Record of Achievement in Practice
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- Sherilyn Dennis
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1 Record of Achievement in Practice Year 2 MH JES.qxd:Layout 1 15/10/12 10:19 Page 1 School of Health Sciences Name Student No: Programme: Cohort: Pathway: Personal Tutor: Record of Achievement in Practice Part Two BSc (Hons) / PGDip / RN (Mental Health Nursing) 2012 Curriculum
2 Student Details Student s Family (surname) Name Student s First Name Student s Number Cohort (Month/Year) Course Tick as Appropriate BSc (Hons) PGDip Locality Tick as Appropriate Tower Hamlets Hackney Newham Personal Tutor Name Contents > Page Introduction...1 NMC Standards...2 Register of Mentors...3 Orientation to Placement Area...4 Student Learning Contract Placement 1 Start of Placement...6 Placement 1 Mid-Point Review...8 Placement 1 End of Placement...9 Placement 2 Start of Placement...10 Placement 2 Mid-Point Review...12 Placement 2 End of Placement...13 Placement 3 Start of Placement...14 Placement 3 Mid-Point Review...16 Placement 3 End of Placement...17 Page Assessment of Practice Criteria...22 Assessment of Practice Levels of Competence...23 Learning Outcomes...24 Record of Learning from Personal and Professional Development Group...31 Record of Inter-Professional (IPE) Learning...31 Record of Testimonies & Feedback...34 Simulated Practice...36 Register of Attendance in Practice...37 Register of Attendance Total Hours...41 Overall Assessment of Practice - Mentor...42 Declaration of Good Character Student & Personal Tutor...43 Placement 4 Start of Placement...18 Placement 4 Mid-Point Review...20 Placement 4 End of Placement...21
3 Introduction > The Assessment Strategy for preregistration Nursing courses leading to the Award of Bachelor of Science (Hons) or Post Graduate Diploma in Nursing with Professional Registration prescribes the process by which student performance is measured against standard statements and clinical learning and practice outcomes that are consistent with: Standards for Pre Registration Nursing Education (NMC 2010) The process for the assessment of clinical learning/practice outcomes, together with the assessment of theoretical outcomes constitutes the Assessment Strategy for pre-registration nursing education programmes provided by City University, London and validated by the NMC. The Assessment Strategy acknowledges that the concept of competency is fundamental to the autonomy and accountability of the individual practitioner, and the practice component of preregistration programmes is structured to facilitate the achievement of competency by enabling the student to apply knowledge, understanding and skills in the safe delivery of care, and to make the transition from student to registered nurse. Key persons in the clinical assessment process are the practice-based Mentor, the Link Lecturer and the Practice Education Facilitator/Manager (PEF/PEM). During each clinical placement, and through a learning contract negotiated by the student and Mentor, the student is required to achieve pre-specified clinical learning outcomes. The assessment of these is the responsibility of the practice-based Mentor. The Link Lecturer and the Practice Education Facilitator/Manager (PEF/PEM) will assist the Mentor in the facilitation of a supportive, creative learning environment and will give support throughout the clinical assessment process. In the Standards for Pre Registration Nursing Education (NMC 2010), the NMC specifies the outcomes for progression from year 1 or First Progression Point to year 2 or Second Progression Point and the standards and competencies that must be achieved for entry to the Professional Register. City University, London assessment strategy enables each of the NMC standards and competencies to be achieved through the student attaining specified theoretical and clinical learning outcomes throughout their programme. This Record of Achievement in Practice document is concerned with the student s achievement of the specified clinical learning outcomes The documentation, which is cumulative, provides a comprehensive account of the personal and professional development and progress of the student, thus providing evidence of the suitability of the student to proceed through pre-determined phases of the pre-registration programme. This document will enable the student to demonstrate that they have acquired the necessary knowledge, skills and attitudes in order to practice safely, and that they are suitably prepared to meet the challenges that professional registration will demand within their chosen area of practice. Mark Jones Head of Practice Education School of Health Sciences City University London 1
4 NMC Standards > In order to provide documentary evidence of achievement of practice and confirmation that students have met the NMC standards for practice this Record of Achievement in Practice document has been developed. This document provides evidence of the student journey through practice over the students programme, and offers mentors a continuous overview of progress and achievement. The NMC (2008) have introduced Standards to support learning and assessment in practice in which the requirements of a mentor undertaking this role are clearly outlined. In order to assist mentors in meeting these standards the following document has been developed, in liaison with practice, students and academics. The following points are some of the statements from the NMC standards publication, for further information please see the standards document, available on the NMC website NMC Requirements: Every student has a named mentor for each period of practice Mentors would not normally support more than three students, from any discipline, at any point in time Whilst giving direct care in the practice setting at least 40% of a student s time must be spent being supervised (Directly or Indirectly) by a mentor/practice teacher A Continuous Achievement Record including comments from mentors, must be passed from one placement to the next to enable judgements to be made on the student s progress The mentor should have access to a network of support and supervision to enable them to fulfil their mentoring responsibilities, assist them in making complex judgements regarding competence such as failing a student and to support their professional development When in the final placement this 40% of the students time is in addition to the protected time (1 hour per week) to be spent with a sign off mentor (End of year 3 or Final Placement) Assessing learning in practice: Most assessment of competence should be undertaken through direct observation in practice Practice Staff should be involved, wherever possible, when competence is assessed through simulation Mentors should consider how evidence from various sources might contribute to making a judgement on performance and competence Mentors should seek advice and guidance from a sign off mentor, practice facilitator, practice teacher or link lecturer when dealing with failing students Confirmation of Competency: The NMC has identified progression points within each approved programme where confirmation is required that students have met specified learning outcomes and competencies i.e. at the end of year one, two and the end of the programme for pre-registration students (or equivalent for Pg Dip students) All mentors may assess specific competencies throughout the programme Mentors must keep sufficient records to support and justify their decisions on whether a student is, or is not competent or Fit to Practice In the final placement (year three or equivalent for PG Dip) of a pre-registration programme, mentors are required to be either a sign off mentor, or supported by a sign off mentor or a practice teacher, in order to make final decisions on proficiency and Fitness to Practice Sign off mentors must have time allocated to reflect, give feedback and keep records of student achievement in their final period of practice learning, equivalent to one hour per student per week. This is in addition to the 40% of supervised practice time already identified All mentors should request evidence from students to demonstrate knowledge and understanding of the requirements of practice at any time during the programme Only sign off mentors must sign off achievement of competency at the end of the programme, unless the mentor is being supervised by a sign off mentor or practice teacher who should countersign that the competency has been achieved by the student The Programme Manager for education must confirm at the appropriate Assessment Board that all NMC requirements have, to the best of their knowledge, been met for individual students, presenting evidence of successful achievement of competencies from a sign off mentor or practice teacher. 2
5 Register of Mentors To be completed only by supervising Mentor To be completed by those staff with a recognised and current mentor/assessor qualification Mentor s Initials (as used on assessment pages) Mentor s Family Name (Print) Mentor s First Name (Print) Date of Last Mentor Update Placement & Organisation Name (incl. Ward/Clinic/Practice Area/Trust Name/Organisation Name) I Student Nurse... (SIGN NAME) confirm that all the above details are genuine Any falsification of this document will lead to disciplinary action being taken including referral to the Fitness to Practice Panel This can lead to discontinuation from the programme 3
6 Orientation to Placement Area to be completed by the student Orientation to your placement area must be completed within the first week Placement 1 Placement 2 Placement 3 Placement 4 Mentor Identified Please Circle YES/NO YES/NO YES/NO YES/NO Induction Pack Available/Given Please Circle YES/NO YES/NO YES/NO YES/NO Emergency Equipment/Procedures Please Circle YES/NO YES/NO YES/NO YES/NO Layout of Area Please Circle YES/NO YES/NO YES/NO YES/NO Introduction to Relevant Personnel Please Circle YES/NO YES/NO YES/NO YES/NO Access to Local Policies - e.g. Moving & Handling, Infection Control, Child Protection, Vulnerable Adults, Violence At Work, and appropriate others Please Circle YES/NO YES/NO YES/NO YES/NO Initials of Mentor and Student Mentor Mentor Mentor Mentor Student Student Student Student 4
7 Student Learning Contract (Continuous Assessment of Practice) > What is your learning contract? A learning contract is a working agreement between the student and their mentor/assessor concerning how the student will meet specific learning outcomes. The Learning Contract will include: 1. What the student will learn (Statement of Learning Needs) 2. What the student will do to meet these outcomes (How Are These to be Achieved) 3. Time period for completion (Target Date) 4. Evaluate if outcome was achieved or progression of learning (Evaluation / Feedback) Learning contracts are about planning. They enable you to make the most of the opportunities available and be organised about achieving your assessment requirements. A learning contract is a plan of what you are going to achieve with your mentor s support and assistance. The process allows you to discuss your needs and plan your time and learning in the placement. Your mentor contracts with you to establish an effective working relationship to facilitate your learning; assess your practice, whilst being an advocate in assisting you to meet your individual learning needs (NMC, 2008). The mentor knows what experiences are available and has the experience to guide you to what is achievable in the time available. Do not forget that you need to meet all the learning outcomes by the submission date of this document. 1. Identify your learning needs - you need to think about your current experience and where you are aiming to be Look at the learning outcomes/competencies you need to achieve by the end of the placement. Which do you feel confident about? Which do you think need more work? What personal traits do you need to work on? Outcomes are something to aim for in terms of knowledge, skills, and attitudes, e.g. you may need to increase your knowledge of how diabetes affects the patients or practise the skill of taking observations, or get more confident about talking to patients who you do not know. You may refer to areas that have been identified in previous placements as requiring more work. This allows you to prioritise activities to fit your own experience e.g. as I have very little experience I would like to learn fundamental nursing skills With your mentor, discuss how you might achieve some of these needs. The mentor will offer guidance about how you may do this including activities that you may undertake Once you have done this you need to write up your agreement or learning contract. This contract needs to be agreed within the first 2 weeks of the placement with your mentor. The contract has outcome criteria, an action plan (which includes what supporting evidence you might present) and evaluation. 2. Set criteria - what will you learn? The learning contract allows you to personalise the assessment outcomes/competencies and pick out the ones most relevant to you for each placement so that you can plan which you do when, and how you achieve them. Learning outcomes describe what will be learnt, not what you will do. You are setting some targets. You will be thinking about your knowledge your skills and your attitudes, e.g. After 3 weeks I want to be competent and confident enough to take Blood Pressures (BP) unsupervised. I will be able to demonstrate my skill and my knowledge around the procedure. 3. Make an action plan - what will you do? Who is going to do what? What evidence will you use to show you have successfully achieved your learning outcome/need? Say what you are going to do to achieve each outcome/competency and what help and resources will you need. You may also identify placement specific activities such as follow a patient journey, visit related clinics, specialist nurses, other members of the multidisciplinary team, carry out a literature search, and write a reflection. These learning activities must be achievable within the time frame allowed, and your mentor will help you to be realistic about what can be achieved. Agree target dates so that you always have something that you are aiming to do but outcomes are spread throughout the placement. Review your progress regularly. For each outcome/competency you and your mentor will need to agree what evidence is required to prove that learning has occurred and the learning outcome met. Both student and mentor sign the outcome to signify its completion. This should be an ongoing activity as you progress through the placement in conjunction with your programme and module outcomes, e.g. I will work with a Registered Nurse for 3 shifts and take as many BPs under supervision as I can. I will then be observed by my mentor to test my competence. I will be able to discuss the equipment used, the health and safety and infection control issues. I will write a reflection or discuss the taking of a BP on a patient outlining special considerations because of their condition, legal and ethical requirements and how I felt taking this observation. 4. Evaluation - how well have you done? How could you improve? It is important to evaluate your progress as you go through the placement. When you have done well you can reflect on how you have done this; if less well, then you can plan to do better next time. You may have achieved all you set out to achieve or even added more outcomes. You may find that you have not achieved as much as you hoped. You may wish to move some outcomes/competencies to the learning contract for the next placement. 5
8 Student Learning Contract Placement 1 Placement 1 to be completed at the beginning of the placement This contract should be done with the support and assistance of your Mentor/Assessor Mentor: Please request to see the student s previous RAP(s) to help you develop this learning contract. Placement Name & Trust/Organisation: Statement of Learning Needs Briefly state below what do you hope to gain from this placement
9 Placement 1 - Student Action Plan Action Plan to meet Individual Learning Needs agreed between the Student and Mentor/Assessor Learning Need N o 1 How this will be achieved? (Action Plan & Possible evidence to demonstrate Achievement) Target Date Evaluation Mentor s Family Name (Print below) Mentor s First Name (Print below) Mentor s Signature Date Student s Family Name (Print below) Student s First Name (Print below) Student s Signature Date 7
10 Student Learning Contract Placement 1 Placement Name & Trust/Organisation: Student Comments please comment on how you have done. Identify your strengths and areas for further development. Reflect on your overall progression Placement 1 Mid-Point Practice Review (This must be completed at the mid placement review meeting) Mentor Comments - please provide information on the student s progress in relation to the outcomes/competencies identified in the learning contract (please comment, for example, on professional behaviour, Clinical Skills and Communication) Action Plan to meet Individual Learning Needs agreed between the Student and Mentor/Assessor Specific Learning Outcomes for Development How this will be achieved? (Action Plan & Possible evidence to demonstrate Achievement) Target Date Placement 1 - Action Plan Following Mid-Point Review Mentor s Family Name (Print below) Mentor s First Name (Print below) Mentor s Signature Date Student s Family Name (Print below) Student s First Name (Print below) Student s Signature Date 8
11 Student Learning Contract Placement 1 - End of Placement Summary Placement Name & Trust/Organisation: Student Comments please comment on how you have done. Identify your strengths and areas for further development. Reflect on your overall progression Mentor Comments - please provide information on the student s progress in relation to the outcomes/competencies identified in the learning contract (please comment, for example, on professional behaviour, Clinical Skills and Communication) Mentor s Family Name (Print below) Mentor s First Name (Print below) Mentor s Signature Date Student s Family Name (Print below) Student s First Name (Print below) Student s Signature Date 9
12 Student Learning Contract Placement 2 Placement 2 to be completed at the beginning of the placement This contract should be done with the support and assistance of your Mentor/Assessor Placement Name & Trust/Organisation: Statement of Learning Needs Briefly state below what do you hope to gain from this placement
13 Placement 2 - Student Action Plan Action Plan to meet Individual Learning Needs agreed between the Student and Mentor/Assessor Learning Need N o How this will be achieved? (Action Plan & Possible evidence to demonstrate Achievement) Target Date Evaluation Mentor s Family Name (Print below) Mentor s First Name (Print below) Mentor s Signature Date Student s Family Name (Print below) Student s First Name (Print below) Student s Signature Date 11
14 Student Learning Contract Placement 2 Placement 2 Mid-Point Practice Review (This must be completed at the mid placement review meeting) Placement Name & Trust/Organisation: Student Comments please comment on how you have done. Identify your strengths and areas for further development. Reflect on your overall progression Mentor Comments - please provide information on the student s progress in relation to the outcomes/competencies identified in the learning contract (please comment, for example, on professional behaviour, Clinical Skills and Communication) Placement 2 - Action Plan Following Mid-Point Review Action Plan to meet Individual Learning Needs agreed between the Student and Mentor/Assessor Specific Learning Outcomes for Development How this will be achieved? (Action Plan & Possible evidence to demonstrate Achievement) Target Date Mentor s Family Name (Print below) Mentor s First Name (Print below) Mentor s Signature Date Student s Family Name (Print below) Student s First Name (Print below) Student s Signature Date 12
15 Student Learning Contract Placement 2 - End of Placement Summary Placement Name & Trust/Organisation: Student Comments please comment on how you have done. Identify your strengths and areas for further development. Reflect on your overall progression Mentor Comments - please provide information on the student s progress in relation to the outcomes/competencies identified in the learning contract (please comment, for example, on professional behaviour, Clinical Skills and Communication) Mentor s Family Name (Print below) Mentor s First Name (Print below) Mentor s Signature Date Student s Family Name (Print below) Student s First Name (Print below) Student s Signature Date 13
16 Student Learning Contract Placement 3 Placement 3 to be completed at the beginning of the placement This contract should be done with the support and assistance of your Mentor/Assessor Placement Name & Trust/Organisation: Statement of Learning Needs Briefly state below what do you hope to gain from this placement
17 Placement 3 - Student Action Plan Action Plan to meet Individual Learning Needs agreed between the Student and Mentor/Assessor Learning Need N o How this will be achieved? (Action Plan & Possible evidence to demonstrate Achievement) Target Date Evaluation Mentor s Family Name (Print below) Mentor s First Name (Print below) Mentor s Signature Date Student s Family Name (Print below) Student s First Name (Print below) Student s Signature Date 15
18 Student Learning Contract Placement 3 Placement 3 Mid-Point Practice Review (This must be completed at the mid placement review meeting) Placement Name & Trust/Organisation: Student Comments please comment on how you have done. Identify your strengths and areas for further development. Reflect on your overall progression Mentor Comments - please provide information on the student s progress in relation to the outcomes/competencies identified in the learning contract (please comment, for example, on professional behaviour, Clinical Skills and Communication) Placement 3 - Action Plan Following Mid-Point Review Action Plan to meet Individual Learning Needs agreed between the Student and Mentor/Assessor Specific Learning Outcomes for Development How this will be achieved? (Action Plan & Possible evidence to demonstrate Achievement) Target Date Mentor s Family Name (Print below) Mentor s First Name (Print below) Mentor s Signature Date Student s Family Name (Print below) Student s First Name (Print below) Student s Signature Date 16
19 Student Learning Contract Placement 3 - End of Placement Summary Placement Name & Trust/Organisation: Student Comments please comment on how you have done. Identify your strengths and areas for further development. Reflect on your overall progression Mentor Comments - please provide information on the student s progress in relation to the outcomes/competencies identified in the learning contract (please comment, for example, on professional behaviour, Clinical Skills and Communication) Mentor s Family Name (Print below) Mentor s First Name (Print below) Mentor s Signature Date Student s Family Name (Print below) Student s First Name (Print below) Student s Signature Date 17
20 Student Learning Contract Placement 4 Placement 4 to be completed at the beginning of the placement This contract should be done with the support and assistance of your Mentor/Assessor Placement Name & Trust/Organisation: (e.g. Ward 4, City Hospital or St John s Health Centre EC1 3XX) Statement of Learning Needs Briefly state below what do you hope to gain from this placement
21 Placement 4 - Student Action Plan Action Plan to meet Individual Learning Needs agreed between the Student and Mentor/Assessor Learning Need N o How this will be achieved? (Action Plan & Possible evidence to demonstrate Achievement) Target Date Evaluation Mentor s Family Name (Print below) Mentor s First Name (Print below) Mentor s Signature Date Student s Family Name (Print below) Student s First Name (Print below) Student s Signature Date 19
22 Student Learning Contract Placement 4 Placement 4 - Mid-Point Practice Review (This must be completed at the mid placement review meeting Placement Name & Trust/Organisation: Student Comments please comment on how you have done. Identify your strengths and areas for further development. Reflect on your overall progression Mentor Comments - please provide information on the student s progress in relation to the outcomes/competencies identified in the learning contract (please comment, for example, on professional behaviour, Clinical Skills and Communication) Placement 4 - Action Plan Following Mid-Point Review Action Plan to meet Individual Learning Needs agreed between the Student and Mentor/Assessor Specific Learning Outcomes for Development How this will be achieved? (Action Plan & Possible evidence to demonstrate Achievement) Target Date Mentor s Family Name (Print below) Mentor s First Name (Print below) Mentor s Signature Date Student s Family Name (Print below) Student s First Name (Print below) Student s Signature Date 20
23 Student Learning Contract Placement 4 - End of Placement Summary Placement Name & Trust/Organisation: (e.g. Ward 4, City Hospital or St John s Health Centre EC1 3XX) Student Comments please comment on how you have done. Identify your strengths and areas for further development. Reflect on your overall progression Mentor Comments - please provide information on the student s progress in relation to the outcomes/competencies identified in the learning contract (please comment, for example, on professional behaviour, Clinical Skills and Communication) Mentor s Family Name (Print below) Mentor s First Name (Print below) Mentor s Signature Date Student s Family Name (Print below) Student s First Name (Print below) Student s Signature Date Student Learning Contract Please use this box for Further Comments if Required Mentor s Family Name (Print below) Mentor s First Name (Print below) Mentor s Signature Date Student s Family Name (Print below) Student s First Name (Print below) Student s Signature Date 21
24 Assessment of Practice Criteria > The following criteria should be used to ensure that the student s performance in clinical practice, from a range of varied clinical settings, meets the learning and practice outcomes required to successfully complete this part of the programme. Under direct supervision, the student should be able to: (a) Perform basic skills safely on the instruction of others (e.g. mentor, qualified nurses), recognising own limitations and potential hazards (b) Demonstrate an understanding of the rationale for nursing care given, drawing upon relevant underpinning knowledge and a range of learning resources (e.g. accessing information such as research articles, nursing notes, data bases). (c) Demonstrate appropriate communication skills with patients/clients and carers and with the health care team. The student must engage in appropriate practice activity to enable the mentor to verify the achievement of clinical outcomes. The student s level of performance should: demonstrate their knowledge and understanding of evidence based practice enable them to demonstrate and begin to discuss their own learning in practice The mentor is required to utilise a variety of methods to assess that the student has achieved the required level of knowledge and skill 1. Direct observation of the student in the clinical practice setting, which will include direct questioning of the student s knowledge, understanding, values, opinions and level of application of knowledge required to practice confidently and competently. 2. Relevant written or verbal feedback from other qualified nurses and/or members of the health care team, to support performance (witness testimony/feedback). 3. Scrutiny of patient/client documentation that has been completed by the student and which is relevant to the achievement of the practice outcome. 4. Reflective accounts by the student which are relevant to the achievement of the practice outcome. 22
25 Assessment of Practice Levels of Competence > In order to assist you in making decisions as to the level of competence demonstrated by students please use this table to assist you. As a visual reminder we have colour coded each section. You should assign a level of competence to each outcome using the criteria statements below to help you make an informed judgement about each student s ability across the range. Students MUST have achieved a minimum of Safe Practice (SP) across all the criteria below for each learning outcome and skill by the end of the final placement in this part of the programme. Levels of Competence Unsafe Practice (USP) Safe Practice (SP) Good Practice (GP) Excellent Practice (EP) KNOWLEDGE & UNDERSTANDING Is not able to demonstrate an adequate knowledge base of care and has significant gaps in understanding. Has ability to identify essential knowledge base, is safe, but needs to develop further understanding. Has a good knowledge base and understanding is evident to support safe and effective practice. Has extensive knowledge base and understanding to safely and effectively support practice. APPLICATION & PROBLEM SOLVING Does not apply problem solving skills to patient care, and at times is unable to recognise situations that require this skill. Has ability to respond to well defined patient care problems with some assistance. Able to respond appropriately to defined patient care problems, and some unexpected problems with minimal or no assistance. Responds flexibly, and effectively to defined and unexpected patient care problems with minimal or no assistance. PARTICIPATION IN CARE & PRACTICAL SKILLS Very poor performance, not able to follow directions. Inappropriate performance observed at times. Sufficient ability to follow directions carefully/ accurately and work independently under guidance in predictable situations of care. Able to safely, confidently and competently work independently under guidance in predicable and less well recognised situations of care. Able to demonstrate flexibility, confidence and competence to work independently, under guidance, in predicable and unpredictable situations of care. 23
26 Record of Achievement in Practice > Learning Outcomes & Suggested Activities Using the assessment of practice levels of competence on the previous page, please identify the level achieved by the student. The student s level of competence may be reassessed in other placement areas, which could lead to the level achieved being adjusted. Learning Outcome Suggested Activities/Evidence Level * Achieved Mentor s Initials Student s Initials Date 1. As partners in the care process, people can trust a newly registered graduate nurse to provide collaborative care based on the highest standards, knowledge and competence. 1.1 Forms appropriate and constructive professional relationships with families and other carers. Observe students interacting with patients and their families/carers and provide feedback Ask students to outline the characteristics of a therapeutic relationship 2. People can trust the newly registered graduate nurse to engage in person centred care empowering people to make choices about how their needs are met when they are unable to meet them for themselves. 2.1Actively empowers people to be involved in the assessment of their capability for self care, and the assessment delivery and evaluation of care 2.2 Provides personalised care when assisting people with their care and self-care and determines their preferences to maximise comfort & dignity. Ask students to explain what is meant by empowerment and ways to promote this Observe students involving patients in decisions about their care and assisting them with their care and give feedback Observe students assisting patients and give feedback on what they did to maximise comfort and dignity Discuss what is meant by personalised care 3. People can trust the newly registered graduate nurse to gain their consent based on sound understanding and informed choice prior to any intervention and that their rights in decision making and consent will be respected and upheld. 3.1 Ensures that people and service users understand the meaning of consent to treatment and care. Ask students to explain what is meant by informed consent and why consent must be given for all treatment and care Discuss what happens when consent cannot be given e.g. very disturbed patients 4. People can trust the newly registered graduate nurse to treat them as partners and work with them to make a holistic and systematic assessment of their needs; to develop a personalised plan that is based on mutual understanding and respect for their individual situation promoting health and well-being, minimising risk of harm and promoting their safety at all times. 4.1 Accurately performs and documents weight, height, TPR & BP using manual and electronic devices, and responds to abnormal findings and signs of deterioration or improvement. Provide opportunities for students to regularly measure TPR & BP using manual and electronic devices under supervision and give feedback Ask students to explain the normal range of values for these observations ** The NMC term The Newly Registered Graduate Nurse is to be interpreted for the purposes of this assessment document as referring to the student nurse. * Unsafe Practice (USP) Safe Practice (SP) Good Practice (GP) Excellent Practice (EP) 24
27 Learning Outcome Suggested Activities/Evidence Level * Achieved Mentor s Initials Student s Initials Date 4.2 Performs routine diagnostic tests (e.g. urinalysis) under supervision, documents the findings and responds to abnormal findings 4.3 Applies knowledge of age and conditionrelated anatomy, physiology and development when interacting with people. 4.4 Understands the needs of patients receiving oxygen and breathless patients 4.5 Is able to assess and prevent complications of immobility Provide opportunities for students to perform urinalysis and blood glucose monitoring under supervision and give feedback Ask students to explain normal and abnormal findings and the required course of action Discuss changes due to aging and the patients condition and how these may influence care Provide opportunities for students to care for patients requiring oxygen through a variety of masks/devices Ask students to demonstrate/outline how to position breathless patients Ask students to outline the principles of safe posture and moving and handling 5. People can trust the newly registered graduate nurse to deliver nursing interventions and evaluate their effectiveness against the agreed assessment and care plan. 5.1 Works within the limitations of own knowledge and skills to question and provide safe and holistic care. 5.2 Prepares people for clinical interventions as per local policy. 5.3 Actively seeks to extend knowledge and skills using a variety of methods in order to enhance care delivery. Observe students working with patients/clients and discuss/give feedback examples of dealing with physical and emotional responses Inform students when their responses are appropriate and/or need further development Provide students with access to local policies and procedures Observe students assisting with the preparation of patients and give feedback Ask students to find out what the NMC states about remaining up to date Give students new topics to learn each week (e.g. mental health conditions seen in the placement, treatments including medicines) and teach the other students 6. People can trust the newly registered graduate nurse to respond to their feedback and a wide range of other sources to learn, develop and improve services. 6.1 Uses supervision and other forms of reflective learning to make effective use of feedback from colleagues and managers Use the regular mentor meetings to get the student to reflect on their learning and give feedback on their strengths and areas in need of improvement ** The NMC term The Newly Registered Graduate Nurse is to be interpreted for the purposes of this assessment document as referring to the student nurse. * Unsafe Practice (USP) Safe Practice (SP) Good Practice (GP) Excellent Practice (EP) 25
28 Learning Outcome Suggested Activities/Evidence Level * Achieved Mentor s Initials Student s Initials Date 7. People can trust the newly registered, graduate nurse to promote continuity when their care is to be transferred to another service or person. 7.1 Assists in preparing people and carers for transfer and transition through effective dialogue and accurate information and reports any patient or carer concerns Provide opportunities to observe and then assist in the transfer/discharge of patients Ask students to identify key information that is required for successful transfer 8. People can trust the newly registered graduate nurse to be an autonomous and confident member of the multi-disciplinary or multi agency team and to inspire confidence in others. 8.1 Contributes to and values others roles and responsibilities within the team and supports and assists others appropriately 8.2 Reflects on own practice and discusses issues with mentors and colleagues to enhance learning 8.3 Communicates with colleagues verbally, face-to-face and by telephone, and in writing and electronically in a way that the meaning is clear, and checks that the communication has been fully understood Provide opportunities for students to observe and then participate in MDT meetings and hand over meetings Give feedback on how students work as part of the team Ask students to reflect on their experience and identify their learning in preparation for the regular meetings with their mentor Provide opportunities for students to communicate with the team verbally e.g. at hand over and listen to them on the telephone Ask students to complete written patient records and give feedback when countersigning Ask students to reflect on what is required for clear, concise verbal and written communication 9. People can trust the newly registered graduate nurse to work safely under pressure and maintain the safety of service users at all times. 9.1 Demonstrates professional commitment by working flexibly to meet service needs to enable quality care to be delivered. 9.2 Uses supervision as a means of developing strategies for managing own stress and for working safely and effectively. 9.3 Works safely in the community and in people s homes and adheres to safety policies such as lone worker policy. Inform students for lack of flexibility with shift patterns etc. Ask students to identify what professional commitment means and give them feedback on their performance Inform students straightaway if there is any cause for concern Use regular mentor meeting to discuss students ability to manage stress and discuss ways to manage this Try to meet weekly to discuss their progress and give encouraging feedback where possible Ask students to outline the key issues in relevant local policies e.g. lone worker 26 ** The NMC term The Newly Registered Graduate Nurse is to be interpreted for the purposes of this assessment document as referring to the student nurse. * Unsafe Practice (USP) Safe Practice (SP) Good Practice (GP) Excellent Practice (EP)
29 Learning Outcome Suggested Activities/Evidence Level * Achieved Mentor s Initials Student s Initials Date 10. People can trust the newly registered graduate nurse to identify and take effective measures to prevent and control infection in accordance with local and national policy Participates in assessing and planning care appropriate to the risk of infection, thus promoting the safety of service users Aware of the role of the Infection Control Team and Infection Control Nurse Specialist, and local guidelines for referral Recognises potential signs of infection and reports to appropriate member of staff. Provide opportunities for students to participate in the assessment of infection risk Ask students to outline appropriate measures to prevent and control infection and knowledge of the MRSA protocol Provide access to local infection control policies and procedures Ask students to explain the signs and symptoms of infection and give examples of infections they have observed 11. People can trust the newly registered graduate nurse to maintain effective standard infection control precautions and apply and adapt these to needs and limitations in all environments Safely uses and disposes of, or decontaminates, multi-use equipment between each person according to manufacturers instructions/local policy. Observe students working and inform them immediately if they do not clean or dispose of used equipment appropriately 12. People can trust a newly registered graduate nurse to provide effective nursing interventions when someone has an infectious disease including the use of standard isolation techniques Safely delivers care under supervision to people who require isolation or protective isolation 12.2 Takes appropriate action in any environment, including the home care setting, should exposure to infection occur e.g. chicken pox, diarrhoea and vomiting, needle stick injury 12.3 Applies knowledge of an exposure prone procedure and takes appropriate precautions and actions. Provide opportunities for students to observe and then provide care for people in isolation Ask students to consider how patients feel when being nursed in isolation Discuss trust/organisation procedures to be adopted in the event of exposure to infections or needle stick injury Ask students to explain how the risk of needle stick injuries can be minimised Ask student to outline what is meant by exposure prone procedures and discuss/demonstrate the necessary precautions and actions ** The NMC term The Newly Registered Graduate Nurse is to be interpreted for the purposes of this assessment document as referring to the student nurse. * Unsafe Practice (USP) Safe Practice (SP) Good Practice (GP) Excellent Practice (EP) 27
30 Learning Outcome Suggested Activities/Evidence Level * Achieved Mentor s Initials Student s Initials Date Understand the need to take personal responsibility to consult with occupational health before carrying out exposure prone procedures if a student has a blood borne virus. Discuss what is meant by a blood borne virus and why staff are required to report to occupational health 13. People can trust a newly registered graduate nurse to safely apply the principles of asepsis when performing invasive procedures and be competent in aseptic technique in a variety of settings Safely performs basic wound care using clean and aseptic techniques in a variety of settings. Provide opportunities for students to perform a variety of aseptic dressings and give feedback 14. People can trust the newly qualified nurse to act, in a variety of environments including the home care setting, to reduce risk when handling waste, including sharps, contaminated linen and when dealing with spillages of blood and other body fluids Adheres to health and safety at work legislation and infection control policies regarding the safe disposal of waste, soiled linen, sharps and blood and other body fluids in hospital and the home/care home setting Ensures people s dignity is preserved when collecting and disposing of bodily fluids and soiled linen Acts to identify and address potential risks in a timely manner in hospital and the home/care home setting. Discuss with students how clinical waste is managed in the community setting Observe students assisting patients with their elimination needs and changing beds and give feedback on what they did to preserve patient s dignity Ask students to assess the risk of infection for a variety of patients and the measures required to prevent/control infection 15. People can trust the newly registered graduate nurse to assist them to choose a diet that provides an adequate nutritional and fluid intake Under supervision helps people to choose healthy food and fluid in keeping with their personal preferences and cultural needs and accurately monitors dietary and fluid intake. Ask students to outline what a healthy diet consists of and why this is important Observe students assisting patients to choose their meals and give feedback 28 ** The NMC term The Newly Registered Graduate Nurse is to be interpreted for the purposes of this assessment document as referring to the student nurse. * Unsafe Practice (USP) Safe Practice (SP) Good Practice (GP) Excellent Practice (EP)
31 Learning Outcome Suggested Activities/Evidence Level * Achieved Mentor s Initials Student s Initials Date 15.2 Supports people with specific dietary and fluid regimens and maintains their dignity and independence wherever possible Identifies people who need assistance with eating or drinking and reports this to ensure adequate nutrition and fluids are provided. Ask students to explain why specific dietary and fluid regimens are required Ask students to find out what is available to enable patients to remain independent (e.g. large handle cutlery) Provide opportunities for students to complete nutritional assessments for patients and identify those at risk 16. People can trust the newly registered graduate nurse to assess and monitor their nutritional status and in partnership, formulate an effective plan of care Contributes to formulating a care plan through assessment of dietary preferences, including local availability of foods and cooking facilities. Provide opportunities for students to observe and then complete nutritional care plans 17. People can trust the newly registered graduate nurse to assist them to choose a diet that provides an adequate nutritional and fluid intake Follows local procedures in relation to mealtimes, (e.g. protected mealtimes) and ensures that people are in an appropriate location, position, offered opportunity to wash hands and offered appropriate assistance for the meal. Ensure that students are aware of local procedures in relation to mealtimes Observe students at work and ensure they offer patients the opportunity to wash their hands 18. People can trust the newly qualified graduate nurse to ensure that those unable to take food by mouth receive adequate fluid and nutrition to meet their needs Recognises, reports and responds appropriately when people have difficulty eating or swallowing Adheres to an agreed plan of care that provides for individual difference, cultural considerations, psychosocial aspects and provides adequate nutrition and hydration when eating or swallowing is difficult. Ask students to outline the procedure to be followed should a patient choke on food Ask students to imagine how it feels to experience difficulties in swallowing and what the patient s priorities might be ** The NMC term The Newly Registered Graduate Nurse is to be interpreted for the purposes of this assessment document as referring to the student nurse. * Unsafe Practice (USP) Safe Practice (SP) Good Practice (GP) Excellent Practice (EP) 29
32 Learning Outcome Suggested Activities/Evidence Level * Achieved Mentor s Initials Student s Initials Date 19. People can trust the newly registered graduate nurse to ensure safe and effective practice in medicines management through comprehensive knowledge of medicines, their actions, risks and benefits Uses knowledge of commonly administered medicines in order to act promptly in cases where side effects and adverse reactions occur. Ask students to learn 10 of the medicines regularly used in the placement; the type of drug, usual dose, action, side effects etc. 20. People can trust the newly registered graduate nurse to administer medicines safely and in a timely manner, including controlled drugs Prepares and safely administers medication orally and by injection under direct supervision. Provide opportunities for students to observe and then participate in drug rounds and preparation and administration of SC and IM injections 21. People can trust a newly registered graduate nurse to keep and maintain accurate records using information technology, where appropriate, within a multi-disciplinary framework as a leader and as part of a team and in a variety of care settings including at home Demonstrates awareness of roles and responsibilities for medicines management, within the MDT including the ways information is shared within a variety of settings. Ask students to outline the role of the doctor, pharmacist and nurse in relation to medicines management Discuss the information required by each professional to ensure safe administration of medicines e.g. allergies, underlying conditions etc. 22. People can trust a newly registered graduate nurse to work in partnership with people receiving medical treatments and their carers Under supervision involves people and carers in administration and self- administration of medicines. Involve students in the process of helping patients and/or carers to understand their medicines Reflect with the student afterwards to identify key issues/considerations 23. People can trust the newly registered graduate nurse to use and evaluate up-to-date information on medicines management and work within national and local policy guidelines Accesses commonly used evidence based sources relating to the safe and effective management of medicine. Ask students to demonstrate how to look up medicines in the BNF and explain what the various headings mean Ask students to find one book or article that outlines the procedure for safe administration of medicines 30 ** The NMC term The Newly Registered Graduate Nurse is to be interpreted for the purposes of this assessment document as referring to the student nurse. * Unsafe Practice (USP) Safe Practice (SP) Good Practice (GP) Excellent Practice (EP)
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