Supporting Learning Assessment in Practice - Essay Example

Topic:  Support Learning Assessment in Practice (Nursing) Introduction An Account of How Learning Theories Inform Knowledge Development within Nursing Practice: Teaching a student nurse how to do Blood Glucose Test, use learning theories and reflect on and evaluate what went really well, what else should have been done and a sum up of the strength in the teaching methods. In the evaluation of the clinical status of the client, the knowledge of the unlicensed person on diabetes management, and the time period between the unlicensed person and client in making a decision of delegating or teaching how to test CBG, the nurse must learn to exercise the discretionary authority when involved in client’s care (Oregon Department of Human Services Seniors and People with Disabilities, 2006). Diabetes educators, in collaboration with other health professional, work to enhance activities in case management to create and evaluate guidelines in clinical practice, recommend therapy changes, and reduce errors in medication (Seley, et al., 2009). Lincolnshire Partnership NHS Trust (2006) noted that nurses must be able to have the knowledge, skills and abilities for lawful, safe, and practice effectively with no direct supervision for them to have competent practice. Teaching a Student Nurse How to do Blood Glucose Test Kozier, et al. (2004) noted that in teaching a student nurse how to do blood glucose test, it must be insured that the nurse practice act and the policy of the facility must be checked. It must also be determined in the procedure manual the person delegated to perform this procedure (Kozier, et al., 2004). A nurse student must be taught to determine the following before obtaining a capillary blood specimen: (1) the type of testing and frequency, (2) the understanding of the client on the procedure, and (3) the response of the client to previous testing. In obtaining blood glucose test, a nursing student must be able to determine whether the puncture site is intact and the circulation is not compromised by means of assessing the puncture site of the skin. Moreover, it is important to note that the student nurse must review the records of medication of the client that may possibly prolong bleeding time (Kozier, et al., 2004). The following are the equipments that must be used by a student nurse in obtaining blood glucose: blood glucose meter, blood reagent strip, paper towel, warm cloth, antiseptic swap, disposable gloves, number 19 or 21 sterile lance, lancet injector, and cotton balls (Kozier, et al., 2004). A type of meter and instructions from the manufacturer must be reviewed and the equipment must be assembled at the bedside. It is important that a nursing student must learn to explain to the client the importance of the procedure, the importance of client cooperation, and the importance of obtaining the results in further care or treatment planning. Kozier, et al. emphasised that asepsis is important in the procedure; therefore, washing of hands must be observed. Reagent strip must be obtained from the container and must be placed on a clean dry paper towel. A nursing student must know that moisture changes the strip contributing to test result alteration. The meter must be calibrated and control sample must be run in accordance to the instruction stated by the manufacturer. The vascular puncture site (i.e. finger) must be selected, and sites with bone must be avoided. Site to be puncture must be cleaned with antiseptic and must be allowed to completely dry. A nursing student must put in mind that alcohol can affect the accuracy of the result (Kozier, et al., 2004). Kozier, et al (2004) added that in obtaining blood specimen, a nursing student must put the gloves on, place the injector and release the needle permitting it to pierce the skin. The first drop of blood must be wiped away using a cotton ball. A nursing student must learn that a greater proportion of serous fluid, which can be found in the first drop of blood, can alter the result of the test. The puncture site must be squeezed gently and the reagent strip must be held until enough blood covers the square indicator. The blood must not be smeared for this will cause inaccurate reading (Kozier, et al., 2004). To assist hemostasis, pressure must be applied to the puncture site of the client using a cotton ball. To obtain an accurate result, for a prescribed time, the blood must remain in contact with the test pad. Most glucose meter displays reading automatically (Kozier, et al., 2004). Meter must be turned off and test strip as well as the cotton balls be discarded accurately right after the procedure. The testing method must be documented and results must be recorded in the client’s record. In client’s record, the results of capillary blood glucose, results and amount, type, route, and time of administration of insulin must be recorded (Kozier, et al., 2004). Learning Theories Nursing learning theories applies three major attributes, namely: (1) behaviourist theory, (2) cognitive theory, and (3) humanism theory. Behaviourist theory when applied in learning must provide student nurses more time to practice as well as perform repeat testing and redemonstration. By trial and error, must provide the learners opportunities to solve problem. Students must also be praised and positive feedback must be provided throughout the student’s experience of learning (Kozier, et al., 2004; Lacher, 2009). In practicing cognitive theory in teaching a nursing student, a teacher must learn to provide an environment conducive to learning, encourage a positive relationship between a teacher and learner, assess developmental and individual readiness of a person to learn and adapt strategies of teaching to the developmental levels of a student (Kozier, et al., 2004; Lacher, 2009). In humanism theory, an empathy that conveys nurse – client relationship must be taught to a nursing student. Learner must be encouraged to establish goals and promote learning that is self – directed (Kozier, et al., 2004). Strengths in the Teaching Methods Lacher (2009) noted that education is recognised first as a discipline, and is considered as an integral part in the practice of nursing. Teaching is an activity planned performed to influence knowledge, behaviour or skills. In order to achieve effective teaching, subjects must be well understood, learning needs of a client must be assessed accurately, and learning environment must be controlled together with the appropriate method (Lacher, 2009). Lacher added that a nursing process must be well correlated with teaching and learning. Other factors considered as the strength in teaching methods include: motivation, readiness, active involvement, content relevance, and feedback from the students. Lacher added that student – teacher rapport is also important. A successful mentor can measure the success in teaching when a student nurse can verbally or through a return demo express the information. Moreover, a knowledgeable and strategic teacher, creating an environment that is positive for teaching, demonstrates professionalism, displays traits that are scholarly, and being supportive are but few of the strengths of faculty performance. Kozier, et al. (2004) stated that other strengths in teaching methods include use of positive reinforcement, participation of the client or student in the development of plan of learning, behaviours that are undesirable not criticized however ignored, and mastering of task assigned. Kozier, et al. added that motivation, readiness, active involvement, relevance of topic, feedback from the students, nonjudgmental support, and organised ideas from simple to complex, repetition, timing, and provision of optimal learning environment are some of strengths in teaching methods recognised. On the other hand, Jomeen, et al. (2008) noted that strengths of teaching methods must be professional and ethical, communication is proper and effective, respect confidentiality between the patient and clientele, behave in an appropriate and non – disruptive way, effectively communicate and responsibly take absence that are planned and unplanned, and upholds reputation of the profession and university. Nurses are able to develop teaching guides for sessions in teaching that nurses gives commonly to save time in constructing their own guides in teaching (Kozier, et al., 2004). The method and teaching contents are standardized by these guides making it easier for a nurse to plan and implement teaching clients and students. These standardized plans of teaching ensure the learners’ consistency of content reducing the risk of confusion whenever different practices are being taught (Kozier, et al., 2004). As an example, in doing blood glucose test, a nurse must be consistent in teaching his student nurses to wash their hands prior to the procedure and sterilize the area where blood samples are taken with alcohol. On the other hand, a nurse must teach the nursing students the things that should not be done in doing blood glucose test. A nursing student must be able to assess comprehensively needs of learning and be able to incorporate data from the history as well as from physical assessment and addresses the support system of the client (Kozier, et al., 2004). By applying the learning theories, a nursing student must be able to repeat the ideas being taught through return demo, assess the development of a person and readiness of an individual to learn and adapt strategies of teaching to the developmental level of the learner, and be able to establish goals and promote learning that is self directive (Kozier, et al., 2004). C: Outline an Action Plan as how to promote teaching and learning in future practice Learning Outcome Content Outline Teaching Methods 1. Describe normal glucose level I. Normal glucose level Describe the normal level of glucose using audiovisuals 2. Describe the signs and symptoms of elevated blood glucose II. Signs and symptoms of elevated blood sugar includes excessive thirst, tiredness, weight loss, yeast/fungal infection, numbness of fingers and toes, blurring of vision, confusion, coma Discuss the mechanism of elevated blood sugar. Use audiovisuals in demonstrating infected appearance of wound. Provide handout in describing signs and symptoms of wound infection 3. Identify the materials needed in blood glucose test III. Blood glucose test equipments/materials: Soap and water for hand washing, blood glucose meter, blood reagent strip, paper towel, warm cloth, antiseptic swab, disposable gloves, number 19 or 21 sterile lancet, lancet injector, and cotton balls Demonstrate the function of the equipments needed for blood glucose tests. If needed, provide handouts listing the equipments. 4. Demonstrate the procedure in obtaining blood glucose test IV: Demonstrate to the students the process of blood glucose extraction and procedure in obtaining blood glucose test results Demonstrate to the nursing students the proper way of doing blood glucose on the client or a mannequin. If possible, provide a handout describing procedure for blood extraction and testing. 5. Describe appropriate action if question from the student nurses or complications will arise V. Resources available for nursing students’ questions including journals and books. Resources available for questions from the clients inclusive of health clinic as well as emergency department Discuss with the nursing student the resources available. If possible, handouts must be provided, available resources and plan in doing follow – up treatment. 6. Describe plan of action after obtaining blood glucose test VI. Demonstrate to the nursing students the process of obtaining the test results, and to record the test results, describing the amount, type, route, and time of administration of insulin, when applicable Demonstrate to the nursing student the proper way of recording results obtained from blood test results. Provide written instructions. 7. Set a date for the student nurses to have repeat testing and return demonstration VII. Provide sufficient time to practice, to perform repeat testing, and have return demonstration of blood glucose testing Set a date with the nursing students for a graded return demonstration. (Source: Kozier, et al., 2004) References: Greenwood, E. (2003). The Learning Experience of a student nurse, a critical analysis. Retrieved April 9, 2009, from http://www.health.heacademy.ac.uk/publications/studentessay/emmalouisegreenwood Jomeen, J., Wray, J., Stimpson, A., Whitfield, C., and McCulloch, A. (2008). Review of Student Guidance for Professional Behaviour. Retrieved April 9, 2009, from www.engagespace.co.uk/engage/nmc/uploaddocs/Consult444/Hull%20University%20NMC%20Report%20on%20Student%20professional%20behaviour.doc Kozier, B., Erb, G., Berman, A., and Synder, S. (2004) Fundamentals of Nursing, 7th Edition. New Jersey: Pearson Education, Inc. Lacher, J. (2009). Teaching/Learning. Retrieved April 8, 2009 from http://www.scribd.com/doc/13766758/Nursing-Teaching Lincolnshire Partnership NHS Trust (2008). Performing Blood Glucose Monitoring In Ward Settings. Retrieved April 09, 2009, from http://www.diabeteseducator.org/export/sites/aade/_resources/pdf/Inpatient_position_statement_LOGO.pdf Nursing and Midwifery Council (2008). Standards to support learning and assessment in practice. Retrieved April 10, 2009, from http://www.nmc-uk.org/aDisplayDocument.aspx?documentID=4368 Oregon Department of Human Services Seniors and People with Disabilities. (2006). Registered Nurse’s Role in Capillary Blood Glucose Testing in Community Based Care Settings. Retrieved April 09, 2009, from http://www.oregon.gov/DHS/spd/provtools/nursing/policy/cbg_testing.pdf Seley, J., D’Hondt, N., Longo, R., Manchester, C., McKnirght, K., Olson, L., and Rogers, S. (2009). American Association of Diabetes Educators Inpatient Position Statement. Retrieved April 09, 2009, from http://www.diabeteseducator.org/export/sites/aade/_resources/pdf/Inpatient_position_statement_LOGO.pdf Read More