Florence Nightingale chool of Nursing & Midwifery King s College London Practice Assessment Document (PAD) Mental Health Branch Degree 2011 Final Year 6KNIPM3B tudent name: Personal tutor: Programme Leader: Branch Leader:
Contents ection Page ection Page 1.0 General guidelines 2 4.0 Placement 3 details 21 1.1 The initial interview (placements 1-3) 2 4.1 Orientation - placement 3 22 1.2 (placements 1-3) 2 4.2 Initial interview - placement 3 23 1.3 End of placement (placements 1-2) 2 4.3 placement 3 24 1.4 ummative assessment (placement 3) 2 4.4 Action plan following midpoint - placement 3 25 1.5 ubmission of the PAD 2 4.5 ummative assessment - placement 3 26 1.6 Monitoring point with personal tutor 2 4.6 Action plan following summative assessment- placement 3 27 1.7 Mentor responsibilities 3 4.7 Personal tutor feedback- placement 3 28 1.8 ummary of PAD submission s and monitoring periods 4 5.0 ign off mentor record sheet 29 2.0 Placement 1 details 5 6.0 Assessment in practice 33 2.1 Orientation - placement 1 6 6.1 Professional values 34 2.2 Initial interview - placement 1 7 6.2 Practice outcomes 36 2.3 - placement 1 8 6.3 Assessment of clinical skills 44 2.4 Action plan following midpoint - placement 1 9 7.0 Additional skills 55 2.5 End of placement placement 1 10 8.0 ervice user/carer involvement in practice assessment 56 2.6 Action plan following end of placement - placement 1 11 9.0 Pre-registration nursing students risk assessment 58 2.7 Personal tutor feedback placement 1 12 10.0 Attendance for clinical supervision 59 3.0 Placement 2 details 13 11.0 Attendance record for practice hours 60 3.1 Orientation - placement 2 14 12.0 Record of meetings/comment sheet 78 3.2 Initial interview - placement 2 15 13.0 Action Plan sheets 82 3.3 placement 2 16 3.4 Action plan following midpoint - placement 2 17 3.5 End of placement - placement 2 18 3.6 Action plan following end of placement - placement 2 19 3.7 Personal tutor feedback placement 2 20 This Practice Assessment Document represents an important part of a formal assessment and examination procedure leading to a professional qualification. Irregularities in its use by students may count as an examination offence. Examination and assessment offences are subject to specific academic regulations, details of which can be found on the College Policy Zone (search for Regulations for Examinations ) http://www.kcl.ac.uk/college/policyzone/ 1
Guidelines for the completion of the Practice Assessment Document (PAD) for students and mentors 1.0 General guidelines Please read this document carefully and familiarise yourself with its contents. For placements 1-2 the following must be completed: Placement details Orientation Initial interview End of placement Assessment of professional values, practice outcomes and clinical skills ervice user feedback (placement 2) Attendance record for practice hours For placement 3 the following must be completed: Placement details Orientation Initial interview ummative assessment Assessment of professional values, practice outcomes and clinical skills ervice user feedback Attendance record for practice hours 1.1 The initial interview (placements 1-3) This is a formal interview between the student and mentor and should take place during the first week of placement. The following should be discussed: Mentor comments and action plans from the previous placements including years 1 and 2. Individual student learning needs/objectives for the placement. Learning opportunities on the placement and how they relate to the PAD. How to demonstrate professional values. Planned meeting times with mentor(s). 1.2 (placements 1-3) The midpoint takes place half-way through the placement. Comments and action plans from this meeting should be documented. 1.3 End of placement (placements 1-2) The end of placement is completed in the final week of placements 1 and 2. Comments and action plans from this meeting should be documented. 1.4 ummative assessment (placement 3) The final assessment of proficiency draws on evidence of assessment over a sustained period of time. The sign-off mentor may use the previous PADs and other evidence to see if competence has been and maintained previously, as well as demonstrated in the current placement. 1.5 ubmission of the PAD It is the responsibility of the student to negotiate with their mentor to ensure that the PAD is completed and ready for submission by the submission s indicated on page 4. The PAD constitutes an integral part of the formal assessment and examination process. tudents should inform their programme or branch lead in the event of non-submission. 1.6 Monitoring point with personal tutor tudents are required to discuss their PAD with their personal tutors on completion of placements 1 and 2. Professional values, practice outcomes, clinical skills and hours that were not at the minimum required level will be clearly identified and documented on the personal tutor feedback sheet. An action plan will be formulated to monitor progress. tudents should also arrange to see their personal tutor prior to submission of the PAD at the end of the year. This is to ensure that the PAD is completed satisfactorily and to answer queries/ concerns. 2
1.7 Mentor responsibilities Mentors are required to meet the criteria stipulated by the NMC tandards (2008) to support learning and assessment in practice including: uccessful completion of an NMC approved mentor preparation programme Participation in annual updating Undertaking a triennial and are responsible for: Organising and co-ordinating student learning activities in practice. upervising students in learning situations and providing them with constructive feedback on their achievements. etting and monitoring achievement of realistic learning objectives. Assessing total performance including skills, attitudes and behaviours. Providing evidence of student achievement or lack of achievement. Liaising with others (e.g. mentors, sign-off mentors, practice facilitators, practice teachers, personal tutors, programme leaders) to provide feedback, identify any concerns about the student s performance and agree action as appropriate. Providing evidence for, or acting as, sign-off mentors with regard to making decisions about achievement of proficiency at the end of a programme. First day: Orientation to ward Within 48 hours: Mentor allocated End of first week: Duty rota completed to achieve 40% of time working with mentor Aims and objectives for the placement agreed with mentor at initial interview of placement: Arrange and complete midpoint with Mentor If necessary, Mentor to complete Action Plan following midpoint Penultimate week : Arrange with Mentor for end of placement /summative assessment for final placement Final week: Mentor will assess practice including: Professional values, practice outcomes and performance of clinical skills Outcome 1 Required level : no action to be taken Outcome 2 ome values, outcomes or skills not at the required level: complete Action Plan The flow chart opposite is a guide for students and mentors as to the process of assessment for each placement. 3
1.8 ummary of PAD submission s and monitoring periods Placement tudent Administrator Personal tutor Branch leader Monitoring periods 1 ubmit to JCMB G15 Bc W/C 14 Oct 2013 Monitors student progress in practice Bc 28 Oct 8 Nov 2013 Bc Meet with personal tutor Monitors action plans. 150 hours during monitoring period. Reports to exam boards. 2 Bc 187.5 hours 3 Bc 450 hours TOTAL 787.5 ubmit to JCMB G15 Bc W/C 10 Feb 2014 Meet with personal tutor during monitoring period. ubmit to JCMB G15 on Monday NOT W/C - 7 July 2014 Meet with personal tutor during monitoring period. Final Hours As soon as completed but no later than midday on 28 July 2014 Data entry of student hours/night duty/sickness. Return PAD to personal tutor. Report non-submissions to branch leads. Data entry of student hours/night duty/sickness. Return PAD to personal tutor. Report non-submissions to branch leads. Data entry of student hours/night duty/sickness. Return PAD to tudent ervices. Report non-submissions to branch leads. Meet with student to PAD during monitoring period. Complete action plan if required cc branch lead, student file. Return PAD to student Meet with student to PAD during monitoring period. Complete action plan if required cc branch lead, student file. Return PAD to student. Meet with student to PAD during monitoring period. Check all elements of the PAD are complete before the student submits the PAD for the final time Monitors student progress in practice Monitors action plans. Reports to exam boards. Monitors student progress in practice Monitors action plans. Reports to exam boards. Completes registration process Bc 24 Feb 7 March 2014 Bc 23 June - 4 July 2014 4
2.0 Placement 1 details Placement details to be completed by student: Name of placement Trust /organisation Allocation (s) From to Personal Tutor Ext Document to be submitted on Placement details to be completed by mentor: Mentor(s) signature Date Professional qualification Mentorship qualification 5
2.1 Orientation placement 1 Orientation to practice area should take place during the first day of placement. Date The following issues must be discussed with the student on the first day of placement: Issue Fire number Fire procedure Location of fire exits Location of fire equipment: fire blankets, hose reels, extinguishers Cardiac arrest number Resuscitation trolley ecurity number Ward/department/school/community setting layout Trust/placement policies to include Manual Handling Policy and procedures for managing violent and aggressive patients pecific local policies /guidelines i.e. COH(H) ignature of student ignature of staff member 6
2.2 Initial interview placement 1 The initial interview should take place between the student and their mentor, during the first week of the placement. Please together: 1. The student s personal objectives for this placement. 2. The experiences available on this placement that will enable the student to achieve the professional values, practice outcomes and clinical skills. 1. My personal objectives for this placement are: 2. The experiences available on this placement that will enable me to achieve the professional values, practice outcomes and clinical skills are: comments: I have ed the mentor s comments from the previous placements (in years 1 and 2) and any areas for development have been included in my comments above. signature... tudent s signature... Date... 7
2.3 - placement 1 tudent s self-assessment Progress in achieving personal objectives: Progress in achieving competence in professional values, practice outcomes and clinical skills: assessment Progress in achieving personal objectives: Progress in achieving competence in professional values, practice outcomes and clinical skills: signature... tudent s signature... Date... 8
2.4 Action plan following midpoint placement 1 (if required) Following a meeting between mentor and student, the following action plan has been agreed: Area for further development What needs to be demonstrated How can this be demonstrated Date for signature... tudent s signature... Date... 9
2.5 End of placement placement 1 tudent s self-assessment Progress in achieving personal objectives : Progress in achieving competence in professional values, practice outcomes and clinical skills: assessment Progress in achieving personal objectives : Progress in achieving competence in professional values, practice outcomes and clinical skills: signature... tudent s signature... Date... 10
2.6 Action plan following end of placement placement 1 (if required) Following a meeting between mentor and student, the following action plan has been agreed: Area for further development What needs to be demonstrated How can this be demonstrated Date for signature... tudent s signature... Date... 11
2.7 Personal tutor feedback placement 1 Professional values: Minimum level required: Consistently Able Yes No Indicate any not completed or marked Unsafe (U) Practice outcomes: Minimum level required: Consistently Able Yes No Indicate any not completed or marked Novice(N)/Unsafe (U) Clinical skills: Minimum level required: Consistently Able Yes No Indicate any not completed or marked Novice (N)/Unsafe (U) Hours: All required hours complete from this placement Yes No If more than 1 week, action plan required Hours: All required hours complete from previous year Yes No Personal tutor comments/action plan if required (cc action plan to Branch Lead and student file) Review :.. tudent s name: tudent s signature: Date: Personal tutor s signature: 12
3.0 Placement 2 details Placement details to be completed by student Name of placement Trust /organisation Allocation (s) From to Personal Tutor Ext Document to be submitted on Placement details to be completed by mentor Mentor(s) name signature Date Professional qualification Mentorship qualification 13
3.1 Orientation placement 2 Orientation to practice area should take place during the first day of placement. Date The following issues must be discussed with the student on the first day of placement: Issue Fire number Fire procedure Location of fire exits Location of fire equipment: fire blankets, hose reels, extinguishers Cardiac arrest number Resuscitation trolley ecurity number Ward/department/school/community setting layout Trust/placement policies to include Manual Handling Policy and procedures for managing violent and aggressive patients pecific local policies /guidelines i.e. COH(H) ignature of student ignature of staff member 14
3.2 Initial interview placement 2 The initial interview should take place between the student and their mentor, during the first week of the placement. Please together: 1. The student s personal objectives for this placement. 2. The experiences available on this placement that will enable the student to achieve the professional values, practice outcomes and clinical skills. 1. My personal objectives for this placement are: 2. The experiences available on this placement that will enable me to achieve the professional values, practice outcomes and clinical skills are: comments: I have ed the mentor s comments from the previous placements and any areas for development have been included in my comments above. signature... tudent s signature... Date... 15
3.3 - placement 2 tudent s self-assessment Progress in achieving personal objectives: Progress in achieving competence in professional values, practice outcomes and clinical skills: assessment Progress in achieving personal objectives: Progress in achieving competence in professional values, practice outcomes and clinical skills: signature... tudent s signature... Date... 16
3.4 Action plan following midpoint placement 2 (if required) Following a meeting between mentor and student, the following action plan has been agreed: Area for further development What needs to be demonstrated How can this be demonstrated Date for signature... tudent s signature... Date... 17
3.5 End of placement placement 2 tudent s self-assessment Progress in achieving personal objectives : Progress in achieving competence in professional values, practice outcomes and clinical skills: assessment Progress in achieving personal objectives : Progress in achieving competence in professional values, practice outcomes and clinical skills: signature... tudent s signature... Date... 18
3.6 Action plan following end of placement placement 2 (if required) Following a meeting between mentor and student, the following action plan has been agreed: Area for further development What needs to be demonstrated How can this be demonstrated Date for signature... tudent s signature... Date... 19
3.7 Personal tutor feedback placement 2 Professional values: Minimum level required: Consistently Able Yes No Indicate any not completed or marked Unsafe (U) Practice outcomes: Minimum level required: Consistently Able Yes No Indicate any not completed or marked Novice (N)/Unsafe (U) Clinical kills: Minimum level required: Consistently Able Yes No Indicate any not completed or marked Novice (N)/Unsafe (U) Hours: All required hours complete from this placement Yes No If more than 1 week, action plan required Hours: All required hours complete from previous placement Yes No Personal tutor comments/action plan if required (cc action plan to Branch Lead and student file) Review :.. tudent s name: tudent s signature: Date: Personal tutor s signature: 20
4. Placement 3 details Placement details to be completed by student Name of placement Trust /organisation Allocation (s) From Personal Tutor to Ext Document to be submitted on Placement details to be completed by mentor Mentor(s) name signature Date Professional qualification Mentorship qualification Placement details to be completed by ign Off mentor ign off Mentor(s) name ign off signature Date 21
4.1 Orientation placement 3 Orientation to practice area should take place during the first day of placement. Date The following issues must be discussed with the student on the first day of placement: Issue Fire number Fire procedure Location of fire exits Location of fire equipment: fire blankets, hose reels, extinguishers Cardiac arrest number Resuscitation trolley ecurity number Ward/department/school/community setting layout Trust/placement policies to include Manual Handling Policy and procedures for managing violent and aggressive patients pecific local policies /guidelines i.e. COH(H) ignature of student ignature of staff member 22
4.2 Initial interview placement 3 The initial interview should take place between the student and their mentor, during the first week of the placement. Please together: 1. The student s personal objectives for this placement. 2. The experiences available on this placement that will enable the student to achieve the professional values, practice outcomes and clinical skills. 1. My personal objectives for this placement are: 2. The experiences available on this placement that will enable me to achieve the professional values, practice outcomes and clinical skills are: comments: I have ed the mentor s comments from the previous placements and any areas for development have been included in my comments above. signature... tudent s signature... Date... 23
4.3 - placement 3 tudent s self-assessment Progress in achieving personal objectives: Progress in achieving competence in professional values, practice outcomes and clinical skills: assessment Progress in achieving personal objectives: Progress in achieving competence in professional values, practice outcomes and clinical skills: signature... tudent s signature... Date... 24
4.4 Action plan following midpoint placement 3 (if required) Following a meeting between mentor and student, the following action plan has been agreed: Area for further development What needs to be demonstrated How can this be demonstrated Date for signature... tudent s signature... Date... 25
4.5 ummative assessment placement 3 tudent s self-assessment Progress in achieving personal objectives : Progress in achieving competence in professional values, practice outcomes and clinical skills: assessment Progress in achieving personal objectives : Progress in achieving competence in professional values, practice outcomes and clinical skills: signature... tudent s signature... Date... 26
4.6 Action plan following summative assessment placement 3 (if required) Following a meeting between mentor and student, the following action plan has been agreed: Area for further development What needs to be demonstrated How can this be demonstrated Date for signature... tudent s signature... Date... 27
4.7 Personal tutor feedback placement 3 Professional values: Minimum level required: Consistently Able Yes No Indicate any not completed or marked Unsafe (U) Practice outcomes: Minimum level required: Consistently Able Yes No Indicate any not completed or marked Novice (N)/Unsafe (U) Clinical kills: Minimum level required: Consistently Able Yes No Indicate any not completed or marked Novice (N)/Unsafe (U) ervice user/carer feedback Yes No Clinical supervision (minimum 4 sessions) Yes No ign off mentor verification Yes No Hours: All required hours complete from this placement Yes No If more than 1 week, action plan required Hours: All required hours complete from previous placement Yes No Personal tutor comments/action plan if required (cc action plan to Branch Lead and student file) Review :.. tudent s name: tudent s signature: Date: Personal tutor s signature: 28
5.0 ign-off mentor record sheet The NMC identify that sign-off mentors must have time allocated to reflect, give feedback and keep records of student achievements in their final period of practice learning. This will be the equivalent of an hour per student per week, in addition to the 40% time working with the mentor. The time allocated may need to be greater earlier in the placement and reduced as they become more confident and competent (NMC 2007). The first meeting should include a discussion of the student s on-going record of achievement from years 1 and 2 and final year s placements. Name of ign-off Mentor Name of Trainee ign-off Mentor Date and time Time spent on ing evidence, discussions and documentation should all be recorded ignature of sign-off mentor and student and time spent in activity igned mentor igned student.. Time spent igned mentor igned student Time spent igned mentor igned student Time spent 29
ign-off mentor record sheet continued Date and time Time spent on ing evidence, discussions and documentation should all be recorded ignature of sign-off mentor and student and time spent in activity igned mentor igned student.. Time spent igned mentor igned student Time spent. igned mentor.. igned student Time spent. igned mentor.. igned student Time spent. 30
ign-off mentor record sheet continued Date and time Time spent on ing evidence, discussions and documentation should all be recorded ignature of sign-off mentor and student and time spent in activity igned mentor igned student. Time spent igned mentor igned student Time spent. igned mentor igned student Time spent. igned mentor igned student Time spent. 31
ign-off mentor record sheet continued Date and time Time spent on ing evidence, discussions and documentation should all be recorded ignature of sign-off mentor and student and time spent in activity igned mentor igned student. Time spent igned mentor igned student Time spent. ign-off Mentor Verification tatement: I verify that this student [give name] meets the proficiencies required for Nursing and Midwifery Council registration. ign-off mentor s name (please print) NMC PIN No ignature Date 32
6.0 Assessment in practice Assessment in practice consists of three domains: professional values, practice outcomes and clinical skills. The performance rating scale below is used to assess practice. Quality of Performance Outcome The student is unable to follow instructions or guidance from the mentor. The student has a lack of understanding of the rationale for the activity. The student spends excessive time on the activity placing little focus on the patient. The student is dependent on guidance and clear prompts to undertake the activity. The student has some understanding of the rationale for the activity. The student may lack confidence, spending considerable time on the activity with some attempt to focus on the patient. The student is able to perform the activity under moderate supervision within a controlled scenario. The student is skilful in some aspects and demonstrates an understanding of the rationale for the activity. The student has some degree of confidence in the activity, some efficiency in the use of time with some focus on the patient. The student is competent in performing the activity under minimal supervision. The student demonstrates a clear understanding of the rationale for the activity. The student is skilful and coordinated with economical use of time and is able to focus on the patient. The required level of achievement that needs to be obtained: The student has demonstrated unsafe practice through the inability to discuss, perform and/or follow instructions despite repeated guidance. The student is able to perform the activity safely under direct supervision and guidance. The student can discuss and perform elements of the activity safely with moderate supervision and guidance, but may not always achieve this. The student is able to demonstrate competent, safe practice with minimal supervision. The student is able to apply relevant knowledge and evidence to practice and discuss the transfer of this knowledge to more complex situations. Professional values: the level of achievement in this domain is consistently able () for each practice placement in year three. Unsafe (U) Expectation in CFP Novice (N) Expectation in Year 2 ometimes Able (A) Expectation in Year 3 Consistently Able () Practice outcomes: must be assessed in each placement in year three. The level of achievement in this domain is consistently able () by the end of year three. Clinical skills: must be assessed across a range of placements and to consistently able () by the end of year three. 33
Professional Values
6.1 Professional values Key to s: Consistently Able =, Unsafe = U Placement 1 Placement 2 Placement 3 1. At all times demonstrates behaviour in accordance with the NMC tandards of Conduct, Performance and Ethics for nurses and midwives. Minimum level required End of placement signature and End of placement signature and ummative assessment signature and Maintains a professional attitude through presentation of self in accordance with the dress code policy in the workplace. Acts in a professional manner with all patients, clients, visitors, and health care team members. Demonstrates consistent punctuality and time keeping. Recognises unsafe practice and consults appropriately. 2. Demonstrates respect for the individual Awareness in community settings that you are a guest in that person s home. Asks the patient or client how they wish to be addressed. When communicating with patients, clients, visitors and health care team members gives individual attention. Acknowledges that individuals have choices and rights. Gains permission before undertaking care procedures ie obtains consent. Gives appropriate information to inform choice. Respects individual s culture, age, gender, sexuality, religion, impairment or disability. 34
Key to s: Consistently Able =, Unsafe = U Placement 1 Placement 2 Placement 3 3. Acknowledges and respects the rights, values, customs and beliefs of individuals and groups Identifies how own beliefs and values may impact on patients and clients care. Understands how values, customs and beliefs may impact on health and social care needs. Avoids labels which stigmatise individuals. Understands and follows the equality and diversity policies of the workplace. Minimum level required End of placement signature and End of placement signature and ummative assessment signature and 4. Maintains privacy and dignity Ensures privacy when carrying out personal care. Ensures privacy when discussing intimate or personal information. Demonstrates sensitivity when maintaining dignity for patients and clients. 5. Maintains confidentiality Practices in accordance with confidentiality policies. Maintains patient and client confidentiality when using practice experience for own learning. 35
Practice Outcomes
6.2 Practice outcomes NMC tandards of proficiency for entry to the register. Practice outcomes for placements 1, 2, 3 (Branch Year 3) 1. Handover Minimum level required The student is able to: Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 1a. Identify and record relevant information for patient care. 1b. Identify additional sources of information required prior to patient assessment, particularly if there are concerns about risk. 1c. Consult with mentor/supervisor if unsure of own level of competency. 1d. Demonstrate understanding and/or need to refer to local and national policies, evidence base/protocol for care. 1e. Recognise and consider equality and diversity issues for individual patients. 1f. Handover patient caseload clearly and concisely and identify key issues for patients and healthcare team. 36
NMC tandards of proficiency for entry to the register. Practice outcomes for placements 1, 2, 3 (Branch Year 3) 2. Assessment Minimum level required The student is able to: 2a. elect and use a relevant assessment tool in relation to patient and staff safety: 1. Lone worker (for community settings) 2. Environment 3. Patient safety 4. afety of others 2b. Establish rapport with patient/ family to identify bio psychosocial needs and appropriate interventions. Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 2c. Acknowledge and support the right of individuals /groups respecting individual choices and the right to confidentiality. 2d. Refer to appropriate patient care records /documentation to inform ongoing assessment. Conduct and document a holistic assessment with regard to the individual s (or local community s): 2e. Emotional, physical, psychological, spiritual and social well-being. 37
NMC tandards of proficiency for entry to the register. Practice outcomes for placements 1, 2, 3 (Branch Year 3) 2. Assessment (cont) Minimum level required 2f. Patient/family/carer/local community needs. Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 2g Discharge plan/need for alternative care setting. 2h. Promoting health and well being. 2i. Analyse information gathered, identify and record patient needs/problems. 2j. Prioritise interventions based on caseload and acuteness of need. 38
NMC tandards of proficiency for entry to the register. Practice outcomes for placements 1, 2, 3 (Branch Year 3) 3. Care delivery Minimum level required The student is able to: 3a. Work collaboratively with patients/ families and carers as part of the team in planning care. Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 3b. Demonstrate an understanding of informed consent for patients and how it is applied. 3c. Discuss and negotiate interventions with patients/ carers/family and the team members. 3d. Review and compile a care plan that is specific, measurable, achievable and reflects current needs. 3e. Provide a rationale for nursing interventions taking account of equality and diversity, privacy and dignity, spiritual care, acuteness of health and well-being needs, social needs and risk. 3f. Provide care with skill and sensitivity relevant to patient, family and carer needs. 39
NMC tandards of proficiency for entry to the register. Practice outcomes for placements 1, 2, 3 (Branch Year 3) 3. Care delivery (cont) Minimum level required 3g. Document care effectively in accordance with professional, ethical and legal requirements. Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 3h. Refer the patient to other health and social care professionals as appropriate. 3i. Recognise the need to adapt care plans and interventions when circumstances change. 3j. Take the opportunity for informal teaching with patients/family, carers, other health professionals and students. 3k. Utilise clinical information systems and/or the Patient Electronic Record (PER) to order and/or obtain information/results. 40
NMC tandards of proficiency for entry to the register. Practice outcomes for placements 1, 2, 3 (Branch Year 3) 4. Evaluation Minimum level required The student is able to: Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 4a. Evaluate and record patient progress with reference to care provided in the appropriate documentation. 4b. Identify whether care provided met the patient/family/carer expectations. 4c. Critically discuss the evidence base for interventions used relevant to the allocated caseload. 4d. Identify recommendations for improving the patient s/ family s/ carer s experience (service improvement). 41
NMC tandards of proficiency for entry to the register. Practice outcomes for placements 1, 2, 3 (Branch Year 3) 5. Management of self and Minimum level others required The student is able to: 5a. Critically reflect on own patient workload planning and prioritisation for management of simple patient caseload or complex patient caseload. Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 5b. Demonstrate understanding of the impact of unexpected events (eg staff sickness, untoward incidents) on the workforce for the shift. 5c. Critically reflect how feedback from patient/carers/family influences own learning. 5d. Demonstrate ability to recognise when issues of conflict or challenge arise in team working. 5e. Critically reflect on how own mood and physical health impacts on their ability to provide care for patients. 42
NMC tandards of proficiency for entry to the register. Practice outcomes for placements 1, 2, 3 (Branch Year 3) 5. Management of self and Minimum level others (cont) required 5f. Delegate activities appropriately to others in the healthcare team. Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 5g. Co-ordinate the delivery of nursing and healthcare for the patient caseload. 5h. Demonstrate effective leadership in the maintenance of safe nursing practice. 5i. Respond to constructive feedback from mentors/supervisors and demonstrate how this contributes to personal development. 5j. Identify personal strengths and areas for development and how to act on these. 43
Clinical kills
6.3 Assessment of clinical skills Care delivery For entry to the register, under supervision, the student is able to: Engagement and psychosocial skills 1. Make and maintain working relationships with patients and/or carers Minimum level required Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 2. Describe practice of enhanced observation 3. Use a solution-focused approach with patients during one to one sessions/individual time 4. Identify and/or use interventions related to cognitive behaviour therapy 5. Apply psychodynamic concepts in their understanding of complex situations with patients and staff 6. Identify ways to help a patient maintain or find work or other meaningful activities 7. Involve patients in their care 8. Acknowledge spiritual needs and respond to these 9. Work collaboratively with carers 44
Care delivery For entry to the register, under supervision, the student is able to: Medication administration 10. afely and effectively administer medication following the steps outlined below: a) Checks that prescription written legibly in the approved drug name b) Identifies patient, history and allergies c) Checks drug (strength, dose and formulation) d) Checks route,, time and frequency e) Completes calculations accurately and independently f) Prepares any relevant equipment g) Describes the use, side effects and contraindications of the administered drug h) Communicates with patient during administration: assessing side effects and giving information i) Identifies whether informed consent has been given j) Administers medication in accordance with Infection Control procedures k) Disposes of sharps in accordance with local policy l) Describes the procedure for reporting errors or near misses without consent Minimum level required Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 45
Care delivery For entry to the register, under supervision, the student is able to: Medication administration 11. Apply principles of motivational interviewing to medication management a) Asks the patient their view of the good and bad things about their medication b) Acknowledges that patient may be ambivalent about medication c) Adopts a neutral attitude towards medication Minimum level required Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 12. Demonstrate understanding of local policy for ECT a) Describes the rationale for ECT b) Describes nursing procedures for preparing patient for ECT and for recovery after treatment 46
Care delivery For entry to the register, under supervision, the student is able to: Physical health care 13. Carry out assessment of physical health a) Temperature (orally and per axilla) Minimum level required b) Rate and quality of respirations c) Pulse d) Blood pressure, including lying and standing measure e) Urinalysis f) Blood sugar level g) Neurological observations h) Weight i) Height j) Calculate BMI k) Measure and record fluid input and output l) Measure and record dietary intake Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment m) Identify any need for assessment of skin integrity n) creen mobility and identify need for referral to physiotherapist/ot o) creen for swallowing difficulties and identify need for referral to peech Therapist 47
Care delivery For entry to the register, under supervision, the student is able to: Physical health care 14. Demonstrate ability to provide appropriate physical health care a) Helps patient maintain their personal hygiene sensitively and safely b) Identifies any need for assistance with eating or drinking c) Recognises any problems with elimination (e.g. constipation, incontinence) and takes appropriate action d) Recognises need for oral care and, where appropriate, carries this out safely e) Understands principles of asepsis as applied to minor wounds and burns Minimum level required Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 15. Enable a patient to develop a plan to improve their physical health/lifestyle a) Helps the patient to identify lifestyle factors affecting physical health b) Helps the patient identify motivation to change health c) Helps the patient identify appropriate goals and steps to achieve these d) Helps the patient evaluate progress and reformulate plan 48
Care Delivery For entry to the register, under supervision, the student is able to: Physical health care 16. Demonstrate ability to identify Early Warning igns in potentially worsening medical conditions and take appropriate action Minimum level required Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment a) Identifies normal limits of physical observations and acts on any changes b) Identifies any other critical abnormalities and appropriate action (Examples may include: shortness of breath, altered level of consciousness, confusion, chest pain, ataxia, low urinary output, haematemesis, melaena) c) Identifies different types of shock and action to take d) Identifies hypo- and hyperglycaemic states and indicates appropriate action 49
Care Delivery For entry to the register, under supervision, the student is able to: Physical health care 17. Apply the principles of infection control to practice Minimum level required Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment a) Identifies potential sources of infection b) Is aware of basic precautions in food handling c) Washes hands correctly d) Identifies means of disposing of waste products e) Assembles sharps bins correctly, uses and disposes of it appropriately f) Uses retractable needles and blood lancets appropriately g) Describes what to do in event of needlestick injury 50
Care delivery For entry to the register, under supervision, the student is able to: Managing emergencies 18. Identify strategies to safely and effectively manage anger and violence a) Identifies factors which can improve communication and minimise aggression from first point of contact b) Identifies increasing risk of aggression c) Identifies steps to reduce likelihood of aggression d) Helps the patient to identify means to manage own aggressive feelings e) Reflects on own/service s role in relation to patient aggression 19. Identify role in emergency situations and has awareness of how to contribute to their management a) Accurately identifies emergency or potential emergency situations b) Takes prompt and effective action in first instance c) ummons appropriate help d) Works as a calm, effective team member during emergency e) Contributes appropriately to postincident analysis f) Participates in documentation and reporting of incident Minimum level required Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 51
Care delivery For entry to the register, under supervision, the student is able to: Legal procedures 20. Correctly identify nurse s role with regard to Mental Health Act (1983) as Amended by the MHA (2007), the Mental Capacity Act (2005) and the Deprivation of Liberty safeguards a) Identifies indications for referral for section assessment b) Demonstrates knowledge of conditions for application of Nurses Holding Power c) Describes the process for accepting section papers accurately and legally d) Explains rights to patients and checks understanding e) Identifies the psychological effects on the patient who is detained under MHA f) Observes the preparation of a nursing report for MHA appeal hearing g) Understands the role of a nurse in ensuring good practice for agreed leave Minimum level required Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 52
Care delivery For entry to the register, under supervision, the student is able to: Legal procedures 21. Correctly identify nurse s role with regard to Care Programme Approach a) Identifies role of care co-ordinator for CPA b) Accurately completes needs assessment c) Contributes to the formulation of a MDT care plan d) Aware of procedures and administration of the upervised Community Treatment and CTOs. Minimum level required Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment 22. Correctly identify nurse s role in safeguarding children a) Identifies limits of confidentiality with respect to safeguarding children b) Aware of procedures for assessment of child safety c) Describes local procedures for referral to Local Authority children s services or to police 53
Care delivery For entry to the register, under supervision, the student is able to: Legal procedures 23. Describe nurse s role in Protection of Vulnerable Adults (POVA): Minimum level required Placement 1 Placement 2 Placement 3 End of placement End of placement ummative assessment a) Identifies different potential types of neglect or abuse b) Describes action to be taken if neglect or abuse suspected 54
7.0 Additional skills List any opportunities to practise additional skills kills Comments on performance 55
8.0 ervice user/carer involvement in practice assessment for nursing students These sheets must be completed in three different placements during the branch programme: one in the final placement of year 2, and in the final two placements of year 3. Consent must be gained from the service user/carer with the mentor present to participate in this exercise. If the service user/carer only wishes to discuss this with the student rather than complete the form below, the mentor could record the points raised below. We would like to hear your views about the way nursing students have contributed to the care you have received. You do not need to disclose your name. The feedback you give will not affect the care you receive and there is no requirement for you to participate (if a carer, this relates to care given to the service user). Please comment on (student name):.................................................. s strengths and weaknesses. Please state what you feel they have done well. Please state what they could do to improve their nursing care. Please add any other information you think would be helpful. Placement name: Date: signature (witness): ervice user s/carer s initials: tudent s initials: 56
ervice user/carer involvement in practice assessment for nursing students (continued) Consent must be gained from the service user/carer with the mentor present to participate in this exercise. If the service user/carer only wishes to discuss this with the student rather than complete the form below, the mentor could record the points raised below. We would like to hear your views about the way nursing students have contributed to the care you have received. You do not need to disclose your name. The feedback you give will not affect the care you receive and there is no requirement for you to participate (if a carer, this relates to care given to the service user). Please comment on (student name):.................................................. s strengths and weaknesses. Please state what you feel they have done well. Please state what they could do to improve their nursing care. Please add any other information you think would be helpful. Placement name: Date: signature (witness): ervice user s/carer s initials: tudent s initials: 57
9.0 Pre-registration nursing students risk assessment The following form must be completed when pre-registration nursing students are visiting patients/clients in their own homes, unaccompanied by Trust staff. The form must be stored in the student s Practice Assessment Document. Name of student... Name of clinical placement... Dates: From... To.... Identifying the hazard Please indicate any hazards the student may be exposed to in the patient s/client s home Identifying control measures to reduce risk Please indicate action taken for controlling hazards and risks identified Additional information Please indicate any additional information such as prohibited activities or other hazards that may affect the student I have discussed the above with the student. I have assessed the student as competent to undertake identified nursing care with identified patients in an unaccompanied capacity. ignature of mentor... Date... I have had the opportunity to discuss the above with my mentor. I feel competent to visit identified patients unaccompanied and know what action to take in the event of an emergency. ignature of student... Date... 58
10.0 Attendance for clinical supervision sessions All third year students must attend a minimum of six clinical supervision sessions within year 3 and have each of these signed and d in the PAD. Please note that attendance is mandatory and that clinical supervision is supported and recognised by the NMC. Ground rules for clinical supervision will be given to students prior to commencing year 3 and these should be shared with mentors. Please list below the s on which you have attended clinical supervision so that we can see how many you have attended. If you attend a clinical supervision session when you are on shift, this cannot be claimed as extra clinical hours. If your clinical supervision takes place when you are not on shift, you may claim this as clinical time but you must record it on the weekly timesheet page and it must be signed off. 1 2 3 4 5 6 7 8 9 Date attended clinical supervision ignature of supervisor 59
Timesheets
11.0 Attendance record for practice hours Completing your record of placement hours Trust inductions count as clinical hours and must be recorded and signed off at the time of induction No more than 48 hours may be worked in any one week No more than 11.5 hours may be worked per shift (this excludes breaks) If you work more than the above stipulated hours per shift or per week, the excess hours will not be counted in the total for the placement. Completing your weekly timesheets Record the hours you have been rostered to work each week. Then, in the appropriate column, indicate the actual shift times you worked, and the total number of hours this equates to. For each shift worked you must obtain the signature of your supervisor ie qualified nurse or mentor (or other professional), who can verify the hours worked. hifts that have not been signed will not be included in your total. Ensure you indicate, using N, if the shift was a night shift. If you are sick, and did not work the rostered hours, you must indicate this using against the relevant shift. You must also complete the on-line notification: https://www.kcl.ac.uk/teares/nmvc/prereg/absence/student/index.php If you are sick/absent and make up hours, these should be recorded in the separate section at the end (page 76), and added to the overall placement total. Record the total hours for each WEEK. Write the TOTAL number of hours worked on the placement in the box at the end. All changes to written information must be verified with a new. One line through a mistake and no tippex. PADs that are filled in incorrectly, or where the weekly or overall totals have not been completed, will be returned for correction before being processed. Please see the example on the following pages, and ensure your document is completed in the same manner. 60
EXAMPLE Placement 1, Week 1 Date Rostered hours Actual hours completed Indicate if night shift (N). If you did not work the shift, indicate if sick () Total hours M 13 ept 2010 07.30 15.30 07.30 15.30 7.5 D Jones T 14 ept 2010 07.30 15.30 07.30 15.30 7.5 D Jones W 15 ept 2010 07.30 15.30 07.30 15.30 7.5 D Jones T 16 ept 2010 07.30 15.30 07.30 15.30 7.5 D Jones F 17 ept 2010 07.30 15.30 07.30 15.30 7.5 D Jones Total practice hours this week 37.5 Placement 1, Week 2 Date Rostered hours Actual hours completed Indicate if night shift (N). If you did not work the shift, indicate if sick () Total hours M 4 October 2010 07.30 15.30 07.30 15.30 7.5 D Jones T W 6 October 2010 20.15 07.45 20.15 07.45 N 10.5 D Jones T 7 October 2010 20.15 07.45 20.15 07.45 N 10.5 D Jones F 8 October 2010 20.15 07.45 None Total practice hours this week 28.5 upervisor s signature upervisor s signature 61