Overview
Both wards were involved in piloting the Scottish Recovery Indicator (SRI) and following completion of the audit recognised the value to be gained by both staff and service users.
Participation in the SRI has led to several changes in our practice. For example:
Local Area
Ayrshire and Arran
Care Setting
All types of care
Evidence Base for Practice
The SRI (part 4) states the service should provide interventions designed specifically to promote participation in life’s roles, to self manage illness, and to enhance relationships with others.
The Mental Health (Care and Treatment) (Scotland) Act 2003 is underpinned by the Milan principles of reciprocity, respect for equality and diversity in a non-discriminatory manner.
The 10 Essential Shared Capabilities for Mental Health promotes working in partnership, challenging inequalities (social inequality and exclusion), promoting recovery, providing service user centred care and making a difference.
Better Health, Better Care, Scottish Government. This document focuses on providing safe, effective care that enhances the patient’s experience of our services.
Quality assurance/impact of practice
A services user involved in the service user interviews commented “I found the exercise interesting, and it opened my mind to the potential for future services”. This is underpinned by the Milan principle of reciprocity and encompasses values based care and the application of the 10 Essential Shared Capabilities.
One staff nurse involved in the pilot stated “audit tools usually identify deficits and do not recognise good practice, but the SRI is different, I’ve never felt more valued or motivated in my entire nursing career”.
According to “Leading Better Care – Report of the Senior Charge Nurse Review and Clinical Quality Indicators Project”, the Charge Nurse has a significant clinical leadership role in developing a culture of person-centred care, leading the delivery of clinically excellent high quality services, ensuring a culture of continuous quality improvement and influencing and facilitating change. The use of the SRI has allowed us to demonstrate our clinical leadership skills within our ward teams.
Practice Summary
Both wards were involved in piloting the Scottish Recovery Indicator (SRI) and following completion of the audit recognised the value to be gained by both staff and service users.
Participation in the SRI has led to several changes in our practice. For example:
In Pavilion 2 service users were keen to be involved in voluntary work but were unsure how to access opportunities. There was a recognised need of the benefit of a computer to gain information enabling service users to pursue voluntary or paid employment. Subsequently one person previously involved in voluntary work re-established the connection with her employers and attended work daily from the ward thus engaging in meaningful employment.
In Croy House one service user felt she had been cut off from her usual social support network. Her children (both adults) lived in New Zealand and Canada and they normally kept in touch via e-mail and web cam. Since coming into hospital she was able to make contact by telephone only, as in-patients do not have access to a computer. It was therefore identified that access to a computer would enhance this service user’s experience of admission.
Through the completion of this tool it was recognised the use of a computer would enhance the service user’s journey of recovery. This service development would enable service users to communicate by e-mail with their friends and families and also to access information regarding benefits, voluntary work and additional information on their illness. This is supported by the Scottish Recovery Network (SRN) which identifies the importance of supporting and enabling people.
This new venture was welcomed by staff and service users. The involvement increased their motivation and their feelings of being valued, involved and appreciated.
Practice Detail
We used the Scottish Recovery Indicator to identify the validity of the tool and to benchmark our services. The aim of this was to allow us to consider areas of practice where we were proficient and at the same time highlight areas where we wanted to develop skill/expertise or knowledge in a recovery focussed manner. As this was a largely self assessment exercise we were free to actively explore our own practice and where necessary challenge ourselves.
The aim of providing nursing practice in a recovery focussed way was commenced by empowering nurses to embrace the principles of engagement and collaboration with the service user.
To encompass the service users strengths and together plan the care which is meaningful to the service user on his recovery journey.
One to one sessions with the service user allowed the opportunity for completion of a care plan based on the service user strengths and what they would do, as opposed to the identification of needs and problems.
This designated time for individual and group therapy provided the means of discussing hopes, dreams and inspiration for the future. It enabled the opportunity to get to know the person and their history.
Together they travelled the journey of recovery by recognising a collaborative approach underpinned by values based practice and innovative initiatives
Service users immediately responded to the recovery focussed approach and readily accepted the aspect of being responsible for their recovery.
The use of the SRI involved service user interviews where questions asked related to several areas of care and if basic needs were satisfactorily being met. These needs included housing, diet, physical and personal care and religious needs; it also questioned whether all service users had access to advocacy services.
The answers obtained assisted staff to identify areas of good practice as well as areas for development. For example, it was found that staff completed nutritional screening
Challenges
Several of the challenges were to empower staff to participate and contribute to the service provider interviews. Staff were supported to initiate the SRI as a practice development tool.
Approaches for finance were made to management for a printer, computer and internet access.
We continue to liaise with IT staff regarding a Protocol for this innovative initiative of patient’s receiving access to internet services. Supervision and monitoring of appropriate use will be met by nursing staff
An education/teaching package will be met by the voluntary sector
Facilitating access to pc’s in the community on discharge is to be arranged as part of the planned care by nursing staff to introduce new recreational and social interests.