scholarly journals Sometimes, not always, not never: a response to Pickard and Pearce

2017 ◽  
Vol 44 (3) ◽  
pp. 209-210 ◽  
Author(s):  
Patrick J Sullivan
Keyword(s):  
Healthcare Professionals ◽  
Clinical Perspective ◽  
Community Settings ◽  
Costs And Benefits ◽  
Ongoing Debate ◽  
Harm Minimisation ◽  
Self Injury

This paper provides a response to Hanna Pickard and Stephen Pearce’s paper ‘Balancing costs and benefits: a clinical perspective does not support a harm minimisation approach for self-injury outside of community settings.’ This paper responded to my article ‘Should healthcare professionals sometimes allow harm? The case of self-injury.’ There is much in the paper that I would agree with, but I feel it is important to respond to a number of the criticisms of my paper in order to clarify my position and to facilitate ongoing debate in relation to this important issue.

Gaining Clinical Perspective on Self-Injury

PsycCRITIQUES ◽  
2017 ◽  
Vol 62 (47) ◽  
Author(s):  
Andrew Nocita
Keyword(s):  
Clinical Perspective ◽  
Self Injury

scholarly journals Identifying and Managing Malnutrition, Frailty and Sarcopenia in the Community: A Narrative Review

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2316
Author(s):  
Shelley Roberts ◽  
Peter Collins ◽  
Megan Rattray
Keyword(s):  
Healthcare Professionals ◽  
Monitoring And Evaluation ◽  
Community Dwelling ◽  
Community Context ◽  
Care Process ◽  
Community Settings ◽  
Community Based ◽  
Comprehensive Overview ◽  
Nutrition Care ◽  
Community Dwelling Older Adults

Malnutrition, frailty and sarcopenia are becoming increasingly prevalent among community-dwelling older adults; yet are often unidentified and untreated in community settings. There is an urgent need for community-based healthcare professionals (HCPs) from all disciplines, including medicine, nursing and allied health, to be aware of, and to be able to recognise and appropriately manage these conditions. This paper provides a comprehensive overview of malnutrition, frailty and sarcopenia in the community, including their definitions, prevalence, impacts and causes/risk factors; and guidance on how these conditions may be identified and managed by HCPs in the community. A detailed description of the care process, including screening and referral, assessment and diagnosis, intervention, and monitoring and evaluation, relevant to the community context, is also provided. Further research exploring the barriers/enablers to delivering high-quality nutrition care to older community-dwelling adults who are malnourished, frail or sarcopenic is recommended, to inform the development of specific guidance for HCPs in identifying and managing these conditions in the community.

Grant writing: Moving from generating ideas to applying to grants that matter

2017 ◽  
Vol 52 (3) ◽  
pp. 236-244
Author(s):  
David Nelson ◽  
Leslie Ruffalo
Keyword(s):  
Health Disparities ◽  
Healthcare Professionals ◽  
Behavioral Science ◽  
The United States ◽  
Grant Writing ◽  
Psychosocial Issues ◽  
Health Issues ◽  
Community Settings ◽  
Innovative Strategies ◽  
Fund Research

There is an extraordinary burden placed upon the healthcare system and people as a result of health disparities that exist within the United States. If there is going to be a concerted effort to develop innovative strategies to reduce health disparities, input from the community and behavioral scientists can and should be included in this approach and narrative. Grant writing provides one vehicle to express the narrative and to provide a means to fund research and programs within clinic-based and community settings. This paper describes a four-step inquiry process to guide healthcare professionals with varying degrees of clinical and scholarship interests through the grant writing process. They include: (1) Why write grants (motivations), (2) what is the area of focus? (Interests), (3) whom should be on the project? (partnerships), and (4) what needs to happen next to move the idea forward? (actions) The complexity of psychosocial issues means that behavioral science is well suited to develop both hypotheses-driven and phenomenological research to understand bio-psycho-social health issues. Grant writing does not need to be mysterious or daunting. It can provide a means to an end, not only to fund research but also as a means to an end of health disparities.

scholarly journals Prevalence of Advance Care Planning Practices Among People with Chronic Diseases in Hospital and Community Settings: A Quasi-Experimental Design

2020 ◽  
Author(s):  
Sarah Yeun-Sim Jeong ◽  
Tomiko Barrett ◽  
Se Ok Ohr ◽  
Peter Cleasby ◽  
Ryan Davey
Keyword(s):  
Health Care ◽  
Chronic Diseases ◽  
Advance Care Planning ◽  
Healthcare Professionals ◽  
Community Setting ◽  
Care Planning ◽  
Community Settings ◽  
Future Health ◽  
Number Of Patients ◽  
Advance Care

Abstract Background: Advance Care Planning (ACP) enables healthcare professionals to embrace the important process where patients think about their values in life and goals for health care, and discuss their future health care preferences with family members for a time when they are not able to make health care decisions. Despite the promotion of ACP last two decades, and well-known benefits of ACP and a written Advance Care Directive (ACD), they are still underutilised in Australia and across the world. Previous studies have provided some insights, however, an uptake of ACP and prevalence of ACDs in community setting is rarely reported.Methods: The aim of this study was to determine the uptake of ACP and prevalence of ACDs among people with chronic diseases in hospital and community settings. A retrospective medical record audit of eligible patients looking for evidence of ACP was conducted in 16 research sites (eight intervention and eight control) in hospital and community care settings. Participants included those who were admitted to one of the research sites, and who were aged 18 years and over with at least one of nine nominated chronic diseases. The primary outcome measures included the number of patients with evidence of ACP through the following practices: completion of an ACD, appointment of an Enduring Guardian (EG), or completion of a resuscitation plan. Results: The overall prevalence of ACD was 2.8% (n=28) out of 1006 audited records, and only 10 of them were legally binding. The number of EGs legally appointed was 39 (3.9%) across the sites. A total of 151 (15.4%) resuscitation plans were found across the eight hospital sites. 95% (n=144) of the resuscitation plans advised ‘Not-for-resuscitation’. Conclusions: The uptake of ACP is very low. Current medical recording system reveals the challenges in ACP lie in the process of storage, access and execution of the ACDs. Given that having an ACD or EG in place is only useful if the treating physician knows how and where to access the information, it has implications for policy, information system, and healthcare professionals’ education. Trial registration: The study was retrospectively registered with the Australian New Zealand Clinical Trials Registry (Trial ID: ACTRN12618001627246). The URL of the trial registry record http://www.anzctr.org.au/trial/MyTrial.aspx

scholarly journals Harm minimisation after repeated self-harm: development of a trust handbook

2008 ◽  
Vol 32 (2) ◽  
pp. 60-63 ◽  
Author(s):  
Nicky Pengelly ◽  
Barry Ford ◽  
Paul Blenkiron ◽  
Steve Reilly
Keyword(s):  
The Self ◽  
Service Users ◽  
Harm Minimisation ◽  
Suicidal Intent ◽  
Self Help ◽  
Self Injury ◽  
Safe Limits ◽  
Self Harm ◽  
Voluntary Organisations ◽  
Effective Treatments

Repeated self-harm without suicidal intent occurs in approximately 2% of adults (Meltzer et al, 2002). Service users report that professionals can respond to self-harm with unhelpful attitudes and ineffective care. Although evidence for effective treatments is poor (Hawton et al, 1999), this therapeutic pessimism is not found in the self-help approaches promoted by voluntary organisations such as Mind: ‘If you feel the need to self-harm, focus on staying within safe limits' (Harrison & Sharman, 2005). User websites frequently offer advice on harm minimisation: ‘Support the person in beginning to take steps to keep herself safe and to reduce her self-injury – if she wishes to. Examples of very valuable steps might be: taking fewer risks (e.g. washing implements used to cut, avoiding drinking if she thinks she is likely to self-injure)’ (Bristol Crisis Service for Women, 1997).

scholarly journals Risk and responding to self injury: is harm minimisation a step too far?

2019 ◽  
Vol 14 (1) ◽  
pp. 1-11
Author(s):  
Patrick Joseph Sullivan
Keyword(s):  
Health Professionals ◽  
Design Methodology ◽  
Legal Obligation ◽  
Clinical Environment ◽  
Harm Minimisation ◽  
Content Type ◽  
Self Injury ◽  
Legal Literature ◽  
Legal Implications ◽  
The Law

Purpose The purpose of this paper is to consider some of the legal implications of adopting a harm minimisation approach in supporting people who self-injure within inpatient mental health units. It is argued that a focus on risk and the increasing influence of the law and legal styles of thinking often associated with the allocation of blame have produced a more risk adverse clinical environment. As a result health professionals are more likely to err on the side of caution rather than engage in practices that although potentially therapeutic are not without their risks. Design/methodology/approach The analysis draws on the clinical, philosophical and legal literature to help understand how harm minimisation may support people who self-injure. It considers some of the complex medico-legal issues that arise in a clinical environment dominated by risk. Findings A focus on risk and accountability has produced an environment where the law and legal styles of thinking have come to influence practice. This is often associated with blame in the minds of the health professional. Given the legal obligation to prevent suicide, health professionals may take a conservative approach when working with people who self-injure. This makes the adoption of harm minimisation difficult. Originality/value This paper provides a legally informed analysis of some of the challenges associated with using harm minimisation techniques with people who self-injure. It adds to the literature regarding this area of clinical practice.

scholarly journals Fostering gerontology students’ competence in Interprofessional collaborative practice

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Janita Pak Chun Chau ◽  
Suzanne Hoi Shan Lo ◽  
Vivian Wing Yan Lee ◽  
Wai Ming Yiu ◽  
Helen Chung Yan Chiang ◽  
...  
Keyword(s):  
Older Adults ◽  
Interprofessional Education ◽  
Healthcare Professionals ◽  
Collaborative Practice ◽  
Common Belief ◽  
Learning Approaches ◽  
Community Settings ◽  
Coordinated Care ◽  
Interprofessional Collaborative Practice ◽  
Health And Social Care

Abstract Background Interprofessional collaborative practice (IPCP) is increasingly recognised as being crucial for the provision of holistic care and optimising health outcomes among older adults, many with multiple complex health problems. However, little is known about the challenges of facilitating this in practice. Therefore, this study explores these issues from the perspective of different healthcare professionals and how this might inform interprofessional education curricula. Methods Sixteen different healthcare professionals working in a variety of aged care (acute, rehabilitative and community) settings were invited to participate in individual semi-structured in-depth interviews designed to: (i) explore the meaning of IPCP; (ii) explore the facilitators of and barriers to IPCP; and (iii) examine the opportunities and challenges in interprofessional gerontological education. All interviews were tape-recorded and transcribed verbatim with thematic analysis conducted by two independent researchers. Results Three major themes emerged from the interviews: the need for IPCP; role preparedness, scope and liability; and strategies for interprofessional education. Respondents shared a common belief that IPCP improves the quality of life of older adults in both hospital and community settings by improving person-centred coordinated care and decision making in care planning. However, respondents perceived major barriers to IPCP to be lack of knowledge about healthcare professionals’ scope of practice, lack of training in interprofessional collaboration, professional culture and stereotypes, and liability issues. Suggested approaches to overcome these barriers included innovative teaching and learning approaches, engaging students early on in the curriculum of health professional degree programmes, and enhancing collaborative effective communication in health and social care settings. Conclusions It is anticipated that these findings will be used to inform the development of a new interprofessional gerontological education curriculum that aims to enhance students’ competence in IPCP.

An overview of enteral feeding in the community

2021 ◽  
Vol 26 (1) ◽  
pp. 26-29
Author(s):  
Sarah Jane Palmer
Keyword(s):  
Enteral Feeding ◽  
Healthcare Professionals ◽  
Social Needs ◽  
Care Plan ◽  
Medical Attention ◽  
Community Settings ◽  
Community Based ◽  
Basic Principles ◽  
Endoscopic Gastrostomy ◽  
Peg Tube

Enteral feeding in community settings is becoming increasingly common, and this article aims to help nurses and other healthcare professionals to refresh their knowledge of the important concepts in the community-based care of patients receiving enteral nutrition via a percutaneous endoscopic gastrostomy (PEG) tube. The article provides an overview on the management and care of the patient, the basic principles surrounding the equipment used, identifying the wider team and essential communication to bear in mind, as well as the importance of tailoring a care plan to the individual's needs, taking into consideration cognition, mental health, social needs and other factors. The article also covers red flags that may be seen in the community after tube insertion that require immediate medical attention.

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