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Biomedical subjects

Richard Griffith

Publications and source records attributed to Richard Griffith.

At least 37 records · Page 2Linked to original sources
PubMed2005

Domestic abuse: protection, intervention and the role of the law.

District nursing sister Gwen Abbot suspects that one of her patients, a 35-year-old woman who lives with her partner in a rented one bedroom flat, is being abused. The woman is reluctant to explain the frequent bruising that is present around her arms and breasts when the district nurse visits. Sister Abbot wonders if she should get involved and if there were any legal measures the patient could take to protect herself from abuse.

Adult↗
PubMed2005

The law and accountability in district nursing practice.

The Welsh health minister Dr Brian Gibbons commented earlier this year that, 'Of all the professions who work in the community, nurses are the most respected and valued' (Western Mail, 25th January 2005). The minister's words reflect numerous opinion polls in recent years where nursing tops the list of most respected professions (Moore, 2004). Vital to this public trust and confidence is the concept of accountability. In this article, the authors encourage you to reflect on your accountability and evaluate how the law imposes standards of practice and behaviour to protect the public and the patients in your care.

Community Health Nursing↗
PubMed2005

Wills and the district nurse: the importance of caution.

John Williams is 65 years old, housebound and lives alone. He is widowed--his wife died 12 months ago--and he has 3 children. The eldest two are his stepchildren, Jack (40 years) and Bert (35 years). The youngest child is his biological daughter, Sarah, who is 28 years old. He has not seen his eldest children since his wife's funeral and Sarah has her own family and only visits occasionally. He is visited by Julie Davies, his district nurse on a daily basis due to a recent bout of flu from which he is finding it difficult to recover. He has early-onset Alzheimer's disease. Julie visits one day to find John in a very low, yet determined mood. He does not feel that he has long left in this life and has drafted a will which he would like Julie and the next door neighbour to witness. Julie notices that the will contains two bequests: one of pounds 5000 is to his neighbour; the second, to his stepson Jack, is of the remainder of his estate 'in full confidence that Jack will share it with the other children as he sees fit'. Julie does not want to get involved but feels pressurized by John into signing and witnessing the will. John dies a week later. Julie is notified that the will is being contested by Sarah.

Family↗
PubMed2005

Public health 1: controlling infectious disease--the role of the law.

CASE STUDY: District nurse Brenda Harrison is exasperated by the behaviour of one of her patients. John, a 43-year-old dairy farmer, has been diagnosed with respiratory tract tuberculosis. Generally amenable and polite, John is stubborn and inclined to want to do things his way. Brenda has explained that he must not milk his cows and to stay away from the dairy. John has also been told the importance of taking the range of antibiotics prescribed for the tuberculosis regularly for the full course over 6 months. Despite this advice and frequent monitoring he has only taken the treatment for short periods before forgetting or simply stopping the treatment when he feels better. As a result John's wife, and now his brother, have also become infected. He continues to milk his dairy herd. Brenda is concerned that John's continued reluctance to take a full course of treatment and to stop contact with milk will result in many more people becoming infected. She wonders if the law could be used to protect public health and force John to complete a course of treatment and stay away from his herd.

Communicable Disease Control↗
PubMed2004

Manual handling and the lawfulness of no-lift policies.

Recent discussions over the plight of a woman who had spent a year sleeping in her wheelchair because the local NHS trust refused to allow her to be lifted into bed highlight the dilemma facing nurses when they are required to manually handle patients (Andrews and Robinson 2003). Nurses are acutely aware that the manual handling of patients can result in back injury (McGuire and Dewar 1993). Yet they are also aware that they owe a duty to patients to provide nursing care to meet their needs and that might only be achieved through manual handling. There is evidence that hospitals in particular have still not met the requirements of the Manual Handling Operations Regulations (Trevelyan 2000). The hazards of working in the community environment have generally been better addressed as part of the assessment for and delivery of individual care packages. This article considers the law's approach to balancing the opposing needs of nurses' and patients' health needs.

Back Injuries↗
PubMed2004

Senior executive adopt-a-work unit: a model for safety improvement.

BACKGROUND: At The Johns Hopkins Hospital (JHH), the patient safety committee created a safety program that focused on encouraging staff in selected units to identify and eliminate potential errors in the patient care environment. As part of this program, senior hospital executives each adopted an intensive care unit and worked with the unit staff to identify issues and to empower staff to address safety issues. JHH PATIENT SAFETY PROGRAM: The program consisted of eight steps, which together require six months for implementation: (1) conduct a culture survey; (2) educate staff on the science of safety; (3) identify staff safety concerns through a staff safety survey; (4) implement the senior executive adopt-a-work unit program; (5) implement improvements; (6-7) document results, share stories, and disseminate results; and (8) resurvey staff. RESULTS: The senior executive adopt-a-work unit program was successful in identifying and eliminating hazards to patient safety and in creating a culture of safety. DISCUSSION: The program can be broadly implemented. The keys to program success are the active role of an executive advocate and staff's willingness to openly discuss safety issues on the units. Regular meetings between the advocates and the units have provided a forum for enhancing executive awareness, increasing staff confidence and trust in executive involvement, and swiftly and effectively addressing areas of potential patient harm.

Baltimore↗
PubMed2004

Court appearance 2: Presenting oral evidence in court.

Mary Harris, a community children's nurse, has been concerned for sometime that two of her patients are being abused. She is required to give evidence at the family proceedings court. Mary is very apprehensive as this is her first court appearance. Last month Mary prepared for her appearance by looking at the structure and rules of the court. She also considered the criteria that had to be satisfied before magistrates could grant an order.

Child↗
PubMed2004

Living wills, duty of care and the right to treatment.

CASE STUDY: Agnes Simon, a district nurse with 20 years' experience, has been caring for a man with motor neurone disease for the last 5 years. During this time the patient has shown remarkable tenacity but the disease has now progressed to the stage where artificial nutrition and hydration (ANH) is required. A percutaneous endoscopic gastrostomy tube has been inserted through which the patient receives food, water and medication. On her most recent visit the patient gave Agnes a signed and witnessed living will. Unusually, the living will did not indicate the patient's wishes regarding the limitation of treatment. Instead it made clear that the patient wished to continue to receive ANH up to the time of his death. He did not want the care team to withdraw this treatment without his permission, as he feared he would suffer from the indignity of slowly dying from thirst and starvation. Agnes has never seen a living will where a patient demands a right to treatment and wonders whether such a document is lawful and binding on her.

Community Health Nursing↗
PubMed2004

Putting the record straight: the importance of documentation.

A nurse from Coventry was recently removed from the national register after failing to keep accurate records for patients in her care. She was found guilty of seven charges of misconduct. The committee heard that she failed to ensure care plans were prepared for several patients covering issues such as diabetes, pain management and dietary needs. On one occasion, she failed to notify staff of a patient's increased risk of haemorrhage following a drug error. The Nursing and Midwifery Council (NMC) found the nurse had systematically neglected a basic and crucial duty to keep proper records for the management of patient care.

Community Health Nursing↗
PubMed2004

Legal requirements for safe handling in community care.

CASE STUDY: Andrea, a district nurse, together with home carers from the local social services department, has been caring for a wheelchair-bound patient with multiple sclerosis for 3 years. The patient requires assistance with going to the toilet and going to bed. She has always been reluctant to be moved using a hoist because of sudden spasms and this causes her great anxiety. Now the patient is refusing to be move mechanically and will only consent to being lifted manually. Andrea and the home care staff are concerned that this might place them at risk of injury and argue that it is against the trust and local authority moving and handling policy, which has a no-lift clause. Andrea would like to refuse to manually lift the patient but decides to check the legal position first.

Accidents, Occupational↗
PubMed2003

The right to refuse life-saving treatment: who decides?

District nurse Alison has a patient, Nigel, who has type 1 diabetes that remains unstable. Nigel's eyesight has deteriorated, his sexual function has dramatically reduced and he has now developed an infection in his right foot which requires immediate treatment. Nigel refuses the treatment and any further insulin declaring he would rather die than live the rest of his life like this. The GP says he will have Nigel detained under the Mental Health Act for assessment and enforced treatment, as his decision to refuse treatment amounts to suicide. Alison is concerned that Nigel will die without treatment, but also worries that to force treatment would be unlawful.

Humans↗