Apprenticeship Learning Log

Date of Learning: 19/01/2024

Time: 9:30-16:30

Title of learning activity Assessment tools

During the discussion, the focus was on various assessment tools that were presented to us. These tools included the National Early Warning Score (NEWS2), Malnutrition Universal Screening Tool (MUST) assessment, Pain assessments, Waterlow assessment and etc. Each of these tools serves as specific purpose in evaluating different aspects of a patient’s condition.

The NEWS2 is a valuable tool that aids in the identification and response to clinical deterioration in adult patients. It plays a crucial rolse in ensuring patient safety and improving overall outcomes. On the other hand, the MUST assessments are a five-step-screening tool designed to identify individuals who are malnourished, at risk of malnutrition, or obese. This tools helps healthcare professional address nutritional concerns effectively. While the Waterlow assessment, utilizes a point-based system to estimate the risk of pressure ulcers in adults. By considering individual data, this assessment helps healthcare providers identify who may be at a higher risk of developing pressure ulcers. Lastly, the Pain assessment is an intrustrment use to measure pain levels in patients.

Habing knowledge about these assessment tools equps me with the ability to conduct comprehensive assessments. By utilizing diferent assessment tools, I can effectively assist in determining, monitoring and developing a personalised plan of care for each individual. This ensures that their specific needs are addressed and that they receive the approporiate care and support.

Apprenticeship Learning Log

Date of Learning: 19/01/2024

Time: 13:30-16:30

Title of learning activity: Wound care

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)

The discussion revolved around the Aseptic No Touch Technique (ANTT), encompassing its principles, significance, and appropriate application in clinical procedures. The ANTT steps were demonstrated, acompanied by sample videos for better understanding. Furthermore, we explored the various factors that includince wound healing and different techniques for wound cleansing. Sample dressing and other material were shown, allowing us to acquire fundamental knowledge in wound dressing and practical skills in wound management.

This knowledge will enable me to comprehend the significance of wound dressing and wound management in supporting individuals under my care. This knoweldge will also aid in identifying any additional internventions required for individual wounds or providing assurance that can faciliate faster recovery.

KBS addressed:

Apprenticeship Learning Log

Date of Learning: 25/01/2024

Time: 9:30-16:30

Title of learning activity: Simulation Assessment

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)

During the stimulation exercise with my academic tutor, we discussed various assessment tools such as MUST, PAIN, Peak flow and etc. We are then presented with a scenario and proceeded to the simulation area where we interacted with different simulated patients. Working alongside another TNA, we conducted assessments, interventions and developed a plan of care.

Utilizing assessment tools and collaborating with a pretend MDT team, we applied the knowledge gained from our module and also practice person-centred care. A phone call inquiring about my patient’s condition prompted me to priorities confidentiality, although I realized the importance of retaining information to better understand my simulated patient’s situation.

While I felt confident in my ability to perform assessment and communicate with patients, establishing rapport with the simulated patient proved challenging due to their pain. However, through building trust and effective communication, I was able to gather necessary information to provide assistance.

Handling over patient details, medical history and medication requirements to the pretend doctor, I ensured that the prescription was signed before seeking assistance from the Nurse in Charge for medication administration. As a Tranee Nursing Associate, we are not allowed to dispense or administered medication so I seek the help of a registered nurse. This collaborative effort resulted in the patient feeling relieved and supported, allowing for a comprehensive assessment and care plan to be developed.

This scenario highlighted the potential challenges that my arise during patient admissions. As a trainee Nursing Associate, it is important to stress the significance of maintaining confidentiality, following prescribing and administering protocols, and being proficient in medication administration. Practicing effective communication and team collaboration is also key in providing quality patient care. All this adhere to the standard and practices including proficiency of the Nursing and Midwifery Council.

KBS addressed:

Apprenticeship Learning Log

Date of Learning: 08/01/2024

Time: 9:30-16:30

Title of learning activity: Last day of Year 1 (finalizing progression)

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)

This marks the final session of the year, during which we revisited the topics of British Values, PREVENT awareness, and the NMC code. Additionally, we had the chance to exchange our personal experiences from our recent placements, discussing both the positive and negative aspects we encoutered. We assess our ePAD to determine any deficiencies in our theory hours, practice hours, and protected practice learning hours. Furthermore, we received guidance on the necessary steps to take in the event of failing to pass the resubmission of our assignemtns including completing our learning logs.

Apprenticeship Learning Log

Date of Learning: 12/01/2024

Time: 9:30 to 12:30

Title of learning activity: Nutritional support

Learning outcomes:

1. Gain an overview of malnutrition
2. Understand the impact of  malnutrition on the individual
3. Understand and gain an insight into using malnutrition screening tools
4. Understand how you can assist patients with their nutritional needs
5. Understand the importance of monitoring and recording dietary and fluid intake.
6. Understand how to measure and record weight and weight
7. Understand the relevance of BMI calculation and how to perform it

This session gave me the knowledge and understanding how important nutritional support.

Malnutrition occurs when there is an imbalance in the intake of energy, protiens, and other nutrients, leading to negative effect on the body tissues, size and funtion. People who are malnourished are more prone to diseases and have a slower recovery from illness due to thier poor nutritional status.

It is important to conduct an assessment at the beginning, such as during hospital admission. This includes measuring the individual’s height and weight to calculate their BMI and using the MUST tool to determine the risk of malnutrition and obesity. Other factors to consider are oral health (such as wearing dentures or difficulty swallowing), dietary requirements (such as being on a texture modified diet), any trauma that may prevent them from eating independently, their food preferences, allergens and intolerances, and whether they can see properly or require eyeglasses. It is important to respect their belief and ensure they can eat as normally as possible.

Monitoring and documenting the individual’s food intake, especially for those at risk of malnutrition or experiencing weight loss, it is essential. It is vital to encourage and educate the individual about the importance of nutrition for their recovery and provide assistance when needed. If there are concerns about their weight or food intake, it is important to seek advice from other members of the multidisciplinary team, such as dieticians and speech and language therapist. They can provide guidance on whether the individual requires any supplementary food or juices. as a trainee nursing associate, it is important to understand and learn to address nutrition deficiencies in individuals. I must also know how to effectively encourage and educate them about the importance of nutrition and the risks it poses to their recovery. It is crucial to use appropriate language when discussing weight issues with individual, as it is not a simple matter.

Time: 13:30 to 16:30

Title of learning activity: Bowel care

Learning outcomes:

1. Gain knowledge of how to perform a holistic assessment of bowel function
2. Understand the causes and treatments of constipation
3. Understand the rationale for a patient requiring a stoma (Including the different types)
4. Know the basics of stoma care and which appliances are most suitable.

In this session I understand the importance of bowel care.

In assessing bowel function it is imporatnt to condider the patient’s overall health, diet, fluid intake, mobility, cognitive abilities, and usual surroundings. The patient’s typical bowel patter and bowel function must also be documented since they may vary from individual to individual. Any medications that may affect normal bowel routine should be identified. Using a Bristol stool chart can help identify and monitory bowel movements and develop a care plan as needed.

Constipation occurs when there are alterations in your bowel movlements, such difficulty passing of stool.

Demonstratioon of proper administration of  suppository was shown  on a dummy. In doing Digital Rectal Examination, always explain the procedure to the patient and obtain their concent.

As a trainee nursing associate, following  NMC requirements for bowel care is important. Demonstration of knowledge, skills and abilities in provideing evidence-based nursing care to meet people’s needs related to nutrition, hydration, bladder and bowel chart is vital.

KSB  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.

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

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, 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.

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.