Date: 30/04/2025

Time: 09:30am – 04:30pm

Title:  Social determinants of health, Epidemiology and Demographics/ Oxygen therapy

We looked at the social determinants of health which refer to social and economic factors influencing health, such as wealth, education, housing, ethnicity, social status. We also looked at epidemiology and demographics. Epidemiology is the study of the distribution and determinants of health-related events in populations while demographics involve statistical data on populations, including age, gender, ethnicity, and socioeconomic status, which help in understanding health trends.

This are all important in understanding health inequalities. With epidemiological data, patterns of disease, risk factors across different population groups can be identified, while demographic data helps pinpoint groups that are affected. Addressing health issues without considering the social determinants would be insufficient.

Moving forward, I will continue to advocate for a more holistic approach in my practice, one that does not just treat symptoms but seeks to understand the root causes of ill health. As I progress in my training, I will continue to evaluate how I can contribute to reducing health inequalities and promote equitable care across diverse populations.

We had a skill session on oxygen therapy during the later part of the day. During the session I was told that oxygen therapy can be administered through different delivery systems such as nasal cannula, Hudson mask, Venturi mask and non rebreathe mask depending on the patient’s condition and these different masks were shown to me. Physical positions while standing, sitting and lying that would improve oxygen levels was also demonstrated. The aim of oxygen therapy is to support patient’s oxygen saturation. I was shown a peak flow meter which is a device used to measure how quickly air can be blow out of the lungs.

This session was important because it enhanced my confidence and understanding the various oxygen delivery systems. I realised how critical it is to choose the right delivery device based on patient’s oxygen saturation levels, respiratory rate and underlying conditions. For example, giving high flow oxygen to a COPD patient without considering CO2 retention risks could be dangerous. Practicing peak flow measurements helped me appreciate how this simple test can provide quick insight into patient’s airway status.

Going forward, I will consolidate this learning by practicing more in clinical settings, most especially in real patient scenarios to reinforce my skills. I will review my place of work protocols on oxygen therapy and peak flow use. I will continually seek feedback from professionals when applying these skills in practice.

KSB addressed:

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

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

K14: Understand the importance of health screening

K21: Understand co-morbidities and the demands of meeting people’s holistic needs when prioritising care

S15: Identify people who are eligible for health screening

S16: Promotes health and prevent ill health by understanding the evidence base for immunisation, vaccination and herd immunity

Date: 05/03/2025

Time: 09:30am – 04:30pm

Title: Planning and Monitoring Care/Clinical Judgment and Shared Decision Making

At the start to the lesson we discussed about comprehensive patient assessment. This is gathering essential information about a patient to create an holistic understanding of their physical, mental, emotional and social wellbeing. This assessment is done considering the Roper Logan Tierney activities of living. They include maintaining a safe environment, communicating, breathing, eating and drinking, eliminating, personal cleansing and dressing/hygiene, controlling body temperature, mobilising, working and playing, expressing sexuality, sleeping and dying.

We were later shared in three groups and given a case study to create a care plan for. By creating a comprehensive assessment for the case study I gained an insights on the importance of holistic care where the physical, mental, emotional and social factors interact and contribute to the patient’s wellbeing. Moving forward, I will further explore more on conducting patient assessment to refine my practice. I also plan to engage in reflective practice regularly to assess how I can improve the assessment process, particularly in terms of making patients feel more comfortable and willing to share sensitive information and finally I aim to use the knowledge gained from the assessment to prioritise and personalise care plans ensuring that they align with the patient’s unique needs and goals.

During the later part of the day we discussed about clinical judgment and shared decision making. Clinical judgement is essential in guiding healthcare decisions and this could be influenced by experience, intuition, ethics, research, evidence base, environment, resources, shared decision making and so on. Shared decision-making reinforces the idea that healthcare is not a one way delivery of service but rather a collaborative process between the patient and the clinician. This empowers patients, giving them autonomy in their treatment choices.

Moving forward, as a  Nursing Associate I plan to incorporate shared decision making as a standard practice in my clinical interactions and continue to improve my communication skills to ensure that patients fully understand their options and feel confident in their ability to make informed choices.

KSB addressed:

K1: Understand the code: Professional standards of practise and behaviour for Nurses, Midwives and Nursing Associates in ( NMC, 2018) and how to fulfil all registration requirements

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

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

K41: Know your rules, responsibilities and scope of practise 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

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

S6: Act as an ambassador for their profession and promote public confidence in health and care services

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

S14: Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and well-being

S18: Applied knowledge, communication and relationship management skills required to provide people, families and carers with accurate information that meets their needs before, during and after a range of interventions

S19: Recognise when capacity has changed, recognise how a person’s capacity affects their ability to make decisions about their own care and to give or withhold consent

S24: Perform a range of nursing procedures and manage devices to meet people’s need for safe, effective and  personal centred care

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

S33: Maintain safe work and care environments

S35: Accurately undertake risk assessments, using contemporary assessment tools

S39: Recognise when people need help to facilitate equitable access to care, support and escalate concerns appropriately

S41: Monitor and review the quality of care delivered, providing challenge and constructive feedback when an aspect of care has been delegated to others

Date: 26/02/2025

Time: 09:30am – 04:30pm

Title: Health Behaviours and Motivational Interviewing/Injection Technique

At the early hours of the day we learnt about health behaviours, the various models of change and motivational interviewing. To me, being healthy is a state of complete physical, mental, social wellbeing. There so many ways health can be promoted such as eating less sugar, avoiding smoking and alcohol, practicing safe sex, regular exercise, having a social life etc. Our choices and changes can be influenced due to our beliefs, attitudes, income, environment etc. There are four model of change and they include transthoretical model, COM-B model, health belief model and theory of planned behaviour. Behaviour change is essential because it directly impacts individual in terms of health improvement, economic benefits, prevention and risk management etc.

Motivational interviewing is a technique aimed at helping individuals explore and resolve ambivalence about their behaviour change. It is useful in situations where a person is uncertain about making a change and it makes the individual feel heard and understood rather than being judged or pushed into action.

Moving forward, I will continue to listen to patients, allow them to express their own motivations and barriers. Using motivational interviewing will allow me to help patients make lasting change by respecting their autonomy, acknowledging their struggles and offering a supportive space. I will also make every contact I get with each patient count.

At the later part of the day, we had a skill session, injection technique. We looked at the different injections and as a Nursing Associate we are only allowed to give two types of injection they are:

Intramuscular injection (IM) – This is injected into the muscle at a 90 degree angle. Sites for IM injection include buttock, upper arm, hip and lateral thigh

Subcutaneous Injection (SC) – This is injected under the skin at a 45 degree angle. Sites for SC injection include arms, abdomen and thighs.

Some of the reasons intramuscular injections are given could be:

1.        Patient cannot take oral medicine due to swallowing difficulties or patient is nil by mouth
2.        Rapid action is required

3.        Medicine is unavailable in oral form

Injection technique is essential not only for ensuring that the medication is delivered correctly but also for minimising discomfort and preventing complications like infection or tissue damage

Moving forward, I will enhance my clinical skills, improve patient care and promote safe practice in administering injections. I would also plan to attend additional training sessions to ensure I stay updated on best practice for injection techniques especially regarding the correct choice of sites for different types of injections.

KSB addressed:

K1: Understand the code: Professional standards of practise and behaviour for Nurses, Midwives and Nursing Associates in ( NMC, 2018) and how to fulfil all registration requirements

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, improvement and the prevention of ill health when engaging with people

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

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

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

S6: Act as an ambassador for their profession and promote public confidence in health and care services

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

S14: Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and well-being

S16: Promote health and prevent ill health by understanding the evidence base for immunisation, vaccination and herd immunity

Date: 19/02/2025

Time: 09:30am – 04:30pm

Title: The Nursing Process and Care Planning/Health Promotion

At the early hours of the day we learnt about the Nursing process, Roper, Logan and Tierney’s activities of daily living model. The nursing process is a systematic method used to ensure this delivery of individualised and effective care. It involves several stages ADPIE

A-  Assessment- This involves collecting comprehensive data about a patient’s health status.

D-  Diagnosis- This is the actual health issues currently being experienced after gathering assessment data.

P-  Planning- This involves collaboration of the nurse, patient and healthcare team to address the identified diagnosis. The goal should focus on improving the patient’s health outcomes.

I-  Implementation- This involves carrying out the interventions identified in the planning step. This could be administering medication or coordinating care with other healthcare providers such as arranging consultations or therapies.

E-    Evaluation- This is the final step where assessment is carried out to see whether patient’s goals are met or not. The patient’s condition is also reviewed to compare it to the expected outcomes.

Care planning is an essential process in Nursing that contributes to effective, personalised and coordinated care. This is an ongoing process that requires constant reflection, reassessment and adjustment to achieve the best outcomes for patients. The Roper, Logan and Tierney’s activities of daily living model considers factors which comprise daily living in a holistic and systematic way. The model proposes 12 areas which include Maintaining a safe environment, communicating, breathing, eating and drinking, eliminating, personal cleansing and dressing/hygiene, controlling body temperature, mobilising, working and playing, expressing sexuality, sleeping and dying.

The nursing process and care planning essential in ensuring that care is individualised and holistic. By actively involving the patient in the planning process and ensuring they understand their care plan, there is always an increase in engagement and compliance. The success of a care plan depends on timely communication, regular updates and accurate documentation.

Moving forward, at work I will actively engage with nurses to see how care plans are being done. I will also continue to reflect on my communication with patients to evaluate whether they are being listened to and their preferences are being met.

Health promotion is essential because it’s not only prevent illness but also empowers individuals reduce inequalities and support economic and societal well-being. It also creates a healthy community and sustainable healthcare systems.

However, there are several barriers to effective health promotion such as time constraints, lack of motivation, financial costs, lack of knowledge and many others. Addressing these barriers is critical for effective health promotion. This includes improving access to resources, increasing public awareness of the importance of healthy behaviours, creating supportive environments.

The Transtheoretical model (TTM) also known as the stages of change model is a widely used framework for understanding how individuals change their behaviours over time. There are 5 stages true which an individual typically moves from changing behaviour; precontemplation, contemplation, preparation, action, maintenance, relapse(optional).

Moving forward, I plan to adopt a more holistic approach to health promotion. This includes not only focusing on individual behaviour change but also considering the broader social, economical and cultural context that shape people’s health.

KSBs addressed:

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

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

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

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

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

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

K14: Understand the importance of health screening

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

S4: Take responsibility for continuous self reflection, seeking and responding to support and feedback to develop provisional knowledge and skills

S10: Provide, promote and where appropriate advocate for, non discriminatory, person centred and sensitive care at all times, reflecting on people’s values and beliefs, diverse backgrounds, cultural characteristics, language requirements, needs and preferences, taking account of any need for adjustments

S13: Apply the aims and principles of health promotion, protection and improvements and the prevention of ill health when engaging with people

S14: Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and well-being

S24: Perform a range of nursing procedures and manage devices to meet people’s needs for safe, effective and person-centred care

S25: Meet people’s needs for safety, dignity, privacy, comfort and sleep

S32: Work collaboratively and in partnership with professionals from different agencies in interdisciplinary teams

Date: 18/02/2025

Time: 09:30 – 04:30

Title: Introduction to Public Health, Principles of Health Promotion and my Role as a Nursing Associate/Person-Centred Care

We looked at definitions of health, health education, public health and my role as a Nursing Associate. Being healthy is whereby a person is free from disease and in a good physical and mental condition. There are various dimensions of health which include emotional, spiritual, mental, social, sexual, intellectual and social.

Health education refers to the process of providing knowledge and skills to individuals or communities about their health and wellbeing. The goal is to promote healthy behaviours and prevent diseases. While public health is concerned with with improving and protecting the health of the public through preventive measures, health promotion and education. By adhering to this, health promotion seeks to reduce health disparities and encourage communities to make sustainable health changes.

As a Nursing Associate, I should be involved with working along side other health professionals to assess needs of patients, act as an advocate, provide health education and promote healthy lifestyles. It is also important to communicate health informations in a way that is understandable and relatable to the diverse communities  as cultural and language differences can be a barrier in health promotion.

Moving forward, I will continue to build on my experiences by further developing my communication and engagement skills especially in multicultural settings in other to meet the unique needs of various groups.

At the later part of the day, we looked at person-centred care. This is attending to a person’s needs, preferences and values. It involves treating patients as active participants in their own care, taking time to understand their unique circumstances, beliefs, desires and tailoring care to suit them. This can enhance trust between the patient and healthcare provider and when patients feel that they are treated as individuals, with dignity and respect they are more likely to be open and cooperative in their care. They are also more likely to engage with treatment plans, follow recommendations and experience better health outcomes.

Some of the core values of person-centred care include rights, privacy, choice, respect, dignity, individuality, independence and partnership. Several barriers can prevent the effective implementation of person-centred care which include time, listening skills , resources limitations, communication, knowledge and so many others. Overcoming these barriers requires effort from healthcare leaders, staff and organisations to prioritise person-centred practices, invest in training, allocate appropriate resources and respect patient’s needs and preferences.

Moving forward, I will continually reflect and seek out additional training on various aspects of patient care and specific techniques for improving patient engagement. I would also improve my communication skills to better understand and meet patient’s needs such as active listening, asking open-ended questions and confirming understanding.

KSBs addressed:

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

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

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

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

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

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

K14: Understand the importance of health screening

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

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

S4: Take responsibility for continuous self reflection, seeking and responding to support and feedback to develop provisional knowledge and skills

S10: Provide, promote and where appropriate advocate for, non discriminatory, person centred and sensitive care at all times, reflecting on people’s values and beliefs, diverse backgrounds, cultural characteristics, language requirements, needs and preferences, taking account of any need for adjustments

S13: Apply the aims and principles of health promotion, protection and improvements and the prevention of ill health when engaging with people

S14: Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and well-being

S23: Work in partnership with people to encourage shared decision making, in order to support individuals, their families and carers to manage their own care when appropriate

S24: Perform a range of nursing procedures and manage devices to meet people’s needs for safe, effective and person-centred care

S25: Meet people’s needs for safety, dignity, privacy, comfort and sleep

S32: Work collaboratively and in partnership with professionals from different agencies in interdisciplinary teams