Brîff 7 Munud - Enghraifft Achos Briwiau Pwysedd Pressure Ulcers case example 7 Minute Briefing

1. BETH YDYW? 1. WHAT IS IT? Mae briwiau pwysedd (a elwir hefyd yn friwiau pwyso neu ddolur gwely) yn anafiadau i’r croen ac o dan y feinwe, sy’n cael eu hachosi’n bennaf gan bwysedd estynedig ar y croen. Maent yn gallu digwydd i unrhyw un, ond fel arfer maent yn effeithio ar unigolion sydd wedi eu cyfyngu i wely neu sy’n eistedd mewn cadair neu gadair olwyn am gyfnod hir o amser. Pressure ulcers (also known as pressure sores or bedsores) are injuries to the skin and underlying tissue, primarily caused by prolonged pressure on the skin. They can happen to anyone, but usually affect people confined to bed or who sit in a chair or wheelchair for long periods of time

2. Enghraifft Achos 2. Case Example Mae “X" yn ddyn 86 mlwydd oed ac yn byw mewn Cartref Gofal Preswyl. Mae ei iechyd corfforol wedi gwaethygu’n ddiweddar ac mae e nawr yn derbyn ei ofal i gyd o’r gwely. Mae Sgôr Waterlow X yn dangos ei fod o risg uchel o ddatblygu briw pwysedd. Mae gan X offer i leddfu pwysedd ar waith a chynllun gofal ar gyfer ail-leoli bob dwy awr. “X is an 86yr old man living in a residential Care Home. His physical health has recently deteriorated and he is now receiving all of his care in bed. X ‘s Waterlow Score indicates he is at high risk of developing a pressure ulcer. X has pressure relieving equipment in situ and a care plan for 2 hourly repositioning

3. Pryder 3. Concern Yn ystod ymweliad rheolaidd gan Gweithiwr Cefnogi Gofal Iechyd, dywedodd X ei fod mewn poen sylweddol. Wrth archwilio’n bellach gwelodd y Gweithiwr Cefnogi Gofal Iechyd bod briwiau pwysedd gradd 2, 3 a 4 ar wahanol safleoedd o gorff X. Sylwodd y Gweithiwr Cefnogi Gofal Iechyd nad oedd y 'Cofnod Troi ac Ail-leoli’ wedi cael ei gwblhau’n rheolaidd ac nid oedd cofnod o safleoedd y briwiau yn cyd-fynd â chyflwyniad X. During a routine visit by a Healthcare Support Worker [HCSW] X indicated he was in extreme discomfort. On closer examination the HCSW observed multiple grade 2, 3 & 4 pressure ulcers to various sites on X’s body. The HCSW noticed the ‘Turning & Repositioning Record’ had not been completed consistently and recording of ulcer sites was not consistent with X’s presentation.

4. CYDNABYDDIAETH 4. RECOGNITION Mae X yn ‘Oedolyn mewn Perygl’ yn unol â diffiniad SSWBA [2014]. Mae ganddo ofynion gofal a chefnogaeth oherwydd ei amodau iechyd corfforol. Mae’r Gweithiwr Cefnogi Gofal Iechyd yn pryderu bod X wedi bod yn destun camdriniaeth ar ffurf esgeulustod, gan nad yw’n gallu rheoli ei anghenion gofal ei hun. Mae hyn yn ‘Bryder Diogelu Oedolion’. Nododd y Gweithiwr Cefnogi Gofal Iechyd bod y sefyllfa hon yn gallu golygu ‘Esgeulustod Bwriadol’ hefyd, sy’n drosedd a gyflwynwyd gan y Deddf Galluedd Meddyliol [2005], ar gyfer oedolion gyda diffyg cymhwyster i wneud X is an ‘Adult at Risk’ in accordance with the SSWBA [2014] definition. He has care and support needs due to his physical health conditions. The HCSW was concerned that X may have been subjected to abuse in form of neglect, since he was unable to manage his own care needs. This is an ‘Adult Safeguarding Concern’. The HCSW recognised that this situation could also constitute ‘Wilful Neglect’ which is a crime introduced by the Mental Capacity Act [2005], for adults who lack capacity to make certain

5. MATERION ALLWEDOL 5. KEY ISSUES Dylai’r Gweithiwr Cefnogi Gofal Iechyd drafod ei phryderon gyda X a sefydlu ei ddymuniad a’i deimladau yn cynnwys beth yr hoffai ddigwydd. Dylai’r Gweithiwr Cefnogi Gofal Iechyd uwchgyfeirio hyn yn syth i’w reolwr llinell a gofyn am gymorth gan ymarferydd cymwys a ddylai gasglu’r dystiolaeth briodol. Gall hyn gynnwys mapiau o’r corff, ffotograffiaeth feddygol, a nodiadau manwl am y pryder a’r weithred a wnaed. The HCSW should speak to X about the concerns and establish his wishes and feelings, including what he wants to happen. The HCSW should escalate immediately to their line manager and request assistance from a qualified practitioner who should collect appropriate evidence. This could include, body maps, medical photography, and detailed notes about the concern and action taken

6. SUT I YMATEB 6. HOW TO RESPOND Bydd gofyn am sylw meddygol ar frys pan fo’r angen e.e. Meddyg Teulu, Nyrs Hyfywedd Meinwe neu ambiwlans. Lle bo pryderon am ‘Esgeulustod Bwriadol’ neu unrhyw drosedd posib arall, rhaid cymryd canllawiau Heddlu Gogledd Cymru. Rhaid hysbysu Rheolwr Cofrestredig y Cartref Gofal am y pryderon a’r gweithrediadau a wnaed. Urgent medical attention should be sought as required e.g. GP, Tissue Viability Nurse [TVN] or ambulance. Where there are concerns about ‘Wilful Neglect’ or any other potential crime, guidance should be taken from the North Wales Police. The Registered Manager of the Care Home should be informed of the concerns and actions undertaken

7. GWEITHREDU 7. ACTION Mae gan bob gweithiwr proffesiynol ddyletswydd i rannu gwybodaeth am bryderon diogelu. Oherwydd bod X wedi cael ei nodi fel ‘Oedolyn mewn Perygl’ rhaid codi’r pryder gyda’r Awdurdod Lleol – beth bynnag ei gydsyniad. Er mwyn sicrhau bod anghenion X yn cael eu bodloni’n gyfannol, rhaid cynnal trafodaethau mewn perthynas ag unrhyw wasanaeth arbenigol ar gael e.e. Nyrs Hyfywedd Meinwe. Os teimlir bod X yn cael ‘anhawster sylweddol’ [SSWBA 2014] neu y tybir fod ganddo’r diffyg i wneud penderfyniadau perthnasol, rhaid ystyried atgyfeirio at adfocatiaeth All professionals have a duty to share information about a safeguarding concern. Since X has been identified as an ‘Adult at Risk’ the concern must be raised with the Local Authority – irrespective of his consent In order to ensure X’s needs are holistically met, discussions should be held regarding any specialist services available e.g. TVN. If it’s felt X may have ‘substantial difficulty’[SSWBA 2014] or is deemed to lack capacity to make relevant decisions, a referral for advocacy should be considered