P A C E - NIPEC · Presentation to EDoNs April 2015 Meetings June, July and August 2015 Product...

Care Planning

Awareness Session

P E A C

Origin

NIPEC Recording Care Project

SINCE 2009……..

Improve the standards of nurse record keeping practice in the region

Recording Care......

What’s the point?

Why Keep Records

I Integral part of practice

Evidence of partnership with people in our care

Communication

Support delivery/continuity of care

Evidence clinical judgement/decisions

Identifies risks

Requirement

Co-production – being person centred

Regulatory – NMC

Legal - Improves accountability and provides evidence

Employer - Policies

What it’s not.....

What it is.....

CARE PLAN

What is a Care Plan

It is.. A written record of the ‘care planning process’.

This process identifies the persons needs , plans the nursing intervention to achieve the desired outcomes and evaluates

the effectiveness of delivered care.

Care planning – Action

Care plan – Recording

Can be viewed as a negotiated contract laying down both parties’ responsibilities

Care plan should..

be Person-centred

Involve person in decision making

be in Partnership

be Collaborative

enable Information Sharing

be Regularly Reviewed

Caution….

Over reliance – not questioned

Difficultly to keep updated as person changes

Constant revision costs time

Not always individual

Not flexible

Reduced critical thinking

Is there a better way The development of the way forward to improve

the quality of care planning within the nursing profession began January 2014

START NOV 2014

CARE PLANNING SUMMIT – January 2015

Presentation to EDoNs April 2015

Meetings June, July and August 2015

Product PACE

Pilot September 2015

Presentation to EDoNs Nov 2015

Larger Pilot Feb-April 2017

Presented to CNO/ EDoNs July 2016

PROCESS OF PLANNING ROLLOUT

What did the literature tell us

Highly skilled

Dynamic process

Variety models underpin care plans

Ongoing reflection required

Complex/ inflexible Difficult to understand

Safety issues

Record keeping not reflective of

delivered care

Involving person and family

Current practice

• Nursing process

• Models

• Care pathways

• Care bundles

• Clinical assessment tools

PACE – What's possible

Passive recipients PARTNERSHIP

Paternalistic

EMPOWERMENT

Informed of care

INFORMED CONSENT

Comprehensive ‘it wasn’t recorded

it wasn’t done’

SIMPLICITY FACTUAL/CONCISE

PACE PERSON

ASSESSMENT

PLAN OF CARE

EVALUATION

When to record

P - At the beginning of a shift and throughout shift

A - Depending on the need - ongoing care/episodes of

care/emergency & critical care

C - Following assessment of needs

E - Throughout the shift, after a plan is in place and the

action has been carried out or if unable to be carried

out

Champions

Champions Role

WHAT

HOW

Motivator

Educator

Facilitate/

Mentor

Embed

Change culture

Evaluator/

Feedback

Role model

Good practice

Promote awareness

Resource

Embracing barriers/

Monitor

Educator Train their peers, tailoring this to their area of

practice.

Can be formal or informal. Run short sessions or work with staff during the shift.

Work through resource pack.

Feedback on the resources and possible development of new materials such as posters, leaflets.

Guide to other resources

Become familiar with NIPEC site with resources and tools for practice improvement

PACE

Embracing Barriers

BARRIER ENABLER

New approach – increase time to record

Given adequate time from nurse leaders

Inadequate training preparation

Adequate training preparation

BARRIER ENABLER

Lack of explanations of change/expectations

Given adequate explanation

Lack of feedback to department level

Facilitate feedback to department level.

Misunderstanding of PACE Training/Resources

Reluctance from patient Explanation

BARRIER ENABLER

Lack of training/ preparation at all levels Lack of awareness

Support from NIPEC

Attendance at training workshops.

Involvement of department champions to cascade

Resource pack.

Training audit tool

BARRIER ENABLER

Fear -not writing enough/change of entire style

Training/on going support at ward level

Fear of legal/professional repercussions

Addressing these issues Revalidation

Staff attitudes - sceptical Communication / Discussion

Challenging department environment

Creative thinking to current processes

Staff levels Appropriate reporting Understanding

Resources

• Resource pack

• NIPEC website http://www.nipec.hscni.net/

• NIPEC microsite

http://www.nipec.hscni.net/resource-section/improve-record-keeping/

• NMC Code

• Standards document