Apprenticeship Learning Log
Date of Learning: 05/04/2024
Time: 9:30-12:30
Title of learning activity: Session 1: Introduction to module and assignement and clinical decision making
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)
Learning outcomes:
a. Will know about the module in general
b. Can understand the details of the module assignments
c. Will explore decision making and clinical judgement briefly
During the session, my lecturer disccused the introduction to module and assignment expection, including the structure and submissio ndates.
The session continued discussing about clinical decision-making in nursing practice, highlighting how difficult it may be to make decision that are safe, patient-centred and in unpredictable situations. There are factors that can contributed in affecting on decision-making and this are the patient, the environment, my role as a nursing associate and my knowledge of the evidence. I learned the importance to methodically collect and analyse patient data in order to asses results and make well-informed judgements. Applications of evidence-based clinical judgement, acknowledging bias in decision making and using tools such as SMART objectives and SBAR were highlighted.
It was stressed the importance of the need of flexibility and reflection in clinical decision-making in the session. It showed me that good decision are built on patient data, research, experience and the input of others. This session reminded me to question my biases and not rely soley on patterns and intuitions. I also realised the imporatnce of person-centred care, understanding that patients’ comorbidites and preferences might differ from what clinical judgement suggest. I benefited in understanding this to ensure that my decision align with the patient values and preferences and that is a key for providing holistic, patient-centred care.
In the future, I hope to widen my understanding of evidence-based methods and improved my proficiency using clinical tools like SBAR. I will try to adapt care plans to the patient’s social situation, preferences and comorbidities. I also need to work on figuring out information that is required for each patient and practising asking appropriate questions. In order to improve patient outcomes and adjust my practise to the changing clinical environment, I will continously reflect on my clinical decision and take into account diverse perspectives.
KSB addressed:
Knowledges
K1, K4, K11, K13, K21, K26, K31, K33, K34, K36, K37, K38, K42,
Skills
S1, S2, S4, S5, S7, S10,
Behaviours
B1, B2, B3
Date of Learning: 05/04/2024
Time: 13:30-16:30
Title of learning activity: Session: 2 A-E Assessment/SBAR/NEWS2
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)
Learning outcomes:
- Interpret data documented on NEWS2 observation chart
- Identify appropriate thresholds for escalation based on NEWS2
- Understand principles of rapid patient assessment using systematic ABCDE approach
- Demonstrate awareness of additional assessment data
The Airway, Breathing, Circulation, Disability, and Exposure (ABCDE) assessment was covered in this session and it demonstrated a systematic approach to patient care. The ABCDE approach prioritises early detection of life-threating conditions and prioritises treatment based on severity. It involves using the National Early Warning Score (NEWS2), which monitors physiological parameters, and the Situation Background Assessment and Recommendation (SBAR) tool for escalation procedures. It also emphasises the significance of clinical judgement, interdisciplinary communication, clinical judgement, and the integration of ethical and legal frameworks.
This session is important to improve patient outcomes by using a structured, standardised approach. The ABCDE assessment enables nurses or nursing associates to identify early signs of deterioration, which can be crucial in preventing adverse events such as sepsis or cardiac arrest. The emphasis on evidence-based intervention and teamwork also reflects the modern healthcare multidisciplinary nature, where communication is key. This approach is especially relevant for patients in acute or emergency settings, where decisions must be made quickly and with accuracy.
I recognise that my clinical decision-making could be enhanced through the systematic application of the ABCDE assessment, familiarising myself with the NEWS2 chart and its thresholds and SBAR tool. By adopting this approach, I can respond more effectively to critical situations, thereby minimising potential risks to patients. The session also reminded me of the need to rely on clinical judgement, emphasising that if something feels wrong, it is crucial to escalate the matter.
Looking ahead, I intend to practice utilising the ABCDE assessment more consistently in both clinical simulations and real-life scenarios to increase my proficiency. Furthermore, I will prioritise becoming familiar with the NEWS2 chart and its associated thresholds, particularly for patients at risk of sepsis. Additionally, I must improve my communication skills, especially in conveying concerns to the interdisciplinary team using the SBAR tool. This will enable me to advocate for patients more effectively when necessary. Finally, I will concentrate on deepening my understanding of the ethical and legal considerations in acute care to facilitate well-informed decision-making in complex scenarios.
KSB addressed:
Knowledges:
K1, K4, K6, K7, K8, K18, K19, K20, K25, K26, K33, K36, K37, K41
Skills:
S1, S2, S3, S4, S5, S6, S7,S22, S40 S42
Behaviours:
B1, B2, B3