Week 7: Workplace Environment Assessment

Week 7: Workplace Environment Assessment

Week 7: Workplace Environment Assessment

Week 7: Workplace Environment Assessment

Week 7: Workplace Environment Assessment

A workplace environment and the overall culture of the workplace are important, especially in healthcare, there is a substantial correlation between these and patient care, health care providers attitudes and behaviors, and much more (Marshall and Broome, 2017). It is the duty of the leaders in health care to impact the modeling and conservation of the culture of excellence and environment of an organization (Marshall and Broome, 2017). Culture encompasses almost all aspects of life, including values, knowledge, behaviors, beliefs, and much more (Marshall and Broome, 2017). It is imperative for the atmosphere or environment to be a healthy one for staff and their patients, allowing for quality patient care (Marshall and Broome, 2017).

Clark Healthy Workplace Inventory

Clark (2015) created a questionnaire to evaluate the health of a workplace, describing the importance of healthcare providers to be able to handle stress effectively, deal with their emotions properly, and communicate with each other respectfully in providing safe quality patient care. After completing the Clark Healthy Workplace Inventory, I was not completed surprised by the results but was vindicated in how I felt my organization had played a role in hindering their staff from working in an environment and culture of excellence (Clark, 2015). The result of the Clark Healthy Workplace Inventory was less than fifty, which is identified as a very unhealthy workplace, which I believe is accurate (Clark, 2015). I have worked for this corporation for ten years and have seen a decline in staff morale, quality patient care, and healthcare providers’ well-being. Our organization used to be more involved in showing us throughout the year in differing ways, their appreciation for the work that we do, but the frequency and the quality of times when they do for us have decreased drastically.

Civility of My Workplace

The results of the workplace inventory conclude that my workplace is a very uncivil workplace. Organization leaders are charged with forming an environment in which nurses feel they are heard and emboldened to speak up, most importantly, when patient safety is a concern (Clark, 2015). Clark (2015) depicts six standards identified by the American Association of Critical-Care Nurses for creating and maintaining a healthy workplace, which includes skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition, and authentic leadership. When using these standards to evaluate the civility of my current organization, my organization suffers a significant problem with civility. My organization is known to not involve nurses and many times, not even the physicians when making policy and procedure changes. I understand that staffing is a concern in many hospitals, but in our hospital, we do not staff based on acuity, we have a staffing ratio and based on the number of patients we have, we get a certain number of nurses. Since I work in an intensive care unit, many times a patient can be such high acuity that they require a nurse just for them to provide adequate patient care; however, my organization’s leaders do not take this into account when we are staffing our unit because all the focus on is the staffing matrix. This is a huge concern to my colleagues and me because we aspire to provide safe quality care to our patients and when short-staffed, we feel we are unable to provide the care our patients deserve.

Personal Incivility Experience

“Incivility in healthcare can lead to unsafe working conditions, poor patient care, and increased medical costs” (Clark, Olender, Cardoni, & Kenski, 2011, p. 324). A nurse’s work is significantly more dangerous than other professions, and nurses are faced with work-related crimes more often than other healthcare providers (Clark, Olender, Cardoni, & Kenski, 2011). Incivility and disruptive behavior are becoming commonplace in healthcare and can be excused or worsened by the organization’s culture (Clark, Olender, Cardoni, & Kenski, 2011). I had a specific situation with an assistant nurse manager who was known throughout the hospital to be a bully, not only was she verbally aggressive, but she caused harm to patients, and it was ignored by management for years.

How Incivility Was Addressed

When I finally went to management about my concerns, I started receiving reprimands and almost lost my job, but actually left it for another position in the facility. It was then that I realized that my organizational leaders will not back you if you come to them with concerns, and may actually come after you in retribution. I am still working for the same hospital, but in a different department, but overall management, I feel just wants us to do our jobs and not create any waves. I work with a great group of nurses who support each other, and this is the only reason I have stayed where I am. Our management team only seems to be concerned about the business aspect of the organization, overlooking their employees and patient safety.

Conclusion

I believe that an organization’s leaders must foster a civil work environment, creating a culture of collaboration and well-being. Leadership influences the responses of their team members in stressful situations; therefore, it is essential for them to provide a good example (Clark, Olender, Cardoni, Kenski, 2011). Management must address the uncivil behaviors, practicing effective communication, conflict negotiation, and problem-solving (Clark, 2015). It is vital for healthcare professionals to focus on a greater purpose, which is providing safe, efficient, quality patient care, understanding and practicing how to communicate with each other respectfully (Clark, 2015).

References

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American

 

Nurse Today, 10(11), 18-23. Retrieved from /orders/www.americannursetoday.com/wp-

 

content/uploads/2015/11/ant11-CE-Civility-1023.pdf

 

 

Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing

 

education and practice: Nurse leader perspectives. Journal of Nursing Administration,

 

41(7/8), 324-330. Doi: 10.1097/NNA.0b013e31822509c4

 

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert

clinician to influential leader (2nd ed.). New York, NY: Springer.

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SCHOLARLY ACTIVITIES

SCHOLARLY ACTIVITIES

FOLLOW EVERY REQUIREMENTS..

I send my new Assignment, I also send you everything you need, you must guide yourself through the Scholarly Activity Summary to be able to perform the Assignment of 5 paragraphs, remember that it is a single activity.

Always all the projects you did were based on PROBLEMS OF HYPERTENSION,

Individual Success Plan (ISP), I send it to you ,if you need it in the last paragraph (Program Competencies Addressed) of the Scholarly Activity Summary

This section consists of a list of program competencies that were addressed in this scholarly activity. Please use the list from the ISP.

LET ME KNOW IF YOU NEED ANYTHING ELSE..THANK YOU

Details:

Throughout the RN-to-BSN program, students are required to participate in scholarly activities outside of clinical practice or professional practice. Examples of scholarly activities include attending conferences, seminars, journal club, grand rounds, morbidity and mortality meetings, interdisciplinary committees, quality improvement committees, and any other opportunities available at your site, within your community, or nationally.

You are required to post one scholarly activity while you are in the BSN program, which should be documented by the end of this course. In addition to this submission, you are required to be involved and contribute to interdisciplinary initiatives on a regular basis.

Submit, as the assignment, a summary report of the scholarly activity, including who, what, where, when and any relevant take-home points. Include the appropriate program competencies associated with the scholarly activity as well as future professional goals related to this activity.

You may use the “Scholarly Activity Summary” resource to help guide this assignment.

While APA format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

You are not required to submit this assignment to Turnitin.

Running head: TREATMENT OF HYPERTENSION 1

TREATMENT OF HYPERTENSION 8

Treatment of Hypertension

Name: Idalmis Espinosa

Institution: Grand Canyon University

Instructor: Tish Dorman

Date: 01/28/18

Hypertension

Hypertension, also known as high blood disease pressure is a serious condition that ultimately results in damaging of blood vessels leaving an individual prone to heart attack, stroke, and other conditions. Various factors increase the likelihood of developing the disease they include obesity, consumption of a lot of salt, diabetes, smoking, and alcohol intake. Globally, hypertension results in the death of millions of people, but with the right administration, the mortality rates can be reduced. Treatment of hypertension is diverse including lifestyle changes and treatment through drug therapy. Lifestyle approach in the treatment of hypertension involves intake of healthy diets, quitting smoking, physical exercise, and reducing alcohol intake. Considering the complexities that surround the treatment and management of hypertension, this paper seeks to demonstrate that it is crucial to incorporate lifestyle modifications alongside medical treatments in the management of high blood pressure.

Background of the Problem

Hypertension is a worldwide health issue that afflicts many individuals. The causative factors for the condition can be genetic or acquired through poor lifestyle habits. The disease may also present as a co-morbidity to other illnesses such as diabetes and kidney disease or hypertension may lead to the onset of these diseases. Hence, the problem prevails in a vicious cycle pattern making treatment goals difficult to achieve (Wang, Ning, Yang, Lu, Tu, Jin & … Su, 2014). In addition, the advancement of the food processing industry has immensely contributed to the development of hypertension because of the relatively higher amounts of salts and other harmful food additives in the diets. If left unmanaged, hypertension can lead to the development of co-morbidities such as heart disease, diabetes, and stroke. Blood pressure involves exertion of force on the walls of the blood vessels, with the amount of force exerted dependent on the levels of resistance from the blood vessels and the amount of work done by the heart.

Problem Statement

Estimates issued by the World Health Organization indicate that in the United States alone, over 85 million people are suffering from hypertension. In the low and middle-income countries in the world, urbanization has steadily caused an upsurge in the number diagnosed cases of hypertension due to changes in lifestyle habits. Globally, increased blood pressure has been found to cause over 7 million deaths, a figure which accounts for over 12% of the total world deaths. Overall, both men and women develop high blood pressure, although the prevalence rates are higher for men than for women. Therefore, hypertension is a public health concern that has been found to cause the development of cardiovascular disease and stroke (Khdour, Hallak, Shaeen, Jarab & Shahed 2013).

A lot of research work has been carried out with the intention of deciphering the etiology of the disease and the best treatment approaches to the problem of hypertension. Although the research efforts have centered on the medical perspectives of treatment, exploration of the role of lifestyle modification as a preventive measure for hypertension needs to be carried out (Khdour, Hallak, Shaeen, Jarab & Shahed 2013). Furthermore, lack of adequate awareness about hypertension on the part of the patient substantially influences the onset of hypertension, and the delayed seeking of treatment for the condition. Also, because of an increase in population and the sharp increase of the geriatric demographic age group, the number of people living with unmanaged hypertension in the world has been on the increase; hence this paper advocates for the use of lifestyle modifications in the management of hypertension among adult males.

Purpose of the Change Proposal

Considering the complexities that surround the treatment and management of hypertension, this paper seeks to demonstrate it is crucial to incorporate lifestyle modifications alongside medical treatments in the management of high blood pressure. This is because ideally, lifestyle changes should be considered not only as preventive measures but also as first line treatment options. These adjustments include dietary changes such as consumption of low sodium, high glycemic index foods, and daily intake of 3-5 servings of fruits and vegetables. Physicians and nurses recommend that pre-hypertensive or hypertensive patients engage in physical exercise which includes half an hour of low to moderate intensity aerobic exercise such as swimming, jogging walking or cycling (Nwankwo, Yoon, Burt, & Gu, 2013). In addition, utilizing stress reduction measures significantly assists with blood pressure control. These measures include avoidance of cigarette smoking and alcohol and consumption of unhealthy diets.

PICOT Statement

To address the problem of hypertension, the following PICOT question was developed: For male grown-ups between the ages of 40 and 70 with hypertension, and with various co-morbidities, will the adjustment in way of life (drawing in routinely in exercise and eating more beneficial and adjusted suppers), contrasted with patients who utilize prescription to treat/deal with their hypertension, help to control their pulse and diminish the danger of creating cardiovascular illnesses in their recuperation period inside a half year? The period will be sufficiently long to make a patient to be capable not to experience the ill effects of hypertension and to likewise lessen the dangers that the people will ordinarily go through.

Literature Search Strategy Employed

For the search of literature review, the Ebscohost data base search was used. Key words used in the search were hypertension, high blood pressure, and hypertension among males. A total of 25 articles related to hypertension were found and another 13 articles discussing high blood pressure and other morbidities were found. Further, no articles related to the topic of hypertension among males were found in the data base. Of the 38 articles found, those that failed to meet search criteria of hypertension and high blood pressure and lifestyle adjustments were eliminated. A total of three articles were left for the literature review.

Literature Review

As discussed earlier, the problem of hypertension has a high prevalence in the United States and the world. Wang et al. (2013) assert that high blood pressure is the single most significant risk factor in the development of cardiovascular disease. The authors further state that low awareness lack of treatment and management leads to an increase in the number of deaths and complications from hypertension. Risk factors such as high body mass index lack of physical exercise and consumption of unhealthy diets cause further problems into an already complex issue.

A National Health and Nutrition Survey reveals that early diagnosis and treatment ensures the prevention of complications of hypertension for instance damage of the arteries and blindness (Nwankwo, Yoon, Burt, & Gu, 2013). However, research by suggests that hypertensive patients may fail to develop signs or symptoms in which case treatment is sought for the eventual complications such as blindness. Lifestyle changes in combination with medication may lower high blood pressure and lead to an improved quality of life for the patient. However, lifestyle modifications alone have been found effective as a first line option treatment for hypertension. These changes include the incorporation 30 minutes of physical activity into the patient’s daily routine.

Ideally the goal of physical exercise is to assist the patient with weight loss and a reduction of the BMI (Khdour et al., 2013). Dietary adjustments entail intake of low sodium diets, intake of high fiber diets, which includes fruits and vegetables, and consumption of low-fat dairy products. Lifestyle modifications also constitute the avoidance of stress and its causative factors such as smoking and alcohol consumption. Dietary changes may involve the nurse or the nutritionist assist the patient develop a feeding plan which is known as dietary approaches to stop hypertension diet.

Applicable Change Model

For patients suffering from hypertension and other chronic diseases, the Chronic Care Model is an effective organizational strategy to caring for hypertensive patients. I this scenario, the model is applicable because it utilizes evidence based research and creates interactions between an educated patient and a proactive team of health care professionals. Moreover, the system is practical and offers support for the patient in management of hypertension (Davy, Bleasel, Liu, Tchan, Ponniah, & Brown, (2015).

Implementation Plan

Following the six components of the Chronic Care Model, the implementation plan will aim to decrease high blood pressure, manage weight, support self-management and decision making that will impact on the overall well-being of the patient. Self-management is critical because it indicates that the patient is in charge of their own health care situation. Applicable changes will be filtered through the components of the Chronic Care Model and tested against evidence-based research to ascertain that they are effective at achieving the goals of blood pressure reduction and weight reduction (Davy, Bleasel, Liu, Tchan, Ponniah, & Brown, (2015).

Potential Barriers to Implementation

Potential barriers to the implementation of the plan include patient apathy and non- adherence to the issues such as physical activity and consumption of healthy diets to achieve the treatment goals of lowering blood pressure and weight reduction (Khatib, 2012). Another key barrier from the patient is an attitude of indifference which may result in the patient viewing the plan as inconsequential and non-contributory to the management of their blood pressure.

Conclusion

As noted, hypertension is among the leading causes of heart attacks, strokes, and other complications. With the right interventions in place, the condition can be managed and treated; hypertension treatment considers two forms of treatment including the use of anti-hypertensive drugs as well as lifestyle modifications. Anti-hypertensive drugs used include diuretics, angiotensin, converting enzymes blockers, beta blockers among others each of the drugs work differently, but all ultimately result in lowering the blood pressure. Therefore, apart from medication, lifestyle changes are also crucial in management and treatment of the disease especially in reducing cardiovascular risks and lowering the blood pressure.

References

Davy, C., Bleasel, J., Liu, H., Tchan, M., Ponniah, S., & Brown, A. (2015). Effectiveness of chronic care models: Opportunities for improving healthcare practice and health outcomes: A systematic review. BMC Health Services Research, 15, 194. http://doi.org/10.1186/s12913-015-0854-8

Khatib, O. M. (2012). Clinical guideline for the management of hypertension. New York, NY: World Health Organization.

Khdour, M., Hallak, H., Shaeen, M., Jarab, A., & Shahed, Q. A. (2013). Prevalence, awareness, treatment and control of hypertension in the Palestinian population. Journal of Human Hypertension, (10), 623. doi:10.1038/jhh.2013.26

Nwankwo, T., Yoon, S. S., Burt, V., Gu, Q. (2013). Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011-2012. NCHS Data Brief (133),1-8.

Wang, J., Ning, X., Yang, L., Lu, H., Tu, J., Jin, W., & … Su, T. (2014). Trends of hypertension prevalence, awareness, treatment and control in rural areas of northern China during 1991-2011. Journal of Human Hypertension, 28(1), 25-31. doi:10.1038/jhh.2013.44

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SUPPORT COMMUNITY PARTICIPATION AND SOCIAL INCLUSION

SUPPORT COMMUNITY PARTICIPATION AND SOCIAL INCLUSION

LEARNER RESOURCE

Developed by Enhance Your Future Pty Ltd 2 CHCDIS003 – Support community participation and social inclusion Version 2

Course code and name

T A B L E O F C O N T E N T S

TABLE OF CONTENTS ………………………………………………………………………………………………………………………. 2

UNIT INTRODUCTION ……………………………………………………………………………………………………………………… 5

ABOUT THIS RESOURCE …………………………………………………………………………………………………………………….. 5 ABOUT ASSESSMENT ………………………………………………………………………………………………………………………… 6

ELEMENTS AND PERFORMANCE CRITERIA …………………………………………………………………………………………. 8

EVIDENCE REQUIREMENTS ……………………………………………………………………………………………………………. 10

KNOWLEDGE EVIDENCE ………………………………………………………………………………………………………………….. 10 PERFORMANCE EVIDENCE ………………………………………………………………………………………………………………. 10

ASSESSMENT CONDITIONS ……………………………………………………………………………………………………………. 11

PRE-REQUISITES …………………………………………………………………………………………………………………………… 11

TOPIC 1 – IDENTIFY OPPORTUNITIES FOR COMMUNITY PARTICIPATION AND SOCIAL INCLUSION ……………. 12

ASSIST IN IDENTIFYING INTERESTS, ABILITIES, PREFERENCES AND REQUIREMENTS OF THE PERSON WITH

DISABILITY TO ENGAGE WITH A SOCIAL NETWORK ……………………………………………………………………………. 12

DEFINITION OF DISABILITY …………………………………………………………………………………………………………………….. 12 TYPES OF DISABILITIES………………………………………………………………………………………………………………………….. 12 ACTIVITIES FOR PEOPLE WITH DISABILITIES ………………………………………………………………………………………………….. 13 DISABILITY SUPPORTS AND REQUIREMENTS …………………………………………………………………………………………………. 16

PROVIDE INFORMATION ON COMMUNITY PARTICIPATION OPTIONS, NETWORKS AND SERVICES TO MEET

THE NEEDS, WANTS AND PREFERENCES OF THE PERSON WITH DISABILITY …………………………………………… 17

ACCOMMODATION SUPPORT ………………………………………………………………………………………………………………….. 17 People with a disability ………………………………………………………………………………………………………………. 17

ACCESS CITY HOTLINE [ACT] …………………………………………………………………………………………………………………. 17 BETTER START FOR CHILDREN WITH DISABILITY ……………………………………………………………………………………………… 18 CARERS …………………………………………………………………………………………………………………………………………… 18 HEALTH CARE AND INFORMATION SERVICES ………………………………………………………………………………………………… 18 DISABILITY EMPLOYMENT SERVICES ………………………………………………………………………………………………………….. 18 DISABILITY PARKING SCHEME ………………………………………………………………………………………………………………….. 18 DISABILITY RIGHTS ………………………………………………………………………………………………………………………………. 19 INTERNATIONAL DAY OF PEOPLE WITH DISABILITY …………………………………………………………………………………………. 19 JOBACCESS ………………………………………………………………………………………………………………………………………. 19 LIVEWIRE ………………………………………………………………………………………………………………………………………… 19 NATIONAL AUSLAN BOOKING AND PAYMENT SERVICE (NABS) ………………………………………………………………………….. 19 NATIONAL COMPANION CARD ………………………………………………………………………………………………………………… 20 NATIONAL DISABILITY INSURANCE SCHEME (NDIS) ……………………………………………………………………………………….. 20 NATIONAL PUBLIC TOILET MAP ………………………………………………………………………………………………………………. 20 NATIONAL RELAY SERVICE …………………………………………………………………………………………………………………….. 20 NATIONAL RESPITE FOR CARERS PROGRAM ………………………………………………………………………………………………… 20 YOUNG CARERS …………………………………………………………………………………………………………………………………. 21

IDENTIFY AND ACCESS APPROPRIATE COMMUNITY PARTICIPATION RESOURCES, PROGRAMS, AGENCIES,

TRANSPORT SERVICES, AIDS AND EQUIPMENT ACCORDING TO THE PERSON’S PREFERENCES AND NEEDS … 22

SPECIALISED TRANSPORT AND TRAVEL……………………………………………………………………………………………………….. 22 Assisted School Travel Program …………………………………………………………………………………………………… 22 Transport for Disability Action Plan ……………………………………………………………………………………………… 22 Accessibility of stations ………………………………………………………………………………………………………………. 23

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TAXI SERVICES – WHEELCHAIR ACCESSIBLE TAXIS (WATS) ………………………………………………………………………………… 23 Disability Parking Scheme …………………………………………………………………………………………………………… 23

MOBILITY AIDS ………………………………………………………………………………………………………………………………….. 23 Community Aids and Equipment Program …………………………………………………………………………………….. 24 Program in Focus ……………………………………………………………………………………………………………………….. 24

COMMUNICATION AIDS ……………………………………………………………………………………………………………………….. 24 Speech Pathologist …………………………………………………………………………………………………………………….. 24 Augmentative and Alternative Communication (AAC) …………………………………………………………………….. 25 Telecommunication Services ……………………………………………………………………………………………………….. 25 Advocacy Groups ……………………………………………………………………………………………………………………….. 25

PERSONNEL ……………………………………………………………………………………………………………………………………… 25 Disability Employment Services ……………………………………………………………………………………………………. 26 Information Service ……………………………………………………………………………………………………………………. 26

RECOGNISE AND ACCOMMODATE THE CULTURAL AND RELIGIOUS NEEDS OF THE PERSON WITH DISABILITY

…………………………………………………………………………………………………………………………………………………. 27

CULTURAL BARRIERS……………………………………………………………………………………………………………………………. 28 STRATEGIES TO ADDRESS CULTURAL BARRIERS……………………………………………………………………………………………… 28

TOPIC 2 – IMPLEMENT STRATEGIES FOR COMMUNITY PARTICIPATION AND INCLUSION ACCORDING TO THE

INDIVIDUALISED PLAN ………………………………………………………………………………………………………………….. 30

ASSIST THE PERSON TO IDENTIFY AND ACCESS COMMUNITY OPTIONS THAT WILL MEET NEEDS IDENTIFIED IN

THEIR INDIVIDUALISED PLAN …………………………………………………………………………………………………………. 30

TYPES OF SERVICE ………………………………………………………………………………………………………………………………. 31

SUPPORT THE PERSON TO ACCESS OPPORTUNITIES TO ESTABLISH CONNECTIONS THROUGH SHARED

INTERESTS …………………………………………………………………………………………………………………………………… 32

ONE-TO-ONE CONNECTIONS AND RELATIONSHIPS ………………………………………………………………………………………….. 32

SEEK FEEDBACK FROM THE PERSON WITH DISABILITY, FAMILY AND/OR CARERS AND/OR RELEVANT OTHERS

AND/OR COLLEAGUES AND/OR SUPERVISOR TO ENSURE THAT THE SUPPORT CONTINUES TO MEET THE

CURRENT AND CHANGING NEEDS AND PREFERENCES OF THE PERSON ………………………………………………… 34

ENSURE STRATEGIES FOR COMMUNITY PARTICIPATION AND SOCIAL INCLUSION ARE REGULARLY REVIEWED

WITH THE PERSON AND SUPERVISOR TO ENABLE POSITIVE OUTCOMES ………………………………………………. 36

IMPLEMENTING THE INDIVIDUALISED PLAN …………………………………………………………………………………………………. 36 TRAINING AND SUPERVISION ………………………………………………………………………………………………………………….. 36

MONITOR LEVEL OF ENGAGEMENT IN CONSULTATION WITH SUPERVISOR …………………………………………… 38

REPORTING ………………………………………………………………………………………………………………………………………. 39

TOPIC 3 – IDENTIFY, ADDRESS AND MONITOR BARRIERS TO COMMUNITY PARTICIPATION AND SOCIAL

INCLUSION ………………………………………………………………………………………………………………………………….. 42

RECOGNISE PHYSICAL, SKILL AND OTHER BARRIERS TO COMMUNITY PARTICIPATION AND SOCIAL INCLUSION

…………………………………………………………………………………………………………………………………………………. 42

INDIVIDUALISED SUPPORT PLAN ………………………………………………………………………………………………………………. 42 OVERCOMING BARRIERS ………………………………………………………………………………………………………………………. 43

COLLABORATE WITH THE PERSON WITH DISABILITY TO IDENTIFY SOLUTIONS TO OVERCOME BARRIERS, IN

CONSULTATION WITH SUPERVISOR ………………………………………………………………………………………………… 44

SUPPORT THE PERSON TO IMPLEMENT STRATEGIES TO ADDRESS BARRIERS TO COMMUNITY PARTICIPATION

ACCORDING TO THEIR INDIVIDUALISED PLAN AND MONITOR THE SUCCESS OF STRATEGIES TO ADDRESS

BARRIERS IN CONSULTATION WITH THE PERSON AND SUPERVISOR ……………………………………………………. 46

RECOGNISE OWN LIMITATIONS IN ADDRESSING ISSUES AND SEEK ADVICE WHEN NECESSARY ………………… 49

Developed by Enhance Your Future Pty Ltd 4 CHCDIS003 – Support community participation and social inclusion Version 2

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DELEGATION, REFERRAL AND HANDOVER ……………………………………………………………………………………………………. 49 ETHICAL STANDARDS …………………………………………………………………………………………………………………………… 49

SUMMARY ………………………………………………………………………………………………………………………………….. 51

REFERENCES ………………………………………………………………………………………………………………………………… 52

Developed by Enhance Your Future Pty Ltd 5 CHCDIS003 – Support community participation and social inclusion Version 2

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U N I T I N T R O D U C T I O N

This resource covers the unit CHCDIS003 – Support community participation and social inclusion.

This unit describes the skills and knowledge required to assist with supporting people with disability in community participation and social inclusion using a person-centred approach. This involves enabling people to make choices to maximise their participation in various community settings, functions and activities to enhance psychosocial well- being and lifestyle in accordance with the person’s needs and preferences.

This unit applies to workers in varied disability services contexts. Work performed requires some discretion and judgement and may be carried out under regular direct or indirect supervision.

The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian / New Zealand standards and industry codes of practice.

ABOUT THIS RESOURCE

This resource brings together information to develop your knowledge about this unit. The information is designed to reflect the requirements of the unit and uses headings to makes it easier to follow.

Read through this resource to develop your knowledge in preparation for your assessment. You will be required to complete the assessment tools that are included in your program. At the back of the resource are a list of references you may find useful to review.

As a student it is important to extend your learning and to search out text books, internet sites, talk to people at work and read newspaper articles and journals which can provide additional learning material.

Your trainer may include additional information and provide activities. Slide presentations and assessments in class to support your learning.

Developed by Enhance Your Future Pty Ltd 6 CHCDIS003 – Support community participation and social inclusion Version 2

Course code and name

ABOUT ASSESSMENT

Throughout your training we are committed to your learning by providing a training and assessment framework that ensures the knowledge gained through training is translated into practical on the job improvements.

You are going to be assessed for:

 Your skills and knowledge using written and observation activities that apply

to your workplace.

 Your ability to apply your learning.

 Your ability to recognise common principles and actively use these on the job.

You will receive an overall result of Competent or Not Yet Competent for the assessment of this unit. The assessment is a competency based assessment, which has no pass or fail. You are either competent or not yet competent. Not Yet Competent means that you still are in the process of understanding and acquiring the skills and knowledge required to be marked competent. The assessment process is made up of a number of assessment methods. You are required to achieve a satisfactory result in each of these to be deemed competent overall.

All of your assessment and training is provided as a positive learning tool. Your assessor will guide your learning and provide feedback on your responses to the assessment. For valid and reliable assessment of this unit, a range of assessment methods will be used to assess practical skills and knowledge.

Your assessment may be conducted through a combination of the following methods:

 Written Activity

 Case Study

 Observation

 Questions

 Third Party Report

The assessment tool for this unit should be completed within the specified time period following the delivery of the unit. If you feel you are not yet ready for assessment, discuss this with your trainer and assessor.

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To be successful in this unit you will need to relate your learning to your workplace. You may be required to demonstrate your skills and be observed by your assessor in your workplace environment. Some units provide for a simulated work environment and your trainer and assessor will outline the requirements in these instances.

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E L E M E N T S A N D P E R F O R M A NC E C R I T E R I A

1. Identify opportunities for community participation and social inclusion

1.1 Assist in identifying interests, abilities, preferences and requirements of the person with disability to engage with a social network

1.2 Provide information on community participation options, networks and services to meet the needs, wants and preferences of the person with disability

1. 3 Identify and access appropriate community participation resources, programs, agencies, transport services, aids and equipment according to the person’s preferences and needs

1.4 Recognise and accommodate the cultural and religious needs of the person with disability

2. Implement strategies for community participation and inclusion according to the individualised plan

2.1 Assist the person to identify and access community options that will meet needs identified in their individualised plan

2.2 Support the person to access opportunities to establish connections through shared interests

2.3 Seek feedback from the person with disability, family and/or carers and/or relevant others and/or colleagues and/or supervisor to ensure that the support continues to meet the current and changing needs and preferences of the person

2.4 Ensure strategies for community participation and social inclusion are regularly reviewed with the person and supervisor to enable positive outcomes

2.5 Monitor level of engagement in consultation with supervisor

3. Identify, address and monitor barriers to community participation and social inclusion

3.1 Recognise physical, skill and other barriers to community participation and social inclusion

3.2 Collaborate with the person with disability to identify solutions to overcome barriers, in consultation with supervisor

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3.3 Support the person to implement strategies to address barriers to community participation according to their individualised plan

3.4 Monitor the success of strategies to address barriers in consultation with the person and supervisor

3.5 Recognise own limitations in addressing issues and seek advice when necessary

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E V I D E N C E R E Q U I R E M E N T S

This describes the essential requirements and their level required for this unit.

KNOWLEDGE EVIDENCE

The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role. This includes knowledge of:

 Rights and responsibilities of people with disability

 Principles of:

o strengths-based practice

o person-centred practice

o community inclusion and best practice examples

 Strategies for strengthening options, networks and services for people with

disability

 Local agencies and services, and resources to obtain community information

about sporting, cultural and specific-interest groups

 Active citizenship and what this means for people with a disability

 Role of carers and/or families and/or relevant others

PERFORMANCE EVIDENCE

The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:

 Supported at least 1 person with disability, by working with them to identify

skills and interests and find matching options within the broader community

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A S S E S S M E N T C O N D I T I O N S

Skills must have been demonstrated in the workplace or in a simulated environment that reflects workplace conditions. The following conditions must be met for this unit:

 Use of suitable facilities, equipment and resources:

o individualised plans and any relevant equipment outlined in the plan

o access to details of appropriate and local resources, programs,

agencies, transport services, aids and equipment

Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.

P R E – R E Q U I S I T E S

This unit must be assessed after the following pre-requisite unit:

There are no pre-requisites for this unit.

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T O P I C 1 – I D E N T I F Y O P P O R T U N I T I E S F O R C O M M U N I T Y P A R T I C I P A T I O N

A N D S O C I A L I N C L U S I O N

ASSIST IN IDENTIFYING INTERESTS, ABILITIES, PREFERENCES AND REQUIREMENTS OF THE PERSON WITH DISABILITY TO

ENGAGE WITH A SOCIAL NETWORK

DEFINITION OF DISABILITY

Disability can be defined in many ways, depending on the perspective, how the information will be used and where it will be used for.

In Australia, many data collections use the definition of disability specified by the World Health Organization (WHO). As per WHO, disability is like an umbrella term for any or all of the following components:

 Impairments—problems in body function or structure

 Activity limitations—difficulties in executing activities

 Participation restrictions—problems an individual may experience in

involvement in life situations.1

TYPES OF DISABILITIES

Disabilities affect people in different ways and at different levels. Two individuals may have the same disability but the effects on their lives may be entirely different. Disabilities occur at any stage of a person’s life. It is important to know the different types of disabilities in order to handle and manage the disability appropriately and sufficiently.

The types of disabilities people face range from physical to mental impairments. But the one thing that is common to all types of disabilities, which is important to acknowledge, is their ability to interfere with one’s capability to perform day to day activities.

1http://www.aihw.gov.au/disability/technical-definitions-of-disability/ (accessed 30 March 2015).

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The following are the different types of disabilities:

 Mobility and Physical Impairments

 Spinal Cord Disability

 Brain Disability (Head Injuries)

 Vision Disability

 Hearing Disability

 Cognitive or Learning Disabilities

 Psychological Disorders

 Invisible Disabilities

ACTIVITIES FOR PEOPLE WITH DISABILITIES

Activities that are conducive to the well-being of an individual should be promoted and made accessible to people with disabilities. Engaging in worthwhile activities has numerous benefits such as better health, improved disposition and broader social network. There are many activities that can help people with disabilities to socialize, express their feelings, show their talents and stay healthier. To get the best results from the activities for the disabled, it is highly recommended that the activities are based on the individual’s skills, interests, physical abilities, level of socialization and therapeutic benefits.

When people with disabilities are engaged and active, they tend to focus on their capabilities rather than their limitations. They gain more self-confidence and improve their self-esteem. The activities which people with disabilities can participate in are as follows:

 Art Therapy – Art therapy is a very good way to encourage people with

disabilities to respond. Art provides a way for individuals to express thoughts

and feelings, especially when there are constraints that limit them to write or

speak. Art also encourages individuals to develop their creativity. It can also

be used to entertain and enrich them. Painting, coloring books, scrapbooking,

jewelry making and other crafting activities are just some of the art activities

that disabled people can enjoy.

 Music Therapy – Music is another effective tool that can elicit reactions or

participation from people with disabilities. Activities can be as simple as

singing, humming or having everyone clap their hands and tap their feet

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along with the music. Playing percussion instruments is another popular

music activity that allows individuals to feel the rhythm and vibrations these

instruments create.2 According to the American Music Therapy Association,

music stimulates the senses, and, therefore, can help to improve an

individual’s mental, social and emotional well-being.3

 Physical Activity – Exercise and physical activities benefit people with

disabilities physically and mentally. To avoid leading a sedentary life, which

exposes individuals to the risk of type 2 diabetes, coronary heart disease,

obesity and high blood pressure even, it is important to incorporate physical

activities into their lifestyle. Physical activities may include swimming,

dancing, yoga, gym exercises and other aerobic activities.

o Paralympics, Special Olympics and Deaflympics – Special Olympics and

Paralympics are two separate organizations recognized by the

International Olympic Committee (IOC). They are similar in that they

both focus on sport for athletes with a disability and are run by

international non-profit organizations.4 Paralympics is an

international competition that involves six disability groups: cerebral

palsy, spinal cord injuries, amputee, intellectual disability, visual

impairment and Les Autres. Les Autres is the group that includes those

who do not fall into the other groups mentioned. Special Olympics

involve competition opportunities and training all year round, and it

deals with all levels of intellectual disabilities. Deaflympics involves

competition for deaf athletes or those with hearing impairments.

 Nature Activities – Nature activities encourage people with disabilities to be

out in an open space, breathe some fresh air and appreciate their natural

surroundings. Scavenger hunts and summer camps are examples of nature

activities that allow them to exercise their visual and tactile abilities. Outdoor

recreational activities such as swimming, boating, fishing, hiking, exploring

2 Amber Keefer, 2015. “Activities for Adults With Developmental Disabilities”.(accessed 30 March 2015), <http://www.livestrong.com>. 3 Ibid. 4 http://media.specialolympics.org/soi/files/press-kit/What’s%20the%20difference%20SO%20and%20Paralympics.pdf (accessed 30 March 2015).

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nature and joining outdoor team sports allow them to socialize and enhance

their people skills. Being outside and being part of the group enable them to

share about themselves, learn from the experiences of others, and they also

learn to be a team player.

 Job Placements – With workforce diversity being implemented by most

organisations and with the mandate of Equal Employment Opportunity Act,

people with disabilities should have access to employment opportunities.

People with disabilities need to be assisted and informed by providing them a

clear idea of the type of job they want to pursue and by helping them assess

the kind of work environment that would best fit them. People with

disabilities may also use their personal and professional networks and online

job search sites to help them with their job search.

The kind of support and assistance given to job seekers with disabilities differ in such a way that some of the steps are more detailed, deliberate and intensive. There are factors to be considered specific to their conditions such as disclosure of disability to employers.

When considering individuals with disabilities for employment, recruiters should follow the principle of “job matching”: finding a job environment and description that suit the current interests, support needs, personality, and skills of the individual with a disability.5

The emphasis on job matching does not replace the fact that further education and trainings are still needed to attain work goals. People with disabilities, like others, may need to attend trainings, seminars or workshops to improve their skills and help them perform better in their work.

These are some samples of job choices people with disabilities may want to consider:

 Government or government-subsidized jobs

 Call Center Staff

 Work-at-Home jobs

 Computer or Information Technology (IT) careers

5 http://www.communityinclusion.org/onestop/section7.pdf (accessed 30 March 2015).

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 Legal or Clerical jobs

 Business Owner/Entrepreneur

DISABILITY SUPPORTS AND REQUIREMENTS

There are various goods and services that can help a person overcome the challenges that come with having a disability. These challenges limit them from fulfilling independent living, as well as participating in daily, cultural, political, social and economic activities.

Below are examples of supports that can address the requirements of people with disability6:

 Personal help/attendant care

 Personal planning supports

 Homemaker services

 Brokerage services

 Technical aids and devices

 Respite and training for family caregivers

 Specialized features at home and in work and learning environments

 Medications, developmental/therapeutic services

 Transportation supports specific to a disability

 Accessible community infrastructure

 Human capacity at the community level to include people with disabilities.

Supports are required of different kinds and in different forms, at all stages of the lifespan: children, youth, adults and seniors.7

6 http://www.inclusionbc.org/our-priority-areas/disability-supports/what-are-disability-supports (accessed 31 March 2015). 7 Ibid.

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PROVIDE INFORMATION ON COMMUNITY PARTICIPATION OPTIONS, NETWORKS AND SERVICES TO MEET THE NEEDS,

WANTS AND PREFERENCES OF THE PERSON WITH DISABILITY

Many disability supports are specialised goods and services and are designed to assist people depending on their specific needs. They are also considered supplemental to other general community supports, including from both the public and private sectors.

Below are different government information for people with disabilities, covering a range of topics, issues and resources such as care, health, payments, support services and employment.

ACCOMMODATION SUPPORT

Accommodation support helps people with disability live in the community and in a home environment. This may also include personal care, attendant care and provision of technical aids and devices. For more information, visit National Information Communication Awareness Network (Nican) (http://nican.com.au)

PEOPLE WITH A DISABILITY

People with disabilities are entitled to services and payments, and these are extended to their families or carers. Organisations that provide people with disabilities often receive support through funding and grants. For more information, visit Department of Human Services (http://www.humanservices.gov.au).

ACCESS CITY HOTLINE [ACT]

People with disabilities who have difficulties using doors or stairways, roadways, getting into buildings, kerbed areas, footpaths or even understanding some signs and directions can contact Access City Hotline – 02 6257 3077. For more information, visit Citizens Advice Bureau [ACT] (http://www.contactcanberra.org.au).

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BETTER START FOR CHILDREN WITH DISABILITY

This initiative aims to provide children with developmental disabilities access to funding to be able to get early intervention services. This can make their situation better and give them a fair chance in life. For more information, visit Department of Social Services (/orders/www.dss.gov.au).

CARERS

Carers are very important in the lives of people with disabilities. This is due to the fact that they are the ones who offer direct care and support to them. There are payments available to carers who provide this kind of care full-time to other people. There are programs and services in place to facilitate this. For more information, visit Department of Human Services (http://www.humanservices.gov.au).

HEALTH CARE AND INFORMATION SERVICES

Different health organizations provide disability support services. These services may include consultation, treatments and information dissemination. Healthdirect is a resource center that provides links to some of Australia’s most reputable health organizations and experts. For more information, visit Healthdirect (http://www.healthdirect.gov.au).

DISABILITY EMPLOYMENT SERVICES

Specialised help is provided for people with disabilities to enable them get and keep a job. For more information, visit Department of Human Services (http://www.humanservices.gov.au).

DISABILITY PARKING SCHEME

Eligible people can enjoy the benefits of parking very close to their destinations. In order to enjoy this, individuals have to apply to have the Australian Disability Parking Permit. For more information, visit Department of Social Services (/orders/www.dss.gov.au).

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DISABILITY RIGHTS

Different resources and links to disability discrimination and the rights of people with disabilities are available and easily accessible. For more information, visit Australian Human Rights Commission (/orders/www.humanrights.gov.au).

INTERNATIONAL DAY OF PEOPLE WITH DISABILITY

Awareness programs about people with disabilities are created to educate the public and encourage support from them. An example of this kind of initiative, there is International Day of People with Disability. This day is important in helping people understand those with disabilities and encourage people to support their rights, dignity and well-being. For more information, visit National Information Communication Awareness Network (http://www.australia.gov.au/directories/australia/nican).

JOBACCESS

The Department of Employment provides practical workplace solutions to help those with disabilities and also their employers. This is done by providing free advice service and telephone information. For more information, visit Department of Employment (/orders/employment.gov.au).

LIVEWIRE

This is a community designed to help young people who are living with chronic illnesses or disabilities. It is safe and fun and accommodates the parents and siblings of the people with disabilities. They are able to share their experiences, and this forum is found online. For more information, visit Starlight Children’s Foundation (/orders/www.starlight.org.au).

NATIONAL AUSLAN BOOKING AND PAYMENT SERVICE (NABS)

NABS provides those with hearing impairments with interpreters. Those who use sign language need an interpreter to be able to communicate with other people who do not understand sign language. For example, if they have private medical appointments then they must be able to communicate with the health professionals in order to get the service they want yet the health professionals may not understand what they are saying. For more information, visit Department of Social Services (/orders/www.dss.gov.au).

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NATIONAL COMPANION CARD

People with disabilities should be able to participate in activities and events without having to pay another ticket for their companion. The Department of Social Services is in charge of making this happen by providing the national companion card. For more information, visit Department of Social Services (/orders/www.dss.gov.au).

NATIONAL DISABILITY INSURANCE SCHEME (NDIS)

NDIS offers individualised support and community linking to people with permanent or severe disabilities, and this is extended to their families and carers too. For more information, visit National Disability Insurance Agency (http://www.ndis.gov.au)

NATIONAL PUBLIC TOILET MAP

National Public Toilet Map is available to provide information on more than 16,000 public toilets in Australia. This includes their opening and closing hours, accessibility and other facilities like baby change and showers. For more information, visit Department of Social Services (/orders/www.dss.gov.au).

NATIONAL RELAY SERVICE

This is a telephone service that is available for those with hearing or speech impairment. This is also used to call someone with the said challenges. This goes a long way towards making their lives smooth. For more information, visit Telecommunications Universal Service Management Agency (http://www.tusma.gov.au).

NATIONAL RESPITE FOR CARERS PROGRAM

Carers need extra help sometimes, and this program provides that help. It helps for a carer to take a short break from caring for their loved one and rejuvenate themselves before resuming. For more information, visit Department of Social Services (/orders/www.dss.gov.au).

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YOUNG CARERS

They fall under the Department of Social Services and offer contacts, support and tips for the children and young people who care for those with disabilities from their homes. For more information, visit Department of Social Services (/orders/www.dss.gov.au).

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IDENTIFY AND ACCESS APPROPRIATE COMMUNITY PARTICIPATION RESOURCES, PROGRAMS, AGENCIES,

TRANSPORT SERVICES, AIDS AND EQUIPMENT ACCORDING TO THE PERSON’S PREFERENCES AND NEEDS

The different states and territories of Australia have programs, services, initiatives and action plans to assist people with disabilities. More detailed information can be found on their main government websites.

Below are examples of different types of supports and resources to guide individuals with disabilities, their families and carers.

SPECIALISED TRANSPORT AND TRAVEL

People with disability who are unable to travel to and from their destinations should be provided transport assistance. There are several programs that address this need, and there are some that are more specific depending on the profile of the individual, for example, students with disability or adults with mobility issues.

ASSISTED SCHOOL TRAVEL PROGRAM

The Department of Education and Communities’ Assisted School Travel Program (ASTP) is on its mission to provide free specialised transport to and from school to eligible students with a disability.

All applications for assisted school travel are assessed based on the program’s eligibility criteria and on the specific travel support needs of students.

TRANSPORT FOR DISABILITY ACTION PLAN

The Disability Action Plan contains action plans that intend to improve the facilities and features of transportation for people with disabilities. It includes, but not limited to, the following:

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ACCESSIBILITY OF STATIONS

‘Easy Access’ wheelchair accessible stations,

 Electronic indicators

 Tactile indicators

 Audio and visual information

 Hearing augmentation at ticket offices

Accessibility of trains

 Dedicated wheelchair spaces

 Priority seats for elderly and less mobile passengers

 Accessible emergency help points

 Audio and visual destination information

 Colour contrasted doors and handrails

TAXI SERVICES – WHEELCHAIR ACCESSIBLE TAXIS (WATS)

DISABILITY PARKING SCHEME

The Australian Disability Parking Scheme helps eligible individuals park nearer to their destination. There is an application process, eligibility criteria and national minimum standards for disability parking concessions.

MOBILITY AIDS

People with a disability are encouraged to fulfill the goal of independent living by providing mobility aids, tools and equipment that they can use in their own home. These aids will also allow them to participate in the community and to do their job in a regular working environment.

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COMMUNITY AIDS AND EQUIPMENT PROGRAM

This program provides a fair and accessible provision of aids, equipment and home modifications to assist people disabilities living at home in the community. This aims to improve the activities, independence and safety of the person with a disability and compensate the carers.

PROGRAM IN FOCUS

The Victorian Aids and Equipment Program (A&EP) provides people with a permanent or long-term disability with subsidised aids, equipment, home, and vehicle modifications.

Ballarat Health Services Statewide equipment program (SWEP) administers the A&EP for items such as mobility aids, including wheelchairs and scooters, hoists, beds, commodes, continence aids, domiciliary oxygen, home modifications and vehicle modifications.

Yooralla administers the Electronic Communications Devices Scheme (ECDS), which assists individuals to communicate with speech generating devices and software.8

COMMUNICATION AIDS

Communication is a primary necessity for everybody. It is through communication that people exchange ideas, express their feelings, build relationships and achieve goals.

People with disability should have access to communication whether they are the initiator or the receiver. Different forms of communication assistance are available through the following:

SPEECH PATHOLOGIST

It is also known as a speech therapist, is a professionally trained expert that gives recommendations and assessments, and works with people who have complex communication needs. QFinder and Speech Pathology Australia are online resources that can help people find a speech pathologist.

8 http://www.dhs.vic.gov.au/for-individuals/disability/aids-and-equipment (accessed 31 March 2015).

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AUGMENTATIVE AND ALTERNATIVE COMMUNICATION (AAC)

It is the term used for all communication that is not speech but is used to enhance or replace speech. For example gestures, eye pointing, body language, pointing to symbols, signing and spelling.9

Lifetec is an organisation that can provide information and advice about high-tech communication aids and equipment.

TELECOMMUNICATION SERVICES

National Relay Service (NRS) is a 24/7 service provider that offers phone and internet- based solutions for people who are deaf or have a speech or hearing impairment.

Telecommunications and Disability Consumer Representation (TEDICORE) promotes equity and accessibility in telecommunications for people with a disability.10

ADVOCACY GROUPS

Communication Rights Australia is a human rights and advocacy service for people with little or no speech.11

AGOSCI is an Australian group representing people with complex communication needs and those who live and work with them.12

PERSONNEL

Employment assistance for people with disabilities should be available in compliance with the law. People with disabilities should be considered for based on the skills and competencies they can offer. There are services and resources that can help job seekers with disabilities such as:

9 /orders/www.qld.gov.au/disability/adults/help-communicating/ (accessed 31 March 2015). 10 Ibid. 11 Ibid. 12 Ibid.

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DISABILITY EMPLOYMENT SERVICES

These are services that provide expert help for people with disabilities, an injury or a health condition to search and retain a job. Essential Personnel is an example service provider.

INFORMATION SERVICE

This type of service provides free information and advice service that can assist people with disabilities and their employers. JobAccess is an example information service provider that offers workplace solutions.

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RECOGNISE AND ACCOMMODATE THE CULTURAL AND RELIGIOUS NEEDS OF THE PERSON WITH DISABILITY

Beliefs and culture are considered important and personal. Values are formed early on in the lives of people and culture and behavior to situations can differ significantly from one society to another.

Understanding the reasons for individuality and culture is very important to cultivate a positive environment for everyone. Here are some ideas on how to recognise and accommodate diversity:

 Be respectful of cultural practices, attitudes and beliefs such as removing

shoes before entering a home

 Empathise – think of the needs of others from their point of view.

 Be polite – use the preferred title and the appropriate tone of voice, listen to

others address each other.

 Show sincere interest.

 Respect a person’s right to privacy and confidentiality.13

When addressing a person from another culture, you may need to consider:

 Different ways of speaking or titles that may be preferred

 Male and female roles clearly defined along cultural boundaries

 Different speech patterns/language

 Codes of behaviour

 Clothing

 Gender-specific tasks to complete

 Non-verbal communication and body language such as eye contact

 Use of physical space14

13 http://etraining.communitydoor.org.au/mod/page/view.php?id=178 (accessed 31 March 2015). 14 Ibid.

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CULTURAL BARRIERS

Cultural barriers may include:15

 Language and communication, including low English proficiency

 Cultural norms, understanding of and attitudes towards illness, disability and

ageing across the community that are different from service principles and

provision

 Issues relating to ageing and disability exacerbated by factors such as

ethnicity, religion, language and migration and settlement experiences

 Different perceptions of the ‘carers’ role

 Impact of pre and post migration and settlement

 Experience on a person/family

 Prejudice and feelings of inadequacy for needing help

 Reluctance to deal with government agencies due to negative experiences of

war, conflict, trauma and state-sanctioned persecution in their country of

origin.

STRATEGIES TO ADDRESS CULTURAL BARRIERS

Core values are a very good foundation for building the principles that will facilitate in forming strategies to reduce and eliminate cultural barriers. Core values may include:

 Equity

 Focus

 Integrity

 High performance

 Value creation

 Respect for people

Following these principles will result in a harmonious culturally diverse environment:16

 Integration – cultural and linguistic considerations are integrated into all

aspects of planning, policy and service delivery.

15 /orders/www.adhc.nsw.gov.au/__data/assets/file/0019/234307/848_ADHC_CALD_Framework_020412_web.pdf (accessed 31 March 2015). 16 Ibid.

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 Valuing cultural diversity – the cultural, linguistic and religious diversity is

recognised as a valuable asset to the community.

 Sharing responsibility – the commitment to cultural competency should be

sector-wide.

 Mutual learning and respect – all staff, communities and services

acknowledge that learning is a two-way process and is based on mutual

respect.

 Strengths-based – the strengths of individuals, families and carers, staff,

services and communities are recognised and built upon.

 Accountability – every individual should be accountable for the cultural

responsiveness and accessibility of the services and programs.

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T O P I C 2 – I M P L E M E N T S T R A T E G I E S F O R C O M M U N I T Y P A R T I C I P A T I O N

A N D I N C L U S I O N A CC O R D I N G T O T H E I N D I V I D U A L I S E D P L A N

ASSIST THE PERSON TO IDENTIFY AND ACCESS COMMUNITY OPTIONS THAT WILL MEET NEEDS IDENTIFIED IN THEIR

INDIVIDUALISED PLAN

Included in the client’s individual plan is the method in which a client can have access to community options to meet their needs. A support worker should help the client in identifying these options. It is part of the support worker’s responsibilities to complete or implement a community access plan. This plan should list the different choices available to clients based, considering their requirements and interests.

The following are some examples of programs and activities prepared for the clients based on their needs and preferences:

Description of need/requirement:

 Need to engage in physical fitness that requires cardiovascular activity and be

involved in a group activity with the same condition and capacity, in a facility

designed to accommodate mobility challenges

Type of service:

 Community-based exercise program – Example: A community recreation

centre has a swimming pool designed for people with mobility issues.

Swimming pools have special features like a sloped entrance into the water

that allows individuals to wheel or walk into the pool with or without help.

 Description of need/requirement: Need to attend art and craft based activities

and experiences that can accommodate a client that needs to develop both

artistic and motor skills

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TYPES OF SERVICE

Specialised service provider that offers creative programs, workshops or special education

 Example: Arts Project Australia provides education and training in visual arts

and studio workshop.

 Description of need/requirement: Need to attend horticultural therapy

Specific horticultural therapy service provider

 Example: Cultivate NSW offers Horticultural Therapy, which includes

techniques and processes to promote the physical, mental and social health of

participants.

 Description of need/requirement: Need equipment to prepare and train for a

sports event with low budget consideration

Equipment rental program

 Example: Wheelchair Sports Alberta rents and loans racing and sports chairs,

rollers, and sports equipment for a small fee.

An individual client can have more than one service, or activity provided that the services or activities selected are appropriate and suit the requirements of the client. It is essential to provide options and information to the clients so that they will be empowered to make their own choices.

Another important factor to consider is the overall condition of the client. Some clients may have more than one disability, also known as dual or multiple disabilities. The type of service or activity should be formed around their disabling conditions and not solely on the primary disability. Identify the services and activities that can specifically accommodate the complex care needs of the client.

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SUPPORT THE PERSON TO ACCESS OPPORTUNITIES TO ESTABLISH CONNECTIONS THROUGH SHARED INTERESTS

People with disabilities should be encouraged to join other groups, particularly those that have the same interests as theirs, to increase community membership and belonging. This will also allow them to foster relationships with other community members, building support systems for each other.

According to Angela Novak Amado, Ph.D., the following strategies were found useful to support relationships with community members. Some strategies will be more useful than others for any particular individual. They are all useful for brainstorming ideas.17

The strategies are classified into two different groups: one-to-one connections and relationships, and increasing community membership.18

ONE-TO-ONE CONNECTIONS AND RELATIONSHIPS

Identify who the person already knows and where the relationship can be strengthened and deepened

 People with disabilities (client) who receive services go to activities or events

in the community. Support workers or family members may have observed

the people or other community members who are already acquainted with

the client or are friendly to the client. Encourage the client to get to know

them better. Invite them to other activities or a get-together.

Identify who would appreciate this person’s gifts

 Gifts are the talents, skills and abilities that the person with a disability does

very well. Search for a venue or create an opportunity where the person can

show these skills and talents.

17 http://rtc.umn.edu/docs/Friends_Connecting_people_with_disabilities_and_community_members.pdf (accessed 1 April 2015). 18 Ibid.

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Identify where you can find an interested person

 Soliciting ideas from other support workers or family members is one way to

get leads on where you can find other people who may share the same

interests with the client.

Identify associations and clubs

 There are two categories of clubs and associations: formal and informal.

Identify the interests of the person with a disability and look for groups that

match the personality and interests of the client. The client will have the

chance to socialize, participate, contribute and be contributed to.

Identify community places where people engage in one of this person’s interests

 Identify all the places or look for events where a particular interest is

celebrated or promoted. Search for persons you can reach who can help you

connect with other like-minded individuals. This can pave the way for

possible job ideas.

Identify community places that are hospitable and welcoming

 There are local places, businesses, neighborhood groups and clubs that are

extra helpful to people with disabilities. They make sure that they make these

people comfortable. They show their support by letting these people be, but

they are very ready to provide assistance when needed. Encourage people

with disability to frequent this kind of places. They may build relationships

with the people there eventually.

Identify places where the person can fit in just the way they are

 There are individuals with disabilities who have what we call “challenging

behavior.” In this case, it is recommended not to “fix” or change the person.

Search for places that can accept them the way they are or places that do not

have issues with this type of condition and situation.

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SEEK FEEDBACK FROM THE PERSON WITH DISABILITY, FAMILY AND/OR CARERS AND/OR RELEVANT OTHERS AND/OR

COLLEAGUES AND/OR SUPERVISOR TO ENSURE THAT THE SUPPORT CONTINUES TO MEET THE CURRENT AND CHANGING

NEEDS AND PREFERENCES OF THE PERSON

It will be necessary to collect feedback from clients’, other carers and families on a regular basis as a standard organisational procedure on the adequacy of the service delivery that they have received. This information will then need to be used to revise and improve service delivery arrangements so that the needs of the client are continually met.

A range of different methods should be used to collect feedback on the adequacy of services provided; these methods must be systematic and be in line with organisational policy and procedure.

Feedback from clients and others can be collected using a series of different methods including:

 Discussions

 Focus Groups

 Surveys

 Direct Questioning

 Review documentation

 Feedback reports

There are two main types of feedback data that can be collected, and these are:

 Quantitative feedback: Collects data in the form of numbers. This means that aspects can be measured and expressed in numbers as percentages or ratios. Quantitative Research tells us ‘how many’, ‘how much’, ‘to what extent’ or ‘what size’ something is.

 Qualitative feedback: Collects exploratory data, it asks a variety of carefully planned questions that seek the underlying reasons, opinions and motivation behind different actions and situations.

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All the information will need to be compiled into workable sections and measured against the client’s goals and objectives in relation to client service. This information is critical in the design and creation of appropriate policies and actions plans that suit the clients and meets the purpose that they were designed for.

Successful analysis on the feedback that you have gathered will inform on different aspects of the client service delivery platforms and can assist in determining what about the services are offered and if they suit the client’s needs as intended.

It is also important that your target audience understands the purpose of the consultation and feedback process to ensure that information collected during the review is in a manageable and useful format.

It is essential that the results from the feedback collection are used to make positive change and ensure that the community services organisations are continuously improving the services that are supplied to clients in line with the feedback collected.

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ENSURE STRATEGIES FOR COMMUNITY PARTICIPATION AND SOCIAL INCLUSION ARE REGULARLY REVIEWED WITH THE

PERSON AND SUPERVISOR TO ENABLE POSITIVE OUTCOMES

IMPLEMENTING THE INDIVIDUALISED PLAN

Developing the individualised plan involves a number of people. The most important member of the team is the client or the person being served. The client should be present at all times whenever there are meetings. Its primary objective is to assist the client in planning how to reach life goals.

When implementing the ISP it is important to observe and practice the following:

 Consistency

 Persistence – Individuals may need several attempts to attain their goals.

Create or look for opportunities to practice and reinforce learning in regular

settings and different environments.

 Clear understanding of the plan and the role as a support worker

 Implement the plan in a positive supporting manner. Recognise the client for

a job well done. Offer feedback when needed and discuss it in a constructive

approach.

 Document all required behaviors, successes and concerns related to the plan.

The plan may need revisions depending on the changes of needs, goals and

desires of the client. Documentation will help identify those areas that need

modifications.

 Make sure to communicate any adjustments in the plan to the supervisor so

that it may be reviewed thoroughly. Consult the supervisor when there is a

challenge or difficulty in the implementation the plan or if the goal is

becoming less viable.

TRAINING AND SUPERVISION

The ability of support workers plays a key role in the success of involving clients in the individual planning process. Support workers should have a greater understanding of their roles and responsibilities to encourage the active participation of the client. Support workers need to be trained, coached and supervised.

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When the planning is person-centred, the recommended forms of training and learning for the support workers could be:

 Practical tasks

 Ongoing training sessions rather than a one-time classroom type of training

 Access to support

 Peer feedback sessions

Quality training and feedback are likely to result in adequate support and service to clients and participation in the individual planning process.

Supervisors of support workers should make sure that the skills acquired during training are applied effectively in the work environment. Support workers need to be motivated and supported enabling them to be aligned with the team’s culture and processes.

The training, opportunities and incentives for staff will be helpful in increasing the participation and cooperation of clients in individual planning.

It is recommended that support workers are adequately supervised to successfully develop, implement and revise high-quality individual plans; and indicate the different scenarios and methods of how people with disabilities and high support needs are included in preference assessment, individual planning and fulfillment.

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MONITOR LEVEL OF ENGAGEMENT IN CONSULTATION WITH SUPERVISOR

When the client has an established individualised plan, centred on meeting their needs, it is important that the plan be continually reviewed in order to determine its effectiveness. The worker needs to monitor the activities of the client to check that they are actually using the services implemented in the original plan.

The needs of the client may change over time. This may be due to the ageing process or it might be that they have simply changed their goals in life. Whatever the reason, it is important for the worker to ensure that the individualised plan is closely aligned with the objectives of the client.

A well-structured individualised plan should incorporate:

 The expected standards of the service

 Staff requirements

 Roles and responsibilities of all parties

 The criteria by which the plan will be monitored

 The reporting process to be followed

 The processes that will be used to obtain feedback

The disability sector, aged care, medical/ clinical services, care, youth work and drug and alcohol services are all have similar standards in terms of organisational requirements, because they are based on standards for community services. Standards are the expectations the organisation holds with regard to the quality of service that will be provided.

While there will be some variation in the standards of each organisation, they are all monitored through government audits and must be compliant with legislative and regulatory requirements. All clients have a right to proper and consistent care and must be treated with respect in all aspects of care.

To ensure that the individualised plan is continually relevant to the needs of the client, organisations need to ensure that:

 The staff they employ are appropriately trained in recognising the ongoing

needs of the client

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 The necessary resources and support mechanisms are available to both the

client and their carers

 Work is continually monitored and measured

 Improvements are made as required

Standards are established to ensure quality and consistency within organisational operations. Likewise, they are put in place to make sure that the performance of the organisations employees is of the required standards. Standards provide operational guidelines for the employees as well as the tools to be used in the measurement of their performance. Monitoring all aspects of care is required to ensure that the relevant standards are being met.

Specialist and external client services need to be monitored according to the agreed procedures, against defined performance indicators. In situations where the service delivery does not meet the required standards, interventions need to be implemented for the necessary improvement to be made.

REPORTING

Part of the role of the community services worker as we have discussed is to assess and monitor the relevance of the individualised plan. When aspects of the plan are identified as not being relevant to the needs of the client, or require review due to their changing needs, it is appropriate for the worker to report this to their supervisor.

The role of the care worker in each individualised plan should be negotiated and agreed between the supervisor and the care workers. So too should reporting procedures and accountability.

For each client, case supervision methods can be implemented to identify any issues that might affect the relevance of the individualised plan. The monitoring of the individualised plan.

The needs and care of the client will often be overseen by a key worker or coordinator. The coordinator generally has a supervisory role and works in close alliance with the other workers of the organisation. Liaising with carers, other organisations, families and other professionals, the coordinator supervises the delivery of services to the client according to their individualised plan.

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Coordinators access clinical expertise from service providers, coordinate responsibility for the clinical implementation of a plan, and provide leadership to other staff to better manage people with complex needs. Key coordinators are the people who supervise the case/ care plan and to whom care workers must report. Thus, it is imperative that the coordinator establishes an effective working relationship with the staff with whom they are supervising.

The coordinator or supervisor can provide valuable input relevant to the areas of the individualised plan that may require review. The coordinator is generally a person who is skilled in the delivery of services and recognising the needs of the client. When a worker recognises the need for review f the individualised plan, they should report it to their supervisor, so that a collaborative decision can be made about the possible changes that may be required. This process should take place with the input of other persons involved in the delivery of services to the client, and of course in consultation with the client themselves.

Case meetings might be held to address specific issues relating to the delivery of services, solve problems and provide the client to provide their input regarding the delivery of services.

Case conferences or meetings might be held to address issues, solve problems, eliminate duplication of problems and allow the client opportunities for input into service delivery plan development.

Organisational policies and procedures should ensure that the necessary time and resources are provided to facilitate for regular case consultation meetings. These meetings enable strategies to be implemented and feedback on progress to be provided.

You may find it beneficial to hold a formal meeting with supervisors and experienced personnel to discuss ideas, develop individualised plans, evaluate the outcomes of an individualised plan or to make the appropriate changes.

When monitoring of the individualised plan, you will need to report to your supervisor or coordinator to ensure that the actions you perform as a care worker meet duty of care requirements and fit within the agreed boundaries of the plan.

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Making regular reports to your supervisor, you will be able to negotiate and discuss; problem-solving, the rights of the clients, issues relating to family members or representatives, accountability and conflict resolution strategies.

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T O P I C 3 – I D E N T I F Y , A D D R E S S A N D M O N I T O R B A R R I E R S T O C O M M U N I T Y

P A R T I C I P A T I O N A N D S O C I A L I N C L U S I O N

RECOGNISE PHYSICAL, SKILL AND OTHER BARRIERS TO COMMUNITY PARTICIPATION AND SOCIAL INCLUSION

INDIVIDUALISED SUPPORT PLAN

This plan includes the following goals:

 Assess the specific needs and abilities of the person with a disability (client).

 Identify a strategic approach to addressing the needs and facilitate

community participation and inclusion.

These plans are developed through the collaboration of experts, the person with the disability and caregivers. Progress should be checked by setting review dates and applying modifications if needed.

People with disabilities often times encounter factors that prevent them from fulfilling their needs, goals and interests. These barriers can be environmental and physical in nature such as:

 Architectural barriers – accessibility problems

 Attitudinal barriers – stigma and negative attitudes

 Transportation barriers – transport difficulties

 Economical barriers – limited financial support

 Barriers of omission – social exclusion, discrimination

A person with a disability is also often times confined by their own physical, emotional and cognitive limitations. These limitations or barriers that are within and from the individual can be temporal or permanent. Some intrinsic barriers are the following:

 Skill/Challenge gaps – life skills, social skills and employability skills

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 Behaviour and attitude – disposition of the individual with disability;

tendency to be uncooperative or withdrawn

 Health Problems – isolation due to illness

OVERCOMING BARRIERS

The principles and best practice of inclusion are reliable basis for identifying and overcoming barriers to participation. The approach may include the following:

 Applying a person-centered process – It is because the overall welfare and

personal preferences of the individual are the key considerations.

 Building partnership with the community and encouraging cooperation

 Involving the family of the person with disability

 Providing open options and opportunities specifically for the individual based

on the person’s goals, strengths, abilities and interests

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COLLABORATE WITH THE PERSON WITH DISABILITY TO IDENTIFY SOLUTIONS TO OVERCOME BARRIERS, IN

CONSULTATION WITH SUPERVISOR

The physical features of different building, establishments and premises can create barriers that can put the additional challenge to people with disabilities. This would create a significant disadvantage to people with disabilities and give them more difficulties in accessing goods or services.

A physical feature is characterized by the following:

 Driven by the architecture, design or construction of the building

 Forms part of the approach, entrance or exit to the premises

 Can be fittings, fixtures, furniture, equipment, machinery or materials

Examples of physical features include:

 Steps, stairways, kerbs

 Floors and paving

 Doors and gates

 Toilets and washing facilities

 Lighting and ventilation

Under the Disability Discrimination Act, reasonable adjustments should be made to overcome these barriers. Adjustments can be done by:

 Removing the physical feature altogether

 Modifying it in such a way that it will no longer be considered a barrier

 Providing reasonable means of allowing disabled people to avoid a feature

and/or use another

Below are examples of physical barriers and solutions:19

Parking spaces are too narrow

19 http://www.nchpad.org/833/4243/Using~a~Fitness~Center~Does~Not~Have~to~be~an~Exercise~in~Frustration~~~~Tips~for~ People~with~Mobility~and~Visual~Disabilities (accessed 2 April 2015).

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 Simple/Low-Cost Solution: Use cones and/or tape and temporary signs to mark additional parking spaces

 Involved/High-Cost Solution: Restripe parking area to include required widths for accessible parking spaces

No curb cuts

 Simple/Low-Cost Solution: Install a temporary ramp between the parking

area and the sidewalk or an accessible entrance

 Involved/High-Cost Solution: Install permanent curb cuts

Ramp is too steep

 Simple/Low-Cost Solution: Install a temporary ramp between the parking

area and the sidewalk or an accessible entrance

 Involved/High-Cost Solution: Lengthen the ramp or rebuild it to include

switchbacks

High countertop for check-in area or desk makes it difficult to see staff and sign in

 Simple/Low-Cost Solution: Place sign-in or check-in materials on a side table

or use a clipboard

 Involved/High-Cost Solution: Install a lower countertop or lower a section of

the existing counter

Facility has two floors but no elevator

 Simple/Low-Cost Solution: Ask staff to move equipment that you use to the

ground level

 Involved/High-Cost Solution: Install an elevator

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SUPPORT THE PERSON TO IMPLEMENT STRATEGIES TO ADDRESS BARRIERS TO COMMUNITY PARTICIPATION

ACCORDING TO THEIR INDIVIDUALISED PLAN AND MONITOR THE SUCCESS OF STRATEGIES TO ADDRESS BARRIERS IN

CONSULTATION WITH THE PERSON AND SUPERVISOR

The lack of availability of transport services is one of the pressing challenges for people with disabilities. Limited access to transportation means limited access to important services and facilities such as education, health care or employment. Transport is an important support service which enables them to enjoy many if not all aspects of the community.

Solutions proposed to curb this problem put emphasis on increasing the accessibility and affordability of transport services and providing alternatives such as:

 Expanding the taxi sector

 Bonus system for taxi drivers who do their job well

 Nationwide travel card concession

 Training of transport operators

Most of the problems that people with disabilities have with regard to transport are magnified for those in the rural and regional areas. Transport is very important in these areas to help reduce the issue of social isolation.

One way to drive transport and mobility management is to create better publicity and promotion about public transportation. Enabling individuals, particularly people with disabilities, by involving them in solving the problems of transportation is one way to manage transport and mobility barriers.

Adequate preparation before actually traveling such as accessing information and schedules in advance is one way to reduce the difficulty of acquiring transportation service.

Some public transport help for people with disabilities is following:

 Assistance dogs  Wheelchair access

 Wheelchair accessible taxis (WATs)

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 Passes for people with physical or cognitive disabilities

 Passes for people who are blind or vision impaired

There are some disabled individuals who have less complex needs and are able to manage transportation needs in a more practical setting. Below are some solutions they can consider:20

 Consider trying the buddy system

 Develop several supporters for the buddy system

 Get information, county and city maps, etc. at the customer service center of

your public transportation agency

 Do a “dry run” before very important first time appointments ( e.g. doctor

appointments or job interviews )

 Ask a peer specialist, case manager, recovery coach, residential counselor, etc.

for help with public transportation trips, as well as trip planning, obtaining

and interpreting schedules, getting maps, etc.

 Plan your trip

 Ride specific routes

 Read and understand route maps and schedules

 Practice getting to and from your bus stop, train station, and subway station

 Practice recognising bus stops, bus numbers, and landmarks

 Consider purchasing transportation passes

 Look for discounted fares and passes for people on disability

 Know how and where to transfer to other buses, trains, and subways. Know

who to ask for help

 Learn to travel independently and confidently by bus, train or subway

The issue of transport and travel should be included in individualised community support plans. This process should include:21

 Identifying goals and strategies with individuals to overcome any travel and

transport issues

20 http://tucollaborative.org/pdfs/Transportation_Monograph.pdf (accessed 2 April 2015). 21 Geoff Arnott, 2011, The Disability Support Worker, Pearson Australia, p.182.

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 Assessing risk factors for health and safety, and putting controls in place

 Reviewing goals and strategies, and making any required adjustments

 Establishing processes to evaluate the ongoing success of goals and strategies

At all times you should ensure that you monitor the strategies you have put in place so that you can identify if the barriers have been overcome.

Without constant monitoring people may begin to not attend activities or they may be very reluctant to attend because their needs have still not been met.

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RECOGNISE OWN LIMITATIONS IN ADDRESSING ISSUES AND SEEK ADVICE WHEN NECESSARY

Support workers may need to evaluate their own skills and limitations to be able to handle issues properly and seek advice and assistance when needed. It is important that support workers are familiar with the policies, protocols and procedures of the organisation. They may refer to these when providing advice when there are requirements for communication support or changes in physical barriers.

DELEGATION, REFERRAL AND HANDOVER

Delegation involves requesting another support worker, usually with the supervisor or management’s approval, to provide care while still overseeing the responsibility for the client’s care.

Referral involves transferring, in part or full, of responsibility for the client’s care. This may be necessary when the support required is outside the expertise or competency of the support worker.

Handover is the process of transferring all responsibilities to another support worker or service provider.

Maintain awareness of own professional limitations and knowledge gaps. When limitations are present and before taking any reasonable steps, it is recommended to consult other team members or the supervisor.

ETHICAL STANDARDS

Ethics is the beliefs that constitute the right conduct in a particular situation or job. A sound ethical framework is necessary for providing high-quality care and to protect the rights of individuals with a disability, especially those who may have complex needs and are more vulnerable.

One element of ethical standards, in the setting of providing care and service to people with disabilities, is being straightforward and honest with the level of competency a support worker possesses. If there are uncertainties in their work, they should know where to go to seek for support or advice.

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Ethical guidelines are important in providing a safe and clear working environment for workers. Transparency is key and setting of expectations should be conducted to lead them to perform well and accordingly.

Individuals providing services should also have adequate training, skills, knowledge to be able to serve effectively in their community.

In order for support workers to recognise their own limitations, they should understand the role, goals and objectives right from the beginning.22

 Ask for help when needed — support work can be isolating with high levels of

independence and responsibility.

 Discuss the support worker’s role with the client or family right at the

beginning, and be sure to set limits on inappropriate or unreasonable

requests.

 Review own performance from time to time.

 Discuss any concerns or worries about work with peers or supervisors.

22 http://www.networknorth.org.nz/file/Policy-Library/boundaries-guidelinesqueenslandhealth.pdf (accessed 2 April 2015).

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S U M M A R Y

Now that you have completed this unit, you should have the ability to support community participation and social inclusion.

If you have any questions about this resource, please ask your trainer. They will be only too happy to assist you when required.

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R E F E R E N C E S

Amber Keefer, 2015. “Activities for Adults With Developmental Disabilities”.(accessed 30 March 2015), <http://www.livestrong.com>.

Geoff Arnott, 2011, The Disability Support Worker, Pearson Australia, p.166.

http://etraining.communitydoor.org.au/mod/page/view.php?id=178 (accessed 31 March 2015).

http://etraining.communitydoor.org.au/mod/page/view.php?id=92 (accessed 2 April 2015).

http://media.specialolympics.org/soi/files/press- kit/What’s%20the%20difference%20SO%20and%20Paralympics.pdf (accessed 30 March 2015).

http://nibusinessinfo.co.uk/content/overcome-physical-barriers-access (accessed 2 April 2015).

http://rtc.umn.edu/docs/Friends_Connecting_people_with_disabilities_and_community _members.pdf (accessed 1 April 2015).

http://tucollaborative.org/pdfs/Transportation_Monograph.pdf (accessed 2 April 2015).

http://www.aihw.gov.au/disability/technical-definitions-of-disability/ (accessed 30 March 2015).

http://www.australia.gov.au/people/people-with-disabilities (accessed 30 March 2015).

http://www.communityinclusion.org/onestop/section7.pdf (accessed 30 March 2015).

http://www.dhhs.tas.gov.au/__data/assets/pdf_file/0011/76286/FINAL_PRINTED_VER SION_IN_FC_LOGO_DHHS_DisabilityFrameworkFeb09.pdf (accessed 30 March 2015).

http://www.dhs.vic.gov.au/__data/assets/pdf_file/0004/603463/pbs_facilitators_manu al.pdf (accessed 1 April 2015).

http://www.dhs.vic.gov.au/for-individuals/disability/aids-and-equipment (accessed 31 March 2015).

http://www.health.nt.gov.au/library/scripts/objectifymedia.aspx?file=pdf/39/02.pdf (accessed 2 April 2015).

http://www.inclusionbc.org/our-priority-areas/disability-supports/what-are- disability-supports (accessed 31 March 2015).

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http://www.nchpad.org/833/4243/Using~a~Fitness~Center~Does~Not~Have~to~b e~an~Exercise~in~Frustration~~~~Tips~for~People~with~Mobility~and~Visual~ Disabilities (accessed 2 April 2015).

http://www.networknorth.org.nz/file/Policy-Library/boundaries- guidelinesqueenslandhealth.pdf (accessed 2 April 2015).

http://www.recreationtherapy.com/articles/promoting-inclusion.htm (accessed 1 April 2015).

http://www.schools.nsw.edu.au/studentsupport/programs/astp/ (accessed 30 March 2015).

http://www.state.sc.us/dmh/client_affairs/volunteer_guide.pdf (accessed 31 March 2015).

/orders/www.adhc.nsw.gov.au/__data/assets/file/0007/228184/31_Clientparticipation intheIndividualPlanningProcess.pdf (accessed 1 April 2015).

/orders/www.adhc.nsw.gov.au/__data/assets/file/0019/234307/848_ADHC_CALD_Fra mework_020412_web.pdf (accessed 31 March 2015).

/orders/www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/Division% 20of%20DD/DirectSupportPerson/Module5NotebookIndividualServicePlan.pdf (accessed 1 April 2015).

/orders/www.dss.gov.au/our-responsibilities/disability-and-carers/program- services/for-people-with-disability/australian-disability-parking-scheme-0 (accessed 30 March 2015).

/orders/www.qld.gov.au/disability/adults/financial-support/ (accessed 30 March 2015).

/orders/www.qld.gov.au/disability/adults/help-communicating/ (accessed 31 March 2015).

/orders/www.qld.gov.au/disability/adults/self-direction-your-life-your-choice/ (accessed 30 March 2015).

/orders/www.qld.gov.au/disability/adults/self-direction-your-life-your-choice/ (accessed 31 March 2015).

Patsy Davies and Claudia Bolton, 1996. http://www.allenshea.com/CIRCL/connections.pdf (accessed 1 April 2015).

http://www.allenshea.com/CIRCL/connections.

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HIS-144 Week 3 The Evolution Of Democracy In The Early Republic

HIS-144 Week 3 The Evolution Of Democracy In The Early Republic

Evolution Of Democracy In The Early Republic

Evolution Of Democracy In The Early Republic

Create a 500-750-word essay depicting the evolution of democracy from the time of President Jefferson to President Jackson. Be sure to include the following:

1.      How was the form of the American Republic different under Jackson than it was under Jefferson?

2.      What caused these changes?

3.      Why were these changes significant to the future development of the American Republic?

Use a minimum of three of the sources provided to support your assignment and be sure to cite the sources.HIS-144 Week 3 The Evolution of Democracy in the Early Republic

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Professional Capstone And Practicum Reflective

Professional Capstone And Practicum Reflective Journal And Scholarly Activities

Professional Capstone And Practicum Reflective Journal And Scholarly Activities

Throughout the course, students will engage in weekly reflection and scholarly activities. These assignments are presented in Topic 1 to allow students to plan ahead, and incorporate the deliverables into the Individual Success Plan if they so choose.

The weekly reflective journals and scholarly activities will not be submitted in LoudCloud each week; a final, culminating submission will be due in Topic 10. No submission is required until Topic 10.

Professional Capstone and Practicum Reflective Journal

Students are required to maintain weekly reflective narratives throughout the course to combine into a final, course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course. This course-long journal assignment will be due in Topic 10.

In each week’s entry, you should reflect on the personal knowledge and skills gained throughout the Professional Capstone and Practicum course. Your entry should address a variable combination of the following, dependent on the specific practice immersion clinical experiences you encountered that week:

  1. New practice approaches
  2. Intraprofessional collaboration
  3. Health care delivery and clinical systems
  4. Ethical considerations in health care
  5. Population health concerns
  6. The role of technology in improving health care outcomes
  7. Health policy
  8. Leadership and economic models
  9. Health disparities

In the Topic 10 submission, each of the areas should be addressed in one or more of the weekly entries.

This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how they met competencies and course objectives.

Scholarly Activities

Throughout the RN-to-BSN program, students are required to participate in scholarly activities outside of clinical practice or professional practice. Examples of scholarly activities include attending conferences, seminars, journal club, grand rounds, morbidity and mortality meetings, interdisciplinary committees, quality improvement committees, and any other opportunities available at your site, within your community, or nationally.

You are required to post one scholarly activity while you are in the BSN program, which should be documented by the end of this course. In addition to this submission, you are required to be involved and contribute to interdisciplinary initiatives on a regular basis.

In Topic 10, you will submit a summary report of your scholarly activity. You may use the “Scholarly Activity Summary” resource to help guide this assignment.

NRS-490-RS-ScholarlyActivitySummary.docx

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ADDITIONAL INSTRUCTIONS FOR THE CLASS

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  • Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

  • Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

  • APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

  • Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

  • LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

  • Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

  • Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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Family Support Assessment

Family Support Assessment

Family Support Assessment

Family Support Assessment

Case management is useful in a variety of settings.  You will be using the nursing process to conduct an in-home assessment in Sentinel City® to develop a plan of care for a family.  The process of collecting, analyzing, and synthesizing data from a variety of sources can help the nurse to gain an understanding of family strengths, values, and needs related to physical and social determinants of health to promote the health and well-being of the family unit.

Complete the Family Support & Home Assessment virtual simulation activity which can be found by clicking Enter Virtual Simulation.

Once you enter Sentinel Hospital

  1. Click BEGIN
  2. You’ll enter the lobby and be led to the hospital map
  3. Clicking SKIP will take you directly to map
  4. Select Location: Family Services Or SIMPath Competencies: Collaboration for Improving Outcomes

Once you are in the room, the Family Support Assessment Form will be available.  Complete the Family Support Assessment Form by asking the client predetermined questions.  When the form is completed, click Submit.  Develop a Family Support Care Plan to address the needs of this family using your institutions’ care plan template or use this care plan template.

  1. Include a properly formatted community health nursing diagnosis that addresses either preschool age children, single mothers, or pregnant women.
  2. Increased risk of (disability, disease, etc.) among (community or population) related to (disability, disease, etc.) as demonstrated in or by (health status indicator, or etiological/causal statement).
    • Example: Increased risk of obesity among school-age children related to lack of safe outdoor play areas for children as demonstrated by elevated BMI rates.

Reading and Resources

Chapter 16 pages 297-316, Chapter 23 pages 395-404, Chapter 20 pages 367-375, Chapter 26 pages 439-447 in Fundamentals of Case Management Practice.

Review clinical guidelines of the AHRQ

Clinical Guidelines and Recommendations

Evidence-based research provides the basis for sound clinical practice guidelines and recommendations. The datab…

 Additional Instructions:

  • All submissions should have a title page and reference page.
  • Utilize a minimum of two scholarly resources.
  • Adhere to grammar, spelling and punctuation criteria.
  • Adhere to APA compliance guidelines.
  • Adhere to the chosen Submission Option for Delivery of Activity guidelines.

Submission Options:

Choose One:

Instructions:

Paper

  • 4 to 6-page paper. Include title and reference pages.

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Incompetent Nurses (Ethic Paper)

Incompetent Nurses (Ethic Paper)

Topic: Incompetent nurses paper for ethic

Direction:

Introduction: Summary of what is known about the ethical issue Well summarized

Ethical Dimensions of the Issue Identified and Discussed (why is this an ethical issue)

Relevance of the Ethical Issue to Health Professions/Nursing Relevance of the Ethical Issue to Nursing

Relevant Ethical Analysis (Principles, Ethical Theories, Laws, and Standards of Practice) Complete Analysis of Principles, Ethical Theories, Laws, and SOP

Personal Professional Response to the Issue Thorough discussion

Conclusion: Reflection of What you Learned Reflection clearly articulated

Correct APA Style (7th)

Correct Length 7 pages of text, PLUS title page and references

The paper will be 7 pages in length—and not exceeding 7 pages of text.

Title page/references are NOT included in this count. Two points will be deducted for each page over the maximum number.

A pdf. version of the paper may NOT be submitted—only a Word document

Minimum of 3 professional nursing references, 5 years old or less (2016 to 2021)

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Soap Note About Multiple Sclerosis

Soap Note About Multiple Sclerosis

Soap Note About Multiple Sclerosis

Soap Note 1 Acute Conditions (15 Points) Due 06/15/2019

Pick any Acute Disease from Weeks 1-5 (see syllabus)

Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)

Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.

Late Assignment Policy

Assignments turned in late will have 1 point taken off for every day assignment is late, after 7 days assignment will get grade of 0. No exceptions 

Follow the MRU Soap Note Rubric as a guide:

Grading Rubric

Student______________________________________

This sheet is to help you understand what we are looking for, and what our margin remarks might be about on your write ups of patients. Since at all of the white-ups that you hand in are uniform, this represents what MUST be included in every write-up.

1)      Identifying Data (___5pts): The opening list of the note. It contains age, sex, race, marital status, etc. The patient complaint should be given in quotes. If the patient has more than one complaint, each complaint should be listed separately (1, 2, etc.) and each addressed in the subjective and under the appropriate number.

2)      Subjective Data (___30pts.): This is the historical part of the note. It contains the following:

a) Symptom analysis/HPI(Location, quality , quantity or severity, timing, setting, factors that make it better or worse, and associate manifestations.(10pts).

b) Review of systems of associated systems, reporting all pertinent positives and negatives (10pts).

c) Any PMH, family hx, social hx, allergies, medications related to the complaint/problem (10pts). If more than one chief complaint, each should be written u in this manner.

3)      Objective Data(__25pt.): Vital signs need to be present. Height and Weight should be included where appropriate.

a)      Appropriate systems are examined, listed in the note and consistent with those identified in 2b.(10pts).

b)      Pertinent positives and negatives must be documented for each relevant system.

c)        Any abnormalities must be fully described. Measure and record sizes of things (likes moles, scars). Avoid using “ok”, “clear”, “within normal limits”, positive/ negative, and normal/abnormal to describe things. (5pts).

4)      Assessment (___10pts.): Diagnoses should be clearly listed and worded appropriately.

5)      Plan (___15pts.): Be sure to include any teaching, health maintenance and counseling along with the pharmacological and non-pharmacological measures. If you have more than one diagnosis, it is helpful to have this section divided into separate numbered sections.

6)      Subjective/ Objective, Assessment and Management and Consistent (___10pts.): Does the note support the appropriate differential diagnosis process? Is there evidence that you know what systems and what symptoms go with which complaints? The assessment/diagnoses should be consistent with the subjective section and then the assessment and plan. The management should be consistent with the assessment/ diagnoses identified.

7)      Clarity of the Write-up(___5pts.): Is it literate, organized and complete?

Comments:

Total Score: ____________                                                          Instructor: __________________________________

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Week 5 Discussion.

Week 5 Discussion.

Week 5 Discussion.

Apply information from the Aquifer Case Study to answer the following discussion questions:

  • Discuss the Mr. Payne’s history that would be pertinent to his genitourinary problem. Include chief complaint, HPI, Social, Family and Past medical history that would be important to know.
  • Describe the physical exam and diagnostic tools to be used for Mr. Payne. Are there any additional you would have liked to be included that were not? 
  • Please list 3 differential diagnoses for Mr. Payne and explain why you chose them.  What was your final diagnosis and how did you make the determination?
  • What plan of care will Mr. Payne be given at this visit, include drug therapy and treatments; what is the patient education and follow-up?

To support your work with evidence bases references. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

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Change Implementation And Management Plan

The Assignment (6-Minute PowerPoint Presentation):Change Implementation And Management Plan

Change Implementation And Management Plan

Change Implementation And Management Plan

APA with in-text citations & references.

MUST CONTAIN PICTURES AND AUDIO AND ADDRESS EACH ITEM WITHOUT TOO MUCH WORDINESS. 

1.Review the Resources and identify one change that you believe is called for in your organization/workplace.

2.This may be a change necessary to effectively address one or more of the issues you addressed in the Workplace Environment Assessment 

It may also be a change in response to something not addressed in your previous efforts. It may be beneficial to discuss your ideas with your organizational leadership and/or colleagues to help identify and vet these ideas.

3. Reflect on how you might implement this change and how you might communicate this change to organizational leadership. 

4. The Assignment (6-minute PowerPoint presentation):

Change Implementation and Management Plan

5. Create a narrated PowerPoint presentation of 5 or 6 slides with video that presents a comprehensive plan to implement the change you propose.

Your presentation should be 5–6 minutes in length and should include a video with you as presenter.

Your Change Implementation and Management Plan should include the following:

6. An executive summary of the issues that are currently affecting your organization/workplace (This can include the work you completed in your Workplace Environment Assessment previously submitted, if relevant.)

7. Description of the change being proposed

8. Justifications for the change, including why addressing it will have a positive impact on your organization/workplace.

9. Details about the type and scope of the proposed change 

10.Identification of the stakeholders impacted by the change

11.Identification of a change management team (by title/role)

12. A plan for communicating the change you propose

13. A description of risk mitigation plans you would recommend to address the risks anticipated by the change you propose

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