Nurses Profound and Multiple Learning Disability Pathway Meeting 5th November 2012
Attendees
Katrina Dickens Learning Disability Acute Liaison Lead Nurse
Karen Sibson Bassett Street
Sam Screaton Mansion House
Andrea Domokos Community Nurse
Heather Newton Community Nurse
Tracey Charity Community Nurse
Emily Wellard Student Nurse
Tendai Simbanouta Student Nurse
Apologises-Heather Crozier- Charnwood Team
Introduction
Discussion was made and it was agreed that the pathway be called Complex Health and Well-being Learning Disability Pathway. This will be taken back to the meeting on the 19th of November 2012 for further discussion.
Diagnosis-knowledge of awareness of associated conditions.
Observations/baseline/monitoring/circulation,breathing
Body Measurements-BMI,MUST (weight,height)
Aortic Aneurym Screening (AAA),
Annual GP health check.
Health Doc→signpost→Core pathway
Medication
-Side effects.
-Baseline.
-Compliance/ concordance
-Knowledge of routes of administration.
-Ensure good protocol in place.
-Ensure reviews happen.
-Administration-role of the Prescriber District Nurse
Pain
-Knowledge of communication needs.
-Behaviour related.
-DISDAT pain tool.
-Ensure pain is addressed.
-Ensure investigations take place.
Respiratory
-Refer to GP, asthma nurse
-Support clinic work
? refer to physio postural drainage.
-Use of oxygen therapy.
-Tracheostomy (very limited).
-Suction- we do but do not train in. Only do in inpatient as nurses.
Urinary
-Management/ recognition of infection.
-Support assessment of continence ( including bowels).
-Support use of continence aids.
? knowledge of catheter care.
Epilepsy
-see Pathway
Digestion
-Nutrition see “Eating and Drinking Pathway” including enteral feeding,if due to Mental Health-see Mental Health Pathway.
-Dementia- see Dementia Pathway.
-Challenging behaviour-see Challenging Behaviour Pathway.
Bowels – bowel screeningfor over 60 year olds.
-signposting to GP, specialist.
- support/monitoring.
Basic dietary advice-healthy eating
Skin-
(Waterlow,WISSK)
-Tissue viability.
-Health promotion/hygiene.
-Signposting re: moles (cancers),sun awareness.
-Signposting to:
tissue viability specialist, physio for moulded chair, ?OT for seating.
Physique/Mobility
-Falls see Pathway
-Signposting to Physios (24 hour positioning and equipment),OT (environmental adaptations).
Feet
-Signpost topodiatry,physio,orthotics.
Oral hygiene
-Support.
-Desensitisation.
-Signpost to Dentist.
-Acute Liaison Nurse involvement.
-Signpost to dental hygienist for good oral care.
Eyes/Ears
(Vision and hearing checklist)
-Awareness of conditions associated with sensory loss.
-Signposting for screening waxing.
-Desensitisation training/ support.
Female Sexual Health
-Signposting for family planning, screening
-Supporting
-Desensitisation.
-Menstrual pain-support.
-Education /training
-Relationships
-Signposting-screening, breast awareness, cervical,HPV vaccination, Chlamydia
Male Sexual Health
-Signposting – screening for prostate, testicular awareness.
-Signposting- family planning.
-Relationships
Sleep
-Sleep hygiene
-Monitoring / support.
Mental Health
See “Mental Health Pathway”
-Stressors.
Lifestyle risks
-Health promotion:
exercise, smoking, drinking,self injurious behaviours
-Risk assessments.
Overarching
Care co-ordination
Communication- accessible information
Capacity
Consent
Involvement
Best interests
Awareness training- training for specific needs- impact of health issue
Health promotion
Continuing Healthcare assessment (DST)
Next Meeting
19th November 12-2 GF Meeting room Mansion House.