Date: 05/02/2025

Time: 09:30am – 04:30pm

Title: Continence Management and Urinalysis/Medicines Management

During the early hours of the day we had skills session where we talked about fluid balance both input and output, incontinence and urinalysis. Fluid balance is the process of maintaining a balance of water intake and output. This is important in managing hydration levels. Fluid balance is done by observing intake such as fluids consumed, IV fluids and outputs such as urine, vomit etc. As a student Nursing Associate, understanding the principles of fluid balance ensures that I can respond promptly to deviations and alert the necessary care professionals. I can also be able to identify signs of dehydration or fluid retention early. Moving forward, as a Nursing Associate I will prioritise regular fluid balance assessments especially in high risk patients such as those with renal impairment. I will also ensure accurate documentation is done to help prevent errrors and ensure timely administration of interventions.

Urinary incontinence is the inability to hold urine in the bladder due to loss of voluntary control over the urinary sphincters while faecal incontinence is the involuntary loss of faeces that is a social or hygienic problem. This is where continence management comes in  to help maintain control over their bladder and bowels. This could be through lifestyle, exercises or the use of continence products such as pads, conveen or catheters. But before all these is done an assessment needs to be carried out to reach a diagnosis and to decide the most appropriate treatment. Continence management is not only important for maintaining hygiene and comfort but also for promoting dignity and independence. A failure to address incontinence can lead to skin breakdown, urinary tract infections and psychological dust such as loss of self esteem and embarrassment. Moving forward, as a student Nursing Associate I will be more mindful of the emotional impact of incontinence on the patient and approach personal care with sensitivity, always maintaining their dignity. I will also communicate effectively with the team, sharing observations and concerns.

Lastly, we talked about urinalysis which involves testing urine for various parameters such as specific gravity, ph, glucose, protein the presence of substances like blood or bacteria. It is an essential tool that provides quick and important insights into a patient’s health. Abnormal result can indicate issues such dehydration or infections. In future, I will improve my ability to interpret urinalysis results. I will ensure that I am familiar with the signs of urinary issues such as UTI or renal impairment so I can act quickly if abnormal results are found.

After the lesson we all went into the clinical area to practicalise all what that has been taught such as how to input datas on the fluid chart (input and output), how to insert a male and a female catheter, how to take out urine from a catheter, testing urine and interpreting.

At the later part of the day, I did a self study on medicines management, the different categories of medicines, controlled drugs, rights of medication, routes of administration and reporting medication errors. Medication management is the safe, effective and appropriate use of medications. It includes prescribing, dispensing, administering and monitoring the use of medication to ensure that the right  patient receives the right medication, in the right dose at the right time via the right route. This is important to prevent advanced drug reactions and medication errors. And if an error should occur, the safety of the patient should be put first, then reporting it quickly, writing an incident report, then an incident investigation may occur and finally reflecting on the incident.

Clear communication, careful documentation and verification process such as checking allergy, drug interactions, indication and contra-indictations are essential in the medication management process. Moving forward I will take regular refresher courses on medicines management that can keep me up to date to reduce errors and improve patient care. I will also increase my vigilance in medication checks, this includes cross referencing patients allergies, current medications and medical history before administering any new medication.

KSB addressed:

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

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

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

K20: Know how people’s need for safety, dignity, privacy, comfort and sleep can be met

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

K24: Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort, and pain

K27: Understand the principles of safe and effective administration and optimisation of medicines in accordance with local and national policies

K28: Understand the effects of medicines, allergies, drug sensitivity, side effects, contraindications and adverse reactions

K29: Understand the different ways by which medicines can be prescribed

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

S26: Meet people’s needs related to nutrition, hydration, bladder and bowel health