Annaleese is now 12 weeks pregnant. Her husband, Jamie is present at today’s appointment in the antenatal clinic.
Annaleese discloses that she has a cochlear implant but also uses British Sign Language and lip reading.
Jamie is a youth worker. They have been married for 8 years and met at the local Deaf Club. Annaleese works there as a youth worker and Jamie used to attend with his brother who is profoundly Deaf.
Annaleese’s grandmother founded the Deaf Club as she herself was profoundly Deaf. Jamie’s dad is Deaf and has always used BSL, having attended a boarding school for the Deaf from 4-18 years so all of Jamie’s family sign. As he says today “I could sign before I could speak.”
ACCESS TO INFORMATION
Women cannot make an informed choice about her choices and care if they do not have the information upon which to base their decision. This information needs to be given as clear, comprehensive and unbiased information as well as being developed through a collaborative relationship with the parents who are living with the disability.
Do you think the written information you give to parents is clear, comprehensive and unbiased? What about parents with particular needs as in this case?
Activity One
Purpose:
To review guidance on how to produce information for new parents living with a disability.
Task:
- Search for UK based websites that provide guidance which can assist you in producing information for parents with disabilities
- Select one website and list at least three key principles that are used to underpin the production of information for at least two different disabilities.
- Post the key points to the discussion board.
NB The Plain English Campaign allows The Crystal Mark to be used on documents as a seal of approval for the clarity of a document and is internationally-recognised.It has been in use since 1990, and is used by over 2,000 organisations who want to provide the clearest possible information.
accessible-info-standard-overview-2017-18.pdf
Activity 2:
Purpose
To consider how whether the information that is given within health care services meets the needs of disabled parents.
Task
Audit one or two pieces of information you give to parents and reflect upon how this may need to be adapted for
Someone with a hearing impairment?
>Ask yourself the following questions:
- How readily available is a range of materials in your clinical setting?
- How is your information displayed?
- Would there be a cost to produce this information in different formats?
- Does the information meet the standards you identified in the previous activity?
ACCESS TO INFORMED CHOICE AND CONSENT
As health professionals we have a duty to offer informed choice and gain informed consent (NMC 2018). All parents must be given information in a format that they can understand. Many questions asked by prospective and new parents with a disability will be the same questions asked by all parents –
Will the test harm my baby?
When shall I come into hospital- how will I know when I am in labour?
When should I start taking folic acid tablets?
Should my baby have the MMR vaccination?
So do new parents living with a disability really have true informed choice and give consent?
Activity 3:
Purpose
To consider whether parents with disability have choices and give truly informed consent.
Task
- Read the following case example from maternity care practice where care could be compromised as informed choice or consent was difficult to obtain.
Annaleese has a hearing impairment. Throughout the antenatal period an interpreter has been used for all appointments with the midwife in the health centre and in the antenatal clinic at the hospital. Annaleese and her partner developed a birth plan and a plan for labour was discussed with her midwife. Annaleese goes into labour at term plus six days. It is bank holiday Monday. Jamie is out of town so is not immediately available to be with Annaleese whilst in labour.
Now answer the following questions
How can informed consent be gained from Annaleese for example to perform a vaginal examination or prior to drug administration?
- could alternative strategies be used to gain her consent?
- consider the consequences if informed consent is not gained from Annaleese
> Using your answers to the above questions demonstrate how the maternity team could improve Annaleese’s care and experience? What choices can be offered to her? What role would each member of the team play?
Reflect upon some of the consequences if care was needed and informed consent needed in the following situations:
- During an antenatal booking visit
- Taking a blood sample
- If her baby is admitted to the neonatal unit
- When she goes home with her baby
- If her child is admitted to a paediatric ward
- She needs to collect medicines from a chemist
- She needs an out of hours doctor
- She needs to attend a family planning clinic
- She needs to attend a clinic for cervical screening
- She needs an emergency operation
Whenever an interpreter is not available?
ACCESS TO HEALTH PROMOTION
As health professionals’ midwives have a major role in public health but without giving attention to physical access and access to information issues we will continue to have problems with uptake and meeting targets in areas such as breast and cervical screening.
Also it is important as new parents that midwives can help signpost health promotion literature around topics affecting baby such as feeding options, immunisations and how to access the places they need to go with their new baby for example, baby clinics and immunisation clinics.
How successful is health promotion for disabled parents?
Activity 4.
Purpose
To consider the importance of health promotion and health education for new parents living with disabilities
Task
List some key health promotion messages and how these messages could be adapted by the inter professional team for
Someone with a hearing impairment?
NCT
Accessible Information Standard- see link here
accessible-info-standard-overview-2017-18.pdf