In my job, it’s my responsibility to ensure all policies, procedures and practices are in place and followed by colleagues and all team members. If there was an individual or several workers, even a company who didn’t follow these policies, procedures and practices, there would be serious consequences for whoever is involved, the company would also be under investigation. These policies, procedures and practices are in place to keep all workers, patients and others involved within the company’s care, to keep individual safe, whether staff members, patients or other professionals are having any care service at that except point in time or not.
The Health and Safety at Work Act 1974 –
Due to health and safety being a legal requirement, it organises the foundation of most of the policies and procedures. It is my duty of care to make sure that the renal technicians team are compliant with all documents regarding health and safety policies, procedures and practices. This is why it’s so important to let the team know when there’s been any changes to any documents by emailing them and each team member, including myself to sign online for each piece of documentation, which has been read, understood and agreed with.
The legislative framework for health and safety and risk assessments in the work setting includes these regulations: Health and Safety at Work Act (HSAWA 1974), Management of Health and Safety at Work Regulations (1999 / 2003), Personal Protective Equipment at Work Regulations (1998), Manual Handling Operations Regulations (1992), Health and Safety (First Aid) Regulations (1981), Health and Safety Information for Employees Regulations (1989), Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR 1995), Electricity at Work Regulations (1989), Control of Substances Hazardous to Health Regulations (COSHH 2002), Regulatory Reform (Fire Safety 2005), The Human Medicines Regulations (2012). In every patient’s house, a care plan is put in place before any renal technicians can go in to give the required care. All these care plans are carried out by trained supervisors, like myself, which includes a thorough risk assessment, agreement for security in the homes, personal emerging evaluation plan (PEEP), COSHH risk assessment form, manual handling risk assessment. This must be in place before any care can be given, for the safety of the team, the patient and the company. The stock is always put away in a clean and tidy manor, minimising risks to the renal technicians, the patient, other professions, friends and families. All doorways and corridors must remain clear at all times in case of a fire. There are daily record documents, which must be filled in daily. This is for the renal staff to know what’ been going on regarding the patients care. If I find that there’s a potential risk starting to show, I will risk assess the situation and inform all staff members and my manager about this and why. If there is an incident or accident, all staff members are aware to log all details down in the daily notes in the care plan as soon as they can, writing only factually. They must then report this to the manager. Its then the managers responsibility to which occurrences that must be reported to the relevant governing bodies. If the same incident or accident becomes reoccurring, by analysing the occurrences, following the company’s policies, procedures and practises, the manager may decide that training needs to be provided in this particular area. The aim is to avoid any more occurrences.
Every time I go out to visit a new patient for a care plan meeting, or to re-asses existing patients, I work alongside the policies, procedures and practices to identify, assess and manage risk to the renal technicians, patients, health care professionals and others. Quite often I will go out to re-asses a hazard or potential hazard to prevent it becoming a dangerous by carrying out risk assessments, agreement for security in the homes, personal emerging evaluation plan (PEEP), COSHH risk assessment form, manual handling risk assessment form and PV and quality assurance contact details.
Step 1 – Identify the hazard – A hazard includes anything that can cause spills or tripping such as cords running across the floor or even ice outside. Anything that can cause falls such as working from heights, including ladders or any raised work area.
Step 2 – Decide who might be harmed and how – This could be the patient, all renal technicians, doctors, nurses, other health care professionals, friends and family members.
Step 3 – Evaluate the risks and decide on precautions – A situation involving exposure to danger and how to prevent them becoming a serious issue. The risk is the chance, high or low, that somebody could be harmed by hazards identified in step 1, together with a warning of how serious the harm could be. A risk factor is something that can increase the chance of the hazard occurring.
Step 4 – Record your significant findings – This is where I must decide how you I will implement any actions, which I have identified in each risk assessment and to ensure this is communicated to all of the renal technicians, my manager and any other staff. I must make sure that I always prioritise and decide who is going to do what and by when, which will always be documented in the patient’s care plan.
Step 5 – Review your assessment and update if necessary – There is no legal time frame for a review on each risk assessment that is in the patient’s care plan, however, it is at my discretion to decide when a review is believed to be necessary. I feel the requirement to check all risk assessment documents monthly and I know that the company policy is every 6 months. This is a working document and changes to the patient’s care can change daily. I will make changes to the patients care plan when necessary depending on the patient’s circumstances.
There are many potential risks to health and social care environments, such as, Equipment, this is checked yearly by an outside company, i.e. the dialysis machines. Contact with hazardous chemicals or waste – All waste fluids from the patients, is collected into large bags at the end of their therapy on the dialysis machine. This is disposed of down the toilet or drain, always with the renal technician using correct Personal Protective Equipment (PPE). Other waste materials are placed into a yellow clinical waste bag, which is collected weekly by a special team. This is set up by myself or the renal nurses at the start of the care process if required.
Handling medication can be a big risk, all of the patient’s medication is kept and remains in the factory delivered boxes and packaging until it’s in use by the renal technician team. Any packaging, boxes or medication that seems to be damaged or tampered with is immediately disposed of and not used. If myself or any of the renal technician’s team have any concerns, I have placed a number in each of the patients care plans. This is for any team member to report to the PV and quality assurance team and also, to make sure it’s been recorded in the patient care plan.
Environmental Hazards – Noise, lighting, surrounding environment, cold, dust and heat pressure.
Psychosocial hazards – Work-related stress, fatigue, workplace harassment and work-related violence. This could be any incident where a renal technician is abused, threatened or assaulted in relation to work. Verbal abuse and threats are the most common types of incident an individual may experience, such as, harassment, intimidation, or other threatening disruptive behaviour, insults, death threats. Physical attacks can also happen, such as, pushing, Punches, injuries, bites, bruises, wounds, dislocations, fractures stalking, stealing, throwing objects, fights and assault with a weapon. It can affect and involve employees, patients, other health care professionals, friends and family members.
For each of the above examples, I monitor each potential hazard every month or as and when required. Any changes are recorded and I tell the team about what has changed and why. I always keep my manager informed about any changes and make sure I have placed any new documents in the care plan to replace the emended documents.
I must always make sure that each care plan including risk assessments are carried out in a person-centred approach, keeping the patient informed about any concerns or amendments when reviewing the care plan. I encourage that each renal technician understands that getting a good balance between managing risks and encouraging choices is important to person centred practice and is an ideal that all health and social care workers need to be committed too. This helps each team member to give each individual patient have choice, autonomy and to always be in control of their care, which has a knock-on effect positively on their self-image, a sense of well-being and overall quality of life.
By helping others to understand that the balance between risk and rights significantly improves practices and it displays that an individual is not only making decisions but is keeping each person involved. When a decision has been made by myself or my manager, only when the renal technicians team understand the reasons behind the change that they begin to understand that it’s a change for the better and will benefit the team and the patients.
I may notice that a member of the renal team may benefit from some extra training or feel the need to call them in for an informal chat. At appraisals, this is a good opportunity to open up about any worries or concerns they may have, such as, I may feel that a staff member may need to improve on their health and safety whilst at work, or even suggest safer options and train them on a different procedure to help the team member perform better in their role. Sometimes there are changes in the legislations, this could have an impact on care being given. This is why it’s important to keep up to date with any policies, procedures and practices changes. When I’m working at a patient’s house, I audit the care plans weekly, which I find that it keeps me up to date with how the staff members are working and coping. If I have several concerns, I will call the all of the renal technicians in for a team meeting.
I noticed that not all renal technicians were wearing the correct Personal Protective Equipment (PPE). I spoke with my manager and it was agreed that a new policy was put into action to send by post each team member three boxes of gloves, a packet of disposable aprons, daily record documents for the care plans as sometimes these documents would get used up and not replaced, meaning there could be a couple of day’s that weren’t documented for, leaving spaces in the care plans. These all get sent out every two months. Or when required.
There was also a policy put in place due to a renal technician from a different area in England, this team member started to refuse to go to a patient’s house, resulting in a rota change for my team members having to cover for the renal technician and the one patient they wouldn’t travel to any more, which I was not happy about. One of my team would be required to travel a long distance to cover this patient, which was not cost effective and meant that my team member had to drive an extra 100 miles per day. After a meeting with my manager, a policy was drawn up to stop this happening in the future, that if a renal technician was working, they must cover