Within this reflective essay I aim to discuss types of reliable evidence from practice used as a means of providing substantiation of my learning and development, I will explore and provide a range of evidence from my portfolio, verifying achievement of my 2 chosen NMC proficiencies within the care delivery domain at Bondy level 4 (appendix 1).I aim to support this with a discussion as to how my chosen evidence undoubtedly provides verification of these requirements, a vital component of this is selecting the right types of evidence to properly outline my personal progress; therefore I will offer a sound rationale for my choices of evidence and the strengths and limitations of them. The proficiencies selected:
3.1.2 Use appropriate risk assessment tools to identify actual and potential risk. 3.1.5 Manage risk to provide care which best meets the needs and interests of patients, clients and the public. My rationale for the selection of these outcomes relates to experiences whilst working in acute care environments, it became increasingly apparent that management and identification of risk both to the patient and within the environment is paramount. Risk assessments need not be complex. It is usually a straightforward but conscientious study of anything in the work environment that might cause someone harm (Health and safety executive, 2012).Once the assessment is complete, manager’s review the identified risks and decide the appropriate action to prevent accidents and injuries. The final task is then to create and act upon a risk assessment plan. Risk assessments are important as they reduce the risks of accidents and ill health to you and your patients that could be very costly both physically and financially. The National Audit Office (2012) stated The National Health Service is currently facing a £4.4 billion bill to meet the cost of medical negligence claims.
using appropriate tools is invaluable in seeing problems before they develop however risk assessment tools are only a part of this assessment and can not replace clinical judgment this is supported by The National Institute for Health and Clinical Excellence (NICE, 2010) who state that patient care should not be judged exclusively on risk assessment tools but on a holistic patient assessment. Showing my ability to meet both outcomes supports my learning from this holistic approach. Evidence from my portfolio to be used:
Work product (Appendix 2)
Witness statement (Appendix 3)
Reflective discussion (Appendix 4)
Question and answer (Appendix 5)
Portfolio evidence allows students to become involved in their own learning, it is a toolbox that reflects the tools collected in preparation for a career in nursing, demonstrating through evidence the knowledge skills and attitudes developed whilst studying and participating in work based learning. This is consistent with social, professional and political development imperative of lifelong learning and continuing education (Young, 2007). Zeichner and Wray (2001) suggest that assessment of portfolio evidence has the disadvantage, similar to other new approaches of learning and assessment, of needing to establish its credibility alongside traditional approaches such as observation. The move toward continued use of portfolios in pre registration training and throughout a nurse’s career was however strongly supported more recently as the way forward within the Francis report (2013) recommendations.
My first piece of evidence is a work product, Airway, Breathing, Circulation, Disability, Exposure (ABCDE) post operative observations (appendix 2) a assessment tool that when used by skilled nurses allows identification of actual and potential risks to postoperative patients before they become critical problems (Thim et al, 2012). A work product is a sample of work developed by the student in the clinical placement (University of Nottingham, 2011)....
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