Discuss the contextual factors in Bill PDF

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1. Discuss the contextual factors in Bill’s background and current circumstances which affect his ability to effectively manage his diabetes

Confirmation bias is defined as when decision maker actively seeks out approval, interprets and recalls information to support their beliefs. 1. Assess and equity = born and grew up in rural setting which means he didn’t have access and equity to health services. 2. Health literacy = non English speaking background Bill has low health literacy which affect his ability to understand, find and apply information towards his diabetes. 3. Nutrition, housing ( education) = Bill was living with his family and friends in indigenous community. When bill moved to city he couldn’t afford a place to live, Bill couldn’t make and consume nutritional food required for his diabetes 4. 5. Economic factors = low socio economic status 6. PCC mental and daily support. Sees range of new health practitioners who might not necessarily offer culturally appropriate person care. Cause and affect (concise) Which circumstance affect his ability to effectively manage his diabetes

1. The reasons behind his inability to manage his diabetes were multifactorial

Bill has several contextual factors that affect his ability to manage his diabetes successfully. Bill was young adult from the rural area of Queensland. Bills was diagnosed with type I diabetes mellitus since he was 12 years old. Bill had limited access to special medical and allied health care……….. Bill left the high school at the end of year 10, functionally illiterate and innumerate because English was not his first language. As bill has low health literacy, he would not be know where to find info and understand and apply to learn how to manage his diabetes. It has been 2 years since bill left his friends and family to live in the city however, Bill has been unsuccessful at finding a job. Bill is also financially unstable which means not being able to afford nutritional food which is essential for the management of diabetes(ref). Type 1 Diabetes has no cure but it can be managed effectively. Selfmonitoring of blood sugar level by testing droplets of blood in a glucose meter but bill has no knowledge and access to effectively manage his diabetes.

Access equality Bill had limited access to special medical and allied health care when he was living in rural and remote area in Queensland. Bills was diagnosed with type 1 diabetes since he was 12 years old. When bill moved to city leaving his friends, family and community, he was seeing different doctors wherever he was staying at the time.

Bill was born and grew up in the rural and remote area of Queensland. Bills was diagnosed with type I diabetes mellitus since he was 12 years old. Bill had limited access to special medical and allied health care Education

Bill has low literacy, which makes it hard for him to understand his diagnoses and wouldn’t know where to find information regarding the management of his diabetes.

Culture Practitioner who might not offer cultural appropriate centred care

2. In the Neurology Ward of the Acute Hospital and in the Rehabilitation Centre we witnessed two distinctly different models of teamwork. Describe these models and discuss the impact these had on Bill’s care. Explain the what happens in the neurology ward access to info, how they communicated, collaborated, what indicated they collaborated together.…. Also, did demonstrate inter des. How did it affect bill because of that discharge summary written by new dr that wasn’t part of that team and didn’t communicated with others.

Inter disciplinary

Doctor and nurse were in constant communication through discussion and also had central electronic medical file for Bill. Nursing staff was able to identify Bills limited knowledge of his diabetes. Neurology ward communicated through central electronic medical file for Bill which was provided by the Emergency Department Inter disciplinary team work is a complex process in which different types of staff work function as an integrated group and collaborate to create goals and plans, coordinate, manage and monitor care. Neurology ward demonstrated inter disciplinary team work by collaborating, they went above and beyond the goal of fixing Bills head injury and discovered the underlying problem of Bill’s ability to manage his diabetes. A team of nurses, physiotherapist, social worker and a neurologist communicated through central electronic medical file provide by Emergency Department, but also had meetings to discuss Bill’s case and they came to conclusion that main problem was Bill’s inability to manage his diabetes. Nevertheless, because of the lack of resources and time in neurology ward Bill was transferred to rehabilitation centre. Inter disciplinary impacted Bill on positive way where he was treated effectively building a sense of collaboration and teamwork and crystalizing the overall picture of care that each patient needs.However, Dr I.P Freely who has not the part of the meeting was assigned to write the discharge summary. Due to the lack of communication with Neurology ward Dr Freely did not emphasise on Bill’s inability to manage his diabetes.

Multi-disciplinary discuss the impact these had on Bill’s care.

They only looked at the discharge summary Didn’t contact neurology ward for additional information Didn’t collaborate Making their own plans and goals Impact on Bill was they didn’t mention his underlying inability to manage his diabetes. Multi-disciplinary team is a group of health care workers with different profession caring for same person. They work independently, develop individual goals and have limited communications.(ref). Rehabilitation centre was provided with a discharge summary describing the initial head injury and to assist his co-ordination and walking. Rehabilitation centre consisted of multi-disciplinary teams, and displayed lack of communication with neurology ward. They only used discharge summary provided by acute hospital for Bill. They had no team meeting for Bill’s case and they had paper based medical records which would impact Bill . This impacted Bill negatively because of the lack of communication and information they didn’t have on Bill’s inability to manage his Diabetes.

Describe the nature of intuitive decision and identify system 1 decision ⁃s el f moni t or i ngofbl oods ugarl ev el sbyr egul ar l yt es t i ngdr opl et sofbl oodi na gl uc os emet er -BUTBI LLHASNO KNOWLEDGEANDACCESS??? ⁃r egul are x er c i s e-AGAI NBI LLI SUNAWAREOFTHEI MPORTANCE ⁃mai nt ai ni ngr egul arc hec k sf ordi abet esc ompl i c at i ons -BI LLI SFACI NG PROBLEMSCOMMUNI CATI NG

She made system 1 decision why? Was it floored ? was it incomplete? Was she under the influence of confirmation biased and didn’t look for additional information What was the communication available with other (multi-disciplinary team) How was their collaboration In term of personal factors she was experienced and expert in neurological rehabilitation she would be used to make quick decision in that area. There were external pressure from organisation to discharge patients Those external pressure extent how team worked.

The organisation didn’t support and resourced collaborative team work.

System 1 is thinking fast. It is our instinctive and automatic decisionmaking process and is how we make the majority of our decisions. This sys

System 1 decision making is referred to quick thinking. In other words, it is an automatic, instinctive and unconscious process of making decisions (ref). It is based on the experiences of the health care professionals and their memories, which enables them to make decisions with not much effort and with limited evidence(REF). An intuitive approach is used in System 1 decision making, and this approach is considered as a vital component in the practice of nursing (Ref). In addition, the feeling of intuition or instinct in nurse practitioners is driven by extensive knowledge and experience (Ref). For instance, in the case study, the Rehab nurse was intuitive to make a decision to discharge Bill. Bill was admitted to the rehabilitation centre due to his head injury and needed help with coordination and walking. The nurse discharged Bill, according to her intuition, as she observed Bill being ambulate and using the toilet confidently by himself. As the nurse was experienced and an expert in neurology rehabilitation, she was used to making quick and intuitive decisions in that field of expertise. Sub consciously she may have compared Bill’s case with a similar case encounter she had previously, which made her make the decision without hesitation. In addition, this illustrates her conformational bias and prevents her from considering any additional information regarding Bill. Conformational bias is referred to … (ref.). Sending Bill home may have been an internal factor, however, it was greatly influenced by external factors. There were external pressures from the organisation to discharge patients due to its lack of resources such as beds. This influenced the nurse to make a rushed decision on discharging Bill without consulting any of the others from the multidisciplinary team. Moreover, there was lack of communication and analytical thinking in the team, demonstrating that the organisation was unsupportive and did not resource collaborative teamwork. The health professionals were working independently and had their own goal and plans for Bill. Considering the views of other team members may have been insignificant to the nurse which influenced her to make an unconscious and intuitive decision. Over-all, since System 1 includes making fast and intuitive decisions, it could lower the standard of treatments for patients like Bill.

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Describe the nature and importance of discharge planning to facilitate transition to community care Describe the role of a Discharge Planner Identify the specific aspects of Bill’s circumstances requiring discharge planning, and include suggestions to address these, including: • Ongoing healthcare (identify some of the professions involved and suggest an appropriate team structure) • Housing (including transition accommodation) • Community social, personal and cultural support through appropriate services, including those focussed on ATSI people (bonus points for nominating an actual community health and welfare service available anywhere in Australia)...