Introduction to the Trust and Guide to the Profile of Learning Opportunities (PoLO) for nursing and midwifery students in practice

Transcription

1 Introduction to the Trust and Guide to the Profile of Learning Opportunities (PoLO) for nursing and midwifery students in practice For nursing and midwifery students at our partner Universities: 1

2 Contents: Page: Introduction to the Trust 3 King s Values and My Promise 3 Host Trust Induction 3 How to get to our sites 4 Practice Placements 4 Definition of supernumerary status 4 Inter-professional learning opportunities 5 Patients who require specialing 5 Accompanying/escorting/transferring patients within the Trust 5 Medicines Management 6 Guide to the Profile of Learning Opportunities (PoLO) 7 Supporting your preparation for learning 7 Practice placement learning opportunities hub & spoke 7 Learning Opportunity and Mapping Grid 8 How to use the Mapping Grid 8 An Example Learning Opportunity and Mapping Grid 9 What we expect from you 10 What you can expect from us 11 Process for raising concerns 13 References 14 Acknowledgments: Thank you to all the Ward Managers, Practice Development Nurses, practice staff, and the Corporate Communications Team at King s College Hospital NHS Foundation Trust who have participated in the development of the PoLO pack. Thank you also to the Link Lecturers and Programme Leads from our partner universities - King s College London, University of Greenwich and London South Bank University - for their contribution and support. 2

3 Introduction to the Trust We are a leading teaching Trust, providing health care services for a diverse local community, mainly serving the London Boroughs of Lambeth, Southwark, Lewisham and Bromley. Patients from a wider catchment area, both nationally and internationally, also access our specialist: neurosciences, haemato-oncology, fetal medicine and liver disease and transplantation services. We promote shared values that underpin everything we do, not only in caring for patients, mothers, and their families and in delivering our services, but also in the way we support and develop our staff, and our students of nursing, midwifery, medicine, and allied health professions. King s Values and My Promise Our values have been created by the people of King s - we see ourselves as a team, working together for the benefit of our patients. We demonstrate King s Values by -: Understanding you Inspiring confidence in our care Working together Always aiming higher Making a difference in our community King s Values have been strengthened by My Promise, a guide which provides practical examples of how we want everyone at the Trust to treat and interact with others. Host Trust Induction Before commencing your first placement, you will complete a Host Trust Induction. The day provides you with an introduction to the Trust, to meet the Assistant Director of Education and Research / Senior Nurse for Education, Support and Development, and includes training from the Infection Control, Health and Safety, and Fire Awareness teams. Midwifery students (KCL) will complete a separate induction with the Midwifery Practice Facilitators (MPFs), and all midwifery students receive additional orientation to maternity services. Please ensure that you bring your Pan London Practice Assessment Document (PLPAD) with you for your attendance to be recorded. 3

4 How to get to our sites There is detailed information on how to get to King s College Hospital (KCH), Princess Royal University Hospital (PRUH), Orpington Hospital, Beckenham Beacon and Queen Mary s Hospital Sidcup at Practice placements We provide a diverse range of practice learning opportunities for student nurses and student midwives undertaking the following programmes with our partner universities. Therefore you could be learning alongside a student from London South Bank University (LSBU), King s College London (KCL) or University of Greenwich (UoG) on one of the following programmes. Adult Pre-registration BSc (Hons) and PG Dip Accelerated programmes in association with: King s College London University of Greenwich Child Pre-registration BSc (Hons) and PG Dip Accelerated programmes in association with: King s College London London South Bank University University of Greenwich Midwifery BSc (Hons) and PGDip Accelerated programmes in association with: King s College London University of Greenwich Return to Practice programme in association with: University of Greenwich Definition of supernumerary status As a student in the clinical setting you will be actively involved in practice - based work, to enable you to learn how to care for individuals, families and carers. You will be regarded as supernumerary, and during your shift you may be allocated patients/clients/mothers to care for under supervision, appropriate to your learning needs and level of competence, and relevant to the practice context of the placement. 4

5 Inter-professional learning opportunities Inter-professional co-operation is fundamental to delivering high standards of personcentred care and services. We encourage students to work with and learn from and about other professional groups involved in a patient s health and social care pathway (CAIPE 2002). This allows you to gain valuable insight into the role and responsibilities of other health and social care professionals. Patients who require specialing Inpatients may be cared for on a 1:1 basis by a nurse, midwife, mental health nurse or healthcare assistant for challenging behaviour or if they are at risk of causing harm to themselves or others. This care may be provided by the Central Specials Team (CST) (Denmark Hill site), ward staff, bank or agency staff. The level of supervision required is indicated via the risk assessment level of supervision algorithm. As a student, it may be appropriate for you to special a patient, under the supervision of your mentor as a learning opportunity. Students must not be left to - special - patients without supervision. You may find it useful to spend time with CST (Denmark Hill) or the Ward Manager and clinical site practitioners / clinical senior nursing team, to look at the decision making process and identify how therapeutic interventions are used to improve patient care. Accompanying / escorting / transferring patients with the Trust Students may escort / transfer conscious patients in a stable, non-critical condition, with minimal care needs, providing they have the required competence, and have been assessed as such by the delegating registered nurse or midwife. This may vary depending on the context of the placement (KCH 2015). Students must be assessed as being fully prepared to manage unexpected/emergency situations as a lone practitioner and therefore the mentor will, with due care make the decision as to the appropriateness of delegating this to a student, considering the safety of the patient/mother. A student may not accompany / escort a patient alone who has an intravenous infusion in progress. Students are not permitted to escort patients alone outside King s College Hospital NHS Foundation Trust (KCH 2010). Students should refer to placement guidance provided by the University (KCL, LSBU & UoG) associated with the programme they are following. 5

6 Medicines Management Students must adhere to the The Medicine s Management Policy (KCH 2014) and the Standards for medicines management (NMC 2008). Please consider the following: Student nurses should be given the opportunity to participate in the administration of medicines by a supervising RN (Level 1 competent), - who remains accountable for the student s practice (KCH 2014) All medicine administration carried out by a student (under supervision) must be countersigned by the RN (Level 1 competent) (KCH 2014) All medicines administered to children under the age of 16 must be double- checked by two registered nurses, (Level 1 competent), one of whom should be a Registered Nurse (Child) or Registered Sick Children s Nurse (KCH 2014) Student nurses must not prepare or administer intravenous medicines (KCH 2014). This includes flushes and setting the pump rate. However alongside the two RNs (Level 1 competent) they are expected to calculate dosage / simple infusion rates, check prescriptions, use available resources e.g. British National Formulary (BNF). Please note this is currently under review (April 2016) Student midwives may not administer medicines unless closely supervised by a qualified midwife who takes responsibility for medicines administered (KCH 2014) Those students with an existing RN qualification, undertaking a further nursing/midwifery programme must not practise outside their current sphere of practice as a student. 6

7 Guide to the Profile of Learning Opportunities (PoLO) As a pre-registration nursing / midwifery student, commencing a new clinical practice placement is an exciting time as you prepare for new challenges, learning opportunities, and the chance to enhance your existing knowledge and skills. We recognise that for some students it can also provoke feelings of anxiety, due to the uncertainty of expectation, and being exposed to a new practice context. Therefore the purpose of the PoLO is to contribute to: creating an environment for learning and facilitation of learning (NMC 2008). Firstly by supporting your preparation for learning before you commence a practice placement, and secondly to identify learning opportunities within the practice area. Supporting your preparation for learning The PoLO will provide information to help you settle into the practice environment which is an important aspect of the whole student learning experience. It will introduce you to the practice context, identify members of the multi-disciplinary team, and present a range of inter-professional learning opportunities. In addition to the identified placement learning opportunities, there will be unexpected/ unplanned for learning opportunities/experiences. You are encouraged to take the opportunity to learn from novel situations, to ensure you are supervised and working within your competency limitations, and to engage with reflective practice. We clarify our expectations of you whilst you are on placement, and highlight what you can expect from your assigned mentor and the practice placement team. Finally, through the process of self-assessment and reflection, the PoLO may assist you to recognise areas of personal and professional strength and areas for development before you commence this placement. Practice placement learning opportunities a Hub and Spoke model The concept of a hub and spoke model will be used to provide a visual overview of the practice placement learning opportunities, reflecting the patient s health and social care journey. The hub (of a bicycle wheel) is defined as the practice area to which you are allocated and where your named mentor is based (Millar 2014), and spokes as identified learning opportunities. A separate hub and spoke model may also be presented, identifying potential learning opportunities which occur outside the ward / unit to which you are allocated or where nonward based health and social care professionals visit a patient/client/mother on the ward. 7

8 Your mentor will discuss with you the appropriateness of you undertaking a spoke visit outside the practice area and will contact the area/professional to make arrangements. In addition to the visual hub and spoke overview and to assist you in identifying how you can achieve the generic and field specific competences (NMC 2009, 2010), the placement learning opportunities will be mapped against the Essential Skills learning outcomes and Professional Values in the PLPAD for your part of the programme e.g. part 1, 2, and 3. This is called the Learning Opportunity and Mapping Grid. Essential Skill Clusters (Nursing): Care, compassion and communication, Organisational aspects of care, Infection Prevention and Control, Nutrition and Fluid Management, and Medicines Management Essential Skill Clusters (Midwifery): Communication, Initial consultation between the woman and the midwife, Normal labour and birth, Initiation and continuation of breast feeding, and Medicines management Professional Values: Professional attitude, Professional behaviour, Professional responsibility, and Safe and compassionate care Learning Opportunity and Mapping Grid A learning opportunity will be identified either as a core learning opportunity (CLO) or a specific learning opportunity (SLO). A CLO for example an assessment, occurs in all practice areas but will vary as to the activities undertaken by you, depending on the practice context and patient need. An SLO, for example, care of patient with a tracheostomy, will only be identified in certain practice areas Learning opportunities are mapped if appropriate to your part of the programme and the learning outcomes/professional values to be achieved. How to use the Mapping Grid Firstly, identify your part of the programme in column 1 which is colour coded. This colour code will relate to learning opportunities relevant to you. The numbers in columns 2 and 3 are the number of each Professional Value and Essential Skill in your PLPAD that the learning opportunity relates to, thereby assisting you to plan your learning. 8

9 An Example Learning Opportunity and Mapping Grid Core Learning Opportunities (Under Supervision): ward/unit based Participate in the assessment of individuals with a range of medical conditions / long term conditions, for example: Neurological conditions e.g. Parkinson s disease & Motor Neurone disease Haematological conditions e.g. Acute Myeloid Leukaemia, Lymphoma You may participate in/observe (with context related examples): Applying relevant knowledge / measuring & interpreting clinical observations e.g. pyrexia Developing skills in the use of related equipment under supervision e.g. dynamap Observing diagnostic procedures e.g. MRI Communication e.g. interpretation service involvement, enhancing listening skills Obtaining specific specimens as required e.g. urine (MSU and CSU), stool, wound swab Documentation e.g. as communication tool for MDT working Risk Assessment e.g. falls or infection control Discharge planning Identifying the patient s health & social care needs The learning opportunities above are mapped against the Professional Values, Essential Skills and Practice Assessments in your PLPAD and are presented in the table below. This will assist you to identify and plan for what you could achieve. Adult Programme and Part 1, 2, or 3 as per PLPAD BSc Part 1 and PGDip part 1 BSc Part 2 and PGDip Part 2 BSc Part 3 and PGDip Part 3 Professional Values statements in PLPAD 1, 2, 4, 5, 6, 8-10, 12, 13 1, 2, 4, 5, 6, 8, 9, 11, 12, 13 1, 2, 4, 6, 7, 9, 10, 13, 14 Essential Skills PLPAD Outcome Number 1-4, 6-9, 12, 13, 19, 20, 21, 22, 25-27, 30 Part 1 Practice Assessment Episode of Care 1, 3, 4, 5, 7, 9, 10, 11, 18, 22, and Part 2 Practice Assessment Episode of Care 1, 2, 13, 16, 17, 18, 23, 24, 27, 29, 43, 49, 52, 53, 54, 55, 62, 66, 69 Part 3 Practice Assessment Episode of Care and Medicines Management 9

10 What we expect from you Before you commence your practice placement we encourage you to: Contact the assigned practice placement one week prior to commencement to arrange to visit the area, and be given your first week duty rota Read through your PLPAD to identify learning outcomes/competencies/skills to be achieved during the placement Consider the context of the practice placement and the potential learning opportunities Plan how you will travel to your practice placement location During your practice placement we expect you to: Treat all people as individuals, with dignity and respect Maintain patient confidentiality Ensure the 6 Cs underpin all that you do (DOH 2012): o Care o Compassion o Competence o Communication o Courage o Commitment Work with and alongside the multi-professional team to promote the health and wellbeing of those in your care, their families and carers Work with and alongside the practice team demonstrating an enthusiasm and motivation for learning Work at least 40% of your shifts with your mentor/mentors/sign off mentors to ensure appropriate supervision (directly or indirectly)/facilitation of learning Ensure you provide your mentor/sign off mentor with your PLPAD and related documentation in a timely manner as required Ensure you adhere to Trust policies and procedures which are available on the Trust intranet (Kingsweb), using the generic log in at any hospital site to which you will be given access. Work within your own level of competence to ensure safe practice Recognise your limitations as a nursing/midwifery student Recognise when to seek assistance Recognise the process for raising concerns (see flow chart, page 13) Be punctual for your shift as negotiated with your mentor/sign off mentor Experience a variety of shift patterns, to reflect 24 hour care, and/or the practice context which may include weekends and night shifts 10

11 Inform the practice area, MPF (midwifery students) and university as soon as possible if you are sick / absent Make your practice placement shifts a priority over any part time work Wear your student uniform with pride and abide by the Trust uniform policy - if arriving and leaving to and from work in uniform, this must be fully covered Ensure you wear your identification badge Reflect on the learning experience, either independently or with the support of your mentor/sign off mentor to identify knowledge and skills acquired, enhanced and consider where further development is needed After you complete your practice placement we encourage you to: Evaluate your practice learning experience to provide constructive feedback, so we know what we do well and where we can improve What you can expect from us Before you commence your practice placement we will: Inform the clinical area of your allocated placement Ensure your assigned mentor/co-mentor/sign off mentor has an appropriate mentor qualification Ensure your mentor/co-mentor/sign off mentor is meeting the requirements for Triennial Review (NMC 2008) During your practice placement you can expect: To be orientated to the practice placement area to which you are allocated Time with your mentor/co-mentor/sign off mentor to identify your learning needs, discuss your current clinical competencies and areas for development Time with your mentor/co-mentor/sign off mentor for your initial, mid point and final interview To maintain supernumerary status To be exposed to a variety of experiences relating to patient care and health and social care related services To receive timely and constructive feedback on your clinical and professional development To seek support from/to discuss any concerns or difficulties with: o Mentor/co-mentor/sign off/associate mentor o Ward Manager 11

12 o University Link Lecturer and / or Clinical Teacher o Practice Development Nurses (PDN) (in most areas) / Midwifery Practice Facilitator (MPF) o Trust based Personal Mentor (PGDip students KCL) To access resources available: o Library facilities PRUH (Education Centre) and Denmark Hill (WEC) o Trust intranet for policies/procedures/guidelines o Online Royal Marsden Manual available on all computer desktops o Evidence-based resource folder in placement area relating to the practice context and patient care After you complete your practice placement we will: Encourage your mentor (s)/sign-off mentor to evaluate their mentoring skills as part of the Triennial Review requirements (NMC 2008) and their continuing professional development Receive feedback from the University on the evaluation of your learning experience Respond to student feedback - commending mentors and practice teams where students are well supported, and dealing with any areas of concern/issues raised appropriately 12

13 Process for raising concerns regarding pre-registration student nurses / midwives on clinical placement To inform or be advised please contact: Dr. Angela Grainger, Assistant Director of Nursing (ADN) Education & Research: or internal X angela.grainger@nhs.net or Jo Goodchild, Snr. Nurse for Education, Support & Development or internal X jgoodchild1@nhs.net Student issue Mentor / Sign Off Ward Manager To discuss concern on a need to know basis For support For guidance ADN (E&R) liaises with: HEI Lead for KCL Adult, Child and Midwifery LSBU - Child Health only U of G - Adult, Child and Midwifery Link Lecturer Mentor & student support, briefing & evaluation Competency document (PLPAD) briefing & support Lecturer Practitioner / Practice Development Nurse / Clinical Facilitator /Midwifery Practice Facilitator Specific clinical training issues Ongoing support and development as required For: Competency / conduct issues Student related adverse incidents Link lecturer absence Personal Tutor Personal student issues Competency / conduct issues MUST ALWAYS be referred to personal tutor 13

14 References: Centre For The Advancement Of Interprofessional Education (CAIPE) (2002) The Definition and Principles of Interprofessional Education. Online available from: Department of Health (2012) Compassion in Practice. Online available from King s College Hospital NHS Foundation Trust (2015) Policy for the Safe Transfer of Patients. Online available from KCH: London. King s College Hospital NHS Foundation Trust (2014) King s Values. Online available from KCH: London. King s College Hospital NHS Foundation Trust (2014) My Promise. Online available from KCH: London. King s College Hospital NHS Foundation Trust (2014) The Medicines Management Policy. KCH: London King s College Hospital NHS Foundation Trust (2012) Controlled Drugs Policy. KCH: London Millar, L. (2014) Use of Hub and Spoke model in nursing students practice learning. Nursing Standard. 28, 49, Nursing and Midwifery Council (2015) Raising concerns: Guidance for nurses and midwives. Online available from Nursing and Midwifery Council (2010) Standards for pre-registration nursing education. Online available from Nursing and Midwifery Council (2009) Standards for pre-registration midwifery education. Online available from Nursing and Midwifery Council (2008) Standards for medicines management. NMC: London Online available from Nursing and Midwifery Council (2008) Standards to support learning and assessment in practice. Online available from Practice Educators / Facilitators Coventry & Warwickshire NHS Trusts (2010) Learning Pathway Toolkit. Coventry University: Coventry 14

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