Apprenticeship Learning Log

Date of Learning: 07 /02/2025

Time: 09:30-16:30

Title of learning activity: Continuous Development Plan

 Diary of Learning activity

Creating a continuous development plan (PDP) and staying proactive involves setting clear goals, tracking progress, and maintaining focus on both short-term and long-term growth. Making a structured approach to help develop my PDP and stay proactive in achieving it:

1. Self-Assessment

• Evaluate your current skills and strengths: Identify my current competencies and areas of improvement. Reflect on your past experiences and performance.
• Assess your personal values and interests: Know what motivate me and aligns with your long-term career or life goals.

2. Set SMART Goals

SMART Goals are specific, measurable, achievable, relevant, and time bound. Ensure goals are clear and concrete:

• Specific: Clearly define the objective.
• Measurable: Identify how you will track progress.
• Achievable: Set realistic expectations.
• Relevant: Align goals with your overall aspirations.
• Time-bound: Set deadlines to stay on track.

Example: Instead of “Improve leadership skills,” a SMART goal could be “Attend a leadership training program by the end of TNA enrol the top up course.

3. Identify Learning Opportunities

• Formal Education or Certifications: This can be attending courses, workshops, or earning certifications relevant to your field.
• Online Learning: Use platforms like Coursera, LinkedIn Learning, or Udemy to take courses that align with your goals.
• Reading & Research: Stay up-to-date with industry trends, books, and articles to broaden your knowledge.

4. Create an Action Plan

Break down your goals into actionable steps. For example, if you want to develop a new technical skill:

• Step 1: Identify resources (e.g., online courses, books, or mentorship).
• Step 2: Set aside a regular time for practice (e.g., 30 minutes per day).
• Step 3: Track your progress with measurable results (e.g., completing assignments, tests, or real-world applications).

5. Regular Review and Reflection

• Track Progress: Regularly check your progress toward each goal. Use tools like spreadsheets, journals, or apps like Trello or Asana to keep tabs on tasks.
• Adjust and Reflect: Periodically reflect on what is working and what’s not. Be willing to adjust your plan as necessary. For example, if you find a particular learning approach isn’t effective, pivot to something else.
• Celebrate Small Wins: Recognize your achievements, even the smaller milestones, as this helps maintain motivation.

6. Stay Proactive

• Time Management: Prioritize important tasks and avoid procrastination. Use techniques like the Pomodoro technique, time-blocking, or the Eisenhower matrix.
• Seek Feedback: Regularly ask for feedback from mentors, peers, or supervisors to help improve performance and get a different perspective.
• Anticipate Challenges: Think ahead and foresee potential barriers to your goals. Develop contingency plans or have strategies in place to handle obstacles proactively.
• Stay Consistent: Consistency is key to any long-term growth. Even if it’s just small actions, do something every day to stay on track.

7. Leverage Networking and Mentorship

• Mentorship: Find a mentor who can guide you, provide feedback, and support your development. This could be a senior colleague or someone in your field you admire.
• Networking: Connect with like-minded individuals, attend events or join online communities to stay engaged in your professional field.

8. Adapt and Learn

• Embrace Failure: View challenges and setbacks as opportunities to learn and grow rather than failures.
• Continuous Improvement: Stay open to new ways of improving. The PDP learning plan should evolve as you grow and as your goals shift.

Example of Proactive Continuous Development Plan:

1. Goal: Improve technical skills in data analysis.
   • Action Steps:
     • Research available courses and select the most suitable one (1 week).
     • Dedicate 5 hours per week to online course and practice exercises (4 months).
     • Complete a real-world project to demonstrate new skills (2 months).
   • Review Timeline: Check progress every month and adjust as necessary.
2. Goal: Improve leadership and communication skills.
   • Action Steps:
     • Attend a leadership workshop within the next 3 months.
     • Take on small leadership tasks at work (e.g., leading team meetings).
     • Seek feedback from colleagues after leading a project.
   • Review Timeline: Reflect on communication and leadership growth every 6 weeks.

KSBs addressed:

K1. Understand the code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC 2018), and how to fulfil all registration requirements

K2.  Understand the demands of professional practice and demonstrate how to recognise signs of vulnerability in themselves or their colleagues and the action required to minimise risks to health

K3. Understand the professional responsibility to adopt a healthy lifestyle to maintain the level of personal fitness and well-being required to meet people’s needs for mental and physical care

K9. Understand the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people

K10. Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes

K14. Understand the importance of health screening

K15. Understand human development from conception to death, to enable delivery of person-centred safe and effective care

S1. Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC, 2018), and fulfil all registration requirements

S2. Keep complete, clear, accurate and timely records

S3.  Recognise and report any factors that may adversely impact safe and effective care provision

S5. Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018)

S7. Communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive and behavioural health challenges.

S8. Recognise signs of vulnerability in self or colleagues and the action required to minimise risks to health

S9. Develop, manage and maintain appropriate relationships with people, their families, carers and colleagues

S14. Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and wellbeing

B1. Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences

B2. Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice

B3. Be adaptable, reliable and consistent, show discretion, resilience and self-awareness

LEARNING LOG YEAR 2 10 05 24 completed

LEARNING LOG YEAR 2 03 05 24 completed

Apprenticeship Learning Log

Date of Learning: 26/07/2024

Time: 09:30-1630

Title of learning activity: Wound Care: Suture/clip/drain removal.

Diary of Learning activity

Today we reflect on

A wound is any damage or injury to the skin or body tissues, typically caused by external factors like cuts, abrasions, punctures, or burns. It disrupts the normal structure and function of the tissue, potentially exposing underlying structures such as muscles, tendons, or bones. Wounds can be classified into different types, including:

• Open Wounds: Where the skin is broken, such as cuts, abrasions, or lacerations.
• Closed Wounds: Where the skin remains intact, but internal tissue is injured, like in contusions or bruises.
• Acute Wounds: Wounds that heal within a normal timeframe, often from a single event (like a cut or burn).
• Chronic Wounds: Wounds that do not heal properly or take a prolonged time to heal, often due to underlying conditions like diabetes or poor circulation.

Wounds vary in severity and may require different levels of medical attention, depending on factors such as size, depth, and location.

Wound healing generally occurs in four main stages, each crucial for repairing and restoring the skin or tissue. These stages are:

1. Hemostasis (Stopping the Bleeding):

This is the initial response to a wound. Blood vessels constrict to reduce bleeding, and platelets gather at the site to form a clot, which prevents further blood loss. Clotting factors also help initiate the healing process.

2. Inflammatory Phase (Cleaning the Wound):

In this stage, the body’s immune system responds to the injury. White blood cells (like neutrophils and macrophages) remove bacteria, dead tissue, and debris from the wound site. This phase also involves the release of growth factors that stimulate the next stages of healing. The wound may be red, swollen, and warm due to increased blood flow.

3. Proliferative Phase (Building New Tissue):

New tissue begins to form, including collagen and extracellular matrix. New blood vessels (angiogenesis) grow to supply nutrients to the area. This phase also involves the formation of granulation tissue, which fills the wound, and the development of a new layer of skin (epithelialization).

4. Maturation (Remodeling):

This is the final stage, which can last for months to years. Collagen fibers in the wound are rearranged, and the tissue strengthens. The wound fully closes, and the scar matures, although the scar tissue will never be as strong or as flexible as the original skin.

The process is complex, and various factors, including nutrition, infection, and overall health, can affect the speed and success of healing.

Skin closure devices are tools used to close or seal wounds, cuts, or surgical incisions to promote healing and reduce the risk of infection. Different types of skin closure devices are available, each designed for specific situations or types of wounds. Here are some common types:

1. Sutures (Stitches):

Absorbable Sutures: These dissolve naturally in the body over time, eliminating the need for removal (e.g., Vicryl, Monocryl).

Non-Absorbable Sutures: These must be removed after the wound has healed (e.g., Nylon, Silk, or Prolene).

2. Staples:

Staples are often used for larger, linear wounds, such as surgical incisions, as they are faster to apply and provide strong closure. They’re commonly used in the scalp, abdomen, or chest.

3. Adhesive Skin Closures (Skin Glue):

These are medical adhesives used to bond the edges of a wound together. Common brands include Dermabond and Histoacryl. They are often used for smaller cuts or surgical incisions and are quick to apply, leaving little to no scarring.

4. Sterile Adhesive Strips (Steri-Strips):

These are thin strips of adhesive material that are placed across the wound to hold the edges together. They are often used for minor cuts or after sutures are removed to prevent the wound from reopening.

5. Wound Closure Clips:

These are small, plastic clips that are applied across a wound to keep it closed. They’re similar to staples but tend to be used for smaller, superficial wounds.

6. Tissue Adhesives (Fibrin Sealants):

These are more advanced adhesives that use fibrinogen and thrombin to help the blood clot and close the wound, often used in surgeries or to seal internal tissues during operations.

Each of these devices has its advantages and is chosen based on factors such as the size, location, and type of wound, as well as the desired cosmetic outcome and healing time.

KSBs addressed:

K1. Understand the code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC 2018), and how to fulfil all registration requirements

K4. Understand the principles of research and how research findings are used to inform evidence-based practice

K6. Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice

K16. Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care

K19. Know how and when to escalate to the appropriate professional for expert help and advice

K22. Know how to meet people’s needs related to nutrition, hydration and bladder and bowel health

K23. Know how to meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity

K41. Know the roles, responsibilities and scope of practice of different members of the nursing and interdisciplinary team, and own role within it

S1. Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC, 2018), and fulfil all registration requirements

S2. Keep complete, clear, accurate and timely records

S3. Recognise and report any factors that may adversely impact safe and effective care provision

S30. Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed

S38. Prioritise and manage own workload, and recognise where elements of care can safely be delegated to other colleagues, carers and family members

B1. Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences

B2. Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice

B3. Be adaptable, reliable and consistent, show discretion, resilience and self-awareness

Apprenticeship Learning Log

Date of Learning: 10/01/2025

Time: 09:30-1630

Title of learning activity: Acute Sim Responding to adverse event.

Diary of Learning activity

Today we reflect on

Airway suctioning is a medical procedure used to remove secretions, mucus, or foreign material from a patient’s airway to maintain or improve ventilation and oxygenation. It’s often performed in critical care, emergency settings, or for patients who cannot clear their airways effectively on their own (e.g., due to a coma, respiratory illness, or post-surgical recovery). Here’s a breakdown of its indications and contraindications:

Indications for Airway Suctioning

1. Inability to Clear Airway Secretions:

When a patient cannot effectively clear their own airway (e.g., due to weakness, neurological impairment, or unconsciousness), suctioning is indicated to help clear mucus, blood, or other secretions that could obstruct airflow.

1. Excessive Secretions:

Conditions like chronic obstructive pulmonary disease (COPD), cystic fibrosis, or pneumonia can lead to excessive mucus production. Suctioning may be necessary when the secretions are too thick or abundant for the patient to clear on their own.

1. Airway Obstruction:

Suctioning is indicated when there is an obstruction in the airway due to vomit, blood, or other foreign material that could impede breathing. This is particularly important in situations like aspiration or trauma.

1. Respiratory Distress or Hypoxia:

If a patient is exhibiting signs of respiratory distress (e.g., labored breathing, decreased oxygen saturation) due to airway blockage, suctioning may be necessary to remove the obstruction and restore normal airflow.

1. Pre- or post-procedure:

Airway suctioning may be performed before or after certain medical procedures (e.g., endotracheal intubation, bronchoscopy) to clear the airway or to prevent complications.

1. Ventilator Patients:

Patients who are on mechanical ventilation may require regular suctioning to remove accumulated secretions that could interfere with the ventilator’s function or cause infections like ventilator-associated pneumonia (VAP).

Contraindications for Airway Suctioning

1. Presence of a Secure Airway:

If the patient has a secured and patent airway (e.g., endotracheal tube, tracheostomy tube), suctioning should only be performed if there is clear evidence of obstruction or excessive secretions. Routine suctioning without a clinical need could cause harm.

1. Increased Risk of Bleeding:

Suctioning should be avoided in patients who are at high risk for bleeding (e.g., after recent surgery, patients with bleeding disorders, or those on anticoagulants) unless absolutely necessary. Suctioning may cause trauma to the airway lining, leading to bleeding.

1. Severe Hypoxia or Bradycardia:

Suctioning may cause temporary hypoxia (low oxygen levels) or bradycardia (slow heart rate), especially if done improperly or for too long. In patients with severe hypoxia or bradycardia, suctioning should be approached cautiously, and oxygen support should be used as needed.

1. Recent Facial or Neck Surgery:

In patients who have undergone recent surgery to the face, neck, or airway (e.g., laryngeal surgery, tracheostomy placement), suctioning should be avoided or performed with extreme caution to prevent trauma or infection.

1. Acute Bronchospasm:

If a patient is experiencing bronchospasm (e.g., in asthma or anaphylaxis), suctioning may provoke further airway constriction and worsen the situation. Treatment for bronchospasm should be prioritized first (e.g., bronchodilators), and suctioning should be delayed unless necessary.

1. Excessive Suctioning:

Repeated suctioning or suctioning for too long can damage the mucosal lining of the airway, leading to irritation, inflammation, or even trauma. It should be performed only when clinically indicated, and care should be taken to limit the duration and frequency of suctioning.

minimizes risks and improve outcomes, suctioning should always be performed according to best practices:

• Sterile technique: Maintain aseptic technique to avoid introducing infection.
• Pre-oxygenation: Administer supplemental oxygen prior to suctioning, especially for patients who are already hypoxic.
• Limit duration: Suctioning should generally be limited to no more than 10-15 seconds to minimize the risk of hypoxia and other complications.
• Monitor closely: Continuously monitor the patient’s vital signs (oxygen saturation, heart rate, respiratory rate) during and after the procedure to assess for any adverse effects.

KSBs addressed:

K1. Understand the code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC 2018), and how to fulfil all registration requirements

K4. Understand the principles of research and how research findings are used to inform evidence-based practice

K6. Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice

K16. Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care

K19. Know how and when to escalate to the appropriate professional for expert help and advice

K22. Know how to meet people’s needs related to nutrition, hydration and bladder and bowel health

K23. Know how to meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity

K41. Know the roles, responsibilities and scope of practice of different members of the nursing and interdisciplinary team, and own role within it

S1. Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC, 2018), and fulfil all registration requirements

S2. Keep complete, clear, accurate and timely recordsS3. Recognise and report any factors that may adversely impact safe and effective care provision

S30. Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed

S38. Prioritise and manage own workload, and recognise where elements of care can safely be delegated to other colleagues, carers and family members

B1. Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences

B2. Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice

B3. Be adaptable, reliable and consistent, show discretion, resilience and self-awareness

Apprenticeship Learning Log

Date of Learning: 10/01/2025

Time: 09:30-1630

Title of learning activity: Acute Sim Responding to adverse event.

Diary of Learning activity

Today we reflect on

Airway suctioning is a medical procedure used to remove secretions, mucus, or foreign material from a patient’s airway to maintain or improve ventilation and oxygenation. It’s often performed in critical care, emergency settings, or for patients who cannot clear their airways effectively on their own (e.g., due to a coma, respiratory illness, or post-surgical recovery). Here’s a breakdown of its indications and contraindications:

Indications for Airway Suctioning

1. Inability to Clear Airway Secretions:

When a patient cannot effectively clear their own airway (e.g., due to weakness, neurological impairment, or unconsciousness), suctioning is indicated to help clear mucus, blood, or other secretions that could obstruct airflow.

1. Excessive Secretions:

Conditions like chronic obstructive pulmonary disease (COPD), cystic fibrosis, or pneumonia can lead to excessive mucus production. Suctioning may be necessary when the secretions are too thick or abundant for the patient to clear on their own.

1. Airway Obstruction:

Suctioning is indicated when there is an obstruction in the airway due to vomit, blood, or other foreign material that could impede breathing. This is particularly important in situations like aspiration or trauma.

1. Respiratory Distress or Hypoxia:

If a patient is exhibiting signs of respiratory distress (e.g., labored breathing, decreased oxygen saturation) due to airway blockage, suctioning may be necessary to remove the obstruction and restore normal airflow.

1. Pre- or post-procedure:

Airway suctioning may be performed before or after certain medical procedures (e.g., endotracheal intubation, bronchoscopy) to clear the airway or to prevent complications.

1. Ventilator Patients:

Patients who are on mechanical ventilation may require regular suctioning to remove accumulated secretions that could interfere with the ventilator’s function or cause infections like ventilator-associated pneumonia (VAP).

Contraindications for Airway Suctioning

1. Presence of a Secure Airway:

If the patient has a secured and patent airway (e.g., endotracheal tube, tracheostomy tube), suctioning should only be performed if there is clear evidence of obstruction or excessive secretions. Routine suctioning without a clinical need could cause harm.

1. Increased Risk of Bleeding:

Suctioning should be avoided in patients who are at high risk for bleeding (e.g., after recent surgery, patients with bleeding disorders, or those on anticoagulants) unless absolutely necessary. Suctioning may cause trauma to the airway lining, leading to bleeding.

1. Severe Hypoxia or Bradycardia:

Suctioning may cause temporary hypoxia (low oxygen levels) or bradycardia (slow heart rate), especially if done improperly or for too long. In patients with severe hypoxia or bradycardia, suctioning should be approached cautiously, and oxygen support should be used as needed.

1. Recent Facial or Neck Surgery:

In patients who have undergone recent surgery to the face, neck, or airway (e.g., laryngeal surgery, tracheostomy placement), suctioning should be avoided or performed with extreme caution to prevent trauma or infection.

1. Acute Bronchospasm:

If a patient is experiencing bronchospasm (e.g., in asthma or anaphylaxis), suctioning may provoke further airway constriction and worsen the situation. Treatment for bronchospasm should be prioritized first (e.g., bronchodilators), and suctioning should be delayed unless necessary.

1. Excessive Suctioning:

Repeated suctioning or suctioning for too long can damage the mucosal lining of the airway, leading to irritation, inflammation, or even trauma. It should be performed only when clinically indicated, and care should be taken to limit the duration and frequency of suctioning.

minimizes risks and improve outcomes, suctioning should always be performed according to best practices:

• Sterile technique: Maintain aseptic technique to avoid introducing infection.
• Pre-oxygenation: Administer supplemental oxygen prior to suctioning, especially for patients who are already hypoxic.
• Limit duration: Suctioning should generally be limited to no more than 10-15 seconds to minimize the risk of hypoxia and other complications.
• Monitor closely: Continuously monitor the patient’s vital signs (oxygen saturation, heart rate, respiratory rate) during and after the procedure to assess for any adverse effects.

KSBs addressed:

K1. Understand the code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC 2018), and how to fulfil all registration requirements

K4. Understand the principles of research and how research findings are used to inform evidence-based practice

K6. Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice

K16. Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care

K19. Know how and when to escalate to the appropriate professional for expert help and advice

K22. Know how to meet people’s needs related to nutrition, hydration and bladder and bowel health

K23. Know how to meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity

K41. Know the roles, responsibilities and scope of practice of different members of the nursing and interdisciplinary team, and own role within it

S1. Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC, 2018), and fulfil all registration requirements

S2. Keep complete, clear, accurate and timely recordsS3. Recognise and report any factors that may adversely impact safe and effective care provision

S30. Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed

S38. Prioritise and manage own workload, and recognise where elements of care can safely be delegated to other colleagues, carers and family members

B1. Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences

B2. Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice

B3. Be adaptable, reliable and consistent, show discretion, resilience and self-awareness

Apprenticeship Learning Log

Date of Learning: 13/12/2024

Time: 09:30-1630

Title of learning activity:  The Nursing Associate and Integrated care

Poster presentation practice workshop

Diary of Learning activity

Today we reflect on

Understand leadership in relation to the role of the nursing associate

Leadership in the context of the nursing associate role refers to the ability to influence, guide, and support colleagues, patients, and healthcare teams in a way that improves care and enhances the effectiveness of the healthcare system. While nursing associates typically don’t have the same leadership responsibilities as registered nurses or senior healthcare managers, they still play a crucial role in leadership at a team level.

Here’s how leadership relates to a nursing associate’s role:

1. Clinical Leadership: Nursing associates are often able to lead by example through their clinical practice. They demonstrate good decision-making, effective communication, and skilful patient care, all of which contribute to team success. In this way, they lead by showcasing competence and responsibility.
2. Teamwork and Collaboration: A significant part of leadership is fostering collaboration. Nursing associates are involved in working closely with other healthcare professionals, and they play a role in ensuring smooth coordination within the team. They contribute by sharing information, supporting colleagues, and helping to resolve issues that arise in the care setting.
3. Patient Advocacy: In daily interactions with patients, nursing associates advocate for the needs and well-being of individuals under their care. By being attentive, compassionate, and effective communicators, nursing associates can influence positive outcomes for patients, and this contributes to leadership within patient care.
4. Mentorship and Support: Nursing associates may also serve as mentors or role models for students or less experienced staff. By sharing knowledge and offering support, they demonstrate leadership in the development of others.
5. Critical Thinking and Problem-Solving: Leadership isn’t just about directing others; it also involves thinking critically and solving problems in real-time. Nursing associates are expected to identify issues, propose solutions, and take initiative to improve patient care or streamline processes, even within the scope of their role.
6. Ethical Leadership: Nursing associates are expected to work with integrity and uphold high ethical standards. Being a leader also means promoting a culture of respect, dignity, and inclusivity in patient care and within the healthcare team.

In summary, while nursing associate’s role requires us to embody leadership through our actions, interactions, and the way we contribute to patient care and team at large.

Understand and apply leadership theory

Leadership theory offers various models that help us understand how leaders influence and guide others. These theories can be applied to nursing associates to enhance their effectiveness in leadership roles, even within the scope of their responsibilities. Here are some key leadership theories and how they can be applied to the role of the nursing associate:

Transformational Leadership

Theory Overview: Transformational leadership emphasizes inspiring and motivating others to achieve higher levels of performance by focusing on the development of individuals and the vision for the future. It involves fostering trust and encouraging personal growth.

Application for Nursing Associates:

Nursing associates can apply transformational leadership by inspiring colleagues to maintain high standards of patient care and professional development.

They can encourage and support others in their growth, providing constructive feedback and positive reinforcement.

By fostering a positive environment, nursing associates can help elevate the morale and motivation of their colleagues, even if they don’t have formal leadership positions.

Self-reflection and Development: Nursing associates should regularly reflect on their leadership style and seek opportunities for growth. Understanding which leadership theory resonates most with their values and work environment can help them refine their approach.

Building Relationships: Regardless of the theory, building positive relationships with colleagues and patients is essential. Nursing associates should work on their communication, empathy, and interpersonal skills to apply leadership in an authentic and effective way.

Adapting to Context: It’s important to recognize that no single leadership theory works in all situations. Nursing associates should be flexible and willing to adjust their leadership approach depending on the team, patient needs, or challenges faced.

By understanding and applying leadership theories, nursing associates can enhance their contribution to patient care, promote teamwork, and develop professionally, ultimately improving the overall healthcare environment.

KSBs addressed:

K1. Understand the code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC 2018), and how to fulfil all registration requirements

K2. Understand the demands of professional practice and demonstrate how to recognise signs of vulnerability in themselves or their colleagues and the action required to minimise risks to health

K4. Understand the principles of research and how research findings are used to inform evidence-based practice

K11. Understand the factors that may lead to inequalities in health outcomes

K13. Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes

K26. Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld

K30. Understand the principles of health and safety legislation and regulations and maintain safe work and care environments

K33. Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes

K43. Understand the influence of policy and political drivers that impact health and care provision

S1. Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC, 2018), and fulfil all registration requirements

S3. Recognise and report any factors that may adversely impact safe and effective care provision

S4. Take responsibility for continuous self-reflection, seeking and responding to support and feedback to develop professional knowledge and skills

S7. Communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive and behavioural health challenges

S9. Develop, manage and maintain appropriate relationships with people, their families, carers and colleagues

S38. Prioritise and manage own workload, and recognise where elements of care can safely be delegated to other colleagues, carers and family members

S43. Contribute to team reflection activities to promote improvements in practice and services

B1. Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences

B2. Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice

B3. Be adaptable, reliable and consistent, show discretion, resilience and self-awareness

Apprenticeship Learning Log

Date of Learning: 06/12/2024

Time: 09:30-1630

Title of learning activity: Improving safety and quality of care

Evidence based decision making and intervention

Diary of Learning activity

Today we reflect on

Gaining an understanding of the requirements for safe and quality care involves recognizing the principles, frameworks, and practices that ensure healthcare delivery is effective, patient-centered, and minimizes harm. Safe and quality care is essential in all healthcare settings and is critical to improving patient outcomes, reducing errors, and ensuring that care is delivered in an ethical and efficient manner.

Key Requirements for Safe and Quality Care:

1. Patient-Centered Care:
   • Respecting Patient Preferences: Patient-centered care involves respecting and responding to the individual preferences, needs, and values of patients. This includes clear communication, shared decision-making, and involvement of patients in their care planning.
   • Holistic Approach: Acknowledging the physical, emotional, social, and spiritual aspects of patient care helps ensure that patients receive care that is not only medically effective but also personally relevant and compassionate.
2. Effective Communication:
   • Clear and Open Communication: Communication is at the core of safe care. This includes accurate and timely information exchange between healthcare providers, patients, and their families. Miscommunication is a major cause of errors in healthcare.
   • Patient Education: Ensuring that patients are well-informed about their conditions, treatment options, and any risks or benefits associated with care is an integral part of providing quality care.
   • Interdisciplinary Team Communication: For safe care, it’s essential that all members of the healthcare team (nurses, doctors, pharmacists, etc.) communicate effectively, particularly during patient handoffs or when care is transferred between teams.
3. Clinical Competence:
   • Skilled Healthcare Providers: The healthcare team, including nurses, doctors, and allied health professionals, must be adequately trained and skilled to deliver care. Ongoing professional development and training are vital for maintaining competence, especially as medical knowledge and technology evolve.
   • Adherence to Clinical Guidelines and Protocols: Evidence-based guidelines and protocols ensure that care is consistent with the latest research and best practices. This helps standardize care delivery and reduces variability in outcomes.
4. Safety Standards and Protocols:
   • Infection Control: Preventing healthcare-associated infections (HAIs) through hygiene practices, sterilization, and proper handling of medical equipment is crucial for patient safety. For example, following hand hygiene protocols can dramatically reduce the risk of infections.
   • Medication Safety: Ensuring the right medications are prescribed, administered, and monitored, along with double-checking dosages and drug interactions, is essential to prevent adverse drug events.
   • Fall Prevention: Many patients, especially the elderly or those with compromised mobility, are at risk of falls. Safe care requires implementing strategies like assessing fall risk, providing proper mobility aids, and adjusting the environment to reduce hazards.
   • Safe Surgical Practices: Adherence to surgical safety checklists, proper sterilization techniques, and verification of patient identity and surgical site are key safety measures in the operating room.
5. Evidence-Based Practice (EBP):
   • Utilizing Research: Healthcare providers should rely on the latest clinical research and evidence when making decisions about patient care. This includes using treatments and interventions that have been proven to be effective through clinical trials or systematic reviews.
   • Data-Informed Decisions: Using patient data, such as lab results, medical history, and ongoing assessments, to inform clinical decisions helps providers deliver tailored care and avoid errors.
   • Regular Auditing and Evaluation: Continuous evaluation of care practices through audits, feedback, and performance reviews ensures that care standards are maintained and that improvements are made where needed.
6. Patient Safety Culture:
   • Reporting and Learning from Errors: Encouraging a culture where healthcare professionals can report errors or near-misses without fear of punishment is critical. This allows organizations to identify patterns of mistakes and address them proactively.
   • Root Cause Analysis: When adverse events occur, conducting a thorough analysis to understand the root causes is essential for preventing recurrence. This involves looking beyond individual mistakes to examine systemic issues, such as inadequate staffing or flawed protocols.
   • Continuous Improvement: Quality improvement initiatives, such as Plan-Do-Study-Act (PDSA) cycles, help organizations continuously monitor and improve their care processes to ensure the highest standards of safety.
7. Patient and Family Involvement:
   • Engagement in Care Decisions: Patients and their families should be encouraged to ask questions, express concerns, and participate in care planning. This involvement improves patient satisfaction and outcomes.
   • Patient Advocacy: Healthcare providers, including nursing associates, can act as advocates for patients, ensuring that their needs are heard, respected, and addressed within the healthcare system.
8. Regulatory and Ethical Standards:
   • Adherence to Legal and Ethical Guidelines: Safe and quality care must comply with healthcare regulations, such as patient confidentiality, informed consent, and professional standards. Healthcare providers must also adhere to ethical principles like beneficence, non-maleficence, and justice.
   • Accreditation and Standards Compliance: Many healthcare organizations are required to meet standards set by accrediting bodies (e.g., The Joint Commission in the U.S. or the Care Quality Commission in the UK). Meeting these standards ensures that care is both safe and of high quality.
9. Staffing and Resource Availability:
   • Adequate Staffing: Sufficient staffing levels ensure that patients receive timely and personalized care. Understaffing can lead to burnout, errors, and neglect, compromising both safety and quality.
   • Appropriate Resources: Adequate equipment, technology, and supplies must be available to ensure care can be provided effectively. This includes everything from medical instruments to electronic health record systems that facilitate communication and coordination of care.
10. Care Coordination and Continuity:
    • Coordinated Care: Ensuring continuity of care, especially for patients with chronic conditions or complex needs, is a fundamental component of quality care. This includes having clear handover processes between healthcare teams, ensuring follow-up care, and managing transitions between different settings (e.g., from hospital to home).
    • Integrated Care: Safe and quality care is often best achieved when healthcare services are integrated, allowing for seamless coordination between primary care, specialty care, mental health services, and community resources.

The requirements for safe and quality care are multifaceted and involve a combination of clinical skills, effective communication, patient-cantered approaches, adherence to evidence-based guidelines, and a supportive organizational culture. Healthcare organizations and professionals must continually strive to meet these requirements to improve patient outcomes, enhance satisfaction, and prevent harm. By prioritizing patient safety, fostering a culture of learning, and providing ongoing professional development, healthcare providers can ensure that care is both safe and of the highest quality.

KSBs addressed:

K1. Understand the code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC 2018), and how to fulfil all registration requirements

K2. Understand the demands of professional practice and demonstrate how to recognise signs of vulnerability in themselves or their colleagues and the action required to minimise risks to health

K4. Understand the principles of research and how research findings are used to inform evidence-based practice

K11. Understand the factors that may lead to inequalities in health outcomes

K13. Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes

K26. Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld

K30. Understand the principles of health and safety legislation and regulations and maintain safe work and care environments

K33. Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes

K43. Understand the influence of policy and political drivers that impact health and care provision

S1. Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC, 2018), and fulfil all registration requirements

S3. Recognise and report any factors that may adversely impact safe and effective care provision

S4. Take responsibility for continuous self-reflection, seeking and responding to support and feedback to develop professional knowledge and skills

S7. Communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive and behavioural health challenges

S9. Develop, manage and maintain appropriate relationships with people, their families, carers and colleagues

S38. Prioritise and manage own workload, and recognise where elements of care can safely be delegated to other colleagues, carers and family members

S43. Contribute to team reflection activities to promote improvements in practice and services

B1. Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences

B2. Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice

B3. Be adaptable, reliable and consistent, show discretion, resilience and self-awareness

Apprenticeship Learning Log

Date of Learning: 29/11/2024

Time: 09:30-1630

Title of learning activity: Formative workshop

Data collection, Audit, and Development of evidence based guideline

Diary of Learning activity

Today we reflect on

The use and context of an evidence base in health policy development is essential for ensuring that policies are effective, grounded in research, and lead to positive health outcomes. In health policy, evidence refers to the data, research, and insights that inform decision-making processes. The evidence base ensures that policies are not only theoretically sound but also practically applicable and responsive to the needs of the population they aim to serve.

Key Aspects of the Evidence Base in Health Policy Development:

1. Types of Evidence:
   • Quantitative Evidence: This includes statistical data, such as prevalence rates of diseases, health outcomes, and financial impacts. For example, research on the effectiveness of vaccination programs or the economic cost of smoking-related diseases.
   • Qualitative Evidence: This encompasses non-numeric data, such as patient experiences, healthcare provider perspectives, and community feedback. This type of evidence helps policymakers understand the “why” behind health trends or behaviors.
   • Systematic Reviews and Meta-Analyses: These aggregate findings from multiple studies to provide a more robust understanding of an issue. Policymakers often rely on these comprehensive reviews to guide their decisions.
   • Guidelines and Best Practices: Clinical guidelines or standards established by professional bodies are also a critical part of the evidence base, helping policymakers to align health policies with the most current clinical standards.
2. Role of Evidence in Policy Development:
   • Informs Policy Design: The evidence base helps policymakers identify the root causes of health problems and the most effective interventions. For instance, evidence on the link between diet and chronic diseases might lead to policies encouraging healthier eating habits.
   • Supports Decision-Making: Policymakers rely on evidence to make informed choices about resource allocation, program implementation, and health interventions. For example, evidence about the effectiveness of early childhood vaccinations can lead to national immunization programs.
   • Enhances Accountability: Using evidence in policy development ensures transparency, making it easier to evaluate the effectiveness of policies after implementation. It also allows for the continuous improvement of health interventions.
3. The Context of Evidence in Health Policy:
   • Local and National Contexts: The relevance and applicability of evidence can vary depending on geographic, cultural, and economic factors. Evidence-based policies must be adapted to local contexts to be effective. For example, a policy addressing mental health may need to be tailored differently in rural vs. urban settings due to variations in service availability and cultural attitudes toward mental health.
   • Political and Social Context: Health policy decisions are also influenced by political ideologies, values, and social priorities. Evidence is often interpreted through these lenses, so the policy development process may involve negotiation between different stakeholders, such as government bodies, health professionals, and advocacy groups.
   • Economic Considerations: Evidence on the cost-effectiveness of interventions is often central to policy discussions. Policymakers need to balance the potential health benefits of a policy with the available budget and economic constraints. For instance, evidence-based decisions might advocate for preventative care, which is often more cost-effective than treatment for advanced diseases.
4. Challenges in Using Evidence:
   • Quality and Availability of Evidence: High-quality evidence can sometimes be scarce or incomplete, especially for emerging health issues or in areas where data collection is poor. In some cases, the evidence might be inconclusive, requiring policymakers to make decisions based on the best available information rather than absolute certainty.
   • Translating Evidence into Action: Even when robust evidence is available, translating that evidence into effective policy can be challenging. For example, evidence showing the benefits of a smoking ban might not immediately lead to successful legislation if political or public resistance is strong.
   • Complexity of Health Issues: Health is influenced by a multitude of factors, such as genetics, environment, behaviour, and access to healthcare. Policy development often requires synthesizing complex and multifaceted evidence, which can be challenging.
   • 1. The Role of Stakeholders in Using Evidence:
        • Healthcare Professionals: Doctors, nurses, and other healthcare professionals are often at the forefront of policy implementation. They can provide valuable insights into how evidence-based policies are applied in practice and offer feedback on what works and what doesn’t.
        • Researchers and Academics: Researchers provide the evidence that forms the foundation for health policy development. Their role is to conduct studies, analyze data, and disseminate findings that can influence policy.
        • Public Health Experts and Advocacy Groups: Public health professionals and advocacy organizations often push for policies that are informed by evidence, especially when it comes to social determinants of health and public health initiatives.
        • The Public: Public opinion can shape policy priorities. Evidence-based policies must often be communicated to the public effectively, especially when it involves behaviour change, such as in anti-smoking campaigns or dietary recommendations.

     Examples of Evidence-Based Health Policy Development:

     1. Tobacco Control Policies:
        • Extensive research into the harms of smoking has led to the implementation of policies such as smoking bans in public places, tobacco taxation, and public health campaigns. The evidence on the health risks of smoking and the effectiveness of these measures in reducing smoking rates has been crucial in shaping global health policies.
     2. Vaccination Programs:
        • Evidence demonstrating the safety and efficacy of vaccines has led to widespread vaccination programs, often mandated by health policies. For example, childhood vaccination schedules are determined by evidence on disease prevention, herd immunity, and the safety of vaccines.
     3. Obesity Prevention and Management:
        • Evidence linking high body mass index (BMI) to chronic conditions like heart disease, diabetes, and cancer has led to policies promoting healthy eating, physical activity, and public health education. Cities have introduced policies like calorie counts on menus or restrictions on junk food advertising, based on evidence about the impact of diet on health.
     4. Mental Health Policies:
        • Evidence highlighting the effectiveness of mental health interventions, such as cognitive-behavioural therapy (CBT), has influenced policy decisions related to mental health services, funding, and public awareness campaigns. Evidence also informs the integration of mental health care into primary healthcare settings.

     Conclusion:

     The use of an evidence base in health policy development ensures that policies are grounded in the best available research and data, leading to more effective, efficient, and equitable healthcare interventions. By integrating evidence with the broader political, economic, and social context, policymakers can design health policies that address the most pressing health challenges while optimizing resources and improving outcomes for individuals and populations.

     KSBs addressed:

     K1. Understand the code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC 2018), and how to fulfil all registration requirements

     K2. Understand the demands of professional practice and demonstrate how to recognise signs of vulnerability in themselves or their colleagues and the action required to minimise risks to health

     K4. Understand the principles of research and how research findings are used to inform evidence-based practice

     K11. Understand the factors that may lead to inequalities in health outcomes

     K13. Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes

     K26. Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld

     K30. Understand the principles of health and safety legislation and regulations and maintain safe work and care environments

     K33. Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes

      

     K43. Understand the influence of policy and political drivers that impact health and care provision

     S1. Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC, 2018), and fulfil all registration requirements

     S3. Recognise and report any factors that may adversely impact safe and effective care provision

     S4. Take responsibility for continuous self-reflection, seeking and responding to support and feedback to develop professional knowledge and skills

     S7. Communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive and behavioural health challenges

     S9. Develop, manage and maintain appropriate relationships with people, their families, carers and colleagues

     S38. Prioritise and manage own workload, and recognise where elements of care can safely be delegated to other colleagues, carers and family members

     S43. Contribute to team reflection activities to promote improvements in practice and services

     B1. Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences

     B2. Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice

     B3. Be adaptable, reliable and consistent, show discretion, resilience and self-awareness

      

Theory Hour Jan 2024