DHW 508 Evaluation of healthcare practice

Task 1

1.1 Eight Objectives of the NZ Disability Strategy (2016-26)

Education- this objective is related to securing the rights of disabled people for getting excellent educational services and achieving their potential throughout their lives. This objective aims at ensuring that all disabled students are able to get appropriate educational services including primary, secondary, and tertiary educational services from the educators/ tutors. This objective ensures that all disabled have equal access to educational services and educational facilities.

Employment and Economic Security- this objective secures the rights of disabled people for getting fair and equal employment opportunities at all levels irrespective of discrimination, stereotyped attitudes, or inequalities. This includes ongoing support, guidance, equal respect, equal access to employment, and participation in business decision-making (Office for Disability Issues, 2019).

Health and Well-Being– this objective provides security to disabled people from equal access to healthcare services for their equal health outcomes and well-being. This objective protects the rights of the disabled for getting equal treatment and care services in PHOs, public hospitals, and community healthcare services.

Rights Protection and Justice– this objective is related to protecting the rights of disabled people for feeling safe, treated equitably, and fairly, equality recognized from the equitable system and justice. This objective supports disabled people from their listening appropriately and safeguarding practices against violence, discrimination, or injustice.

Accessibility- The objective enables disabled people for their equal access to education, employment, healthcare, banking, church, entertainment, transportation, and other public services. This objective ensures that all disabled have equal access to housing, schooling, hospitals, and all public places for their equal benefits (Beehive Govt. NZ, 2016).

Attitudes- this objective of the NZ disability strategy protects disabled people from positive similar attitudes, fair treatment, equal respect, and dignity against stereotypes, discrimination, stigmatism, or other negative attitudes. This objective secures disabled people for equal treatment and benefits from positive attitudes.

Choice and Controls- this strategy objective secures disabled people by enabling them to have their own choices, make informed consent and decisions and autonomy in working, and control over their lives. This strategy objective empowers disabled people to have good control over their lives, life decisions, and autonomy to make choices within their controls (Waitemata& Auckland District Health Board, 2018).

Leadership- this strategy objective explores the opportunity to demonstrate leadership for disabled people to be leaders or role models in employment, business, or other sectors. This objective ensures that disabled people are supported to develop their leadership potential and take responsibility to pursue and achieve goals.

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1.2 Incorporation of Five Strategy Objectives of NZ Disability Strategy into health and disability advocacy

Education-

Justification– incorporating this objective will ensure that the disabled older people with mental disability (e.g. patients with dementia problems) are supported through effective communication and education by healthcare professionals for involving the patients/ families in the healthcare plan.

This strategy objective is applied in a clinical scenario wherein an older adult with mental illness or dementia is supported through educating the patient by the physician, psychiatrist, and nurses to provide guidance and education regarding controlling their behaviors, food diets, involvement in exercises and physical activities, and stress relaxation/ management techniques. For example, Alzheimer’s NZ organization supports the mentally disabled people with dementia by facilitating the patient/ families for getting appropriate guidance and important information related to dementia care through dementia support call 0800 004 001. Maoris patients with dementia are educating in simple language by healthcare professionals to remind them of taking medicines, following food diet schedules, and involving in physical activities and exercising for ensuring their long-term health and well-being (New Zealand Government, 2019).

Protection of Rights and Justice-

Justification– The main reason for incorporating this strategic objective is to protect the rights of the disabled people with physical/ mental impairment for getting equal respect and treatment from positive attitudes, equal behaviors, and fair treatment by the healthcare professionals from an equitable healthcare system.

The incorporation of this strategic objective into the health and disability sector will assist to ensure that all mental/physically disabled patients are able to get appropriate, timely, and quality medical treatment and healthcare facilities for their health benefits. For example, in the social model approach of dementia care, the focus is placed on meeting cognitive needs from an equitable social care system by avoiding stereotyped attitudes, discriminating practices, stigmatism, or other prejudiced actions (Office for Disability Issues, 2019). For example, the Maori adults with dementia are benefited from an equitable healthcare system for treating them fairly and equitably for the equal distribution of healthcare services, medicines, and facilities by avoiding delays, stereotyped attitudes, or racial discrimination.

Accessibility-

Justification– the reason behind the incorporation of accessibility objective will ensure that all mentally disabled people with dementia are accessible to get the standard treatment and quality healthcare services for their equal health outcomes/ benefits.

Incorporation of this strategy objective protects the rights of the mentally disabled people with dementia for equal access to medical treatment, diagnostic and medicines, and care facilities by avoiding the discriminations/ stereotypes based on racial discrimination. An equitable and inclusive healthcare system creates value to patients from equal behaviors, positive attitudes, and healthcare quality for equal access to healthcare services, patient education and empowerment, and participation in healthcare plan by avoiding the barriers of inequality, stereotypes, racial discrimination, and stigmatism. The medical model of disability greatly focuses on all mentally disabled people with anxiety/ dementia disorders are fairly treated, equally respected, and supported by an equitable care system by ensuring equal access to medical facilities, diagnostic, psychological care support, and equal participation in the decision-making (Office for Disability Issues, 2019).

Choices and Controls- the reason for incorporating this strategic objective is to empower disabled people with physical/ mental impairments for making choices and decisions on healthcare services and treatment within their own control.

Justification– Applying this strategic objective in the public hospitals, clinics, or residential care units protects the rights of Maoris to get the right kind of treatment by ensuring appropriate listening of patients and their control over decisions of healthcare services, medical treatment, and other lifecare decisions. This strategy objective will ensure that all Maori patients are communicated/ informed by involving them in their healthcare plans for the choice of treatment or kind of services as per their budget and health requirements. Incorporating the strategy objective into the Maori healthcare model will ensure that all Maori patients are communicated/ informed for getting their consent and asking for choices before giving therapy, treatment, or care services. The choices and decisions of Maoris with dementia for healthcare services are respected by the healthcare professionals for their health and well-being (Beehive Govt. NZ, 2016).

Attitudes–

Justification- the main reason for the incorporation of this strategic objective is to secure the rights of disabled people with mental disabilities by fairly treating them with respect and dignity and getting equal healthcare services by avoiding stereotyped/ negative attitudes of the healthcare professionals.

Incorporating this objective will provide greater clinical experiences of mentally disabled people from their appropriate listening and equal respect and treatment to them for getting respectful and quality care. For example, the disabled Maoris are seen and respected similarly from positive attitudes by respecting their care preferences and healthcare needs for providing them appropriate care accordingly. The social disability model places focus on equalized access to healthcare services and equal health benefits to all from positive attitudes and avoiding stereotyped attitudes, stigmatism, and discriminations (Beehive Govt. NZ, 2016).

Task 2

2.1 Health and safety Strategies in New Zealand, the UK, and Australia

H& S Strategies in New Zealand-

Infection Prevention and Control Policy- this policy includes 5 standard precautions for infection control including hand hygiene (safety gloves, washing hands, and using hand sanitizers), PPE, safe use and disposables of waste, routine environmental cleaning, and safe practices for the handling of bloods, secretions, and other body fluids. This policy is administered by the Ministry of Health (MoH) that provides directions and control regulations for minimizing or eliminating infection risks by adhering to safety guidelines, hand hygiene, and cleaning standards (Ministry of Health, 2019). For example, HHNZ (Hand Hygiene New Zealand) Programme is administered by HQSE New Zealand to provide safety guidelines or instructions, such as washing hands, using hand sanitizer, and wearing gloves before and after patient services for controlling the aspects related to hand hygiene and minimizing risks of infectious diseases.

Moving and Handling Policy– This policy provides guidelines for safe manual handling of medical equipment and safe moving of patients by complying with safety guidelines as per ACC (Accidental Compensation Corporation). This policy greatly focuses on providing a safe work environment, training, and adequate safety guidelines regarding the use, handling, lifting or pulling of equipment, and insurance covers as compensation in the case of injuries or accidental deaths at the workplace. This policy includes risk assessment, M&H techniques, organizing training for educating the health workers, facility design, reporting accidents/ injuries, and monitoring of safety performance. The ACC provides guidance and safety steps for the safe use or handling of different handling equipment, such as standing hoists, mobile hoists, slide sheets, wheelchairs, stretchers, slings, and other M&H equipment for preventing accidents/ injuries (Worksafe NZ, 2020).

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Health and Safety Strategies and Regulations in Australia

Safe Patient Handling Policy- this strategy provides an approach for moving or transferring patient/ client by minimizing or eliminating the manual handling tasks of the physically disabled patients as per OSHA, 2011 guidelines and safety standards. The ANMF’s safe handling policy promotes using mechanical lifting aids and other M&H equipment to assist in patient safety practices in handling, moving, transferring, and mobilization of patients. This strategy emphasizes the importance of a safe patient handling program for improving the quality and safety of patient-care practices and reducing exposure to risks related to manual handling/lifting injuries by 95%. This provides techniques and safety guidelines for safe patient handling in various activities including carrying, lifting, pulling, pushing, and/or lowering in ensuring patients’ safety (ANMF, 2015).

Australian Infection Control and Prevention Policy 2019- The National Health and Medical Research Council (the NHMRC) provides guidelines for preventing and controlling infection-related risks. This H&S policy in Australia provides guidelines for hand hygiene and cough etiquette, environmental hygiene, the use of PPE, antibiotic stewardship, vaccinations, surveillance, the safe use and disposal of needles, environmental cleaning, and safe practices for blood transfer and excretions. The strategy promotes the safety of patients by focusing on important guidelines for hand hygiene, such as wearing safety gloves and masks, cleaning hands with disinfectants, and sanitizing hands and equipment for preventing or minimizing microbiological infection (viral, bacterial, or fungal) related risks or incidences (National Health and Medical Research Council, 2020).

H&S Strategies and Regulations in the UK-

Infection Control Strategy- this policy is aimed at reducing the incidences of infection-related risks in PHOs, clinics, or hospitals, and maximizing the safety of healthcare workers and patients. The infection control strategy includes hand hygiene (washing and sanitizing, wearing safety gloves), isolation policy (isolating the infected patients from others or keeping in a separate ward), social distancing policy (keeping distances at the workplace), disinfection policy (using disinfectants and cleaning agents), and inoculation risk policy (minimize the risks of Blood-Bourne or air-Bourne infections. For example, the NHS provides protocols and safety regulations for hand hygiene, decontamination of equipment, PPE, isolation of patients, and safe work practices for minimizing infection risks against microbial infections, such as Covid-19 infections (NHS, 2018).

Moving and Handling Policy- this strategy is related to safe handling of equipment/ devices at hospitals and safe moving/ transferring of patients. The HSE of the UK government provides safety regulations for handling/ lifting equipment for the safe moving/ transferring/ carrying of patients. This strategy aims at preventing the number of injuries and accidental deaths related to handling and moving of patients by complying with HSWA (Health and Safety at work Act 1974), manual handling operation regulations (MHOR, 2002), Management of Health and Safety Regulations (MHSWR), 1999, and PUWER (Provision and Use of Work Equipment Regulation) 1998 (HSE, 2017).

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2.2 Comparison of Health and Safety Strategies and Regulations in New Zealand with Australia and the UK

Manual handling Strategy and Regulation-

Similarities- the manual handling strategy and policy regulations are similar in New Zealand, the UK, and Australia in the way of providing safety guidelines and instructions for the safe manual handling and lifting of all equipment, pushing, pulling, and carrying heavy loads for preventing accidents or injuries.

Differences– the manual handling strategy is different in Australia, New Zealand, and the UK in the way of purpose, legal term, and safety regulations. HSWA, 2015 is the main legislation through which Worksafe NZ guides the workers/ employees for safe manual handling and moving of patients by minimizing or eliminating the risks arising from the work (Worksafe NZ, 2020). In Contrast to above, in Australia, the Safe Patient Handling Policy of the Australian Nursing and Midwifery Federation (ANMF) provides safety guidelines as per HSWA, 2011 for manual handling of medical equipment and moving of patients (ANMF, 2015). While, in the UK, the manual handling policy is regulated and administered by the HSE for providing the safety guidelines and instructions for manual handling and moving through HSWA 1974, MHSWR 1999, LOLER 1998, and MHOR, 1992 (HSE, 2017).

In NZ, the manual handling policy follows the PDCA approach (plan, do, check, and act) for safety performance through safe carrying, lifting, and/ or using of equipment (Worksafe NZ, 2020). In Australia, the manual handling policy provides guidelines for safe handling by minimizing the lifting of heavy items, preventing muscle strain, and reducing bending, twisting (ANMF, 2015). While in the UK, the manual handling policy follows a manual handling risk assessment procedure to focus on four areas including safe workplace design and layout, characteristic of load, nature of tasks, job security, and capabilities of workers for safe work practices.

Infection Control and Prevention- this strategy has similarities in NZ, the UK, and Australia in the way of preventing harm through standard precautions for hand hygiene, PPE, environmental scanning, infection control, disinfectants, and transmission-based precautions. This strategy and regulations are different in the way of purpose, protocols, guidelines, and safety standards. In New Zealand, HQSE (Health Quality and Safety Commission) NZ administers and controls infection risks through hand hygiene regulations and the HHNZ program (Worksafe NZ, 2020). In comparison to the above, the policy in Australia is administered by the Australian Commission on Safety and Quality to gain control over infection risks through hand hygiene, infection management, prevention of needle-stick infection, and catheter insertion (National Health and Medical Research Council, 2020). In the UK, the NHS provides safety directions and guidelines for controlling infectious risks and preventing infectious diseases, such as Covid-19 through hand hygiene policy, PPE policy, and social distancing rules and Health and Social Care Act, 2008 (NHS, 2018).