Hodges' Model: Welcome to the QUAD: nursing care

Hodges' model is a conceptual framework to support reflection and critical thinking. Situated, the model can help integrate all disciplines (academic and professional). Amid news items, are posts that illustrate the scope and application of the model. A bibliography and A4 template are provided in the sidebar. Welcome to the QUAD ...

Showing posts with label nursing care. Show all posts
Showing posts with label nursing care. Show all posts

Saturday, September 13, 2025

On Care, Papers, Distance, Pressure, Academia and Falls

In my student nursing days late 1970s there was a big-stick of motivation. It wasn't management, and yet it was. There was a stigma attached to a patient developing a pressure sore - decubitus ulcers. The NHS then had many psychogeriatric wards, but that care is now with nursing homes. Despite the best efforts some patients did, especially on the mental health infirmary, which was staffed by 'general'  trained nurses too. Using aseptic technique wounds had to be packed (stage 3-4?). Some of the treatments, were not exactly 'evidence-based'. There is a historical account of previous treatments provided on 'Asylum Years'.

In the 1990s I was working on a 'book' about health, nursing and informatics (it was simpler then?). Submitting the project as a book proposal, a letter from one publisher reads: 'thanks but no thanks'. Although unsuccessful, that exercise accounts for the range of interests I still maintain today, and the scope of posts here on W2tQ. Continuing to clear and sort notes, one is for the 'book':

Abbott, P., & Payne, G. (Eds.). (1990). New Directions in the Sociology of Health (1st ed.). Routledge. https://doi.org/10.4324/9781351141727

From the above book, I've a page of notes headed "For chapter 2" drawing on a brilliant chapter 4:

Distance Decay and Information Deprivation: Health Implications for People in Rural Isolation

By George G. Giarchi

Abstract

Deprivation is frequently associated with the lives of inner city dwellers in old densely packed terraced housing, or with the residents in high-rise city slums and concrete council houses. In substantive socio-economic terms the deprivation of both the urban and the rural setting are the effects of the same structural dysfunctions, as aptly demonstrated by Townsend's 1968 classic study of poverty. On the basis of empirical studies rural deprivation affects the standards of health of many people in the countrysides of the UK particularly the most vulnerable dependent populations, such as younger children and older adults at the lower end of the social scale. The houses which are 'unfit' are damp, poorly lit, badly ventilated or lack healthy sanitation: clothes are rotten with mildew. Leschinsky's nationwide survey of rural health services indicates that centralization of health provision is a major reason for health disparities in rural areas.


I looked up the author, guessing that they were possibly still in academia, emeritus, or more likely (then, a decade or more in their career) retired by now. The search did not take long, but filled me with sadness and anger:

'A coroner has said there were "missed opportunities" to prevent the death of a hospital patient who died after developing a bedsore.

George Giacinto Giarchi, 86, died in November 2017 at Plymouth's Mount Gould Hospital after being treated for weeks at Derriford Hospital after a fall.

At Plymouth Crown Court coroner Ian Arrow said Mr Giarchi died of multi-organ failure from the pressure ulcer.

His family urged ministers to ensure hospitals had adequate staffing levels.

The former Plymouth University professor was admitted to Derriford Hospital after falling and fracturing his arm at home on 25 September 2017.

He was later transferred to Mount Gould where the lesion was first noticed.'

Pressure ulcers, known as bed sores, are injuries caused by pressure on the skin often seen in bedridden patients.'

https://www.bbc.co.uk/news/uk-england-devon-48798285

 Thank you and bless you Prof. George G. Giarchi RIP.

Jones, P. (2012). Exploring several dimensions of local, global and glocal using the generic conceptual framework Hodges's model. The Journal Of Community Informatics. 8(3). Retrieved from https://www.academia.edu/3794699/Reflecting_on_the_glocal_through_the_conceptual_framework_of_Hodges_s_model

Friday, October 14, 2022

Update on draft papers iii

There was news today about the draft paper on:

"First Episode of Psychoses, Early Intervention, Cardiovascular Nursing, Research Methods and Hodges' model."

It has been accepted and I can submit formally. 👍

This project - yes, a further distraction (that has borne fruit) started in March resulting in 4,800 words, an illustration of the model and 4 figures (2x2 tables). That I think, with the editors, guide the reader in applying Hodges' model, or at least the scope of its application, which is situated and person-centred.

I approached a journal regards the draft "Society, Technology and COVID19 in Hodges' model". Having reduced the original 12000 words to 7700, the paper is of interest, but is (as expected) too long. There is the possibility of reducing the word count to 5000, or splitting the essay.

This invites revisiting the original and teasing out the informational themes: fake news, mis- dis- malinformation and agnotology (in part 2?). Then I would (to a degree), finally be returning to the concept of 'information':

Jones, P. (1996) Humans, Information, and Science, Journal of Advanced Nursing, 24(3),591-598.

- which keeps 'calling' (with complexity, emergence...).

I will consider the options, but submit the above: an instance of much appreciated encouragement and support by the editors. Writing this has proved an enjoyable challenge.

As ever, if you have any sources to add to the bibliography, wonder about using Hodges' model I would be pleased to hear from you: h2cmng at yahoo.co.uk

Saturday, March 19, 2022

NANDA International's First Webinar

On Thursday a webinar - NANDA-I's first - provided an update on Nursing Diagnoses:

 

It wasn't just what is new and revised in the diagnoses that was of interest, but the explanation and discussion of the Level of Evidence criteria. Resources, challenges, ways to get involved, and future directions were also described. The levels of evidence criteria for diagnoses submission stood out, reinforcing how 'concepts' remain key to this work and application.

In the Q&A I asked about NANDA-I (and other classification schemes) contributing to the metrics for the Sustainable Development Goals (and not just 'health' SDG-3) and Social Determinants of Health. Since the 1990s nursing informaticians saw terminology systems and technology having a role in making nursing visible. This is crucial at the global* level of SDGs, SDoH and challenges that are not 'on the horizon', but are a present and real danger: climate change, conflict, pandemics, and mass migration. Despite such uncertainties, I found the event very encouraging.

 *local, and glocal too.

TABLE OF CONTENTS:

Part 1 The NANDA International Terminology: General Information

1 What's New in the NANDA-I 2021-2023 Edition
2 International Considerations on the Use of the NANDA-I Nursing Diagnoses


Part 2 Recommendations for Research to Improve the Terminology
3 Future Improvement of the NANDA-I Terminology
4 Revised Level of Evidence Criteria for Diagnosis Submission


Part 3 The Use of NANDA International Nursing Diagnoses
5 Nursing Diagnosis Basics
6 Nursing Diagnosis: An International Terminology
7 Clinical Reasoning: From Assessment to Diagnosis
8 Clinical Application: Data Analysis to Determine Appropriate Nursing Diagnosis
9 Introduction to the NANDA International Taxonomy of Nursing Diagnoses
10 Specifications and Definitions Within the NANDA International Taxonomy of Nursing Diagnoses
11 Glossary of Terms


Part 4 The NANDA International Nursing Diagnoses

Domain 1. Health promotion
Domain 2. Nutrition
Domain 3. Elimination and exchange
Domain 4. Activity/rest
Domain 5. Perception/cognition
Domain 6. Self-perception
Domain 7. Role relationship
Domain 8. Sexuality
Domain 9. Coping/stress tolerance
Domain 10. Life principles
Domain 11. Safety/protection
Domain 12. Comfort
Domain 13. Growth/development

Friday, April 09, 2021

Pioneering safe staffing whistleblower nurse dies aged 91: c/o RCNi

individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group
Graham Pink at his home in Manchester in January 2008
Picture: Neil O'Connor
courage : compassion : values : commitment : leadership


"A nurse who was among the first in the UK to blow the whistle on safe staffing issues has died aged 91.

Graham Pink first raised concerns about poor staffing and the dangers to patients when he worked at Stepping Hill Hospital in Greater Manchester in 1990. His four-year campaign to highlight inadequate staffing levels made a lasting impression on the nursing profession. Mr Pink died on 6 March in Barnsley, South Yorkshire.

Nurses caring for him remembered his safe staffing campaign

Speaking to Nursing Standard about his final months, his niece and carer Sarah Pink said: ‘Barnsley Hospital gave him a lot of care and attention and treated him with a huge amount of respect. There were nurses caring for him who said they knew him from what he did and how he stood up for the NHS back then. One sister said it was an honour to meet him and take care of him.’"

HRH The Duke of Edinburgh RIP

https://www.rcn.org.uk/employment-and-pay/safe-staffing

My source: RCNi via twitter: 

https://twitter.com/rogerkline/status/1380398894740348929?s=20

Sunday, July 12, 2020

Nursing: The Adult Patient 1966

"To the Student"

"To the Teacher"


individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group - population

"The ways in which the nurse helps people are infinitely varied, and she is being called on constantly to exercise the very delicate judgment." p.xiii




"Nurses respond to pressure in many different ways. Some withdraw, going as far from patients as possible. (They clean the medicine cabinet; it does not complain.) Some go about their work mechanically, refusing to get involved emotionally because involvement brings too much worry." p.xiv




"The  particular aim of the authors of this book is to assist you in understanding and helping each individual patient for whom you care. ...

"For a particular patient at a particular time, one aspect of nursing care may outweigh all others in importance."

"We believe that nurses need to develop a broad orientation to the care of patients, wherever the patient may be." p.xii

"All divisions in the study of nursing are arbitrary. There is unity of nursing, regardless of whether it is practiced at home, in a hospital, in a jungle or a desert; whether the patient is a child or an adult; whether the illness is physical, mental, or both." p.xiii

"Neither the "intercom" system nor the monitoring device that indicates the patients' vital signs was meant to supplant the nurse. ... In the future there will be more machines to perform mechanical tasks, but no machine can establish the creative, sustaining relationship with people that helps them to get well." p.xiv.
... Whatever their differences in social and economic background, temperament or relative state of health, your patients will have in common certain basic human requirements - skilled care, understanding and respect." p.xiii 

"Some try old social skills in new situations. These may or may not be applicable. Social chit-chat may make the nurse feel at ease but may be one way to avoid learning abount the patients' needs. Some nurses manage t ofind a a formula that is exactly right for them. They become involved enough to be concerned about helping patients, while continuing to grow and learn." p.xiv

"The nursing situation today is far from ideal. Many nurses face a staggering workload - not only in relation to the number of patients for whom they are responsible but also because of the greater responsibility that is being delegated to them as advances are made in medical science." p.xiv.

"Chapters on disaster nursing and world health problems have been included in the conviction that the profession of nursing has an important role to play during any disaster." p.x-xi



There is a definition of 'health' in this book (p.53), but no specific reference to nursing theory or models of nursing. Reading the references, the definition of health is neither derived from nursing or a WHO source. The definition does refer to health being more than the absence of illness.

Addressing acute contemporary issues, Chapter 59 'Nursing in Accident Disaster' includes Nuclear Disaster pp.1103-1114; while Chapter 60 on 'World Health Problems' is more comprehensive than I expected in such a book and at this time. Although the Cuban missile crisis was only fours years prior to publication.

Smith, D. W., & Gips, C. D. (1966). Care of the adult patient: Medical-surgical nursing. Philadelphia: Lippincott.

Saturday, June 13, 2020

Mirror 4: 'Health Career' = life chances

individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group - population


Meditations in an Emergency
May 21–August 30, 2020
UCCA

My source:
Dally, J. (2020) The art world gets back to business. Life&Arts, FTWeekend, 23-24 May, p.11.

Image source:
https://www.e-flux.com/announcements/329368/meditations-in-an-emergency/

Saturday, September 21, 2019

Quotidian Care

Hodges' model #h2cm -
Is this your 'daily' paper?
Is care integrated on a daily basis
(or any other basis)?

individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group - population
Quotidian: fancy word for daily, ordinary
Quotidian: is this 'ordinary' care truly personalised then according to the person's choices?
BEING - dressed & washed, content
Don't get lost in a preoccupation with tasks and what 'quotidian' means here.
A smile a day*
My name: my day, my night

Quotidian IS night & day
Basic Nursing Care
Hygiene, Skin, Activity, Mobility
BEING: Getting Dressed & Washed, content
Quotidian Malaria: paroxysms occur daily
being ALIVE..
The Handover
That apple* - balanced diet ...

 Basic Social - Personal - Care 
Social Visits, Relationships
Quotidian: OR "Not seen you in Ages!"
Social Activities, community
The Daily, Weekly Routine
Our time :together - our day, our night

Quotidian: (Reports?) By the Book
Work policy
Health and Safety
Are you/we overworked today?
Was there NO work today: ZERO hours?
The (Comprehensive) Record


*It's the attitude and effort that counts and knowing you're not alone.

Wednesday, March 27, 2019

Nursing's Golden Ratio: Safe-Staffing:Law

individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group - POPULATION

Care Philosophy:
Task orientation Vs Person-centred
(Reality: Hybrid that assures person-centredness?)

Individual Patient's, Friend's and Family impression

Individual Patient's, Friend's and Family experience (AND memory)

Confidence in Care
(Confidence as a Learning Environment)
 Individual Nurse's Values
Individual Patient Outcomes
PURPOSES 

Numbers - count
"40,000 missing Nursing" [RCN]
Ratios: x :: y
Staffing Research (Falls, Quality...)
Operational Research; Measures
Dependency; Chronicity; Nursing hours / day; Skill-mix; Care undone
Productive Nursing Care
Demographics: Local, National, Int.
TIME:
tasks, events, priorities, shifts
The E's: Efficiency, Effectiveness, Equity, Equality

 PROCESS
Qualitative



Duty of Care
Public awareness / sensibilities
History of Research into Staffing
(Time and Motion studies)

Direct Nursing Care
High Quality Nursing Care = The Golden Ratio

PRACTICE
Quantitative

Recruitment, Retention, Attrition
Workforce Planning
Professional Accountability
Commensurate: Policy - Law
NMC Code of Conduct
Contract of Employment
Employment T&C
Emigration Policy, Overseas Workers
Professional Bodies inc RCN, Unions ...
Nurse Administration Support
Information System - Synergy?
 POLICY



My prompt with thanks: https://twitter.com/DannGooding/status/1110929934262898689


Additional sources [ c/o @DannGooding ]

A critical moment: NHS staffing trends, retention and attrition
Health Foundation, ISBN: 978-1-911615-25-5

RCN

American Nurses Association, Nurse Staffing Literature Review

Friday, March 15, 2019

Under the SSKIN

Since W2tQ started almost 15 years ago a collection of 250 draft posts have gathered (virtual dust). Many are probably empty - half-baked ideas - with no clear title (reminder - of the contents).

In nursing there are (thankfully) constant reminders, one being: the need to strike a balance between the person, being least restrictive, assumed mental capacity, best interests and high quality care delivery.

Revisiting the threshold concepts, h2cm and deprivation of liberty safeguarding draft paper brings recollection of a draft post and the lesson:

In many nursing situations you cannot assess what you cannot see.

In Nursing Times 29.11.11 a Nursing Practice comment item was titled:

“Compulsory training would help every HCA spot moisture lesions” 


Denise Elson, points to the SKIN (Surface, Keep moving, Incontinence and Nutrition) bundle as a set of very useful principles, and further refined to SSKIN:

https://www.plymouthhospitals.nhs.uk/tv-sskin
SSKIN - Surface: Skin inspection: Keep moving: Incontinence: Nutrition

The Tissue Viability use the principle of SSKIN:
  • Surface: make sure you're on a supportive surface 
  • Skin inspection: check it isn't discoloured or sore 
  • Keep moving: change your position often 
  • Incontinence: keep clean and dry 
  • Nutrition: eat healthily and drink frequently ( https://www.plymouthhospitals.nhs.uk/tv-sskin )

As a reflective exercise, if needed, think about SSKIN within h2cm - Hodges' model. Not just the physical (SCIENCES) focus but how these relate to the INTRA-INTERPERSONAL, SOCIAL, POLITICAL and the SPIRITUAL. We will revisit this using h2cm.

On the blog's 15th anniversary 20th April, I'll also try and put some numbers together.

Whitlock, J., et al. (2011) Using the skin bundle to prevent pressure ulcers. Nursing Times; 107: 35, 20-23.

See also:
Tissue Viability Society

Monday, September 17, 2018

The Economist: a Nurse, an Obituary - Lini RIP

individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group

Lini



Many Keralans work in the Gulf.

More lucrative than staying at home.

Dream of Gulf as a magical place.

Proud pictures taken outside the house.

Study

Motivation
Ambition
Love

Lini - died of the Nipah Virus
(fatal in 70% of cases)
May 21st 2018, aged 28

Night shift
Patient admitted: Mohamed Sadiq from Changaroth Panchayat
Fever, breathing difficulty
Fluids, paracetamol, change of clothes,
sit with all night long
The patient died after a few days

 Travel by bus to work from Chempanoda, slow but beautiful journey across rivers, areca-nut and rubber trees, past wooded hills. The Western Ghats tower to the east, catch the evening sun.

Bats - infected water, or the mangoes nearby.

Lini was studying to improve her knowledge ...
Puthussery
(family)


Lini --------Sajeesh
|
|
---------------
|                    |
Rithul (5 yrs)       Sidharth (2 yrs)

Sajeesh, away 5 yrs Bahrain working as an accountant
Daily phone calls, returned a few times a year
Able to afford 1 storey brick house

Social media - rumours
Origin of infection?
to be eligible for a permanent government nursing job.

On contract to Perambra Taluk hospital
Upgraded from a community health centre 10 yrs ago
Still short of doctors and specialists
Difficult cases still go to Kozhikode 50km away

Lini worked as a daily-wage nurse - flexible hours.

Place not quite paradise as farmers at times gathered to protest when their land was misclassified as protected forest and claims to ownership were rebuffed.

Husband tried to get a family visa, but
Lini wanted a nursing job in Gulf first.
(She loved her work too much)


Obituary, Lini Puthussery, The Economist, June 2nd, 2018, 427, 9094, p.86.


Wednesday, August 01, 2018

ii Yes, Nursing is both an Art and Science but ...

The value and provenance of 
nursing, 
nursing's benefits and 
high quality nursing care 
cannot just be a matter of 
record*
on paper, screen, media 
or artificial neural network ...

individual
|
INTERPERSONAL : SCIENCES
humanistic ------------- NURSING as ART & SCIENCE ------------ mechanistic
SOCIOLOGY : POLITICAL
|
group
Nursing ... 
and its many dimensions ...

"How do you prove that you own a work of conceptual art? This is an interesting issue in today’s art market, with the trend towards the dematerialisation of art, and the primacy of the idea over its physical presence."


"For example, the late US artist Félix González-Torres’s works include “Candy Spills”, in which wrapped sweets are piled on the floor or in a corner, to be taken and eaten by viewers. When the pile has gone, the owner of the work replenishes it. So what stops anyone making and selling their own “Candy Spill”?"

"The answer is the certificate of authenticity issued by the artist or their estate. This scrap of paper is, in fact, the only proof that the work of art genuinely belongs to you, and this is actually what you buy and sell."

*
1. Often heard: "If it is not written down, it never happened."
2. Nurse registration.
3. The Uniform ™

Georgina Adams, Conceptual: only worth the paper it's written on, Financial Times, Life & Arts. June 9, 2012 p.11.

Wednesday, March 14, 2018

PROCESS and tick the boxes DO

For four decades at least and much longer (70 years?) within many health services there has been a preoccupation with process. Patients and carers may then perceive such services and how services are delivered as machine-like. As a whole the experience then constitutes an actual output - an outcome of clinics, appointments, waiting lists, tests and treatments. This is very unfortunate amid ongoing claims for services that are person-centred, individualised, patient oriented and even patient-first.

The patient is left to feel like a diagnosis, or even worse a problem in search of a diagnosis; tossed from one clinical encounter to another. In-between all this activity there are hopefully some compassionate brush strokes that soften the picture and patient experience. If not people notice the impact on values and quality of care ...


Whenever I see the word 'holistic' I wonder if it really is holistic? Yes, you can be holistic by ticking all the boxes, but nursing involves much more.

individual
|
INTERPERSONAL : SCIENCES
humanistic --------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group

✓

✓

✓

✓


'Process' has been delivered at the door of nursing by management and the appeal to theory to inform practice. Nursing itself produced the 'nursing process'.

The nursing process through the stages of assess, plan, implement and evaluate prompted the argument that nurses were processing patients. To nurses of a certain age the nursing kardex, the record filled in every shift mirrored the nursing process. In a way recourse to process is not a problem, it is inevitable. It is to be expected. As we deal with space, time, risks and decisions ... we have to make judgements that are invariably process bound.

The four P's can help to 'balance the books' ...

individual
|
INTERPERSONAL : SCIENCES
humanistic --------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group

PURPOSE

PROCESS

PRACTICE

POLICY


We need to remind ourselves of the four P's as they affect us individually and as organisations and collaborative agencies.


PURPOSE

PROCESS
PRACTICE

PURPOSEPROCESS
PRACTICEPOLICY


Perhaps, patient engagement can be defined as when the tick-boxing is obvious but it is also taking account of the 4Ps (and in a way beyond tokenism). For example, patients, carers and the public involved in policy review? The patient is then more realistically involved in the activity. Anything else, really is a tick-box exercise.

Progress has been made (at least in the four decades of my purview). Government policy is in continuous development but there remains - as ever - much to do. Especially in spanning the various distances that apply from policy, experience, care to be delivered and how; from the individual to the health services and health system as a whole.

('P'rogress! Mm... Is there another way to measure progress?) ;-) 

Monday, May 30, 2016

Book: Secret diaries - span the generations...

http://www.meulenhoffboekerij.nl/

Dutch Bestseller, 'The Secret Diary of Hendrik Groen'


Hodges' model can span the generations through 'life chances' and the 'health career'...


Book cover image: Publishers Weekly

My source: Paxman, J. (2016) Diary, FT Weekend, Life & Arts, 28-29 May. p.2.

Saturday, August 15, 2015

In order to listen... 4 holistic care...

As we 'listen' to patients, carers and others in need of care - verbally and non-verbally - we need for safety's sake to be aware of our starting point and where we are heading. Even if only roughly, amid raw emotions, pain, confusion, fear and hope - that next step must be a safe one.

Is there a logic to the steps being taken? There may not be. Sometimes it is listening and being there. There may not be a clear destination, but how will we know when we have arrived at that point in-between? If the way becomes unclear, what signs do we read that might point to the need for an extra hand on the tiller?

Do we have the tools to remain oriented? Is there a compass-4-care? A re-source to map the journey we are both being taken upon?

If listening is but a part of holistic care, is there a tool we can utilise to integrate these many and yet unique journeys?


Source - title:
Alicea-Planas, J. (2015). Listening to the Narratives of Our Patients as Part of Holistic Nursing Care. Journal of Holistic Nursing, Volume XX, Number X, XXXX. doi:10.1177/0898010115591396

Thursday, May 21, 2015

NMC Code and Guidance on using social media responsibly

http://www.nmc.org.uk/standards/guidance/social-networking-guidance/
NMC: Guidance on using social media

In March the Nursing & Midwifery Council published a new Code for nurses and midwives.

There is also guidance on the use of social media for this group of health professionals.


https://www.nmc.org.uk/standards/guidance/social-media-guidance/

Saturday, March 15, 2014

So many gardens: Press Release [ now ]

It had to happen. Twice over.

The irony that just as so many homes with older people living in them have gardens that are in a state of neglect, so too do many nursing and care homes.

Of course this is a sign in those domestics homes of reduced abilities.

In the residential care and nursing homes, garden neglect is reassuring.

A $ure sign that the love and spending is on the blooms inside?

Monday, March 03, 2014

The limitations of the healthcare sector


4
many
decades there 
have been recurring 
issues, austerity measures, 
requirements, policy challenges, 
policy initiatives, gaps between theory 
and practice, a crisis in compassionate care, 
rising waiting times and a plethora of other concerns.

All these then and much more 
affect the
 healthcare
 sector

Clearly, there is no 'magic wand', but there must be a way to address some of the difficulties? 
Within health and social care, locally, nationally and globally we need a tool to help improve interprofessional reflective practice, to support person-centered, holistic care across physical, emotional, social, political and spiritual domains of care. 

The future demands a resource (free, open, easy to learn) that can also facilitate self-care, health literacy and the many carers within families and communities.
So, how big is your picture?



Sector_of_Circle.jpg Wikimedia Commons

Thursday, January 09, 2014

Resistence is futile: give in to the obvious need for the 'nhm'


INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

individual
nhm

ohm + nhm


nhm

nhm (+ ohm!)
group - population


ohm: The ohm (symbol: Ω) is the SI derived unit of electrical resistance, named after German physicist Georg Simon Ohm. (Wikipedia)


nhm: The nhm (symbol: +).
However, the principles do not extend to problems posed by cognitive impairment as a result of the illness and the ever present danger of wandering, seeking old and familiar surroundings, or acting on memories from years gone by. Some patients become aggressive at times; the service must have mechanisms for managing patients effectively in ways that recognise their inherent worth and humanity. The stigma and abbreviated autonomy that is implied in managing people with dementia requires a new holistic method of managing their care that relates the care to the patients'/service users' values. p.80. [my emphasis]

Heginbotham, C. (2012) Values-Based Commissioning of Health and Social Care, Cambridge, CUP. (Review to follow).

Wednesday, November 20, 2013

Consultation on the proposed withdrawal of the SNOMED CT national care planning content

In addition to responding myself, I notice on the actual consultation page on 'Citizen Space' there is an option to share this consultation.

Dear Peter,

You are registered for the care planning content via the HSCIC Technology Reference data Update Distribution website.

The national Care Planning Content is designed for use to support care planning functionality across health and social care. This functionality crosses many professions/sectors which may have differing descriptions for a care plan in the traditional health record (e.g. treatment plans, birthing plans, support plans, intervention plans or care order sets). The content can support the interoperation of care plans across boundaries and paper based care plans based on the pack have also been used successfully to gain greater familiarity with structured terminology (SNOMED CT).

More details at: ...

The absence of a declared owner or sponsor for this product means that we are proposing to withdraw it and are keen to hear views and understand the impact of not maintaining this content and its associated services.

We have a number of questions to determine how information Standards could best support the development of a standard for care planning, the consultation can be found at: ...

- and we would value and encourage your feedback on this proposal.

If you have any questions regarding the above you can contact us by sending an e-mail to information.standards AT hscic.gov.uk. This is the preferred form of communication.
...

Regards
The TRUD support team
Health and Social Care Information Centre

Tuesday, October 01, 2013

Time, History, Technology, Institutions, Transparency and Reflective Practice










Despite the passing of time
refactored as
institutional history
 and
 technical solutions,
reflective practice
and
transparency
in care
remain aspirational.










Image: Sculpture at Prague Congress Center