BSc (Hons) Midwifery Studies

Transcription

1 Faculty of Health and Life Sciences Pre-Registration Health Studies Programmes BSc (Hons) Midwifery Studies Year Three Practice Assessment Document (Module MW0619: Preparation for Working Life) September 2012 Cohort Student Midwife Name:... Placement Area:... Midwife Sign - Off Mentor:... Midwife Link Tutor:.. Guidance Tutor:...Angela King.angela.king@unn.ac.uk Practice Placement Facilitator:... 1

2 Practice Learning Outcomes for Year Three All of the practice learning outcomes listed below must be achieved by the student during year three of the programme. Highlighted outcomes must be achieved at the end of week 118 of the programme ( w/c/ 15/12/14) Practice Learning Outcomes 1 Effective communication with women and their families throughout the pre conception, ante natal, 16 intra partum and post natal periods 2 Provision of programmes of care which respect, promote and support individual s rights interests, 17 preferences, beliefs and cultures 3 Holistic assessment of health throughout the pre conception, ante natal, intra partum and post 18 natal periods 4 The confirmation of pregnancy and the care and support of women during pregnancy and monitor 19 their wellbeing 5 Care for and support women and monitor their well- being and that of the fetus during labour 20 6 Care for and support women and monitor their well- being and that of the fetus during the birthing 21 process 7 Care for and monitor the well- being of the neonate and provide support for the parents 22 8 Care for and support women during the puerperium and monitor their wellbeing 23 9 Provide advice and support on feeding babies including meeting nutritional needs Demonstrate safe and effective practice in the management of emergencies 26 11a Demonstrate safe and effective practice in the management of medicinal products 27 ( Intrapartum experience ) 11b Demonstrate safe and effective practice in the management of medicinal products 28 ( case loading experience) 12 Demonstrate safe and effective practice in the completion, storage and retention of records 30 13a Demonstrate safe and effective practice in the application of legal frameworks, professional 31 standards and requirements ( Intrapartum experience_ 13b Demonstrate safe and effective practice in the application of legal frameworks, professional 32 standards and requirements (Case loading experience ) 14 Refer women who would benefit from the skills and knowledge of others, working collaboratively 33 across professional boundaries and with other agencies and groups as required 15 Care for and monitor the wellbeing of women at risk and for whom the midwife is not the lead 34 professional during ante natal, intra partum and post natal periods. 16 Care for and monitor the well- being of the vulnerable neonate and provide support for the parents Care for and support women and families who are experiencing unfulfilled birth expectations, 36 pregnancy loss, peri-natal or other deaths. 18 Contribute to the well- being of women, families and their communities Manage and prioritise competing demands which impact upon individual service users and the 38 wider organisation of midwifery care 20 Develop and enhance fitness to practice as a midwife 40 Page 2

3 NOTES FOR GUIDANCE These must be read in conjunction with the sign-off mentor handbook The student and sign-off mentor should carefully study the content of the practice assessment documentation (PAD) at the beginning of the placement. The practice outcomes for this period of practice learning experience contribute to the NMC Competencies required to achieve the NMC Education Standards. These are listed fully in the UNN mentor handbook. The NMC also require evidence that students have met the requirements of the Essential Skill Clusters, which are also listed in the mentor handbook and have been mapped against the practice learning outcomes and criteria in this booklet. Any issues associated with completing the practice assessment documentation can be discussed with the midwife link teacher (MLT) or guidance tutor (GT) at any time. The student and sign-off mentor must consult the practice learning outcomes and performance criteria listed in the practice assessment document (PAD). The required outcomes and the information from previous placements/guidance tutorials will assist the sign-off mentor and the student to make an appropriate action plan to meet the students learning needs. Previous learning summaries must be reviewed via the Placement Assessment Summary records to inform the planning process and to meet NMC requirements regarding ongoing record of achievement. Students will have received guidance regarding planning for learning from their guidance tutor during preparation for the practice learning experience. Students should summarise and record key evidence relating to each practice learning outcome and criteria in the space provided in the PAD booklets. Consideration of any reasonable adjustment a student may require in relation to practice experience should be part of the planning process. For example, the equipment required for students with hearing impairments in relation to outcomes 4 and 5. Reasonable adjustments are agreed prior to placement experiences and full details of this process are available in the practice placements handbook. The student s level of performance should normally be discussed during weekly reviews. Weekly constructive feedback, based on the student s recorded evidence of their performance will help to facilitate the student s personal and professional development throughout the placement. This will be recorded in their weekly learning log. Areas of strength and any areas of concern must be documented in the action plan, which is part of the learning log. This will enable the student to provide evidence of practice learning and the sign-off mentor to verify the evidence utilised to inform assessment decisions. 3

4 The mid-placement formative review of student progress and projected performance between the sign-off mentor and student will be discussed and recorded on the mid-placement review traffic light form. It must be completed by the midpoint of the practice experience. If amber or red is triggered the mentor must inform the MLT without delay,and action planning will be initiated. If a student is not achieving as planned at any point in the placement OR if you have any significant areas of concern, then contact MUST be made with the MLT or PPF. It is important that reasons for failing are documented on the assessment of practice documentation. The student must be made aware as soon as possible that she/he is not achieving or if there are significant concerns regarding the placement. The Placement Assessment Summary form must be discussed and completed by the sign-off mentor at the end of the intrapartum and community placements. The student must also sign the form to show they have read the comments. In preparation for the tripartite assessment a summative assessment decision (achieved/not achieved) will be made and documented by the sign-off mentor in relation to the student s achievement of the practice learning outcomes. The grading for this placement will require the student to complete a combined theory and practice assessment within the placement setting. The student will articulate and discuss their practice experiences and evidence they have collected in a viva in order to demonstrate their preparedness for midwifery registration and their achievement of the required practice outcomes for the programme. In addition to the viva the MLT and mentor will review a selection of evidence. At the end of the tripartite assessment the midwife teacher will retain the student s assessment documentation for internal quality mechanisms. 4

5 PRACTICE LEARNING AND ASSESSMENT PROCESS Pre-Practice Experience Week One of Placement Mid-Placement End of Placement Post-Practice Experience Pre-practice seminar with GT. Student becomes familiar with documentation and requirements for this practice experience Initial meeting: With student and sign-off mentor. Orientation and action planning Formal Mid Placement Review: With student and sign-off mentor to review progress and complete traffic light form Seminar/ study day: With GT to review progress & evidence Summative assessment decision including viva Made by sign-off mentor, supported by a midwife link teacher Post-practice seminar with GT, reviewing experiences and student s ongoing record of achievement PRACTICE EXPERIENCE Student collects and documents evidence of their practice experiences and abilities The sign-off mentor continuously assesses the student s abilities, using a range of assessment methods Process supported by the Practice Learning Team... Sign Off mentors and Lead Mentors Supervisors of Midwifes Practice Placement Facilitators (PPFs) Guidance Tutor (GT) Midwife Link Teacher 5

6 Year 3 Practice Placement The year three practice experience is one integrated 27 week placement separated into two parts by a block of theory. The student will have 2 identified sign-off mentors; the principle sign-off mentor will be based within the community, the second based on the associated delivery suite. The student will commence with a 1 week community placement, to orientate and commence identifying women for their caseload. They will then have a seven week core delivery suite experience to consolidate the student s knowledge, understanding and skills in relation to the support of the normal birthing process. Identified practice outcomes specific to the birth experience must be achieved and signed off by the sign off mentor ( delivery) during the seven week delivery suite experience. The emphasis will be upon the student midwife recognising the needs of women around the time of birth and developing confidence in the care and management required at this time. The remaining placement time will involve the student having a core placement on the community but also engaging in experiences to ensure she/he achieves the practice learning outcomes within this document. In order to achieve this the student must discuss with her/his sign-off mentor and midwife link tutor to identify experiences appropriate to their learning needs.. In addition the student is required to develop skills in managing a case load which are expressed in practice learning outcome 19. The NMC (2009) state that The programme must develop the knowledge and skills of student midwives,so that at the point of registration they are competent and confident in supporting women in normal childbirth. Included in this focus must be skills in critical decision making to support appropriate referral to other health professionals or agencies when there is recognition of normal processes being adversely affected and compromised NMC(2009) Standards for pre-registration midwifery education.london:nmc Placement Weeks Week of 27/10/2014 will be community based,to enable the student to meet her sign-off mentor and identify a small group of women in early pregnancy for her caseload Weeks 03/11/ /12/2014 (7 weeks) will be a hospital intrapartum placement and the designated practice outcomes which align to Module MW0619: Preparation for Working Life will be assessed (achieved or not-achieved) at the end of the placement. Grading involving all the competencies will be completed at the end of the year. Weeks 16/02/2015, 23/02/2015 and 02/03/2015 will involve 2 days practice and 3 days theory time Weeks 09/03/ /08/2015 include 19 community based weeks,the students will be actively involved in all aspects of care to achieve practice outcomes and their caseload requirements,opportunities for home birth experience should be maximised. Week of 25/05/2015 is programmed as annual leave,this is flexible and the student may negotiate with the mentor to take 5 days (37.5 hours) at another time as a full week or any combination of individual days during the community placement weeks. The integrated practice based summative assessment which aligns to Module MW0619 Preparation for Working Life will take place during the final two weeks of placement.the remaining practice outcomes will be assessed (achieved or not-achieved),evidence will be reviewed and a viva performed to determine a final grade/mark. The assessment will be undertaken jointly by the sign-off mentor and the MLT 6

7 Negotiated experience During the community placement students have the opportunity to negotiate learning experiences they think will be beneficial to their professional development in consultation with their mentor and MLT. A period of up to 3 weeks (112.5 hours) may be utilised. It is expected that the student herself will negotiate to access these placements. Students may consider an experience in maternity locations in their own or another trust,perhaps to gain experience with other client groups,specialist midwives,community breastfeeding support services,perinatal mental health services,fetal medicine at RVI or the mother and baby unit at St George s hospital in Morpeth. Any experience accessed out with our placement trusts will be observational,when planning experience in another trust the PPF should be contacted.students will be expected to identify the experience and the learning value in their learning log and evidence to substantiate the achievement of practice outcomes. Guidelines for Case Load Working The NMC (2009) state that Students must provide care and support to a group of women from early in their pregnancy, throughout the antenatal period, during the labour and birth and then into the postnatal period until care by the midwife is complete. This may take the form of caseload holding. Providing this experience to all student midwives enables them to better understand the impact of pregnancy, birth and the integration of a new baby into family life, as well as learning about the practicalities of planning, implementing and evaluating midwifery care in a way that is relevant to women. NMC(2009) Standards for pre-registration midwifery education.london:nmc Guidance: Students will spend the first placement week (27/10/2014) with the Community Midwife sign-off mentor and identify at least 5 women in early pregnancy as a caseload. These will be women who offer the potential for the student to manage care with substantial involvement in their antenatal,intrapartum and postnatal care.it is expected that the student will maintain contact with these women during their intrapartum placement and university study block either directly with the women or via their mentor. The points outlined below should be taken into account when selecting women: The woman can be a primigravida or multigravida. A woman may have chosen a home or hospital birth place. Women chosen will have an EDD during the community placement weeks The woman should not have any major obstetric risk factors. Consider choosing women who have social issues that require additional midwife and other agency support,these may include women who are homeless/live in shelter accommodation, are recent immigrants to the UK,women from travelling communities those seeking asylum,women who have experienced domestic violence. Consider including women with mental health problems. The mentor will gain the informed consent of the woman / family. It is your responsibility to make safe travel arrangements, if you have agreed to be called out of working hours, and to make your contact details and on call arrangements known to your mentor and the hospital staff (do not give women your personal telephone number) The Midwife Link teacher will support the process of case selection and ongoing monitoring of progress and achievement of the practice competencies 7

8 Caseload Experience Evidence of Achievement Practice Outcome 19 specifically relates to case load requirements: a) Manage a case load of a small group of women throughout their childbirth experience including antenatal,intranatal and postnatal care b) Demonstrate professional and personal leadership skills in the context of midwifery practice c) Confident working within a variety of models of service delivery and negotiating with others when necessary to manage competing priorities d) Able to use a variety of methods to judge the quality of care provision and contribute to governance,audit and service improvement e) Inspires confidence via effective evidence based decision making in a range of care contexts,safely identifying,managing,reducing or removing risk f) Identifies and describes procedures for dealing with raised concerns:complaints,unsafe practice, breaches of security, accidents g) Discuss how service users(individuals and communities)are involved with planning and evaluating local maternity services Evidence which will be useful to support achievement of this practice outcome A record of all caseload cases must be documented, and contribute to the evidence of achievement for Practice Outcome 19. The minimum information should include: - Case Number - Brief history and description of the case, including the outcome for the woman and her - family - Details of care events during antenatal care, care during labour and birth, postnatal - mother and baby care Care experience which illustrates the skills and qualities of leading care across the range of required experiences.this must include caseload cases and reflect the care of a minimum of five women. Reflection upon the performance of self and midwifery practice in relation to this outcome including an analysis and appraisal of the theory and practice interface.the reflective models suggested in the PPDF are a useful source for this activity. UNICEF UK Baby Friendly University Standards The Tomorrow, workforce (TWF) Pre-Registration curriculums has incorporated the UNICEF UK Baby Friendly University Standards,and the practice outcomes in each year of the programme are mapped with the standards.the students in the September 2012 cohort will be participating in the UNICEF University Accreditatation final stage 2 evaluation during this final year of their programme. Information regarding the standards and revised learning outcomes can be accessed via the UNICEFwebsite. 8

9 Evidence to Support achievement of Practice Outcomes in Year 3 Students are required to provide evidence to support their achievement of all the practice outcomes. A range of evidence may be utilised. For example: Practice Learning Log Skills Passport Case Studies Critical Incident Analysis Testimony of Witness Identification and summary of learning and relevance of a range of material specific to the practice outcome and its application to the practice context, e.g. Trust guidelines, NICE guidance/care pathways, research studies, literature reviews, web based resources For some practice outcomes there may be more specific evidence guidance which you are required to present (see outcomes 9, 11b, 19). 9

10 Modules of Study The modules of study undertaken by the student midwife in year 3 aim to complement their practice experience. By successfully completing these modules, the student will be expected to achieve the following: MW0624 Evidence Based Practice project Aims of Module The module aims to develop students' ability to make informed use of published research and other sources of information; to be able to synthesise several sources of evidence; and to apply evidence and research to evaluate and enhance practice situations. Learning Outcomes Articulate and justify an evidenced-based focus relevant to their own practice and profession. Critically appraise and synthesise evidence from a range of sources. Debate different methodological designs and ethical implications and apply research findings appropriately in context. Evaluate levels of evidence and the implications for building the evidence base for their profession. Discuss clinical reasoning/decision making based on a range of factors, including research, practice evidence and impact of collaborative working with services users, carers and other professional groups. MW0616 Consolidating Practice Around Birth Care Aims of Module The aim of the module is to enhance and further develop midwifery skills to support the care of women/fetus/infant during labour and birth including the early perinatal period, by undertaking a critical evaluation of the contextual factors and the range of evidence that underpins contemporary approaches to care. The module aims to support an extended period of integrated practice during which the student will address development of proficiencies as a midwife Learning Outcomes 1. Critically debate the concept of normality. 2. Analyse the diverse role of the midwife in facilitating normal birth. 3. Relate appropriate knowledge to demonstrate safe and effective midwifery skills in the care of women and infants during labour and childbirth. 4. Examine the range of contextual factors that influence care provision in labour & birth in contemporary practice. 5. Evaluate evidence that underpins woman-centred midwifery care in labour and birth. 10

11 MW0617 Consolidating Practice for Maternal and Infant Care Aims of Module The aim of this module is to enhance, develop and equip the student with the skills necessary to undertake their role as lead carer in the antenatal and postnatal contexts, including the development of caseload working. Students will debate and critically review midwifery practice and the parameters of normality in the antenatal and postnatal periods; problem-solving and constructing appropriate evidence-based care for women in relation to more complex case analyses, which address and represent service user perspectives. The module aims to support an extended period of integrated practice during which the student will address development of proficiencies as a midwife. Learning Outcomes 1. Critically analyse their own contribution to midwifery care in relation to antenatal and postnatal contexts with specific reference to caseload practice. 2. Review and appraise holistic healthcare needs for women, babies and families, ensuring the provision of appropriate safe and effective midwifery care. 3. Consolidate skills for assessing normality and risk in the antenatal and postnatal periods, including the ability to prioritise needs, manage and refer as appropriate. 4. Evaluate the evidence which underpins women, baby and family centred care in the antenatal and postnatal periods. MW0618 leading and Improving Midwifery Aims of Module This module aims to prepare the student to develop their skill, knowledge and competence in order to undertake a collaborative service improvement project. The module will include exploration and evaluation of contemporary theories and evidence-based tools, which impact on midwifery practice. It will enable students to examine further the impact that leadership and change management have on improving services. Appraise present professional skills, knowledge and practice, and provide evidence of how those areas have developed through leading and implementing a service improvement project. Analyse professional relationships with service user's carers and other disciplines in order to evaluate how collaboration improves patient outcomes and adheres to professional standards. Critically analyse risk assessment processes and the collaborative management of patient safety in professional practice. Demonstrate critical awareness of cost effectiveness, organisational barriers and sustainability when developing and implementing a collaborative service improvement. Critically analyse change management tools and decision making processes which inform and underpin all professional practice. 11

12 MW0619 Preparation for Working Life Aims of Module The module aims to prepare students for their role as accountable practitioners of midwifery by undertaking a critical evaluation of the components and complexities of the role and the evidence that underpins contemporary approaches to professional practice. The module aims to support an extended period of integrated practice during which the student will address development of proficiencies as a midwife, which includes experience of caseload holding to enable students to effectively lead, manage and prioritise care for childbearing women and their infants. Learning Outcomes 1. Critically debate the concept of "professional judgement" and the role of the midwife in leading, managing and prioritising care for women in childbirth. 2. Evaluate a range of service provision models in relation to their effectiveness regarding care delivery and workload practices. 3. Examine a range of frameworks and contextual factors that influence clinical decision making. 4. Evaluate the evidence underpinning risk assessment processes and their management in practice. 5. Critically reflect upon personal and professional development, readiness to practice as a graduate midwife in relation to professional and regulatory bodies and employer expectations. 6. Achieve required competencies appropriate to practice learning experiences. The assessment for the module will involve the sign-off mentor and an academic staff member coming together to review the students' viva presentation of evidence drawn from the PPDF, including practice assessment feedback and formative activities, which will demonstrate readiness for entry on to the professional register. 12

13 EXPERIENCES OF PARTICULAR VALUE Working with other professional groups Procedures for management of obstetric emergencies Care of low risk women in normal labor Intranatal Drug administration and storage Immediate care of the baby Normal birth and immediate care Ongoing care and support past 10 days Services for vulnerable women and children Community, antenatal & postnatal care Community based midwifery services Midwifery Supervision and Risk Management Case load of low risk women Hospital Based Care 13

14 Orientation to Practice Experience Community The following issues are to be explained to the student during the first week in the practice area. Mentor and student should sign the checklist when completed to the satisfaction of both parties. Profile of Practice Area Mentor Signature Student Signature Date Philosophy of Care Policy/Guidelines for Practice Health and safety and risk assessment including discussion of personal safety Location of Facilities and Equipment (including equipment for moving and handling and resuscitation) Procedure in the event of Fire Procedure in the event of Obstetric Emergency Policy for the Receiving and Referring of Messages/Enquiries Name of the Midwife Link Teacher, Guidance Tutor / PPF and Contact Arrangements Review of practice learning outcomes for this placement experience and initial planning for learning Discuss professional expectations such as uniform and punctuality Discuss time keeping and documentation of attendance /absence Discuss PPDF and relationship to placement learning including ongoing record of achievement Discussion of numbers book / skills passport 14

15 Orientation to Practice Experience Birth experience The following issues are to be explained to the student during the first week in the practice area. Mentor and student should sign the checklist when completed to the satisfaction of both parties. Profile of Practice Area Philosophy of Care Policy/Guidelines for Practice Health and safety and risk assessment including discussion of personal safety Location of Facilities and Equipment (including equipment for moving and handling and resuscitation) Procedure in the event of Fire Procedure in the event of Obstetric Emergency Policy for the Receiving and Referring of Messages/Enquiries Name of the Midwife Link Teacher, Guidance Tutor / PPF and Contact Arrangements Review of practice learning outcomes for this placement experience and initial planning for learning Discuss professional expectations such as uniform and punctuality Discuss time keeping and documentation of attendance /absence Discuss PPDF and relationship to placement learning including ongoing record of achievement Discussion of numbers book / skills passport Mentor Signature Student Signature Date 15

16 Practice Outcome 1: Under supervision of the midwife observes and participates in: Effective communication with women and their families throughout the pre conception, ante natal, intra partum and post natal periods Range of experiences should include; Examples should include those with linguistic, mechanical and comprehension difficulties a) Consistently shows ability to communicate safely and effectively with women; providing guidance for juniors b) Is able to listen to women enabling them to think through feelings and make informed choices about their health and care c) Where appropriate uses the skills of active listening, questioning, paraphrasing and reflection to assist in verbal and non verbal communication d) Uses appropriate and relevant communication skills to deal with difficult and challenging circumstances in individual and group scenarios e) Acts professionally and appropriately in situations where there may be limits to confidentiality( safeguarding of vulnerable children/adults0 f) Provides accurate information in a format which is easy to understand and is able to discuss actions and consequences with women g) Understands and applies legal frameworks when ontaining consent and consistently uses appropriate strategies to enable informed consent h) Anticipates how women may feel and responds with empathy providing physical and emotional comfort including appropriate use of touch i) Effectively uses a variety of media to communicate with women Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement 1 Completed by student and verified by sign off mentor Outcome 1 : Effective communication with ACHIEVED (evidence verified) women and their families throughout the pre conception, ante natal, intra partum and post natal periods End of Placement Comments by Sign-Off Mentor NOT ACHIEVED 16

17 Practice Outcome 2: Under supervision of the midwife undertakes and leads in: The provision of programmes of care which respects, promotes and supports individual s rights interests, preferences, beliefs and cultures. Range of experiences should include; Examples should include discussion with women regarding screening, the place of birth, birth plans, offering choice re: care labour, provision of postnatal care. Including low risk, high risk and complex care. a) Consistently uses a range of evidence and data to identify the needs of women, babies and families to inform planned care. b) Demonstrates respect for client autonomy and the rights of women to be involved as partners in their care. This includes when a particular choice may result in harm to themselves or their unborn child, unless a court of law orders the contrary. c) Uses appropriate strategies to encourage and promote choice for all women in the provision of maternity care. Promoting care environments that are diversity sensitive and free from exploitation, discrimination and harassment. d) Articulates a clear plan of care which assimilates the local context and the culture and choices of the women involved. e) Actively engages in partnerships with women that are sensitive to age, culture, spiritual beliefs, disability, gender and sexual orientation. And speaking out if these rights are compromised. f) Facilitates informed choices regarding antenatal screening tests ensuring women fully understand the purpose of all tests before they are taken. g) Discuss with women local/national information to assist with making choices, including local and national voluntary agencies and websites. h) Is able to seek out required information about less common/specialised ante natal screening tests. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 2 : The provision of programmes of care which respects, promotes and supports individual s rights interests, preferences, beliefs and cultures. ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor 17

18 Practice Outcome 3: Under supervision of the midwife undertakes and leads in: Holistic assessment of health throughout the pre conception, ante natal, intra partum and post natal periods Examples should range across the childbirth continuum and include biophysical measures such as, blood tests, urinalysis, vital signs and BMI; also psychosocial assessments such as domestic violence, alcohol and substance misuse, mental health problems. Involving Women, babies and equipment; Mobile clients and clients with limited mobility a) Demonstrates skill in undertaking an accurate assessment taking into account maternal history and current concerns. b) Can distinguish between information which is relevant to care planning and that which is not. c) Takes initiative to ensure informed choices regarding antenatal screening tests ensuring women fully understand the purpose of all tests before they are taken and is able to seek out information about less common/specialized tests. d) Can accurately interpret data and results and share this information sensitively with women including the ability to discuss any further action or consequences. e) Consistently demonstrates competence in maintaining a safe environment for women and colleagues using relevant evidence and providing guidance for juniors, e.g. safe use of equipment. f) Delivers care with dignity. Challenges situations / others where dignity is compromised. g) Promotes a care environment that is diversity sensitive and free from discrimination and harassment. h) Assess and implement measures to manage, reduce or remove risk that would be detrimental to the woman, self or others. i) Demonstrates skill in providing women with the opportunity to disclose domestic abuse and is able to respond appropriately. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 3 Holistic assessment of health ACHIEVED (evidence verified) throughout the pre conception, ante natal, intra partum and post natal periods End of Placement Comments by Sign-Off Mentor NOT ACHIEVED 18

19 Practice Outcome 4: Under supervision of the midwife undertakes and leads in: The confirmation of pregnancy and the care and support for women during pregnancy and the monitoring of their wellbeing Range of experiences should include; Examples should include women at different stages of pregnancy, single and multiple pregnancies, first and subsequent pregnancies Low and high risk pregnancies, at home and in institutional settings a) Consistently shows the ability to assess maternal and fetal wellbeing relevant to gestation and acts upon the need to refer when necessary. b) Enables women to recognise normal pregnancy development and when to seek advice. c) Identifies the rationale for and where possible is actively involved in the provision of care in non-traditional NHS settings, e.g. voluntary agencies, and local authority services d) Demonstrates evidence based practice in the provision of ante natal care which is consistent and effectively identifies and manages risk. e) Demonstrates the ability to ensure client safety and promote wellbeing during pregnancy. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 4: The confirmation of ACHIEVED (evidence verified) pregnancy and the care and support for women during pregnancy and the monitoring of their wellbeing End of Placement Comments by Sign-Off Mentor NOT ACHIEVED 19

20 Practice Outcome 5: Under supervision of the midwife undertakes and leads in: The care and support for women and monitoring of their well-being and that of the fetus during labour. Range of experiences should include; Women at different stages of their labour process. First and subsequent pregnancies and births. A range of birth settings may include hospital, midwifery led birth centre & home. a) Ensures that women s labour and birth is diversity sensitive and meets individual needs and preferences. b) Applies in depth knowledge of the physiology of labour and birth. c) Identifies the onset of labour and discusses the findings accurately sharing the information with women including any further actions. d) Consistently and accurately assesses maternal and fetal wellbeing sharing the information with women including any further actions. e) Identifies and appropriately manages the latent and active phases of labour, using a variety of methods including examination and observation. f) Anticipates and leads care which responds to maternal comfort and support needs, including responding to discomfort and pain during labour. g) Able to assess progress in labour and discuss findings with women amending birth or care plans accordingly assessing progress and sharing information with women. h) Critically appraise and justify the use of any intervention such as artificial rupture of membranes or continuous electronic fetal monitoring as part of the management of normal birth. i) Recognise any deviation from the normal progress of labour or the wellbeing of the woman or fetus and implements timely referrals. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 5: The care and support for women and monitoring of their well-being and that of the foetus during labour ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor 20

21 Practice Outcome 6: Under supervision of the midwife undertakes and leads in: The care and support for women and monitoring of their well being and that of the fetus during the birthing process Range of experiences should include; Women at different stages of their labour process. First and subsequent pregnancies and births. A range of birth settings may include hospital, midwifery led birth centre & home a) Accurately assesses the birthing process, including latent and active phases, monitoring maternal and fetal wellbeing and responding appropriately. b) Can lead the preparation of the environment ready for birth. in accordance with parent s wishes and safety requirements including explanations of any equipment that may be required c) Safely supports women in the birth of their baby, providing guidance and assistance. d) Sensitively cares for women being attentive to the moment of birth and responding to woman s needs. e) Discusses the rationale for the care and support of the woman during the birthing process. f) Assess and monitor the woman s condition throughout the third stage of labour facilitating safe delivery of the placenta and membranes by physiological or active management g) Accurately assess the immediate post birth wellbeing of the woman and takes any necessary action to ensure her safety and minimize risk. h) Can undertake an episiotomy and repair the perineum using a recognized evidenced based method. (may be achieved via simulation) i) Supports feeding when the baby is ready ensuring close proximity to the mother and the rationale for skin to skin contact Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 6: The care and support for women and monitoring of their well being and that of the fetus during the birthing process ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor 21

22 Practice Outcome 7: Under supervision of the midwife undertakes and leads in: The care of the baby and monitoring of their well-being and the provision of support for the parents. Range of experiences should include; Forms and location of Examples should include immediate and ongoing care through to evidence to validate discharge from midwifery care. At home and in an institutional setting achievement Completed by Following normal and assisted births. Physical, social and emotional student and verified by sign health. off mentor a) Accurately assesses the health and wellbeing of the newborn baby, applying understanding of physiological adaptation. b) Anticipates and acts on the need for referral e.g. peri natal infection, birth trauma and jaundice c) Demonstrates skill in promoting parent infant interaction, avoiding unnecessary separation of mother and baby and takes appropriate action to enable bonding when separation is unavoidable. d) Takes the lead in creating an environment which sensitive to individual and cultural differences surrounding attachment process. e) Ensures a safe environment for the baby taking undertaking appropriate assessments and actions and sharing information with women regarding promoting infant health and wellbeing, e.g. identification, thermoregulation and safety f) Acts upon the need to refer when there is a deviation from appropriate infant growth. g) Ensures women can recognise deviations from normal and feel confident to seek advice re any concerns. h) Assess and plan individualised care for the baby in partnership with woman considering the social, religious, cultural and emotional circumstances. i) Undertake examinations and screening tests as appropriate and as identified by Child Health Promotion Programme (CHPP). j) Discuss with the woman and her family key aspects of the CHPP. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Outcome 7: The care of the baby and monitoring of their well-being and the provision of support for the parents. ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor 22

23 Practice Outcome 8: Under supervision of the midwife undertakes and leads in: The care for and support of women during the puerperium and the monitoring of their wellbeing Range of experiences should include; Forms and location of Examples should include immediate care through to discharge from evidence to validate midwifery care, normal, assisted births and caesarean birth and including achievement Completed by women with complex care needs. Including physical, emotional and social student and verified by sign needs. off mentor a) Is able to assess the purpose, significance and timing of post natal assessments. b) Can accurately interpret data / results and share this information sensitively with women, including the ability to discuss any further action / consequences as necessary. c) Consistently uses appropriate evidence to promote wellbeing and minimize risk during the puerperium. d) Works in partnership with women ensuring understanding regarding post natal recovery and emotional adjustments. e) Demonstrates understanding of impact of deviations from normal recovery and take appropriate action including delivering care which provides both practical and emotional support f) Recognises, and responds to, the significance of maternal behaviour and mood changes and the identification of risks which require referral to specialist services. g) Gives appropriate and safe guidance to women regarding sexual health and family planning and ensures that women are aware of the availability and location of local services. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Outcome 8: The care for and support of women during the puerperium and the monitoring of their wellbeing ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor 23

24 Practice Outcome 9: Under supervision of the midwife undertakes and leads in: The provision of advice and support on feeding babies including meeting nutritional needs Range of experiences should include; Examples should include Supporting and informing women and others throughout the childbirth continuum, including primiparous and multiparous women, face to face and via the telephone a) Leads in a variety of forums where information is shared with women about the advantages and disadvantages of different infant feeding methods without regarding breastfeeding and artificial feeding as equal choices b) Is thoroughly conversant with the Baby Friendly Initiative best practice standards, and the midwife role and responsibility in implementing best practice c) Evaluate the implementation and effectiveness of Baby Friendly Initiative best practice standards and local initiatives in the workplace and locality d) Confident at exploring with women the potential impact of delivery room practices upon breastfeeding,to include different pain relief methods and skin to skin contact on the wellbeing of mother and baby and on the establishment of breastfeeding e) Communicates accurate,evidence based unbiased information with mothers on activities that may have an impact on breastfeeding and infant health. These should include; attitudes to breastfeeding mother infant separation restricted feeding practices use of teats, dummies, nipple shields supplementation adult-infant bed sharing f) Critically evaluates the care provided in a selection of cases where there were infant feeding challenging circumstances. (within infant feeding workbook) g) Actively liaises with professional and community based support networks, involves appropriate help such as a lactation consultant when specialized skills are required to support successful breastfeeding h) i) Keeps accurate records relating to infant feeding including plans of care, any problems encountered and referrals. j) Discusses with women the importance of exclusive breastfeeding for 6 months and timely introduction of complementary foods and continuing breastfeeding during the weaning period and beyond. k) Demonstrates effective interpersonal skills when sharing information with women In face to face and over the telephone conversation, takes into account differing cultural traditions, beliefs and personal attitudes and professional ethics. Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor 24

25 Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Outcome 9: The provision of advice and support on feeding babies including meeting nutritional needs ACHIEVED (evidence verified) NOT ACHIEVED (Mentor signature and date) End of Placement Comments by Sign-Off Mentor Evidence which will be expected to support achievement of this practice outcome Cases which illustrate both skills and abilities and leading care in this area and which address the range of experiences required.this must include a minimum of 5 case studies detailing care episodes,rationale and evaluation Identification and appraisal of a range of relevant material appropriate to the provision of advice and support on feeding babies and meeting their nutritional needs with reference to the Infant Feeding Workbook,trust breastfeeding policy and strategy to achieve UNICEF Baby Friendly Accreditation,dialogue with Infant Feeding Coordinator, WHO International Code of Marketing Breast Milk substitutes and relevant UK Legislation,web based resources,research studies,literature reviews Skills passport sections and Learning Log relevant to the practice outcome and criteria. Reflection upon the performance of self and midwifery practice in relation to this outcome. 25

26 Practice Outcome 10 : Under supervision of the midwife undertakes and leads in: Safe and effective practice in the management of emergencies. Range of experiences should include; Examples should include community and hospital based care and emergency procedures including maternal, fetal, neonatal and environmental emergencies a) Demonstrates skill in procedures related to obstetric emergencies including leading and working with other staff, including PPH and shoulder dystocia. (list those experienced in real time or via simulation). b) Confident in initiating basic emergency call procedures in both primary and secondary settings and can sustain emergency measures until help arrives. c) Recognise and act accordingly when confronted with deteriorating patients in both primary and secondary settings. d) Initiates emergency measures if required, such as episiotomy, basic life support of the infant or woman. e) Demonstrate sound understating of the physiology which underpins obstetric emergencies and the evidence which supports their management. f) Has undertaken annual updating regarding fire and evacuation training. g) Continues to provide holistic care to women and their family including providing information and contact with infant post delivery. h) Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 10: Safe and effective practice in the management of emergencies. ACHIEVED (evidence verified) (Mentor signature /date) NOT ACHIEVED (Mentor signature /date) End of Placement Comments by Sign-Off Mentor 26

27 Practice Outcome 11a ( Intrapartum experience) Under supervision of the midwife undertakes and leads in: Safe and effective practice in the management of medicinal products. Examples should include hospital based intrapartum care, a variety of routes and medicines utilised throughout the maternal childbirth continuum & fetal/neonatal care a) Explains basic pharmacology and applies knowledge of therapeutic action to midwifery practice in intrapartum care b) Is able to take a medicine history within a midwifery context. c) Is aware of personal accountability in respect of supplying and administering unlicensed products. d) Utilises and accurately interprets medicine legislation related to midwives exemptions, and is conversant with pharmacy only and general sales lists, midwives supply orders and patient group directives. e) Accurately calculates doses of medicinal products utilised during childbirth f) Safely manages drug administration via routes and methods commonly used in normal midwifery practice and maintains accurate records using prescription charts correctly.to include oral, inhalation,intra-muscular, per vaginum, per rectal and self administration routes g) Consistently evaluates and monitors the effect of medicines - their effect on the woman, fetus, neonate and progress of labour, including anticipating and acting promptly to report and manage care when side effects, adverse reactions or anaphylaxis occur. h) Demonstrates ability to safely order, receive, store and dispose of medicinal products including controlled drugs and applies knowledge of local and national policies. i) Confident in accessing commonly used evidenced based sources of information relating to the safe and effective use of medicinal products and can question when medicinal products may or may not be an appropriate choice. j) Ensures information sharing is women centred enabling women to make safe and informed choices about medicinal products during birth and in the perinatal period. k) Assesses and meets maternal needs in relation to pain relief during child birth. l) Demonstrates understanding of the need for recognised competence in providing complementary therapy and/ or advice Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor and identifies appropriate referral pathways to a registered complementary therapist. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Outcome 11a: Safe and effective practice in the management of medicinal products. (Intrapartum experience) ACHIEVED (evidence verified) NOT ACHIEVED (Mentor signature and date) End of Placement Comments by Sign-Off Mentor 27

28 Practice Outcome 11b: (Caseloading experience) Under supervision of the midwife undertakes and leads in: Safe and effective practice in the management of medicinal products. (caseloading experience) Examples should include community and hospital based care, a variety of routes and medicines utilised throughout the maternal childbirth continuum & neonatal care a. Explains basic pharmacology and applies knowledge of therapeutic action to all aspects of midwifery practice. b. Is able to take a medicine history within a midwifery context. c. Is aware of personal accountability in respect of supplying and administering unlicensed products. d. Utilises and accurately interprets medicine legislation related to midwives exemptions, and is conversant with pharmacy only and general sales lists, midwives supply orders and patient group directives. e. Accurately calculates doses of medicinal products utilised during the antenatal, postnatal and neonatal periods f. Safely manages drug administration via routes and methods commonly used in normal midwifery practice and maintains accurate records using prescription charts correctly.may include oral, inhalation, intramuscular, self administration, intraocular routes g. Consistently evaluates and monitors the effect of medicines - their effect on the woman, fetus, neonate including anticipating and acting promptly to report and manage care when side effects, adverse reactions or anaphylaxis occur. h. Demonstrates ability to safely order, receive, store and dispose of medicinal products including controlled drugs and applies knowledge of local and national policies. i. Confident in accessing commonly used evidenced based sources of information relating to the safe and effective use of medicinal products and can question when medicinal products may or may not be an appropriate choice. j. Achieved a score of 100% in the safe medicate assessment k. Ensures information sharing is women centred enabling women to make safe and informed choices about medicinal products during pregnancy birth and in the post natal period. l. Assesses and meets maternal needs in relation to pain relief throughout pregnancy, birth and in the postnatal period m. Assess the woman s ability to administer medicines to herself and when prescribed and required, her infant, and gives clear instructions, confirming understanding in relation to the use of medicines. n. Demonstrates understanding of the need for recognised competence in providing complementary therapy and/ or advice and identifies appropriate referral pathways to a registered complementary therapist. o. Demonstrates understanding of how medicine legislation would apply to self employed practice. p. Keeps effective records of medication supplied and administered in primary settings Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor 28

29 Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Outcome 11b: Safe and effective practice in the management of medicinal products. ( Caseloading experience) ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor Evidence to support achievement of this practice outcome must include demonstration of a score of 100% in the Safe medicate assessment 29

30 Practice Outcome 12 : Under supervision of the midwife undertakes and leads in: Safe and effective practice in the completion, storage and retention of records Range of experiences should include; Examples should include a range of formats including hand written and IT assisted as utilised throughout the childbirth continuum a) Provides accurate, legible and comprehensive records based on best available evidence and which detail reasoning behind any actions or interventions Including: - Maternal, fetal and neonatal assessments. - Care plans and evaluation. - Medicine administration. b) Effectively keeps a record of information sharing with women about the benefits and risks of relevant medication. c) Uses prescription charts correctly and maintains accurate records of medicine storage selection and usage, including controlled drugs. d) Familiar with accessing and recording information other than in handwritten form. e) Works within the legal framework for data protection and demonstrates confidentiality and appropriate access to information f) Ensures with the mother that she is aware of the legal requirements to register the baby s birth. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 12: Safe and effective practice in the completion, storage and retention of records ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor Practice Outcome 13a : ( Intrapartum Experience) Under supervision of the midwife undertakes and leads in: Safe and effective practice in the application of legal frameworks, professional standards and requirements Range of experiences should include; Examples should include intrapartum hospital based care, interactions with clients and staff and make reference the Midwives Rules. Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor 30

31 a) Works within the NMC Midwives rules and standards including demonstrating understanding of the role of midwifery supervision. b) Demonstrates the knowledge and ability to apply legislation (including medicines) to support midwifery practice in both primary and secondary settings and outside the NHS. c) Can articulate professional limitations and boundaries. d) Maintains confidentiality of information. e) Practices within the limitations of their own competence, knowledge and sphere of professional practice consistent with the legislation relating to midwifery practice. f) Challenges situations/others where the dignity of women may be compromised, consistently upholding the rights of women and acting as an advocate. g) Takes into account UK legal frameworks and professional ethics when planning care, managing the complexities arising from ethical and legal dilemmas. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Outcome 13: Safe and effective practice in the application of legal frameworks, professional standards and requirements ( Intrapartum Experience) ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor 31

32 Practice Outcome 13b : ( Caseloading Experience) Under supervision of the midwife undertakes and leads in:safe and effective practice in the application of legal frameworks, professional standards and requirements Range of experiences should include; Examples should include community and hospital based care, interactions with clients and staff and make reference the Midwives Rules. a) Works within the NMC Midwives rules and standards including demonstrating understanding of the role of midwifery supervision. b) Demonstrates the knowledge and ability to apply legislation (including medicines) to support midwifery practice in both primary and secondary settings and outside the NHS. c) Can articulate professional limitations and boundaries. d) Maintains confidentiality of information. e) Practices within the limitations of their own competence, knowledge and sphere of professional practice consistent with the legislation relating to midwifery practice. f) Challenges situations/others where the dignity of women may be compromised, consistently upholding the rights of women and acting as an advocate. g) Takes into account UK legal frameworks and professional ethics when planning care, managing the complexities arising from ethical and legal dilemmas. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 13: Safe and effective practice in the application of legal frameworks, professional standards and requirements (Caseloading experience) ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor 32

33 Practice Outcome 14: Under supervision of the midwife undertakes and leads in: The referral of women who would benefit from the skills and knowledge of others, working collaboratively across professional boundaries and with other agencies and groups as required. Range of experiences should include; Examples should include NHS services, local authority and voluntary agencies and with reference to medical, mental health, substance misuse services and social referral. a) Discusses with women local and national information to assist with making health choices including voluntary agencies and web based information. b) Works confidently, collaboratively and in partnership with women and others to ensure the needs of women are met. c) Demonstrate an understanding of roles and responsibilities within the multi disciplinary team for medicinal products management including sharing of relevant information. d) Demonstrates understanding of the need for recognised competence in providing complementary therapy and/or advice and identifies appropriate referral pathways to a registered therapist. e) Is competent in recognising and advising women who would benefit from more specialist services. f) Acts appropriately in sharing information to enable and enhance care across professional and agency boundaries recognizing who does and who does not need to know and seeking consent when appropriate. g) Confidently consults and explores solutions with other professionals and agencies, values contributions but challenging when necessary the practice of self and others. h) Demonstrates skill in working collaboratively and leading groups and teams to enhance health outcomes for women. i) Demonstrates understanding and participates where appropriate in the protection of vulnerable adults and children. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 14: The referral of women who would benefit from the skills and knowledge of others, working collaboratively across professional boundaries and with other agencies and groups as required. ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor 33

34 Practice Outcome 15: Under supervision of the midwife undertakes and leads in: Caring for and monitoring the wellbeing of women at risk and for whom the midwife is not the lead professional during ante natal, intra partum and post natal periods. Range of experiences should include; Examples should include providing care for pregnancy complications, IOL, augmentation of labor, instrumental delivery, LSCS, and post natal complications a) Recognises and acts upon findings and needs which would warrant referral and different care pathways during pregnancy. b) Demonstrates safe evidence based practice and contributes to the management of women with complicated pregnancies, e.g. PIH, anaemia and associated fetal monitoring c) Recognises and acts upon findings and needs which would warrant referral and different care pathways during labour and delivery, e.g. prolonged labour, premature labour. d) Demonstrates safe evidence based practice and contributes to the care of women with complicated labours and assisted births. e) Recognises and acts upon findings and needs which would warrant referral and different care pathways during the postnatal period e.g. thrombo embolic disorders, infection f) Demonstrates safe evidence based practice and contributes to the care of women with complicated post natal recovery, e.g. post surgery g) Continues to provide midwifery care to women undergoing complications as part of a multi-disciplinary team demonstrating leadership and advocacy. h) Is confident to call appropriate professional regardless of hierarchy, when care requires expertise beyond the midwifes current or scope of practice. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 15: Caring for and monitoring the wellbeing of women at risk and for whom the midwife is not the lead professional during ante natal, intra partum and post natal periods. ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor 34

35 Practice Outcome 16: Under supervision of the midwife undertakes and leads in: Caring for and monitoring the well-being of the vulnerable neonate and providing support for the parents. Range of experiences should include; Examples should include immediate care through to discharge from midwifery care, assisted births, low-birth weight infants, those with feeding difficulties, congenital disorders, birth defects and pathological conditions. Within the primary care and home setting a) Is aware of and responds to a range of potential physical health issues which may impact upon a neonate and necessitate referral and differing care, e.g. temperature control, nutritional requirements jaundice, infection b) Under supervision of a nurse/midwife demonstrates safe practice in the provision of care for vulnerable neonates. c) Is aware of and responds to a range of potential social and emotional health issues which may impact upon a neonate and the family unit and necessitate referral and differing care. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 16 : Caring for and monitoring the ACHIEVED (evidence verified) well-being of the vulnerable neonate and providing support for the parents. End of Placement Comments by Sign-Off Mentor NOT ACHIEVED 35

36 Practice Outcome 17: Under supervision of the midwife participates, undertakes and (where/if appropriate) leads in: Caring for and supporting women and families who are experiencing unfulfilled birth expectations, pregnancy loss, peri-natal or other deaths. Minimum Indicative criteria Examples should include women s experiences throughout and out with the childbirth continuum and involve care and support within the hospital and community settings a) Identifies a range of potential unfilled hopes, expectations and losses surrounding the childbirth experience b) Demonstrates sensitivity to those who have unfilled birth expectation and appreciates the role of the midwife when responding to women s emotional needs c) Is aware of lay and professional guidance and support for women and their families who encounter loss during childbirth d) Can effectively share information with women in challenging circumstances such as following screening results, loss and bereavement Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 17:Caring for and monitoring the wellbeing of women at risk and for whom the midwife is not the lead professional during ante natal, intra partum and post natal periods. ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor 36

37 Practice Outcome 18: Under supervision of the midwife undertakes and leads in: The wellbeing of women, families and their communities. Range of experiences should include; Examples should include well women and families, vulnerable adults and children and reflection upon leading at least 3 health education activities one of which must be group based and one of which must be about breastfeeding a) Acknowledges roles and relationships in families providing guidance for women and promoting family interaction which reflects women s preferences and experiences and meet family needs. b) Demonstrates a working knowledge of the public health needs of the local demographic area and the strategies in place to improve health. c) Ensures that the mother is aware of the availability and benefits of child health services and the role of the health visitor. d) Able to lead a variety of forums where information is shared with women and skillfully explores attitudes towards lifestyle choices such as smoking, diet, alcohol and infant feeding. e) Actively works with other professionals and agencies including community based peer support networks to improve the health of women and children. f) Competent in providing health improvement promotional, information and support interventions to women which reflects their cultural background and enables them to make appropriate health care choices for themselves and their children into the second year of life and beyond. g) Evaluate the implications of the social, cultural and emotional circumstances of the woman and her family upon her health. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence - Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 18 : The wellbeing of women, families and their communities. ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor 37

38 Practice Outcome 19: Under supervision of the midwife undertakes and leads in: The management and prioritisation of competing demands which impact upon individual service users and the wider organisation of midwifery care Range of experiences should include; Examples should include well women and families and reference to local service provision and care pathways a) Manage a case load of a small group of women throughout their childbirth experience including antenatal, intra natal and postnatal care. b) Demonstrate professional and personal leadership skills in the context of midwifery practice. c) Confident working within a variety of models of service delivery and negotiating with others when necessary to manage competing priorities. d) Able to use a variety of methods to judge the quality of care provision and contribute to governance, audit and service improvement. e) Inspires confidence via effective evidence based decision making in a range of care contexts safely identifying, managing, reducing or removing risk. f) Identifies and describes procedures for dealing with raising concerns: - Complaints - Unsafe practice - Breaches of security - Accidents g) Discuss how service users (individuals and communities) are involved with planning and evaluating local maternity services. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 19 : The management and prioritisation of competing demands which impact upon individual service users and the wider organisation of midwifery care ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor 38

39 Evidence which will be useful to support achievement of this practice outcome A record of all caseload cases must be documented, and contribute to the evidence of achievemen t for Practice Outcome 19. The minimum information should include: - Case Number - Brief history and description of the case, including the outcome for the woman and her family - Details of care events during antenatal care, care during labour and birth, postnatal mother and baby care Care experience which illustrates the skills and qualities of leading care across the range of required experiences.this must include caseload cases and reflect the care of a minimum of five women Reflection upon the performance of self and midwifery practice in relation to this outcome including an analysis and appraisal of the theory and practice interface.the reflective models suggested in the PPDF are a useful source for this activity 39

40 Practice Outcome 20: Under supervision of the midwife undertakes and leads in: The development and enhancement of fitness to practice as a midwife Range of experiences should include; Individual refection and refection and feedback from others. Verbal and written means of reflecting upon and developing practice insights a) Demonstrates skill in identifying, exploring and challenging the attitudes of self and others in relation to health behaviour and professional practice b) Confident to identify unsafe practice in self and others and act appropriately. c) Manages challenging situations effectively d) Acts professionally to ensure that personal judgments values and attitudes do not compromise practice. e) Through reflection and evaluation demonstrates commitment to personal professional development. f) Recognises and responds to emotional discomfort and distress of self and others. g) Reflects on own practice recognising circumstances that may be more difficult and challenging and takes appropriate action. h) Makes effective use of the frameworks for statutory supervision of midwives, meeting the NMC Standards. Methods of assessment to be completed by sign off mentor (please circle) Observation of direct care: Questioning relating to direct care: Simulation: Reflective discussion: Review of evidence Forms and location of evidence to validate achievement Completed by student and verified by sign off mentor Outcome 20 : The development and enhancement of fitness to practice as a midwife ACHIEVED (evidence verified) NOT ACHIEVED End of Placement Comments by Sign-Off Mentor 40

41 Traffic Lights: (Sample of Form to be carbonised and issued separately) FORMATIVE ASSESSMENT ACTION PLAN STUDENT: Programme: Placement: Type of experience: GREEN ACTION PLAN AMBER ACTION PLAN RED ACTION PLAN Is working successfully towards all learning outcomes in the placement assessment booklet. No remedial action is necessary; to continue as per action plan. Is working towards most of the learning outcomes in the placement assessment booklet. However needs to pay particular attention to the identified outcomes listed on the action plan. Mentor: The mentor and student have agreed an action plan for learning and have identified how opportunities and evidence will be provided. The action plan will be regularly reviewed. Mentor: Is not progressing as required to meet the expected learning outcomes in the placement assessment booklet. Failure to achieve these outcomes by the end of the placement will result in the student being unsuccessful on the placement and associated module to which this placement is attached. The learning outcomes not being achieved are listed, along with criteria for their achievement in the action plan. The mentor and student will have regular meetings to discuss progress and provide regular feedback to the guidance tutor. Mentor: Student: Guidance Tutor: Date: Student: Guidance Tutor: Date: Student: Guidance Tutor: Date: I do / do not (delete as appropriate) require contact with the program academic team. Please contact me on the telephone number below (if contact requested). Tel no. Sign-off mentor (name & date) 41

42 Placement Attendance Record BSc (Hons) Midwifery Studies Cohort: September 2012 Year: 3 Placement: Community(1week) and Intrapartum Student Name:...(please print) Placement Area The chart below must be completed weekly and signed by the student and mentor. The following detail is to be recorded: shift time and hours worked, sickness (S) absence (A) study time (authorized as clinical time) (ST) and the weekly total of hours worked, excluding main meal break. Record in ink with no alterations or the use of tipp-ex. Week Commencing Monday Tuesday Wednesday Thursday Friday Saturday Sunday Total hours worked this week Mentor Signature Student Signature 27/10/2014 Community 03/11/ /11/ /11/ /11/ /12/ /12/

43 15/12/2014 Total hours worked this placement = Hours Placement week is 37.5 hours Students are to work no more than 40 hours in any week or 75 hours in 2 consecutive weeks. Total working hours for this placement is 300 Hours Deficit hours = Hours 43

44 Placement Attendance Record BSc (Hons) Midwifery Studies Cohort: September 2012 Year: 3 Placement: Community Student Name:...(please print) Placement Area/s: The chart below must be completed weekly and signed by the student and mentor. The following detail is to be recorded: shift time and hours worked, sickness (S) absence (A) study time (authorized as clinical time) (ST) and the weekly total of hours worked, excluding main meal break. Record in ink with no alterations or the use of tipp-ex. Week Commencing Monday Tuesday Wednesday Thursday Friday Saturday Sunday Total hours worked this week Mentor Signature Student Signature 16/02/2015 Practice 2 days 23/02/2015 Practice 2 days 02/03/2015 Practice 2 days 09/03/ /03/ /03/ /03/ /04/