Report on end-of-life care provision

Report on end-of-life care provision Task: Think of a service/programme, which you believe could improve the quality of end-of-life care provision and write a report to management, in an attempt to persuade them to implement this service/programme. This report should include a description of the service, the rationale for its implementation and the perceived challenges. It would also be beneficial to show an awareness of any possible limitations of this service/programme and measures to minimize these. To the management, A way to improve the end-of-life care within our health care system would be by implementing the Gold Standards Framework. This framework was developed in 2000 by Dr Keri Thomas; a general practioner with a special interest in Palliative Care. I am writing in order to ask for the implementation of the Gold Standard Framework within our hospitals. The main purpose of this Gold Standard Framework is to provide training to us healthcare professionals and staff in order to enable â€Å"a gold standard of care for all people in the last years of life†. This is a systematic, evidence based way in optimizing patient care nearing end of life provided by healthcare professionals and healthcare workers. One must also state that according to the Department of Healths End of life Care Strategy (2008) they state that all organisations providing end of life care are expected to adopt a coordinated process such as the Gold Standards Framework. This framework also improves the coordination of care between nurses and members of the multi-disciplinary team. This framework focuses on seven key tasks mainly; communication, co-ordination, control of symptoms, continuity, continued learning, carer support and care of the dying. In order for this framework to be implemented successfully one must also evaluate current practice and identify the changes required. One must also identify the eligible patients undergoing palliative care and are at an end of life stage. Health care team meetings must also be organized within the multidisciplinary team. The Gold Standard Framework also aims at identifying and assessing symptoms at an earlier stage. This could be a possible limitation as it might not always be possible to anticipate which patients are during their last year of life. This could be easily tackled by using the prognostic screening tool provided with the Gold Standard Framework and with the help of monthly multi-disciplinary t eam meetings. Callaghan, Laking, Frey, Robinson Gott (2014) identified in their cross sectional study that the prognostic tools assist in identifying patients at an early stage whom would benefit from the Gold Standard Framework . This is a result of monthly discussions that would take place within the multidisciplinary team. Early identification allows enough time for healthcare professionals to determine patients wishes and prepare the patient and the relatives. The healthcare workers would also have enough time to adequately refer these patients accordingly such as palliative care services when needed. In their study conducted results showed the screening guides used would be the first step in implementing and identifying means by which we address patients’ needs. The authors also add that by these prognostic tools one will be able to also identify future anticipated patients whom would benefit from these services. Patients at an end-of-life stage have acknowledged five main goals for improved quality of care; to avoid prolonging dying, reduce the pressure on their families, to maintain relationships with relatives and loved ones and adequate pain and symptom management. Death and dying is a natural process of life but nowadays it is being seen as something to fear. Due to medical and technological advancements these have aided in prolonging life, which has urged many families to delay death and dying of their loved ones. This is a result of families wanting to spend time with their loved ones, this may also result in a far more traumatic event as false hope may be portrayed that life can be maintained. Technological advancements have made it more difficult for the persons implicated. However patients wishes and the caregivers wishes may not always be the same, therefore the implementation of the Gold Standard Framework will aide in supporting family members. Through early identification of the se patients, their wishes and goals would be planned into action and communicated with caregivers. Furthermore this framework will allow patients within the community to die where they would wish. This would make the experience less traumatic for family members as they would have been prepared and reduce the risk of creating false hope. The Gold Standard Framework provides quality improvement training and programmes to healthcare professionals in order to be able to provide gold standard care. This framework also provides tools and measures for support to healthcare professionals; the framework aims to provide on-going assessment to patients, good communication, the ability to improve quality of life and dying with dignity. It is known that a number of admissions to the acute hospital are due to dying patients, with the gold standard model this number is reduced with the help of earlier identification of these patients which would result in reduced hospital admissions. Patients would be identified at an earlier stage and the appropriate care and support would be provided to the patients and family, furthermore these patients would be followed up by community care services as part of the Gold Standard Framework. This framework will also aim to improve the coordination of care by providing better communication and cross-boundary care. As a result of successful completion and implementation of the gold standard model one would also perceive improved skills provided by healthcare professionals and improved confidence in providing care. This would also generate a better improved patient satisfaction throughout. Furthermore the Gold Standard Framework will reduce hospitalization and therefore reduce the cost associated. The Gold Standards Framework would also enable patients to feel secure and supported by planning care ahead. Family and patients would also feel empowered through the increase in communication and through working together with the patient. Support would be provided through the process, healthcare workers would be able to refer patients accordingly to community care services such as respite care, provisions of equipment and practical assistance. Relatives would also be followed thr ough bereavement support, one would have to plan ahead and form a protocol in dealing with relatives and helping them through the bereavement process. This is also stated by Payne (1999) where it is outlined that meeting carers’ needs would be an essential part, providing information, practical help and emotional support would result in a better patient outcome. I believe that with the implementation of this framework one would perceive some challenges and limitations but these can be identified at an early stage. One might find resistance from healthcare professionals to attend the training and meetings required in order to attain the Gold Standard Framework but these can be eliminated as there are various pathways in which one can receive the training. This could be easily negotiated between staff members in order to find the adequate time and place for training and multi-disciplinary meetings. Challenges that might also be associated with this framework may be the increased workload associated with this framework, as a result adequate support services are to be provided. It would also be vital to divide administrative work between co-workers; as a result this would also encourage their participation in professional development activities and within the framework itself. Furthermore the framework should be adjusted to our local services an d requirements; as a result improvements should be done accordingly. The patients informal carers must also be included within this framework, it is vital that they as well are taught and informed. Patients informal carers should also be empowered and assisted at home by Hospice services and community care nurses. These carers must also be trained and educated in what they should expect when their loved ones are dying and what they can do in order to allow the patients to die with dignity. The Gold Standard Framework also allows Advanced Care Planning which also allows the patients to inform care givers what is important to them, their spiritual needs or something they might need to do in order to allow and enable them to die with dignity. Implementing this framework will ensure the best possible care in the final days by anticipating the patients needs and providing the support and coping mechanisms required by the family. As a healthcare professional, the care of a dying patient is never easy and always proves as a challenging experience to all parties involved. However, implementation of the Gold Standard Framework aims at providing the best possible care to all individuals involved within the death of a dying patient. This framework will improve the quality of end-of-life care provided within our community and aiding other services presently provided by Hospice and MMDNA. Furthermore the successful implementation of this framework will also improve outcomes for our patients.

IT Agreements

Seva Bharat recognizes the critical importance of protecting the privacy of Individuals and securing the confidentiality of all official records. Employees of the Department of Information Technology (IT) will make appropriate efforts to protect and secure official data and information. IT positions frequently have privileged access to computing systems, applications, databases, network monitoring tools and other equipment that may contain records and information that are private and confidential in nature.As an employee of Seva Bharat's Department of Information Technology, I may be entrusted with such rivileged access and encounter or have access to sensitive, confidential or proprietary Information whether or not It Is labeled or Identified as such. I acknowledge the sensitive and confidential nature of information concerning Seva Bharat / LCT / SBPT / SST / MI employees, consultants, alumni, donors, vendors, and other stakeholders of the Seva Bharat community.I understand and agr ee that this Information may only be disclosed with proper authorization and in the exercise of my designated duties. I agree not to use any access or information available to me In he course of my duties to engage in any activity that conflicts with the interests of Seva Bharat or use any access available to me to provide information to others engaged in any activity that conflicts with the interests of Seva Bharat. pecifically, with respect to office compuung systems, networks, records, flles, email and other information, I agree that I will treat all confidential information as such by respecting the privacy of users, the Integrity of the systems and the related physical resources, and I will: Access, copy, or store data solely In performance of my Job responsibilities, limiting erusal of contents and actions taken to the least necessary to accomplish the task. 2.When providing direct services to users, copy or store data or information only with the user's consent and only to co mplete a specified task, and only to copy and store user data for long enough to complete the specified task. 3. Not seek personal benefit or permit others to benefit personally from any data or Information that has come to me through my work assignments. 4. Not make or permit unauthorized use of any information in the office information systems or records. . Not enter, change, delete or add data to any information ystem or file outside of the scope of my Job responsibilities. 6. Not intentionally or knowingly Include or cause to be included in any record or report, a false, inaccurate or misleading entry, 7. Not intentionally or knowingly alter or delete or cause to be altered or deleted from any records, report or information system, a true and correct entry. 8.Not release official data other than what is required for the completion of my Job responsibilities. 9. Not exhibit or divulge the contents of any record, file or Information system to any person except as required for the completion of my Job esponsibilities. u lake every reasonaDle precautlon to prevent unautnorlzea access to any passwords, user identifications, or other information that may be used to access official information systems or records. 1 1 .Limit access to information contained in or obtained from the systems to authorized persons. 12. Report any incidents of my non-compliance with the terms of this agreement to my supervisor. I further agree not to independently contract to perform or provide information technology services to other entities not associated with Seva Bharat while employed by the Department f Information Technology, or to use offcial resources in the delivery of privately contracted services.I understand official resources include time, equipment, computers, tools, software, phone, email or other items that are provided by or acquired through my relationship as an employee of the Seva Bharat community. Page | 1 I understand and agree that my failure to comply with the t erms of this agreement will have consequences and may result in disciplinary action up to immediate termination and criminal prosecution, depending upon the infraction's severity, evidence of my intentions, and the sensitivity and scope of the information ompromised.

A Difficult Child

A difficult child It is true that some children are easier to raise than others. They are happy, affectionate, sociable and self-disciplined. Others, however, can be irritable, stubborn, aggressive, and restless. Despite their parents’ great efforts, these children are difficult to deal with and to bring up. During the years, people’s opinion about children who face challenges in controlling their feelings and behavior has shifted from one point of view to another. On the one hand, the blame was placed on parents – somehow it was their fault that their children misbehave.If parents were more understanding, patient and caring, then their children would be good. This view didn’t make any sense to many parents and even put them to a cul-de-sac, because their parenting worked for one of their children, but not for other. On the other hand, the experts came to believe that difficult children are like this because of their innate makeup, they are simply born wit h certain traits, and it is not their fault. Irritability, indifference, fussiness or aggressiveness in children is seen as part of their nature, and parents have no choice but to learn to live with such traits in their child. Similar essay: Having Children While YoungIt goes without saying that, dealing with difficult children isn’t an easy task and changes to positive side require a long time. In fact, the older they grow, the more rebellious they are likely to become, that’s why it’s very important to discern the difficulties in the upbringing of the child at his early age. Moreover, parents relate to their children can make a huge difference in how youngsters feel about themselves and respond to their environment. Therefore, parents should become child’s support and encouragement.Children learn by example, they absorb all the information like sponges and the best way to promote good habits and behavior is by practicing parents by themselves. One more vital point for parents is to be more involved in child’s life, it means that family members should always keep a healthy relationship with the kid and create a comfort level that will enable him find relatives helpful an d reassuring. The last, but not less significant aspect is making child responsible for his decisions and choices, there should always be a consequence of every action, good or bad.This will make him responsible for everything he does and will require a good amount of thinking before any action is taken. I’d like to conclude by saying that â€Å"a difficult child† is not an illness or medical diagnosis, difficult children are normal, they can become positive, enthusiastic, perhaps even especially creative individuals if they are well managed when young, as well as treated with most care and love, from parents, family members, relatives, teachers or any other people around them.

Shawshank Redemption Reflection - 2090 Words

The movie â€Å"Shawshank Redemption† shows what goes on in a prison. The movie depicts the part of a prison that most people are not aware of. People think of a prison as a place a person is tortured physically as well mentally. However, all that being said true, friendship, hope, and loyalty exists in prison. The movie shows how the main characters Red and Andy build a friendship that lasts in life after prison and loyalty among the inmates. Besides the development of friendship, the movie clearly shows the everyday routine of a prisoner’s life. The movie focus on the main characters Andy, who used to be the vice president of Portland bank before entering prison convicted with a double murder of his cheating wife and a man she was with and†¦show more content†¦His skills helped him gain the trust and popularity from both Mr. Warden and his inmates. He is calm and cool in behavior that made him likable. He is loyal as he made sure he kept the promise he made t o his friend Red. Andy has high external as he is educated and had a high position in a bank. On the other hand, Red has been in prison for his entire adult life which resulted in a change of personal system. He doesn’t think of life after prison. He has been â€Å"institutionalized â€Å". He has become dependent on the required system that he doesn’t think he can survive after prison. The word institutionalized as described by Red is the process by which prisoners first hate the prison then gets used to it that finally, even their lives depend on it. (Movie). Red is also the guy that can get you anything. He sells â€Å"cigarettes, a bag of resources and a bottle of brandy† which resulted in high power and respect from his inmates. He values the life he has in prison than anything else. I believe this is because it has been a long time since he was out to see the world. He has already adjusted his behavior and way of life in regards to the required system of the prison. The rest of the prisoner’s personal system lies between these two. The other concept related to the personal system and demonstrated in the movie is self-concept. Each of the inmates has their own self-concept. The way they see themselves differs from person toShow MoreRelatedSS1611 leelokyiu Essays1056 Words   |  5 Pagesï » ¿SS1611 Movies and Psychology Story Book Movie Titleï ¼Å¡The Shawshank Redemption Student Nameï ¼Å¡Lee Lok Yiu Student Numberï ¼Å¡53057085 Teacher Name ï ¼Å¡Dr. Andus Wong Summary of the movie The story begins with a young and successful banker Andy Dufresne whose life changes dramatically when he is convicted of the murderer of his wife and her secret lover. Therefore, Andy is sent to Shawshank Prison to be permanently sentenced despite his claims of innocence. 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