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Workarounds and Their Implications for Patient Safety.

What is a workaround? Identify a workaround (specific to technology used in a hospital setting) that you have used or perhaps seen someone else use, and analyze why you feel this risk-taking behavior was chosen over behavior that conforms to a safety culture. What are the risks? Are there benefits? Why or why not?
Discuss the current patient safety characteristics used by your current workplace or clinical site. Identify at least three aspects of your workplace or clinical environment that need to be changed with regard to patient safety (including confidentiality), and then suggest strategies for change.

Sample Solution

sometimes necessary in times of crisis however discussing this in supervision, I reflected that this can compound the power imbalance between worker and service user. To be empowering my role should be to encourage Miss X to engage with services that support her to develop her tools and resources that is if a crisis arises again she can draw on her own positive coping strategies to manage thus enabling her to achieve better outcomes for herself [Huston 2015] Miss X began working with a Psychologist from TSS, to ensure all professionals involved were working consistently and coherently a multidisciplinary case review was convened. This was a very positive experience of multidisciplinary working an information sharing with the view of improving outcomes for Miss X. From this all professionals involved including myself gained an understanding of the effect Miss X’s attachment disorder had on her ability to communicate her thoughts, feelings and emotions. Before Miss X could focus on gaining the tools and strategies required to master independent living, she needed support to develop her emotional framework. McCreave (2004) argues that once a person becomes traumatised everything else in life becomes secondary to them, if Social Work fails to recognise the impact of trauma, it may fail to recognise the reasons why Service Users may not engage or may not accept supports or services. As a practitioner, I had to rethink my intervention, whilst Miss X was in this period of crisis with heightened anxiety, it was not only unrealistic expecting her to complete independent living skills but it was compounding her anxiety therefore a different approach had to be adapted. I adapted person centred techniques in conjunction with elements of Motivational Interviewing and pro-social modelling. I felt using scaling questions when Miss X displayed certain behaviour worked well in helping her to make the links between identifying how she was feeling and enabling her to link this with the emotion with the behaviour she was displaying. As this work progressed, I began to change the type of questions I asked. I wanted to use questions that would enable Miss X to consider what her future looks like if she continues thinking the way she is and what it looks like if she changes her behaviour (Britt et. Al, 2004). This really worked for Miss X. After a period of time she was able to verbally communicate how she had been feeling. Teaching from this module helped me identified Narrative Theory as an important tool in Social Work. The use of Narrative theory can provide Service User’s with new meaning to their stories (Seo et. Al, 2015). The benefit of adopting this approach meant by listening to Miss X’s negative story I could support her to reconfigure this to positive interpretations (Seo et. Al, 2015). The Ethics of narrative practice, are based on respecting individuals as experts in their own lives (Williams, 2014). During the course of completing this module reflecting on action a dilemma I have encountered is sometimes trusting the Service Users are expert in their own lives when they make choices and decisions which seems to contradict the ‘expert’ title. For example, Miss X decided at 18 she wanted to have contact with her birth mum. Miss X had not seen her mum since the age of 2 and it was deemed unsafe for her to have contact growing up. As an adult Miss X had a right to contact her mum and she had several questions she needed answered. I respected Miss X’s right to do so but my initial reaction was to try and shield her from further hurt. I had been working with Miss X for several months and she was finally in a good place emotionally and I was worried meeting her birth mum would set her back. Reflecting on the work we had completed on developing her emotional language and framework, I hoped Miss X had developed the resources required to cope with such an emotionally charged meeting. In respecting her choice whilst not fully agreeing with it, I supported Miss X to prepare by helping her formulate expectations she had for the meeting and helping her see how she may feel if these expectations weren’t met. By adopting a strengths based approach, I praised Miss X for her courage and we completed role plays to enact what Miss X wanted to say to her mum. In doing this Miss X knew she had been listened to and she felt empowered to so something that was vitally important to her.

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