School of Nursing & Midwifery Clinical Module 3 Adult Branch. Ongoing Record of Achievement and Assessment of Practice. Module code: NAM2009

Transcription

1 School of Nursing & Midwifery Clinical Module 3 Adult Branch Ongoing Record of Achievement and Assessment of Practice Module code: NAM2009 Student Name: Student Number: Intake: Personal Tutor: Programme Co-ordinator: Contact Number: If this booklet is found, please return to: School of Nursing and Midwifery, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL Telephone:

2 7 8 9 Submission date 2

3 CONTENTS Page About the Module General information concerning the module and its assessment 4-5 NMC proficiency standards for year 3 6 Documenting experiences, progress and achievement... 7 Skills - scores and descriptors 7 Personal Development Statement and reflection 8-9 Action Plans for future learning 9 Clinical Protocols Attendance and Sickness/Absence Policy Injury in Practice 14 Student Responsibilities While on 15 Responsibilities of the Mentor.. 16 Responsibilities of the Link Lecturer 17 Student Issue Arising in Practice Protocol 18 Specific Student Support Issues 19 NMC Criteria for Entry to the Register Clinical Skills: Care, Compassion and Communication Organisational Aspects of Care Infection Prevention and Control Nutrition and Fluid Management Medicines Management Additional skills Core Clinical Skills Percentile feedback on performance in Clinical module 2 OSCE. 62 Documentation for placements Documentation Personal Tutor Report Documentation Personal Tutor Report 99 9 Documentation Supplementary placement Summative Report Clinical Module Link Lecturer Record SECTION 2: Additional Student Support Record Additional student support record 137 It is important to make contact with your personal tutor after submission of your ongoing record of achievement to arrange a time for discussion and reflection on personal progress. 3

4 This booklet is an extremely important document and you should keep it carefully. It will be the focus of the assessment of your progress and achievement and your mentor or link lecturer will want to see it regularly throughout placements. You will also be required to submit it to your personal tutor at the end of each placement on a specified date. 1. It will help to focus your learning in clinical practice. 2. It encourages you to relate theory to practice. 3. It documents your experience and achievement towards the NMC Learning Outcomes Module Content This module is clinically based and will provide you with the opportunity to link theory to practice and to further develop the skills and knowledge acquired during the theoretical modules. The module will provide you with the knowledge and clinical skills required to provide holistic nursing care and to link theory to practice. Compulsory Elements 100% clinical practice attendance. Must undertake progress reports in placements 7 and 8 Successful completion of Total Care Management Assessment, Summative Clinical Practice Assessment and a Calculation Skills Test. These 3 components must be passed independently Learning Outcomes On successful completion of the module the student should be able to demonstrate evidence of achievement of the Standards of Proficiency (NMC, 2004) BSc(Hons) / Diploma in Nursing Sciences The final summative assessment cannot be undertaken if the student has ANY outstanding academic modules or components of academic modules. Key stage assessment Total Care Management A Total Care Management Assessment will be undertaken no earlier than week 10 during 9 and will include: Written Submission - Nursing Care Management Plan This written submission will be in the form of a nursing care management plan for a group of patients. A group will constitute 1-2 patients in a high dependency setting or 4 6 patients in other care settings. Please note the written submission and your Ongoing Record of achievement and Assessment of Practice must be available to the examiners (mentor and link lecturer) immediately prior to the observational assessment. If these are not available the assessment will not proceed. Planned period of observation: A lecturer and a member of clinical staff attached to the placement area will conduct the assessment. The assessment will take place over a span of duty. Each student will be observed on not less than 4 occasions, during an overall period of not more than 4 consecutive hours. Each assessor will record a minimum of 2 observations. Each period of observation should normally be between minutes duration. During the observation assessors may question students on any matter related to the observation. 4

5 Oral Examination The oral examination will take place after the 4 hour period of observation and will last for 20 minutes following period of observation and will be based on the Written Submission and observations of care. Final Summative Phase 9 A Sign off Mentor will meet with you for one hour each week during the final placement to discuss your progress and develop an action plan. The sign-off mentor may use the on going record of achievement and assessment of practice (clinical module 2 and 3) and other evidence to see if competence has been achieved and maintained previously, as well as demonstrated in the current placement. The final week of placement they will conduct the final assessment. The final summative assessment cannot be undertaken if the student has ANY outstanding academic modules or components of academic modules. 5

6 NMC STANDARDS OF PROFICIENCY: (1) Professional and Ethical Practice Manage oneself, one s practice, and that of others in accordance with the Code of Professional Conduct (NMC, 2008) recognising one s own abilities and limitations Practice in accordance with an ethical and legal framework, which ensure the primacy of patient and client interest and well-being, and respects confidentiality Practice in a fair and anti-discriminatory way, acknowledging the differences in beliefs and cultural practices of individuals or groups (2) Care Delivery Skills Engage in, develop and disengage from therapeutic relationships through the use of appropriate communication and interpersonal skills Create and utilise opportunities to promote the health and well-being of patients, clients and groups Undertake and document a comprehensive, systematic and accurate nursing assessment of the physical, psychological, social and spiritual needs of patients, clients and communities Formulate and document a plan of nursing care, where possible in partnership with patients, clients, their carers and family and friends, within a framework of informed consent Based on the best available evidence, apply knowledge and an appropriate repertoire of skills indicative of safe nursing practice Provide a rationale for the nursing care delivered which takes account of social, cultural, spiritual, legal, political and economic influences Evaluate and document the outcomes of nursing and other interventions Demonstrate sound clinical judgement across a range of differing professional and care delivery contexts (3) Care Management Skills Contribute to public protection by creating and maintaining a safe environment of care through the use of quality assurance and risk management strategies Demonstrate knowledge of effective inter-professional working practices which respect and utilise the contributions of members of the health and social care team Delegate duties to others, as appropriate, ensuring that they are supervised and monitored Demonstrate key skills (4) Personal and Professional Development Demonstrate a commitment to the need for continuing professional development and personal supervision activities in order to enhance knowledge, skills, values and attitudes needed for safe and effective nursing practice Enhance the professional development and safe practice of others through peer support, leadership, supervision and teaching NMC (2008) 6

7 Documenting experiences, progress and achievement in placement In each placement the following must be completed: Development plan Prior to each placement, you are required to complete a self-assessment to determine what knowledge and skills you have in relation to the above learning outcomes and what you still need to gain. On arrival in your placement you will be introduced to your mentor who will orientate you to the environment, people and your role. Within the first couple of days she/he should complete your orientation interview and sign it. During initial discussions your mentor will explain the type of experiences available in the placement and you should take this opportunity to consider how best to meet the learning outcomes. You then need to document the experiences/activities you have negotiated in the development plan section. You will need to have the development plan, midway review and personal development statement completed before your mentor can complete your progress report or clinical practice assessment. An action plan for future learning will be completed at the end of each placement. Skills In each placement you must indicate which skills you have practised by inserting the score from the grid which represents your experience in the appropriate column. This should be completed before your mentor completes your progress report or assessment. Score Descriptor 0 Not available 1 Not Practised 2 Limited opportunity to practise 3 Practised on a regular basis Core Clinical Skills You are expected to complete four of the identified core clinical skills during clinical module 3. It is advisable to discuss your selection with your mentor and to consider the relevance of the core clinical skill to the type of placement and your experience to date. Administration of medicines and drug calculations must be completed during clinical module 3. 7

8 Personal Development Plan A personal development statement should be completed at the end of each placement before your progress report or summative clinical practice assessment is undertaken. The purpose of this statement is to improve your ability to reflect on what and how you have been learning. It will help you to become more confident and independent in learning and more aware of the professional role of the nurse. The statement should utilise the Gibb s reflective cycle as a framework to assist development of your reflective writing. Gibbs' Reflective Cycle (1988) is viewed as straightforward and provides a cyclical framework to help guide reflective practice. Model of Reflection What do you reflect on?.reflect on experiences that you think are important because you: Think you have learnt a lot Are pleased with what you feel you have achieved Received recognition Put in considerable time and effort Found the experience either positive or enjoyable Found the experience peculiarly negative or disturbing in some way When engaging in reflection, it is important that you: Be spontaneous. Express yourself freely. Be open to ideas. Choose a time to suit you. 8

9 Be prepared personally. Choose a reflective model (Taylor, 2001) This should include evidence of a developing knowledge base that underpins safe nursing practice and evaluate your progress towards achievement of the learning outcomes for the module. The personal development statement will influence your action plan for future learning Action Plan for future learning The action plan in each placement should articulate your personal goals and refer directly to the learning outcomes. This will help you to develop a positive attitude to learning and a personal strategy for success. 9

10 Clinical Supervision When undertaking clinical practice you will be assigned a Mentor who will oversee and guide your practice and learning in the clinical environment. This will normally be a registered nurse who is one of the staff in the placement facility. Your Mentor will also assess your progress towards achieving learning outcomes, and in conjunction with yourself and educational staff, ensure that areas of non-achievement are identified and appropriate measures taken. The link lecturer will maintain contact with you during your placements. This may take the form of a personal visit, or telephone call as appropriate. You are responsible for contacting the link lecturer should you have queries on any matter while in practice. Planned liaison shall take place to ensure maximum learning opportunities and learning outcomes are achieved. Levels of Contact Contact is defined as a personal visit, or telephone call. Year 3 Length of Number of contacts Academic Staff present at Summative Assessment 7 6 weeks /Telephone Contact n/a 8 6 weeks 1 personal visit contact midway if required otherwise / telephone 9 14 weeks 1 contact at commencement of 14 weeks n/a No 2 personal visit contacts prior to management assessment Presence at management assessment. Rights of Patients and Clients As a nursing student, you should respect the rights and wishes of patients and clients at all times. Any patient or client has the right to refuse to allow you to participate in their care. You should, therefore, make this clear when first giving information to patients or clients regarding the care they are about to receive. Identification When speaking to patients or clients, either directly or by telephone, you should always introduce yourself. You should make it clear that you are a student and not a registered practitioner as it is illegal for anyone to make deliberate or false representation as a registered nurse, midwife or health visitor. You must wear your authorised name badge when in uniform. 10

11 Accepting Responsibility There may be occasions when your mentor may not be able to directly accompany you as you carry out your work. As your skills, experience and confidence develop, you will become increasingly able to deal with these situations. If you find yourself in a situation where you have to perform a procedure for which you have not been fully prepared or in which you are not adequately supervised, you should not participate in that procedure. Rather, you should discuss the matter as quickly as possible with your supervisor. Confidentiality Patients and clients have the right to know that information given by them in confidence will only be used for the purpose for which it was originally given. Details of patients or clients should therefore not be discussed with any third party. Access to patient or client records (governed by local policies on the handling and storage of records) should be kept to a minimum and only used when necessary for the care being provided. A registered practitioner should closely supervise the use of records and should countersign any written entry made by you into a patient or client s record. More advice on confidentiality can be found in the Guidelines for records and record keeping (NMC 2010) Complaints Local policies are available for dealing with complaints by patients and clients or their families. If it is indicated to you that someone is unhappy with the care or treatment they are receiving, you should report the matter immediately to your supervisor, mentor or link lecturer. Uniform DHSSPS (2008) states The association between the inappropriate wearing of uniforms and the risk of infection is inextricably linked in the public perception, and the way in which staff dress and present themselves sends messages to the public which may impact on their perception of their care or treatment. How staff dress, and their appearance, is therefore of significant importance in portraying a professional image to all users of its service, whether patients, visitors, clients or colleagues, (p.4). When gaining clinical experience or at other times as dictated by the School, it will be necessary for you to wear a uniform. The School of Nursing and Midwifery uniform includes: Authorised tunic and trousers Black shoes (see below) Authorised outdoor wear Appropriate epaulettes for year in training Your uniform must be worn in accordance with locally agreed Health Board or Trust policies. Such policies are devised and approved to safeguard patients/clients, staff, and the public from possible risks of infection, injury, or offence. The following general guidance is given, which should be read in conjunction with any such local policies: Your uniform must be regularly laundered and changed, must be neat, clean and worn in full, in a professional manner. 11

12 Wrist or hand jewellery must not be worn when visiting or working in clinical placement; a single flat band ring is acceptable. Any visible body piercing must be removed when on duty. No unauthorised decoration should be worn, with the exception of a nurse s fob - watch and an identification badge, which should always be worn when in uniform. Closed plain black leather shoes with a low heel no more than 1" high MUST be worn. Trainers and ballerina type pumps must not be worn. Any open type shoe or sandal is a potential hazard to the wearer. Long hair must be neatly tied back and worn above the collar at all times. Long fingernails are a potential hazard to patients/clients; therefore they must always be worn short. False nails or nail varnish are not permitted in clinical practice. Make-up, if worn, should appear natural and not be excessive. Perfume/body sprays: it is important to be cognisant of the fact that these can cause irritation and potential nausea to patients and clients, especially those who are very ill. Body art may be offensive to some ill, vulnerable patients and clients and should be covered whilst on duty. Chewing gum is not permitted when on duty. When leaving the hospital grounds to go off duty, it is important that you change out of uniform. If changing facilities are not available, it is essential that the outdoor wear cover the uniform. The School of Nursing and Midwifery coat forms a compulsory part of the uniform outside of clinical areas. Information on where to purchase this will be advised. In areas where uniform is not worn, standard of dress should be in keeping with that expected of a professional. These regulations will be strictly enforced and failure to adhere to the regulations will result in you being withdrawn from practice pending resolution of the issues. Practice Hours s will be in both hospital and non-hospital settings, and will require you to undertake shifts and weekend work. Most hospital-based facilities provide care for people on a 24-hour basis, seven days per week. You will be required to be on duty during a variety of times of day/night and over the seven-day week. You will be required to work 371/2 hours per week unless otherwise advised by the module co-ordinator for clinical module 3. Attendance 100% attendance in clinical experience is mandatory. You must respect the need for punctual reporting for duty. At the discretion of the Programme Co-ordinator, if you fail to meet this requirement you will have the opportunity to compensate for clinical practice missed. If you fail to satisfy attendance requirements or if your absence is deemed to compromise the satisfactory completion of the programme you will be referred to the School Student Support Committee (SSSC) or the School Student progress Committee (SSPC). Sickness/Absence Policy If you are unable to attend for clinical experience due to illness or other extenuating circumstances, it is your responsibility to notify the manager of the ward/facility of any absence. This must be done before the time at which you are due to commence work/shift. You should expect to provide a reason for your absence and some indication of your expected length of absence. It is also your responsibility to notify the School of Nursing and Midwifery of your 12

13 absence in accordance with policies laid down in the BSc (Hons) / Diploma of Nursing and Midwifery sickness/absence policy. Failure to report absence will result in this being recorded as an unauthorised absence. Absences must also be reported to the School telephone number: This will take you to the student voice box. Please ensure to speak slowly and clearly stating your name, student number, intake, name of the placement you are allocated to and give an indication of expected length of absence. All absences will be recorded. Absence of less than 5 days should be made up during the placement period and must be re-arranged with the mentor. Self-certification of illness is permitted for an absence of up to five working days. Fully completed self-certification forms must either be sent to the medical evidence section in the undergraduate nursing sciences in the MBC or outside office hours should be placed in the red box at reception in the foyer of the School of Nursing and Midwifery. Consecutive self-certification is not permitted. Absences of five days/one week or more must be reported to the clinical allocations unit with accompanying signed medical certificate. All absences must be made up. If this period is more than 371/2 hours clinical allocations will arrange this making up time. The time should be made up in the placement area where practice was missed. Any outstanding absences/sick time must be completed prior to commencement of placement 9 and completion of summative clinical practice assessment. NB All absences even if made up will be declared on references and should be documented on all job applications. If you are experiencing any difficulty of a professional, academic or personal nature you should advise your Personal Tutor or Programme Co-ordinator so that the appropriate support can be provided. Students who accumulate absences for which we do not have any understanding will be notified in the first instance by letter. If this happens the onus is on you as a student to forward an explanation of your absences to the Programme Co-ordinator. If your attendance continues to give cause for concern you will be called to the School Student Support committee (SSSC) or School Student Progress Committee (SSPC). Changes to Clinical Allocation and Annual Leave No student has authority to arrange or change any clinical allocation for any reason. All difficulties must be addressed through clinical allocations. Annual leave is set within the course and it will not be possible to change your annual leave. 13

14 Injury in Practice If as a student you sustain an injury of any kind in practice, you must immediately inform the mentor or clinical manager. It is essential that you adhere to local policy with regard to dealing with this injury. Any student who experiences back pain for any reason should immediately remove themselves from clinical placement and should report to QUB s Occupational Health Unit. Any student who has been absent due to back pain must be deemed fit by QUB Occupational Health Unit before resuming duty. You are reminded that you are required to adhere to Moving and Handling procedures and to make your personal tutor aware of the incident. Please note all injuries must be fully documented on the Trust s incident form and copied to the programme co-ordinator and to QUB Occupational Health Unit. 14

15 The Responsibilities of the Student in Clinical is to: On commencement of placement provide ward manager/mentor with a telephone contact number on which you can be reached. During clinical placement your on-going record of achievement should be available for your mentor to review and record your progress and support throughout each placement. Read the list of learning outcomes and discuss with your mentor how you are going to achieve them. Take every opportunity to extend your knowledge and experience and use the learning outcomes and cluster skills as a guide to negotiate a range of learning opportunities that will enable you to practise, develop and maintain competence. Negotiate opportunities to complete at least one core clinical skill in each placement, administration of medicines must be completed by 9. In each placement indicate which skills you have practised using the appropriate numerical value. Work with your mentor as often as possible. Take the initiative but always within the limits of your knowledge and experience. Don t be afraid to admit when you are unsure and ask for assistance but don t get into the habit of using this as an excuse for not taking responsibility. In each placement write a Personal Development statement before your progress report or summative clinical practice assessment is undertaken. Use the Gibb s reflective cycle to reflect on what and how you have been learning in relation to the learning outcomes. The statement should include evidence of a developing knowledge base that underpins safe nursing practice. An Action Plan will be written after discussion with your Mentor. This plan should articulate your personal goals and refer directly to the learning outcomes. Identify examples of the use of evidence in planned nursing interventions for the patients/clients in your care. Seek feedback regularly from your mentor to help you to make a realistic self-assessment of your experience and achievement. Utilise the more formal feedback that will be given in progress reports as the basis of planning your future learning requirements. Keep your entire Ongoing Record of Achievement and Assessment of Practice safe. If it is lost it will be your responsibility to replicate. 15

16 The Responsibilities of the Mentor Prioritise workload to accommodate the support of students within the clinical setting. Orientate the student to the nature of the placement and provide support to facilitate transition from one learning environment to another. Select, organise, co-ordinate and evaluate appropriate student learning activities in practice and provide feedback as required. Supervise students in learning situations and provide them with constructive feedback on their achievements throughout the experience. Set and monitor achievement of realistic learning objectives by selecting appropriate learning strategies which encourage refection on current and future learning needs and actions. Supervise student completing core clinical skills and provide feedback. Assessing total performance including skills, attitudes and behaviours. Providing evidence as required by programme providers of student achievement or lack of achievement. Liaising with others (e.g. mentors, sign-off mentors, practice facilitators, practice teachers, personal tutors, programme leaders, other staff, service users and carers) to provide feedback, identify any concerns about the student s performance and agree action as appropriate. If a student requires additional support the mentor requires to action the university policy- page 18 Support learning in an inter-professional environment. Providing evidence for, or acting as, sign-off mentors with regard to making decisions about achievement of proficiency at the end of a programme. Provide support and guidance towards achieving NMC Learning Outcomes in accordance with the Code (NMC 2008) and in conjunction with the student and lecturing staff ensure that areas of non-achievement are identified and appropriate measures are taken. Complete all commentary sections of the cluster and core clinical skills and progress reports as required for each placement, ensuring date and signatures are recorded for all entries. Effectively manage failing students. Ask questions to ascertain the student s ability to link theory to practice towards the provision of safe and effective evidence based care. Complete a progress report as required for each placement. Sign-off mentor will undertake the final summative Clinical Practice Assessment, agreeing areas of achievement or non-achievement as appropriate. Complete sickness/absence record. 16

17 Responsibilities of the Link Lecturer: Discuss and review the student s practice experiences. Liaise with Mentor to discuss student s progress. Liaise with Practice Education Facilitator if there are any issues regarding mentorship or the learning environment Guides and monitors student s progress. Support towards achieving learning outcomes and in conjunction with the student and Mentor ensure that areas of non-achievement are identified and appropriate measures are taken. Complete a progress report as required. Report any issues of concern to personal tutor / programme co-ordinator. Complete an educational audit of practice placement as required. 17

18 If a student requires additional support the mentor requires to action the university policy Queen s University Belfast School of Nursing and Midwifery Student Issue Arising in Practice Protocol ASSESS (M) ADVISE PC RESOLUTION ACTION PLAN PUT IN PROGRESS NOTES (M, LL) ISSUE CONTINUES NO FURTHER ACTION REFER TO QUB SSSM/SSPC SSSC/SSPC RESOLUTION ACTION PLAN/ RECORD IN ROA and A NO RESOLUTION NO FURTHER ACTION QUB FITNESS TO PRACTISE PROCEDURE INVOKED KEY: M = Mentor LL = Link Lecturer PC = Programme Coordinator QUB = Queen s University Belfast ROA and A = Record of Achievement and Assessment SSSM = School Student Support Meeting SSPC = School Student Progress Committee 18

19 Guidelines Specific Student Support Issues In order to support students towards registration with NMC at the end of the course a record is required that will incorporate all elements of the course and any issue that may arise requiring support. This is of particular significance given the nature of the nursing course with its module structure and variety of placements. This record will include any student issues under the following headings: Disability, Occupational Health, Conduct and Competence in so far as they may potentially impact on the student s progress or public safety. Specific student support issues are identified in the specific support section of this achievement record. All records need to be clear and specifically detailed to address issues identified. ACTIONS REQUIRED: Prior to module commencement or placement Practice education facilitator will be advised of any student requiring particular support or adjustment for a placement and risk assessments required prior to the student s placement. It is anticipated that this will relate to a very small number of students. For all students an assessment will be undertaken, the issue will be entered into the specific support summary table and an action plan will be placed in the Specific Student Support section 2 of the Ongoing Record of Achievement and Assessment of progress. A copy will also be provided to the link lecturer for discussion with the mentor. Induction to placement by mentor Identify if the student has a specific support issue Read the specific support summary table in Section 2 which will outline any support issues. Discuss any specific support requirements with student recorded in the action plan. Sign the support section of the induction record once discussion has occurred. Ensure that the placement development plan takes cognizance of any support action required in the context of the specific placement. Midway review Please ensure that the review considers and records achievement of the placement outcomes in light of the student support issues. End of placement review Clearly record placement outcomes in light of student support issues in the progress report. New issues identified in placement These must be discussed with the student, recorded in the progress notes and reported to the link lecturer immediately so that the Student Issues Arising in Practice protocol can be actioned. 19

20 The NMC (2004) have identified Standards of Proficiency to be achieved for entry to the Register under the following domains 1. Professional and Ethical 2. Care Delivery 3. Care Management 4. Personal / Professional Development To assist students to achieve the learning outcomes the NMC (2007) have now mapped these to Essential Skills Clusters to be achieved at the end of the branch programme. This section details the Essential Skills Clusters and in all placements the students should use the following grid to indicate evidence of progress. Score Descriptor 0 Not available 1 Not Practised 2 Limited opportunity to practise 3 Practised on a regular basis The mentor will provide verbal and written commentary on your overall performance in each set of skills Care, compassion and communication Organisational aspects of care Infection and prevention control Nutrition and fluid management Medicines management Additional skills Elimination skills Moving and handling Pre and post operative care Respiratory skills Blood transfusion Infusion devices Venepuncture Core Clinical Skills Administration of Medicines Wound Care Patient Assessment Care Planning Transfer and Discharge Patient Teaching Intravenous Fluid Management It is the student s responsibility to: (a) Inform the mentor of any specific learning needs (b) Negotiate and participate in all opportunities to acquire and develop knowledge and skills (c) Highlight concerns or weaknesses to mentor / link lecturer. 20

21 Satisfactory skilled performance depends on your ability to demonstrate three key aspects of all skills: Psychomotor (the ability to perform the skill) Cognitive (the knowledge base) Affective (the manner/demeanour of the student and ability to attend to the feelings/emotions of the individual patient/client and their families). 21

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23 Care, Compassion and Communication Please indicate a score relevant to your level of experience in each placement 1. Provide care based on the highest standards, knowledge and competence. 7 8 Demonstrates clinical confidence through sound knowledge, skills and understanding relevant to the Adult Branch. Is self aware and self confident, knows own limitations and is able to take appropriate action 9 Acts as a role model in promoting a professional image Acts as a role model in developing trusting relationships, within professional boundaries Recognises and acts to overcome barriers in developing effective relationships with patients/clients Initiates, maintains and closes professional relationships with patients/clients and carers Uses professional support structures to develop self -awareness, challenge own prejudices and enable professional relationships, so that care is delivered without compromise (Standard: 7, A1, 2, 3, 4, 5, 6, C4, K1, P3 Code: 1.2, 1.3, 2.3, 6.1) 2. Engages the patient / client as partners in care. Should the patient / client be unable to meet their own needs then the nursing student will ensure that these are addressed in accordance with the known wishes of the patient / client or in their best interests Is sensitive to patient / client needs, choice and capability and appropriately incorporates this into planned care Supports access to independent advocacy Recognises situations and acts appropriately when patient / client choice may compromise patient safety Uses strategies to manage situations where the patients clients wishes conflict with planned care Acts to ensure that patients / clients who are unable to meet their activities of living have these addressed in a sensitive and dignified manner and a record is kept in relation how these needs are met, e.g. bathing, elimination, care of the skin, nails, hair, eyes, teeth and mouth Works confidently, collaboratively and in partnership with patients / clients, their families and other carers to ensure that needs are met in care planning and delivery, including strategies for self care and peer support Helps the patient / client to identify and use their strengths to achieve their goals and aspirations (Standard: C3, D1, E1, G1, 2, 3, Code: 2.1, 3.1, 3.2, 4.4) 3. Treat the patient / client with dignity and respect them as individuals. Acts professionally to ensure that personal judgments, prejudices, values, attitudes and beliefs do not compromise the care provided Is proactive in promoting and maintaining dignity Challenges situations/others when patient/client dignity may be compromised Uses appropriate strategies to encourage and promote patient/client choice (Standard: C4, E3, J1 Code: 1.4, 2.1, 2.2)

24 Please indicate a score relevant to your level of experience in each placement 4. Care for the patient / client in an environment and manner that is culturally competent and free from discrimination, harassment and exploitation. 7 8 Delivers care that is culturally competent and free from discrimination, harassment and exploitation. Upholds patients /clients legal rights and speaks out when these are at risk of being compromised Takes into account differing cultural traditions, beliefs, UK legal frameworks and professional ethics when planning care Is proactive in promoting care environments that are culturally sensitive and free from discrimination, harassment and exploitation. Manages challenging situations effectively Standard: B1, 4, C1, 2, 3, 4, K2, 3, 4 Code: 2.1, 2.2, 3.2, Provide care that is delivered in a warm, sensitive and compassionate way. Anticipates how the patient/client might feel in a given situation and responds with kindness and empathy to provide physical and emotional comfort Makes appropriate use of touch Listens to, watches for, and responds to verbal and non verbal cues Delivers care that recognises need and provides both practical and emotional support Has insight into own values and how these may impact on patient/client interactions Recognises circumstances that trigger personal negative responses and takes action to prevent this compromising of care. Recognises and responds to emotional discomfort / distress in self and others Through reflection and evaluation demonstrates commitment to personal and professional development Standard: A2, B5, C3, 4, D1, E2, H4, P2, 3 Code: 2.3, 2.5, Listen, and provide information that is clear, accurate and meaningful at a level at which the patient/client can understand. 7 8 Consistently shows ability to communicate safely and effectively with patients/clients providing guidance for juniors Communicates effectively and sensitively in different settings, using a range of methods and styles Provides accurate and comprehensive written and verbal reports based on best available evidence Acts to reduce and challenge barriers to effective communication and understanding Is proactive and creative in enhancing communication and understanding Where appropriate uses the skills of active listening, questioning, paraphrasing and reflection to support a therapeutic intervention Uses appropriate and relevant communication skills to deal with difficult and challenging circumstances(e.g. responding to emergencies, unexpected occurrences, saying no, dealing with complaints, resolving disputes, de-escalating aggression, conveying unwelcome news ) Standard: C4, D1, E1, 2, F1, 3, G3, H4, J1, K2, M1, N1, 2, Q2, Q3, Code: 2.2, 3.2, 4.3, 4.4,

25 Please indicate a score relevant to your level of experience in each placement 7. Protect and treat as confidential all information relating to themselves and their care. 7 8 Acts professionally and appropriately in situations where there may be limits to confidentiality (e.g. public interest, protection from harm) Recognises the significance of information and who does / does not need to know Acts appropriately in sharing information to enable and enhance care (carers, MDT and across agency boundaries) Works within the legal frameworks for data protection (e.g. access to and storage of records) 9 Acts within the law when confidence has to be broken Standard: A4, B1, 2, 3, 4, D2, G1, K2, 3, 4, M1, 2, 3, P4 Code: 1.2, 3.2, 3.3, 5.1, 5.2, Ensure that the patient / client consent will be sought prior to care or treatment being given and that their rights will be respected. Uses appropriate strategies to enable patients/clients to understand treatments and other interventions in order to give informed consent Works within legal frameworks when seeking consent Assesses the needs and wishes of carers and / or relatives in relation to information and consent Demonstrates respect for patient/client autonomy and their right to withhold consent in relation to treatment within legal framework (Standard: A1,B1,C2, 3, E2,K2,3,4,P4 Code:3.1,3.2,5.3,

26 Please comment in relation to progress of Care, Compassion and Communication skills 7 Date: Mentor Print Name Signature 8 Date: Mentor Print Name Signature 9 Satisfactory- Performs these Care, Communication and Compassion Skills safely and effectively without the need for direct supervision. The Mentor should Indicate which statement reflects the students overall performance in this set of skills Date Mentor Print Name: Signature Unsatisfactory performance of these Care, Compassion and Communication Skills requires constant prompting and support Date Mentor Print name Signature 26

27 Organisational Aspects of Care Please indicate a score relevant to your level of experience in each placement 9 Make a holistic and systematic assessment of the patient / client needs and develop a comprehensive plan of nursing care 7 that is in their best interests and which promotes their health and well-being and minimises the risk of harm. Makes a holistic and systematic assessment of physical, emotional, psychological, social, cultural and spiritual needs, including risk, and creates a comprehensive plan of nursing care in partnership with the patient/client, carer, family or friends Takes responsibility for assessment and planning of care delivery 8 9 Applies evidence to practice Works within the context of a multi-professional team to enhance the care of patients/clients Promotes health and well-being through teaching patients/clients and carers about their condition and treatment Uses a range of techniques to discuss treatment options with patients/clients Enables patients/clients to take an active role in making choices concerning their care Discusses sensitive issues and provides appropriate advice and guidance e.g. contraception, substance misuse, impact of lifestyle on health Refers to specialists when required # Acts appropriately when faced with sudden deterioration in patients /clients physical or psychological condition or emergency situations (e.g. abnormal vital signs, patient/client collapse, choking, seizure, cardiac arrest, self-harm, extremely challenging behaviour, attempted suicide) Measures, documents and interprets vital signs and acts appropriately on findings - Accurately undertakes and records baseline assessment of weight, height, temperature, pulse, respiration & blood pressure ( manual and electronic); Glasgow coma scale; early warning score indicators (*) Performs routine diagnostic tests (e.g. urinalysis, blood sugar monitoring, peak flow, limb perfusion,) relevant to the area of work and acts appropriately on findings Works within a public health framework to assess needs and plan care for individuals and groups (Standard: A3, 4, 6, C3, 4, E1, 2, 3, 4, F2, 3, G3, H1, 2, 5, 6, J1, 2, K1, 2, 3, 4, M1, 2, 3, Q1, 2, 3 Code: 1.2, 1.4, 2.1, 2.4, 3.1, 4.3, 4.4, 6.5, 8.1) # N.B. Students should review the above situations and be prepared to answer questions on the appropriate response and first aid in any of these situations relevant to the placement area. 10. Deliver and evaluate care against the comprehensive assessment and care plan. 7 Provides safe and effective care in the context of patients /clients age, condition and developmental stage Prioritises the needs of groups of patients/clients and individuals in order to deliver care effectively and efficiently Detects, records and reports deterioration/improvement and takes appropriate action Implements strategies for evaluating the effect of interventions, taking account of the patients /clients /carers interpretation of physical, emotional, and behavioural changes. Reviews and makes adjustments to the care plan in response to evaluation, communicating these changes to colleagues Standard: A4, E2, 3, F3, G1, 3, J1, 2, L1, M3 Code: 2.1, 4.3, 6.1 Skills identified as (*) are required to be assessed for entry to the Register

28 Please indicate a score relevant to your level of experience in each placement 11. Act to safeguard adults requiring support and protection. 7 8 Recognises and responds appropriately when adult patients are vulnerable, at risk, or in need of support and protection Shares information safely with colleagues and across agency boundaries for the protection of individuals/the public Makes effective referrals to safeguard and protect adults requiring support and protection Works collaboratively with other agencies to develop, implement and monitor strategies to safeguard and protect vulnerable individuals and groups Supports patients/clients in asserting their human rights Aware of responsibility to challenge practices which do not safeguard those requiring support and protection Standard: A2, 5, B2, 4, C2, E2, K4, L2, 4, 5, M2, O1 Code: 1.5, 3.9, 3.10, 5.4, Respond appropriately to feedback from patients/clients, the public and a wide range of sources as a vehicle for learning and development Shares complaints, compliments and comments with the team in order to improve care Responds appropriately and effectively to feedback Supports patients / clients who wish to complain As an individual and team member, actively seeks and learns from feedback to enhance care and own professional development Works within legal frameworks and local policies to deal with complaints, compliments and concerns Standard: A4, 6, B1, 4, C2, D1, E2, H3, K2, 4, L5, M3, P1, 3, 4 Code: 1.5, 4.3, Promote continuity when their care is to be transferred to another service or person. Works with colleagues in other services to ensure safe and effective transition between services Prepares patients/clients and their carers for the transition / transfer between services Works in partnership with the patient/client to develop strategies for smooth transfer / transition and evaluates the outcome Standard : D1, 2, E2, F1, 2, 3, G3, H4, J1, 2, M1, 2, 3 Code : 2.1, 4.3, Be confident in their own role within the multi-disciplinary / multi-agency team and to inspire confidence in others Appropriately consults and explores solutions and ideas with others to enhance care Appropriately challenges the practice of self and others across the multi-professional team Takes appropriate role within the team Act as an effective role model in decision making, taking action and supporting more junior staff Works inter-professionally as a means of achieving optimum outcomes for patients/clients Standard: A4, 5, D4, G3, H6, K4, L2, 5, M1, 2, 3, N1, 2, 3, O4 Code: 4.3, 4.4, 4.5, Safely delegate care to others and to respond appropriately when a task is delegated to them. Works within the requirements in the NMC Code of professional conduct: standards for conduct, performance and ethics in delegating care and when care is delegated to them Takes responsibility and accountability when delegating care to others Prepares, supports and supervises those to whom care has been delegated Recognises and addresses deficits in knowledge and / or skill in self and takes appropriate action Standard: A1, N1, 2, 3 Code: 1.3, 4.6,

29 Please indicate a score relevant to your level of experience in each placement 16. Safely lead, co-ordinate and manage care Inspires confidence and provides clear direction to others Takes decisions and is able to answer for these decisions when required Bases decisions on evidence and uses experience to guide decision-making Acts as a positive role model for junior staff Manages time effectively Negotiates with others in relation to balancing competing/conflicting priorities Standard: A4, D1, G1, 3, H1, 2, 6, I1, K1, 2, M2, N3 Code: 1.3, Work safely under pressure. Demonstrates good time management Prioritises own workload and manages the competing / conflicting priorities of the caseload, ward or department Appropriately reports concerns regarding staffing / skill-mix Recognises stress in others and provides appropriate support or guidance Enables others to identify and manage their stress Standard: A6, B4, D1, G1, 3, I1, K1, 2, 3, 4, L2, 3, 4, 5, M2, N1, 2, 3, Code: 1.3, 6.4, 6.5, 8.1, Identify and safely manage risk in relation to the patient/client, the environment, self and others. Reflects on and learns from patient safety incidents as individual and team member and contributes to team learning Participates in clinical audit to improve patient/client care Assesses and implements measures to manage, reduce or remove risk that could be detrimental to patients/clients, self and others Assesses, evaluates and interprets risk indicators and balances risks against benefits, taking account of the level of risk the patient/client, or others are prepared to take Works within legal frameworks to promote safety and positive risk taking Works within policies to protect self and others Takes steps not to cross professional boundaries and put self or colleagues at risk Standard: A4, 5, B1,3 4, D1, 2, E4, F1,2 3, H1, 2, 3, 4, 5, 6, K3, 4, L2, 3, 4, 5, M1, 3 Code: 2.2, 2.3, 3.1, 3.2, 8.1, 8.2, Work to resolve conflict and maintain a safe environment. 7 Selects and applies appropriate strategies and techniques for defusing, disengaging and managing actual and potential violence and aggression Standard: B4, D1, 2, F2, J2, K2, 3, L2, 5, O4, Q3 Code: 1.4, 2.2,

30 Please indicate a score relevant to your level of experience in each placement 20. Select and manage medical devices safely. 7 8 Works within legal frameworks and applies evidence based practice in the safe selection and use of medical devices Safely uses and maintains a range of medical devices appropriate to the area of work, including ensuring regular servicing, maintenance and calibration Keeps appropriate records in relation to the use and maintenance of medical devices and the decontamination processes required as per local and national guidelines Explains the devices to patients/clients and / or carers and checks understanding Standard: E3, L1, 4, 5, P3 Code 1.5, 2.1, Please comment on progress related to Organisational Aspects of Care Skills 7 Date: Mentor Print Name Signature 8 Date: Mentor Print Name Signature 9 Satisfactory-Performs these Organisational Aspects of Care Skills safely and effectively without the need for direct supervision. The Mentor should Indicate which statement reflects the students overall performance in this set of skills Date : Mentor Print Name Signature Unsatisfactory performance of these Organisational Aspects of Care Skills requires constant prompting and support Date: Mentor: Print name Signature 30