What are progress notes?

Progress notes are written records of the care and support that you provide to your clients. They are important for a number of reasons, including:

• Communicating with other members of the care team

• Tracking your client's progress towards their goals

• Documenting any incidents or concerns

• Providing evidence of your work

What should be included in progress notes?

Your progress notes should include the following information:

• Your name and the date and time of the note

• Your client's name and identification number

• A summary of the care and support you provided

• Any significant incidents or concerns

• Your client's response to the care and support

• Any recommendations for future care

How should progress notes be written?

Progress notes should be written in a clear and concise style. They should be objective and factual, and should not include your opinions or interpretations.

Here are some tips for writing effective progress notes:

• Use the active voice instead of the passive voice.

• Be specific and use concrete details.

• Avoid jargon and technical terms.

• Write in chronological order.

• Use headings and subheadings to organize your notes.

• Proofread your notes carefully before submitting them.

Where should progress notes be kept?

Progress notes must be stored in a secure location, accessible only to authorized personnel, and retained for a duration that aligns with your organization's policies and procedures. Tas Home Nursing (THN) employs the ShiftCare app as the designated platform for managing and safeguarding these records.

Suggested template for staff to follow as a guide.

Date:

Client:

Summary of Shift: 

Support Provided:

Observations:

Incidents/Concerns:

Next Steps:

Comments:

NDIS Quality and Safeguards Commission – Quality, Safety and You

This engaging digital course outlines the responsibilities of workers under the NDIS Code of Conduct, viewed through the lens of NDIS participants. It's recommended for all certified NDIS providers to incorporate this training into their new employee onboarding process. Existing staff are also urged to complete the course over time. The training consists of four segments and takes roughly 90 minutes to complete. A completion certificate is awarded at the end. 

National Disability Services (NDS) – Human Rights and You eLearning Program

This complimentary, video-driven online course delves into the importance of human rights in the context of supporting individuals with disabilities. The course is divided into four segments, requiring approximately 30 minutes to complete, and concludes with a certificate. 

NDS – Understanding Abuse eLearning Program

Offered by NDS, this no-cost, half-hour digital course equips disability support staff to identify abuse as an infringement on an individual's human rights. The course emphasizes the importance of focusing on each individual's well-being as the optimal approach to safeguarding rights and reducing the risk of abuse. It also outlines indicators that abuse may be happening to clients. 

La Trobe University – Support for Decision Making 

This complimentary online resource is grounded in the belief that all individuals have the right to be involved in making decisions that affect them. Utilizing a research-backed framework, the course aids support workers in empowering those they assist to make choices and exert control in their lives. The course is divided into six segments, each requiring between 30 to 60 minutes to complete. 

Traumatic Brain Injury (TBI) – University of Tasmania Understanding TBI MOOC

This freely accessible MOOC is designed for anyone interested in gaining a deeper understanding of TBI, including disability support workers. The course spans five weeks, requiring about two hours of commitment per week. Participants can earn a certificate by successfully completing the end-of-module quizzes. 

Mental health – MHPOD

This free, research-supported online learning platform offers over 100 hours of content across 74 different subjects. Initially created for mental health professionals like nurses and psychologists, the resource has been extended to include disability support workers. 

NDS – Hand Hygiene Short Course

This complimentary 30-minute course focuses on the essential aspects of hand hygiene, detailing proper hand-washing techniques and the consequences of inadequate hand hygiene. 

Department of Health – COVID-19 infection control training

In light of the ongoing COVID-19 situation in Australia, this free digital training is aimed at care providers in all health sectors, including NDIS disability support. Registration is required to access the course modules. 

Australian Commission on Safety and Quality in Health Care – Infection Prevention and Control eLearning 

This collection of modules offers insights into the fundamentals of infection prevention and control in Australian healthcare environments. The 'Introduction to Infection Prevention and Control' module is appropriate for all healthcare providers and students, including those working in disability support.

To enrol, you need to register as a new user in the National Hand Hygiene Initiative‘s Learning Management System.

DoFoodSafely 

This free digital course, supported by various Australian health departments, instructs staff on safe food handling practices in commercial environments. After completing the seven segments, participants can take a quiz to earn their DoFoodSafely Certificate of Completion.

Quick Contacts in Tasmania

• Emergency: 000

• If you have a hearing or speech impairment and your life or property is in danger, you can contact police, fire or ambulance on 106 directly through a TTY (also known as a teletypewriter or textphone). 

• Tas Home Nursing: 0422 961 296

• Poisons Information Hotline: 131 126

• Health Direct: 1800 333 000

If a Client is Suicidal

• Immediate Response: Stay calm, stay with the client, ensure safety.

• Ask Directly: Ask if suicidal, use compassionate language.

• Seek Help: Call 000 if immediate danger, or Lifeline 131 114.

• Notify Supervisor: Inform your supervisor promptly.

• Document: Record incident, follow organizational protocols.

If a Client is Seriously Injured

• Safety First: Assess, provide first aid, ensure immediate safety.

• Call Emergency Services: Dial 000 if needed.

• Notify Supervisor: Contact supervisor, follow organizational guidelines.

• Incident Report: Document details, include witnesses if available.

If a Client Poses a Danger in the Community

• Assess the Situation: Determine risk, consider immediate and long-term safety.

• Maintain Safety: Prioritize everyone's safety, including your own.

• Notify Authorities: Call 000 if immediate danger, follow legal obligations.

• Contact Supervisor: Seek guidance, follow organizational protocols.

• Documentation: Record incident, include all relevant details.

Domestic, family or sexual violence

• Listen Actively: Offer a safe, non-judgmental space for the client to share. Avoid interrupting or questioning their experience.

• Ensure Safety: Assess immediate danger. If there's a threat to their safety, help them access emergency services or a safe shelter.

• Provide Information: Offer resources, such as local helplines, counseling services, and legal options. 1800RESPECT 1800 737 732  is available for free, 24 hours a day, 7 days a week to support people impacted by domestic, family or sexual violence. 

• Respect Autonomy: Empower the client to make their own decisions. Do not pressure or make decisions for them.

• Document & Report: Follow organizational protocols for documentation. Report if mandated, but always inform the client about any actions taken.

Remember, the specifics of how to handle such disclosures might vary based on local laws, organizational policies, and the unique needs of the client. Always prioritize the safety and well-being of the client.

### **Self-Care Guide for Support Workers**

#### **1. Recognize the Importance of Self-Care**

- Understand that taking care of yourself isn’t selfish; it's essential. By ensuring your own well-being, you're better equipped to help others.

#### **2. Set Boundaries**

- Clearly define your working hours and stick to them as much as possible.

- Learn to say "no" when necessary. It's okay to decline additional tasks or shifts if it compromises your well-being.

#### **3. Take Regular Breaks**

- Even short breaks during the day can help you recharge. Take a walk, practice deep breathing, or simply relax for a few minutes.

- Ensure you take your allocated days off and consider occasional longer breaks or vacations.

#### **4. Stay Connected**

- Talk to colleagues about challenges and share coping strategies. They can offer support and understanding.

- Maintain a social life outside of work. Spend time with loved ones and engage in activities that bring you joy.

#### **5. Seek Supervision or Counseling**

- Regularly debrief with a supervisor or counselor. This can help process difficult situations and emotions.

- Consider joining a support group for professionals in your field.

#### **6. Prioritize Physical Health**

- Engage in regular exercise, even if it's just a short walk every day.

- Eat a balanced diet and stay hydrated.

- Ensure you get adequate sleep.

#### **7. Engage in Relaxation Techniques**

- Consider practices like meditation, yoga, or deep breathing exercises.

- Find hobbies or activities that help you relax and disconnect from work.

#### **8. Educate Yourself**

- Attend workshops or seminars on self-care and stress management.

- Stay updated on best practices in your field to feel more confident and competent in your role.

#### **9. Avoid Over-reliance on Stimulants or Depressants**

- Limit caffeine intake, especially in the latter part of your shift.

- Be cautious with alcohol or other substances. They might offer temporary relief but can exacerbate stress and fatigue in the long run.

#### **10. Set Realistic Expectations**

- Understand that you can't help everyone or solve every problem. Focus on what you can control and let go of the rest.

- Celebrate small victories and acknowledge your efforts.

#### **11. Create a Comfortable Work Environment**

- Personalize your workspace, if possible, to make it more inviting.

- Ensure you have the necessary tools and resources to do your job effectively.

#### **12. Stay Financially Informed**

- Financial stress can add to your burdens. Create a budget, save regularly, and seek financial advice if needed.

#### **13. Continuously Reflect and Adjust**

- Regularly assess your well-being and make adjustments to your self-care routine as needed.

- Remember that self-care is an ongoing process, not a one-time event.

In conclusion, as a support worker, you play a pivotal role in the lives of many. By prioritizing your own well-being, you not only ensure your own health but also enhance the quality of care you provide. Remember, self-care is not a luxury; it's a necessity.

**Professional Boundaries for Support Workers**

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**Introduction**

Professional boundaries delineate the limits of the relationship between support workers and their clients. These boundaries safeguard the safety, well-being, and integrity of both parties, ensuring the relationship remains professional, preventing conflicts of interest, exploitation, and other potential harms.

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**Key Principles of Professional Boundaries**

1. **Role Clarity**: Always be clear about your role as a support worker and avoid venturing outside of your professional capacity.

2. **Power Dynamics**: Be aware of the inherent power imbalance in the support worker-client relationship and never exploit it.

3. **Consistency**: Ensure all clients receive consistent care, respect, and professionalism.

4. **Confidentiality**: Always protect the privacy and personal information of clients, disclosing only when there's a risk to their or someone else's safety.

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**Scenarios for Self-Evaluation and "Do Nots"**

1. **Gifts and Gratuities**:

   - Scenario: A client offers you a gift as a token of appreciation.

   - Reflection: Is accepting the gift appropriate? Could it create a sense of obligation or perceived favoritism?

   - **Do Not**: Accept gifts that could compromise the professional relationship or create conflicts of interest.

2. **Personal Relationships**:

   - Scenario: A client lives in your neighborhood and invites you to a social gathering.

   - Reflection: Is attending appropriate? How might this affect the professional relationship?

   - **Do Not**: Engage in social relationships with clients that could blur professional boundaries.

3. **Self-Disclosure**:

   - Scenario: A client inquires about your personal life, including family, relationships, or personal struggles.

   - Reflection: How much personal information, if any, is appropriate to share?

   - **Do Not**: Share personal details that could compromise your professional stance or the client's perception of you.

4. **Physical Contact**:

   - Scenario: A client is distressed and seems to need a comforting gesture, like a hug.

   - Reflection: Is physical contact appropriate? Are there other ways to offer comfort?

   - **Do Not**: Initiate or engage in physical contact without clear consent or understanding of its implications.

5. **Social Media and Technology**:

   - Scenario: A client sends you a friend request on a personal social media platform.

   - Reflection: Is it appropriate to accept?

   - **Do Not**: Engage with clients on personal social media platforms, as it can blur professional lines.

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**Strategies to Maintain Professional Boundaries**

1. **Regular Training**: Participate in workshops and training sessions on professional boundaries.

2. **Supervision and Peer Support**: Discuss boundary challenges with supervisors or peers for insights.

3. **Clear Communication**: Set and communicate clear expectations with clients about the professional relationship.

4. **Self-awareness**: Reflect on actions and decisions to ensure alignment with professional standards.

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**Conclusion**

Adhering to professional boundaries is paramount for the efficacy and integrity of the support worker-client relationship. By understanding, reflecting upon, and practicing these boundaries, support workers can ensure optimal care while protecting both their professional and personal well-being.