FNP550 - Midterm review

docx

School

Toronto Metropolitan University *

*We aren’t endorsed by this school

Course

550

Subject

Sociology

Date

Jan 9, 2024

Type

docx

Pages

Uploaded by CommodorePuppy3931

WEEK 1 Lordly and McLellan (2012) - Dietetic students’ identity and professional socialization Professional socialization - Process by which people selectively acquire the values and attitudes, the interests, skills and knowledge current in groups of which they are, or seek to become, a member. - Dietetic students bring previous life experiences To the process of professional socialization, and their formal dietetic education (the place where they gain competencies associated with the field, and where they develop an identity as practitioners) exposes them to value systems knowledge and language that may be new to them but it has been established within the profession - Study about how dietetic students ended up studying this and how the program has changed them - Most said they were interested in broad areas before, like loving cooking and physical activity and health - Some said there was an interest in health and exercise - When they were asked about a career they were interested in before it was medicine or dentistry - Students weren't aware of what the profession of dietetics entailed - Students enter programs because of a natural affinity to health Early influences of entrance into dietetics - Health conscious active parents - Trying to eat well and keep their kids active and themselves - Eating environment - Affordability when younger, independance on eating behaviours growing up, what your family purchased… - Expectation of attending university - Parents wanting you to be a doctor or medicine related profession - Mother’s dieting practices - Looking at the way mom did diets while growing up and always trying to lose weight - Family member with health issue modifiable with diet

- Accommodating family members’ dinners due to conditions or diseases - Disordered eating: self or family - Having experienced one or close to one causes intrigue - Seen as a model or advocate (others, close friends or celebrities) - Seeing how some health professionals achieve things that advance health and nutrition - Seeing other people’s diet pattern and wonder how they should be eating - School as a platform to learn science and sports - Working at grocery stores, seeing and loving science at school, working at different sides of the nutrition spectrum like manufacturing vs retail - Exposure to course work - Understanding the different sides of dietetics beyond the clin ical dietitian - Internship involvement - Getting involved in volunteering programs and unions at college, working towards helping people benefits you and others - Getting connections and opportunities to exposure to practitioners - Meeting dietitians and future colleagues, getting to talk to them about their professional life and personal life - Professors as role models - They shape our education and make you feel comfortable while getting knowledge Main takeaways - Purpose is to find a better understanding about identifying an d developing professional socialization among undergrad dietetic students - Important to teach about open mindedness and how social norms and values change overtime - Teaches how to adapt and provide equitable care - Contribution of early influences -> the interest of future dietetics students begins in early life experiences, which can happen through broad interests in medicine and helping others, or in interests like cooking and physical activity. Its about how their life journey has been linked to food and the role food has had in their lives - Contribution of dietetic education -> differences between the expectation of an internship and the actual internship

- When student’s beliefs and values clashed with instructors, they tend to agree with them and conform to their beliefs -> can be due to the need for good grades or to think they know best and are unconditionally role models MacLellan, Lordy and Gringas (2011) - Professional socialization in dietetics - Professionalization -> complex and interactive process by which the content of the professional role is learned and the values and attitudes integral to the profession and sense of occupational identity which are characteristic of a member of that profession are internalized - Process by which we develop a professional identity - Self-regulation, adoption of code of ethics, formal education… Where? - Formal academic education and internships or clinical training - Provides environment where students can from a new identity of themselves as health professionals Personal accomplishment - Dietitians perceive only a moderate sense of accomplishment - They feel as if they only had a moderate influence on others - Dietitians feel they lack power in the workplace, when doctors had the most power - 2007 - American Dietetic Association found that dietitians feel undervalued and have low opinions of their profession and themselves - Public option says 93% of canadians view dietitians as the most credible and reliable source of nutritional info Professional identity -> image an occupation can project to its clients, public and other professionals and to governments - Dietitians need to have a clear notion of their identity and the boundaries of their roles on the health care team How do dietitians become dietitians? - Personal interest in nutrition has been the strongest factor influencing a decision to study dietetics Stages of professional socialization - Phase 1: presocialization (before formal education)

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

- Coming with individual preconceived notions and expectation of the profession, unique attitudes and beliefs that influence their views of their future roles - Thinking about the reason why you have chosen dietetics, thinking about early influences and other later factors such as job accessibility - - Phase 2: formal socialization (during formal education) - Beginning to maybe see a lack of congruence between expectations and the school’s expectations -> leads students to behave how they think instructors want them to behave - The disappointment of expecting to treat people but first year did not include any contact weight patients - Then, the disappointment of wanting to develop relationships with patients in internships, but the instructors wanted them to develop skills required to fulfill duties - Nurses became less invested in serving patient and more concerned with how other members of the healthcare team saw their work - Phase 3: post-socialization (during practice) - Socialization continues after students graduate - Its a career-long iterative process of reworking professional identity - Stages of assuming adequacy, realizing practice, and developing a reputation Participants in the socialization process - Family, friends, educators, role models, and peers - Creating a safe environment and positive student teacher relationships to help students develop their professional capacity - Students rely on one another for support and to cope with the demands of clinical practice WEEK 2 Burton (2000) - Critical essay on professional development in dietetics through a process of reflection and clinical supervision - Clinical supervision has been proposed to help practitioners effectively manage change and improve practice

- Clinical supervision promotes professional development and safeguards standards, the development of expertise and delivery of quality care - Clinical supervision - an enabling and developmental process - Reflection - important part of clinical supervision - Ability of the practitioner to examine their own actions, thoughts and feelings - Active process that allows self-awareness, learning and professional expertise - Reflection-in-action - dynamic process, thinking on your feet - Reflection-on-action - retrospective process, thinning about what has occurred after an incident in an attempt to make sense of what happened - Reflection-before-action - thinking through a situation in advance of taking action - If you fail to plan, you plan to fail Carper’s 4 ways of knowing - Empirical - Technical knowledge - Ethical - Knowing right from wrong - Personal - Self understanding - Aesthetic - The art of practicing Role of the supervisor - Monitor - professional standards - Manager - ensuring policies and practices are followed - Teacher - imparting knowledge - Mentor - supportive relationship - Therapist - providing counselling - Analyst - insights into the art of the profession - Mirror - facilitating the explorations - Trainer - providing training in practical skills - Evaluator - assessing dietetic competence and standards of care - Reviewer - formulating new interventions - Facilitator - assessing supervisee’s stress levels and providing support - Professional representative - providing a role model for professional practice Benner’s 5 levels of reflection

- Stage 1: Novice (Unconsciously incompetent) - Stage 2: Advanced beginner (Consciously incompetent) - Stage 3: Competent (Consciously competent) - Stage 4: Proficient - Stage 5: Expert (Unconsciously competent) Elements required for success: SCCOTTC - Skilled supervisor - needs the knowledge and skills to perform role effectively - Committed supervisee - developing interpersonal skills and actively contributing to the process - Commitment - needs to come from the organization staff and other colleagues - Organization - needs to value staff and have explicit due to revources - Time - uninterrupted time away from the work place - Training - essential for all concerned in the process - Culture - Understanding organizational assist on orientation of new practitioners Barr et al. (2002) - The value of experiential educations in dietetics - Survey of RDs who passed the exam were asked to self-report their perceived value of professional preparation in 4 areas of dietetic education - Didactic program - Supervised practice - Work experience - Continuing education Experiential learning - Reflective and repetitive model - Active participation in events or activities that lead to the accumulation of knowledge Lack of confidence - This is seen in entry-level dietitians and it may reflect the nature of the first position - When it is in clinical dietetics, confidence and authority to make managerial decision is developed through years of practice and greater role responsibilities Levels of preparedness

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

- The majority reported feeling adequately prepared or very prepared for their first job as an RD regardless of the degree obtained (graduate or undergraduate) Results - Internship - highers response for all aspects of professional development - Didactic program - knowledge was the highest contributor - Internship - contributed the most to skill developm ent - Work experience - contributed the most to confidence - Continuing education - contributed the most to knowledge WEEK 3 CODE OF ETHICS - Ethics - the values that guide dietitians decision and actions in various contexts - Code of ethics - developed to articulate the application of 4 healthcare ethical principles which guide evidence-based dietetics practice - Beneficence - Non-maleficence - Respect for autonomy - Respect for persons/justice - The college holds members accountable for adhering to the Code of Ethics, and will inquire into allegations of a breach and take appropriate action in relation to the severity of the breach NONE OF THE DOCUMENTS AND LEGISLATION SHOULD BE READ OR APPLIED IN ISOLATION OF THE OTHERS Ethical principles Respect for autonomy - Dietitians will treat clients and their SDM as self-governing decision makers - Acknowledge and accept client’s choices when obtaining informed consent for nutrition treatment and consent for collecting and disclosing personal health information - Consider the specific needs, wants and goals of clients to provide client-centred services - Be open to client input, respect decisions, accommodate choices and document the treatment accordingly

Beneficence - Dietitians will act in the best interest of clients and society - Demonstrating professionalism, constructive dialogue and civility in all communications and social media - Report inappropriate behaviour or treatment of a client by fulfilling reporting obligations - Take responsibility by being accountable for one's actions when practicing dietetics - Bill clients to reflect the extent of delivered services and maintain financial records whenever billing occurs in dietetic practice - Practice using an evidence-based approach to meet a client’s needs - best evidence in balancing anticipated benefits and risks in supporting decisions - Collaborate with interprofesional colleagues, participate in and contribute to decisions that affect the wellbeing of clients Non-maleficence - Dietitians will avoid and minimize harm to others - Provide accurate and truthful information in all communications - Refrain from communicating false, fraudulent, deceptive, misleading, disparaging or unfair statements or claims - Refraian from verbal, physical, emotional and sexual harassment - Uphold professional boundaries and abstain from sexual relationships with any clients - Avoid conflicts of interest - refrain from accepting gifts or services which potentially influence or may give the appearance of influencing professional judgement - Practice within the limits of individual competence and scope of practice, know when to refer and collaborate with the inter professional team - Remain conscious of the need to be risk -aware and to identify any potential type of harm when practicing dietetics - Identify risk of harm (type, likelihood, frequency, impact, duration…) - Determine how best to mitigate the risk of harm in the specific situation, respond with appropriate actions and apply protective factors - Deciding to do nothing may be a viable risk response but avoiding a response or ignoring a risky situation may lead to harm or misconduct

- Determine whether others need to be involved in the decision making process, development and implementation of the protective factors Respect for persons/justice - Dietitians will show respect and treat others fairly and equitablyt - Act in a caring afrespectful manner and treat people with dignity - Provide culturally safe and competent care - refocus your behaviour, attitude, awareness, knowledge, skills and policies to better serve the interests of the public - Collaborate with others to reduce health disparities and protect human rights; promote fairness and equitable treatment - Maintain objectivity, which is essential for any dietitian in order to exercise professional judgement - Be collegial, have an understanding of how to work effectively with others and to manage conflicts - Contribute knowledge, skills and judgement and a professional attitude focused on client welfare to activities promoting safe, client-centred dietetic practices COLLABORATIVE CARE PROFESSIONAL PRACTICE GUIDELINE PURPOSE: to set out the knowledge and behaviours that a dietitian mst demonstrate when working in collaborative care teams and environments - Helps dietitians integrate knowledge, skills, attitudes and behaviours in utilizing their professional judgment when working with interprofessional colleagues CHARACTERISTICS: Guideline statements are interrelated and used in combination with other college documents such as the code of ethics and standards of practice and relevant legislation, policies and other guidelines - Collaborative care: style of care involving a team of healthcare providers and a client who work in a participatory, collaborative and coordinated approach to share decision making around health and social care - Collaborative care team: clients and their healthcare providers work together to achieve the optimal health outcomes - could be the team located in the same practice setting and interacting closely, or providers working independently but providing care to the same client

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

- Collaborating: active partnership based on sharing, co-operation and coordination to solve problems and provide a service - Interprofessional: more than one health care profession on a health care team who work together - Interprofessional Care: provision of comprehensive health services to clients by multiple health caregivers who work collaboratively to deliver quality care - Interprofessional collaboration: the process of developing and maintaining effective interpersonal working relationships with learners, practitioners, patients, clients, families and communities to enable optimal health outcomes Section 1: Role, Responsibility and decision-making - Collaborative care should be client and family centered - Active participants in care: professional team, family members and clients - Client or SDM is key participant - When possible, client should be treated as member of the team - If capable and desirable, client may act as the leader to become active participant in their own care - Clarify team members’ roles and responsibilities as part of each client’s care plan - Understand who is capable to do what in terms of treatment - Clearly define who is on the team, what are the roles and responsibilities and what will each person do - These will differ depending on the specific needs of the client, setting… - Dietitians exercise professional judgment within the limits of individual competence and collaborate with others, seek counsel and make referrals as appropriate - There should be mutual respect and trust in the team - Document roles and responsibilities in care plan - Dietitians are accountable for dietetic services delivered in collaborative environments - Professional obligation to maintain individual accountability when practising dietetics - Dietitians should use critical thinking, problem solving and good judgment

- Must ensure maintenance of comprehensive client health record when nutrition assessment and intervention is provided - Records provide accountability of what was done by whom - Shared evidence-informed decision-making for safety and quality care - Dieititans are encouraged to work in a participatory and coordinated approach when providing collaborative care - evidence -informed decision-making - Decisions should be made based on the client’s informed choices and healthcare professionals working together to ask, access, and act on research evidece Section 2: Communication, conflict management and evaluation - Effective collaboration requires effective communication - Establish a clear process and have a shared language - Be acutely aware of whether your communication is getting through - Communication is a continuous process, reflection and learning op - Develop a process and format of client health record keeping for effective communication - Timely and clear record keeping prevents gaps, errors and duplication - Duty to be collegial and communicate effectively - Active listening facilitates information sharing - There should be a strategy for conflict management - Establish process for conflict resolution and decision-making - Be able to identify conflict - If dietitians are concerned about the safety of a nutrition intervention recommended by others, address with the individual practitioner - Address conflict in a constructive manner - Should have a clear leader - Together the team determines who will it be and it may change or alternate from time to time based on the care plan and priorities - Consider when it is beneficial to document who is the team lead - Team functioning and evaluation - Establish group expectations and clear process to evaluate whether the team is meeting goals - Evaluative measures - Team members need to learn about, from and with each other

- Reflect standards of respect and civility - Teams function best when they have shared team values - Education and training - Continuous individual and collective learning and training - Reflect on practice and professional competence to identify any gaps and develop plans for professional development - Seek out opportunities to learn from each other to enhance the effectiveness of collaborative efforts - Opportunities for team members to connect with and educate each other based on their respective knowledge bases and expertise to enable the best possible outcomes ETHICAL PRACTICE KNOWING AND DOING - Ethics is about the values that guide a dietitian’s decisions and actions in dietetic practice - In dietetic care, we can't separate our actions from ethical considerations - what we do and dont may have significant meaning and impact on clients - New code of ethics - to better demonstrate how to be more deliberate, purposeful and more open to the participation of others in our decision making PROFESSIONAL JUDGMENT - Applying knowledge, skills and experience, in a way that is informed by professional standards, laws and ethical principles, to develop an opinion or decision about what should be done to best serve clients Building blocks of professional judgment: - Knowledge - foundation of professional judgment through academic and practicum experience - Professional obligations - to practice safely, competently and ethically applying laws and ethics standards - Client input - consider needs, wants and goals of clients for client-centred services - Experience - practical wisdom, reflective practice and examining outcomes ICDEP - Version 2.0 - april 2013

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

- Version 3.0 - july 2020 - Discussions suggesting an update started in 2016 - Best practice for competency updates is every 5-7 years Issues found in 2016 - Need for clarification, refinement and currency - Need for a glossary and interpretation guide - to avoid inconsistency - French translation was problematic, inaccurate and inconsistent - Foundational knowledge needs better integration into PCs and PIs - PCs should more clearly stand alone as the expected workplace outcome of pre- registration education and assessment - PI language needs improvement - less redundancy and clearer expectations Process to develop v3.0 - Volunteer working group - 2017 - Pan-canadian, academic and practice education representation - Resource limited - Multi step approach - Brings knowledge and experiences from practice - Reviewed literature and documents - Had debates and discussions about word choices - Cross referencing v2 not to lose meaning - Stakeholder engagement (other professionals, indigenous communities..) Additional feedback gathering - Validation surveys - 2018 - PC validation with dietitians in practice - 2019 - PI validation with dietetics educators - Adjustments were made to PCs and PIs based on responses - Development of interpretive guide ICDEP v3.0 - Purpose -> outcome-based standards for entry-to-practice dietetic education and entry level practice Changes from v2 to v3 - Domains of competence (previously “areas of practice”) - New names - Context statements to describe each one

- Increased from 5 with 30 PCs to 7 with 50 PCs - New order - New addition: food and nutrition expertise is a new domain in the first position in PCs and PIs -> coming from the foundational knowledge specifications in v2 - Food and nutrition expertise -> marks the dietitian central to all activities in 3 dietetic practice domains - Nutrition care - Population health promotion - Food provision - PCs - Some removed, moved, reworded or maintained - Combined evaluation and modified plan when appropriate in each domain - Informatics changes to inflammation and management technologies - Nutrition care PCs were reworded to better reflect the NCP terminology - New PC content to ensure currency: - 2.01 - Practice within the context of Canadian diversity - 2.03 - Practice in a manner that promotes cultural safety - 2.07 - Use risk management approaches - 3.04 - Use effective electronic communication skills - 4.04 - Undertake knowledge translation - 4.07 - Foster development of food literacy in others - 4.08 - Foster development of food skills in others - PIs - Removed, added, moved, reworded - Moving food skills from food expertise into management and leadership domain - Change in the words of PIs assessments - Knows, knows how, shows how, does assessment - PI statements streamlined to reduce redundancy and deliverable expected - V2 - 441 items - V3 - 210 items

WEEK 4 Framework for managing risk in dietetic practice - Where is there potential risk of harm to clients? Risk management -> Analysis and control of risks - It's a methodical approach to recognizing the likelihood of risk , analyzing the impact of the potential harm , and implementing strategies to identify and respond to circumstances putting clients at risk Steps to manage risk of harm: - Find the source of risk and analyze the harm - Could be the RD, her issues with clients, workload, staffing, funding, system limitations - Explore protective factors - Can be RD competencies, skills, or environmental processes, policies, resources - Apply the best protective solutions - Determine whether other need to be involved to implement protective factors and the responses need to be client-centred - Evaluate experiences, processes and protective outcomes - Was the risk minimized? Did the process lead to safe dietetic services? Did the communication within the team maximize learning? LAWS RELATED TO DIETETIC PRACTICE ● Re gulated Health Professions Act, 1991 ● Dietetics Act, 1991 ● Business Corporation Act ● Child and Family Services Act ● Drug & Pharmacies Regulation Act ● Good Samaritan Act ● Health Care Consent Act ● Home Care and Community Services Act, 1994 ● Mental Health Act ● Human Rights Code ● L ong-Term Care Homes Act ● Patient Restraints Minimization Act

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

● Personal Health Information Protection Act, 2004 ● Personal Information Protection and Electronic Documents Act (Canada) ● Public Hospitals Act ● Retirement Homes Act, 2010 ● Statutory Powers Procedure Act ● Substitute Decisions Act SCOPE OF PRACTICE - Dietetic scope of practice statement - Defined in the Dietetics Act, 1991 - “The practice of dietetics is the assessment of nutrition and nutritional conditions and the treatment and prevention of nutrition related disorders by nutritional means” - Scope of practice includes what dietitians are legally permitted to do under the Dietetics Act 1991 and the RHPA (Regulated Health Professions Act) 1991 CONTROLLED ACTS - 14 acts under the RHPA - Healthcare actions considered harmful if performed by unqualified persons - Dietitians have been given the legal authority under the Dietetics Act to perform only one controlled act, skin pricking (below the dermis procedure) - Allows us to take blood sampled for the purpose of monitoring capillary blood readings CANADA HEALTH ACT - Federal legislation for publicly funded health care insurance - To protect, promote and restore the physical and mental wellbeing of residents of Canada and facilitate reasonable access to health services without financial barriers WEEK 5 PAUSE BEFORE YOU POST

- People are changing their behaviours based on what they read and see online - Social media marketing is strong - Social media can be used to inform and educate - Ethical breaches can happen - Marketing campaigns - Patients and clients can communicate to share experiences Canadian organizations have grown their social media presence - To increase outreach to patients with education - Case studies prompt peer to peer reflection - Postings improve patient client safety - Micro-communities support sharing info Professional concerns: - Maintaining confidentiality, privacy and boundaries online - Upholding a professional image Maintaining professional behaviours: - Consult standards of practice - Maintain confidentiality and privacy - PHIPA - Maintain appropriate communication - Maintain professional boundaries - Maintain professional image - anything you post online stays there forever - Maintain professional behaviours - Conflict of interest - Informed consent - Advertising and marketing - Documentation and record keeping PRIVACY LEGISLATION - Personal health information belongs to the client not the practitioner - Knowing why the info is being collected - Only collecting amount needed - Collecting directly from the client - Destroying when no longer necessary - Preventing inadvertent disclosure of info - Advising clients about your policies for collecting, using and safeguarding info

- Allow requesting corrections for errors PHIPA - Personal Health Information Protection Act (2004) - Protects information and privacy right in Ontario - Provincial act PIPEDA - Personal Information Protection and Electronic Documents Act (2004) - Federal act applies to all organizations collecting, using, disclosing personal info while engaged in commercial activity - Relevant for non-health aspects of business 7 STEPS TO DEVELOP POLICIES COMPLIANT WITH PHIPA 1. Designate your organization contact person 2. Inventory the information to be covered 3. Identify the purposes for which you collect, use and disclose info 4. Develop practices regarding safeguards, retention and destruction 5. Develop practices regarding access, correction and complaints 6. Establish a privacy breach protocol 7. Implement privacy plan THE TEN PRINCIPLES FOR PRIVACY OF PERSONAL INFORMATION - AICLLASOIC 1. Accountability 2. Identifying purposes 3. Consent 4. Limiting collection 5. Limiting use, disclosure, and retention 6. Accuracy 7. Safeguards 8. Openness 9. Individual access 10. Challenging compliance

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

FNP550 - Midterm review

Related Documents