High intensity Support Skills

Complex Bowel care

Dolphin Wellness can provide complex bowel care to the participants at risk of severe constipation or faecal incontinence, for example, CP GMFCS1 levels 3,4,5; spinal injuries; some ABI and where the bowel care plan involves non- routine treatment such as use of non-routine PRNs.

We guarantee our service by ensuring our staffs receive the following trainings: basic anatomy of the digestive system, importance of regular bowel care and understanding of stool characteristics indicating healthy bowel functioning and related signs and symptoms, basic understanding of related conditions including autonomic dysreflexia; symptoms/indications of need for intervention and when to refer to health practitioner e.g. overflow, impaction, perforation; infection, understanding of intervention options and techniques including administering enemas and suppositories, digital stimulation, massage etc. and related guidelines and procedures, nutrition and hydration requirements. A detailed care plan will be established while developing service agreement, our staffs will follow the care plan, observe and record change bowel habits; administer laxatives, enemas or suppositories according to procedure and identify when to seek health practitioner advice.

Enteral Feeding and Management

Supporting a person who is reliant on percutaneous endoscopic gastrostomy (PEG) feeding can be part of a general support worker role. A person reliant on NG feeding typically has more complex health issues requiring high intensity support. A detailed care plan will be established while developing service agreement.

Our support worker will follow personal hygiene and infection control procedures; confirm need and consent for enteral feeding, introduce food via tube according to plan; monitor rate and flow of feeding and take appropriate action to adjust if required; keep stoma area clean and monitor and report signs of infection; check that the tube is correctly positioned, monitor equipment operation; follow procedures to respond to malfunction e.g. blockages, follow procedures to document a request to review mealtime plan where required; liaise with health practitioners to explain/demonstrate requirements (e.g. hospital staff), recognise and respond to symptoms that could require health intervention e.g. reflux, unexpected weight gain or loss, dehydration, allergic reaction, poor chest health.

Tracheostomy Care

Our staffs with advanced skills to provide Tracheostomy care had been trained and demonstrated competency to support a person dependent on ventilation. They follow personal hygiene and infection control procedures; monitor skin condition and keep stoma area clean; follow procedures (in plan) to perform routine suctioning to maintain clear airways; monitor report abnormal secretions; clean and maintain suctioning equipment; support routine tube tie changes (as outlined in plan and in support of an appropriate health practitioner); maintain charts/records; recognise and respond to signs that airways are obstructed; implement emergency procedures deteriorating health or infection.

Ventilation Care

Once the need for ventilation is confirmed in participant’s care plan, we will assigned fully trained staff to the participants, follow personal hygiene and infection control procedures; identify and connect or assemble components of ventilation equipment according to instructions, follow instructions to operate prepare ventilator for operation, fit the breathing mask, start ventilation and monitor that it is working effectively, follow trouble-shooting procedures to respond to alarms and maintain equipment.

We can provide care to participant has a tracheostomy and uses a ventilator, and participant requires ventilation but does not have a tracheostomy to provide either invasive or non-invasive ventilation.

Urinary Catheters Care

Our staffs looking after participants with Urinary Catheters (IDC and SPC) had received training in Basic understanding of urinary system for males and females; hydration; types of catheters; procedures and challenges in inserting catheters in males and females (intermittent catheters only); common complications associated with using different types of catheters, indicators of complications that require intervention and understanding when to involve a health practitioner. Therefore, we can provide quality catheter care by replacing and disposing of catheter bags; maintaining charts/records; monitoring skin condition around catheter; recognising and respond/report blockages, dislodged catheters, signs of deteriorating health or infection.

Subcutaneous Injection and Diabetic Management

Dolphin Wellness provides subcutaneous injection for medication administration (including but not limited to insulin, Erythropoietin Morphine, Diacetylmorphine, and Clexane) and diabetes care support to participants with a care plan enlisting management of subcutaneous injection and medication administration. Staffs deployed to support participants with diabetes and a subcutaneous injection needs are required to attend compulsory training and deemed competent in subcutaneous injection and diabetes management support provision. Safe and quality care will be guaranteed by confirming client details and need for injection, following personal hygiene and infection control procedures; following safe injecting procedures using pumps and pens (containing pre-measured dose), monitoring for any adverse reactions and proper management of emergency situations.

Complex Wound Management

Dolphin Wellness staffs who can provide complex wound care had gear up with comprehensive knowledge and skills in common skin integrity risks; common indications of infection and required response; implications of prolonged or worsening infection; purpose and methods for positioning and turning to manage pressure and choking risks; implications of wound management for delivering daily support activities such as showering, toileting, mealtime assistance and mobility. As a result, we can recognise risk and symptoms of pressure, identify when to refer to health practitioner; follow plan instructions to inspect/replace dressings (under health practitioner supervision and only when indicated in wound management plan).