Apprenticeship Learning Log
Date of Learning: 22/09/2023
Time: 9:30 to 12:30
Title of learning activity: Social determinants of health, epidemiology, demographics and disease surveillance and Group presentations
Demography is the way in which we study population to determine the causes of health and diseases while the study of demography is study of human population with respect to their size, structure and dynamics.
Epidemiology is the study of a population and how often the disease occurs in differing groups within the population .]
Social determinants are economic and social factors that have a profound effect on health.
Health inequalities are the avoidable and unfair differences in health status between groups of people who are united by their shared socio-economic status or gender than by any health-related attributes.
I have learnt that there are other factors that can affect people’s health because of social determinants and health inequalities.
There are people who are fortunate to access all help they can get but others are struggling to even ends met. There are also because of cultural beliefs.
We had a group presentation about why is it worse for health to live in north East than in deprived area in London.
KBS addressed:
| Knowledge | 1-20, 24, 30, 33, 36, 39-41, 43 |
| Skills | 1, 5, 7-9, 13-16, 35 |
| Behaviours | 1, 2, 3, |
| K | Knowledge |
| K1 | Understand the code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC 2018), and how to fulfill all registration requirements |
| 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 |
| K7 | Understand the importance of courage and transparency and apply the Duty of Candour |
| K8 | Understand how discriminatory behaviour is exhibited |
| K9 | Understand the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people |
| K10 | Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes |
| K11 | Understand the factors that may lead to inequalities in health outcomes |
| K12 | Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being |
| K13 | Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes |
| K14 | Understand the importance of health screening |
| K15 | Understand human development from conception to death, to enable delivery of person-centred safe and effective care |
| K16 | Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care |
| K17 | Understand commonly encountered mental, physical, behavioural and cognitive health conditions as applied to delivery of care |
| K18 | Understand and apply the principles and processes for making reasonable adjustments |
| K19 | Know how and when to escalate to the appropriate professional for expert help and advice |
| K20 | Know how people’s needs for safety, dignity, privacy, comfort and sleep can be met |
| 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 |
| K36 | Understand the roles of the different providers of health and care |
| K39 | Understand the principles and processes involved in supporting people and families with a range of care needs to maintain optimal independence and avoid unnecessary interventions and disruptions to their lives |
| K40 | Understand own role and contribution when involved in the care of a person who is undergoing discharge or a transition of care between professionals, settings or services |
| K41 | Know the roles, responsibilities and scope of practice of different members of the nursing and interdisciplinary team, and own role within it |
| S | Skills |
| S1 | Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and fulfil all registration requirements |
| S5 | Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018) |
| S7 | Communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive and behavioural health challenges |
| S8 | Recognise signs of vulnerability in self or colleagues and the action required to minimise risks to health |
| S9 | Develop, manage and maintain appropriate relationships with people, their families, carers and colleagues |
| S13 | Apply the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people |
| S14 | Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and wellbeing |
| S15 | Identify people who are eligible for health screening |
| S16 | Promote health and prevent ill health by understanding the evidence base for immunisation, vaccination and herd immunity |
| S35 | Accurately undertake risk assessments, using contemporary assessment tools |
| B | Behaviours |
| 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 |
Date of Learning: 22/09/2023
Time: 13:30 to 16:30
Title of learning activity: Introduction to Oxygen therapy
In this session we aim to learn the following:
- Identify different methods of administering oxygen therapy; and
- Discuss the use of oxygen therapy in practice, including indications and cautions.
-
Become familiar with equipment used for delivering oxygen
This session taught me a lot, working on a ward gave me a lot of skills, but oxygen therapy was explained thoroughly.
Instead of treating breathlessness, oxygen therapy targets hypoxaemia, and the goal is to maintain patients’ oxygen saturation within an appropriate range.
It is important to check for abnormalities in breathing, such as the use of accessory muscles, intercostal recession, wheezing/other noises, coughing, nasal flare-ups, and level of consciousness. When checking oxygen levels, it is important to consider the patient’s position, but people with COPD have a specific position that is comfortable for them to breathe. Pulse oximetry and blood gas analysis are both used to determine oxygen levels, and I am familiar with them both.
As a medicine, oxygen should be prescribed before being administered, but in an emergency, it should be given as soon as possible and documented appropriately afterward.
The target for some people is 94-98% since they are not at risk of carbon dioxide retention, while for others, like those with chronic asthma, cystic fibrosis, or bronchiectasis, the target is 98-92% and others are lower, such as 85-90%, but it must be specified on the prescription.
The following oxygen delivery devices were shown to me, some of which I am familiar with and some of which I haven’t seen before:
1. Nasal cannulae – up to 4Liters/min of oxygen but do not deliver consistent concentration of oxgen-23-30%
2. Hudson mask (simple mask) at least 5-10 liters/min
3. Venturi mask
4. Nonrebreather mask -min 10liters/min and standard flow rate of 15liters/min
5. CPAP
6. Venturi mask
The importance of cautions not just in the hospital setting but at home was also discussed, such as how oxygen therapy can dehydrate respiratory membranes, the use of a preventative dressing for pressure sores, the use of lubricants such as petroleum jelly, no smoking, how oxygen supports combustion, avoid naked flames, static, electricity, alcohol gel, certain oils, greases, and recently moisturised (with paraffin oil) skin.
I had the chance to see the oxygen delivery devices including the humidification which is used if patient experience upper airway dryness or require high flow oxygen for over 24 hours, continuous positive airway pressure (CPAP) mask, oxygen concentrator machines and to practice some scenarios which helped me understand more about what to look for when administering oxygen to the patient.
This learning helps me think of my role as a future nurse associate in making sure I am knowledgeable about oxygen therapy and makes me understand the harm it will cause to patients and follow the right guidelines according to policies in place.
KBS addressed:
| K | Knowledge |
| K1 | Understand the code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC 2018), and how to fulfill all registration requirements |
| 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 |
| K22 | Know how to meet people’s needs related to nutrition, hydration and bladder and bowel health |
| K23 | Know how to meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity |
| K24 | Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain |
| K25 | Know how to deliver sensitive and compassionate end of life care to support people to plan for their end of life |
| K26 | Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld |
| K27 | Understand the principles of safe and effective administration and optimisation of medicines in accordance with local and national policies |
| K28 | Understand the effects of medicines, allergies, drug sensitivity, side effects, contraindications and adverse reactions |
| K29 | Understand the different ways by which medicines can be prescribed |
| K30 | Understand the principles of health and safety legislation and regulations and maintain safe work and care environments |
| K33 | Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes |
| K34 | Know and understand strategies to develop resilience in self and know how to seek support to help deal with uncertain situations |
| K36 | Understand the roles of the different providers of health and care |
| K39 | Understand the principles and processes involved in supporting people and families with a range of care needs to maintain optimal independence and avoid unnecessary interventions and disruptions to their lives |
| K40 | Understand own role and contribution when involved in the care of a person who is undergoing discharge or a transition of care between professionals, settings or services |
| K41 | Know the roles, responsibilities and scope of practice of different members of the nursing and interdisciplinary team, and own role within it |
| S | Skills |
| S1 | Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and fulfil all registration requirements |
| S2 | Keep complete, clear, accurate and timely records |
| S3 | Recognise and report any factors that may adversely impact safe and effective care provision |
| S4 | Take responsibility for continuous self-reflection, seeking and responding to support and feedback to develop professional knowledge and skills |
| S5 | Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018) |
| S6 | Act as an ambassador for their profession and promote public confidence in health and care services |
| S7 | Communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive and behavioural health challenges |
| S8 | Recognise signs of vulnerability in self or colleagues and the action required to minimise risks to health |
| S9 | Develop, manage and maintain appropriate relationships with people, their families, carers and colleagues |
| S10 | Provide, promote, and where appropriate advocate for, non-discriminatory, person-centred and sensitive care at all times, reflecting on people’s values and beliefs, diverse backgrounds, cultural characteristics, language requirements, needs and preferences, taking account of any need for adjustments |
| S11 | Report any situations, behaviours or errors that could result in poor care outcomes |
| S12 | Challenge or report discriminatory behaviour |
| S13 | Apply the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people |
| S14 | Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and wellbeing |
| S15 | Identify people who are eligible for health screening |
| S16 | Promote health and prevent ill health by understanding the evidence base for immunisation, vaccination and herd immunity |
| S17 | Protect health through understanding and applying the principles of infection prevention and control, including communicable disease surveillance and antimicrobial stewardship and resistance |
| S18 | Apply knowledge, communication and relationship management skills required to provide people, families and carers with accurate information that meets their needs before, during and after a range of interventions |
| S19 | Recognise when capacity has changed recognise and how a person’s capacity affects their ability to make decisions about their own care and to give or withhold consent |
| S20 | Recognise people at risk of abuse, self-harm and/or suicidal ideation and the situations that may put them and others at risk |
| S21 | Monitor the effectiveness of care in partnership with people, families and carers, documenting progress and reporting outcomes |
| S22 | Take personal responsibility to ensure that relevant information is shared according to local policy and appropriate immediate action is taken to provide adequate safeguarding and that concerns are escalated |
| S23 | Work in partnership with people, to encourage shared decision making, in order to support individuals, their families and carers to manage their own care when appropriate |
| S24 | Perform a range of nursing procedures and manage devices, to meet people’s need for safe, effective and person-centred care |
| S25 | Meet people’s needs for safety, dignity, privacy, comfort and sleep |
| S26 | Meet people’s needs related to nutrition, hydration and bladder and bowel health |
| S27 | Meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity |
| S28 | Support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain |
| S29 | Give information and support to people who are dying, their families and the bereaved and provide care to the deceased |
| S30 | Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed |
| S31 | Act in line with any end of life decisions and orders, organ and tissue donation protocols, infection protocols, advanced planning decisions, living wills and lasting powers of attorney for health |
| S32 | Work collaboratively and in partnership with professionals from different agencies in interdisciplinary teams |
| S33 | Maintain safe work and care environments |
| S34 | Act in line with local and national organisational frameworks, legislation and regulations to report risks, and implement actions as instructed, following up and escalating as required |
| S35 | Accurately undertake risk assessments, using contemporary assessment tools |
| S36 | Respond to and escalate potential hazards that may affect the safety of people |
| S39 | Recognise when people need help to facilitate equitable access to care, support and escalate concerns appropriately |
| B | Behaviours |
| 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 |