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Foundations of Field of Practice

Presentation Screencast Marking Rubric Level 4

(Failure to pass the LO constitutes an automatic fail)
Students are expected to demonstrate relevant skills and competencies; to be articulate in expressing ideas orally; and to be coherent and structured in terms of written or
other media. Forms of expression at this level may be descriptive but students are expected to demonstrate an increasing understanding of the theoretical background of
their study and the analytic competence to explore it, as well as its relationship, where appropriate, to particular skills. Students are expected to develop an awareness of
strengths and weaknesses in their skill sets. (Level 5 UG Contextualised N&M Grade Descriptors, 2018)

P Number

Please place P Number here

2853976
First Class Honours Distinction Upper 2nd Class Lower 2nd Class 3rd Class Fail
Grade Descriptors Upper First Class Good to Very Good Adequate to Sound Adequate Unsatisfactory
(100-90%) (89-80%) (79-70%) (69-60%) (59-50%) (49-40%) (<40%)
Outstanding Outstanding Excellent Merit Pass Pass Fail

The student has Exceptionaly developed Outstanding The screencast has been produced The screencast has been A proficiently developed Satisfactory developed The screencast has been
screencast. It is developed to a excellent standard. It is developed to a good screencast. It is screencast. It is presented developed to an
developed a
presented very screencast. It is presented very confidently, with the standard. It is presented presented condfidently, to a satisfactory standard, unsatisfactory level. It is
screencast that is confidently, with the presented very student articulating their ideas with confidently, with the and articulates the the student articulates presented poorly with the
presented student articulating confidently, with great clarity following the student articulating their majority of their ideas their ideas to a ideas and knowledge
confidently, provides their ideas with great the student recommended structure and ideas with generally a well, demonstrating satisfactory standard expressed poorly with little
clarity/insight following articulating their guidance good level of clarity some clarity, and following the to no merit.
clarity, thought and
the recommended ideas with great following the following the recommended structure The presntation is difficult
structure, adhering structure and guidance clarity following recommended structure recommended structure to follow and does not
to the available the recommended adhere to the
guidance and structure and recommended guidance.
guidance
outcomes.

Markers Comments:

The student has Exceptional exploration Outstanding Excellent exploration of the nursing Good exploration of the Proficient exploration of Satisfactory exploration of Insufficient exploration of
of the nursing process exploration of the process nursing process the nursing process the nursing process the nursing process
demonstrated
nursing process
foundational
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knowledge of the
nursing process
Markers Comments:

The student has Exceptional application Outstanding Excellent application of the nursing Good application of the Proficient application of Satisfactory application of Insufficient application of
of the nursing process application of the process to the case study nursing process to the the nursing process to the nursing process to the the nursing process to the
applied the nursing
to the case study nursing process to case study the case study case study case study
process to the FoP the case study
specific case study
Markers Comments:

The student has Exceptional Outstanding Excellent demonstartion of the role Good demonstartion of Proficient Satisfactory Insufficient demonstartion
demonstartion of the demonstartion of of the nurse in supporting the role of the nurse in demonstartion of the demonstartion of the role of the role of the nurse in
demonstrated
role of the nurse in the role of the patients/service users within the FoP supporting role of the nurse in of the nurse in supporting supporting patients/service
foundational supporting nurse in supporting patients/service users supporting patients/service users users within the FoP
knowledge of the patients/service users patients/service within the FoP patients/service users within the FoP
role of the nurse in within the FoP users within the within the FoP
FoP
supporting patients
within the FoP
Markers Comments:

The student Exceptional insight in to Outstanding Excellent insight in to stratagies to Good insight in to Proficient insight in to Satisfactory insight in to Insufficient insight in to
stratagies to engage with insight in to engage with patients/sdervice users stratagies to engage with stratagies to engage stratagies to engage with stratagies to engage with
demonstrates
patients/sdervice users stratagies to and their families patients/sdervice users and with patients/sdervice patients/sdervice users patients/sdervice users and
foundational and their families engage with their families users and their and their families their families
knowledge of patients/sdervice families
strategies to engage users and their
families
with their
patients/service
users and families
Markers Comments:
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The student Exceptional exploration of Outstanding Excellent exploration of the FoP Good exploration of the Proficient exploration Satisfactory exploration of Insufficient exploration of
the FoP specific learning exploration of specific learning outcomes FoP specific learning of the FoP specific the FoP specific learning the FoP specific learning
demonstrates
outcomes the FoP specific outcomes learning outcomes outcomes outcomes
foundational learning
knowledge in outcomes
relation to the FoP
specific outcomes
Markers Comments:

Overall Grade Summary of Comments and Final Grade Awarded:

Awarded:

Name of Marker: Date Marked:

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Copy of written transcript (To include your reference list)

Please copy and paste your transcript and reference list below:

Foundation Field of Practice Script

Hi, welcome to the screencast, my P number is on the screen and today I’ll be discussing Rishi who is the patient.

Introduction:
Rishi is a 24-year-old Asian British male living in the UK with wife and 18 months old son. Rishi is diagnosed with epilepsy from a young age which seizure
activities have been controlled up till the wife has noticed Rishi just staring at the screen for a few seconds then blinking before continuing with the work
in the last few months. Rishi works from home 9-5 Monday to Friday as well working in late evenings and weekends therefore has little to no time to
spend time with family or exercise. The lack of exercise and ordering out food from home which tend to be high in calories and high fat has led to the
weight gain and Rishi is currently 18st and 2lbs. Recently within the year, Rishi is diagnosed with type 2 diabetes and this is what I’ll be focusing on in this
presentation. GP has recommended that Rishi change the diet, exercise in order to lose weight, take medication consistently as well as monitor
glucose levels regularly. However, Rishi doesn’t entirely understand the whole process of monitoring glucose levels and is worried to ask for help from his
wife as she is looking after their son who has medical needs which Rishi doesn’t want to be added on to the wife’s worries. Therefore, Rishi wants to be
independent about health. ‘Type 2 diabetes metabolic disorder in which persistent hyperglycaemia is caused by a combination of deficient insulin
secretion and resistance to the action of insulin’. (NICE,2024).

Role of a Nurse:
The role of the nurse is to take a holistic approach which is ‘an assessment that considers all aspects of a person’s wellbeing, their spiritual and health
and social needs’ as it ‘ensures that the person’s concerns and problems are identified so support can be provided to address them’ (NICE,2019). This
includes their ‘mental and physical health, spiritual beliefs, cognitive health and social elements’ (NMC,2024). Holistic care means we don’t see the
person as a patient but as an individual as ‘There is so much more to a person than the personal health goal, or illness or condition, they’re being treated
for. Who they are as an individual does so much to determine their health and care journey.’ (NMC,2024). This allows one to build up a strong rapport
with trust and respect enabling Rishi to find comfort to talk about health problems without feeling judged in a way. ‘Emotional health refers to how a
person thinks and feels’ (Sissons, B ,2022).
There is already a communication barrier between Rishi and wife due to the lack of availability to help support the son in appointments. It has been
putting pressure on their relationship, therefore this has led to Rishi building a fear of asking for help from the wife about health. So, Rishi may fear that
Nurses are too busy and not ask for help in the same way which will be overcome in the holistic approach by creating a safe and comfortable
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environment to share information about health as well as making sure Rishi feels supported by the wife and try reduce both of their worries about Tejas
which can be done by booking Tejas appointments on Rishi’s day off or doing a follow up call explaining what was discussed in the appointment. Making
Rishi feel a sense of belongingness in the family as Rishi is aware of what is happening and what care is provided to Tejas. From Maslow Hierarchy of
Needs, Love and Belongings is ‘the third level in the pyramid and it refers to the human emotional need for interpersonal relationships, affiliating,
connectedness, and being part of a group’ (Brodie, K,2024). ‘Abraham Maslow’s Hierarchy of Needs is a motivational theory that allows us to understand
human motivation and argues that the ‘lower-level needs must be largely satisfied before higher needs can be addressed’ (Brodie,K (2024).

As it is important for nurses to ‘Make sure that people’s physical, social and physiological needs are assessed and responded’ so we need to ‘pay special
attention to promoting wellbeing, preventing ill health and meeting changing health and care needs of people during all life stages’ (NMC, 2023). ‘Mental
health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute
to their community’ (World Health Organisation,2022). The role of a nurse is to make sure that Rishi understands how to take care of their health to
support diabetes as Rishi has been newly diagnosed so may feel overwhelmed and is unable to do the things planned. Nurse needs to make Rishi aware
that continuing with the current lifestyle will deteriorate and complications will occur, therefore educating about nutrition and meal planning suited for
diabetes i.e. a low-fat diet and medication management like taking medication on time and understanding what the medicines are for and why they are
needed.
A diabetes nurse needs to be involved since they are the best to deal with the situation for teaching Rishi how to take blood glucose levels as well as
nutrition. Rishi has full mental capacity for own life decisions; a nurse should still ask for the patient's preference in their own health as the NMC states
the nurse should ‘encourages and empowers people to share decisions about their treatment and care’ (NMC, 2023) suited to work lifestyle. Therefore,
‘Spiritual care is about a person’s sense of connection and what’s most meaningful for them’ (NMC, 2024). Nurses need to provide reliable and effective
care supported by latest research and best practice, ensuring high quality care for their patients ‘nurses need to make sure that any information or advice
given is evidence-based, including information relating to using any health and care products or services’ (NMC,2023) and ‘health systems need effective,
evidence-based interventions to improve health outcomes for adults with multiple long-term conditions’ (Arakelyan, S, et al, 2023)

Assessment:
So the assessment the nurse would take for Rishi is the BMI assessment. ‘BMI is a practical measure to decide whether a person is overweight/obese by
using weight and height’ (NICE,2024). The Nurse would need to ask Rishi if it is okay to take height and weight in order to calculate BMI. The height for
Rishi is 5ft 11 and weight is 18st and 2lb therefore Rishi’s BMI is 35.4 which is considered as obese (NHS,2023). This is because Rishi orders high calories
and high fat food from outside and because Rishi isn't active due to the busy work schedule therefore both of these risk factors have led to Rishi having
type 2 diabetes as this increases insulin resistance. ‘Being overweight increases insulin resistance and inhibits blood sugar control and metabolic
syndrome increases the risk of cardiovascular disease’ (Nursing standards,2023). As Rishi is a British Asian a lower BMI threshold is used as ‘people with a
South Asian, Chinese, other Asian, Middle Eastern, Black African backgrounds are prone to central adiposity and their cardiometabolic risk occurs at
lower BMI’ (NICE,2024) and they are 2-4 more likely to develop type 2 diabetes than white people’ (NICE,2024). The Nurse needs to be aware that
interpreting BMI data isn’t an accurate assessment for example ‘Adults with high muscle mass as it may be a less accurate measure of central adiposity in
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this group’ however as the Nurse knows that Rishi is not taking care of health with nutrition and exercise, BMI can be used as a way to how healthy,
‘overweight and obese’ a person is (NICE,2024).

Diagnosis:
Using Rishi’s BMI, the nurse will diagnose Rishi as obese as a result of his diabetes as mentioned in the introduction. The healthy BMI for the age range
is ‘18.5-23’ (NHS,2023) therefore Rishi has a high risk of developing chronic diseases like ‘coronary heart disease and hypertension (NICE,2024). As Rishi
wants to be able to take Tejas to watch sports who is currently 18 months if Rishi continues with the lifestyle this will be less likely to happen as obesity
can ‘reduce life expectancy by 2-4 years in people with a BMI if 30-35g/m2’ (NICE,2024).

Planning:
In planning, the Nurse needs to educate Rishi about remembering to take medication on time. So this would be to explain the importance of the
medication, what will happen if Rishi continues on not taking medication on time, why Rishi needs the medicine and what the medicine is used for. The
Nurse needs to make sure Rishi and the wife attend the appointment with the diabetes specialist team to allow them both to be educated about diabetes
as well as the wife who is the closest family to Rishi which is the short-term plan. This enables them to build a stronger relationship and make Rishi feel
supported and have a sense of belonging which allows Rishi to be more comfortable to ask for help if needed. The diabetes nurse needs to ensure that
Rishi mainly and wife understand the importance of monitoring Rishi’s blood glucose so they know what to do in a situation when Rishi’s blood glucose
levels are too high or low. As Rishi has no interest in doing housework/cooking the dietician needs to educate the wife about the nutrition needed for
diabetes as well as Rishi, this makes Rishi more aware of what diet works best for his diabetes. As everyone is different therefore some things make work
better for one than the others. This allows Rishi to change the diet which the GP has told Rishi to, examples of diet include mediterranean diet, low fat
diet and a low carbohydrate diet.
The long-term goal that nurse will have for Rishi is to lose weight. This can be achieved by changing the diet which is a short-term goal allowing the
patient to achieve the long-term goal and exercising. The nurse knows that Rishi has interest in sports but due to the busy work schedule Rishi has no
time for it so the nurse can suggest a goal for the patient to walk 10k steps a day during the week. Instead of always sitting in a sedentary position,
purchase a foldable treadmill machine where Rishi can walk and work at the same time. On the days off, if Rishi has some, Rishi can join the gym or a
local sport team in the area which is good for releasing stress from work or home.

Implementation:
In implementation the Nurse needs to refer Rishi to the Diabetes Specialist Team who need to teach Rishi how to monitor blood glucose levels all the
time and make sure Rishi understands what to do when the blood glucose levels are too high or too low. Not only just teach Rishi but to teach Rishi’s wife
as well so that Rishi feels supported and relieved when Rishi is stuck or confused about monitoring the blood glucose level, the wife can come help Rishi
for the first few times. This allows Rishi to become independent in health in the long run which is what Rishi aims to be. There should be a structured
education plan for diabetes management as Rishi is newly diagnosed for diabetes and unaware of what to do, therefore after the appointment with the
diabetes specialist, an educated video about diabetes should be sent to Rishi and this includes how to monitor the glucose levels and what to do if blood
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sugar levels are too high or low. This allows Rishi who enjoys technology to watch in own time or at times when Rishi is stuck on what to do.
The Nurse also needs to refer Rishi to a dietician to teach Rishi and the wife about nutrition needed for a diabetic patient, as Rishi doesn’t cook, the wife
needs to be aware of what food should be consumed or diet that works for Rishi with the work schedule to ensure Rishi has enough calories that will
supply enough energy for Rishi to work. Meal prepping will save time, especially Rishi’s work schedule. The dietician can offer a range of diets like
Mediterranean diet and low carbohydrate diet or making small changes like using low fat dairy products and having whole grains and pulses. ‘For
managing diabetes typically promotes the adoption of a Mediterranean diet (MD) with high-carbohydrate (50–60% of daily energy requirements) and
low-fat regimen (no more than 30% of total energy), emphasizing caloric restriction, increased fibre consumption, and focusing on vegetables, fruits,
whole cereals, in addition to lean proteins from fish and poultry and healthy fats such as extra virgin olive oil. There is growing evidence on the use of
these dietary approaches to intervene against type 2 diabetes and overall protection against cardiovascular diseases’ (Currenti W, et al, 2024). Both a low
carbohydrate diet and a Mediterranean diet have ‘showed positive results in weight loss’ (Currenti W, et al 2024). But the low carbohydrate diet results
‘in a greater reduction in BMI, waist circumference, waist–hip ratio, fat mass, and total body water with no statistically significant differences in free-fat
mass and ‘ leads to a greater reductions in various health markers including systolic blood pressure, diastolic blood pressure and blood glucose levels.
(Currenti W, et al 2024). However, the choice of the diet depends on Rishi if the patient wants to follow a low carbohydrate diet or Mediterranean diet as
the patient has got mental capacity of its own choices, but it is highly recommended that ‘For adults with type 2 who are overweight, discuss and agree
an initial body weight loss target of 5% to 10%. (NICE,2022)’. During the time off work Rishi can take Tejas for a walk in the pram which enables wife to
have a break and to have quality father and son time. As there are many benefits with walking especially with obese type 2 diabetes patients like
‘improved body-shape, decreased body weight and waist circumference, and increased exercise capacity have been previously identified. Further, lower
levels of glucose and insulin after meals and improved glucose metabolism have also been recognized as benefits of walking experienced by overweight
and obese adults’ (Kadir, M.A., et al, 2019).

Continuing on with implementation the Nurse needs to tell Rishi about the complications that may occur if Rishi continues with the lifestyle whilst having
diabetes. For example, there is a risk of Hyperglycaemia which is ‘a condition where there is excess level of glucose in the person’s bloodstream’ and this
can lead to increased risk of more serious illness’. Rishi remains in sedentary position all the time during work and having increased workload can
increase stress levels which studies have shown that ‘due to a sedentary lifestyle and increased stress, the glycaemic profile of the participants was
uncontrolled, which negatively impacted their quality of life’ (Mahajan, A. and Muley, A. 2024).Having too much sugar can ‘damaging blood vessels,
tissues or organs, developing heart disease like stroke/kidney damage as well as affecting the nervous system or even the ability to see’ (Dziak,M,2023).
Complications occurring with having high sugar levels are ‘Atherosclerotic cardiovascular disease including stroke and peripheral arterial disease which is
the leading cause of death in people with type 2 diabetes as well as being a risk factor for the development of diabetic foot disease and foot ulcers’
(NICE,2024)

Evaluation:
Physiological health is defined as ‘the ability to maintain health or recover to a healthy state after disease’ (Aryes, J.S. , 2020). In evaluation the nurse
needs to organise a routine home health check-up for Rishi’s diabetes and glycaemic control every 3-6 months as well as weight to see if BMI has
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improved with the change in diet. It is more convenient at home as Rishi has such a busy work schedule therefore Rishi is more unlikely not to turn up to
the appointment if scheduled at the GP surgery or the hospital as Rishi may think it is a waste of time or unable to get time off. Also discussing any
concerns, problems or questions at Rishi own house will be more comfortable as Rishi will be more likely to open up instead of rushing the appointment
due to having work piling up. If there are signs of deterioration from Rishi, the nurse needs to refer Rishi to a diabetes specialist team as they are the best
healthcare workers that know more about what to do further on.

Thank you for listening to the presentation, the next 2 slides are the references I used in the presentation and in the script there are some references as
well.

References:
Arakelyan, S. et al. (2023) 'Effectiveness of holistic assessment-based interventions in improving outcomes in adults with multiple long term conditions
and/or frailty:an umbrella review protocol', JBI Evid Synth, 4:21 (9), pp. 1863-1878. Available at: https://doi.org/10.11124/JBIES-22-00406 (Accessed at
23rd November 2024)

Ayres, J.S. (2020). The Biology of Physiological Health. Cell, [online] 181(2), pp.250–269. doi:https://doi.org/10.1016/j.cell.2020.03.036. (Accessed 8
December 2024)

Brodie, K. (2024). Maslow’s Hierarchy of Needs. [online] Early Years TV. Available at: https://www.earlyyears.tv/maslows-hierarchy-of-needs / (Accessed
8 Dec. 2024).

Currenti, W., et al. (2024). ‘Comparative Evaluation of a Low-Carbohydrate Diet and a Mediterranean Diet in Overweight/Obese Patients with Type 2
Diabetes Mellitus: a 16-Week Intervention Study’. Nutrients, [online] 16(1), p.95. doi:https://doi.org/10.3390/nu16010095. (Accessed on 7th december
2024)

Dziak,M. (2023) ‘Hyperglycemia’, Salem Press Encyclopedia of Health [Preprint]. Available at: https://research.ebsco.com/linkprocessor/plink?
id=a21bd8ed-670b-3062-b4a0-e71c56275349 (Accessed at 26 November 2024)
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Kadir, M.A., et al. (2019). Perceived Benefits and Barriers of Walking among Overweight and Obese Adults. Health Marketing Quarterly, 36(1), pp.54–70.
doi:https://doi.org/10.1080/07359683.2019.1567004. (Accessed 12th December 2024)

Living with Spouse Halves Risk of Being Overweight in Type 2 Diabetes. (2016b). Nursing Standard, 31(7), pp.17–17.
doi:https://doi.org/10.7748/ns.31.7.17.s21. (Accessed 24th November 2024

Mahajan, A. and Muley, A. (2024). Assessment of Lifestyle factors, Stress levels, and Quality of Life among People with Type 2 Diabetes Mellitus. Deleted
Journal, 21(1). doi:https://doi.org/10.1186/s12982-024-00173-2. (Accessed 10th December 2024)

National Health Service (NHS) (2023). Your BMI Result - Calculate Your Body Mass Index (BMI) for Adults - NHS [online] nhs.uk. Available at:
https://www.nhs.uk/health-assessment-tools/calculate-your-body-mass-index/calculate-bmi-for-adults/result (Accessed at 24th November 2024)

National Institute for Health and Care Excellence (2019). Recommendations | End of Life Care for Adults: Service Delivery | Guidance | NICE. [online]
Nice.org.uk. Available at:https://www.nice.org.uk/guidance/ng142/chapter/Recommendations (Accessed 3rd December 2024)

National Institute for Health and Care Excellence (2024). How Should I Confirm If a Person Is Overweight or obese? [online] NICE. Available at:
https://cks.nice.org.uk/topics/obesity/diagnosis/identification-classification/ (Accessed 9 Dec. 2024)

National Institute for Health and Care Excellence (2024). What Are the Risk factors? [online] NICE. Available at: https://cks.nice.org.uk/topics/diabetes-
type-2/background-information/risk-factors/ (Accessed 3 Dec. 2024).

National Institute for Health and Care Excellence (2024a). Diabetes - Type 2. [online] NICE. Available at: https://cks.nice.org.uk/topics/diabetes-type-2/
(Accessed 6 Dec. 2024)

National Institute for Health and Care Excellence (NICE) (2024). CKS Is Only Available in the UK. [online] Available at:
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https://cks.nice.org.uk/topics/obesity/background-information/complications/ (Accessed 12 Dec. 2024)

National Institute for Health and Care Excellence (NICE) (2024). Diabetes - Type 2: What Are the complications? [online] NICE. Available at:
https://cks.nice.org.uk/topics/diabetes-type-2/background-information/complications/ (Accessed 7 Dec. 2024)

National Institute for Health and Care Excellence [NICE] (2022) ‘Type 2 Diabetes in adults: Management’ NG28. Available at:
https://www.nice.org.uk/guidance/ng28/chapter/Recommendations (Accessed at 24th November 2024)

Nursing and Midwifery Council (NMC) (2023) ‘The Code Professional Standards of Practice and Behaviour for Nurses and Midwives Nursing and
Midwifery Council. London: [Online] Nursing and Midwifery Council. Available at: https://www.nmc.org.uk/standards/code/read-the-code-online/
(Accessed at 23rd November 2024)

Nursing and Midwifery Council (NMC) (2024). Holistic Care - the Nursing and Midwifery Council. [online] www.nmc.org.uk. Available at:
https://www.nmc.org.uk/standards/guidance/holistic-care/ (Accessed at 3rd December 2024)

Sissons, B (2022). Emotional well-being: What Is it, causes, How to Improve. [online] www.medicalnewstoday.com. Available at:
https://www.medicalnewstoday.com/articles/emotional-wellbeing (Accessed at 8th December 2024)

World Health Organization (2022). Mental Health. [online] World Health Organization. Available at:
https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response (Accessed 8 Dec. 2024)
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