Module 1 - Holistic Care - St John New Zealand



Gold Level Caregivers CourseStudent HandbookName:Division:Course start date: Contents Module PageHolistic Care3Safety12Communication21Skin and Wound Care25Basic Personal Care30Nutrition in the Community37The Grieving Process43Observations45Module 1 - Holistic CareBy the end of this session the learner will be able toIdentify what is required to provide holistic careKnow the rights of individuals Understand the implications of the Treaty of Waitangi and its relationship to HealthIdentify the basic needs of all individuals Identify good health practicesHolistic Care/WellnessWhat does holistic care mean to you?center93345-406213754260Define each component of the 7 Dimensions of wellness2732773228740Physical wellness2749553219450Social wellness2749553597320Emotional wellness2749552794000Environmental wellness2749553581400Spiritual wellness2768603575050Intellectual wellness2768604603750Occupational wellnessThe Rights of IndividualsMake brief notes under each of the following headings:Right 1: Right to be treated with Respect:Right 2: Right to freedom from discrimination, coercion, harassment, and exploitation:Right 3: Right to dignity and independence:Right 4: Right to services of an appropriate standard:The Treaty of WaitangiArticle 1 - GovernanceThe Chiefs of the Confederation, and all these chiefs who have not joined in that Confederation give up to the Queen of England for ever all the Governorship (Kawanatanga) of their lands. Article 2 - AutonomyThe Queen of England agrees and consents (to Give) to the Chiefs, hapus, and all the people of New Zealand, the full chieftainship (rangatiratanga) of their lands, their villages and all their possessions (taonga: everything that is held precious) but the Chiefs give to the Queen the purchasing of those pieces of land which the owner is willing to sell, subject to the arranging of payment which will be agreed to by them and the purchaser who will be appointed by the Queen for the purpose of buying for her. Article 3 - EquityThis is the arrangement for the consent to the governorship of the Queen. The Queen will protect all the Maori people of New Zealand, and give them all the same rights as those of the people of England. Impact of British Settlement on the Maori peopleGAINSCOSTThe health links between the Treaty of Waitangi and HealthArticle 1 – Governance Achieve Maori Participation in all aspects of health. This is the P______________________ principle of the Treaty of WaitangiArticle 2 – AutonomyAchieve the advancement of Maori health aspirations, practices and general wellbeing. This is the P_______________________ principle of the Treaty of Waitangi. Article 3 – EquityUndertake health promotion, which improves Maori health outcomes. This is the P______________________ principle of the Treaty of Waitangi The Basic Needs of Individuals (Maslow’s Hierarchy of Needs)Under each heading list the needs that an individual requires to fulfil each need:Physiological needs-54269816210Safety NeedsLove and Belonging NeedsEsteem NeedsWhat is Self-ActualisationName two people in history who you think has achieved self-actualisation and why?Identify good health practicesWhat type of foods do you usually eat?How much sleep to you get each night?What do you do for recreation?How much exercise do you do in a week?Module 2 – Safety By the end of this session the learner will be able toUnderstand informed consentUnderstand the importance of hand washing State the principals of infection control in a home or community settingDemonstrate how to use Personal Protection Equipment in a home or community settingUnderstand the care and custody of medicine in the home and community settingIdentify the correct procedures to follow when using medicines in the home. Informed ConsentWrite notes on the following components of informed consent“Informed consent is a process rather than a one off event. The essential elements of this process are effective communication, full information and freely given competent consent”Effective communicationCompetence Voluntarism Full informationProcess Read through the following scenario in groupsJacob is staying with his 75-year-old grandmother Rose for the summer holidays. While Rose was bringing a snack to Jacob’s room she tripped on a mat in the hallway and skinned her knee on the wooden floors. Jacob approached his grandmother and asked if she was ok, she replied that she had grazed her knee, and it was starting to bleed a bit. Jacob had done his first aid badge in the previous holidays and quickly went to get his first aid kit. Jacob went to work cleaning and dressing his grandmother’s knee. Rose was very interested in what her grandson was doing, and tried talking to Jacob about what he was doing, but Jacob was busy concentrating and diligently putting his knowledge into practice and ignored his grandmother’s questions. Jacob had completed the task and treated his grandmother successfully and Rose was very proud of what her grandson had learnt. Discuss was there informed consent?What components of informed consent are missing?Hand WashingDefine the following types of hand washing:Social hand washProcedural hand washSurgical scrubWhat are the 5 moments of hand hygiene? Moment 1:Moment 2:Moment 3:Moment 4:Moment 5:In groups of three, one carer, one patient and one person to mark your book use the checklist below and demonstrate the following until everyone has had a turnCHECKLIST – Washing hands Procedural WashMaterials collected togetherRemove all jewellery and watchesWet wrists and handsApply sufficient soap to handsLather soap and scrub hands palm to palmScrub between and around fingersScrub back of each hand with palm of other handScrub fingertips of each hand in palm of opposite handScrub each thumb clasped in opposite handScrub each wrist clasped in opposite handContinue for at least 30 secondsRinse thoroughly in running waterWipe and dry hands thoroughly with paper towelsTurn off tap using paper towelName of person marking: Infection ControlList the main ways in which infection can enter the body:1.2.3.4.List the ways in which infection can be controlled and prevented in the home or community? 1.2.3.4.5.Personal Protective Equipment (PPE) acts as a barrier between infectious materials and the:M_______________________________E_______________________________N_______________________________S_______________________________Name these types of PPE1841502247901.________________________4013201447802.________________________5435601847853.________________________1974853352804.________________________546103581405.________________________In groups of three, one carer, one patient and one person to mark your book use the checklist below and demonstrate the following until everyone has had a turnCHECKLIST – Removal of disposable glovesWashes handsExplains to patient why caution is necessaryChooses correct size of glove – not loose fittingPuts gloves on and checks for holes and tearsCarries out any necessary procedures for patientRemoves first glove by peeling it backwards from the wrist, using finger and thumb. Glove pulled inside outUsing exposed hand, picks up first glove (touching the clean inside only) and uses it to pull off second glove from wristTakes care not to touch outside of second glove with clean handDisposes of glove appropriately Washes handsName of person marking ...........................................................MedicationNotes on correct care and custody of prescription medication in the home/community setting:What are the ways in which medications can be administered to a patient? 2.3 4. 5.6. 7.8. 9.10.What are the 5 rights of medication administration?Right_____________________________________________DRight_____________________________________________RRight_____________________________________________PRight_____________________________________________ARight_____________________________________________TModule 3 - CommunicationBy the end of this session the learner will be able toDemonstrate effective communication with individuals from all age groupsDemonstrate effective communication with individuals with specific communication needsIdentify barriers to effective communication and ways to overcome themDemonstrate the ability to dial both the New Zealand Health Line and Emergency ServicesWhat is communication?Identify at least 3 types of non-verbal communication Communicating with those that have specific needsIdentify at least 5 ways that we can communicate with people that can’t talk. Identify at least 5 ways that we can communicate with people that have a hearing impairment. Identify at least 5 ways that we can communicate with people that have sight impairment. Identify at least 5 things that can impact on communication in a stressful environment. Listening What is the mnemonic SOLER used for?What does the mnemonic SOLER stand for?SOLERContacting the Emergency ServicesWhat services do you get when you contact 111? When would you contact these services?What is the number for Healthline New Zealand?What is the function of Healthline NZ?When would you contact Healthline NZ?What is the number for the National Poisons Centre?Module 4: Skin and Wound CareBy the end of this session the learner will be able to:Identify common causes of pressure areas and prevention methodsIdentify the difference between healthy and unhealthy woundsDemonstrate the ability to clean a wound effectivelyHave an understanding of different dressings products available in the communityIn your groups discuss the below subjects. Record your answers in the spaces provided.What are pressure ulcers?What conditions can lead to pressure sores?What prevention measures you can take?In groups, discuss the difference between a healthy and an unhealthy woundHealthyUnhealthy Do different wounds need different dressings? In groups look as the dressing available to you and discus when you might or might not use them. Hint: waterproof, non-stick, specialtyPrimaporeOpsiteMelinonSteri stripsBand AidsBurns dressings In groups of three, one carer, one patient and one person to mark your book use the checklist below and demonstrate the following until everyone has had a turn. CHECKLIST – Cleaning a woundMaterials collected togetherIntroduces self and explains procedureWashes handsPuts on glovesExpose the wound by removing previous dressingInspects wound for healing, discharge or rednessDispose of previous dressingRemoves dirty gloves and discards appropriatelyWashes handsPuts on clean glovesApplies warm water (or available wound cleaning solution) to swabsClean wounds with swabsDries wounds with dry swabsRecovers wounds with appropriate dressingRemoves rubbishRemoves dirty gloves and discards appropriatelyWashes handsName of person marking: Module 5: Basic Personal CareBy the end of this session the learner will be able to:Acknowledge dignity, respect and privacy at all times when providing care.Show an understanding of requirements of different individual's bedroomsHave an understanding of how to prepare a bathroom for individuals to useDemonstrate the ability to assist individuals to dress themselvesDemonstrate the correct procedures for:Washing a faceWashing hairBrushing teethIdentify what feelings you think the patient/ person being cared for may feel when having care provided for them12345Identify what feelings you think the person providing the care may have.12345Identify 3 things that you need to be considerate of when providing personal care123There are physical needs of the environment that are needed to ensure a patients comfort and well-being while being cared for. Discuss the following headings as a group and record your findings.RoomThe patients’ room should:FurnitureThe patient’s furniture should:Nursing AidsAids that may be needed are:BedWhat things should be considered about the bed?Identify 8 things that are needed to prepare a bathroom for someone prior to having a shower.12345678Think about what things you do to care for yourself on a daily basis, from having a shower, brushing your teeth, and washing your hair.How long does it take you to do each of these things?ActivityTimeBrush your teethWash your hairHave a shower/ BathGo to the toiletEatHow long it would take you to do these activities if you could not use your dominant hand? ActivityTimeBrush your teethWash your hairHave a shower/ BathGo to the toiletEatIn groups of three, one carer, one patient and one person to mark your book use the checklist below and demonstrate the following until everyone has had a turn.CHECKLIST – Assisting a patient with clothing where limbs are affectedRemoving clothingWashes handsExplains procedure to patientSlips outer garment over head, and off the unaffected arm while supporting the affected armSlips garment off the affected armEnsures patient is comfortableBrushes and/or combs patients’ hairWashes handsAdding ClothingWashes handsExplains procedure to patientCollects clothingSlips the affect arm into sleeve of garment, grasps patients hand and gently slides sleeve along armPlaces other arm into sleeve and assists with adjustment of clothes e.g.: buttons, zip etcEnsures patient is comfortableBrushes and/or combs patients’ hairWashes handsNote: To pass this list you must have a tick in all the shaded boxes.Name of person marking: In groups of three, one carer, one patient and one person to mark your book use the checklist below and demonstrate the following until everyone has had a turn.CHECKLIST – Washing a patients faceMaterials collected togetherExplains procedure to patientArranges equipmentWashes handsFills bowl with warm waterAsks patient if they want soap on their face clothWets the cloth, but wrings it out, so it is not drippingCarefully wash the patients faceUse a different bit of the face cloth for each eye, wiping from inside to outside in one swipeDries the patients face, checking that it feels dry for the patient.Clears away equipmentHelps patient back into comfortable positionWashes handsNote: To pass this list you must have a tick in all the shaded boxes.Name of person marking: In groups of three, one carer, one patient and one person to mark your book use the checklist below and demonstrate the following until everyone has had a turn.CHECKLIST – Wet shampooMaterials collected togetherExplains procedure to patientArranges equipmentWashes handsPositions patient so as to reduce risk of wetting themEnsures patient is comfortableBrushes and/or combs patients hairAsks patient to hold flannel over eyesSlowly pours water over hair until wet. Applies shampoo and massages scalpRinses hair with water until hair is free from shampoo. Repeats with more shampoo if necessaryWraps patient’s hair in a towel. Dries patient’s face, neck and shouldersDries patient’s hair. CombsAssists patient to a comfortable position. Returns equipment. Asks patient how their hair feelsWashes handsNote: To pass this list you must have a tick in all the shaded boxes.Name of person marking: Dental HygieneHow often should you visit the dentist? How often should you change your toothbrush?How much toothpaste should a child under 6 use?How long should you clean your teeth for?Name some other things you can use to aide with cleaning your teeth?In groups of three, one carer, one patient and one person to mark your book use the checklist below and demonstrate the following until everyone has had a turn.CHECKLIST – Brushing a patients teethMaterials collected togetherExplains procedure to patient. Helps patient into a comfortable positionWashes handsWets toothbrushApplies appropriate amount of toothpasteTilts the brush at a 45degree angle against the gum line and sweeps/rolls the brush away from the gum line.Gently brushes the outside, inside and chewing surface of each tooth using short, back and forth strokesGently brushes tongue to remove bacteria and freshen breathGives patient water to rinse mouthGets patient to spit out waterRepeats brushing of teethGives patient water to rinse mouthGets patient to spit out waterWashes patients faceRemoves equipmentSettles patientWashes handsNote: To pass this list you must have a tick in all the shaded boxes.Name of person marking: Module 6: Nutrition in our CommunityBy the end of this session the learner will be able to:Understand the basic nutritional needs of an individual on a daily basis and when unwellIdentify different food preparations for special conditions and injuriesDemonstrate the ability to correctly feed someone who is unable to feed themselvesUnderstand the nutritional complications of persistent diarrhoea and vomitingHealthy Food Pyramid1114425227965005422902663190Eat Most020000Eat Most43243501558290Eat Some00Eat Some1790700243205Eat Little00Eat Little16573502472690002238375133540500On the diagram below indicate what proportion of our plate each food group should take up.287655029527500112395029527500287655025654000In small groups, discuss which foods to eat more and which foods to eat less of if you are suffering from a cold/flu, stomach bug, or physical injuryEat MoreEat LessCold or FluStomach BugPhysical InjuryIn groups, discuss people of different ages and circumstances who may need food prepared in different ways. HINT: Babies or someone with a broken jawList below five different ways to prepare food1.2.3.4.5.In groups, discuss what makes meal time a pleasant experience for someone who requires assistance with eating. List below at least six ways to make meal time more pleasant.1.2.3.4.5.6.List three things that you can use when you helping someone who requires assistance to eat. 1.2.3.In groups of three, one carer, one patient and one person to mark your book use the checklist below and demonstrate the following until everyone has had a turn.CHECKLIST – Assisting Someone with FoodIntroduces self and explains procedureChecks if the patient needs to use the toilet and offers to wash individuals hands and faceHelps patient into a comfortable position. Protects bedclothesAsks patient about any preferences they may have regarding flavour and temperatureGathers Materials together and washes handsBrings tray to bed. Sits down by patientUsing fork or spoon, feeds patient. Allows time for chewingGives drink by patient’s preferred methodClears tray away.Offers to wash patients face and handsWashes hands.Name of person marking: Describe the nutritional complications of persistent diarrhoea and vomitingList below four signs and symptoms of dehydration1.2.3.4. Module 7: The Grieving ProcessBy the end of this session you will be know how to:Understand the physical changes that occur at the end stages of life Have an awareness of the feelings of all people involved in an individual’s death Identify the 5 stages of griefHave an awareness of the documentation an individual may complete prior to the end of lifeBrainstorm in groups and discuss the fears of the patient that is dying. Write your findings in the space below.Brainstorm in groups and discuss the practical means of caring for the patient. Write your findings in the space below.Brainstorm in groups and discuss the signs of approaching death. Write your findings in the space below.Brainstorm in groups and discuss the feelings of a caregiver after the death of their patient. Write your findings in the space below.Identify the 5 stages of Grief What is an Enduring Power of attorney?How long after a burial or cremation does a death need to be registered with Births, Deaths and Marriages?Module 8: ObservationsBy the end of this session the learner will be able to:Learn different ways of collecting information from individuals using multiple toolsDemonstrate the correct procedure in taking baseline observations and recording them appropriatelyUnderstand the differences when assessing individuals from varying age groupsHave knowledge of common household ailments and at what point medical assistance is requireWhat is the difference between a sign and a symptom?We can make observations about an individual’s health by using our senses. List as many ways you can think to gather information from an individual.Using the following headings, discuss in groups what observations you can make in the following areas.Head (eyes, nose, mouth, face)Breathing (cough, posture)Urine & StoolSometimes when individuals are unwell, a background story is helpful. There are some easy questions you can ask to learn a lot about an individual. Record the questions in the acronym below.SAMPLEThe level of pain your patient is in is also a valuable observation. Fill in the words below in the Pain Assessment acronym.PQRST The information we gather from an individual and the way we gather it is very dependent on what age of the individual. In groups discuss how observation gathering is altered by the age of the individual. Record your findings below.BabyToddlerTeenagerAdultOlder AdultTemperature, pulse and respirationsCorrectly name and label on the body below four place you can take an individual’s pulseCorrectly name three places you can measure an individual’s temperature.265366525717500What is normal body temperature? ≤ 35.5°C Hypothermia≥ 38°C HyperthermiaIn groups of three, one carer, one patient and one person to mark your book use the checklist below and demonstrate how to take someone’s Temperature, Pulse and Respirations until everyone has had a turn.CHECKLIST – Temperature, pulse, respirationTemperatureMaterials collected togetherIntroduces self and explains procedure to patientArranges equipmentWashes handsPositions patient in a comfortable positionPlaces protective slip over digital thermometer and turns thermometer on with power buttonAsks patient to open mouth. Places thermometer under tongue. Tells patient to hold thermometer with lips closedRemoves thermometer from month once beep heard, reads temperature and recordsCleans thermometer and places in storage containerWashes handsPulseSupports arm with wrist slightly extended, with two fingers over radial pulseCounts for 30 seconds, doubles and recordsRespirationsContinues to hold wrist as if taking pulseHolds arm in a relaxed position over lower chest or abdomenCounts for 30 seconds, doubles and recordsWashes handsName of person marking: When recording observations they are only useful if they can be interpreted at a later stage. Discuss in your groups some golden rules to documenting observations. In groups discus the following aliments. Talk about the signs and symptoms of each, as well as when medical assistance may be necessary.Cold & FluGastro (Tummy Bug)Skin Rash ................
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