To help guide your practice here are some basic guidelines for best practice for managing risks, medication, behaviour, infection control and skin integrity. At the end of the article you will find website and document links for further reading and information regarding best practice.
The Ministry of Health guidelines for managing emergencies promotes 4 principles, the 4 R’s.
The first step when taking on a new client is to identify any potential risks and hazards, both short term and long term. For example a client may have stairs in their home, this could be a potential hazard for falls. Another example is a client may have motor skill/balance issues, this is another potential risk for falls. By identifying possible risks and/or hazards a worker can aim to reduce the likelihood of incidents occurring.
Once you have identified all potential risks and hazards within your working environment it is important to identify the ways you can respond to a potential incident. Keep helpline numbers, client family contact numbers and any other important emergency numbers saved in your mobile phone or in your wallet.
If an accident were to happen respond immediately taking action with the appropriate responses you have previously identified. Once you have secured the immediate safety of the client or property ensure to contact the appropriate family members or emergency services.
Recovery from any incident requires coordinated efforts. Be ready to provide support to your client and their family to help them recover.
If an incident occurs during a visit please ensure to report this incident when submitting your visit. There will be an option on the visit submit form to “report an incident”. You will then be asked to clarify the type of incident and add any details. An alert will be automatically sent to the organiser and Mycare. The incident will be recorded within the Mycare system retaining a transparent record between client, worker, organiser and Mycare.
Managing challenging behaviour
A client who displays challenging behaviour is a client who is deemed a risk to themselves or to others (such as their support workers). Challenging behaviour is often linked to clients who have communication difficulties.
When starting work with a new client it is important to note the ways they communicate and identify any communication difficulties. Challenging behaviour often arises because of frustration with inability to communicate thoughts and feelings.
Challenging behaviour may be presented through:
- Verbal abuse
- Inappropriate sexual behaviour
- Inappropriate social behaviour etc.
When working with a client who has challenging behaviour always try to understand why they are behaving that way. By taking the time to try understand you may uncover that the client is perhaps feeling anxious or bored. By recognising how the client is feeling you can attempt to avoid such situations in future practice and reduce the number of behavioural outbursts. If a client’s behaviour is posing a physical risk to themselves or to you remain calm and respond immediately. Calm yourself and your client and contact the appropriate persons, i.e. emergency services and/or the client’s family.
If you are truly struggling to manage a client’s behaviour first sit down with their family members and have a discussion. They may have techniques and tips they can share with you on how to manage the clients behaviour. If you are feeling overwhelmed you can find carer support groups here.
Care work often involves clients who regularly take medication, sometimes several medications, for physical and/or intellectual needs. It can also involve clients who have certain allergies or intolerances.
It is important to understand why your client needs medications, what medications they take, what this medication does for them, what will happen if the medication is missed, and the amount of each medication they take each day.
Best practice for medication management requires caregivers to keep an updated list of any allergies/intolerances, all prescribed medications, and the corresponding daily volumes the client is required to take.
Caregivers should work with the client’s family to develop a way, or use the current family system, for storing and administering client medications. Best practice involves sitting down with the client’s family to develop a medicine management plan. Include where medicine is stored, how much is administered daily, when refills will be required, and what time of the day medication should be given to the client.
Always check to see if your client has any difficulty swallowing and if it is necessary to crush pills and add to food or liquid. Check with family members and the clients GP to find out if there are any physical administration requirements.
If you have any concerns about a client’s medication or physical health discuss these with the client’s family members and consult their GP. You can also call Healthline 24 hrs a day to speak to a registered nurse for free on 0800 611 116.
Best practice in any section of the health sector involves taking preventive actions. The first step is always hygiene. The basics of hand washing, not sharing food and drink, and covering your nose/mouth when coughing and sneezing.
It is recommended to maintain an up to date first aid certificate and any other training relevant to your client’s medical needs.
If your client has any physical ailments, infections or diseases that require specific management outside of your usual practice scope then consult their GP for relevant practice guidelines.
If your client is a senior then they are at higher risk of skin integrity issues (cracked skin, teared skin, wounds, etc.) Impaired skin integrity leaves an individual open to risk of infection, blood loss, body temperature regulation issues and more.
It is vital that if your senior client has an incident which results in a breakage of the skin you respond with first aid and take them to see a doctor.
Some tips for helping your client maintain skin integrity are:
- Make sure your client is consuming enough water.
- Encourage your client to eat a nutritious diet.
- Avoid hazardous/risky situations that could result in your client injuring themselves.
- Encourage basic hygiene – hand washing but with a mild soap that is easy on the skin.
- Ensure that when heading outside your client is wearing sunscreen.
- Encourage your client to wear a hat and clothing that covers their skin to protect it from the sun.