Healthcare Support Worker
Induction Book
This book has been designed to give you information about your Healthcare Support Worker Induction Programme. This programme follows on from your Trust Induction and it is designed to give you the skills and knowledge required to work safely and to contribute to the delivery of high quality patient care.
You will find information about the aims of each topic that will be covered during the programme, as well as providing some background reading to help you explore more around the key aspects. You will also find details of additional resources and training that you can access to improve your knowledge.
Before attending your Healthcare Induction Programme you will be expected to set yourself objectives about what you would like to achieve from the programme.
Please complete your objectives before you arrive & bring them with you on the first day of your programme.
Induction Training
Future Training Needs12 Week Care
Certificate
5 Day Healthcare Support
Worker
Induction Programme
INDEX
Page
4
Introduction & Personal Objectives
5
The Patient Experience
6
Consent
7
Patient Safety
8 - 9
Infection Prevention & Control
10 - 14
HCSW Induction Programme – Topics
Introduction
As United Lincolnshire Hospitals Trust (ULHT) design, develops and improves its services to meet ever changing demands, so the healthcare workforce must respond and reflect those changes.
New and innovative ways of working, often across teams of multi-professionals must be developed to ensure that high levels of competence, knowledge and skills are integral to the delivery of care.
Despite the changes in the Health Service, the one thing that remains constant is that patients want their contact with healthcare professionals to make them feel safe, cared for, respected and involved. The constantly changing role of registered nurses will have direct implications on the role of the Healthcare Support Worker. As the registered nurses role expands and develops it is important that we work as a team in a supportive way that provides excellent care for the patients in our care.
As Healthcare Support Workers you play a significant role in the delivery of a high quality service delivered within the trust. It is essential that you are supported and developed and given opportunities to understand and know about the standards of behaviour within the organisation
As the role of Healthcare Support Workers grow, so does the need to make sure that you have access to relevant, high-quality education, training programmes and learning opportunities.
Personal Objectives
It is important that before you attend your induction programme you think about what you would like to achieve during this training.
Please state below three objectives you would like to achieve during your Induction Programme: Objective 1: ……… ……… ……… ……… Objective 2: ……… ……… ……… ……… Objective 3: ……… ……… ……… ………
The Patient Experience
Improving the patients experience is a key aim for the NHS. By asking, monitoring and acting upon patient feedback, organisations are able to make improvements in the areas that patients say matter most to them.
• Respect for patient centred values, preferences and expressed needs including: cultural issues; the dignity, privacy and independence of patients and service users; an awareness of quality-of-life issues; and shared decision making.
• Co-ordination and integration of care across the health and social care system.
• Information, communication and education on clinical status, progress and process of care in order to facilitate autonomy, self care and health promotion.
• Physical comfort including pain management, help with activities of daily living and clean and comfortable surroundings.
• Emotional support and alleviation of fear and anxiety of such issues as clinical status, prognosis and the impact of illness on patients, their families and their finances.
• Welcoming the involvement of family and friends, on whom patients and service users rely, in decision making and demonstrating awareness and accommodation of their needs as care-givers.
• Transition and continuity as regards information that will help patients care for themselves away from a clinical setting, and co-ordination, planning and support to ease transitions.
• Access to care with attention. For example, to time spent waiting for admission or time between admission and placement in a room in an in-patient setting. Waiting time for an appointment or visit in the out-patient, primary care or social care setting.
The patient and user experience is integral to United Lincolnshire Hospitals NHS Trust’s core business. Therefore all staff working within the Trust have a duty to ensure that all those who use our services receive an experience that meets or exceeds their physical and emotional needs and expectations. The Trust knows that patient experience is critical to both individual patients and their families and goes well beyond the health outcomes of their care.
The following eight aspects of healthcare are most important to patients: 1. Fast access to reliable health advice
2. Effective treatment delivered by trusted professionals 3. Involvement in decisions and respect for preferences
4. Clear, comprehensible information and support for self-care 5. Attention to physical and environmental needs
6. Emotional support, empathy and respect
7. Involvement of, and support for family and carers 8. Continuity of care and smooth transitions
Consent
Consent is a patient’s agreement for a health professional to provide care. If consent is not given then it could be deemed as assault. It is important that any permission given by the patient is based on a clear understanding of the treatment or intervention they are agreeing to receive.
This is known as the principle of informed consent, it is an ethical but not legal principle in England and Wales, and it stresses the importance of trust and underpins the concept of a focused approach. This gives rise to the duty to respect patient’s autonomy and the right to decide whether or not to undergo any health care intervention.
As a professional when obtaining consent you have three key responsibilities: 1. You must act in the best interests of the patient
2. You must ensure that the process of obtaining consent demonstrates a clear level of accountability
3. That all discussions and decisions relating to consent must be recorded accurately
A patient has the right to be informed and they have a right to withhold consent – for some or no reason at all.
This can be evidenced with the Mental Capacity Act 2005, which was fully implemented in October 2007. The purpose of the Mental Capacity Act is to maximise the opportunity of those individuals that lack capacity to make decisions for themselves. The five principles of the Act are:
1. Always begin by assuming the person has capacity
2. To take all reasonable steps to help them decide for themselves 3. Making an unwise decision does not mean the person lacks capacity
4. Any decisions taken on behalf of the person who lacks capacity must be in their best interests
5. Any decision must minimise restriction to their liberty
To ensure you have done all you can to help someone make a decision you should:
• Provide all relevant information, but only that which is required
• Provide advice on the consequences of making, not making, the decision
• Consult with others on the best way to communicate with the patient
Patient Safety
The Risk Management Policy for ULHT is an example of a system which protects patients and provides guidance and instruction.
The risk policies and standards available on the Trust intranet collectively produce some structure to the management of risk in the Trust and will help to give you clear instructions on how to carryout a task.
When caring for patients you should ensure you:
• Follow performance standards outlined
• Read and understand relevant policies and protocols provided by ULHT
• Identify local risk management systems that are designed to assist ULHT to manage incidents effectively (e.g. Incident Reporting)
• Complete and follow proactive risk assessments
Infection Prevention
As we carry out our daily working routines we pick up micro organisms from everyone and everything we come into contact with. These can easily be passed onto anything and anyone we touch. Some of these micro organisms are normally harmless but may be capable of causing infection to susceptible people. Poor hand hygiene and hand cleaning techniques have been identified as a major influence in higher rates of healthcare associated infections. Good hand hygiene and hand cleansing techniques remove the micro organisms from our hands before they can be passed on. This therefore underpins all infection prevention and management practice.
Hand Decontamination
Effective hand decontamination is one of the simplest yet most effective methods of reducing hospital acquired infection.
Hands are the principle route by which cross infection occurs. Soap and water should be used in all cases where hands are visibly soiled or when dealing with a patient who is positive for Clostridium Difficile or an ESBL infection (Extended Spectrum Beta-Lactamases - which is a name used for a group of bacteria that are resistant to many commonly used antibiotics).
Alcohol hand gels can be used when the hands are not visibly soiled. When should hands be cleaned in a clinical setting?
Before Patient Contact To protect the patient against harmful germs carried on your hands
Before an Aseptic Process To protect the patient from harmful germs, including the patients own from entering his/her body
After body fluid exposure To protect yourself and the healthcare environment from harmful patient germs After patient contact To protect yourself and the healthcare
environment from harmful patient germs After contact with patient surroundings (furniture,
objects etc)
To protect yourself and the healthcare environment from harmful patient germs After removing gloves To protect the patient against harmful germs
carried on your hands When should hands be cleaned in a non patient setting?
Upon arriving at your workplace To protect yourself and the healthcare environment from harmful germs
After using the toilet or assisting someone To protect yourself and the healthcare environment from harmful germs
Before handling food To protect the patient against harmful germs carried on your hands
Before leaving work To protect yourself and the healthcare environment from harmful germs
Universal (Standard) Precautions
These should be used with all patients and should be especially applied when dealing with or coming into contact with blood and body fluids. These include:
Use of Personal Protective Equipment (PPE) – aprons, gloves, face masks, eye protection
Selection of PPE must be based on the risk of transmission of micro-organisms to the patient and the healthcare worker
Broken skin Any cuts or abrasions to hands or forearms must be covered with a waterproof dressing.
Sharps Must be disposed of at the point of care in an
appropriate container
Spillage of blood or body fluids Spillages must be cleaned up as per Trust Policy
Waste and Linen disposal Waste contaminated with blood or body fluids must be discarded into correct bag (see ULHT Waste Policy
Used linen must be disposed of as per ULHT Linen Policy
Healthcare Support Worker Induction Programme – Topics Covered
The programme will include a mixture of seminars and presentations, practical workshops and group work. You are encouraged to take an active part in each session & to ask any question that you may have.The 6cs, dignity in care, respect and accountability are embedded throughout the programme.
The 6C’s (Compassion in Practice), Accountability & Standards of Behaviour
It has been shown that knowledge and skills are not enough to deliver excellence in patient care. Excellence comes from how we deliver what we know – therefore excellence relies on how we behave. This session will include:
• The key themes for the way we should all behave
• The standards of behaviour expected of Healthcare Support Workers
• The 6C’s (Care, Compassion, Commitment, Courage, Communication & Competence)
Patient Hygiene
The aim of this session is to equip Healthcare Support Workers with skills and knowledge required to assist patients to meet their hygiene needs. This will include:
• How to establish the patient care requirements, ensuring their individual needs and wishes are discussed, including any religious or cultural needs
• How to prepare the immediate environment and equipment needed
• How to assist patients and encourage the patient to maintain independence as far as possible
• Understanding how the patient should be cared for after their hygiene needs have been met
• Understanding the importance of reporting any problems or changes in a patients condition and who to report the information to
• How to measure a patient for anti-embolic stockings and how to apply the stockings correctly
Mouth Care
The aim of this session is to understand the importance of good oral hygiene and techniques to providing effective mouth care. This will include:
• The healthy mouth and what an unhealthy mouth might mean
• Signs that could indicate problems in the mouth
• The implications of poor mouth care, including denture care
Healthcare Support Worker Induction Programme – Topics Covered
Continence
The aim of this session is to give an awareness of how continence issues can affect a patient and how to assist patients with their individual needs. This will include:
• Gaining an awareness of the types of incontinence and the effect this can have on a patient
• The types of products available and how to use them correctly
• How to complete paperwork e.g. stool charts, fluid balance charts
• Understanding the importance of reporting any problems or changes in a patients condition and who to report the information to
Conveen Care
The session will include:
• What is a conveen & the types available
• How to measure & apply convenes correctly
• Problems & advice on how to resolve them
Stoma Care
The aim of this session is to give an awareness of the different types of stomas and how to assist patients with stoma care. This will include:
• Gaining an awareness of the different types of stomas
• Gaining an awareness of the types of stoma care equipment available, how to change stoma bags and how often the bags should be changed
• Understanding how stomas can affect a patients view of their body image
• When to and how to contact the stoma care team
Infection Prevention and Control
The aim of this session is to give an understanding of how infection is spread and how this can be minimised. This will include:
• Types of infection and how they are spread
• Understanding the importance of hand washing and correct hand washing techniques
• Waste disposal
• How to clean equipment e.g. commodes, hoists, mattresses etc
• Understanding the correct use of Personal Protective clothing
• Isolation Nursing
• The correct use of body washes
Healthcare Support Worker Induction Programme – Topics Covered
Tissue Viability
The aim of this session is to gain an awareness of what pressure ulcers are and the Healthcare Support Workers role in the prevention of pressure ulcer development. This will include:
• How pressure ulcers are categorised
• Repositioning techniques e.g. 30% tilt
• Understanding the importance of reporting any changes in a patients skin condition or changes in a patients abilities, such as reduced mobility, lack of appetite etc
Charts & Admission Paperwork
The aim of this session is to understand the importance of completing paperwork correctly & the importance of hourly rounds check. This will include:
• Understanding the reasons why these checks are made
• Look at the paperwork in detail, gaining an understanding of how to complete it correctly
Nutrition & Water for Health
The aim of this session is to ensure Healthcare Support Workers gain the knowledge and skills to assist patients with their nutritional and fluid needs. This will include:
• Gaining an awareness of the nutritional needs of patients
• Understanding religious and cultural requirements and personal preferences
• Understanding how poor nutrition can affect a patients health and wellbeing
• How to assist patients to choose appropriate food, including how to complete menu cards
• Modified diets and the correct techniques used to thicken fluids
• Understanding the importance of correct patient positioning to ensure safe eating and drinking
• How to position yourself when assisting patients with food and drink
• Protected mealtimes
• How to encourage patients to eat and drink and what to do if a patient does not want to eat and drink
• What action to take if a patient has adverse reactions to food and drink
• How to complete paperwork e.g. food charts and fluid charts and why it is important to do this correctly
• Gain an awareness of the role of the Dietician
Healthcare Support Worker Induction Programme – Topics Covered
Moving and Handling of People
The aim of this session is to give Healthcare Support Workers awareness of the legislation related to moving and handling and of manual handling equipment. It also introduces Healthcare Support Workers to correct moving and handling techniques that should be used when caring for patients. This training will include:
• An introduction to risk assessment and why these should be carried out on each patient
• An introduction to the equipment available to assist with the moving and handling of people, including beds and hoists
• Understanding the Healthcare Support Workers responsibilities when moving and handling people
• Understanding the importance of reporting changes in a patients condition and abilities and who to report the information to
Excellence in Care
This will include:
• Introduction to the ABCDE approach
• Basic Life Support
• The Resus Trolley
• Understanding the importance of reporting any changes in a patients condition and who to report the information to
*Please ensure you have looked at the Resuscitation Services Website prior to the date of your Excellence in Care session – www.resuscitationservices.co.uk
Healthcare Support Worker Induction Programme – Topics Covered
End of Life Care & Last Offices
This session will include:
• Definitions of Palliative Care & Terminal Care
• Communication and Breaking Bad News
• The Stages of Bereavement
• How to perform Last Offices
Dementia Care
This session will include:
• Understanding what is Dementia and how to care for a patient with Dementia
• What is Delirium
• Communication and distraction therapies
• Understanding the impact of the environment for Dementia patients
• How to manage aggressive outbursts
Introduction to the Care Certificate
This session will include:
• What is the Care Certificate
• How will the Care Certificate be assessed
• The Learners Responsibility
• The HCSW Code of Conduct
Learning Disability
This session will include:
• To inform Hospital Staff about the role of the Acute Learning Disabilities Liaison Nurse (ALN) and the needs of learning disabled Patients.
• To ensure staff know why the ALN role is required, how to contact ALN and how ALN can support Acute Hospital staff and patients with LD
• To highlight the health needs of people with LD
• To ensure Staff are aware of reasonable adjustments and what additional support a patient with LD requires while in the Acute Hospital
Resources and Contact Details
Carolyn Moran – Clinical Education Nurse Clinical Education Team,Education Centre, Lincoln County Hospital, Greetwell Road,
Lincoln LN2 5QY
Tel: 01522 573919
Email: [email protected]
Skills for Care - Code of Conduct for Healthcare Support Workers & Adult Social Care Workers in England
British Journal of Healthcare Assistants www.healthcare-assistants.co.uk/
Dignity in Care
The Dignity Challenge www.dignityincare.org.ukDignity in Care Policy (ULHT 2011)
eLearning
NHS eLearning 000 eDementia – Introduction to Dementia NHS eLearning 000 Safeguarding Adults parts A+B
NHS ESR eLearning 000 Mental Capacity 000 Consent – Capacity and Difficult Consent
Resources and Contact Details
The Patient Experience
The Patient Experience Strategy 2012 – 2015 (ULHT intranet)
NICE guidance CG138 Patient Experience in Adult NHS services: http://guidance.nice.org.uk/CG138
Consent
United Lincolnshire Hospital Trust Consent Policy (2011) ULHT Mental Capacity Policy (2011)
Risk Assessment
Risk Assessment Policy (2007) United Lincolnshire Hospitals NHS Trust Risk Management Standards for Acute Trusts (2008) NHSLA
www.nhsla.com/riskmanagement
Healthcare standards – www.hcsu.org.uk
