Date of Learning Log: 20/09/2024

Time: 09:30-16:00

Learning Activity 1: Introduction to Methods and Methodologies.

In this learning activity, I explored the importance of evidence-based practice (EBP) in enhancing the quality of care. I examined various EBP frameworks and demonstrated an understanding of the strengths and weaknesses of different forms of evidence used in health and social research and service evaluation. Finally, I analysed the professional issues that may arise when implementing EBP.

A research methodology is a strategic plan that directs the selection and application of research methods. It serves as a framework for collecting, analysing, and interpreting data, ensuring that the research is systematic, valid, and credible. This approach is particularly relevant to evidence-based practices in health and social care.

Methods refer to the specific tools and techniques employed to gather data in research. These can include a variety of approaches such as surveys, interviews, focus groups, observations, and experiments, each tailored to capture different types of information. For instance, surveys might be used to collect quantitative data from a large population, while interviews may delve deeper into individual experiences and perspectives, providing qualitative insights.

On the other hand, methodologies encompass the overarching theoretical frameworks that guide the selection and application of these methods. They provide the underlying rationale for why a particular method is chosen and how it aligns with the research objectives. Common methodologies include qualitative approaches, which focus on exploring complex phenomena through understanding and interpretation, and quantitative approaches, which emphasise measurement and statistical analysis to test hypotheses. By integrating various methods within these methodologies, researchers can enhance the robustness of their studies and draw more comprehensive conclusions.

Quantitative focuses on quantity (numbers) – counting, measuring, analysing numerical data.

Qualitative focuses on quality (words) – understanding quality of experiences or phenomena – words, interviews, observations and narratives.

Mixed methods combines both qualitative and quantitative.

Common research methodologies in healthcare:

• Phenomenology:
  Focuses on lived experiences (e.g., understanding patients’ experiences with chronic illness).
• Ethnography:
  Studies cultures and communities (e.g., understanding how a healthcare practice works within a specific group).
• Randomised Controlled Trials (RCTs):
  Tests the effectiveness of interventions by randomly assigning participants into groups (e.g., testing new medication efficacy).
• Cohort Studies:
  It follows a group over time to observe outcomes (e.g., studying the long-term effects of a healthcare intervention or smoking effects).

PDSA Methodology:

Plan: Identify Your Problems

This stage involves defining the problem and determining the objectives for improvement. In research terms, this is when you generate your research question and decide whether a qualitative or quantitative methodology is most appropriate

Do: Test Potential Solutions

At this stage, the research methodology is applied to collect data, whether through qualitative interviews or focus groups or quantitative experiments or surveys.

Check: Study Results

Here, the data is analysed to see whether the solution or intervention had the desired effect. This is where the analysis of either qualitative (themes and narratives) or quantitative (statistical analysis) data takes place.

Act: Implement the Best Solution

Finally, based on the results, the findings can be used to implement the best solution in practice or suggest changes in policy. This is the application of the findings to real-world nursing or healthcare practices.

Learning Activity 2: Search Strategies and Hierarchies of Evidence

In this learning activity, I engaged in a comprehensive literature search by employing various search strategies. I explored different databases and utilized specific keywords to gather relevant articles and studies. Throughout this process, I deepened my understanding of the hierarchy of evidence, which helped me assess the quality and reliability of the sources I found. I meticulously evaluated the literature to determine how each piece of evidence could be effectively applied in practice. This involved critically analysing methodologies, results, and implications, ensuring that the evidence I selected was both applicable and beneficial for real-world situations.

There are various forms of literature that you might come across while researching or examining previous studies. Each form offers a different degree of evidence, and grasping these classifications will assist you in determining their appropriate use and evaluating their credibility.

1. Clinical Guidelines

• Clinical guidelines provide evidence-based recommendations to guide healthcare professionals in making decisions about patient care. They are created by expert panels after reviewing large bodies of evidence.
• Example: NICE (National Institute for Health and Care Excellence) guidelines in the UK.

2. Systematic Reviews

• A systematic review synthesises the results of multiple studies on the same topic to draw a more comprehensive conclusion.
• Why it’s valuable: Systematic reviews provide high-level evidence as they minimise bias by including a broad range of research.

3. Research Studies

• These include primary studies such as randomised controlled trials (RCTs), cohort studies, and case-control studies, which generate new data.
• Importance: Primary studies form the backbone of clinical evidence.

4 Internet Articles

• While articles from websites may provide useful background information or recent updates, they are generally considered lower-quality sources of evidence due to lack of rigorous peer review.

5. Non-Research Articles

• These include opinion pieces, editorials, and commentaries. While helpful for insight or debate, they are not evidence-based and should not be the primary source for clinical decision-making.

6. Grey Literature

• This refers to information produced outside traditional publishing channels. It includes conference proceedings, government reports, or unpublished studies.
• Why it matters: Grey literature can provide insight into emerging issues but should be approached with caution as it may not have undergone peer review.

NB: There is a difference between a systematic review and a meta-analysis. A systematic review summarises and evaluates the research but does not combine results statistically. A meta-analysis goes a step further by statistically combining data from multiple studies.

KSB ADDRESSED:

Knowledge:

Skills:

Behaviour:

Date of Learning Log: 13/09/2024

Time: 09:30-16:00

Learning Activity 1: Resilience and Emotional Intelligence

During the session, we delved into the intricate relationship between emotional intelligence and resilience and their profound impact on the development of nursing associates. Throughout the learning activity, we actively explored the physiological processes involved in processing emotions. We defined and discussed the nuanced concepts of emotional intelligence and resilience and delved into the practical aspects of developing these attributes as a nursing associate. Lastly, we focused on fostering self-awareness and reflecting on our emotional intelligence, thereby creating a deeper understanding of its relevance in our professional roles.

Emotional hijacking is a condition in which our feelings dominate, resulting in impulsive responses that we often regret. This hijacking starts with an event that serves as a “trigger.” A trigger might include a co-worker criticising your work in front of others, a conflict with a colleague, or even a personal setback.

Emotional intelligence, often referred to as emotional quotient (EQ), is the capacity to recognise, use, and regulate one’s own emotions constructively to reduce stress, communicate successfully, empathise with others, tackle challenges, and resolve conflicts.

Empathy, intuition, and self-awareness are pivotal in effective leadership. However, developing these traits can be challenging, and applying them carries certain risks that leaders must navigate carefully. A diverse group of eighteen leaders and scholars has come together to delve into the intricacies of managing emotional intelligence within an organisation.

Whether they embrace it or not, leaders are tasked with shaping and managing the emotional atmosphere of their teams and organisations. Emotional intelligence encompasses the ability to recognise, understand, and influence one’s own emotions as well as the emotions of others. The advantages of cultivating this skill set are profound, as it fosters deeper understanding and stronger connections with those around you.

When leaders develop a keen awareness of their emotional states, they are also better equipped to interpret and respond to the emotional cues of others. This heightened sensitivity can lead to stronger relationships, enhanced teamwork, and improved conflict resolution. Additionally, emotional intelligence facilitates healthier interactions with family and friends as individuals become adept at forgiveness and maintaining harmonious connections.

Ultimately, mastering emotional intelligence is not just about personal development; it’s about creating a thriving environment where individuals feel understood and valued, paving the way for greater collaboration and success within organisations.

Emotional intelligence (EI) offers numerous advantages for healthcare professionals, such as enhanced patient care. EI enables healthcare providers to better comprehend their patients’ emotions, leading to improved care quality and increased patient satisfaction. Enhanced teamwork is another benefit, as EI aids healthcare professionals in collaborating effectively, resolving conflicts, and maintaining composure during stressful situations. Additionally, EI assists healthcare professionals in managing their stress levels, which is particularly crucial in high-pressure roles. Furthermore, EI enhances leadership skills, allowing healthcare professionals to become more effective leaders and improving clinical outcomes and job satisfaction. EI also supports healthcare organisations in attracting and retaining skilled talent. Lastly, EI fosters a better work-life balance within healthcare organisations by facilitating flexible scheduling and various support services.

The four main components of emotional intelligence (EQ) are:

1. Self-awareness: This refers to the ability to understand your own emotions, strengths, and weaknesses. Self-awareness can lead to better decision-making, improved communication, and more meaningful relationships.

2. Self-management is controlling one’s emotions, behaviours, and impulses. Effective self-management allows one to respond appropriately to various situations and maintain a positive outlook.

3. Social awareness: This involves the ability to interact well with others. Social awareness helps you build meaningful relationships and better understand yourself and those around you.

4. Relationship management: This is the ability to identify, analyse, and manage relationships with individuals inside and outside your team. Strong relationship management skills can aid in successful negotiation and conflict resolution.

Emotionally intelligent people have control over their emotions and are adept at navigating social interactions.

Emotions are intricately connected to leadership and oversight in various ways, including emotional intelligence. Leaders with high emotional intelligence can significantly influence their employees’ job satisfaction, performance, and overall well-being. They can foster a positive work atmosphere by developing strong relationships, communicating effectively, and mediating conflicts. Emotions can also spread among individuals and groups, known as emotional contagion. Through emotional leadership, leaders can promote positive emotions in their employees, such as joy, hope, and pride. They can achieve this by expressing emotions, maintaining open communication, and providing supportive care. Employees who manage their emotions effectively might face lower job satisfaction and heightened stress levels. Conversely, those with supervisors exhibiting transformational leadership are less likely to undergo these negative experiences. Leaders can strategically utilise emotions to inspire their teams and offer meaningful feedback. For instance, they may leverage positive emotions to motivate their team or adopt negative emotions to convey a sense of urgency.

Learning Activity 2: Evidence-based Practice in Healthcare

This learning activity deepened my understanding of the importance of evidence-based practice (EBP) in healthcare. I learned how EBP ensures patient safety and allows for more personalised care. I also explored the barriers to implementing EBP and how it informs clinical judgment. We also discussed the NMC Code and its role in ensuring that information and advice align with the best available evidence.

Evidence-based practice (EBP) plays a crucial role in healthcare. It ensures that professionals utilize the most current and effective methods of care, rooted in the latest research findings. By relying on rigorous scientific evidence, EBP significantly enhances patient safety and improves health outcomes, as it minimizes the risks associated with outdated or ineffective treatment options.

Furthermore, EBP fosters an environment of critical thinking and continuous professional development among nursing staff. It encourages them to stay informed about advancements in medical research and question traditional practices. This ongoing learning process allows healthcare providers to refine their skills and adapt their approaches based on evolving evidence, ultimately leading to higher-quality care.

In addition, EBP integrates patient preferences and values into the decision-making process, resulting in more personalised, patient-centric care. Healthcare providers can tailor treatments that align with individual needs and preferences by considering what matters most to patients, enhancing patient satisfaction and engagement.

Finally, by prioritising evidence-based interventions, EBP supports cost-effective care by reducing the likelihood of unnecessary or ineffective treatments. This not only conserves healthcare resources but also contributes to the overall efficiency of healthcare delivery, ensuring that patients receive the most appropriate and effective care for their conditions.

Barriers to Implementing EBP:

• Lack of Time – Busy workloads limit time for research.
• Limited Access to Research – Difficulty accessing journals and databases.
• Lack of Knowledge/Skills – Insufficient training in appraising and applying evidence.
• Resistance to Change – Preference for traditional practices.
• Lack of Leadership Support – Management may not prioritise EBP.
• Resource Limitations – Insufficient equipment or staffing.
• Conflicting Research Findings – Uncertainty about the best evidence.
• Lack of Confidence – Hesitation in adopting new methods.
• Organisational Culture – Environments not focused on research.
• Patient Preferences – Patient choices may not align with evidence.

Where to get evidence from:

1. Research Studies, e.g. A randomised controlled trial (RCT) published in the BMJ (British Medical Journal) comparing the effectiveness of different interventions in reducing hospital-acquired infections in UK hospitals.
2. Systematic Reviews and Meta-Analyses, e.g., A Cochrane Review evaluating multiple studies on the effectiveness of vaccination programmes in reducing seasonal flu among older adults in the UK.
3. Clinical Guidelines, such as those of NICE (National Institute for Health and Care Excellence), are widely used to manage hypertension in NHS trusts in the UK.
4. Professional Experience and Expertise, e.g. A senior nurse practitioner’s expertise in managing long-term conditions, combining their experience of treating patients in a local NHS trust with the latest guidelines and evidence.
5. Patient Preferences and Values: In shared decision-making, a UK cancer patient chooses between treatment options, informed by their preferences and the latest evidence from the NHS Cancer Patient Experience Survey.
6. Healthcare Databases, e.g. CINAHL (Cumulative Index to Nursing and Allied Health Literature) or PubMed, provide access to a wide range of UK-based peer-reviewed articles relevant to nursing and healthcare.
7. Institutional Data and Audits, e.g., a clinical audit conducted by an NHS trust in England to assess the outcomes of a new falls prevention programme in a local hospital.
8. Textbooks and Expert Opinion, e.g., UK nursing textbooks such as “The Royal Marsden Manual of Clinical Nursing Procedures” are often used to guide nursing practice based on expert consensus.
9. Grey Literature, e.g. A report from The King’s Fund, a UK-based think tank, on the challenges faced by the NHS in adopting digital technologies in nursing care.
10. Local or National Health Statistics, e.g. Data from Public Health England on obesity rates, inform local public health interventions across the UK.

Process of EBP:

1. Asking the Question
   Formulate a straightforward clinical question to address a specific patient problem.
2. Acquiring the Best Evidence
   Search for the most relevant and up-to-date research to answer the question.
3. Appraising the Evidence
   Critically assess the quality, validity, and relevance of the research.
4. Applying the Findings to Clinical Practice
   Integrate the evidence into clinical decision-making, considering patient needs and preferences.
5. Evaluating the Outcomes of Change

Monitor and assess the impact of the applied evidence on patient outcomes and practice.

A systematic review is a comprehensive and organised approach to identifying, assessing, and summarising all available research evidence on a particular topic or question. It adheres to a defined protocol for collecting studies, rigorously evaluating their quality, and synthesising the findings to offer an in-depth understanding of the subject. Systematic reviews are regarded as highly trustworthy because they reduce bias and guarantee that healthcare decisions, such as those in nursing, are grounded in the most reliable evidence available.

We emphasize evidence-based practice (EBP) because it significantly enhances patient outcomes. Research-supported interventions are more likely to be effective and safer for individuals. Utilizing the best available evidence guarantees that patients receive validated care. This results in improved recovery rates, reduced complications, and an overall superior quality of care.

EBP also helps utilize resources more efficiently, subsequently lowering costs. By adopting evidence-based practices, we avoid unnecessary procedures and treatments that might not yield effective results, thus conserving both time and money. For example, administering antibiotics only when there is sufficient evidence for their necessity helps prevent overprescription and contributes to the fight against antibiotic resistance, conserving resources and minimizing harm.

Healthcare organisations, such as the NHS, actively endorse the adoption of EBP because it is consistent with national guidelines and regulatory standards. It also helps fulfil the expectations of regulatory bodies like the Nursing and Midwifery Council (NMC), highlighting the importance of safe and effective practices. By embracing EBP, we align ourselves with best practices and diminish the legal risks linked to outdated or ineffective care.

Integrating EBP allows us as healthcare professionals to stay abreast of the latest research and advancements. It fosters lifelong learning and critical thinking, enabling us to continuously enhance our practice. This means we are not merely adhering to protocols—we comprehend the rationale behind our actions and how they benefit the patient.

Thus, when discussing EBP, we refer to making informed decisions that improve patient care, more effective resource utilisation, and ongoing professional development. In essence, valuing EBP is synonymous with valuing the quality of care we deliver daily.

KSB ADDRESSED:

Knowledge:

Skills:

Behaviour:

Date of Learning Log: 06/09/2024

Time: 09:30-16:00

Learning Activity: Providing and Monitoring Care

PADLET:

The key takeaway from the session was understanding more in-depth professional values, decision-making, partnership working, safeguarding, and being able to present in the class, where I was given advice on how to present properly and the importance of time management.

I truly enjoyed the lesson, as it gave me the experience of presenting in front of the class, which will prepare me for my oral presentation assignment.

After the session, I gained more knowledge on researching and presenting information clearly and engagingly.

The session requires full engagement because we must research and present the information we found.

This learning will be used in my assignment and will also help when presenting my assignment.

I will need to read further about the topic and widen my literature. This will help me gain more knowledge about the subject and help me further when creating my assignment.

Providing and Monitoring Care:

In our recent learning activity, the module on leadership and collaborative working delved into the crucial aspects of providing and monitoring care. We engaged in a comprehensive discussion surrounding professional values and their profound impact on care delivery. The session highlighted the significance of shared decision-making and partnership working in the context of delivering care, emphasizing the collaborative approach to ensure optimal patient outcomes. Furthermore, we explored the intricacies of safeguarding and the critical importance of adhering to protocols to ensure the safety and well-being of those under our care.

Person-centred care is a practice in which patients actively participate in their own medical treatment in close cooperation with their health professionals. Sometimes, relatives may be involved in creating the patient’s health plan.

Shared decision-making occurs when a healthcare provider and a patient work together to make the best healthcare decision for the patient. The optimal decision considers evidence-based information about available options, the provider’s knowledge and experience, and the patient’s values and preferences.

Partnership working is when two or more groups or individuals come together to work towards a common goal. It’s also known as collaborative or joint working.

Safeguarding is a term used in the United Kingdom, Ireland, and Australia to denote measures to protect the health, well-being, and human rights of individuals. It allows people—especially children, young people, and vulnerable adults—to live free from abuse, harm, and neglect.

Professional Values are the guiding principles that individuals uphold in their work and business environments. These values play a crucial role in shaping the workplace culture, influencing how employees interact with each other, make decisions, and contribute to the organization’s overall success.

In the afternoon, we worked as a group on Carol’s case. We brainstormed ideas and presented in class how we can showcase the importance of decision-making, partnership, and patient care.

Learning Activity 2: Bowel Management: Enema/Suppositories

The nurse assistant is an integral part of the healthcare team, playing a crucial role in assisting patients with bowel and bladder retraining. This involves implementing individualised retraining plans, closely documenting the progress of each patient, and providing continuous support and encouragement throughout the process. Additionally, the nurse assistant is responsible for monitoring the patient’s condition and promptly reporting any changes or concerns to the healthcare team for further evaluation and intervention.

Constipation is a condition that causes infrequent or uncomfortable bowel movements and includes hard, dry stools that are difficult to pass. Other symptoms include painful bowel movements, bloating, and feeling sluggish. Constipation is common and can affect people of all ages. It can be caused by several things, including:

Diet: Not getting enough fibre in your diet can lead to constipation. Fibre helps promote regular bowel movements.

Medications: Certain medications, such as pain medications, antidepressants, antacids, iron pills, and more, can cause constipation.

Illness: A brief illness, such as a respiratory infection, can cause constipation.

Change in routine: A change in routine, such as travel, can cause constipation.

Neurological diseases: Parkinson’s disease, stroke, spinal cord injury, and multiple sclerosis can cause constipation.

Digestive diseases, such as irritable bowel syndrome (IBS), colorectal cancer, and diverticulitis, can cause constipation.

Constipation can usually be treated with simple changes to your diet and lifestyle. However, if you have chronic constipation that doesn’t respond to simple measures, you should see your doctor.

Laxatives play a crucial role in providing relief for patients with various conditions such as irritable bowel syndrome with constipation, chronic idiopathic constipation, and opioid-induced constipation. They are also utilised to empty the bowels prior to medical procedures like colonoscopies. It’s important to note that if you are following a low-sugar, low-caloric, or low-sodium diet, it is essential to consult a healthcare professional before using a laxative. Additionally, for individuals taking laxatives containing mineral oil, it’s advised that mineral oil should not be taken frequently or for extended periods as it may lead to gradual build-up in body tissues, potentially causing further health issues.

KSB ADDRESSED:

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Skills:

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Date of Learning Log: 09/08/2024

Time: 09:30-16:00

Learning Activity: Delivering Quality Care through Evidence-Based Practice – Introduction to the module.

This learning activity introduced me to delivering quality care through an evidence-based practice module. We discussed the learning outcomes and summative assignment deadline and participated in questions and answers.

During the session, we engaged in a group activity where we analysed and discussed a video on innovation, improvement, and the evolution of changes in healthcare services. We also explored the significance of evidence-based practice in ensuring the quality and safety of nursing. This approach provides a strong foundation for clinical decisions based on the best available evidence. By aligning nursing practices with evidence, evidence-based practice ensures practical and safe care and promotes standardisation and continuous improvement, all of which are crucial elements of high-quality healthcare.

Implementing interventions should be based on the latest and most robust evidence available in healthcare. It is crucial to ensure that the care provided is patient-centred, respecting and responding to individual patient preferences, needs, and values. Effective communication is essential in promoting transparent, accurate, and timely exchange of information among the healthcare team, patients, and their families. Interprofessional collaboration involves working closely and cooperatively with other healthcare professionals to optimise patient outcomes. Additionally, continuous quality improvement (CQI) is vital, requiring ongoing assessment and improvement of healthcare processes and outcomes to ensure the highest standard of care.

The 10 ways to choose a service improvement are as follows: Personal Experience: positive or negative. Experiences can involve the care they receive as patients, interactions with healthcare providers, or witnessing how colleagues handle certain situations. E.g. A nurse who experienced poor communication during a family member’s hospital stay may be motivated to implement better communication protocols in their practice, ensuring that patients and families are kept well-informed throughout their care journey.

Personal Interest: A healthcare professional’s interest in a specific area of medicine or patient care can drive them to improve services related to that interest. This passion often leads to deeper engagement and a commitment to excellence.

Curiosity About Something in the Media: Covering healthcare issues, innovations, or patient stories can spark curiosity and inspire healthcare professionals to explore new ideas or improve existing services.

State of Practice in a Particular Area: The current state of practice in a specific area of healthcare can highlight the need for improvements, especially if the standard of care is outdated or inconsistent. A mental health practitioner may notice that the state of care in their region is heavily reliant on medication with limited access to therapy. This could lead them to advocate for and develop more comprehensive mental health services that include a balance of medication, therapy, and community support.

Solving a Problem: Identifying and addressing a problem in healthcare services is a common motivation for improvement e.g. increased falls, pressure damage.

Hot Topics Under Discussion: Emerging trends or topics within the healthcare community can drive improvements as professionals seek to stay current and address new challenges or opportunities. Example: With the increasing focus on patient-centred care, a hospital might review and improve their patient engagement strategies, ensuring that patients are actively involved in their care decisions and treatment plans.

Personal Values: Healthcare professionals’ values, such as a commitment to compassion, equality, or excellence, often guide their efforts to improve services. These values drive a desire to provide the best possible care for all patients. An HCP who values social justice might work to improve access to care for underserved populations, developing outreach programs that ensure all patients, regardless of background, receive the care they need.

Gaps in Practice: when there is a discrepancy between the ideal standard of care and the care currently provided. Identifying these gaps can lead to targeted improvements to bridge them.

Healthcare Policy: Changes in healthcare policy, whether at the local, national, or international level, can prompt service improvements as healthcare organisations adapt to new regulations or guidelines. For example, a new policy mandating the use of electronic health records (EHRs) might lead a hospital to overhaul its data management system, improving accuracy, efficiency, and coordination of patient care.

Epidemiological/Demographic/Other Data: Data from epidemiological studies, demographic reports, or other sources can highlight trends or issues that require service improvements. This data-driven approach ensures that changes are based on evidence and actual need. If epidemiological data shows a rising incidence of diabetes in a community, a healthcare provider might introduce new diabetes education and prevention programs to address this growing health concern.

Learning Activity 2: Group Activity

During the afternoon session, our cohort was split into three groups, each assigned a specific scenario to discuss. In my group, we were tasked with addressing the issue of improving hand hygiene compliance. To start our discussion, each member shared insights into our organisation’s existing policies and procedures related to hand hygiene. We delved into a thorough examination of various strategies aimed at boosting compliance rates, discussing potential interventions such as staff training, visual reminders, and the implementation of monitoring systems. Additionally, we explored methods for assessing the effectiveness of these strategies, considering factors such as data collection and analysis methods.

Following the completion of the group work, the summative assignment was thoroughly deliberated upon. It was emphasised that the assignment entails the creation of either a poster or a PowerPoint presentation, lasting approximately 10 minutes, for the purpose of presentation. The content of the presentation should focus on discussing an area of improvement in practice, delving into the associated learning outcomes. Furthermore, it should effectively demonstrate an understanding of management, leadership, and behaviour within the context of the chosen area of improvement.

KSB ADDRESSED:

Knowledge:

Skills:

Behaviour

Date of Learning Log: 08/08/2024

Time: 09:30-16:00

Learning Activity: Module Introduction and Reflecting Critically.

From today’s session, the module and assessment were introduced. In this session, I participated in understanding the purpose of the module and the assignment brief, demonstrating the ability to use reflection as a tool, demonstrating the use of reflective models and critically reflecting upon learning to date. I was also introduced to padlet which will be used during the sessions to reflect on the takeaways of the lessons.

Self-reflection is a powerful tool for personal growth and development that can help people gain self-awareness and understand their identity. Here are some ways to demonstrate the ability to use reflection as a tool for self-development:

1. Ask open-ended questions: Prompt self-reflection by asking questions like, “What could I have done differently today?”
2. Journal: Express your thoughts and responses to questions through journaling.
3. Practice gratitude: Take time to review what you’re thankful for.
4. Meditate: Use meditation to practice self-reflection.
5. Take a walk: Reflect on your thoughts and experiences while taking a walk.
6. Spend time alone: Practicing self-reflection can be done by spending time alone.
7. Talk with friends: Engage in conversations with friends to practice self-reflection.
8. Practice mindfulness: Incorporate mindfulness practices into your routine for self-reflection.
9. Practice creative expression: Use creative expression to practice self-reflection.

Self-reflection can benefit many aspects of life, including relationships, parenting, and professional development.

Reflecting on your actions helps you develop your skills and assess their effectiveness, rather than just continuing to do things the same way. It involves positively questioning what you do and why you do it, and then deciding if there’s a better or more efficient way to do it in the future. One notable process for reflective practice is Gibbs’ reflective cycle, which involves describing what happened, considering your feelings and thoughts during the experience, evaluating what was good or bad about it, and analysing what else you can make of the situation.

Critical reflection is a process of reasoning to make sense of an experience. It involves being descriptive, analytical, and critical and can be expressed in various forms, such as in writing, orally, or through artistic means.

The session emphasises the importance of self-reflection for personal growth and development. It introduces various ways to demonstrate the ability to use reflection as a tool, such as asking open-ended questions, journaling, practising gratitude, and engaging in mindfulness. Reflective practice, including using Gibbs’ reflective cycle and critical reflection, is also highlighted as an essential process for making sense of experiences and promoting self-awareness.

Learning Activity 2: Professionalism and Accountability

I gained valuable insights into the crucial aspects of leadership, professionalism, and accountability in the nursing field. Effective leadership involves setting a positive example, serving as a role model, and exhibiting strong communication skills. Additionally, the importance of fostering a culture of teamwork, honesty, care, and respect for patients and colleagues was highlighted. Furthermore, the session underscored the significance of maintaining professionalism and adhering to the scope of practice, as every action taken carries a weight of accountability.

During this session, we were split into groups and given a topic. My team created a PowerPoint presentation on our topic, ‘The NMC code’. The task included reflecting on the professional requirements of nursing associates, in which we demonstrated how NAs are accountable professionals. We also discussed how leadership relates to professionalism and accountability.

A nursing associate is a crucial member of the healthcare team, responsible for providing high-quality, person-centred care within specific practice guidelines. They must possess a comprehensive understanding of medical knowledge and practical skills to ensure the safety and well-being of their patients. Working closely with registered nurses, nursing associates play a vital role in monitoring and assessing patient care, maintaining accurate records, and communicating effectively with other healthcare professionals.

In addition to their clinical responsibilities, nursing associates are expected to prioritize the promotion of health and well-being, as well as the prevention of illness, across a variety of healthcare settings. This may include collaborating with patients, their families, and the broader community to educate and advocate for healthy lifestyle choices.

Furthermore, nursing associates are tasked with upholding the ethical and legal frameworks within their practice scope, ensuring that patient dignity is always maintained. They must demonstrate a deep commitment to professional conduct, confidentiality, and respect for individual rights while delivering care. Adhering to these standards is essential for building trust and maintaining the integrity of the healthcare profession.

KSB ADDRESSED:

Knowledge:

Skills:

Behaviour

Date of Learning Log: 02/08/2024

Time: 09:30-16:00

Learning Activity 1: Summative Assignment

In today’s session, I successfully submitted my summative assignment in Turnitin. The case study assignment required me to write a comprehensive 2500-word essay focusing on long-term conditions. The essay delved deeply into assessment skills and care planning, emphasizing the importance of working in partnership to develop person-centred care plans based on evidence-based guidelines. The care planning process encompassed not only maintenance but also addressing acute exacerbations, both within the hospital setting and in the community.

KSB ADDRESSED:

Behaviour:

Date of Learning Log: 01/08/2024

Time: 09:30-16:00

Learning Activity 1: Summative Exam

I attended my summative exam for decision-making in care for nursing associates in this session. Before the exam, we were given case studies to determine each patient’s condition, which I studied in preparation.

During the exam I was able to revisit core anatomy, physiology, pathophysiology and pharmacology, assessment skills and prioritisation for person-centred care. The exam was underpinned by the nursing process and the main framework when evaluating and managing physical health deterioration with the ABCDE approach. In the exam, I needed to assess and manage individuals who are experiencing acute deterioration or mental health crises. I examined specific communication skills for conducting appropriate interviews and gaining a clear history.

KSB ADDRESSED:

Behaviour:

Date of Learning Log: 26/07/2024

Time: 09:30-16:00

Learning Activity 1: Wound Care: Suture/Clip/Drain Removal

This learning activity taught me about the integumentary system and wound healing process. The use of sutures and clips/staples and an understanding of the procedures required for removal and wound drains were explored. Additionally, the necessary procedures for the removal of the vacuum drain were also discussed.

When providing wound care, it’s important to start by cleaning the wound thoroughly. You can do this by rinsing it with either bottled or tap water, or by using sterile wipes. It’s also crucial to clean the skin around the wound with soap and water or antiseptic, but make sure not to get antiseptic into the wound itself. After cleaning, gently pat the area dry using a gauze swab or a clean tea towel. Once the wound is clean and dry, you can then proceed to put on a sterile dressing or a plaster to protect it.

The skin is composed of different layers, with the epidermis being the outermost layer. It provides a waterproof barrier and contributes to skin tone. Beneath the epidermis lies the dermis, which contains connective tissue, hair follicles, blood vessels, lymphatic vessels, and sweat glands.

Wounds are injuries that break the skin or other body tissues. They encompass a range of injuries such as cuts, scrapes, scratches, and punctures. While they often result from accidents, wounds can also be caused by surgical procedures, sutures, and stitches. Although minor wounds may not seem serious, it is crucial to clean and attend to them properly to prevent complications.

Wound healing is an intricate and highly regulated biological process that occurs in four primary stages: haemostasis, inflammation, proliferation, and remodelling, also known as maturation. These stages work in a coordinated manner to repair damaged tissue and restore the integrity of the skin or other affected tissues. Haemostasis, the initial stage, involves the process of clotting and occurs immediately after an injury. It is the body’s immediate response to stop bleeding and prevent further blood loss.

Each stage must proceed correctly for proper healing. Delays or complications at any stage, such as infection, can slow down or impair the healing process.

Signs of infection can occur in various parts of the body or after injuries and surgeries. Recognising these signs early is crucial for preventing complications.

• The skin around your wound is red or sore or feels hot and swollen.
• Your wound has liquid (often green or yellow pus) coming out of it.
• Your wound opens.
• You feel generally unwell or have a temperature (fever.)

To remove the drain, we follow a simple and usually painless procedure. First, we release the vacuum, then we remove the stitch holding the drain in place, and finally, we remove the tube. Your wound dressing may be changed once the drain is removed.

Grasp the drainage tube close to the skin with your dominant hand and remove the drain quickly and steadily. Distract the patient to help them prepare for the drain removal. You may feel slight resistance, but if there is strong resistance, pause and ask the patient to take a deep breath. The primary purpose of a vacuum drain is to prevent the accumulation of fluid, including blood and infected fluids, and to minimise the collection of air. Effective wound drainage management involves thoroughly assessing the wound area and current dressing. This includes evaluating the type and volume of exudate, the condition of the wound base, peri-wound skin, and wound edges, and selecting an appropriate dressing to maintain an ideal moist wound environment.

Learning Activity 2: Simulation consolidation of history-taking and assessment skills.

In this learning activity, I gained a good understanding of communication in providing person-centred care and analysed and assessed non-verbal cues and their impact on communication. The importance of active listening and its role in successful communication were discussed and illustrated. Communication barriers were discussed, and how to overcome them where possible. The appropriate communication strategy selection in different situations was explained.

As a nursing associate, I must meet the skills and standards set by the NMC, such as platform 3: Provide and monitor care, Annexe A and B, which includes history taking of patient’s past medical conditions, both physical and psychological. History taking in nursing refers to gathering comprehensive and detailed information about a patient’s medical, social, and psychological history. This is a critical step in assessing the patient’s health, identifying potential problems, and planning appropriate care. It helps nurses understand the patient’s health status and anticipate future healthcare needs. The skills required for history taking are interviewing, observation, reviewing documents, listening, clinical knowledge and understanding, and communication skills.

The process of effective history-taking involves good communication and active listening. Using open-ended questions allows patients to describe their symptoms or history in their own words. Active listening means paying close attention to what the patient says without interpreting. Additionally, showing empathy, understanding, and compassion towards the patient’s experiences is essential during history-taking. Asking follow-up questions and summarizing the patient’s words ensures accurate understanding. Non-verbal communication, such as body language, facial expressions, eye contact, gestures, and tone of voice, plays a crucial role in the history-taking process in nursing. It helps build rapport, show empathy, and create a comfortable environment for the patient.

Information can be gathered from the patient/service user, their families or carers, medical records, and referral information. Several barriers to communication must be anticipated during history taking, such as language, level of education, level of cognition, physical barriers, or abusive relationships. Nursing associates must ensure solutions to these barriers, such as booking interpreters, using communication aids, ensuring adequate pain relief if the patient is in pain, etc.

There are 6 sections on history taking, including the presenting complaint, history of the presenting complaint, past medical history, drug history, social history, and impression/diagnosis. The importance of family history is also essential during history taking, such as information about any significance in the family history, specifically about immediate family—parents and siblings—diagnosis, age of onset/age, and cause of death. Social history is an integral part of the history-taking process, where nurses gather information about the patient’s lifestyles, daily activities, relationships and environmental factors. This helps understand social determinants influencing the patient’s health, behaviour and well-being. Sexual history in nursing is vital to a patient’s overall health assessment. It involves gathering information about a patient’s sexual activity, practices, preferences, and potential risks related to sexual health. This helps nurses provide holistic care by identifying issues that may impact physical, emotional, or sexual well-being, such as sexually transmitted infections (STIs), contraceptive needs, or concerns about sexual function. Occupational history involves gathering previous and current employment, financial stability, and working patterns.

Review of systems, also referred to as system review questioning or ROS, is a structured approach utilized by healthcare providers, including nurses, to evaluate a patient’s well-being by inquiring about specific aspects of various bodily systems. This aids in pinpointing any symptoms or issues that may not have been communicated during the initial history-taking, and it guarantees a thorough evaluation of the patient’s overall health condition.

Effective history-taking consists of clarifying by recalling to the patient your understanding of the history symptoms and remarks, summarising the history back to the patient to clarify any discrepancies, and asking the patient if there is anything else to give the person a final opportunity to add any further information.

KSB ADDRESSED:

Knowledge:

Skills:

Behaviour: