Apprenticeship Learning Log
Date of Learning: 12/04/2024
Time: 9:30 to 12:30
Title of learning activity: Session 3: Introduction to human factors, managing risk and theory of decision making and clinical judgement and sickle cell
Diary of Learning activity
(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)
Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):
Learning outcomes:
1. Explore the importance of HF
2. Define HF/Ergonomics
3. Understand the role of clinical decision making and clinical judgement
4. Analyse the policies around decision making
5. Define sickle cell disease (SCD)
6. Explain the genetics of SCD
7. Understand a little bit of history and how this is passed on to generations and its mechanism
8. discuss the S/S, diagnosis, treatment, and complications
In this session, There were three topics; human factors, managing risk and theory of decision making and clinical judgement and sickle cell disease.
First is about human factors, a video was shown and it shows a person, unfortunately loss her life connected to a lot factors which include human factors.
Human factors/Ergonomics focuses in analysing the relationships between humans and various components within the system. It is also the practice that utilises theories, principles, data and techniques to provide and create design that enhance human health and the overall efficiency of the system. In clinical practice it includes people, system and cultures and mental models.
I have learned that human factors or ergonomics mean the same but one terms may be used more in certain context or sectors and it can be affected by cognitive capacity, workspace, tasks, supervision, teamwork/colleagues, culture and organisation, rules and protocols, and personal stress, alertness, tiredness etc. Outcomes can be improved by being aware of some behaviours such as resolve, ambiguity, intervenes if deviation from standard, concentrates on facts not personalities, does not compete with others, encourages input from others, identify potential threats and errors and use open Q’s and seeks colleagues’ ideas.
In healthcare, there is potential for improvement through the mitigation of error consequence and it can be achieved by implementing measures to trap errors and avoid their occurrence such as standardising equipment, providing comprehensive teaching and training and preventing the administration of similar packets of medication and conducting audits. This can significantly contribute to improve the overall quality and safety of healthcare practices.
Second is managing the risk and theory of decision making and clinical judgement. In this topic I learned that clinical decision making can be simple and complex and it can be affect by knowing the evidence, yourself, environment and the patient/person while decision making process includes using cues and gathering and analysing patient data systematically, making judgement, making decisions and evaluating outcomes.
Last topic was the sickle cell disease (SCD) which is a genetic disorder with abnormal red bl0od cells that are crescent shaped, detached to the oxygen and stick together with other abnormal red blood cells and clogged the small blood vessels and blocks oxygen passing through and prevent the body from having enough supply of oxygen to the body. This abnormal red blood cells can only live for ten to twenty days which normal red blood cells on the other hand can last up to three months. The normal type of haemoglobin and genetics of SCD are Hb A, Hb A2 and Hb F while the abnormal is Hb S, Hb C and Hb E.
Diagnosis of SCD includes conducting a blood test to check for the presence of HbS. A negative indicates the absence of the sickle cell gene while positive result needs further testing to differentiate between sickle cell traits or sickle cell disease. Additionally, low levels of haemoglobin can serve as an indicator of SCD, along with other blood test.
Symptoms of sickle cell disease varies from person to person and change overtime
- anaemia
- fatigue
- pain (chest, abdomen, bones and joints)
- pain varies in the intensity and last for few hours or weeks.
- painful swelling of hands and feet
- frequent infections
- delayed growth
- vision problems
Complications of sickle cells includes;
- stroke
- acute chest symptoms
- pulmonary hypertension
- organ damage
- leg ulcers
- gallstones
- blindness
Treatment of SCD is usually avoiding pain, relieving symptoms and preventing complications
- regular doctor review of pain medication and prevent complications
- bone marrow transplant
- antibiotics
- analgesic
- assessing stroke risk
- vaccinations
- regular blood transfusion
- nitric oxide
There are also some experimental treatments like gene therapy and turning off the defective gene while reactivating another gene
As a TNA all this topic will help me and guide me in better myself in understanding human factors that can affect in healthcare outcomes, knowing and managing the risk of clinical judgement and decision making and also understanding how sickle cell disease develop, signs, symptoms, management and treatment.
KBS addressed:
K1 Understand the code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC 2018), and how to fulfil all registration requirements.
K2 Understand the demands of professional practice and demonstrate how to recognise signs of vulnerability in themselves or their colleagues and the action required to minimise risks to health.
K3 Understand the professional responsibility to adopt a healthy lifestyle to maintain the level of personal fitness and well-being required to meet people’s needs for mental and physical care.
K4 Understand the principles of research and how research findings are used to inform evidence-based practice.
K5 Understand the meaning of resilience and emotional intelligence, and their influence on an individual’s ability to provide 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.
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.
K14 Understand the importance of health screening.
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.
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.
K24 Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort, and pain.
K30 Understand the principles of health and safety legislation and regulations and maintain safe work and care environments.
K33 Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes.
K35 Understand own role and the roles of all other staff at different levels of experience and seniority in the event of a major incident.
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.
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.
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.
S13 Apply the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people.
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.
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.
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.