Annex B: Nursing Procedures
Supporting Solomon provided Alex with opportunities to observe and participate in a range of nursing procedures relevant to the care of people with PMLD. Under appropriate supervision, Alex developed an understanding of how evidence-based nursing interventions support safety, health, wellbeing and quality of life. He also recognised the importance of making reasonable adjustments and adapting care to meet Solomon's communication and support needs.
Assessment, Monitoring and Recognition of Deterioration
What Alex did
Alex participated in monitoring Solomon's health and wellbeing and observed how staff assessed for signs of deterioration, including respiratory changes, aspiration risk, seizure activity, nutritional concerns and changes in comfort or behaviour. He discussed how concerns would be documented and escalated appropriately.
What this demonstrated
The importance of ongoing assessment and early recognition of deterioration in maintaining safety and preventing avoidable harm.
Annex B Procedures Demonstrated:
- 1.2 Physical health and wellbeing
- 1.2.1 Symptoms and signs of physical ill health
- 1.2.2 Symptoms and signs of physical distress
- 1.2.3 Symptoms and signs of deterioration and sepsis
- 2.7 Whole body systems assessment
- 2.12 Neurological observations and assessments
- 2.13 Identify and respond to signs of deterioration and sepsis
- 2.16 Recognise and manage seizures
Nutrition, Hydration and PEG Care
What Alex did
Under supervision, Alex observed and participated in supporting Solomon's nutrition, hydration and medication administration through his Percutaneous Endoscopic Gastrostomy (PEG) tube. He observed PEG site care, infection prevention measures, feeding regimes and the monitoring of nutritional status and potential complications associated with enteral feeding.
What this demonstrated
The role of evidence-based interventions in supporting nutrition, hydration and medication management for people with complex health needs.
Annex B Procedures Demonstrated:
- 5.1 Observe, assess and optimise nutrition and hydration status
- 5.2 Use contemporary nutritional assessment tools
- 5.4 Record fluid intake and output
- 5.7 Manage artificial nutrition and hydration using enteral routes
- 5.9 Manage fluid and nutritional infusion pumps and devices
- 11.8 Administer medications using a range of routes
- 11.9 Administer and monitor medications using enteral equipment
Respiratory Assessment and Support
What Alex did
Alex observed how respiratory health was monitored and discussed the increased risk of aspiration and respiratory infection experienced by many people with PMLD. He learned how staff assessed for changes in respiratory status and implemented interventions to support respiratory wellbeing.
What this demonstrated
The importance of respiratory assessment and timely intervention in preventing complications and promoting wellbeing.
Annex B Procedures Demonstrated:
- 2.7 Whole body systems assessment
- 8.1 Observe and assess the need for respiratory intervention
- 8.3 Take and interpret oximetry measurements
Mobility, Positioning and Skin Integrity
What Alex did
Alex observed how staff supported Solomon with positioning, mobility and postural care. He explored the role of physiotherapy, specialist equipment and pressure area care in maintaining comfort, preventing complications and promoting quality of life.
What this demonstrated
The importance of proactive interventions in maintaining mobility, comfort and skin integrity.
Annex B Procedures Demonstrated:
- 3.3 Use appropriate positioning and pressure-relieving techniques
- 4.1 Observe, assess and optimise skin integrity
- 7.1 Risk assessment to optimise mobility and safety
- 7.2 Use contemporary moving and handling techniques
- 7.3 Use moving and handling equipment
Infection Prevention and Control
What Alex did
Alex observed infection prevention and control measures associated with PEG care, equipment management and the prevention of respiratory infections. He recognised the importance of maintaining safe practice to reduce the risk of avoidable harm.
What this demonstrated
The contribution of infection prevention and control to safe, high-quality nursing care.
Annex B Procedures Demonstrated:
- 9.1 Observe, assess and respond to infection risks
- 9.2 Use standard precautions protocols
- 9.4 Use appropriate personal protective equipment
- 9.6 Use evidence-based hand hygiene techniques
- 9.7 Safely decontaminate equipment and environment
- 9.9 Safely assess and manage invasive medical devices
Medicines Management
What Alex did
Alex discussed the principles of safe medicines administration and observed medicines being administered via Solomon's PEG tube. He considered the importance of professional accountability, accurate documentation and monitoring for potential adverse effects.
What this demonstrated
The importance of safe medicines management in supporting effective and person-centred care.
Annex B Procedures Demonstrated:
- 11.1 Assessment of ability to self-administer medication
- 11.6 Professional accountability for safe administration
- 11.8 Administer medications using a range of routes
- 11.9 Administer and monitor medications using enteral equipment
- 11.10 Recognise and respond to adverse reactions to medications
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