HOLY TRINITY UNIVERSITY College of Nursing & Health Sciences Puerto Princesa City

RELATED LEARNING EXPERIENCE METACOGNITIVE LEARNING FEEDBACK DIARY

1. List and describe your learning experience as it happens.

=> This week is the last week of our community exposure this semester in this area. It was a very short exposure compared to the past semesters. Although the time is very short, we made it a point that we can make the most out th of this week. On the 5 of December, K: We learned furthermore on how to enhance our spot map and we partake in providing knowledge to the community on proper wound care which is related to our concept in inflammatory. S: On skills, we applied what we have learned in CHN; how to properly organize the profile and we assessed our host family; we gathered all necessary information for our manuscript. We also identified the problems that are present there. Also, we started planning on the goals and list down the activities to do the on the next exposure. A: As we continue our duties, we make it a point that when we communicate we establish rapport with the clients and talk with them in th th a respectful manner. On the 6 and 07 day, I was absent because I was sick. 2. What is your thought and reaction to the learning experience? => This week, I was the team leader, although I was absent for two (2) days I know for myself that I did my best as a team leader, though I still have more to do If I was present the whole week with this I am happy with my nd rd performance somehow, but also quite disappointed because of my absence on the 2 and 3 day. 3. Based on your reflection, what are the things you could have done otherwise? What do you need to learn? Know? => I could have be more attentive and careful on my health so I could be present always. Also, I need to review more on my concepts in CHN because I tend to forget more of them. 4. How could you put together what you have learned? => I could put together all my learning by first, careful on my health so as for me to perform properly, also by being focused in each and every detail that I do in all my exposure so that It will be utmost worthy and not time wasting. 5. What biblical text/food for thought/quotation/words to ponder do you think can support your action? =>Disciplining yourself to do what you know is right and important, although difficult, is the highroad to success, selfesteem, and satisfaction I chose this quote because it applies to my learning now that I should be disciplined enough, to do my duties properly and of course with Gods guidance.

HOLY TRINITY UNIVERSITY College of Nursing & Health Sciences Puerto Princesa City

RELATED LEARNING EXPERIENCE METACOGNITIVE LEARNING FEEDBACK DIARY

1. List and describe your learning experience as it happens.

=> This week is my first ever exposure to the Neonatal Intensive Care Unit (NICU) this is also the first week of exposure to the clinical setting this semester; On the first day, we had an orientation, K: We reviewed the rules and regulations during our duties in the ONP, about the requirements, and etc. then we had a major orientation at the conference room of the ONP, wherein we were taught about the brief history of the hospital and its protocols. On the second day, we stared the usual activities we were reviewed about the medications through administering them and providing a drug study prior to administration, we also reviewed the computations needed for the IVFs and other rd contraptions present. There. On the 3 day, we had a brief review together with Dr. Quicho about hypothermia and hyperthermia and its nursing responsibilities. We also had a bedroom conference wherein we learned about Sepsis Neonatorum, Meconium Stained, and Transient Tachypnea and also about Heplock. S: We started our duty in the NICU, as usual we took the vital signs, assessed the babies a bit and provided baby bath. The same thing goes throughout the week. We did as much intervention as we could in the limited time that is left. A: We do everything as if the babies there are our relatives and provide respect to their mothers and to the staff there and of course with our group mates. 2. What is your thought and reaction to the learning experience? => I feel fulfilled this week, I have learned and reviewed some concepts and I was able to perform properly. 3. Based on your reflection, what are the things you could have done otherwise? What do you need to learn? Know? => As always, reading prior to exposure is very helpful since it helps us not to forget during the duty. 4. How could you put together what you have learned? => I could put together all my learning by reviewing prior to duty and continue to do those that are good. 5. What biblical text/food for thought/quotation/words to ponder do you think can support your action? =>In the realm of ideas, everything depends on enthusiasm, in the real world, all rest on perseverance. Johan Wolfgang. Ive chosen this because it tells us that when we are enthusiastic and persevered to learn or to do something, our productivity improves.

Web address: http://www.sciencedaily.com/releases/2013/10/ 131001151055.htm

New Tuberculosis Vaccine Developed

Oct. 1, 2013 A tuberculosis vaccine developed at McMaster University offers new hopes for the global fight against tuberculosis. "We are the first to have developed such a vaccine for tuberculosis," said Dr. Fiona Smaill, professor and chair of the Department of Pathology and Molecular Medicine of the Michael G. DeGroote School of Medicine at McMaster. She led the phase one clinical study published today in the journal Science Translational Medicine. The vaccine, based on a genetically modified cold virus, was developed in the lab of Zhou Xing, professor of pathology and molecular medicine and the McMaster Immunology Research Centre, who co-led the phase one study. Both are also members of the Michael G. DeGroote Institute for Infectious Disease Research. "Tuberculosis is a serious public health threat," Smaill said. "One-third of world's population is infected with the organism that causes tuberculosis, and it remains the top infectious killer of people only secondary to HIV; yet, the current vaccine used to prevent it is ineffective." The control of tuberculosis (TB) has met with further challenge from high incidence of multi-drug resistant tuberculosis, she added. The new vaccine was developed to act as a booster to Bacille Calmette Guerin (BCG), currently the only TB vaccine available. BCG was developed in the 1920s and has been used worldwide. The new "booster" would reactivate immune elements that over time diminish following BCG vaccination. Currently the BCG vaccine is part of the World Health Organization's immunization program in Asia, Africa, Eastern Europe and South America, as well as Nunavut, the only Canadian jurisdiction where the BCG vaccine is routinely given because of the high rate of tuberculosis in the territory. It is typically given in the first year of life. The McMaster vaccine has been more than a decade in the making. McMaster researchers began the first human clinical trial in 2009 with 24 healthy human volunteers, including 12 who were previously BCG-immunized. "The primary goal was to look at the safety of a single dose vaccine injection," said Xing, "as well as its potency to engage the immune system." By 2012 they established that the vaccine was safe and observed a robust immune response in most trial participants. More clinical trials are needed to measure the vaccine's real potential, Xing added. Smaill added: "As a doctor who looks after patients who have tuberculosis, including those who are HIV infected, I realize how important it is going to be to control this infection with a good vaccine. "We are probably one of a few groups in the world who are actually doing bench-to-human tuberculosis vaccine work, and we are excited to be part of this and thrilled that it started at McMaster." TITLE: New Tuberculosis Vaccine Developed SUMMARY: This article is about a study made in McMaster University wherein they have developed which acts as a booster to BCG that was developed on the 1920s. The new "booster" would reactivate immune elements that over time diminish following BCG vaccination. REACTION: I am so happy when I read this article, since it helps us to have a more advanced method of fighting the incidence of having PTB. With this vaccine, We can reduce morbidity rate in the case of PTB. APPLICATION: Since this is not yet available in the Philippines, I can continue giving health education on the promotion and prevention of PTB and also I can ask this to some physician to provide further information.

Web address: http://www.sciencedaily.com/releases/2013/10/ 131017080650.htm

The NICU Environment: Not All Silence Is Golden

Oct. 17, 2013 Medical technology has improved the survival rates of premature infants, but adverse developmental outcomes are a continuing problem. Researchers have turned their attention to the neonatal intensive care unit (NICU), where premature infants spend their first few weeks or months, for potential answers. In a new study scheduled for publication in The Journal of Pediatrics, researchers studied the relationship between different room types in the NICU and the developmental outcomes of the children at 2 years of age. Research has suggested that the bright and noisy environment in the typical NICU may adversely affect the growth and development of premature infants, so infants should be kept in a quiet environment. Therefore, many NICUs are undergoing renovations to create private rooms, rather than traditional open wards. According to Roberta Pineda, PhD, and colleagues from Washington University School of Medicine, "We hypothesized that infants hospitalized in private NICU rooms would have better neurodevelopmental outcomes than infants in open wards." The researchers studied the outcomes of 127 infants born < 30 weeks gestational age between 2007 and 2010 in a single-center NICU that was located in an urban area with low parental visitation rates. Approximately one-half of the infants were assigned to open wards and the other one-half were assigned to private rooms. Infants underwent neurobehavioral testing, amplitude integrated electroencephalography, and brain imaging prior to NICU discharge. Early neuroimaging and electrophysiological findings suggested altered cerebral development in infants in private rooms compared with those in open wards. Eighty-six of these preterm infants were assessed again at 2 years of age, which showed that children who were in private rooms in the NICU had lower language scores and demonstrated a trend toward having lower motor scores and more externalizing behaviors. Although there has been a trend to reduce noise exposure to infants in NICUs by changing to a private room model, this research raises concerns that this change might result in insufficient stimulation for normal brain development. Sensory deprivation is known to affect neurodevelopment, and private rooms decrease the sensory experiences, like sound and light, of the infants. Dr. Pineda notes, "Although a noisy NICU environment might well be detrimental to brain development, a lack of voice and auditory exposure with long periods of silence may also be detrimental." Further research should be directed at determining the optimum environment for infants within the NICU.

NICU

HOLY TRINITY UNIVERSITY Puerto Princesa City COLLEGE OF NURSING & HEALTH SCIENCE

In Partial Fulfillment of the Requirements in RELATED LEARNING EXPERIENCE CLINICAL EXPOSURE OSPITAL NG PALAWAN

METACOGNITIVE JOURNAL

PREPARED BY: DIANA LAURA LEI V. DE LEON LEVEL III BS NURSING