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.

Apprentice Activity log

Date: 06/10/2023

Time: 09:30 to 12:30

Learning outcomes:

• To understand the rationale behind helping individuals make healthy lifestyle choices.
• To gain some knowledge of the definitions of behavioural changed and how models help explain this.
• To gain an understanding of how as nurses can influence behaviour change using motivational interviewing techniques.
• To practice these skills using scenarios provided.

We started the lesson on giving feedback on our poster assignment, a lot of good examples was shown but needing improvement to follow the learning outcomes required for the poster assignment.

We discussed about what NMC required as a future nurse

We had an opportunity to practice these skills using scenarios and we presented our scenarios. I used the techniques of motivational interviewing, I follow the open ended questions, affirmations, reflective listening and summarizing but I jumped into recommending a solution to the service user (pretend) and learned that I should have supported the service user to come up a solution that they are comfortable. I should have not suggested it without consulting the service user.

transactional analysis

It is important to how to treat patients, build relationships, and be in partnership with the patients. Treat them the same and never talk down to them.

KBS addressed:

Date: 06/10/2023

Time: 13:30 to 16:30

Title of the Activity: Clinical Judgement and Shared Decision Making

Learning outcomes:

• Define clinical judgement and discuss its use in practice
• Understand the influences on our ability to make clinical decisions
• Identify ethical considerations in the decision-making process
• Identify the principles of shared decision making and apply these to practice
• Explore the barriers and facilitators to shared decision making
• Identify how shared decision making is advocated through policy and regulated by law.

I have learned that clinical judgment and decision-making are essential skills and key processes in nursing. Clinical judgment requires accurate assessments in order to deliver safe and effective nursing interventions. However, assessment, clinical judgment, and decision-making are all subject to change. The lesson covered the following patterns; assess, systematic nursing diagnosis, plan, implement, recheck, and evaluate.

Intuition is a sixth sense or feeling that a nurse uses to empathize with and communicate with service users. It is also important to reflect on experiences and determine the best course of action based on them. In the discussion of ethical sensitivity, autonomy, beneficence, justice, and nonmaleficence were discussed. There was a discussion about accountability and responsibility, as well as their differences.

As a health professional, I learned that shared decision-making involves providing different choices to the service user, supporting them, and working with them to decide on the treatment plan for the service user, making sure they are at the center of the decision-making process for their treatment. It is beneficial to gain an understanding of what’s important to the service user. They will feel supported and empowered to make informed choices or decisions. And in an ethical and legal perspective, shared decision-making will respect the service user’s autonomy, we as a healthcare professionals are not causing any harm but doing good instead, it is a legal requirement and also it requires healthcare professionals to take reasonable care to ensure the service users are aware of any material risk involved in any recommended treatment or any alternative treatments. Shared decision-making is like a partnership that enable service users and healthcare professionals to work together and share expertise equally in the decision-making process.

I have learned what to know before informing the service user including decision support, decision aids, and recording decisions. Barriers to shared decision-making were also included in this lesson which are: time, resource, standardized approach to practice, attitude, lack of decision aids, service users not wanting to be involved, service users unable to be involved, and decision-making capacity.

This lesson enables me to understand clinical judgment and decision-making and understand the importance of providing quality care to service users.

KBS addressed:

Apprenticeship Learning Log

Date of Learning: 08/09/2023

Time: 9:30 to 12:30

Title of learning activity: Health Promotion in Older People & Benefit of Physical Activity

Learning outcomes:

1. Understand the impact that ageing has on physical and mental health
2. Identify health promotion/public health activities that can enhance wellbeing in older people
3. Recognise the challenges experienced by this age group and understand how you as a nurse might help.
4. Understand the benefits of exercise for all ages groups within health promotion.

This session made me understand how ageing affect physical and mental health.

Some of the conditions can be hearing loss, neck/back pain, cataracts and refractive erros, heart failure & CKD, diabetes, menopause, arthritis,immobility and loss of balance, incontinence, hypertension, dementia, and Alzheimer’s, deression, anxiety and loss of confidence. This conditions can affect a person’s daily living and it impact on their lives.

Ageing well and health promotion in older adults is important because it reduce risk of condition related to aging, reduces stress and elevating moods to help prevent issues, prevents premature death, reduce socio-economic burden and health aging improves mental and physical well-being.

There are health promotion/ public health actitives that can enhance wellbeing of older people such as TTT (Think, Test and Treat), There’s no excuse for elder abuse, end PJ paralysis, falls prevention, Exercises and benefits of muscle and bone strenghtening activities at different ages, boost your immunity this winter with flu and covid booster, age uk,malnutrition in older people,campaign to end loneliness.

There challenges and barriers that older people experiences like poor and mental health, poor functional ability affecting daily living and lifestyle, ageism, financial insecurity, caregiving, access to health care services, social isolation and end of life preparations.

As a nursing associate we can play a big impact in educating older people and advocating for them to assist them to do exercises or attend social gatherings in promothing good health and wellbeing,

Exercise is a health promotion that is beneficial to all ages group as it ageing well start from a young age.

KBS addressed:

Date of Learning: 08/09/2023

Time: 13:30 to 16:30

Title of learning activity:Delivering Care in Alternative Settings Workshop

Learning outcomes:

• Share own experiences to understand working in different settings
• To gain an understanding of person-centred care in different settings
• To gain an understanding of shared decision making in different settings

We had a discussison about our own experiences and how we understand the person centred care, how we make sure that the patient or individual is being cared for according to their wishes and preferences, treated with respect and dignity and included in the shared decision making which includes the MDT and carers or families.

Delivering care in different settings differ in each one but still should be person centered care. This is according to the fundamental standards of Care Quality commisions.

KBS addressed:

Apprenticeship Learning Log

Date of Learning: 24/11/2023

Time: 9:30 to 12:30

Title of learning activity: Promoting Mental Health across the lifespan

Date of Learning: 24/11/2023

• to understand the factors that affect mental wellbeing at different stages of the lifespan.
• to gain knowledge relating to specific challenges that individual groups might encounter.
• to understand the role of the nurse when caring for a person’s mental wellbeing.

I learned the difference about mental health and mental illness. Mental health refers to a person’s overall wellbeing where they recognise their own capabilities and cope with the normal stress of life but can work and actively contribute to their community while mental illness are health conditions that affect a person’s emotions, thoughts or actions that cause distress or difficulties in carrying out daily activities such as socialising, working or spending time with family.

It is crucial to understanding the positive and negative factors that impact mental. This helps us recognise, cultivate, and foster the positive factors and also identifying and offering support to minimise the negative factors. Recognising and work with personal strengths promote resilience.

I have learn from Ericson’s Psychosocial stages summary chart where it has different basic conflicts and outcomes across the lifespan.

We had group activity where we listed different issues of different age which might impact on mental health and well being.

I have learned that during early stages of life, it is crucial to ensure the provision of support and understanding in order to promote positive mental health outcomes. It is also important to look after our own mental health. Our environment and status in life contributes to it.

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.

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.

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

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.

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.

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.

Time: 13:30 to 16:30

Title of learning activity: Preventing long term conditions.

Learning outcomes are:

• To understand the implications of alcohol intake above the recommended levels
• To gain knowledge around safe levels of drinking
• To identify what you can do as a nurse to guide individuals in making healthier choices around their alcohol intake.
• Discuss the impact of smoking on health across the lifespan
• Describe effects of smoking on respiratory system
• Discuss what cigarettes contain and why they damage health
• Identify what knowledge is needed to provide effective care to someone who smokes or lives with a smoker
• Look at impact of smoking from a bio-psychosocial perspective and be aware of your attitude and role(Biological, Psychological, Sociological)

Alcohol is an economic burden estimated at between 1.3% and 27% of annual gross national product and 1 in 10 patients has an emergency alcohol specific readmission within 30days. It also contributes to 200 health conditions due to acute alcohol intoxication, or to the toxic effect of alcohol misuse over time.

The Chief Medical officer’s guideline for both men and women is to not drink more than 14 units a week on a regular basis, spread drinking evenly over 3 or more days, if you wish to cut down the amount you drink, its good to have several drink-free days each week. Risk of developing range of health problems like cancer of the mouth, throat and breast increases the more you drink on a regular basis.

Also advices including limiting the total amount of alcohol you drink on any single occasion, drink more slowly, drinking with food, and alternating with water, planning ahead to avoid problem.

The risk of drinking too much can cause accidents resulting in injury and causing death, misjudging risky situations and losing self control.

As a healthcare provider there are ways to help individuals delivering advice to change behaviour. By accessing online training, I can be able to confidently identify individuals who may be at risk due to alcohol consumption. I can then provide advice to help them change their behavior and I can offer support to help them reduce their intake. I can also provide them with information leaflet to encourage them to consider their health risk.

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.

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.

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

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.

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.

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.

Apprenticeship Learning Log

Date of Learning: 08/09/2023

Time: 9:30 to 12:30

Title of learning activity: Introduction to public health policy, screening and the role of the nursing associate

Learning outcomes:

• To understand the learning outcomes of the module
• Understand the definitions of health and wellbeing, Public Health, Health Promotion and Health Education
• To enhance your knowledge of the role of the nurse within these areas
• To discuss the guidelines for the presentation and gain an overview of what is expected for the assessment for the module.

I did a self directed learning on this topic and this are the things I have learn:

Health derived from the old english ‘hael’ meaning ‘whole’ signaling that health concerntat the whole person. It is influenced by family, cultural background, religion, educational level, gender, ethnicity and social class. It also influenced by media, environment and social policies

There are different dimentions of health which are physical, emotional, intelectual, sexual, social, spiritual, and societal.

There are diffrent models of health;

• medical model which focus on the physical dimention rather than considering any of the others
• holistic model uses the WHo definition (1946) which is health is a stage of complete physical, mental and social wellbeing an not merely the absesne of disease
• biopychosocial model where this advances the medical model by incorporating some aspects of the holistic model.
• ecological model provides framework for understanding how individuals and their social environments mutually effect each other.
• wellness model -builds on the principles of the holistic model which is a process and resource for everyday life.

Defintion of diseases is any damaging deviation from the usual structure or functioning of a living being, typically linke to specific indicaitons, symptons and distnct from physical harm.

Health promotion involves empowering individuals to enhance their health by gaining greater control over it.

Health education is teaching people about health and how to live healthily and it is key components of health promotion. Its a combination of learning experience designed to facilitate voluntary actions conductive to health. It can be printed materials, websites, blogs, vidoes, social netwroking sites, TV adverts or posters.

Public health is improving the health of the nation that relies in many factors such as takling socioeconomic inequalities in health, making health everyone’s business and making the healthy choise the easy choise. Public health also balances health promotion, preventive care and illness treatment.

It is important for a Nurse Associate to be involve as they can provide education and empower individuals, work in collaboration with other professionals and agencies, can provide broad focus by providing a range of activities within disease prevention and the co-ordination of services for those at risk and can have a hollistic undertanding of health and recognises that good health is dependent on multiple determinants. Following the Nursing and Midwifery Council standards of profic

Public health has 3 major reasons of prevention; first is to prevent the person from becoming unwell by providing vaccines and health education about diet, sexual health, stress management, exercise, smoking and alcohol use; second is early detection of ill-health by screening cervical caner, detecting high blood pressure or high cholesterol and poor mental health and third is to minimise the impact of a disease on a person by helping them manage a long term condition and preventing deterioration and complications  like advising with diabetes about the use of their medication.

KBS addressed:

Date of Learning: 08/09/2023

Time: 13:30 to 16:30

Title of learning activity: Person Centred Care

Learning outcomes:

1. Identify the principles of person-centred care and apply these to practice;
2. Explore the barriers and facilitators to person-centred care; and
3. Identify how person-centred care is advocated through policy and regulated by law.

I did a self directed learning on this learning, read the lesson and watched patient stories on shared decision making.

Person centred care, according to Health Education England (HEE) is prioritising the individual’s needs and making clinical decisions that respect their preferences, needs and values. It involves treateing the person with dignity and respect and placing them at the center of decision making process. It helps individual to gain knowledge, skills, and confidence to better manage their own health and make informed decisions. Health and social care providers work together with individuals who use their services. It includes various tools and activities, as well as a mindset that values and supports individuals to be active partners in their own care. IT is also the core fundamental standard of care for Care Quality Commission (CQC) as they are an independent regulator of health and social care in England. Hospitals and all healthcare providers are subhect to CQC inspection and are rated accordingly.

There are eight core values in person centred healthcare which are individuality, rights, privacy, choise, independence, dignity, respect and partnership. The principles of person-centered care include respecting patients’ values, preferences, and expressed needs, coordinating and integrating care. It also has principles which involves providing information and education, ensuring physical comfort, offering emotional support, alleviating fear and anxiety, involving family and friends, and ensuring continuity and smooth transitions.

Person-centred care is crucial because numerous individuals desire to have a greater role in their healthcare. They long to be treated with dignity, compassion, and respect, resulting in enhanced patient experience, improved quality of care, and the attainment of health goals. Moreover, it offers better value for money as it ensures that services are tailored to the needs and preferences of the individuals who uses them, rather than solely focusing on the convenience of the providers.

Person centred care has numerous advantages. Patients who receive this type of care are less likely to rely on emergency hospital services. They are also more likely to adhere to their treatment plans and take their medication correctly. Additionally, they tend to be more satisfied with their care and make treatment choices based on their own values and preferences rather than those of their clinician. They also tend to opt for less invasive and costly treatments. Moreover, patients who receive person centred care are more likely to engage in positive health behaviors and experience better health outcomes. As patient engagement increases, staff performance and morale also improve. Furthermore, patients feel more confident in managing aspects of their own care, leading to reduced hospital stays and readmission rates.

The government has implemented various policies to improve healthcare services. These policies include the following:

• Person-Centred care, which is crucial for the successful integration of health and care services. The NHS Five Year Forward View and the Care Act [2014] highlight the importance of Person-Centred care.
• The Five Year Forward View [2014], specifically in Chapter 2, emphasizes the need for a more engaged relationship with patients, carers, and citizens to promote wellbeing and prevent illness. It also prioritizes giving individuals more control over their own care.
• The Care Act [2014] aims to place individuals at the center of their care and support, maximizing their involvement.
• The NHS Long Term Plan [2019] further emphasizes the goal of empowering individuals by giving them more control over their health and the care they receive. It also focuses on providing people with a greater say in their care, especially towards the end of their lives.

There are barriers to person centred ways of working such as time, listening skills, resources, working practices, knowledge, standarise ways of practice, communication, therapeutic relationship and self awareness of staff.

Apprenticeship Learning Log

Date of Learning: 22/12/2023

Time: 9:30 to 16:30

Title of learning activity: Complex Care/ Vulnerable groups/Interdisciplinary working

Learning outcomes

•To understand the meaning of complex care and how this varies in different settings and demographics
•To apply person centred care and shared decision making to complex care
•To understand the role of the nursing associate within integrated care

The first part of the session focuses on complex care, which is defined as care people need as a result of multiple concurrent chronic conditions, functional impairments, mental health challenges, and social vulnerability.

We watched a video about a person with multiple health conditions and mental health challenges. The video discussed what nursing assistants should do and how to support them.

The video showed how the person with multiple health conditions (heart problem, diabetes, vascular disease, and overweight) was less motivated to learn about his condition due to a lack of knowledge about medical terms and conditions. Also, the person lacks motivation and encouragement to take control of his health because many factors contribute to this, such as his wife’s health issues, lack of confidence in health providers, and being overweight.

Our discussion was about which MDT members might be involved with his care, what the NA’s role is, and making sure that it is a person-centered care that includes shared decision making.

The person will need doctors to check his physical health, nurses who will educate, support and encourage him, and a psychiatrist to address his mental health issues. In addition, the person will be encouraged to become more active and consider other options that interest him. In addition, his wife will be supported and encouraged to relieve the stress the person is experiencing.

Vulnerability refers to the need for special care, support, or protection due to factors such as age, disability, risk of abuse or neglect. Both children and adults can experience vulnerability, and it can occur anywhere, even within the confines of one’s own home.

Second part of the session tackles about homelessness which is defined as lacking a permanent residence. However, even if someone has a roof over their head, they can still be considered homeless. Being homeless can be dangerous, as it exposes individuals to various risks such as assault, theft, violent crime, decreased employability, low self-esteem, lack of a fixed address, susceptibility to exploitation (e.g., sex work, drug trafficking, begging), increased vulnerability to communicable diseases, higher likelihood of substance use, and increased chances of enduring mental illness with long-lasting effects. It also poses a risk to public health, contagious illness, preventable chronic conditions, tri-mobility, incivility, expensive, lack of social abilities and inability to work – burden.

The tri-mobility of homelessness are physical health, mental health and substance use.

We also discusssed communicable diseases which are infectious disease that are cuase by pathogenic microogranisms, such as bacteria, viruses, parasites or fungi; the disease can be spread, directly or indirectly, from one person to another.

Social exclusion  means the fact of being unable to participate fully in society, expecially because of poverty or belonging to a minority group. People who can be socially excluded can be homeless, refuges and new migrants, black, asian, minority ethnic groups, women-poor equality, single parents, lower wages, young people-care leavers, substance users and disability.

Social exclusion refers to the inability to fully particiapte in society, often due to poverty or being part of a minority group. Those who may experience social exclusion include individuals without homes, refugees, new immigrants, people of black or asian descent, minority ethnic groups, women facing economic challenges, single parents, individuals with lower wages, young people who have left care, substance users, and those with disabilities. Public health is at risk due to certain behaviors. These behaviors include being less likely to listen to authority figures, considering self-neglect as normal, experiencing poor mental well-being and withdrawing from society, dealing with long-term mental health problems, feeling shame or embarrassment, being judgmental, lacking social skills, and not understanding healthcare systems.

As a nursing associate, it is important to listen to people concern, their preferences and needs, educate them with the risk and benefits and use simple words that they can understand, encourage and support them all throughout their care and decision and promote healthy living.

KBS addressed:

Date of Learning: 12.09. 2023
Time: 9:00 to 16:30

Title of Learning Activity: Co-producing professional healthcare education; how do we all work together 12/09/2023

There were several presentations throughout the day with keynotes like service user and carer co-production with staff and student experiences from UCLAN and unpacking the ‘Co’ of Co-production. Community Engagement and Service Users was a participatory action research group at the University of Central Lancashire in 2004.

The program featured a lot of speakers with their own specialised knowledge and experiences of mental health. Many of the speakers shared their experiences throughout their careers and some are also service users. Learning from experts and service users about their experiences was beneficial.

Also, I attended a presentation from the Nursing and Midwifery Council (NMC) about the role of the NMC, public safety, and public engagement. However, their presentation slides did not work, and we ended up running out of time.

KBS addressed: