Communication and Documentation in Community Nursing

9 September 2016

This can be achieved by implementing and upholding good communication and documentation practice in every healthcare department (Miller & Cameron, 2011). This briefing paper will provide an insight into the complexities of communication and documentation in community nursing when caring for children at end of life. It will highlight the areas in need of development and it will propose two options for the improvement of communication and documentation between different healthcare professionals in the community.

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This paper will also discuss different leadership and management theories and will present recommendations of how these theories can be applied to each proposal. Proposed options: Option A:Implementing weekly meetings with all healthcare professionals involved in the child’s care. Option B:Developing a policy to implement parent-held records in the home to document the child’s care, treatment, potential problems and concerns. Background:

On a recent practice placement opportunity with a children’s home care team, one of the main problems encountered was the insufficient communication and documentation both within the home care team and between the team and other healthcare professionals involved in the care of children at end of life. It soon became apparent that not only was the lack of good communication and documentation affecting the healthcare professionals involved, it also had an immense impact on the parents of the children at end of life. On

witnessing the distress this was causing to all parties involved, it was suggested that either weekly meetings be held or parent-held records be implemented in the home. The remainder of this paper will discuss how to implement these procedures and will identify the advantages and disadvantages of both options with respect to the healthcare professionals and the families involved. It will also discuss the different leadership and management styles those in managerial positions would benefit from in order to implement each option. Proposal: Option A

Implementing weekly meetings with all healthcare professionals involved in the child’s care Aim:To improve communication and documentation between different healthcare professionals involved in the child’s care and to promote a streamlined plan of care for children at end of life Excellent communication between healthcare professionals is a vital component of effective end of life care in any setting (Lowery et al, 2012). However, it is even more important when communication and documentation crosses organisational boundaries (Gardner, 2003).

When a child at end of life is being cared for in the home, numerous healthcare professionals will be involved. These include but are not limited to; community nurses, specialist nurses and doctors, GP’s, carers and social workers (DoH, 2009). Ensuring consistently good communication and documentation between all parties involved will guarantee excellent quality of care and it will enhance the patient and carer experience (Horwarth & Morrison, 2011).

Healthcare professionals are faced with continuous change and it is important for those in managerial positions to develop various leadership and management styles in order to effectively manage complex situations (Grimm, 2010). In order for weekly meetings between all healthcare professionals involved in the child’s care to be implemented, the key worker tasked with organizing this would benefit from adopting a situational leadership approach.

Situational leadership can be described as adjusting a particular leadership style to deal with a particular situation or dilemma (Northouse, 2013). Although it is suggested that some straightforward or obscure situations are best dealt with through a task-orientated approach such as transactional leadership (Crevani et al, 2010), this particular situation would profit from a situational approach. Situational leaders are described as having the ability to recognize the presentation, commitment and competence of others and to be flexible in order to meet others needs (Lynch et al, 2011).

Each of the healthcare professionals involved in the care of the child will have very difficult and demanding work schedules and adapting the situational leadership style will allow the key worker to recognize this and therefore will aid in their decisions on how to implement the weekly meetings (Whitehead et al, 2009). Implementing weekly meetings with all healthcare professionals involved in the child’s care has many advantages.

As communication and documentation between all parties has been very dissatisfactory and caused distress to the patient’s parents, it is vital that all parties involved are familiar and up to date with the changing condition and treatment of the child and any problems or concerns that they may have. It is imperative that collaborative working in such an unpredictable and complex situation is done with efficiency and control (Brown et al, 2000). Implementing weekly meetings will provide the multi-disciplinary team with a joint understanding of the child’s current nursing, medical and social needs (Moules & Ramsay, 2008).

The weekly meetings will also allow the healthcare professionals to anticipate any changes in the child’s treatment and to develop necessary action plans to highlight each member of the team’s roles and responsibilities (Moules & Ramsay, 2008). The disadvantages of implementing weekly meetings, as mentioned previously in the paper, is the fact that the healthcare professionals involved in the child’s care will no doubt have very difficult and demanding work schedules.

They will have numerous children under their care and agreeing on a time and place for a collaborative weekly meeting between all parties involved will certainly have its limitations and may prove impossible (Gibson et al, 2012). To overcome these obstacles, the key worker may decide to implement weekly conference calls over the phone or by computerised video call. Not every organisation will have access to video calling but recent modernisation should allow each party to participate in conference calls by phone (Richter et al, 2001).

Although weekly meetings between different healthcare professionals involved in a child’s care at end of life have proved very advantageous to many trusts and organisations (Carter et al, 2007), they have also demonstrated to be difficult to organise and manage (Pontin & Lewis,2008). The ideal solution is for everyone involved to meet or speak in person but should this prove impossible, Option B – Developing a policy to implement parent-held records in the home to document the child’s care, treatment, potential problems and concerns may be the preferred alternative.

Proposal: Option B Developing a procedure to implement parent-held records in the home to document the child’s care, treatment, potential problems and concerns. Aim:To improve communication and documentation between different healthcare professionals involved in the child’s care and to promote a streamlined plan of care for children at end of life Improving communication and documentation between different healthcare professionals involved in the care of a child at end of life is a clear necessity.

When numerous parties are involved from different organisations, confusion and miscommunication can cause severe distress and undue harm to the child and their family (Anderson, 2013). The quality of care a patient receives relies heavily on appropriate and correct communication and documentation between all healthcare professionals engaged in the child’s care (Tjia et al, 2009). Avoiding miscommunications and providing clear records will allow each caregiver to provide and receive accurate and timely information about the child and the care they have received (NMC, 2009).

Implementing appropriate and effective procedures for such communication and documentation will prevent any unnecessary distress or harm to the child and their parents. When initiating the procedure to implement parent-held records in the home to document the child’s care, treatment, potential problems and concerns, those in managerial positions responsible for such input may achieve rapid success if they were a transformational leader. Transformational leaders convey a clear image of the future (Cherry, 2014).

They can identify how to provide motivation to their team and to encourage them to practice within the team’s vision (Sims et al, 2009). If members of the multidisciplinary team are allowed to participate in initiating new procedures, they will feel important and will develop a part-ownership of the potential outcome, allowing the final result to be achieved (Rolfe 2011). Transformational leaders have been depicted as following a democratic approach to leadership.

Democratic leaders consider their team will succeed if motivated and provided with opportunities to demonstrate autonomy (Bass, 2008). Some disadvantages have been noted when taking a democratic approach to leadership. It was suggested that the autocratic style of leadership is more efficient because rather than controlling their team members, the democratic leader merely guides them (Whitehead et al, 2009). However, in order for parent-held records to be implemented, every member of the multi-disciplinary team must be compliant.

To deliver quality care and implement new procedures, transformational leaders can ensure their team is committed to the new process (Malloy & Penprase, 2010). Advantages to implementing parent-held records include consistent record keeping between all healthcare professionals, carers and parents of the child. This allows for each healthcare professional to view and assess what care and treatment has been provided by other healthcare professionals previous to their current home visit.

It permits the parents of the child to input any concerns they have and to note any changes in their child’s condition. It is an ideal alternative to implementing weekly meetings between all healthcare professionals involved in the child’s care. Disadvantages to note on implementing parent-held records are compliance of healthcare professionals, inaccurate information being entered and individual hand writing skills. Every healthcare professional involved in the child’s care must be committed and consistent in keeping the parent-held records up to date.

They must ensure their written communication skills are of an excellent standard and that all notes are clear and concise. Parent-held records have shown to improve nursing care of the child being nursed in the home. They have shown improvements in nursing practice and therefore have led to continuous high quality of care for children and their families (RCN, 2011). Conclusion: Excellent communication skills and careful documentation are an important part of nursing practice, whether in the clinical or community setting (Perry & Potter, 2014).

One of the fundamental aims for nurses in all areas is to safeguard the welfare of their patients and service users (RCN, 2007). This can be achieved by implementing and upholding good communication and documentation practice in every healthcare department (Miller & Cameron, 2011). This briefing paper has provided an insight into the complexities of communication and documentation in community nursing when caring for children at end of life.

It has highlighted the areas in need of development and it has proposed two options for the improvement of communication and documentation between different healthcare professionals in the community. This paper has also examined the different leadership and management styles required by those in managerial positions need to adopt in order to implement each option discussed. It has also presented recommendations of how these leadership and management styles can be applied to each proposal.

Being able to identify the different leadership styles relevant to their nursing practice enables those in managerial positions to implement innovative policies and procedures. Recognizing the leadership and management styles discussed in this paper allows nurses to enhance their skills and therefore become capable leaders. Implementing either strategy will improve the nursing care provided to children at end of life and will enhance the healthcare professionals goals of achieving excellent communication and documentation skills between each member of the multi-disciplinary team. .

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