The School Of Nursing And Midwifery. BMedSci Nursing (Adult) CLINICAL SKILLS PASSPORT Student Details NAME: COHORT: I understand that this booklet may be reviewed by my mentor, the programme leader, my personal tutor, the UoS link tutor, the learning environment manager, the external examiner and all subsequent mentors. Signature of Student Date
Guidelines on the use of this document This document is designed to help you direct your learning in relation to your clinical skills development and assist you in keeping a record of your progress. It is a compulsory part of the summative assessment of practice documentation and should be used to provide additional evidence at your progress reviews at the intermediate and final interview of each practice learning experience. It should be completed by the end of the programme. It lists the core skills expected to be achieved by all students during the programme that may not be included in the assessment of practice record. The list of skills is not exhaustive; in recognition of this fact, a section is included for you to add any skills unique to your personal learning experiences. You can initial and date each skill at Level 1 when you have been instructed in or observed the skill. This can take place either in the School of Nursing or in practice. Levels 2, 3 and 4 must be initialled and dated by a Registered Nurse in practice: Level 1: You have been taught the skill in School or observed the procedure in the practice setting Level 2: You have participated in the skill under direct supervision Level 3: You have consistently performed the skill safely on a number of occasions and required minimal supervision Level 4: You can consistently perform the skill safely and competently, giving the rationale for your actions PLEASE BEAR IN MIND THAT APPROPRIATE LEVELS OF SUPPORT ARE REQUIRED FROM A FIRST LEVEL REGISTERED NURSE FOR EACH UNIT WHEN USING THIS DOCUMENT. It is expected that, when performing each skill, you exhibit not only the skill element but also demonstrate that you have a sound knowledge base and understand the underlying principles, making reference to national and local policies as appropriate. 2
First Level Registered Nurse Signature Register Print Name Clinical Area Job Role Signature Contact Telephone Number 3
Mandatory Training Record Fire Safety Year 1 Year 2 Year 3 Date Signature Date Signature Date Signature Patient Safety Personal Safety Basic Life Support Moving and Handling -Theory -Practical Infection Prevention and control -Handwashing Equality and Diversity Information Governance 4
Breathing SKILL 1 2 3 4 Assess individuals breathing and patency of airway Monitor and record peak flow & act appropriately Maintain safe administration of oxygen as prescribed Monitor and record expectorant Obtain sputum specimen and send for analysis Correct disposal of sputum secretions Assist and monitor clients receiving nebuliser therapy Demonstrate and support patients in the use of correct inhaler technique Provide psychological support to the breathless client Collaboratively work within the Multidisciplinary team (MDT) to provide assessment and care for people with breathing problems 5
Vital Signs SKILL 1 2 3 4 Complete relevant track and trigger charts, report findings and treat accordingly Demonstrate the ability to monitor and record Blood Glucose, recognise abnormalities and respond appropriately. Assist in the recording of an Electro Cardiogram (ECG) Recognise deteriorating patient and responds appropriately : 1. A E assessment 2. Cardio Pulmonary Resuscitation (CPR) 3. Anaphylaxis Recognises the causes of Deep Vein Thrombosis (DVT) and takes appropriate action in prevention, in conjunction with the MDT Can recognise and appropriately manage anaphylaxis 6
Pain Assessment and Management SKILL 1 2 3 4 Effectively uses pain assessment tools and responds appropriately to findings. Administers pharmacological and non-pharmacological treatments following policies and procedures Monitors effectiveness of the treatment for pain Refers to appropriate members of the MDT for pain management advice 7
Preparation of Patients undergoing Investigations and/or Interventions Skill 1 2 3 4 Provides psychological and emotional support to patients and their significant others prior to undergoing procedures. Provides effective monitoring and care of patients in the post-operative /procedure phase. 8
Pressure Area care SKILL 1 2 3 4 Demonstrates the ability to utilise relevant risk assessment tools used within the workplace Demonstrates the ability to inspect skin and recognise any changes that suggests tissue damage and can grade this appropriately Produces a comprehensive plan of care from findings of the assessment Delivers a variety of interventions to effectively deliver pressure relieving care Evaluates and records effectiveness of care intervention Demonstrates understanding of working with the MDT by seeking advice from, or referring patient to, Tissue Viability Specialist. 9
Infection Prevention and Control SKILL 1 2 3 4 Can recognise signs of infection and respond appropriately Demonstrates correct handwashing procedures. Makes appropriate use of all PPE (Personal Protective Equipment) as required Disposes of clinical and non-clinical waste and soiled linen according to local policy and IPC procedures. Promotes correct Infection Prevention Control (IPC) practice amongst Patients, Visitors and Colleagues Assesses the needs of the infectious person or people and applies appropriate isolation techniques Applies knowledge of exposure prone procedures and takes appropriate precautions and actions. Works effectively as part of the MDT when faced with issues that could impact on IPC procedures e.g. lack of isolation facilities or confused or critically unwell patients that require isolation due to infection. Initiates and maintains appropriate measures to prevent and control infection according to rate of transmission of micro-organisms in order to protect service users, members of the public and other members of staff Demonstrates the safe handling of sharps following policies and procedures Is able to describe the process for reporting needle stick injuries 10
Wound Care SKILLS 1 2 3 4 Assesses simple wounds using relevant tools and documentation to recognise signs of healing or complications Reports to and works with other members of the MDT e.g. Tissue Viability or Wound care teams in the complex care of wounds. 11
Personal Cleansing and Dressing Skills 1 2 3 4 Demonstrate the ability to assess, plan, implement and evaluate care for a range of clients who are unable to cleanse or dress independently Assists patients to maintain their oral hygiene Provides support and encouragement to the client requiring assistance with cleansing and dressing and enables them to be as independent as possible, whilst maintaining dignity and privacy. Demonstrates the ability to segregate laundry following local policies and procedures 12
Eating and Hydration Skill 1 2 3 4 Utilising appropriate assessment tools e.g. MUST scoring makes a comprehensive assessment of clients needs in relation to nutrition and hydration and acts appropriately to findings Accurately monitors and records nutritional intake on appropriate charts and acts on any changes or inadequate intake. Accurately monitors and records fluid intake on fluid balance charts and reports when intake/output is above or below requirements. Assists patients into a position that is suitable for eating and drinking, taking into account any health conditions/needs they may have. Assists and encourages clients with feeding and drinking as required, maintaining dignity and promoting independence where possible. Communicates with the MDT (Dieticians, SALT s) to construct a plan of care based on the information gained from the monitoring. Effectively uses nausea assessment tools and responds appropriately to findings, administering medication if prescribed Monitors effectiveness of the treatment for nausea Assesses clients who are unable to take oral diet and fluid and plans, implements and assesses care for Nasogastric feed PEG feed Enteral feed Parental feed Checking position and patency of the tube and correct type of feed and rate to be administered, in these instances. Understands the risks associated with dysphagia and can deliver appropriate care to minimise the risks. 13
Elimination Skill 1 2 3 4 Establish client s usual pattern and nature of elimination and reports any changes. Assist Clients to use Bed Pan Urinal Commode Toilet Whilst promoting independence and maintaining privacy and dignity Cares for clients with indwelling catheters Empty s catheter bag as required Monitors urine output Monitors and records bowel action, and uses Bristol Stool chart to monitor for any abnormalities Can perform urinalysis and document and report findings correctly Can obtain urine samples following correct procedure in the following instances: Mid stream urine (MSU) From an in-dwelling catheter 24 hour urine collection Responds appropriately to any detected abnormalities and reports to appropriate person. 14
Medicines Management Skill 1 2 3 4 Demonstrates the ability to read a medicines prescription chart effectively Safely disposes of equipment following administration of medications as per health and safety requirements Correctly records medicine administration and at the appropriate time Records any problems with administering medications, including omissions, in the appropriate documentation Understands the process of ordering, receiving, storing and disposal of medication safely in Primary Care Secondary Care Understands the process of ordering, receiving, storing and disposal of controlled drugs in Primary Care Secondary Care Can competently carry out drug calculations Under direct supervision for Tablets and Capsules Liquid medicines Injections Can recognise and report adverse drug reactions and near misses Can demonstrate how to look up formulary of medicines to ensure safe administration Can work with MDT to ensure Medicine Management works effectively Understands the principles and can administer medications under Patient Group Directives 15
Intravenous Therapy Skill 1 2 3 4 Monitors and assesses clients receiving Intravenous Fluids Under direct supervision of the Registered Nurse, assists in the reading of prescription for, selection of IV fluids and assembling equipment, prior to infusion being initiated by the Registered Nurse. Utilises appropriate assessment tools to assess the exit site of invasive devices for any potential problems. E.g. VIP score (Visual Infusion Phlebitis) Safely removes peripheral IV cannula and disposes of it appropriately. Understands and follows correct national and local procedures regarding the collection of blood and blood products, under close supervision Understands and follows correct national and local procedures regarding the storage of blood and blood products, under close supervision Monitors the patient receiving blood and blood products before, during and after the procedure Can identify signs and symptoms of a blood or blood product adverse reaction during or after administration and reports this appropriately. Safely disposes of equipment following administration of blood or blood products 16
End of Life Care (EoL) Recognises when a patient is nearing the end of their life Assists in the development of the End of Life Care pathway Skill 1 2 3 4 Contributes to the assessment, planning, implementation and evaluation of care for clients who are at EoL, recognising and respecting their individual beliefs and values. This should include: Symptom recognition and management Advanced care planning Provide psychological support for clients who are at EoL and their significant others Liaise with other member of the MDT McMillan Nurse Hospice team Voluntary Services Clinical Nurse Specialist Communicate appropriately with patients at EoL and their relatives/carers Follows local policies and legal requirements in relation to care of the deceased person Can provide appropriate support to bereaved relatives/significant others 17
Mobility Skills 1 2 3 4 Can complete, act upon and review moving and handling risk assessments Encourages individuals to play an active role in moving and handling procedures, according to their level of ability Can complete falls risk assessments and plan action to reduce risk as appropriate Completes relevant incident forms/documentation following a fall 18
Health Promotion Skills 1 2 3 4 Can identify behaviours that can have an impact on health Participates in health screening as appropriate. Supports people with long term conditions to manage their condition, providing education as appropriate 19
ADDITIONAL SKILLS Skills 1 2 3 4 20
ADDITIONAL SKILLS Skills 1 2 3 4 21