

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Contents:

Answer to Question 1 - 1.1 3
Answer to Question 2 – 2.1 5
References 13
Bibliography 14
Appendix 15

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Answer to question 1 – 1.1

Legislation and national service standards influence organizational policies and practices to
achieve best possible outcomes for people like Mr. Frazer by implementing laws, regulations,
and acts which cover all areas of care that help and support people like Mr. Frazier. The national
minimum standards for example are applied to make sure that the standards and quality of care
are consistent nationally and this results in ensuring the best possible care given to people like
Mr. Frazer.

There are also standards like the care standards act which protects people or patients from any
abuse or disrespect which guarantees that the people have the freedom to exercise their rights
whenever they are abused or mistreated so they will expect nothing else but just quality service
of care from health care providers. However, given the openness of care homes to changes, they
are needing sufficient resources (BBC News, 2003).

There are also assigned inspectors to care or manage establishments and provide them with
information regarding the establishment. These inspectors also enter and inspect care
establishments to make sure that the patients are given good quality care services and ensure that
the patients are treated well. With all of these policies and standards implemented by the
government, the clients or patients are ensured that best possible outcomes are achieved or will
be achieved whenever they want the best care service possible.

Word count: 227


There are a lot of factors that may affect the achievement of the best possible outcomes for Mr.
Frazier. Let me tell you some possible factors that will affect his improvement.

Mr. Frazier has Alzheimer‟s disease so I can assume that he is having some hard time
communicating effectively with other people like his wife, relatives, and his health care
providers. Communication is an important factor in a patient‟s progress because first of all, in
order to get positive results, the patient and nurse should understand each other‟s roles so that
they can communicate effectively and work together for ensuring progress for the patient.

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The patient‟s cooperation or compliance in receiving medicines or care service is also a vital
factor in achieving the best possible outcome for Mr. Frazier. In order to have positive results,
patients should comply with the health care advisor‟s recommendations. If given medications, he
should always try to follow the prescribed dose consistently and if given restrictions, patients
should acknowledge their limitations and follow every restraint.

The systems and procedures of Mr. Frazier‟s medication is an important factor in also getting
positive results because his progress also depends largely on this. His health adviser should plan
an effective way of dealing with Mr. Frazier and her wife‟s problems and look for the best
possible solutions for giving them a better scenario in which all of them can benefit especially
Mr. Frazier.

Word count: 235


Communication between care workers and individuals plays a big part in expecting outcomes. In
fact, according to 0845 Number (n.d.), professionals who are „working in such an industry needs
to be able to learn proper communication methods in order to work effectively as a health care
specialist.‟Effective communication with both parties is important because health care is an
interpersonal service where a sick person depends on his care giver to give him the best possible
care needed in order to produce the best outcomes. In order to see positive results, the patient and
his or her health care provider should agree to mutual understandings of how they are going to
work together to achieve success for the patient effectively.

As a patient, he should give his all-in trust in his nurse that the intentions of his nurse are only to
give him progress and ensure the best possible outcome for him. I stated this because in health
care, mistrust is often an issue. As a health care provider, you should also understand your
patient‟s limitations and his areas of needs and not just do what you want to do without thinking
about your client‟s feelings or what your client‟s needs are. If both parties come to some mutual
understanding and have some sense of cooperation in working together then there should be no
problem in the delivery of care to achieve the best possible outcomes for everybody.

Word count: 238

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There are a lot of possible factors that may have lead to Mrs. Ellen‟s loss of independence, non-
participation, and social exclusion. Her deteriorating concentration and dexterity may have lead
to her loss of independence because she felt that she couldn‟t do things on her own anymore. She
has lost confidence in herself and because of that; she may have stopped participating with social
activities and then may also be the reason that she has been isolating herself from others.

Her deteriorating concentration and dexterity caused by old age has been magnified and been
sped up by her loss of confidence or loss of belief in herself. She has been depressed about her
mental state that it affected her also emotionally resulting to aggravating her deteriorating
concentration and dexterity.

For someone to live a healthy life, one must believe and always be optimistic that he or she is
healthy. In Mrs. Ellen‟s case at first, her emotional state isn‟t healthy and her self-concept is also
weak and this resulted to her feeling of deterioration. Now that she is put in a nursing home
where she can get help and attention from others, she is displaying positive results and suddenly
she is learning to do things she used to love to do independently.

Word count: 211


There are plenty of processes and support mechanisms to maximize independence and choice for
people like Ellen.Nottinghamshire County (n.d.), for instance, offers intermidiate care services
primarily to „...promote faster recovery from illness, preventing acute hospital admissions,
support timely discharge and maximise independent living.‟Everything depends on how the
health care provider approaches and treats these types of patients like Ellen. Here are some of the
ways.

Empowering people no matter how we deliver it is an effective way to help these patients regain
their independence and autonomy of choice. The care provider should treat these types of
patients with respect and dignity. They should not be treated as if they are “old or disabled” but
instead we should treat them as normal persons. In order for a patient to be independent, he

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should feel independent. A good caring relationship with the patient is an effective way to
encourage the patient to be independent.

To gain autonomy of choice for patients like Ellen, the health care provider should put the
patient in scenarios where the decisions are not just answered by “yes” or “no” but instead give
them plenty of options to choose from and encourage these patients to decide on their own.
When these patients get used to being in these kind of scenario where they should make
decisions on their own and do certain tasks on their own then that‟s the time they slowly develop
a sense of autonomy where they, on their own, can recognize their own strengths and how to
utilize them.

Word count: 256


Organizational systems may be managed to promote participation and independence for
individuals. In order for a person to be independent, he must feel empowered. For one to feel
empowered, other people should welcome him to the society like a normal human being. For one
to feel welcome, he must participate in social activities. When he starts to participate with other
people, he will gain confidence because of the encouragement from others and that‟s the time he
will start to gain confidence in doing things again by himself.

Nursing homes should organize plenty of social activities for patients to participate because these
activities keep them healthy socially. They should implement systems that encourage both the
health care provider and the patient to interact effectively. The health care provider should treat
patients with respect and they should respect the patient‟s decision-making and treat him with
dignity. It is human nature that when other people respect or praise your decisions, then that
encourages you to decide things more on your own. This is a simple fact that can be applied also
to individuals similar to Ellen‟s case. It should be a “must” to treat these people patiently and
treat them with warmth and care so that their confidence level will rise resulting to their sense of
autonomy.

Word count: 214

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Every patient has the right to make his or her own decisions and sometimes this comes in the
way of the health care provider giving care and the right interventions to these certain patients.
Old people are most of the time quite proud but stubborn and especially when he is feeling very
independent. This can be a hindrance to us health care providers at times and it is normal that we
encounter this in the future when we are working in similar situations.

Let me give you an example of a scenario that normally happens in care homes or hospital.

A 78-year old man has been a chronic smoker for the last 50 years. He is used to smoking two
packs of cigarettes a day. He was accompanied by his daughter to the hospital for a general
check-up and has been diagnosed that he has a severe case of tuberculosis. His doctor and his
nurse restricted him from smoking and told him to quit or else his tuberculosis will be
aggravated. He refuses to listen to them stating that he has the right to do what he wants and
continue smoking.

Now this is a difficult scenario but sadly, this is a tension that happens often between care
providers and patients. We care providers should find effective ways to get our message through
so that we can give the right intervention to the patient who is hesitant to follow us because of
his own freedom of choice.

Word count: 247

Answer to question 3 - 3.1

When I was reading the case study, I felt that these women are being abused horribly. These
patients are at risks of grave abuse and harm which sometimes resulted to psychological trauma.
These old women are vulnerable and they do not deserve to be treated by such inhumane
behavior. An individual is at risk of abuse or harm if he or she is vulnerable and unable to defend
himself or herself from possible maltreatment by others.

Someone can be called a vulnerable adult if she is aged 18 years or older who may be unable to
take care of herself and protect herself from being exploited, raped, harmed, or any insane
physical abuse. The effects of persons being abused are physical and worse, it is even more

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traumatic to them psychologically. These patients are unable to defend themselves from such
risks of abuse because they may have mental health problems, some disabilities of some sorts,
sensory impairments, old and weak, or just have some illness of any form that could hinder them
from defending themselves of such dirty deeds. These patients are most of the time helpless and
may be too scared to report such incidents because fear, intimidation or trauma is mostly driving
them mad. The effects of these abuses are so fatal that it could damage them physically,
emotionally, psychologically, and sometimes could result to death.

Word count: 228


There are various options which would have been helpful for protecting these helpless
individuals from abuse while balancing legislation requirements and guidance with the tensions
involved. First, we must assess these individuals. Intervention of abuse will involve setting up an
inter-agency framework. The people who are assessing should make sure that these patients are
not in immediate danger. If necessary, provide medical treatment if it is urgent. We should also
report such acts to the local authorities and leave evidences as they are as they can be useful for
court trials or claiming charges against the suspect.

There are agencies who agreed to work together to decide actions to take in investigating such
abuse situations and to plan with the vulnerable person of how to protect them. There are also
regulations that help protect vulnerable persons from such risks of abuse. One is Protection Of
Vulnerable Adults scheme or (POVA). POVA will act as a workforce ban for any professional
worker who has harmed vulnerable adults in their care. It adds protection to the CRB or Criminal
Record Bureau checks and it will stop the further employment of people who have the potential
to abuse.

There is also the Children Act 1989 which provides the legislate framework in behalf of the
children. It helps protect children from such abuses or maltreatment and neglect.

Word count: 223

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For a known setting, the effectiveness of policies, procedures, and managerial approach for
promoting management of risks is important because risks are very harmful and they could be
everywhere and anybody could suffer with the effects of these risks. If these risks are responsibly
managed or controlled then there would be less probability for danger. We should develop
effective policies and procedures for risk intervention to ensure safety around the vicinities.

Before doing risk management, we should always do some assessment. These risks are less
immediate than danger but they could turn into danger in the near future if not assessed and
managed right away. We should look at every scenario and check if there‟s an immediate risk or
a hidden risk around, then we should plan ahead of time on how to manage it so we that prevent
future hazards that will happen to people.

The right policies for risks, prevention and protection procedures and the right managerial
approach for promoting management of risks can go a long way. Just by planning ahead, we
could prevent disasters for people to happen in the future. Everyone should be well aware of the
relevance of health and safety in every area and should start doing proper risk management by
assessing and planning ahead and then implement the right procedures to prevent disasters from
happening.

Word count: 223


For improving management approaches to managing risks of abuse in the setting of this case
study, management should identify what could be the probable and potential causes for such
risks of abuse to people. Every workplace should be monitored closely by management and
inspection teams to check if the chemistry of care worker to patient is harmonious and that there
are no rising tensions arising. This should be a continuous process and should not only be done
once.

To predict, identify, and prevent risks from happening, the management should look at past
history of every staff, patient, or anybody involved in the workplace. They should also have the
right policies, rules and regulations that should protect certain individuals and to prevent abuse

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from happening. The management should have the right interventions of risks and should do
continuous risk assessments.

If found that there is an incident of abuse happening, the management should do everything
effectively and justly. They should protect the abused and treat them and deal with the
perpetrator justly, but of course we cannot jump right away into conclusions. First, we must find
out why he did those things and give a thorough investigation and then when all data are
gathered, give some just actions, and then make sure to it that these things will not happen again
in the future.

Word count: 223


There are ranges of legislations, guidance, codes of practice and policies that apply to the
handling of medication. Here are some:

Medicines Act 1968 – It is an act of parliament of the UK that governs the manufacturing and the
supply of medicines in the UK.

The UK Misuse of Drugs Act in 1971 – Controls drugs from being misused, abused, and banning
narcotics from reaching the public.

The National Minimum Standards also set some minimum standards for health care
establishments to follow. They are requiring the people who are handling medicines to keep
records on everything that happen like what is currently prescribed to the patients, which service
users are taking them and which dates they were taken. By following these standards and
policies, it is being ensured that the movement of drugs from the supplier to the doctor
prescribing it, the health care provider administering it to the patient, and down to the client or
patient taking it that every sequence goes the right way and that these drugs are properly handled
and taken under the right guidance and codes of practice. With these legislations, guidance,
codes of practice, and policies applied to handle medication, it ensures that these drugs are safe,
legally prescribed and taken, and not abused therefore minimizing overdose, illegal drug abuse,
and avoiding some drugs to be given to the wrong users.

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To those care providers who are tasked to administer immunisations, they are required to
undergo a certain training first. The Health Protection Agency (2005) states that „Anyone
involved in immunisation should have access to training – whether working for the NHS or in
private healthcare.‟ Please refer to the Appendix section of this paper [page 15].

Word count: 281


Let me analyse how national service standards promote safe practice in the handling of
medication. As we have learned, there are some drugs that can be sold to almost anybody
without the need of prescription and there are certain drugs that are heavily controlled and are
only given when prescribed because they are usually used to treat severe pain, anesthetics, or
dependence of drugs and they have additional safety precautions. With some legislations,
policies and national service standards that are guiding us health care providers, drug suppliers,
and even patients into how to promote safe practice in the handling of medication, we are
ensured that all types of drugs whether controlled drugs or drugs that are free to the public are
never misused or abused. These national service standards make sure that drugs are given to the
right persons who really need them and not fall into the wrong hands. Let us always remember
that not everyone are responsible drug consumers and that some people may want the wrong
drug or may take the right drug with the wrong dosage or some patients are hesitant to intake the
right drugs that are prescribed for them. These national standards helps a lot in controlling drug
movement and setting such standards for health care establishments and pharmacies to promote
safety with drug handling.

Word count: 221


The policies and procedures for administering medication in achieving the best possible
outcomes for service users are effective because it ensures us that drugs are administered to the
right persons who really need them and these policies and procedures guide them on how to use
these drugs effectively to ensure us of the best possible outcomes. Not all drug-dependent
patients are responsible enough or have the right knowledge on what to take and whether to take

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it or not. It is the responsibility of the health care providers and the registered persons who
handle drugs to implement these policies and procedures and make sure that each drug are safe
for consumers to take. On the other hand, even with the presence of the medication policies,
there still quite a number of patients who are experiencing such errors coming from the nurses.
According to a study conducted by Haw et. al. (2005), one of their significant findings showed
that „Fifteen percent of the errors had the potential to cause moderate or severe harm to patients.‟

I want to share a personal experience of mine. I am not sure if you‟ve heard about the anti-
obesity drug called Reductil. I, Cesar Ramon Causin, used to weigh 270 pounds when I was a kid
until I was in my late teens and I lost that weight in the past 6 or 7 years thanks to that drug and
some dieting. I have recently maintained myweight to about 170 pounds. When I first arrived
here in the UK, I used to eat a lot due to stress and homesickness so I gained about 10 to 15
pounds. I got desperate when I knew I‟ve gained some weight and was thinking seriously about
going on Reductil again even though It was unnecessary for me. Remember, Reductil is only for
gravely obese patients and not anorexic people like me. I searched the internet and went to
www.reductil.co.uk and I was thinking of ordering a dosage for two months. I was disappointed
when I found out that it was banned in the UK for its side-effects. Now, I‟ve lost back most of
the weight that I have gained here in this country by dieting properly and because I‟ve been busy
with my daily activities. I am now glad that I wasn‟t able to buy that medicine that was banned
due to its hazardous side-effects. Remember, Reductil is only for gravely obese patients and not
for anorexics like me. I am happy that I saved myself from wasting about 200 pounds worth of
medicines that I really didn‟t need and I avoided the risks of its side-effects.

Word count: 439

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References

BBC News, 2003. Standards aim to end elderly abuse [Online]. Available at:
http://news.bbc.co.uk/2/hi/health/441358.stm [Accessed 4 August 2010]

Haw, C. M., Dickens, G. & Stubbs, J., 2005. A Review of Medication Administration Errors
Reported in a Large Psychiatric Hospital in the United Kingdom [Online]. Available at:
http://psychservices.psychiatryonline.org/cgi/content/full/56/12/1610[Accessed 4 August 2010]

Health Protection Agency (HPA), 2005. National Minimum Standards for Immunisation
Training [Online]. p.6-7. Available at:
http://www.hpa.org.uk/web/HPAwebFilea/HPAweb_C/1196942164323 [Accessed 5 August
2010]

Nottinghamshire County, n.d. Intermediate care services [Online]. Available at:
http://www.nottinghamshirecountyteachingpct.nhs.uk/my-nhs-services/community-
services/intermidiatecare.html [Accessed 4 August 2010]

0845 Number, n.d. Importance of Effective Communication in Health Care [Online]. Available
at: http://www.0845number.org.uk/best-numbers/importance-of-effective-communication-in-
health-care.html [Accessed 4 August 2010]

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Bibliography

Meier, B., 2010. The New York Times. Prescription Drug Abuse Move to Restrict Pain Killers
Puts Onus on Doctors [Online]. Available at: http://www.worldhealthnews.harvard.edu/
[Accessed 4 August 2010]

Roan, S., 2010. Los Angeles Times. Alzheimer’s Disease: The best bets for prevention, so far.
[Online]. Available at: http://www.latimes.com/news/health/la-he-alzheimers-prevention-
20100726,0,7179300,full.story [Accessed 4 August 2010]

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Appendix

(Health Protection Agency (HPA), 2005. National Minimum Standards for Immunisation
Training [Online]. p.7)

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