Aboriginal and Torres Strait Islander Health and Cultural Safety

Introduction to Implications of Practice and Prevention for Poisoning

Poisoning is one of the leading reasons behind the childhood injury among the children of Aboriginal community. The higher risk of poisoning has been seen in the Aboriginal children of age 0-4 years. Children have been admitted to the hospitals with the cases of poisoning during their developmental stage. Pharmaceutical substances, such as prescription medications and overthe-counter have been considered as the most common and unintentional cause of poisonings in Australia. Among Aboriginal and Torres Strait Islander community children, analgesic, psychotropic, antiepileptic, and other general as well as cardiovascular medications have been found the most common causes of pharmaceutical poisoning. It has also been seen that the aboriginal children were poisoned mostly within their residential premises, out of which kerosene oil is found as the most common poison. Kerosene oil has potentially evoked the risks of aspiration pneumonia and the hazardous first aid measures that are practised and followed by the care givers has increased the risk. The complications related to this are rare but, can be prevented by the provision community education and spread of awareness regarding up-to-dated attention in order to seek medical care along with the forestalling of destructive first aid practices (Senserrick et al. 2010).

The case scenario prepared for this assessment is a reflection that focuses on the health issue “Poisoning” among the children population.

Case Study Scenario

During my clinical placement, I was being posted in a child ward. As I was new there I was observing the pattern of work the other nurses were following and there, I noticed that there were children from different communities. Though, I did not asked about this to anyone that who among the all belongs to which community but, the behaviour and the actions of the staff member clearly showed the discrimination. The ward was specifically for the children injured with unintentional poisoning. When a same age group of population is getting care at the same place from the same healthcare providers, there was still some bias between the quality care services provided to them. What I personally noticed there was, lack of cultural competency, poor leadership, and poor therapeutic communication. All of the three aspects are important in provision of healthcare services and patient-centered care.

Topic

The topic of this assessment is Implications of practice and prevention for poisoning among the Aboriginal children. Reducing the rate of poisoning among the Aboriginal children needs a combination of strategies and this include household storage interventions, packaging legislation enforcement, and accessible poisons information centeres. According to Adams, et al., (2016) Till now, no identified prevention programmes for the injury from poison have exclusively addressed the unintentional poisoning in Aboriginal children. However, the key to prevent childhood poisoning is safe storage of the medications. It has been reportedly seen that Aboriginal families often face various challenges and barriers in the promotion of safe storage and this is because the outlay of the safety prohibitions and apparatus in the home installations. However, this problem could be solved by providing equipments at no cost or at low cost. This could potentially enhance the storage practices at households, predominantly with the fitting and education help (Senserrick , et al. 2010).

Nursing or Midwifery Interventions

The actions that could be taken by an Aboriginal health care practitioner depend on different types of instructions and the support that are available. In general, there are two types of supervisions that could be provided by the practitioners:

Operational supervision:

This is the day-to-day regular supervision that is required in assisting with the recital of the responsibilities and duties along with meeting the policy requirements of employment.
This may include:
Performance with respect to the Role Description
Performance development i.e. performance development and appraisal
Mandatory training
Orientation and inductions
Rostering/timesheets
Support and guidance.

Clinical supervision:

The person who has and fulfils the primary responsibilities regarding clinical supervision of the work that is done by the Aboriginal practitioner is termed as primary clinical supervisor.
He is responsible for the development and agreement of the Practice Plan that has to be implicated by collaborating with the individual Aboriginal Health Practitioner. It has been identified that there are chances that the other clinicians can also provide clinical supervision to the Aboriginal Health Practitioner regarding specific locations or activities.
Clinical supervision have been provided by a:
Registered nurse
Medical officer
Allied health professional
Aboriginal Health Practitioner – that has at least 2 years of continuous experience that too recently and with the required type of supervision Midwife
Dentist

However, effective clinical supervision that is potential in provision of effective clinical supervision includes:

Understanding the roles and responsibilities of Aboriginal people
Understanding the components of the Aboriginal with Certificate IV
Setting up of a clear goal of expectations regarding the clinical supervisory relationship
Development of children-centered care and practice plan in collaborating with the Aboriginal Health Practitioner along with activity planned reviews of the Practice Plan
Using along with maintaining the clinical supervision documentation i.e. Performance Appraisal, Practice Plan, and Development
Evaluation of the efficacy of supervision
Setting up some new learning objectives facilitating reflective practice • providing a culturally safe and respectful work environment

Cultural safety is the most important aspect while providing care to the patients that belong to a different culture from the practitioner.

Cultural Safety in Nursing or Midwifery Practice

Cultural safety can be described as an atmosphere that is safe and protected for people. A surrounding where people do not face any assault, rebuff their identity, regarding who they actually are and what they want. It is all about shared knowledge, shared meaning, shared respect, and experiences about learning, working, and living together with self-respect and dignity.

In case of Aboriginal people cultural requires:

Surroundings with cultural resilience within the Aboriginal communities
Cultural competency from those who are engaged with Aboriginal communities

However, Communication, Recognition, Respect , and Embrace are the factors that help in maintaining the cultural safety.

References for Implications of Practice and Prevention for Poisoning

Adams, S. et al. (2016). Child Safety Good Practice Guide: good investments in unintentional child injury prevention and safety promotion. Sydney: Sydney Children's Hospitals Network.

Dayasiri, M., Jayamanne, S. F., & Jayasinghe, C. Y. (2018). Patterns and outcome of acute poisoning among children in rural Sri Lanka. BMC Pediatrics, 18(1), 274. https://doi.org/10.1186/s12887-018-1246-0

Senserrick ,T. et al. (2010). Aboriginal injury prevention projects: a rapid review. Ultimo, Australia: Sax Institute for NSW Health and the George Institute.

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