Date of Learning: 07/03/2025
Time: 09:30-16:30
Title of learning activity: End Point Assessment Preparation

This marked the conclusion of my final session at the University, a significant milestone in my academic journey. During this session, we delved into the intricate details of the registration process for the Nursing and Midwifery Council (NMC), an essential step towards my future professional practice.

I was fortunate to have a valuable one-on-one meeting with both of my dedicated academic assessors, Colin Rowe and Joicy George. In this personalised discussion, we thoroughly reviewed my academic progression, assessing not only my overall grades but also the skills I have developed throughout my studies. We addressed several important concerns, including the necessity of completing my theoretical hours to ensure they align with the program requirements. Additionally, we emphasised the importance of having the tripartite agreements properly signed, which play a crucial role in securing my eligibility for future placements and professional registration. Overall, this session was instrumental in ensuring that I am fully prepared for the next steps in my nursing career.

Date of Learning: 28/02/2025
Time: 09:30-16:30
Title of learning activity: End Point Assessment Preparation

In this learning activity, we discussed the preparation for the end point assessment, focusing on the NMC standards. I also received an explanation of the revalidation process, along with some tips and advice on how to complete it successfully. The tasks required for completion were outlined, and we talked about the transition from being a student to becoming a registered nursing associate.

The class session was very helpful for me as it provided a clear understanding of what to expect after completing the course. I gained insights into potential career opportunities and progression available upon finishing the program.

I was reminded of the importance of fulfilling all course requirements, including learning logs, theory hours, tripartite assessments, and other necessary tasks to achieve sign-off. Additionally, the declaration of good character form was introduced, with an explanation of its purpose and how it is essential for registration with the Nursing and Midwifery Council (NMC).

Date of Learning Log: 17/01/2025

Time: 09:30-16:00

Learning Activity: Preparation for Practice

Clinical Skills:

1. Male and Female Catheterisation
2. Injection Technique
3. NG insertion
4. Basic Wound Management
5. Medications Administration
6. 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:

Skills:

Behaviour:

Date of Learning Log: 10/01/2025

Time: 09:30-16:00

Learning Activity: Airway Management and Suctioning

Endotracheal suctioning entails the mechanical aspiration of pulmonary secretions from patients who have artificial airways. This procedure is necessary to ensure a clear airway, enhance oxygenation, stimulate coughing, and prevent infections to keep the airway open. Oral suctioning is crucial for removing secretions from the mouth in patients who lack the ability to swallow effectively or at all. When performing oral suctioning, it is essential to use a safe technique to avoid damaging the teeth and gums. Before conducting oral suctioning, you should prepare the necessary equipment and verify that it is fully charged. Set the required suction pressure, typically up to 115 mmHg for adults and 100 mmHg for children. It’s important to explain the procedure to the patient, position them upright, ensure adequate lighting, and wash your hands or don personal protective equipment (PPE). Check the suction pressure, avoid suctioning beyond the tonsils, and limit the duration to no more than 10 seconds. During suctioning, closely monitor the patient’s facial expressions and stop immediately if any signs of distress are observed. To enhance oxygenation and lessen the effort required for breathing, various techniques can be utilized, starting with Diaphragmatic Breathing, which is fundamental for healthy breathing that engages the diaphragm. Additionally, practicing Nose breathing instead of Mouth breathing—where air is inhaled through the nose and exhaled through the mouth—is beneficial, as the nasal passages filter, warm, and humidify the air.

Oral care constitutes a fundamental aspect of nursing care. It contributes to the patient’s quality of life and overall well-being. Maintaining good oral hygiene helps prevent issues such as cavities, gum disease, and bad breath. Oral health is associated with overall health, enabling individuals to speak clearly, taste, chew, and smile effectively. Adopting proper oral habits can help preserve teeth for a lifetime.

To demonstrate safe oral suctioning techniques using a Yankauer suction device, it is crucial to assess the patient’s risk for aspiration and their ability to protect their own airway or adequately clear secretions, as failure to do so can result in upper airway obstruction. Inform the patient about how the procedure will assist in clearing secretions and that it will only take a few seconds. If appropriate, encourage the patient to cough if they have the reflex to do so. Verify the patient’s position, gather supplies, and don non-sterile gloves. If there is a risk of body fluid splash, apply a mask. Insert the Yankauer catheter and activate suction by covering the thumb hole.

The retention of airway mucus poses a significant challenge for postoperative and critically ill patients, as well as the caregivers tasked with managing it. Retained secretions can increase the work of breathing and lead to hypoxemia, atelectasis, and pneumonia. Atelectasis refers to a condition where the lungs partially or completely collapse. Mild cases generally do not exhibit signs or symptoms, but breathing difficulties may arise if the condition worsens. This condition can be extremely dangerous and life-threatening, requiring laboratory tests or imaging, and is treatable by medical professionals, potentially lasting several days or weeks.

KSB ADDRESSED:

Knowledge:

Skills:

Behaviour:

Date of Learning Log: 20/12/2024

Time: 09:30-16:00

Learning Activity 1: Delivering Quality Care through Evidence-Based Practice

Today is the presentation day for the delivering quality care through evidence-based practice. My topic was implementing video surveillance for fall prevention. Overall, I think I have delivered my presentation within the 10 minutes allocation in which I made sure that my points were clear and easy to understand. The presentation was submitted on 19/12/2024.

Date of Learning Log: 18/12/2024

Time: 09:30-16:00

Learning Activity 1: Leadership and Collaborative Working Submission Day

During this time, I used the time to check and submit my assignment via turn it in. I ensured that I double-checked my work and checked for similarities. I submitted my assignment on time and followed the submission instructions.

Date of Learning Log: 13/12/2024

Time: 09:30-16:00

Learning Activity 1: The Nursing Associate and Integrated Care

In this learning activity, I discussed the policies that guide patient care, gained insights into integrated care, explored the existing integrated care systems, and comprehended the role of nursing associates within integrated care.

The delivery of care to patients is guided by various health and social care frameworks established by NHS England, Health Education England, and the Department of Health and Social Care. Key legislation includes the Health and Social Care Act 2012 and national guidelines and protocols issued by NICE. Additionally, local procedures and protocols from trusted employers and guidance from Clinical Commissioning Groups (CCGs) and Primary Care Networks (PCNs) play an essential role. Professional standards are governed by the Nursing and Midwifery Council (NMC) Code, the NMC’s Standards of Proficiency for Registered Nurses, and oversight from the Royal College of Nursing. The Care Quality Commission (CQC) provides regulatory oversight. Together, these governance structures demonstrate a commitment to accountability and continuous improvement in service quality, striving for excellence in all aspects of personal health and social care.

Integrated care aims to provide holistic prevention and treatment that addresses a client’s biological, psychological, and social needs. According to the American Psychological Association, integrated care’s “triple aim” focuses on improving patient access, quality of care, and cost-effectiveness. Integrative health ensures well-coordinated care among providers and institutions by combining conventional and complementary approaches to address the whole person. Integrated care involves sharing patient information (with the patient’s consent), which reduces the chances of unnecessary procedures or conflicting treatments. This coordination ensures that every provider is aligned regarding treatment plans, leading to improved collaboration and a more personalised approach to care. Integrated Care Systems (ICSs) bring organisations together to connect health and care services, enabling individuals to receive the support they need in the right place and at the right time.

Nursing associates will work across all aspects of the nursing process, providing individuals with high-quality, holistic, and person-centred care. They will support registered nurses in assessing, planning, and evaluating patient care. Nursing associates’ duties include undertaking clinical tasks, helping individuals and their families when faced with unwelcome news and life-changing diagnoses, and performing and recording clinical observations such as blood pressure, temperature, respiration, and pulse. Nursing associates contribute to service delivery and patient care by assisting nurses with a broader range of caregiving responsibilities, enhancing patient communication, providing more personalised care, acting as patient advocates, and identifying and escalating cases of deteriorating health.

London has developed five Sustainability and Transformation Partnerships (STPs) to support collaborative working in North West London, North Central London, North East London, South East London, and South West London. All these partnerships have achieved ICS status. An emergency response plan’s primary function is to outline the incident-specific details for the five functional components of the ICS: Command, Operations, Planning, Logistics, and Finance/Administration.

Learning Activity 2: Poster presentation workshop

In this learning activity, I had the opportunity to present my assignment in front of the class as a mock presentation. By doing this I was able to gain knowledge on how to improve my presentation and the delivery. This was a good workshop to identify the strengths and weaknesses of my presentation content and delivery.

KSB ADDRESSED:

Knowledge:

Skills:

Behaviour:

Date of Learning Log: 06/12/2024

Time: 09:30-16:00

Learning Activity 1: Improving Safety and Quality of Care

This learning activity will deepen my understanding of the essential requirements for delivering safe and high-quality care in a clinical setting. This includes exploring best practices for patient safety and the protocols that ensure the delivery of care meets established standards. I will learn how to effectively escalate concerns when they arise, ensuring that patient safety issues are communicated promptly and addressed appropriately. Additionally, I aim to clarify the concepts of near misses—incidents that could have led to patient harm but were avoided, serious adverse incidents that result in significant damage or injury, and major incidents that can cause catastrophic outcomes. Through this learning process, I will also demonstrate my understanding of the critical role that Nursing Associates play in maintaining safe and quality care within the healthcare team, contributing to positive patient outcomes and fostering a culture of safety.

Safe and quality care entails preventing harm to patients or individuals receiving care and managing the associated risks of service users. The key principles for enhancing patient and health outcomes include demonstrating respect and gratitude, involving the patient’s family and friends, collaborating with the patient, offering emotional support when necessary, and engaging the patient in discussions about their care plan.

Proper staffing is crucial for delivering safe and effective health and care services, ensuring that the right individuals with the appropriate skills are present in the right place and at the right time for patient safety. Implementing care hours per patient for sustainable staffing levels comes with certain expectations. Recruiting the right staff involves evidence-based workforce planning, professional judgment, and comparing staffing levels with peers. For the expectations of the right skills, staff must complete mandatory training upon being hired in care roles to develop their skills and knowledge. Lastly, efficient deployment and adaptability determine the right place and time for staffing.

To raise concerns about safe and quality care, it is necessary to bring the issue to the attention of a manager or a more senior individual within the organisation. This process can often provide objectivity and oversight to your concerns, as a line manager may need to justify their decisions.

Incidents or adverse events resulting from actions taken (or not taken) that have caused unexpected harm that should have been preventable fall under this category. This includes errors or mistakes in procedure or near misses—situations that could have harmed someone but were avoided by luck or intention. If an incident occurs, it is important to complete a Datix report to help management understand how to escalate the matter and investigate what happened and why. The following steps are essential for ensuring safe work practices.

To illustrate an understanding of the role of Nursing Associates, this means that if the organisation hires nursing associates like me, I must be able to show that we are qualified, skilled, competent, and possess the experience necessary to evaluate the health, safety, and welfare of those utilizing the service, and to address their care and treatment requirements, while also adhering to regulatory standards.

Learning Activity 2: Revision Session, Assignment Guidance, Assignment Presentation Workshop.

In this learning activity, the key concepts from the module were reviewed to consolidate understanding, guidance was provided on presentation logistics using Microsoft Teams, and the plans and expectations for the assessment day were discussed.

The importance of Evidence-Based Practice (EBP) in improving the quality of care is thoroughly examined. In this discussion, I highlighted various definitions of quality care, emphasising its multifaceted nature that encompasses safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. Additionally, I elaborated on the concept of EBP, defining it as the conscientious integration of the best available evidence, clinical expertise, and patient values in decision-making processes.

I detailed the sources of evidence used in EBP, which include a range of research studies—both randomized controlled trials and observational studies—and the vital role of clinical expertise drawn from practitioners’ experiences. I underscored the significance of incorporating patient values and preferences and the importance of utilizing organisational data to inform practice. Furthermore, I touched upon the role of expert consensus and local resources in shaping evidence-based interventions.

The discussion also clarified the distinction between methods and methodologies, providing insights into how various approaches are applied within research. I offered an overview of qualitative research, which seeks to understand phenomena through interviews, focus groups, and observational studies, and quantitative research, which focuses on numerical data and statistical analysis to draw conclusions. This comprehensive examination aimed at laying a strong foundation for understanding how EBP can be systematically applied to enhance the quality of care delivered to patients.

We discussed the EBP frameworks used in healthcare, and I was reminded of how to use the PICO framework, CRAAP test, and EBP process. Furthermore, we explored different types of literature and identified their strengths and weaknesses. Lastly, we analysed the professional issues involved in implementing EBP to enhance the quality of care.

KSB ADDRESSED:

Knowledge:

Skills:

Behaviour:

Date of Learning Log: 29/11/2024

Time: 09:30-16:00

Learning Activity 1: Formative Workshop

In this learning activity, I made significant progress in understanding and applying the module learning outcomes to my assignments. I gained a clearer grasp of the marking criteria associated with the module, which is helping me develop my skills in providing constructive peer support.

The learning activity commenced with a detailed identification of the module’s specific learning outcomes. We explored how these outcomes are integrated into each lecture session, allowing us to see their relevance in real time. During this process, we utilized a Padlet to collaboratively identify and document our insights. This platform enabled me to articulate and reflect on what I had learned thus far, fostering a deeper understanding of the material.

As part of the activity, I was tasked with critiquing two pieces of literature using the established marking criteria. This exercise challenged me to apply my knowledge critically and engage deeply with the texts. Additionally, I participated in group work focused on these critiques, which fostered discussion and allowed me to hear diverse perspectives on the material.

This session proved to be invaluable for my assignment, as it provided me with a benchmark to assess whether my written work was aligned with the expectations of the module. I was able to identify areas that needed improvement and confirm that I was on the right track. Moreover, I had the opportunity to provide peer feedback to my classmates. Through this process, I not only shared my thoughts on their work but also learned from their ideas, which enriched my own writing skills and enhanced my ability to articulate constructive criticism. Overall, the activity was instrumental in my learning journey, equipping me with practical tools and insights for future assignments.

Learning Activity 2: Data collection, Audit and Development of evidence-based guidelines

In this learning activity, I learned about the use of context in evidence-based health policy development, explained what an audit is, identified the audit cycle, and developed my understanding of data collection.

An evidence base in health policy development refers to the collection of research, data, and evaluations used to inform and guide decision-making. It provides the foundational knowledge that policymakers rely on to make informed, effective, and efficient policy decisions that address health issues. The use and context of an evidence base include:

1. Informed Decision-Making: Evidence ensures that health policies are grounded in scientific facts and real-world data rather than assumptions or personal opinions.

2. Improving Outcomes: Utilising evidence from clinical studies, population data, and other research can enhance patient outcomes, public health initiatives, and cost-effectiveness.

3. Addressing Health Inequities: Evidence can identify disparities in health, helping to create policies that meet the needs of underserved or vulnerable populations.

4. Accountability and Transparency: Relying on an evidence base ensures that health policies are transparent and that decisions can be justified to the public and stakeholders.

5. Continuous Improvement: As new evidence emerges, health policies can be updated and refined to respond to evolving health trends, challenges, or technological advancements.

An audit is a structured method utilized to evaluate, assess, and enhance the effectiveness, quality, or results of a specific service or process. In the realm of healthcare, audits are generally carried out to confirm that health services adhere to established standards and regulations, to evaluate the quality of care, and to pinpoint areas needing improvement. There are two main categories of audits in healthcare:

• Clinical Audits: Concentrate on the quality of patient care by comparing actual practices with evidence-based guidelines.
• Health System Audits: Investigate broader processes, such as budgeting, resource allocation, and compliance with policies.

The audit cycle refers to the systematic process of conducting an audit, typically used in financial auditing, internal auditing, or any other type of compliance or performance review. It involves a series of stages that auditors follow to gather evidence, assess findings, and make recommendations for improvement or compliance.

Here are the key steps involved in the audit cycle:

1. Planning
   • Objective Setting: Establish the scope and objectives of the audit, understanding what areas will be reviewed.
   • Risk Assessment: Identify key risks that could affect the accuracy or reliability of the information being audited.
   • Audit Strategy: Develop an audit plan and methodology, including timelines, resources, and approaches to be used.
2. Fieldwork (Evidence Gathering)
   • Data Collection: Gather evidence through various methods like interviews, document reviews, testing, observations, and sampling.
   • Testing: Perform tests to evaluate the accuracy, completeness, and integrity of financial records, transactions, or controls.
3. Analysis
   • Evaluate Findings: Analyze the collected evidence to assess whether it aligns with the objectives of the audit.
   • Identify Issues: Detect any discrepancies, weaknesses, or non-compliance issues.
4. Reporting
   • Audit Report: Summarize findings and provide recommendations for corrective actions or improvements. The audit report typically includes an opinion or conclusion on the subject of the audit (e.g., financial statements, internal controls).
   • Communication with Management: Share the findings with relevant stakeholders, such as management, board members, or regulatory authorities, depending on the type of audit.
5. Follow-Up
   • Action Plan: Ensure that the auditee develops and implements corrective actions based on the audit findings.
   • Review: Revisit the organization after a certain period to assess whether corrective actions have been implemented and whether the audit objectives have been met.
6. Closure
   • Once the follow-up review confirms that necessary actions have been taken, the audit cycle is considered complete.

The audit cycle is usually iterative, as audits are conducted regularly to maintain accuracy, ensure compliance, and improve organizational performance.

Data collection is a crucial step in the audit process, especially in health policy development and clinical audits. It involves gathering information that will provide insights into the effectiveness, quality, and outcomes of health services. Effective data collection must be:

1. Systematic: The process should be structured and consistent, ensuring that data is collected in a way that is reproducible and valid.
2. Relevant: Data should directly relate to the questions being asked or the areas being audited. For example, patient health outcomes, resource utilization, or adherence to clinical guidelines.
3. Accurate and Reliable: Data must be correct, up-to-date, and collected from credible sources to ensure trustworthiness.
4. Quantitative or Qualitative:
   • Quantitative Data: This refers to numerical data, such as the number of patients treated, patient outcomes, or infection rates.
   • Qualitative Data: This includes non-numerical information, such as patient satisfaction or staff opinions, which provide deeper context to the numbers.
5. Ethical: The collection of data must adhere to ethical guidelines, including obtaining informed consent, protecting patient confidentiality, and ensuring the integrity of the data collection process.

Types of data collection methods include surveys, interviews, focus groups, observation, and the review of existing records or databases. Proper data collection ensures that audits are based on accurate and comprehensive evidence, enabling health policies and practices to be based on solid information.

By understanding the role of evidence, audits, and data collection, you can see how these components are interlinked in improving health policy and practice.

KSB ADDRESSED:

Knowledge:

Skills:

Behaviour:

Date of Learning Log: 18/10/2024

Time: 09:30-16:00

Learning Activity 1&2: Promoting Health and Preventing Ill Health

In this learning activity, I learned the principles of health promotion and illness prevention in clinical practice, analysed how EBP underpins strategies for promoting health and preventing disease, critically evaluated current health promotion intervention and their effectiveness on research, and lastly, applied EBP to develop plans for health promotion and illness prevention in real-world practice.

Health promotion is about empowering individuals to enhance their control over their health. It extends beyond focusing on personal behaviours to include various social and environmental strategies. The key principles of health promotion are maintaining a nutritious diet, engaging in regular physical activity, balancing work and adequate rest, and fostering a positive mindset. A healthy diet comprises nutrients such as carbohydrates, fats, fibre, minerals, proteins, vitamins, and water.

The principles of health promotion include:

• Empowerment: Enabling people to have more control over the decisions and actions that affect their health.
• Participative: Involving people in decision-making.
• Holistic: Considering the various influences on health and how they interact.
• Equitable: Ensuring that outcomes are fair for service users.
• Intersectoral: Working with other relevant agencies and organisations.
• Sustainable: Ensuring that the outcomes of health promotion activities are sustainable over time.
• Multi-strategy: Working on several strategy areas, such as programs and policy.

Health promotion involves assisting individuals in enhancing their health and gaining greater control over it. It is an affirmative notion that perceives health as a resource for daily living rather than merely a goal to achieve. Health promotion encompasses more than just healthcare and engages policymakers across all sectors and levels.

Health promotion and disease prevention strive to enhance health and well-being across all life stages. While they share numerous objectives and often intersect in their functions, they differ in their emphasis. Health promotion emphasizes empowering individuals to take charge of their health through a range of social and environmental strategies. Its goal is to enhance control over health factors, including diet, physical activity, and tobacco consumption. Additionally, health promotion tackles mental health, injury prevention, and sexual health issues. In contrast, disease prevention concentrates on averting diseases, mainly through healthcare services. Disease prevention encompasses primary prevention, which seeks to eradicate health issues at their origin, and secondary prevention, which focuses on early detection and intervention for negative health conditions.

Group Work:

Our group collaborated on a comprehensive plan aimed at preventing the onset of illness. To ensure its effectiveness, we grounded our strategies in robust, evidence-based research and considered the latest guidelines from reputable health organisations. Each team member contributed insights into relevant studies and data that reinforce our proposed interventions. We meticulously outlined how the selected evidence supports each component of our plan, detailing the rationale behind our choices. Additionally, we established clear criteria for evaluating the plan’s effectiveness, incorporating both qualitative and quantitative measures to assess outcomes and make necessary adjustments. Through this process, we aimed to create a sustainable and impactful approach to illness prevention.

KSB ADDRESSED:

Knowledge:

Skills:

Behaviour: