#WeLDNs - Tuesday 21st January 2020 8:30pm (GMT Standard Time) Moulster & Griffiths Nursing Model

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Hosted by WeLDnurses using #WeLDNs

This chat is guest hosted by @GwenMoulster @HabitualJoshing @SarahAmes20

The Moulster and Griffiths Nursing Model

As part of the centenary celebrations for learning disability nursing, Gwen Moulster, Sarah Ames, Jane Iorizzo, and Joshua Kernohan updated and published the ‘Moulster and Griffiths Nursing Model’. They did this with a view to sharing good practice with colleagues, and to show case a nursing model that was already embedded into clinical practice in various parts of the UK.

In preparation for this chat the introduction below will give some oversight into both the nursing process and nursing models and some background into the development of the Moulster and Griffiths model.

The Nursing Process

The Nursing and Midwifery Council (NMC 2015) code of practice requires that nurses assess, plan, implement and evaluate the care they provide in accordance with the nursing process as described by Virginia Henderson (1966) and introduced to health care in the UK in the 1970s.

The nursing process provides a framework for decision making but it requires nurses to have the clinical skills and knowledge to know what to assess and how to reach the right decision:nursing models provide the means to achieve this (Schober, 2008).

Nursing models

A nursing model, at its simplest, is a philosophy or view of nursing that informs the way people practice (Aggleton and Chalmers 2000). It is recognised within healthcare that there is a relationship between the use of models of care and the achievement of outcomes for those receiving support (Kaplow and Reed 2008).

Any nursing model should only be viewed as an aide to decision-making, and not a replacement for clinical judgement. At its core, a nursing model does this by exploring the relationship between 4 concepts: personhood, the role of the nurse or nursing,health and the environment (Hamilton and Price, 2017).

The use of conceptual models in learning disability nursing has been a challenge, in part due to models being borrowed from other disciplines, or branches of nursing (Horan, 2004).

It has been suggested that in the past learning disability nurses had difficulty articulating the contribution they make, leading to scrutiny and challenge of their purpose (Mitchell, 2002). Where there may be a lack of role clarity, use of a conceptual model acts as a means of highlighting what is important to and for the professional group (Curley 2004).

Pearson, Vaughan and FitzGerald (2005) suggest that when using a nursing model to structure work not only is care more consistent, but there is less conflict in the team, other professionals increasingly understand the role of the nurse, and it acts as a guide in decision-making, goal setting and even recruitment. When using a nursing model, a team can ensure continuity of care and provide a high standard of support (Aggleton and Chalmers, 2000),and by using the Moulster and Griffiths model, learning disability nurses will ensure that all people, regardless of locality, receive the same standard of person-centred and evidence-based nursing care (Ames 2013).

The value-base of the Moulster and Griffiths model

The values base for learning disability nurses is best described within Strengthening the Commitment (Scottish Government 2012), which includes

The Moulster and Griffiths model places the person with learning disabilities at the centre of the process, using the principles from Valuing People: promoting rights, inclusion, choice and control (DH 2001; DH 2009).The model is person-centred and encourages all nurses to ensure the person who has learning disabilities and the important people in their life are fully included and engaged in the process.

Schober (2008) suggests that nurses who have developed models of practice attempt to explore the interplay between the person, their health, the nurse and the wider social environment. This can be clearly seen in the Moulster and Griffiths model, which sees the nurse as a facilitator of social inclusion and the promoter of the rights of the individual to enable better health and wellbeing. The model recognises the individual is ‘disabled’ by the social environments around them and the services and support they can access;if learning disability nurses can help get this right for the person by supporting reasonable adjustments, they can help that person live a meaningful and fulfilled life.

Learning disability nursing may differ from other fields of nursing practice in that we work with people who may not be ‘ill’ or ‘sick’. Our role, however, fits well with modern definitions of nursing that focus on the role of the nurse in improving quality of life, advocating for the person and incorporating health promotion and prevention of illness (International Council of Nurses 2002; RCN 2003).

Our role then, in working in a person-centred and holistic way, is to increase the person’s resources in order to help the person realise their goals or increase their ability to cope and adapt to the changes around them. Health is a dynamic concept, and the importance of the social determinants of health, and the impact of health inequalities cannot be overlooked (Brooker and Waugh 2017).

Developing the model

The Moulster and Griffiths model was developed in the Haringey Learning Disability Partnership in 2009 in response to a need for a more consistent approach to nursing in a multi-disciplinary and multi-agency learning disability team. Nurses in the Partnership didn’t use a specific nursing model, and the quality of care planning and implementation depended upon the knowledge and skills of the individual practitioner (Moulster, Ames and Griffiths 2012).

However, the nursing team relied on the initial multi-disciplinary assessment and based their care planning on the information gathered. At the time nurses did not undertake further,profession specific assessments, not all interventions were evidence-based and there was a limited use of routine outcome measures.

It was felt the introduction of a standard nursing model could help improve nursing care.  In identifying a model appropriate for their service, they agreed it should be evidence-based, outcome focused,person-centred and reflective. Following a review, it was felt no one model fitted the needs of learning disability nurses within the service and the Moulster and Griffiths model was created.

The Moulster and Griffiths model has many unique attributes, but also draws on and combines elements from the self-care nursing model (Orem 2001), the ecology of health model (Aldridge 2004), the cycle of reflective practice (Gibbs 1988), person centred care approaches (McCormack& McCance 2006), and the Health Equalities Framework (Atkinson et al 2015).It also includes a person-centred screening tool which is based on work by Amey et al (2006). Other aspects of the new nursing model were drawn from the experience, knowledge and skills of the nurses. In developing the nursing assessment, the inclusion of reasonable adjustments was influenced by work in Gloucestershire and the easy read care plans were developed from resources created in Barnet. 

The model has been trialled in a range of different settings, including inpatient services, respite services and community learning disability teams. The model is dynamic and can be adapted to reflect changing practice and feedback from those individuals using the model. As the model changes it remains based on the four key principles of being evidence-based, supporting reflection, demonstrating outcomes, and being person-centred.

Additional Reading

We recommend the following:

Moulster G, Iorizzo J, Ames S and Kernohan J (2019) Aflexible model to support person-centred learning disability nursing

Moulster G, Iorizzo J, Ames S and Kernohan J (2019) The Moulsterand Griffiths Learning Disability Nursing Model: A Framework for Practice.London and Philadelphia: Jessica Kingsley Publishers

Moulster, G., Ames, S., and Griffiths, T. (2012) A newlearning disability nursing framework. Learning Disability Practice, 15(6),pp.14-18.

Moulster, G., Ames, S., and Griffiths, T. (2012) Implementationof a new framework for practice: Learning Disability Practice, 15(7), pp.21-26.

Moulster, G., Ames, S., and Griffiths, T. (2012) A newlearning disability nursing framework. Learning Disability Practice, 15(8),pp.18-20

References

Aggleton, P. and Chalmers, H. (2000) Nursingmodels and nursing practice. Hampshire: Palgrave.

Aldridge, J. (2004) Intellectual disability nursing:a model for practice. In J. Turnbull (ed) Learning Disability Nursing. Oxford: OxfordBlackwell Publishing.

Amey, P., Gregson, K.,Johnson, M., Moulster, G. and Nobbs, M. (2006) Person-centred planning: a team approach. Learning Disability Practice, 9(7)pp.12-16.

Ames S (2013) Modelfollowers. Learning Disability Practice, 16(8), p13

Atkinson, D.; Boulter,P.; Hebron, C. and Moulster, G. (2014) Exposure to health inequalities as ameasure of outcomes. Learning Disability Practice, 17(1), pp. 20-24.

Atkinson, D.; Boulter, P.;Hebron, C. and Moulster, G. (2015) Health Equality Framework. The CompletePractitioner’s Guide. UK Consultant Nurse Network. Accessed 6 January 2020. https://www.ndti.org.uk/uploads/files/HEF%2B_manual_plus_final.pdf

Binnie, A. and Titchen, A. (2001) Freedom toPractice: The Development of Patient-centred Nursing. Oxford: ButterworthHeinemann.

Brooker, C. and Waugh, A. (2017) Foundations ofNursing Practice: Fundamentals of Holistic Care. London: Mosby.

Curley, M. (2004) The state of synergy. Excellencein Nursing Knowledge, 1(1), pp.2-10.

Department of Health (2001) Valuing People: ANew Strategy for Learning Disability for the 21st Century. London: Departmentof Health.

Department of Health (2009) Valuing People Now:a new three-year strategy for people with learning disabilities. London:Department of Health.

Gibbs et al (1988) citedin C. Bulman and S. Schutz (eds) Reflective Practice in Nursing. Oxford: JohnWiley & Sons Ltd.

Hamilton, P. and Price, T. (2017) ‘The nursingprocess, holistic assessment and baseline observations’ In C. Booker and A.Waugh (eds.) Foundations of Nursing Practice: Fundamentals of Holistic Care. London:Mosby.

Henderson,V (1966). The Nature of Nursing: A Definition and its Implications forPractice, Research, and Education. New York: Macmillan Publishing

Horan, P. (2004)Exploring Orem’s self-care deficit nursing theory in learning disabilitynursing: philosophical parity paper: part 1. Learning Disability Practice, 7(4),pp. 28-33.

International Council of Nurses (2002) The ICNdefinition of nursing. Geneva: International Council of Nurses.

Kaplow, R. and Reed, K.(2008) The AACN synergy model for patient care: a nursing model as a force ofmagnetism. Nursing Economics. 26(1), pp.17-25.

Mallik, M., Hall, C., Howard, D. (2009) NursingKnowledge and Practice: Foundations for decision making. London: BalliereTindall

McCormack, B. andMcCance, T. (2006) Development of a framework for person-centred nursing.Journal of Advanced Nursing, 56(5), pp.472-479.

Mitchell, D. (2002)Using history in learning disability practice. Learning Disability Practice.5(9), pp.16-20.

Moulster, G., Ames, S.,and Griffiths, T. (2012) A new learning disability nursing framework. LearningDisability Practice, 15(6), pp.14-18.

Nursing and MidwiferyCouncil (2015) The Code: Professional standards of practice and behaviorfor nurses and midwives. London. Nursing and Midwifery Council. Accessed 20July 2018. https://www.nmc.org.uk/standards/code/  

Orem, D. (2001) Nursing:Concepts of practice. London: Mosby. (Original work published 1991.

Pearson, A.; Vaughan, B. and FitzGerald, M.(2005) Nursing models for practice. London: Butterworth-Heineman.

Royal College of Nursing (2003) Definingnursing. London: Royal College of Nursing.

Royal College of Nursing (2016) Connect forChange: An update on learning disability services in England. London: RoyalCollege of Nursing. Accessed 1 September 2018.https://rcn.org.uk/professinoal-development/publications/pub-005525.

Schober, J. (2008) ‘Frameworks for practice.’In S. Hinchcliff, S. Norman and J. Schober (eds) Nursing Practice andHealthcare: A Foundation Text. London: Hodder Arnold.

ScottishGovernment (2012) Strengthening the Commitment. Edinburgh: The ScottishGovernment.

World Health Organisation (1986) Ottawa charterfor health promotion. Ottawa: World Health Organisation. Accessed 31 August2018.  http://www.who.int/healthpromotion/conferences/previous/ottawa/en/





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 Chat Summary

 

On the 21st January 20120 @WeLDNurses hosted a chat on the Moulster and Griffiths Learning Disability Nursing Model. The chat was co-hosted by three of the authors of the accompanying book – Gwen Moulster, Joshua Kernohan and Sarah Ames. They were joined by participants with wide-ranging experiences and knowledge bases of working with people with learning disabilities, including lecturers, family carers and student nurses. There were some pre-prepared questions around use of nursing models, reflection and use of evidence in nursing, which helped to focus the chat and create discussion. 

People’s experiences of using nursing models were varied, from not using them at all, to combining several to meet their own needs, to sticking with one that was first discovered as a student nurse (see classics such as Orem / Aldridge / Roper!). There was some discussion around the difficulties of using profession-specific models while in work, as opposed to following more generic pathways which meet the needs of the wider service and commissioning requirements. However, it was pointed out that using a profession-specific model can be a way to evidence the work that you are doing and measure the nursing input, which would also appeal to service management and commissioning (as well as improve the care you are giving!). Whichever model (or not!) that is used, everyone was in agreement that the use of evidence to inform nursing interventions is so important. Again, people had varying experience in finding evidence suitable for use. Using NICE guidance, research papers, NHS libraries and journal clubs may appeal to the more academically minded, but there were also alternative suggestions such as using feedback from individuals and reflection of casework, researching with peers or using peer supervision, and using your own research as a way to create your own evidence base. It was highlighted that there can be gaps in quality evidence for learning disability nursing, so everyone is encouraged to build their evidence base and share this through conferences / articles / peer work / get on twitter and promote it. Overall the discussion about using a nursing model, or elements of different models, in practice was encouraging, and it was great that student nurses are engaged in working in this way as they will be able to take this into practice when they are on placement and qualify. Thanks to everyone who joined in. 

Thanks to Sarah Ames - @sarahames20

Chat Coordinated by Daniel Marsden - @dmarsden49





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 #WeLDNs transcript

 
@WeLDnurses
21 January 2020 20:30
Welcome to tonight's #weldns chat with hosts @GwenMoulster @SarahAmes20 @HabitualJoshing If you're joining the chat, please give us a wave!
@WeLDnurses
21 January 2020 20:31
To join the discussion please use #weldns in each of your tweets. In some circumstances you may be linking in evidence, if so, please also use #ebp
@lynnewalsall
21 January 2020 20:31
Evening all Lynne in Walsall ready to chat about the Moulster & Griffiths Model #EBP #weldns
@dmarsden49
21 January 2020 20:31
@WeLDnurses @GwenMoulster @SarahAmes20 @HabitualJoshing Good evening! #weldns https://t.co/2cXZnz1Eo9
@LucyAnn_Spencer
21 January 2020 20:31
@WeLDnurses @GwenMoulster @SarahAmes20 @HabitualJoshing ?? hi from North Wales! #WeLDNs
@HabitualJoshing
21 January 2020 20:31
Hi Josh here, over in chilly Staffordshire #weldns
@Mermcm
21 January 2020 20:31
@GwenMoulster @WeLDnurses @SarahAmes20 @HabitualJoshing ?????? #WeLDNs
@lynnewalsall
21 January 2020 20:31
RT @WeLDnurses: Welcome to tonight's #weldns chat with hosts @GwenMoulster @SarahAmes20 @HabitualJoshing If you're joining the chat, pleas…
@WeLDnurses
21 January 2020 20:32
For those joining us for the first time tonight, search for #weldns check the 'Latest' tab and refresh every once in a while. When your ready jump in with a comment!
@StaceyReesRNLD
21 January 2020 20:32
RT @GwenMoulster: Getting ready for tonight's chat in a few minutes time. #WeLDNs #MoulsterGriffiths https://t.co/ZDrAPINYm5
@GwenMoulster
21 January 2020 20:32
RT @WeLDnurses: To join the discussion please use #weldns in each of your tweets. In some circumstances you may be linking in evidence, if…
@GwenMoulster
21 January 2020 20:32
RT @WeLDnurses: Welcome to tonight's #weldns chat with hosts @GwenMoulster @SarahAmes20 @HabitualJoshing If you're joining the chat, pleas…
@GwenMoulster
21 January 2020 20:32
RT @WeLDnurses: For those joining us for the first time tonight, search for #weldns check the 'Latest' tab and refresh every once in a whil…
@lynnewalsall
21 January 2020 20:32
RT @WeLDnurses: For those joining us for the first time tonight, search for #weldns check the 'Latest' tab and refresh every once in a whil…
@LucyAnn_Spencer
21 January 2020 20:32
RT @WeLDnurses: For those joining us for the first time tonight, search for #weldns check the 'Latest' tab and refresh every once in a whil…
@LucyAnn_Spencer
21 January 2020 20:33
RT @WeLDnurses: To join the discussion please use #weldns in each of your tweets. In some circumstances you may be linking in evidence, if…
@ross_6479_RNLD
21 January 2020 20:33
RT @WeLDnurses: Welcome to tonight's #weldns chat with hosts @GwenMoulster @SarahAmes20 @HabitualJoshing If you're joining the chat, pleas…
@Shaun_LDNurse
21 January 2020 20:33
@WeLDnurses @GwenMoulster @SarahAmes20 @HabitualJoshing Sorry forgot the #WeLDNs
@ross_6479_RNLD
21 January 2020 20:33
@WeLDnurses @GwenMoulster @SarahAmes20 @HabitualJoshing Ross here #waves from up north #WeLDNs
@paularich1977
21 January 2020 20:33
RT @WeLDnurses: For those joining us for the first time tonight, search for #weldns check the 'Latest' tab and refresh every once in a whil…
@ross_6479_RNLD
21 January 2020 20:33
RT @WeLDnurses: To join the discussion please use #weldns in each of your tweets. In some circumstances you may be linking in evidence, if…
@WeLDnurses
21 January 2020 20:33
@Shaun_LDNurse @GwenMoulster @SarahAmes20 @HabitualJoshing Welcome Shaun! #weldns
@ross_6479_RNLD
21 January 2020 20:33
RT @WeLDnurses: For those joining us for the first time tonight, search for #weldns check the 'Latest' tab and refresh every once in a whil…
@StaceyReesRNLD
21 January 2020 20:33
@WeLDnurses @GwenMoulster @SarahAmes20 @HabitualJoshing Hello from ?????????????? looking forward to the chat #WeLDNs @carlyannedavies @aw_2812 @VickiG1086 @SophieB1711 @helenabegum9 @GarethClement6
@paularich1977
21 January 2020 20:33
@WeLDnurses @GwenMoulster @SarahAmes20 @HabitualJoshing Hi everyone ?? just got in from work. #weldns
@lynnewalsall
21 January 2020 20:33
RT @dmarsden49: Looking forward to tonight's #weldns chat. #sept18pbl https://twitter.com/WeLDnurses/status/1219503642178244608
@WeLDnurses
21 January 2020 20:34
#weldns Q1 Which nursing models have you used your practice, how have they helped you?
@GwenMoulster
21 January 2020 20:34
RT @WeLDnurses: #weldns Q1 Which nursing models have you used your practice, how have they helped you?
@ross_6479_RNLD
21 January 2020 20:34
RT @WeLDnurses: #weldns Q1 Which nursing models have you used your practice, how have they helped you?
@lynnewalsall
21 January 2020 20:34
RT @WeLDnurses: #weldns Q1 Which nursing models have you used your practice, how have they helped you?
@WeLDnurses
21 January 2020 20:34
@paularich1977 @GwenMoulster @SarahAmes20 @HabitualJoshing Good on you for joining us! #weldns
@CommunityLd
21 January 2020 20:35
@WeLDnurses If I’m honest I don’t think I’ve ever followed on. Clinical judgement and clinical reasoning of the #Ebp has always been my guide, along with intuition #weldns
@lynnewalsall
21 January 2020 20:35
@WeLDnurses #weldns nursing models help with structure and quality
@theLDphysio
21 January 2020 20:35
@WeLDnurses @GwenMoulster @SarahAmes20 @HabitualJoshing #weldns, sneaking in the back door here
@HabitualJoshing
21 January 2020 20:36
@WeLDnurses Looking back, prior to my nursing career, I remember using assessments for cyp with disabilities clearly based on Roper, Logan and Tierney. It clicked in yr 1 of my training. #WeLDNs
@LucyAnn_Spencer
21 January 2020 20:36
RT @WeLDnurses: #weldns Q1 Which nursing models have you used your practice, how have they helped you?
@anne_ambridge
21 January 2020 20:36
#waves #weldns
@HelenT2018
21 January 2020 20:37
@WeLDnurses @GwenMoulster @SarahAmes20 @HabitualJoshing ?? #weldns
@paularich1977
21 January 2020 20:37
@LucyAnn_Spencer @WeLDnurses @GwenMoulster @SarahAmes20 @HabitualJoshing Amazing how quick you can get home when there’s a chat to get to ?? #weldns https://t.co/AAd98SB6LF
@Mermcm
21 January 2020 20:37
I’m not sure I’ve actually used a ‘formal’ Nursing model since my student days of RLT, but I follow the principles of many models I think #WeLDNs https://twitter.com/WeLDnurses/status/1219719816644153344
@dmarsden49
21 January 2020 20:37
@WeLDnurses In my first nursing role, we used an adapted form of Roper...it was generalised & helped build relationships & quick wins toward the main referral issue. #WeLDNs
@paularich1977
21 January 2020 20:37
RT @WeLDnurses: #weldns Q1 Which nursing models have you used your practice, how have they helped you?
@HabitualJoshing
21 January 2020 20:37
@WeLDnurses The area where I first worked as a NQN was using the Moulster and Griffiths Model, so I became very familiar with it ?? #WeLDNs
@lynnewalsall
21 January 2020 20:37
@HabitualJoshing @WeLDnurses #weldns agree with you Josh Roper Logan & Tierney was main one - but there were others too
@LucyAnn_Spencer
21 January 2020 20:37
@WeLDnurses I’ve used the Aldridge model on placement #weLDNs
@LucyAnn_Spencer
21 January 2020 20:38
@WeLDnurses I’ve used the moulster and griffiths model on a case study for a formative VIVA #weLDNs
@HabitualJoshing
21 January 2020 20:38
@lynnewalsall @WeLDnurses Yeah, as a student I always liked Orem’s model and Aldridge’s too #weldns
@GwenMoulster
21 January 2020 20:39
RT @lynnewalsall: @HabitualJoshing @WeLDnurses #weldns agree with you Josh Roper Logan & Tierney was main one - but there were others too
@StaceyReesRNLD
21 January 2020 20:39
@WeLDnurses Throughout my training I always used the ecology of health model (alridge) #weldns
@GwenMoulster
21 January 2020 20:39
RT @LucyAnn_Spencer: @WeLDnurses I’ve used the Aldridge model on placement #weLDNs
@HabitualJoshing
21 January 2020 20:39
How did you find it? #weldns https://twitter.com/lucyann_spencer/status/1219721004966121475
@CommunityLd
21 January 2020 20:39
@GwenMoulster @WeLDnurses I think it’s probably the lack of them or promotion of them in pre Reg education. There’s care planning processes such as CPA or My Shared Pathway but there’s no underpinning evidence for them #weldns
@LucyAnn_Spencer
21 January 2020 20:39
@MrMCornell @WeLDnurses The moulster and griffiths model ?? #WeLDNs
@LorenaHauton
21 January 2020 20:40
@WeLDnurses Just saying hello #WeLDNs as I’m not a LDN. Yet. ?? Had a life changing week and looking at Graduate entry LD at Nottingham
@GwenMoulster
21 January 2020 20:40
@LucyAnn_Spencer @WeLDnurses #WeLDNs The Aldridge model was very influential in our thinking when we developed the model Lucy. Also Orem & Roper et al
@Mermcm
21 January 2020 20:40
Gwen remember your #weldns #hashtagpolice ?? https://twitter.com/GwenMoulster/status/1219720718956531718
@Shaun_LDNurse
21 January 2020 20:40
@WeLDnurses I know they’re there some where. I’m taken aback by how much solely pathway directed takes place so far (NB: limited exposure to CLDT yet). Where’s the #Nursing?.. enter the Moulster Griffiths. #WeLDNs
@dmarsden49
21 January 2020 20:41
@WeLDnurses In more recent times, we used the McCormack & McCance person centred nursing care model to develop the 4c Framework for use in acute hospital. #WeLDNs #ebp https://journals.rcni.com/nursing-standard/the-4c-framework-for-making-reasonable-adjustments-for-people-with-learning-disabilities-ns.2017.e10152
@anne_ambridge
21 January 2020 20:41
#weldns. Models are fantastic for novices as they act as a prompt to asking appropriate questions
@SarahAmes20
21 January 2020 20:41
@HabitualJoshing @WeLDnurses I've been using the Moulster and Griffiths model since I was a 3rd year student - as I worked with both Moulster and Griffiths! So this has been the main one for me since qualifying ?? #weldns
@GwenMoulster
21 January 2020 20:41
@Mermcm #WeLDNs oops sorry.
@lynnewalsall
21 January 2020 20:41
RT @GwenMoulster: @LucyAnn_Spencer @WeLDnurses #WeLDNs The Aldridge model was very influential in our thinking when we developed the model…
@HabitualJoshing
21 January 2020 20:41
@TakePartin_Art @WeLDnurses Welcome! And what a great career to be considering #weldns
@StaceyReesRNLD
21 January 2020 20:41
@WeLDnurses I qualified in 2012 and worked in a community LD team. We started to use the Atkinson et al (2015) model #WeLDNs
@lynnewalsall
21 January 2020 20:41
RT @anne_ambridge: #weldns. Models are fantastic for novices as they act as a prompt to asking appropriate questions
@GwenMoulster
21 January 2020 20:42
@TakePartin_Art @WeLDnurses #WeLDNs very pleased to see you here Lorena
@WeLDnurses
21 January 2020 20:42
@CommunityLd From where does the intuition emerge? #weldns
@WeLDnurses
21 January 2020 20:42
@theLDphysio @GwenMoulster @SarahAmes20 @HabitualJoshing Welcome Alistair! #weldns
@GwenMoulster
21 January 2020 20:42
@LucyAnn_Spencer @MrMCornell @WeLDnurses #WeLDNs good answer Lucy ??
@WeLDnurses
21 January 2020 20:43
#weldns Q2 What does person centred nursing mean to you? #weldns
@Shaun_LDNurse
21 January 2020 20:43
@WeLDnurses ... even Roper-Logan etc and ADLs have, in my estimation, has largely abstracted and have been subsumed into form-based care (again supporting directed pathways). #WeLDNs
@Mermcm
21 January 2020 20:43
#WeLDNs do people find that it’s difficult to implement ‘Nursing’ models in MDTs esp integrated services?
@CommunityLd
21 January 2020 20:43
@WeLDnurses It’s probably what I mean with clinical reasoning, learning from experience and evidence #weldns
@LorenaHauton
21 January 2020 20:43
@HabitualJoshing @WeLDnurses Thank you. Am parent of young adult with complex LD. Time to use my personal and professional experience to help others directly ?? #weldns
@StaceyReesRNLD
21 January 2020 20:43
@WeLDnurses @GwenMoulster @SarahAmes20 @HabitualJoshing @carlyannedavies @aw_2812 @VickiG1086 @SophieB1711 @helenabegum9 @GarethClement6 Throughout my training I was interested in the Ecology of Health model (Aldridge) and I know this influended the M&G framework #weldns
@HabitualJoshing
21 January 2020 20:43
@Shaun_LDNurse @WeLDnurses I like that point; pathways are very multidisciplinary in approach, and a nursing model can help identify and articulate (and measure) the nursing contribution within it #weldns
@WeLDnurses
21 January 2020 20:43
@LucyAnn_Spencer Have you got any links to this Lucy? #weldns
@HabitualJoshing
21 January 2020 20:43
RT @anne_ambridge: #weldns. Models are fantastic for novices as they act as a prompt to asking appropriate questions
@ross_6479_RNLD
21 January 2020 20:44
RT @WeLDnurses: #weldns Q2 What does person centred nursing mean to you? #weldns
@LucyAnn_Spencer
21 January 2020 20:44
@HabitualJoshing I loved it. I loved how it was easy to follow and linked into the HEF. It allows for reflection and links in EBP. #WeLDNs
@WeLDnurses
21 January 2020 20:44
@TakePartin_Art Lorena, Please feel free to join in the discussion, you're more than welcome! #weldns
@paularich1977
21 January 2020 20:44
RT @WeLDnurses: #weldns Q2 What does person centred nursing mean to you? #weldns
@lynnewalsall
21 January 2020 20:44
#weldns making sure the person is at the centre of everything and is enabled to how control of their own dreams https://twitter.com/WeLDnurses/status/1219722081446912001
@StaceyReesRNLD
21 January 2020 20:45
@WeLDnurses Exactly what it says on the tin - the person at the centre of the care. #WeLDNs
@GwenMoulster
21 January 2020 20:45
@CommunityLd @WeLDnurses #WeLDNs Ideas and approaches develop over time and we can probably all be 'dated' by the areas considered most important when we trained. Nursing models have been both in and out of favour
@WeLDnurses
21 January 2020 20:45
@Mermcm Thank you Marina, consider yourself a hashtag CSO! #weldns
@Shaun_LDNurse
21 January 2020 20:45
@HabitualJoshing @WeLDnurses They are indeed, and it’s an important distinction to make and remember (ie. the nursing contribution). #WeLDNs
@GwenMoulster
21 January 2020 20:45
RT @lynnewalsall: #weldns making sure the person is at the centre of everything and is enabled to how control of their own dreams https://t…
@Mermcm
21 January 2020 20:45
Putting the person we support and their wishes and feelings (as well as those of families/carers when necessary & appropriate) at the heart of what we do - fitting the box to the person not the other way round #weldns https://twitter.com/WeLDnurses/status/1219722081446912001
@ross_6479_RNLD
21 January 2020 20:46
@WeLDnurses Considering the individual in all approaches, their needs goals and preferred outcomes and working with them and those important to them to achieve #WeLDNs
@LiamFreeman1991
21 January 2020 20:46
@WeLDnurses @GwenMoulster @SarahAmes20 @HabitualJoshing Running bit late but hello from Birmingham #weldns
@SarahAmes20
21 January 2020 20:46
@CommunityLd @WeLDnurses In the Moulster and Griffiths care plan there is space to state your previous experience in using the planned intervention, alongside space to cite published evidence. Recognising that experience of the nurse counts #weldns
@GwenMoulster
21 January 2020 20:46
RT @WeLDnurses: #weldns Q2 What does person centred nursing mean to you? #weldns
@GwenMoulster
21 January 2020 20:46
RT @Mermcm: #WeLDNs do people find that it’s difficult to implement ‘Nursing’ models in MDTs esp integrated services?
@WeLDnurses
21 January 2020 20:46
@StaceyReesRNLD Have you got a link to the evidence Stacey? #weldns
@paularich1977
21 January 2020 20:46
@WeLDnurses Tailoring care to the persons needs and wants, respecting their views and treating people with dignity. Putting that person at the heart of their care and involve them in decisions about their care where possible #weldns
@LucyAnn_Spencer
21 January 2020 20:46
@WeLDnurses I used the core nursing assessment. I’ll try and find a link. I did struggle to find evidence of the model though. I think there is a page in a book but the only copy I could find was £80 on eBay ?? #WeLDNs
@CommunityLd
21 January 2020 20:47
@GwenMoulster @WeLDnurses It also depends on the organisation you work for and whether they will allow their use #weldns
@HabitualJoshing
21 January 2020 20:47
@WeLDnurses That we look at the wider concept of health and ensure the person is central to all decisions. Collaborative working rather than a one size fits all approach #weldns
@lynnewalsall
21 January 2020 20:47
#weldns this is exactly how our students have used the model in theory assignments and in practice #ebp provides so much structure of the novice practitioner https://twitter.com/LucyAnn_Spencer/status/1219722402575323136
@LucyAnn_Spencer
21 January 2020 20:47
@WeLDnurses I would love to see evidence of this book though or if anybody has any evidence surrounding the model? Maybe I’m not looking in the right places. #WeLDNs
@StaceyReesRNLD
21 January 2020 20:48
@WeLDnurses Yes, this would be a good start https://onlinelibrary.wiley.com/doi/10.1002/9780470774557.ch13 #WeLDNs #EBP
@CommunityLd
21 January 2020 20:48
@SarahAmes20 @WeLDnurses That’s great. I like using structured clinical judgment risk assessments as it allows you to use evidence too #weldns
@WeLDnurses
21 January 2020 20:48
@CommunityLd It's an interesting and useful activity to reflect and expose the experiences that have influenced your intuition, these will all be rooted on some sort of nursing framework. #weldns
@GwenMoulster
21 January 2020 20:48
RT @CommunityLd: @GwenMoulster @WeLDnurses It also depends on the organisation you work for and whether they will allow their use #weldns
@HabitualJoshing
21 January 2020 20:48
RT @lynnewalsall: #weldns this is exactly how our students have used the model in theory assignments and in practice #ebp provides so much…
@florenceella
21 January 2020 20:48
@WeLDnurses @GwenMoulster @SarahAmes20 @HabitualJoshing Good evening! Dipping in and out over here in Birmingham! ???? #WeLDNs
@LiamFreeman1991
21 January 2020 20:49
@WeLDnurses Every believe, wish, value should be considered when preparing care plans #weldns
@LucyAnn_Spencer
21 January 2020 20:49
@WeLDnurses Putting the person at the centre of their care. Putting the person first and not the needs of the service or others #WeLDNs
@GwenMoulster
21 January 2020 20:49
RT @lynnewalsall: #weldns this is exactly how our students have used the model in theory assignments and in practice #ebp provides so much…
@WeLDnurses
21 January 2020 20:49
RT @GwenMoulster: @CommunityLd @WeLDnurses #WeLDNs Ideas and approaches develop over time and we can probably all be 'dated' by the areas c…
@GwenMoulster
21 January 2020 20:49
RT @StaceyReesRNLD: @WeLDnurses Yes, this would be a good start https://onlinelibrary.wiley.com/doi/10.1002/9780470774557.ch13 #WeLDNs #EBP
@HabitualJoshing
21 January 2020 20:49
RT @LiamFreeman1991: @WeLDnurses Every believe, wish, value should be considered when preparing care plans #weldns
@WeLDnurses
21 January 2020 20:50
RT @StaceyReesRNLD: @WeLDnurses Yes, this would be a good start https://onlinelibrary.wiley.com/doi/10.1002/9780470774557.ch13 #WeLDNs #EBP
@CommunityLd
21 January 2020 20:50
@WeLDnurses Absolutely, it’s probably a hybrid of a few influences #weldns
@trishgriffin_ku
21 January 2020 20:50
@WeLDnurses @GwenMoulster @SarahAmes20 @HabitualJoshing #weldns ????
@lynnewalsall
21 January 2020 20:50
RT @StaceyReesRNLD: @WeLDnurses Yes, this would be a good start https://onlinelibrary.wiley.com/doi/10.1002/9780470774557.ch13 #WeLDNs #EBP
@WeLDnurses
21 January 2020 20:50
@StaceyReesRNLD Thanks for sharing! #weldns
@WeLDnurses
21 January 2020 20:50
@florenceella @GwenMoulster @SarahAmes20 @HabitualJoshing Welcome Flo! #weldns
@WeLDnurses
21 January 2020 20:51
@trishgriffin_ku @GwenMoulster @SarahAmes20 @HabitualJoshing Welcome Trish! #weldns
@LucyAnn_Spencer
21 January 2020 20:51
@SarahAmes20 @CommunityLd @WeLDnurses I really like this part of it #WeLDNs
@theLDphysio
21 January 2020 20:51
@WeLDnurses How do we get many of the points raised here across to our mainstream colleagues when it comes to acute admissions and in patient care planning? #weldns
@WeLDnurses
21 January 2020 20:51
RT @trishgriffin_ku: @WeLDnurses @GwenMoulster @SarahAmes20 @HabitualJoshing #weldns ????
@LiamFreeman1991
21 January 2020 20:51
@WeLDnurses During Theory, it has been RLT nursing model, but I am looking toward to using MG nursing model #weldns
@StaceyReesRNLD
21 January 2020 20:52
Totally. The M&G framework allows for a reflective approach and takes into account experience and #EBP #weLDNs https://twitter.com/weldnurses/status/1219723534487953409
@LiamFreeman1991
21 January 2020 20:52
RT @WeLDnurses: Welcome to tonight's #weldns chat with hosts @GwenMoulster @SarahAmes20 @HabitualJoshing If you're joining the chat, pleas…
@HabitualJoshing
21 January 2020 20:52
RT @StaceyReesRNLD: Totally. The M&G framework allows for a reflective approach and takes into account experience and #EBP #weLDNs
@LiamFreeman1991
21 January 2020 20:53
RT @WeLDnurses: #weldns Q1 Which nursing models have you used your practice, how have they helped you?
@Mermcm
21 January 2020 20:53
RT @StaceyReesRNLD: Totally. The M&G framework allows for a reflective approach and takes into account experience and #EBP #weLDNs https://…
@paularich1977
21 January 2020 20:53
RT @StaceyReesRNLD: Totally. The M&G framework allows for a reflective approach and takes into account experience and #EBP #weLDNs
@StaceyReesRNLD
21 January 2020 20:53
@HabitualJoshing @Shaun_LDNurse @WeLDnurses Agreed. Outcome focussed objectives and evaluation is key #weldns
@WeLDnurses
21 January 2020 20:54
#weldns Q3 How do you use evidence to inform your nursing practice and where do you look for evidence?
@GwenMoulster
21 January 2020 20:54
@theLDphysio @WeLDnurses #WeLDNs We have been working with acute liaison nurses to consider how they might use the model in their practice and I am talking to students from all fields about transferability especially in person centred approaches.
@LorenaHauton
21 January 2020 20:54
@theLDphysio @WeLDnurses That’s where the chain breaks. Had all plans in place last week at hospital with our LD liaison nurse and a LD plan but wasn’t implemented. As a consequence Son woke in recovery with no one familiar there was detrimental :( #weldns
@lynnewalsall
21 January 2020 20:54
we need to ensure its use Liam #weldns #ebp It is a big part of our new curriculum especially our year 3 @wlvuni_LD https://twitter.com/LiamFreeman1991/status/1219724321175822336
@theLDphysio
21 January 2020 20:54
@WeLDnurses What I mean in with clarity, we know all HCPs should want this. However if LeDeR has shown us anything it's that, once the person becomes and in pt, person centred care goes out the window. How do we advocate then? #weldns
@Mermcm
21 January 2020 20:54
RT @GwenMoulster: @theLDphysio @WeLDnurses #WeLDNs We have been working with acute liaison nurses to consider how they might use the model…
@dmarsden49
21 January 2020 20:54
RT @WeLDnurses: #weldns Q3 How do you use evidence to inform your nursing practice and where do you look for evidence?
@LucyAnn_Spencer
21 January 2020 20:54
RT @StaceyReesRNLD: Totally. The M&G framework allows for a reflective approach and takes into account experience and #EBP #weLDNs
@CommunityLd
21 January 2020 20:54
@WeLDnurses That’ the person is at the centre of everything. There values and preferences are accounted for and are not treated as just recipients of care #weldns
@GwenMoulster
21 January 2020 20:55
RT @StaceyReesRNLD: Totally. The M&G framework allows for a reflective approach and takes into account experience and #EBP #weLDNs https://…
@dmarsden49
21 January 2020 20:55
RT @GwenMoulster: @theLDphysio @WeLDnurses #WeLDNs We have been working with acute liaison nurses to consider how they might use the model…
@GwenMoulster
21 January 2020 20:55
RT @StaceyReesRNLD: @HabitualJoshing @Shaun_LDNurse @WeLDnurses Agreed. Outcome focussed objectives and evaluation is key #weldns
@GwenMoulster
21 January 2020 20:55
RT @WeLDnurses: #weldns Q3 How do you use evidence to inform your nursing practice and where do you look for evidence?
@LiamFreeman1991
21 January 2020 20:55
@lynnewalsall @wlvuni_LD Of course, it is my new go to book to ensure that I. Providing the best interventions for people with learning disabilities #weldns
@theLDphysio
21 January 2020 20:56
@GwenMoulster @WeLDnurses Great to hear, i often wonder what the workload of the LD liaison nurse looks like in hospitals. Do you find the above works? #weldns
@LucyAnn_Spencer
21 January 2020 20:56
@lynnewalsall @wlvuni_LD It’s something I would really like to see implemented up here in north wales #WeLDNs
@trishgriffin_ku
21 January 2020 20:56
@anne_ambridge #weldns need to incorporate into not just BSc & MSc programmes but into Nursing Associates as they are central to care
@HabitualJoshing
21 January 2020 20:56
@WeLDnurses I look for evidence for conditions, assessments, interventions etc and make sure that is embedded in care plans. The M&G model has multiple stages where evidence is considered and reflected upon. #weldns
@StaceyReesRNLD
21 January 2020 20:56
RT @GwenMoulster: @theLDphysio @WeLDnurses #WeLDNs We have been working with acute liaison nurses to consider how they might use the model…
@lynnewalsall
21 January 2020 20:57
#weldns totally Trish https://twitter.com/trishgriffin_ku/status/1219725407710261248
@trishgriffin_ku
21 January 2020 20:57
@Mermcm #weldns why is this?
@GwenMoulster
21 January 2020 20:58
@TakePartin_Art @theLDphysio @WeLDnurses #WeLDNs this is so important Lorena. Things are slowly changing and improving and in some hospitals things are so much better. We have a long way to go until culture changes and person centred care is embedded. I hope yoru son is recovering well now
@Mermcm
21 January 2020 20:58
NICE guidance, recent research eg PBS, case studies and examples of ‘good practice’ #ebp #weldns Although still often (maybe not always right) on experience & ‘intuition’ https://twitter.com/WeLDnurses/status/1219724849846767617
@lynnewalsall
21 January 2020 20:58
@LucyAnn_Spencer @wlvuni_LD Lucy it can be done #weldns
@SocialistHB
21 January 2020 20:58
@WeLDnurses Taking the time to learn what is important to the person, to learn how they are best supported and what works for them in terms of care delivery. Ensuring that the individual remains at the centre of every decision you support them in making #WeLDNs
@CommunityLd
21 January 2020 20:58
@WeLDnurses I think all practice starts with a question eg what do need to do about x? Appraise my own knowledge first and adopt a solution focussed approach. Searching for evidence could be via relative journals or peers #weldns
@HabitualJoshing
21 January 2020 20:58
RT @Mermcm: NICE guidance, recent research eg PBS, case studies and examples of ‘good practice’ #ebp #weldns Although still often (maybe no…
@StaceyReesRNLD
21 January 2020 20:58
@WeLDnurses This framework has key points where it encourages #EBP which is so important. I always look for new evidence #EBP #weldns
@LucyAnn_Spencer
21 January 2020 20:59
@WeLDnurses I have been scrolling through databases etc to find best practice. Using nice guidelines. Speaking to #RNLD As a student I find it’s hard to know if you are always looking at the right things #WeLDNs
@LiamFreeman1991
21 January 2020 20:59
@WeLDnurses When it comes to something I don't know in nursing practice, I am straight on computer and research like mad, so when I come back I have better understanding of the practice. Normally, I go from Google>websites>databases. General to research. #weldns
@LucyAnn_Spencer
21 January 2020 20:59
@lynnewalsall @wlvuni_LD I’ve already got a plan ?? #WeLDNs
@LiamFreeman1991
21 January 2020 20:59
RT @WeLDnurses: #weldns Q3 How do you use evidence to inform your nursing practice and where do you look for evidence?
@paularich1977
21 January 2020 20:59
RT @Mermcm: NICE guidance, recent research eg PBS, case studies and examples of ‘good practice’ #ebp #weldns Although still often (maybe no…
@Mermcm
21 January 2020 20:59
@trishgriffin_ku Because we are not always undertaking ‘Nursing’ but generic casework that could be done by any professional... find it hard to justify or implement a Nursing model or be person centred when targets & box ticking the name of the game ... #weldns
@GwenMoulster
21 January 2020 21:00
@Mermcm https://www.nice.org.uk/guidance/ng97/chapter/Person-centred-care #WeLDNs
@LorenaHauton
21 January 2020 21:00
@GwenMoulster @theLDphysio @WeLDnurses #Weldns yes Thankyou. Got him home to his safe familiarity as soon as could. Sometimes being “here and now” in his mind has advantages of not dwelling on the memories as we do.
@SarahAmes20
21 January 2020 21:00
@WeLDnurses I've found working with trust librarians really helpful - they can find things quickly that might take you much longer! And have found attending journal clubs useful - even if the articles being discussed are not LD focussed it can help with your searches / open up ideas #WeLDNs
@SocialistHB
21 January 2020 21:00
@WeLDnurses It supports practice in being a continual process of evaluation, in order to deliver the best and most effective care possible #WeLDNs
@lynnewalsall
21 January 2020 21:00
research matters hey Liam #WeLDNs https://twitter.com/LiamFreeman1991/status/1219726189813583872
@theLDphysio
21 January 2020 21:00
@TakePartin_Art @WeLDnurses I'm sorry to hear this. Its not an isolated case I fear. Who do we have to influence in order to affect change? #weldns
@trishgriffin_ku
21 January 2020 21:01
@theLDphysio @WeLDnurses #weldns by including as core component in all pre-reg health and social care programmes and.... medical student education. Win the latter battle and get people using early in their careers
@CommunityLd
21 January 2020 21:01
@WeLDnurses It was using this that I developed the internet risk awareness intervention and the Nursing Times Award. As there wasn’t any evidence I created some ?? #weldns
@ross_6479_RNLD
21 January 2020 21:01
RT @WeLDnurses: #weldns Q3 How do you use evidence to inform your nursing practice and where do you look for evidence?
@drliberty
21 January 2020 21:01
@WeLDnurses Databases, research papers, data gathered on interventions, feedback from individuals, other RNLD’s #WeLDNs
@StaceyReesRNLD
21 January 2020 21:01
#weLDNs https://twitter.com/staceyreesrnld/status/1219726532752629761
@trishgriffin_ku
21 January 2020 21:01
RT @GwenMoulster: @theLDphysio @WeLDnurses #WeLDNs We have been working with acute liaison nurses to consider how they might use the model…
@lynnewalsall
21 January 2020 21:02
RT @trishgriffin_ku: @theLDphysio @WeLDnurses #weldns by including as core component in all pre-reg health and social care programmes and..…
@lynnewalsall
21 January 2020 21:02
RT @drliberty: @WeLDnurses Databases, research papers, data gathered on interventions, feedback from individuals, other RNLD’s #WeLDNs
@Shaun_LDNurse
21 January 2020 21:02
@WeLDnurses An approach predicated on fact that the person being supported is at the very centre of things of actions/interactions - and, always when possibly, part of that process at determining how to centre things. #WeLDNs
@GwenMoulster
21 January 2020 21:02
@CommunityLd @WeLDnurses #WeLDNs incorporating evidence into the care plan is a crucial way of ensuring others are able to see the evidence you have used to underpin your practice. It ensures continuity and supports seamless care #ebp
@LiamFreeman1991
21 January 2020 21:02
@lynnewalsall Very much so, but for me to understand the research, I got to look at general information to help breakdown the research papers. #weldns
@LorenaHauton
21 January 2020 21:02
@theLDphysio @WeLDnurses That’s will be my dissertation! ?? #weldns
@LucyAnn_Spencer
21 January 2020 21:02
@StaceyReesRNLD @lynnewalsall @wlvuni_LD @USWCareSciences @SwanseabayNHS That’s good to hear! It would be great to roll it out nationwide #WeLDNs
@lynnewalsall
21 January 2020 21:02
RT @GwenMoulster: @CommunityLd @WeLDnurses #WeLDNs incorporating evidence into the care plan is a crucial way of ensuring others are able…
@HabitualJoshing
21 January 2020 21:03
RT @GwenMoulster: @CommunityLd @WeLDnurses #WeLDNs incorporating evidence into the care plan is a crucial way of ensuring others are able…
@lynnewalsall
21 January 2020 21:03
this is the best way #WeLDNs https://twitter.com/LiamFreeman1991/status/1219727014262910981
@lynnewalsall
21 January 2020 21:03
RT @TakePartin_Art: @theLDphysio @WeLDnurses That’s will be my dissertation! ?? #weldns
@CommunityLd
21 January 2020 21:03
@GwenMoulster @WeLDnurses I think with evidence that has to be both patient centred evidence eg patient clinical history and #Ebp #weldns
@WeLDnurses
21 January 2020 21:04
@trishgriffin_ku @anne_ambridge Interesting observation. What would be the distinction between Nursing and Nursing Associate knowledge and action with this? #weldns
@HannahScrivene2
21 January 2020 21:04
@WeLDnurses Reading journal articles recommended by lecturers,textbooks and using local and national policies and guidance for the correct procedures.I think the M&G model allows you to be more aware of importance of a good evidence-base #weldns
@LucyAnn_Spencer
21 January 2020 21:04
@SarahAmes20 @WeLDnurses Journal clubs sound interesting! I’ve never heard of that before #WeLDNs
@GwenMoulster
21 January 2020 21:04
@LucyAnn_Spencer @WeLDnurses #WeLDNs this is always a dilemma. What evidence is 'good' or valid evidence? There is a hierarchy of evidence that can help you decide on its validity. Talk to a librarian, they are a great source of advice
@WeLDnurses
21 January 2020 21:05
#weldns Q4 How easy is it to demonstrate the effectiveness of your specific interventions?
@lynnewalsall
21 January 2020 21:05
RT @WeLDnurses: #weldns Q4 How easy is it to demonstrate the effectiveness of your specific interventions?
@LucyAnn_Spencer
21 January 2020 21:05
RT @GwenMoulster: @CommunityLd @WeLDnurses #WeLDNs incorporating evidence into the care plan is a crucial way of ensuring others are able…
@trishgriffin_ku
21 January 2020 21:06
@theLDphysio @WeLDnurses #weldns by all Trusts investing in acute and primary care liaison nurses in all wards/departments and not by paying lip service with a couple in major acute hospitals for example
@LiamFreeman1991
21 January 2020 21:06
RT @WeLDnurses: #weldns Q4 How easy is it to demonstrate the effectiveness of your specific interventions?
@GwenMoulster
21 January 2020 21:06
RT @trishgriffin_ku: @theLDphysio @WeLDnurses #weldns by including as core component in all pre-reg health and social care programmes and..…
@lynnewalsall
21 January 2020 21:06
this is a great why it spread good practice #weldns we encourage students to take research into practice areas too #ebp https://twitter.com/LucyAnn_Spencer/status/1219727539121332224
@GwenMoulster
21 January 2020 21:06
RT @drliberty: @WeLDnurses Databases, research papers, data gathered on interventions, feedback from individuals, other RNLD’s #WeLDNs
@lynnewalsall
21 January 2020 21:06
RT @GwenMoulster: @LucyAnn_Spencer @WeLDnurses #WeLDNs this is always a dilemma. What evidence is 'good' or valid evidence? There is a hier…
@lynnewalsall
21 January 2020 21:07
#WeLDNs yes yes yes https://twitter.com/trishgriffin_ku/status/1219727891073839104
@Mermcm
21 January 2020 21:07
Though ‘standard’ hierarchies of evidence often are not as applicable in LD, a lot of RCTs for example still use as exclusion criteria. Often case study designs and clinical reasoning provide justification #weldns https://twitter.com/GwenMoulster/status/1219727594876219392
@trishgriffin_ku
21 January 2020 21:07
@theLDphysio @GwenMoulster @WeLDnurses #weldns maybe national role brief?
@HabitualJoshing
21 January 2020 21:07
@WeLDnurses Sometimes that is a challenge. Though using the M&G model I will evaluate impact against HEF score, other specific outcome measure, and person-centred/ quality of life goals. It’s not just a reduction in score but identifying what specifically has made the difference #WeLDNs
@GwenMoulster
21 January 2020 21:07
RT @trishgriffin_ku: @theLDphysio @WeLDnurses #weldns by all Trusts investing in acute and primary care liaison nurses in all wards/departm…
@StaceyReesRNLD
21 January 2020 21:07
@LucyAnn_Spencer @lynnewalsall @wlvuni_LD @USWCareSciences @SwanseabayNHS Defo. @pphillips2020 facilitates a pan ??????????????LDLN CoP - @GwenMoulster it wld bfab if we could look@using this model in their prac #weldns
@dr_shibley
21 January 2020 21:08
from @jandewing https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2702.2004.00925.x from @ProfBrendan https://blogs.bmj.com/ebn/2015/11/16/person-centred-care/ #weldns https://twitter.com/WeLDnurses/status/1219722081446912001
@trishgriffin_ku
21 January 2020 21:09
RT @GwenMoulster: @CommunityLd @WeLDnurses #WeLDNs incorporating evidence into the care plan is a crucial way of ensuring others are able…
@ross_6479_RNLD
21 January 2020 21:09
RT @WeLDnurses: #weldns Q4 How easy is it to demonstrate the effectiveness of your specific interventions?
@LucyAnn_Spencer
21 January 2020 21:09
@WeLDnurses I think it can be quite difficult to demonstrate the effectiveness of interventions. Linking the HEF is a great way to show effectiveness and whether health inequalities have reduced #WeLDNs
@SarahAmes20
21 January 2020 21:10
@LucyAnn_Spencer @WeLDnurses Try contacting your local NHS trust library and see what they have on offer. They can also help with Athens access etc for articles. This site might help https://www.hlisd.org/ #WeLDNs
@WeLDnurses
21 January 2020 21:10
Thanks for sharing @dr_shibley #ebp #WeLDNs weldns https://twitter.com/dr_shibley/status/1219728603325267968
@GwenMoulster
21 January 2020 21:10
@Mermcm #WeLDNs yes that's why we have to explore as widely as we can. We need to develop anhd valdiate evidence ourselves by becoming more involved in research, evaluation audit etc. There is not enough LD nursing evidence. @NorthwayRuth has done work on this, lots to learn #ebp
@dr_shibley
21 January 2020 21:10
RT @WeLDnurses: Thanks for sharing @dr_shibley #ebp #WeLDNs weldns https://twitter.com/dr_shibley/status/1219728603325267968
@WeLDnurses
21 January 2020 21:11
#WeLDNs Q5 How do you use reflection in your nursing practice?
@lynnewalsall
21 January 2020 21:11
RT @GwenMoulster: @Mermcm #WeLDNs yes that's why we have to explore as widely as we can. We need to develop anhd valdiate evidence ourselve…
@dmarsden49
21 January 2020 21:11
RT @WeLDnurses: #WeLDNs Q5 How do you use reflection in your nursing practice?
@StaceyReesRNLD
21 January 2020 21:11
@WeLDnurses #HEF is key. strengths of this model is an outcome focussed app which allows you to think about eval throughout nursing process #weldns
@ross_6479_RNLD
21 January 2020 21:12
@WeLDnurses I think it depends on the intervention and how effective the measures you use are. My aim is to find a way to use a person led outcome measure in my job #WeLDNs
@GwenMoulster
21 January 2020 21:12
RT @WeLDnurses: #WeLDNs Q5 How do you use reflection in your nursing practice?
@LucyAnn_Spencer
21 January 2020 21:12
RT @WeLDnurses: #WeLDNs Q5 How do you use reflection in your nursing practice?
@LiamFreeman1991
21 January 2020 21:12
RT @WeLDnurses: #WeLDNs Q5 How do you use reflection in your nursing practice?
@ross_6479_RNLD
21 January 2020 21:12
RT @WeLDnurses: #WeLDNs Q5 How do you use reflection in your nursing practice?
@CommunityLd
21 January 2020 21:12
@WeLDnurses Yes there needs to be an outcome measure. Measurements should be both quantitative and qualitative but unfortunately commissioners rely on the former to justify spending #weldns
@Mermcm
21 January 2020 21:12
Yes! #weldns https://twitter.com/GwenMoulster/status/1219729025565970433
@lynnewalsall
21 January 2020 21:12
@GwenMoulster @Mermcm @NorthwayRuth #WeLDNs pehaps we can get more students to engage with #ebp research of the model in practice. Hopefully then publishing too
@Mermcm
21 January 2020 21:13
Would be great to do this #weldns https://twitter.com/lynnewalsall/status/1219729532279840783
@Shaun_LDNurse
21 January 2020 21:13
@WeLDnurses 1. It’s not necessarily a linear process #WeLDNs but roughly speaking its problems (lists) to solutions and using the major databases to move down the hierarchy (selective reading, appraisal tools etc). So important for #Nurses to get right though, as generally speaking...
@trishgriffin_ku
21 January 2020 21:13
@WeLDnurses @anne_ambridge #weldns level of skills and competencies required. Nursing Associate is generic course/qualification rather than field specific
@GwenMoulster
21 January 2020 21:13
@StaceyReesRNLD @LucyAnn_Spencer @lynnewalsall @wlvuni_LD @USWCareSciences @SwanseabayNHS @pphillips2020 #WeLDNs I'm sure we could Stacey
@HannahScrivene2
21 January 2020 21:13
@WeLDnurses I suppose this can be shown through continuous evaluation of the interventions throughout their care plans so really it shouldnt be that difficult in some respect because its part of our role. Although i may have misinterpreted the question ?? #WeLDNs
@lynnewalsall
21 January 2020 21:13
#WeLDNs #ebp totally at the centre of what I do :) https://twitter.com/WeLDnurses/status/1219729127873241088
@LucyAnn_Spencer
21 January 2020 21:13
@WeLDnurses I’ve reflected on incidents and things which I have questioned in practice. I’ve found it really useful and I’ve been able to learn from it #WeLDNs
@StaceyReesRNLD
21 January 2020 21:14
@Mermcm I would be keen for @USWCareSciences students to be involved in this @NorthwayRuth #weldns
@samabdulla
21 January 2020 21:14
@WeLDnurses Constantly, although the movement to action is the hardest part! #WeLDNs
@drliberty
21 January 2020 21:14
@WeLDnurses Can be difficult, however using outcome measures such as HEF and focusing on the end goal for the specific individual makes the journey worthwhile #WeLDNs
@NorthwayRuth
21 January 2020 21:14
@GwenMoulster @Mermcm Absolutely- we need to be able to appraise and apply research but also work together to generate evidence - look for and create opportunities for involvement in research #WeLDNs
@LiamFreeman1991
21 January 2020 21:14
@WeLDnurses Through the good times and the bad times. Bad to see how I can learn from the experience and the good, to remember why I am student nurse and what I want to achieve, in the future #weldns
@LucyAnn_Spencer
21 January 2020 21:14
@WeLDnurses I love how reflection is incorporated into the model. It reminds you to think and reflect. I think it will be very useful as a student on placement and when I am qualified #WeLDNs
@Shaun_LDNurse
21 January 2020 21:15
@WeLDnurses 2. we’re carrying a lot less checklist in our heads courtesy of rote learning (say compared to the medics, or to a certain extent even the physios). Oh and don’t forget relatable guidelines! #WeLDNs
@Mermcm
21 January 2020 21:15
Yes that’s often the issue. Especially where the ‘system’ doesn’t fit the person, can reflect on where things didn’t work but v hard to change things... #weldns https://twitter.com/samabdulla/status/1219729906524925958
@lynnewalsall
21 January 2020 21:15
RT @samabdulla: @WeLDnurses Constantly, although the movement to action is the hardest part! #WeLDNs
@ross_6479_RNLD
21 January 2020 21:15
@WeLDnurses Data analysis, supervision, individual focussed workshops, incident analysis, evaluation session and care plan review sessions #WeLDNs
@GwenMoulster
21 January 2020 21:16
@CommunityLd @WeLDnurses #WeLDNs depends where you are Ross, some commissioners recognise the #HEF as the outcome measure of choice. Generally, there is a bit of movement away from counting numbers to demonstrating outcomes
@GwenMoulster
21 January 2020 21:16
RT @lynnewalsall: @GwenMoulster @Mermcm @NorthwayRuth #WeLDNs pehaps we can get more students to engage with #ebp research of the model in…
@HabitualJoshing
21 January 2020 21:17
That sums it up nicely #WeLDNs https://twitter.com/ross_6479_rnld/status/1219730312151928838
@drliberty
21 January 2020 21:17
#WeLDNs https://twitter.com/drliberty/status/1219730194262609921
@lynnewalsall
21 January 2020 21:17
RT @GwenMoulster: @CommunityLd @WeLDnurses #WeLDNs depends where you are Ross, some commissioners recognise the #HEF as the outcome measure…
@LiamFreeman1991
21 January 2020 21:17
@WeLDnurses Sometimes a reflection in the pub is needed #weldns
@samabdulla
21 January 2020 21:17
@HabitualJoshing Such a show off #WeLDNs
@LucyAnn_Spencer
21 January 2020 21:17
@lynnewalsall @GwenMoulster @Mermcm @NorthwayRuth I’m writing a research proposal as an assignment around students experience of using the model #WeLDNs
@paularich1977
21 January 2020 21:17
@WeLDnurses Reflect daily on things that have happened throughout the shift or about care plans etc. Supervision is a great tool, reflection plays a big part of the preceptorship programme too #weldns
@SarahAmes20
21 January 2020 21:17
@WeLDnurses I've often found myself reflecting on casework when I'm removed from work - and this can often be when the lightbulb moment comes, as I'm taking time to really think about what I'm doing. It's so important to try to have some protected time for reflection at work #WeLDNs
@HannahScrivene2
21 January 2020 21:18
@WeLDnurses Alot of the time in both in theory at uni and when in placement,often without realising it i think! I'm a final year student and am really trying to make sure i document my experiences/reflections...i do have a tendency to forget though! #WeLDNs
@StaceyReesRNLD
21 January 2020 21:18
RT @GwenMoulster: @Mermcm #WeLDNs yes that's why we have to explore as widely as we can. We need to develop anhd valdiate evidence ourselve…
@martsjourney
21 January 2020 21:18
@WeLDnurses So sorry I am late #WeLDNs I'll catch up now
@lynnewalsall
21 January 2020 21:18
great #WeLDNs #ebp https://twitter.com/LucyAnn_Spencer/status/1219730752658726912
@GwenMoulster
21 January 2020 21:18
@StaceyReesRNLD @Mermcm @USWCareSciences @NorthwayRuth #WeLDNs it would be great to see this. There will be an evaluation of the implementation of the model across Surrey and Borders later in the year.
@dmarsden49
21 January 2020 21:18
@WeLDnurses I use the John's model of reflection, used it in an action research project #weldns #ebp what models have others used? http://www.afpp.org.uk/filegrab/Johnsmodelofreflection.pdf
@CommunityLd
21 January 2020 21:18
@GwenMoulster @WeLDnurses I’ve recently completed a service evaluation for a post diagnostic support service for newly diagnosed autistic adults using the realist evaluation model. On this occasion the commissioners wanted both data sets with narratives providing the more powerful data #weldns
@WeLDnurses
21 January 2020 21:20
@HannahScrivene2 What do others think? #weldns
@lynnewalsall
21 January 2020 21:20
@dmarsden49 @WeLDnurses #weldns driscoll model what? so what? now what? simple
@Shaun_LDNurse
21 January 2020 21:20
@WeLDnurses New, relevant, or significant things [positive and negative]... knowledge, skills, and values [present/absent] etc. On the practicalities, index card while in practice for pompting and the REFLECT promote followed by the model that suits. #WeLDNs
@GwenMoulster
21 January 2020 21:21
RT @dmarsden49: @WeLDnurses I use the John's model of reflection, used it in an action research project #weldns #ebp what models have other…
@martsjourney
21 January 2020 21:21
@WeLDnurses All about the person, person first before any nursing. What did they like what do they like, how they can be in control, be supported to be in control and be part of all areas of Their care, not 'doing to' 'or for' #WeLDNs
@Shaun_LDNurse
21 January 2020 21:21
@WeLDnurses * REFLECT prompts. #WeLDNs
@LucyAnn_Spencer
21 January 2020 21:21
@dmarsden49 @WeLDnurses I’ve used Gibbs model. #WeLDNs
@martsjourney
21 January 2020 21:22
@WeLDnurses Not yet but it is due to play a part in an exam for a current module #WeLDNs I am still learning...
@WeLDnurses
21 January 2020 21:22
@LucyAnn_Spencer @lynnewalsall @GwenMoulster @Mermcm @NorthwayRuth Sounds exciting @LucyAnn_Spencer We hope tonight's chat can be helpful. Please keep us informed, perhaps there are more ways that we can utilise social media with your work! #weldns
@heidimckmatron
21 January 2020 21:22
Definitely! #WeLDNs https://twitter.com/trishgriffin_ku/status/1219725407710261248
@CommunityLd
21 January 2020 21:23
@WeLDnurses I use Gibbs as it was drummed into me! Don’t think I could change now #weldns
@lynnewalsall
21 January 2020 21:23
which ever model meets your needs #WeLDNs https://twitter.com/LucyAnn_Spencer/status/1219731872084787203
@GwenMoulster
21 January 2020 21:23
@dmarsden49 @WeLDnurses #WeLDNs we included Gibbs in the model as an example but always believed its important for people to find an appproach for reflection that suits their personal needs and style.
@WeLDnurses
21 January 2020 21:23
@martsjourney Welcome Martina! #weldns
@lynnewalsall
21 January 2020 21:23
RT @GwenMoulster: @dmarsden49 @WeLDnurses #WeLDNs we included Gibbs in the model as an example but always believed its important for people…
@GwenMoulster
21 January 2020 21:24
RT @Shaun_LDNurse: @WeLDnurses * REFLECT prompts. #WeLDNs
@HabitualJoshing
21 January 2020 21:24
#WeLDNs https://twitter.com/weldnurses/status/1219731141227417600
@WeLDnurses
21 January 2020 21:24
@lynnewalsall @dmarsden49 Have you got a link to share Lynne? #weldns
@GwenMoulster
21 January 2020 21:24
RT @LucyAnn_Spencer: @dmarsden49 @WeLDnurses I’ve used Gibbs model. #WeLDNs
@HabitualJoshing
21 January 2020 21:24
RT @GwenMoulster: @dmarsden49 @WeLDnurses #WeLDNs we included Gibbs in the model as an example but always believed its important for people…
@Shaun_LDNurse
21 January 2020 21:24
@WeLDnurses Used it in theory, looking forward to seeing it in action. #WeLDNs May I ask more experienced colleagues though? Generic templates and/or proformos used? Service specific? Or is it an individual thing?.. #LDNursing?..
@Mermcm
21 January 2020 21:25
I like the ‘3 what’s’ as it’s straightforward and good for eg clinical/peer discussion but my own personal reflection is generally more messy - the ‘swampy lowlands’ we were discussing the other day! #weldns https://twitter.com/dmarsden49/status/1219731073355128832
@GwenMoulster
21 January 2020 21:25
RT @Shaun_LDNurse: @WeLDnurses Used it in theory, looking forward to seeing it in action. #WeLDNs May I ask more experienced colleagues tho…
@martsjourney
21 January 2020 21:25
@GwenMoulster @dmarsden49 @WeLDnurses We have to write a reflective piece soon, we were discussing today in class.... I seem to keep going back to Gibbs as, well basically it makes sense to me ?? #WeLDNs
@dmarsden49
21 January 2020 21:25
@lynnewalsall @WeLDnurses There's also Fooks model of critical reflection. #weldns #ebp https://www.tandfonline.com/doi/abs/10.1080/14623943.2011.616687
@LucyAnn_Spencer
21 January 2020 21:26
@WeLDnurses I’ve only used it on a case study in uni. I am back out on placement in a few weeks so I am looking forward to using it then #WeLDNs
@HannahScrivene2
21 January 2020 21:26
@WeLDnurses Not yet,but i have mentioned to colleagues when i've been on placements,some weren't aware of it. I do hope to use it once i'm qualified though. #WeLDNs
@lynnewalsall
21 January 2020 21:26
https://www.ukessays.com/essays/nursing/driscoll-model-of-reflection-on-nursing-care-ethics.php try this as a start #weldns https://twitter.com/WeLDnurses/status/1219732406158155776
@CommunityLd
21 January 2020 21:26
@WeLDnurses I would’ve liked to had more of an opportunity in my current role but it wasn’t to be. Will look for opportunities upon my return to practice ??#weldns
@WeLDnurses
21 January 2020 21:26
@LucyAnn_Spencer @dmarsden49 Have you got a link to share Lucy? #weldns #ebp
@lynnewalsall
21 January 2020 21:26
RT @HabitualJoshing: #WeLDNs https://twitter.com/weldnurses/status/1219731141227417600
@HabitualJoshing
21 January 2020 21:26
@Shaun_LDNurse @WeLDnurses We have developed and provided various templates, but recognise that areas may want to adapt this to meet local need. The model provides the framework, but the tools are down to you #WeLDNs
@Shaun_LDNurse
21 January 2020 21:26
@WeLDnurses * I’m a bit of an anorak, when it comes to design, layout, application #WeLDNs. Esp. Around usability and high-yield info (on account of the #SpLDs).
@GwenMoulster
21 January 2020 21:26
@Shaun_LDNurse @WeLDnurses #WeLDNs whatever tools you use, the important thing is to remember the underpinning values base and the four key prinicples, person centred, reflective, evidence based and outcome focussed nursing care
@WeLDnurses
21 January 2020 21:27
@HabitualJoshing Second hashtag CSO of the evening, consider ourselves banged to rights?? #weldns
@HabitualJoshing
21 January 2020 21:27
RT @GwenMoulster: @Shaun_LDNurse @WeLDnurses #WeLDNs whatever tools you use, the important thing is to remember the underpinning values bas…
@LucyAnn_Spencer
21 January 2020 21:27
@HannahScrivene2 @WeLDnurses I think a lot of RNLD, especially those who aren’t on twitter aren’t aware of it. I think as students we are able to share the model and get people using it #WeLDNs
@CommunityLd
21 January 2020 21:27
@heidimckmatron @WeLDnurses Let me know if you can’t access it #ebp #weldns https://www.emerald.com/insight/content/doi/10.1108/JIDOB-04-2013-0008/full/html
@WeLDnurses
21 January 2020 21:28
RT @dmarsden49: @lynnewalsall @WeLDnurses There's also Fooks model of critical reflection. #weldns #ebp https://www.tandfonline.com/doi/abs/10.1080/14623943.2011.616687
@lynnewalsall
21 January 2020 21:28
@HabitualJoshing #WeLDNs with students and awesome placement areas. This helped to develop a mentorship model #TelfordModel
@WeLDnurses
21 January 2020 21:28
Thanks Lynne! #weldns #ebp https://twitter.com/lynnewalsall/status/1219732943385612289
@HabitualJoshing
21 January 2020 21:28
That’s your first and final warning #weldns ?????? https://twitter.com/weldnurses/status/1219733284286074885
@HabitualJoshing
21 January 2020 21:28
RT @lynnewalsall: @HabitualJoshing #WeLDNs with students and awesome placement areas. This helped to develop a mentorship model #TelfordMod…
@lynnewalsall
21 January 2020 21:28
#WeLDNs spread the word :) https://twitter.com/LucyAnn_Spencer/status/1219733345850023939
@GwenMoulster
21 January 2020 21:28
RT @WeLDnurses: Thanks Lynne! #weldns #ebp https://twitter.com/lynnewalsall/status/1219732943385612289
@WeLDnurses
21 January 2020 21:29
Thanks to everyone for joining the #weldns chat this evening, in particular @SarahAmes20 @HabitualJoshing & @GwenMoulster for offering to host tonight!
@GwenMoulster
21 January 2020 21:29
RT @lynnewalsall: @HabitualJoshing #WeLDNs with students and awesome placement areas. This helped to develop a mentorship model #TelfordMod…
@GwenMoulster
21 January 2020 21:29
RT @CommunityLd: @heidimckmatron @WeLDnurses Let me know if you can’t access it #ebp #weldns https://www.emerald.com/insight/content/doi/10.1108/JIDOB-04-2013-0008/full/html
@LucyAnn_Spencer
21 January 2020 21:29
RT @GwenMoulster: @Shaun_LDNurse @WeLDnurses #WeLDNs whatever tools you use, the important thing is to remember the underpinning values bas…
@lynnewalsall
21 January 2020 21:29
RT @WeLDnurses: Thanks to everyone for joining the #weldns chat this evening, in particular @SarahAmes20 @HabitualJoshing & @GwenMoulster f…
@LiamFreeman1991
21 January 2020 21:29
@HannahScrivene2 @WeLDnurses That is goodness of being student nurse, we can share new models and help change practice for the better #weldns
@WeLDnurses
21 January 2020 21:30
#weldns Lots of #ebp shared this evening! https://twitter.com/CommunityLd/status/1219733372609744901




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