Date of Learning Log: 17/01/2025
Time: 09:30-16:00
Learning Activity: Preparation for Practice
Clinical Skills:
- Male and Female Catheterisation
- Injection Technique
- NG insertion
- Basic Wound Management
- Medications Administration
- Wound Assessment- stage of wound healing, signs of infection and dressing selection.
Clinical skills refer to the competencies that healthcare professionals employ to evaluate patients, determine diagnoses, and provide clinical judgments. These actions are carried out directly by healthcare providers and can influence clinical outcomes, involving both cognitive skills such as clinical reasoning and decision-making. Additionally, non-technical abilities like teamwork and communication are also significant.
Male and female catheterisation involves the use of various types of catheters, though some are specifically designed for either males or females. The primary distinction between male and female catheters lies in their size, as female urethras are generally shorter than male urethras. A woman’s urethra typically measures about 3-4 cm, while a male urethra can be around 18-20 cm long. Due to these size differences, catheters for women usually range from 7-20 cm in length, while male catheters range from 30-40 cm in length. Common reasons for catheterization in both genders include urinary incontinence, a medical condition characterized by the loss of bladder control, which can lead to involuntary urination during activities like sneezing, lifting, exercising, or coughing. Urinary incontinence may also result from a sudden sense of urgency, a consistent flow or dribble of urine, or specific mental or cognitive disorders. Urinary retention is diagnosed when individuals do not fully empty their bladder during urination.
Injection techniques vary: Intravenous (IV) injections provide the quickest method to deliver medication straight into a vein; Intramuscular (IM) injections are administered deep into a muscle for rapid absorption; Subcutaneous (SC) injections are placed just beneath the skin; and Intradermal (ID) injections are applied to the upper skin layer.
NG insertion involves placing a slender plastic tube through a nostril, towards the esophagus, and into the stomach. This tube is used for delivering food and medication directly to the stomach or for collecting substances from it. The insertion begins at the nostril with the largest opening and the tube is guided down the back of the nostril to the nasopharynx. The patient is instructed to swallow as the tube advances into the pharynx.
Basic wound management principles include: achieving haemostasis, cleaning the wound, providing analgesia, closing the skin, and dressing the wound with subsequent advice.
To clean a wound, first ensure your hands are clean or wear a fresh pair of gloves. Rinse the wound with mildly soapy water and then clean it with fresh water. Additionally, cleanse the skin surrounding the wound. Gently pat the wound dry. The aim of wound management is to remove debris and avert infection, allowing the wound to heal through the formation of connective tissue for granulation, leading to repair. Epithelial tissue develops in a moist environment conducive to healing.
Medication administration consists of delivering a prescribed substance to patients for the diagnosis, treatment, or prevention of medical conditions. It is a crucial duty for nursing associates to verify all items on the medication list as accuracy is vital to prevent medication errors and ensure patient safety across all medications they are prescribed.
Examine the tissue for any indications of necrosis, infection, or granulation. Assess the discharge type and volume while also noting any odours. Measure the edges of the wound and check for any undermining or tunnelling. Utilize standardized tools such as the Wound Assessment Tool.
KSB ADDRESSED:
Knowledge:
| K1 | Understand the code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC 2018), and how to fulfill 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 |
| K6 | Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice |
| K7 | Understand the importance of courage and transparency and apply the Duty of Candour |
| 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 |
| K11 | Understand the factors that may lead to inequalities in health outcomes |
| K12 | Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being |
| 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 |
| K15 | Understand human development from conception to death, to enable delivery of person-centred safe and effective care |
| K16 | Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care |
| K17 | Understand commonly encountered mental, physical, behavioural and cognitive health conditions as applied to delivery of care |
| K18 | Understand and apply the principles and processes for making reasonable adjustments |
| K19 | Know how and when to escalate to the appropriate professional for expert help and advice |
| K20 | Know how people’s needs for safety, dignity, privacy, comfort and sleep can be met |
| K21 | Understand co-morbidities and the demands of meeting people’s holistic needs when prioritising care |
| 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 |
| K24 | Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain |
| K26 | Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld |
| 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 |
| K30 | Understand the principles of health and safety legislation and regulations and maintain safe work and care environments |
| K37 | Understand the challenges of providing safe nursing care for people with complex co-morbidities and complex care needs |
| K38 | Understand the complexities of providing mental, cognitive, behavioural and physical care needs across a wide range of integrated care settings |
| K39 | Understand the principles and processes involved in supporting people and families with a range of care needs to maintain optimal independence and avoid unnecessary interventions and disruptions to their lives |
| K40 | Understand own role and contribution when involved in the care of a person who is undergoing discharge or a transition of care between professionals, settings or services |
| K41 | Know the roles, responsibilities and scope of practice of different members of the nursing and interdisciplinary team, and own role within it |
| K42 | Understand and apply the principles of human factors and environmental factors when working in teams |
| K43 | Understand the influence of policy and political drivers that impact health and care provision |
Skills:
| 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 |
| 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) |
| 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 |
| 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 |
| 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 |
| S21 | Monitor the effectiveness of care in partnership with people, families and carers, documenting progress and reporting outcomes |
| S22 | Take personal responsibility to ensure that relevant information is shared according to local policy and appropriate immediate action is taken to provide adequate safeguarding and that concerns are escalated |
| 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 need for safe, effective and person-centred care |
| S25 | Meet people’s needs for safety, dignity, privacy, comfort and sleep |
| S26 | Meet people’s needs related to nutrition, hydration and bladder and bowel health |
| S27 | Meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity |
| S28 | Support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain |
| S29 | Give information and support to people who are dying, their families and the bereaved and provide care to the deceased |
| S30 | Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed |
| S31 | Act in line with any end of life decisions and orders, organ and tissue donation protocols, infection protocols, advanced planning decisions, living wills and lasting powers of attorney for health |
| S32 | Work collaboratively and in partnership with professionals from different agencies in interdisciplinary teams |
| S33 | Maintain safe work and care environments |
| S34 | Act in line with local and national organisational frameworks, legislation and regulations to report risks, and implement actions as instructed, following up and escalating as required |
| S35 | Accurately undertake risk assessments, using contemporary assessment tools |
| S36 | Respond to and escalate potential hazards that may affect the safety of people |
| S37 | Participate in data collection to support audit activity, and contribute to the implementation of quality improvement strategies |
| S38 | Prioritise and manage own workload, and recognise where elements of care can safely be delegated to other colleagues, carers and family members |
| S39 | Recognise when people need help to facilitate equitable access to care, support and escalate concerns appropriately |
| S40 | Support and motivate other members of the care team and interact confidently with them |
| S41 | Monitor and review the quality of care delivered, providing challenge and constructive feedback when an aspect of care has been delegated to others |
Behaviour:
| 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 |