An evidence-based proposal for the role development of paraprofessionals to include enteral tube feeding responsibilities at Centre X

Baptista, Veronica (2016) An evidence-based proposal for the role development of paraprofessionals to include enteral tube feeding responsibilities at Centre X. Masters dissertation, University of Cumbria. Item availability may be restricted.

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The number of persons with disabilities is increasing, both internationally and locally. Additionally, there are more persons with multiple complexities who require enteral tube feeding (ETF). Presently, there is only one local, day care facility, for adults with exceptionalities. This facility, referred to as Centre X, employs case workers and paraprofessionals. No nursing personnel are available onsite. Paraprofessionals provide basic care for clients, including assisting clients with leisure, or work-related, activities and supporting personal care needs, such as toileting and feeding. To date, ETF is viewed as a nursing responsibility, even though the Bermuda Nursing Council (BNC) does not indicate this to be the case (Parker (BNC), 2014). Consequently, individuals with disabilities who require ETF are excluded from Centre X and its programme offerings.

This dissertation explores the feasibility of establishing a local ETF programme to robustly train the paraprofessional staff of Centre X to assume ETF responsibilities, for an evidence-based change in practice. The project is representative of a complex change initiative. As such, a plethora of change management tools are discussed and critically applied to the proposal for role development. The literature review explores various themes important in the consideration of expanding the paraprofessional role. Topics include parental psychosocial disability impact, disability effects on adults with disabilities, present roles of nurses and paraprofessionals, legal issues of role development, evidence regarding expanded practice, consequences of poor ETF practice and ETF standards of care which promote safe client outcomes. The ACT model (Biech, 2007) and the CDC’s framework for public health programme analysis (CDC, 2016, 1999) have both been systematically applied throughout the change process. The work undertaken thus far, will guide the construction of a business case proposal, which will be presented to senior management for approval consideration of the stated change initiative.

The work presented in this dissertation affirms that paraprofessionals can, and should, be trained to undertake ETF responsibilities (WHO, 2015; NICE, 2012). In so doing, less discrimination will take place at Centre X, and people with disabilities, requiring ETF, will be able to participate in social and/or training opportunities (ADS, 2016). As an RN, this writer has a legal and ethical duty to advocate for quality improvements to be made in caring for vulnerable members of the community (RCN, 2012; BNC, 2012, 2005). There is clear consensus by international organisations that governments must provide disability services for its citizens (WHO, 2015; UK Chief Nursing Officers, 2012; UN, 2007, 2006). Providing appropriate care is a matter of human rights (WHO, 2015; UK Chief Nursing Officers, 2012; UN, 2007, 2006). Allowing paraprofessionals to assume ETF responsibilities would be a start to realising this international mandate (WHO, 2015; UN, 2007, 2006).

Item Type: Thesis/Dissertation (Masters)
Departments: Academic Departments > Nursing, Health & Professional Practice (NHPP)
Additional Information: Dissertation submitted in partial fulfilment for the MSc in Advanced Practice and Social Care Programme.
Depositing User: Anna Lupton
Date Deposited: 02 Aug 2017 15:08
Last Modified: 05 Jul 2021 16:01
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