Hong Kong College of Medical Nursing Advanced Practice Nursing (Medicine) Certification Program Fellow Membership Examination (Sub-Specialty Module Rheumatology) Clinical Log Book Endorsed on 5 May 2017 Name of Candidate 1 Rheumatology Nursing Log Book 2017
Advanced Practice Nursing (Medicine) Certification Program Fellow Membership Examination (Sub-Specialty Module- Rheumatology Nursing) Table of Contents: 1 General instruction for Candidate.....3 2 Purpose of the Log Book... 3 3 Responsibilities of the Candidate 3-4 4 Responsibilities of the Mentor.. 4 5. Personal Data of the Candidate... 5 6 Record of...6-11 7 Record of Case Study and/ or Presentation.... 11 8 Nurse Led Clinics - Planning, Development and Operation...... 11 9 Quality Improvement and Change Management.. 11 10 Research/ evidence-based practice.... 12 11 Clinical Log Sheet... 13 12 Evaluation Form. 14 13 Reference: Competency Framework.....15-16 2 Rheumatology Nursing Log Book 2017
1. General Instructions for the Candidate The Candidate should regularly read and access information related to Specialty Training published by the Hong Kong College of Medical Nursing as updated on website. 2. The Purpose of the Log Book 1. To assist the Candidate in reflecting the learning opportunities in clinical practices 2. To facilitate the Mentor to assess the clinical competence of the Candidate and provide support and guidance to accomplish the Certification Program 3. Responsibilities of the Candidate 1 Each Candidate, upon enrollment, will be issued with the Log Book at the commencement of Advanced Practice Nursing (Sub-Specialty: Rheumatology) Certification Program training. It will be the property of the Candidate. 2 The Candidate should record the followings: All supervised assessment on the patients All supervised interventions on the patients All special encounters with the patients/families All nursing activities in Nurse-led Clinic / Patient Support Group Case conferences Research activity Journal reading and reflection Continuous Professional Activities Attending Mortality and Morbidity Meetings Attending/ leading Continuous Nursing Education activities Case presentations Nurses rounds Attending/presentation in conferences, seminars Speaker or author in nursing education seminars / conference / journal paper Leading Patient Safety activity Leading Staff Occupational Safety activities Leading Risk Management and Quality improvement activities The above list is not exhaustive as the log book serves as a means that demonstrate reflective learning of the Candidate. 3 The Candidate is strongly advised to keep the Log Book with him/her at all times and to fill in relevant information on a regular basis. Patient(s) MUST NOT be 3 Rheumatology Nursing Log Book 2017
identified by names or Hong Kong Identity Card numbers. Cases should be recorded using patients and /or hospital numbers. 4 The Candidate should discuss his/her progress as documented in the Log Book with his/her mentor at regular intervals, and a summary record of experience must be ed by the mentor. This dialogue serves an opportunity for the Candidate to reflect on the learning and growth in the nursing profession. This regular assessment allows deficiencies in experience to be remedied early in the course of the training. An evaluation form should be ed by the Chairman of Examination and Accreditation Committee before recommendation to the Hong Kong Academy of Nursing for admission to Fellow Member. 5. The Candidate should seek the mentor s endorsement of the Training Program before submission to the Chairman of the Examination and Accreditation Committee. 6 The Candidate should complete at least 70% of the Log Book (fulfill the mandatory requirement) before final assessment. 4. Responsibilities of the Mentor 1 The Mentor facilitates the Candidate to map learning opportunities in the clinical practices to the competence framework 2 The Mentor has the responsibility to guide the Candidate to reflect on encounters in the clinical areas by asking what has happened, why and what is the learning point? 3 The Mentor is to facilitate the Candidate to identify opportunities to develop the leadership abilities to lead the team. 4 The Mentor is to polish the Candidate s presentation and writing skills and encourage him/her to present cases and papers. 5 The Mentor is to encourage the Candidate to be active team players in clinical rounds. 6 The Mentor should not take more than three Candidates at the same work place. 7 The Mentor should not hold Trainer status in more than 2 specialties. 8 The Mentor has the responsibility to guide the Candidate to prepare for the Training Program 4 Rheumatology Nursing Log Book 2017
5. Personal Data of the Candidate Name of the Candidate Sex Chinese Name Registration Number of the Candidate Date of entry into the training program Address Email Telephone Name Title/Rank Institution/Department/Unit Supervision Period 5 Rheumatology Nursing Log Book 2017
6. Record of (*= Mandatory) A. *Clinical examination and disease activity assessment on rheumatic diseases RA (CDAI/ SDAI/ DAS 28 score) (5 scenarios) B. *Clinical examination and disease activity assessment on rheumatic diseases AS (BASDAI/ BASFI/ BASMI) (5 scenarios) C. Clinical examination and disease activity assessment on rheumatic diseases PsA (PASI score) (2 scenarios) D. Clinical examination and disease activity assessment on rheumatic diseases SLE (SLEDAI/ SLICC) (2 scenarios) 6 Rheumatology Nursing Log Book 2017
E. *Interpretation of abnormal blood result/ biomarkers/ autoantibodies for patient with rheumatic disease (5 scenarios) F. *Interpretation of investigations, radiology examinations and specific Rheumatology assessment CT / MRI / PET scan / musculoskeletal USG / Capillaroscopy (3 scenarios) G. *Patient management for Rheumatology procedures (Arthrocentesis, Intra-articular injection, Skin biopsy) (5 scenarios) H. *Management of patients with Rheumatoid Arthritis (5 scenarios) 7 Rheumatology Nursing Log Book 2017
I. *Management of patients with SpA (5 scenarios) J. *Management of patients with SLE (5 scenarios) K. *Management of patients with Scleroderma (3 scenarios) L. *Management of patients with Inflammatory myopathies (3 scenarios) 8 Rheumatology Nursing Log Book 2017
M. *Management of patients with Gout (3 scenarios) N. Management of patients with uncommon Rheumatic Diseases (at least 3 scenario for different diseases) O. Collaborative care of patients with other specialties, e.g. Obstetric, Orthopaedics, etc. P. *Management of special situations in patients with rheumatic disease Sepsis, Operation, Malignancy, Pregnancy, Vaccination, Disease Flare Up (3 scenarios with different situations) 9 Rheumatology Nursing Log Book 2017
Q. *Medication and patient management in Conventional DMARDs therapy - Education, Counseling, Monitoring, Titration (10 scenarios with different drugs) R. *Medication and patient management in systemic steroid therapy - Education, Counseling, Monitoring, Titration (3 scenarios) S. *Patient education, screening, and ongoing management in biologic therapy (5 scenarios with different biologics) T. *Empowerment and Self-management Education for rheumatology patient with physical and psychosocial needs (5 scenarios) 10 Rheumatology Nursing Log Book 2017
U. *Patient management through Telecommunication, e.g. Telephone Advice Line, Phone follow-up (3 scenarios) V. *Collaboration with multidisciplinary team (MDT) members and / or community care services: case conference, make referrals (3 scenarios) Date 7. *Record of Case Study or Project (Not less than 2 cases, please refer to Clinical Log Sheet at the back as a reference format) 8. *Nurse Led Clinics planning, development and operation (5 activities) Date Activity 11 Rheumatology Nursing Log Book 2017
9. *Quality Improvement and Change Management A. Risk and quality management (CQI) leading to environmental improvement and patient safety (2 activities) Date Activity B. Facilitate change and adopt evidence-based practice in nursing care (2 activities) Date Activity 10. *Research/ Evidence-based Practice: Continuous Learning through Research/ Journal Club sharing/ Scientific Seminars or Conference (at least 5 activities) Date Activity Sign 11. *Management and leadership skills Lead a working group to coordinate patient support service, patient education program, health promotion activity or symposium (1 scenario) Date Sign 12 Rheumatology Nursing Log Book 2017
12. Clinical Log Sheet This is a suggested format to facilitate mentor mentee discussion. Session date: Level of care the Candidate provided: Observation only Primarily mentor managed Independent care with presentation to mentor agreement Client information: Initial Sex/Age Occupation Social background Resource / support network Diagnosis / medications Relevant medical, mental conditions and other parameters Physical psycho-social problems identified Intervention and education Management and education provided Reflection / learning Mentee ature Mentor comment Date Mentee ature Date Mentor ature Date 13 Rheumatology Nursing Log Book 2017
13. Evaluation form to be completed by the Mentor for recommending to attend assessment leading to award of HKAN Fellow Member Name of Mentee Supervising Period EVALUATION Subject areas Grading Pass Needs Borderline Fail improvement fail Clinical knowledge & professional judgment Meeting the domain of competence Managed patient with complex clinical profile Established therapeutic relationship with patient/family Reliability / sense of responsibility Led CQI activity Led nursing team and demonstrated leadership abilities Overall rating Recommendation Recommended as qualified and competent Not recommended Additional comments (use additional sheet if necessary) Name of Mentor Fellow number Signature Endorsed Not endorsed Chairman of Examination & Accreditation Committee Date Signature 14 Rheumatology Nursing Log Book 2017
14. Reference: - Competency Framework Domains 1 Managing clients with complex healthy conditions 2 Enhancing therapeutic nurse-client relationship 3 Demonstrating effective leadership and team work 4 Enhancing quality assurance and improvement 5 Managing & negotiating innovative & effective approaches to care delivery 6 Enhancing professional attributes of general & advanced practice 7 Enhancing personal attributes Subject areas 10.1 Clinical aspect of Rheumatology Domains 1 2 3 4 5 6 7 10.1.1 Musculoskeletal system, immune system, pain perception and pathways 3,4,5,6,7,11 2,3,5 --- --- --- 1 --- 10.1.2 Screening, diagnosis, related investigation and nursing assessment for Rheumatic Disease 1,3,4,5, 6,7,8,11 1,2,3, 6 1,2 1,2,5 1 4,5,7 1 10.1.3 Clinical features, assessment and management of patients with: a) Inflammatory Arthritis RA, SpA b) CTD SLE, Scleroderma, Inflammatory myopathies c) Gout, Tophaceous gout, Pseudogout d) Infection related joint diseases: Septic Arthritis, Reactive Arthritis e) Metabolic bone disease Osteoporosis, Endocrine related arthropathy f) Degenerative bone diseases: Osteoarthritis g) Uncommon Rheumatic disorders - Adult Still s Disease - Vasculitis - Polymyalgia Rheumatica - Fibromyalgia - Behçet s disease - Sjögren s syndrome - Relapsing Polychrondritis 10.1.4 Clinical evaluation for patient with inflammatory arthritis with All All --- --- 1,2,3,4 1 1 All All --- --- 1,2,3,4 1 1 All All --- --- 1,2,3,4 1 1 All All --- --- 1,2,3,4 1 1 All All --- --- 1,2,3,4 1 1 All All --- --- 1,2,3,4 1 1 All All --- --- 1,2,3,4 1 1 All 1,2,3,6 --- --- 1,2,3,4 2 1 different assessment tools 10.1.5 Dermatological perspective in All All --- --- 1,2,3,4 1 1 15 Rheumatology Nursing Log Book 2017
rheumatic diseases with distinct features: Lupus Erythematosus, Dermatomyositis, Scleroderma, Rheumatoid Arthritis, Vasculitis 10.1.6 Orthopaedic perspective in rheumatic diseases: operative management in hand, knee & hip and 1,2,3,6,7,9,10,11 1,2,3,4,5,8 --- --- 1,2,3,4 1,3 1 foot & ankle 10.1.7 Management of special situations in patients with rheumatic disease: Sepsis, Operation, Malignancy, Pregnancy, Vaccination, All All --- --- 1,2,3,4, 5,7 1,2,3,4,5,6,7,8 1 and Disease Flare Up 10.1.8 Medications management in rheumatic disease All All --- 1,2,5 All 1,2,3,4,5,6,7,8 1 10.2 Biologic Care 10.2.1 Types of biologics 2,3,4,5,7,8,9, 11 2,3,4,8 --- --- All 1,2,3,5,6,7, 8 1 10.2.2 Patient assessment and screening for biologic therapy All 1,2,3,4,5,6,8 --- --- All 1,2,3,5,6,7, 8 1 10.2.3 Counseling for biologic therapy: financial issues, pregnancy, family planning All 1,2,3,4,5,6,8 --- --- All,2,3,5,6,7,8 1 10.2.4 Delivery of biologic infusion All All --- All All 2,3,5,6,7,8 1 10.2.5 Education of self-injection All 1,2,3,4,5,6,8 --- All All 2,3,5,6,7,8 1 10.2.6 Safety monitoring All All --- All All 1,2,3,5,6,8 1 10.2.7 Data management on biologic registry 9,11 --- --- --- All 4,5,6,7 1 10.3 Patient Education 10.3.1 Patient s journey, stage of changes and coping strategies 10.3.2 Formulate and implement 1,2,3,6, 8,9 All 1,2 --- --- --- 1 patient education incorporating patient s physical, psychosocial, and All All All 1,5 --- 2,3,5,6,7 1 developmental needs 10.3.3 Identify and assist patient s All All 1,2 --- 4 --- 1 concordance to treatment 16 Rheumatology Nursing Log Book 2017
10.3.4 Patient empowerment and self-management All All All 2,3,4, 5,6 1,4,6 1,2,8,9,11,1 2 1 10.3.5 Educate and counsel patient and/or support system regarding medications, problem solving, All All All 1 --- 2,3,5,6,7 1 communication skills, stress management, and safety issues 10.3.6 Educate and advise in MDT approach including physiotherapy, occupational therapy, dietary All All All 1,6 --- 2,3,5,6,7 1 management, podiatry and social worker 10.4 Psychosocial care 10.4.1 Comprehensive psychological and social assessment All 1,4,5, 6,8 1 --- --- 3,8 1 10.4.2 Psychosocial impact of rheumatic diseases All All 1 --- --- --- 1 10.4.3 Acknowledge depression and recognize early s associated with All All 1 --- --- --- 1 various rheumatic disease processes 10.4.4 Effective communication and counseling All All 1 --- --- 2,3,8 1 10.4.5 Psychosocial aspect and current social resources from Medical Social Worker s perspective 1,2,7,9,1 1 All 1,4,5 --- --- 8 1 10.5 Care of patient with Telecommunication methods All All All All All 2,3,5,7,8 1 10.6 Coordination and collaboration of care 10.6.1 Collaborate with physicians, nurses, dietitian, social workers, psychologists, occupational therapists, physiotherapists, podiatrists and All All All 1,6 1,4 9,10,11 1 community agencies in planning appropriate management of patient problems 10.6.2 Explore and collaborate the community resources which provide All All All 1,5 1,4 9,11,13 All 17 Rheumatology Nursing Log Book 2017
psychotherapeutic services: Community Rehabilitation Network, Hong Kong Arthritis & Rheumatism Foundation 10.7 Develop nurse-led clinic All All All All All 1,2,8,9,11,1 2 All 10.8 Develop care-pathway and care model on Rheumatic diseases All 1,2,3,4,5,8 All All 1,4,6 1,2,8,9,11,1 2 All 10.9 Develop and foster patient safe environment and initiate improvement strategies in quality All All 3,4 All 1,2,3, 7 4,5,6,7,9,10, 11,12,13 All and risk management 10.10 Develop/ review clinical care protocols and facilitate change by adoption of evidence-based practice 9 5 1,5,6 1,3,5, 6 2,3,5, 6,7 1,6,7,9,11,1 2,13,14 1,2 in rheumatology care 10.11 Management and leadership skills All 7 All All 3,4,5, 6,7 All 1,2 18 Rheumatology Nursing Log Book 2017