Student Name. ID Number. Cohort. Cohort Leader

Transcription

1 Canterbury Christ Church University Faculty of Health & Wellbeing Mental Health Nursing Pathway On-going Achievement Record [OAR] Part 4 of 4 Clinical Skills Acquisition Document Student Name ID Number Cohort Cohort Leader

2 Record of Essentials Skills Development This record is designed to provide the supporting evidence of the achievement of a selection of the essential nursing skills identified by the NMC (2010) as necessary to progress from year 1 to year 2 and from year 2 to year 3 and finally to register as a mental health nurse. The record relates to some of the essential skills that are applied to the competencies in your year 1, year 2 and year 3 Assessment of Tools [APTs]. In order to have the essential skills clusters [ESCs] for care, compassion and communication, nutrition and fluid management, infection control and medicines management within these APTs signed off by your mentor you will need to have the related skills signed off in this record. The skills identified in this record are just some of the ESCs and the evidence which is related to the competencies in your APTs. The ESCs in this record have a mainly psychomotor and numeracy skills focus. However, all the ESCs have been mapped and identified in the APTs. It is advisable to carry your record with you when on duty so that you can have skills signed of as you achieve them. Make use of the record to influence what you include in your learning contract and which learning opportunities you participate in. This record must be signed by your mentor. To support your ongoing learning and development and to meet regulatory requirements for supporting learning and assessment in practice it is essential that you understand that you will be required to share the contents of your APTs with practitioners, academic links and your cohort leader. Sharing your documentation ensures that any issues can be identified and addressed in order to give you the opportunity to achieve the requirements in placement that will enable you to progress to subsequent years or qualified status. In your last placement at the end of your three year programme your Sign-off Mentor will review all elements of your OARs and you will be required to provide evidence of meeting your practice competencies. Submission Arrangements: In your final placement before each exam board your mentor will examine everything recorded in your OARs and Skills Booklets (part 4). Mental Health Nursing students will submit their OARs to a central location on a pre- arranged date. Your OAR will then be disseminated to your personal tutor who will review all sections and confirm successful completion prior to each of the end of year examination board For this reason, you are strongly advised to photocopy assessment documentation after each placement and keep it in a safe place. This will ensure that a complete copy of your documentation can be produced, if for any reason your working copy is mislaid. If you are unable to produce your documentation, you are at risk of being unable to have your competence confirmed. 2

3 STUDENT CONSENT I.(full name) understand that I will be expected to share the records of my achievement held in this document with mentors, academic links and my cohort leader and that at progression points one and two my mentor will review all of my programme documentation. During my final placement in year three a sign-off Mentor will review all of my year / programme documentation and use this to inform the final sign off of my proficiency. I am aware that this document is my responsibility and that it must be kept intact so that my mentor can see my progression across my placements. I understand that I will need to maintain a photocopy of each completed section to ensure that I am able to produce a complete set of documentation prior to my final summative assessment. I also understand that I must seek consent from all service users that I work with, for their permission to receive care from me and that they have the right to withdraw this consent at any time and this will not affect their care. Signed: Print name:. Date:.. 3

4 Levels of Performance for Participation in Clinical Skills Supervision Guide Levels of Performance Knowledge and understanding Year 1 (participation) When involved in the care of patients, under direct supervision the student: Through discussion with their Mentor is able to demonstrate a working understanding of the principles underpinning essential care and routine monitoring. Year 2 (identification) When involved in the care of patients, under supervision the student: Through student initiated discussion with their Mentor demonstrates a working understanding of the wider factors that underpin and impact on effective nursing practice Year 3 (management) When managing a case load or a ward, under indirect supervision/independently the student: Applies relevant knowledge and skills to more complex and unexpected situations Problem-solving skills Under guidance of their Mentor can apply a problem-solving process to simple and straightforward situations Applies a problem-solving approach to their practice and can identify for their Mentor possible solutions to more demanding clinical problems Demonstrates sound problem-solving skills and clinical judgement. Values and attitudes Demonstrates an interest in learning about practice. In routine situations can interact appropriately with patients and their carer s and friends and work well within the team. Acknowledges and works within the boundaries of their knowledge, skills and level of education Takes an active role in leading own learning experience. Can interact effectively with patients, families and colleagues in more demanding situations. Acknowledges and works within the boundaries of their knowledge, skills and level of education Manages and develops own practice and that of others in accordance with the NMC (2008) professional code. Clinical skills Applies safe principles to core essential skills under the supervision of their Mentor Can undertake core skills safely with minimal supervision and can perform more complex skills under the guidance of their Mentor Performs more complex skills with minimal supervision and is able to guide a junior student nurse to undertake essential core skills 4

5 SKILLS ACQUISITION Guidelines for participation in clinical skills Mental Health Pathway These guidelines are an indicator of when students are able to participate in clinical skills based on the timing of their theoretical input and should be used in conjunction with the levels of performance for participation in clinical skills guide. This is not an exhaustive list and does not limit the student s opportunity to learn through observation and direct supervision. All skills should be supervised and practised as part of individualised care to an identified group of patients and be based on student and mentor assessment of competence. They may be practised on several occasions before final signature of competence is achieved except those identified that have a specified number of attempts. Please remember mentors are accountable for delegation decisions and students are responsible for ensuring that they work within their limitations. 5

6 Skill Students may perform in practice Yes / No Conditions Year 1 Year 2 Year 3 Emergency procedures First Aid Yes Yes Yes Following participation in annual mandatory training within CCCU Life Support Yes Yes Yes Following participation in annual mandatory training within CCCU Check emergency drugs No Yes Yes As 2 nd checker only Administer emergency drugs No No No Under no circumstances Oral Suction using yankaeur sucker Yes Yes Yes Under direct/closer supervision Suction tracheostomy tubes No No No Under no circumstances Drug administration Checking and calculating Yes Yes Yes Under direct supervision medications Checking and calculating controlled No Yes Yes As 2 nd checker only and in line with Trust policy medications Administration of drugs Yes Yes Yes Under direct supervision Administration of controlled No No No Under no circumstances medications Administration of intravenous medications No No No Under no circumstances 6

7 Skill Drug administration continued Check and calculate rate of intravenous fluids Change giving sets and administer intravenous fluids Students may perform in practice Yes / No Year 1 Year 2 Year 3 Conditions Yes Yes Yes Under direct supervision No No No Under no circumstances Administration of vaccines No Yes Yes Under direct supervision and if have received anaphylaxis training in line with Trust policy Participate in administration of blood transfusion and blood products No As per Trust policy Under direct supervision and in line with Trust policy Use volumetric pumps Yes Yes Yes Under direct supervision Monitoring Temperature recordings Yes Yes Yes See supervision guide Pulse Yes Yes Yes See supervision guide Respirations Yes Yes Yes See supervision guide Oxygen saturations Yes Yes Yes See supervision guide Urinalysis Yes Yes Yes See supervision guide Complete neurological observations No Yes Yes See supervision guide Completion of Early Warning Score Yes Yes Yes See supervision guide Charts Peak flow measurements Yes Yes Yes See supervision guide Attach patient for cardiac monitoring No Yes Yes See supervision guide Perform an ECG recording Yes Yes Yes If in line with Trust policy and under direct supervision Blood glucose monitoring Yes Yes Yes If training has been provided 7

8 Skill Students may perform in practice Yes / No Conditions Year 1 Year 2 Year 3 Other nursing procedures Assessment of wounds Yes Yes Yes Under direct supervision Aseptic technique Yes Yes Yes See supervision guide Care of central lines No No No Under no circumstances Insertion of peripheral venous cannulae No No No Under no circumstances Removal of peripheral venous cannulae Yes Yes Yes See supervision guide Insertion of naso-gastric tube Yes Yes Yes See supervision guide Care of PEG feeding tubes Yes Yes Yes See supervision guide Care and removal of urinary catheter Yes Yes Yes See supervision guide Insertion of female urinary catheter Yes Yes Yes See supervision guide Insertion of male urinary catheter No No No Under no circumstances Insertion of sutures No No No Under no circumstances Removal of sutures and clips Yes Yes Yes See supervision guide Removal of wound drains Yes Yes Yes See supervision guide Removal of chest drains No No No Under no circumstances Carry out therapeutic observations of a patient within eyesight No No Yes Under supervision and in accordance with Trust policy Transfers and escorts Escorting to and from procedures No No No Under no circumstances Accompanying patients to witness procedures (with escort) after obtaining patient consent Yes Yes Yes Student to remain supernumerary to escort and not left unaccompanied with patient at any time Accompanying patients to court (with escorts) after obtaining patient consent) Yes Yes Yes Student to remain supernumerary to escorts and not left unaccompanied with patient at any time 8

9 Completion of the skills on the following pages will ensure the student can evidence aspects of care in order to achieve the progression point criteria at the end of each year of practice. Please note to achieve the required standard in the listed skills the student must: 1. Have been taught the skill either in the academic skills facility or in the practice setting 2. Have the opportunity to observe a registered practitioner undertaking the skill following local policies and procedures 3. the skill safely and in line with local policies and procedures and NMC guidelines 4. Have undertaken the skill with due attention to Informed Consent, the comfort, safety, privacy and dignity of the individual 5. Performed the skill smoothly and safely without need of the intervention of a registered practitioner 6. Demonstrate appropriate interpersonal skills (verbal and non-verbal) 7. Demonstrate empathy for the patient and understanding of the implication of the skill for them 8. Complete accurate record keeping after undertaking the skill 9. Be aware what the evidence suggests regarding best practice and is able to discuss some of the relevant theory 10. Provide a rationale for the skill and resources used Please note: Students are expected to continue to practice with attention to points 3-10 at all times even after skills have been achieved and signed off by mentors

10 Progression Point 1 [Year 1] Skills Acquisition Criteria Mentors: Please note the statements in BOLD font MUST be achieved for the student to provide evidence of having met all of the NMC ESCs and NMC proficiencies for each progression point criteria and are cross-referenced to the relevant competencies in the Assessment of Tools. If a skill is demonstrated in practice then BOTH boxes must be signed once competence achieved. Statements that are in bold italic font and marked with an asterisk (*) are essential skills that have been brought forward from the second year (progression point two) as they are considered within this mental health programme to be important to include in year one. These skills are achievable in the first year due to the placements structure Wellbeing; Care of Older People and Learning Disabilities. If a student achieves these successfully in year one and there is not an opportunity to achieve them in the second year eg aseptic technique, these may be counted as having been completed for progression point two. All progression point two ESCs that have been brought forward to year one, are included again in year two as these are skills that students should frequently perform if there is the opportunity in the placements. Statements in light italic font are additional skills related to the ESCs that may be achieved whilst in the practice settings Extra blank boxes have been made available to be completed if additional skills are experienced within the clinical setting. Lecturers: Please note the above instructions for mentors. Please sign skills that have been demonstrated in University.

11 1.2 CP1 D1 5, 6, 8 Essential Skills (bold) additional useful skills (italics) Essential skills cluster : Care, compassion and communication Works within limitations of the role and recognises own level of competence by: (Registered Nurse / Mentor) Asks for advice/guidance when necessary; Aware of skills are able to perform in year one and those they are not. 1.4 PHIR D1 3 Shows respect for others by: Communicates with patients in a courteous manner which takes into account their mental health issues, culture and physical needs. 1.5 PHIR D2 1 D3 8 Is able to engage with people and build caring professional relationships by: Actively listens to patients in an attentive manner; Shows understanding of patients circumstances; Shows empathy towards patients. 5.5 DRCMH D1 7, 8.1 D2 1.2, 3, 5, 5.1 D4 4 Evaluates ways in which own interactions affect relationships to ensure that they do not impact inappropriately on others by: Discussing interactions with patients in supervision with mentor.

12 9.1 HB1 D3 7 Essential Skills (bold) Additional useful skills (italics) Essential skills cluster : Organisational aspects of care Responds appropriately when faced with an emergency or a sudden deterioration in a person s physical or psychological condition (for example abnormal vital signs, collapse, cardiac arrest, self harm, extremely challenging behaviour, attempted suicide) including seeking help from an appropriate person by: (Registered Nurse / Mentor) Immediately seeks help from an appropriate person; Can identify systems in place in the clinical area eg use of panic buttons; Is able to give an accurate account of what they observed in the patient s behaviour. *9.2 HB1 D3 3 *Accurately undertakes and records a baseline assessment of weight, height, temperature, pulse (including apex beat), respiration and blood pressure using manual and electronic devises (this is an ESC 9.2 which is repeated in year 2 second progression point) The student is required to demonstrate numeracy skills in this assessment eg calculation of pulse etc by: Identifies and uses appropriate documentation to record baseline assessments; Can give a normal range of weight, height, temperature, pulse, respiration and blood pressure that could be expected for three patients whose care they are observing (90% accuracy).

13 *9.7 HB1 D3 7 Essential Skills (bold) Additional useful skills (italics) Essential skills cluster : Organisational aspects of care *Performs routine, diagnostic tests for example urinalysis under supervision as part of assessment process (near client testing). (This is an ESC 9.7 which is repeated in year 2 second progression point) by: (Registered Nurse / Mentor) Requests a urine sample from a patient and providing the appropriate receptacle for the sample; Performs the diagnostic test using the right equipment 17.1 HB1 Recognises when situations are becoming unsafe and reports appropriately by: Informs appropriate person that eg patient is becoming angry/unsettled

14 21.1 HB1 Essential Skills (bold) Additional useful skills (italics) Essential skills cluster : Infection prevention and control The student follows local and national guidelines and adheres to standard infection control precautions by: (Registered Nurse / Mentor) Using appropriate universal precautions eg gloves, disinfectant; Correctly uses and disposes of items (equipment) in accordance with local policy and manufacturers guidance eg gloves and instruments; Wears appropriate personal protective equipments eg disposable apron; Appropriate use of coloured disposal bags; Appropriate use of laundry bags; 22.1 HB1 The student demonstrates effective hand hygiene and the appropriate use of standard infection control precautions when caring for all people by: Washes hands in accordance with policy Explains to patients rationale for using specific infection control precautions eg use of gloves, requesting patient to wash hands when entering clinical area

15 24.1 HB1 Essential Skills (bold) Additional useful skills (italics) Essential skills cluster : Infection prevention and control Adheres to local policy and national guidelines on dress code for prevention and control of infection including: footwear, hair, piercing and nails by: (Registered Nurse / Mentor) Wears appropriate footwear in line with Trust policy Hair is appropriately presented in line with Trust policy The visibility of body piercing is in line with Trust policy and is not an infection control risk Jewellery is worn in line with Trust policy Nails are kept short and clean 24.2 HB1 The student maintains a high standard of personal hygiene by: Uniform/clothing is cleaned regularly to prevent cross infection 24.3 HB1 The student wears appropriate clothing for the care delivered in all environments by: Wears clothes that are appropriate for patient/clinical area and are approved by the Trust/placement area

16 *25.1 HB1 Essential Skills (bold) Additional useful skills (italics) Essential skills cluster : Infection prevention and control *The student demonstrates understanding of the principles of wound management, healing and asepsis. (this is an ESC 25.1 which is repeated in year 2 second progression point) by: (Registered Nurse / Mentor) Safely performs basic wound care using clean and aseptic techniques in a variety of settings. *25.2 HB1 *Assists in providing accurate information to people and their carers on the management of a device, site or wound to prevent and control infection and to promote healing wherever that person might be, for example, in hospital, in the home care setting, in an unplanned situation. (This is an ESC 25.2 which is repeated in year 2 second progression point) by: Explains to a patient how to care for a wound Explains to a patient how to prevent wound infection

17 / HB1 D3 5.1 Can be met in year 1, 2 or 3 Essential Skills (bold) additional useful skills (italics) Essential skills cluster : Nutrition and fluid management In liaison with a Registered Midwife, the student provides essential advice and support to mothers who are breast feeding (this is an ESC which is repeated in year 3 entry to the register) by: (Registered Nurse / Mentor) Explains to the mother one advantage of breast feeding to the baby and to the mother Explains to the mother how and where to obtain advice during period of breast feeding other than midwife 30.1 HB1 The student reports to an appropriate person where there is a risk of meals being missed by: Informs appropriate person when a patient may miss a meal for whatever reason Has knowledge of diet and fluid requirements needed for health and during illness//recovery Record and monitor whether patient is eating and drinking sufficiently Accurately monitors, records and reports fluid intake and output appropriately to other team members recognising where it falls below requirements Assists patients to drink and eat where appropriate 30.2 HB1 The student follows food hygiene procedures by: Ensures that food is offered and given to patients in a hygienic manner eg environment, utensils, plates, own and patients hands are clean and that where food is heated, it is at appropriate temperature

18 33.1 HB1 Essential Skills (bold) additional useful skills (italics) Essential skills cluster : Medicines management The student is competent in basic medicines calculations relating to: Tablets and capsules Liquid medicines Injections including : unit dose; sub and multiple unit dose; SI unit conversion by: Skill Achieved (Registered Nurse / Mentor) Can accurately calculate quantity of tablets/capsules required to meet prescribed dosage of medication; Can accurately calculate quantity of liquid medication required to meet prescribed dosage of medication; Can accurately calculate quantity of liquid medication required to meet prescribed dosage of medication. In University by: Passing the computer based programme Safe Medicate. A minimum pass mark of 80% is required an only two attempts will be allowed for this assessment.

19 Additional Skills Skill Achieved (Registered Nurse / Mentor) MODULES: CP1 Collaborative 1 PNP Principles of Nursing PHIR Promoting Health Through Interpersonal Relationships DRCMH Developing Recognition of Common Mental Health Problems HB1 Human Biology for Mental Health 1 : Foundations

20 Progression Point 2 [Year 2] Skills Acquisition Criteria Mentors: Please note the statements in BOLD font MUST be achieved for the student to provide evidence of having met all of the NMC ESCs and NMC proficiencies for each progression point criteria and are cross referenced to the relevant competencies in the Assessment of Tools. If a skill is demonstrated in practice then BOTH boxes must be signed once competence achieved. Statements that are in bold italic font and marked with an asterisk (*) are essential skills that have been brought forward from the third year (entry to the register) to this year (year two, progression point two) as they are considered within the mental health pathway to be important to include in year two. These skills are achievable in the second year due to the placements structure Working Age Adult (In-patient) and Working Age Adult (Community). If a student has achieved these successfully in year two and there is not an opportunity to achieve them in the third year eg medicines management, these may be counted as having been completed for progression point three. All progression point three ESCs that have been brought forward to year two, are included again in year three as these are skills that students should frequently perform if there is the opportunity in the placements. Statements in light italic font are additional skills related to the ESCs that may be achieved whilst in the practice settings Extra blank boxes have been made available to be completed if additional skills are experienced within the clinical setting. Lecturers: Please note the above instructions for mentors. Please sign skills that have been demonstrated in University.

21 ESC/Module 2.4 SUESMI D3 8, 8.1 Essential Skills (bold) additional useful skills (italics) Essential skills cluster : Care, compassion and communication The student actively supports people in their own care and self care by: (Registered Nurse / Mentor) Assists a patient to perform personal hygiene whilst respecting their privacy and dignity 8.2 LEMH D1 1 The student applies principles of consent in relation to restrictions relating to specific client groups and seeks consent for care by: Ensures patient gives consent for care Can identify circumstances where patient consent is complex 8.3 LEMH D1 1 The student ensures that the meaning of consent to treatment and care is understood by the people or service users by: Asks the patient s understanding of consent to treatment Explains to the patient why consent to treatment is necessary

22 9.2 HB2 D3 7 Essential Skills (bold) additional useful skills (italics) Essential skill cluster : Organisational aspects of care The student accurately undertakes and records a baseline assessment of weight, height, temperature, pulse, respiration and blood pressure using manual and electronic devices (this assessment requires the student s numeracy to be tested) by: (Registered Nurse / Mentor) Carries baseline measurement of all the above; Accurately records the above measurements on the appropriate documents 9.3 HB2 D3 5, 5.1 The student understands the concept of public health and the benefits of healthy lifestyles and the potential risks involved with various lifestyles or behaviours, for example, substance misuse, smoking, obesity by: Can identify the effect alcohol misuse can have on weight; Can identify the effect drug misuse eg smoking cannabis can have on blood pressure; Can identify the effect obesity can have on blood pressure and weight; 9.4 HB2 D2 6 The student can recognise indicators of unhealthy lifestyles by: In relation to an identified patient identify one or more indicators of an unhealthy lifestyle eg smoking; unhealthy diet

23 ESC/ Module/ 9.6 HB2 D3 7 Essential Skills (bold) additional useful skills (italics) Essential skill cluster : Organisational aspects of care The student measures and documents vital signs under supervision and responds appropriately to findings outside the normal range (This assessment requires the student s numeracy skills to be tested) by: Accurately measures blood pressure; Accurately measures temperature; Accurately measures respiration. Can identify normal ranges for the above and if the patient s measurements are outside of these ranges; * Can articulate possible reasons for measurements being outside Normal ranges (Registered Nurse / Mentor) 9.7 HB2 D HB2 D3 7 The student can perform routine, diagnostic tests for example urinalysis under supervision as part of assessment process (near client testing) by: Gives the appropriate receptacle to the patient to collect a urine sample; Carries out routine diagnostic test using the appropriate equipment and in line with Trust policy; Identifies when results are outside of normal ranges. The student collects and interprets routine data, under supervision, related to the assessment and planning of care from a variety of sources by: Collects data such as smoking amount, type and frequency; Collects data such as weekly alcohol intake amount, alcohol % and frequency; Collects data such as taking of illicit drugs amount, type and frequency. Collects data on the above in relation to their effects of the patient physically, socially and mentally.

24 21.2 HB2 D4 6 Essential Skills (bold) additional useful skills (italics) Essential skill cluster : Infection prevention and control The student participates in assessing and planning care appropriate to the risk of infection thus promoting the safety of service users by: (Registered Nurse / Mentor) Identifies when there is a potential risk of infection and participates in planning the care for the patient HB2 D4 6 The student participates in completing care documentation and evaluation of interventions to prevent and control infection by: With an identified patient identified in 21.2 above, complete care plan and evaluate the efficacy of the interventions used to prevent and/or control infection HB2 D4 6 The student is aware of the role of the Infection Control Team and Infection Control Nurse Specialist, and local guidelines for referral by: Identifies appropriate policy and guidelines for referral; Can identify how referral is carried out according to Trust policy 21.5 HB2 D4 6 The student can recognise potential signs of infection and reports to relevant senior member of staff by: Recognises when a wound is at risk of becoming infected; Can articulate the signs of a wound becoming infected; Can articulate who they would report the above to.

25 22.3 HB2 Essential Skills (bold) additional useful skills (italics) Essential skill cluster : Infection prevention and control The student participates in the cleaning of multi-use equipment between each person by: (Registered Nurse / Mentor) Demonstrates using the appropriate cleaning mechanism eg stethoscope; 22.4 HB2 The student uses multi-use equipment and follows the appropriate procedures by: Uses equipment such as a stethoscope and ensures prevention of cross infection HB2 The student safely uses and disposes of, or decontaminates, items in accordance with local policy and manufacturers guidance and instructions by: Demonstrates disposal of items and can identify the local policy and guidance HB2 The student adheres to requirements for cleaning, disinfecting, decontaminating of shared nursing equipment, including single or multi-use equipment, before and after every use as appropriate, according to recognised risk, in accordance with manufacturers and organisational policies by: Can demonstrate how to clean/disinfect or decontaminate an item of shared nursing equipment such as a stethoscope.

26 25.1 HB1 Essential Skills (bold) additional useful skills (italics) Essential skill cluster : Infection prevention and control The student demonstrates understanding of the principles of wound management, healing and asepsis. Safely performs basic wound care using clean and aseptic techniques in a variety of settings by: (Registered Nurse / Mentor) Carries out a clean and an aseptic technique; Alerts an appropriate person if concern about wound eg possible infection/deterioration (This assessment was brought forward to year one, progression point one. If ESC successfully passed in year one and there is no opportunity for wound care in this year, student can demonstrate procedure as if in real practice skills rehearsal) 25.2 HB2 The student assists in providing accurate information to people and their carers on the management of a device, site or wound to prevent and control infection and to promote healing wherever that person might be, for example, in hospital, in the home care setting, in an unplanned situation by: Explains to a patient or their carer how to manage a wound to promote healing. (This assessment was brought forward to year one, progression point one. If ESC successfully passed in year one and there is no opportunity for wound care advice in this year, student can demonstrate procedure as if in real practice skills rehearsal)

27 26.1 HB2 Essential Skills (bold) additional useful skills (italics) Essential skill cluster : Infection prevention and control The student adheres to health and safety at work legislation and infection control policies regarding the safe disposal of all waste, soiled linen, blood and other body fluids and disposing of sharps including in the home setting by: (Registered Nurse / Mentor) Disposes of soiled linen in correct laundry bag; Disposes of all bodily waste in accordance with Trust policy; Disposes of sharps correctly accordance with Trust policy HB2 The student ensures dignity is preserved when collecting and disposing of bodily fluids and soiled linen by: Explains to patient what student is doing; Ensures collection and disposal is given privacy; Demonstrates understanding and empathy for patient whilst above is being carried out HB1 D3 5.1 Can be met in year 1, 2 or 3 In liaison with a Registered Midwife, the student provides essential advice and support to mothers who are breast feeding (this is an ESC which is repeated in year 3 entry to the register) by: Explains to the mother one advantage of breast feeding to the baby and to the mother Explains to the mother how and where to obtain advice during period of breast feeding other than midwife

28 27.2 HB2 D3 5.1 Essential Skills (bold) additional useful skills (italics) Essential skills cluster : Nutrition and fluid management The student accurately monitors dietary and fluid intake and completes relevant documentation (this assessment requires the student s numeracy skills to be tested) by: (Registered Nurse / Mentor) Monitors and adds up fluid and dietary intake over a period of time; Completes the relevant documentation; Reports findings to the appropriate person HB2 D3 5.1 The student identifies people who are unable to or have difficulty in eating or drinking and reports this to others to ensure adequate nutrition and fluid intake is provided by: Identifies patients who, due to their health are unable to or are having difficulty eating and drinking; Reports this to an appropriate person and ensures adequate nutrition and fluid intake is provided HB2 D3 5 The student takes and records accurate measurements of weight, height, length, body mass index and other appropriate measures of nutritional status (this assessment requires the student s numeracy skills to be tested) by: Records the patient s weight; Measures the patient and records height; Can calculate the body mass index using the appropriate mathematical formula; Can identify signs of dehydration Identifies the normal range for a patient s BMI

29 29.2 HB2 D3 5 Essential Skills (bold) additional useful skills (italics) Essential skills cluster : Nutrition and fluid management The student applies knowledge of fluid requirements needed for health and during illness and recovery so that appropriate fluids can be provided by: (Registered Nurse / Mentor) Identifies normal fluid intake; Identifies variations to normal fluid intake in relation to patient s health problem; 29.2 HB2 D3 5 The student accurately monitors and records fluid intake and output (this assessment requires the student s numeracy skills to be tested) by: Accurately adds fluid intake and output over a period of time.

30 ESC/Module 33.2 HB HB2 Essential Skills (bold) additional useful skills (italics) Essential skills cluster : Medicines Management *The student is competent in the process of medication related calculation in mental health nursing involving: Tablets and capsules; liquid medicines; injections; IV infusions including unit dose, sub and multiple unit dose/complex calculations/si unit conversion (this assessment requires the student s numeracy skills to be tested) by: Can calculate with 100% accuracy the amount of tablets/capsules to be given according to prescribed dosage; Can calculate with 100% accuracy the amount of liquid medicines to be given according to prescribed dosage; Can calculate with 100% accuracy sub and multiple unit dose/complex calculations/si unit conversions (This is ESC 33.2 which is brought forward from year 3 and will be repeated in year 3). *The student safely manages drug administration and monitors effects (this assessment requires the student s numeracy skills to be tested) by: (Registered Nurse / Mentor) Accurately and safely administers medication to the patient as prescribed; Is aware of possible side effects; Can monitor for possible side effects. (This is ESC 36.4 which is brought forward from year 3 and will be repeated in year 3)

31 38.4 HB2 Essential Skills (bold) additional useful skills (italics) Essential skills cluster : Nutrition and fluid management *The student safely and effectively administers and, where necessary, prepares medicines via routes and methods commonly used and maintains accurate records (this assessment requires the student s numeracy skills to be tested) by: (Registered Nurse / Mentor) With 100% accuracy prepares and administers medication via routes and methods commonly used with the client group. (This is ESC 38.4 which is brought forward from year 3 and will be repeated in year 3) Additional Skills Skill Achieved (Registered Nurse / Mentor) MODULES their Physical Treatment SUESMI : The Service User Experience of Serious Mental Illness HB2 Biology for Mental Health 2 Mental Disorders and LEMH : Law and Ethics for Mental Health

32 Progression Point 3 [ Year 3] Entry to the Register Skills Acquisition Criteria Mentors: Please note the statements in BOLD font MUST be achieved for the student to provide evidence of having met all of the NMC ESCs and NMC proficiencies for each progression point criteria and are cross-referenced to the relevant competencies in the Assessment of Tools. If a skill is demonstrated in practice then BOTH boxes must be signed once competence achieved. Some ESCs in this year have been brought forward to year two (progression point two) as they were achievable in the second year due to the placements structure (Working Age Adult (in-patient) and Working Age Adult (Community) and as they are considered, within the mental health pathway to be important to include in year two. If a student has achieved these successfully in year two and there is not an opportunity to achieve them in the third year eg medicines management, these may be counted as having been completed for progression point three. All progression point three ESCs that have been brought forward to year two, are included again in year three as these are skills that students should frequently perform if there is the opportunity in the placements. Statements in light italic font are additional skills related to the ESCs that may be achieved whilst in the practice settings Extra blank boxes have been made available to be completed if additional skills are experienced within the clinical setting. Lecturers: Please note the above instructions for mentors. Please sign skills that have been demonstrated in University.

33 9.20 HB3 D3 7 Essential Skills (bold) additional useful skills (italics) Essential skills cluster : Organisational aspects of care The student acts autonomously and appropriately when faced with sudden deterioration in people s physical or psychological condition or emergency situations, abnormal vital signs, collapse, cardiac arrest, self-harm, extremely challenging behaviour, attempted suicide by: Assesses the patient s situation and can identify the first action required eg use of a panic button, use of emergency phone number; Reflects on own action in a critical manner; (Registered Nurse / Mentor) 9.21 HB3 D PLM D HB3 The student measures, documents and interprets vital signs and acts autonomously and appropriately on findings by: Measures signs eg blood pressure, pulse, respiration, notes patient s colour; Takes appropriate course of action eg positions patient correctly, calls for help. The student takes effective role within the team adopting the leadership role when appropriate by: Manages a team/ward taking a leadership role on repeated occasions where appropriate. The student safely uses and maintains a range of medical devices appropriate to the area of work, including ensuring regular servicing, maintenance and calibration including reporting adverse incidents relating to medical devices by: Safely uses relevant medical devices eg stethoscope and ensures regular monitoring to check efficacy.

34 21.11 HB3 Essential Skills (bold) additional useful skills (italics) Essential skills cluster : Infection prevention and control The student recognises infection risk and reports and acts in situations where there is need for health promotion and protection and public health strategies by: (Registered Nurse / Mentor) Can articulate when there is a potential risk of infection and acts appropriately HB3 The student adheres to infection prevention and control policies and procedures at all times and ensures that colleagues work according to good practice guidelines by: Can identify appropriate policies in line with the Trust; Ensures colleagues are aware of policies and work in line with them HB3 The student challenges the practice of other care workers who put themselves and others at risk of infection by: Identifies possible behaviours and practices of other care workers who may put selves and others at risk of infection; Challenges other care workers in an assertive manner and ensures practices are revised; Take further action if practices are not improved.

35 25.3 HB3 Essential Skills (bold) additional useful skills (italics) Essential skills cluster : Infection prevention and control The student safely performs wound care, applying non-touch or aseptic techniques in a variety of settings by: Skill Achieved (Registered Nurse / Mentor) Can demonstrate a safe nontouch and an aseptic technique (this can be skills rehearsal if there is no opportunity in placement) HB3 The student manages hazardous waste and spillages in accordance with local health and safety policies by: Can demonstrate the procedure for managing hazardous waste and spillages in accordance with Trust policy; Can demonstrate how would instruct others to do the same HB1 D3 5.1 Can be met in year 1, 2 or 3 In liaison with a Registered Midwife, the student provides essential advice and support to mothers who are breast feeding (this is an ESC which is repeated in year 3 entry to the register) by: MUST be met by / in Year 3 Explains to the mother one advantage of breast feeding to the baby and to the mother Explains to the mother how and where to obtain advice during period of breast feeding other than midwife

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37 27.8 HB3 D3 5.1 Essential Skills (bold) additional useful skills (italics) Essential skills cluster : Nutrition and fluid management The student refers to specialist members of the multi-disciplinary team for additional or specialist advice by: (Registered Nurse / Mentor) Can identify when referral may be necessary and can articulate how to do this via Trust policy HB3 D3 5.1 The student makes a comprehensive assessment of people s needs in relation to nutrition identifying, documenting and communicating level of risk (this assessment requires the student s numeracy skills to be tested) by: Assesses a patient s nutrition needs in relation to their general health; Formulates a care of plan that ensures adequate nutrition; Monitors level of risk associated with possible nutrition status; Communicates possible risks to others HB3 D3 5.1 The student acts autonomously to initiate appropriate action when malnutrition is identified or where a person s nutritional status worsens, and report this as an adverse event by: Can identify when a person may be at risk of or has malnutrition; Can identify how to report this as an adverse event and the steps that should be taken for the patient.

38 29.6 HB3 D3 5.1 Essential Skills (bold) additional useful skills (italics) Essential skills cluster : Infection prevention and control The student identifies signs of dehydration and acts to correct these (this assessment requires to student s numeracy skills to be tested) by: (Registered Nurse / Mentor) Can identify signs of dehydration eg poor urinary output, acute confusion, dry skin etc Records and monitors fluid intake over a period of time; Records and monitors fluid output over a period of time HB3 D3 5.1 The student ensures that appropriate food and fluids are available as required by: Offers food and fluids that are acceptable to the patient; Employs kindness and sensitivity when the patient has difficulty in eating or drinking; Orders appropriate food and fluid from appropriate resources eg kitchen, community, meals on wheels.

39 33.2 HB3 Essential Skills (bold) additional useful skills (italics) Essential skills cluster : Medicines management The student is competent in the process of medication related calculation in mental health nursing involving: Tablets and capsules; liquid medicines; injections; IV infusions including unit dose, sub and multiple unit dose/complex calculations/si unit conversion (this assessment requires the student s numeracy skills to be tested) by: (Registered Nurse / Mentor) Can calculate with 100% accuracy the amount of tablets/capsules to be given according to prescribed dosage; Can calculate with 100% accuracy the amount of liquid medicines to be given according to prescribed dosage; Can calculate with 100% accuracy sub and multiple unit dose/complex calculations/si unit conversions This will be assessed within practice and Safe Medicate HB HB3 The student safely manages drug administration and monitors effects (this assessment requires the student s numeracy skills to be tested) by: Accurately and safely administers medication to the patient as prescribed; Is aware of possible side effects; Can monitor for possible side effects. The student safely and effectively administers and, where necessary, prepares medicines via routes and methods commonly used and maintains accurate records (this assessment requires the student s numeracy skills to be tested) by: With 100% accuracy prepares and administers medication via routes and methods commonly used with the client group.

40 Additional Skills Skill Achieved (Registered Nurse / Mentor) Assist a patient to recover following a short-term anaesthetic eg following ECT. Demonstrate ability to carry out therapeutic observations of a patient within eyesight in accordance with Trust policy. Explain the rationale for therapeutic observations and levels used within placement Trust policy. MODULES HB3 : Human Biology for Mental Health 3 Physical Disorders and their Treatment PLM : Policy, Leadership and Management

41 FINAL ASSESSMENT OF PROFICIENCY A sign-off mentor who has met the NMC additional criteria for assessing proficiency must complete this final assessment of proficiency 1 Sign off Mentor Declaration: I confirm that student nurse/ midwife* HAS / HAS NOT*, provided sufficient evidence to demonstrate that the NMC standards of proficiency have been achieved progressively on Year 1, Year 2 and Year 3 placements. In addition, the student CAN / CANNOT demonstrate that they have maintained the requisite standards of proficiency in their final placement and, therefore, meets / does not meet* the defined NMC standards of proficiency for entrance to the register. *Please delete as necessary Final Outcome: PASS / FAIL (please specify) Sign-Off Mentor Name (print): Full Signature: Date: Nurse Adult: Child: Mental Health: Workplace Evidence seen by Mentor in support of final practice assessment: (e.g. Yr1, 2, 3 OARS, Clinical Skills Book, Assessment in placement, feedback from service users & colleagues) 1 Please refer to the NMC (2008 Stand ards to Support Learning and Assessment in, Section for further information

42 Process of Assessment Preparation for placement by University [in collaboration with providers] Student researches placement and identifies learning needs to inform Learning Contract Identification of future learning needs for next placement Formal discussion and negotiation of learning contract related to competencies with mentor. Agree date of formative assessment and document on Learning Contract PASS Documented submitted FAIL Undertake planned resit opportunities Summative meeting and completion of assessment with mentor. Summary of assessment completed. NO Undertake self assessment in relation to progress referring to Standards / ESC s and Learning Contract Student satisfied with progress / opportunities YES Pass / Fail noted. YES Tripartite meeting with academic link, mentor and student Completion of evidence to support learning, Formative meeting and completion of assessment. Student summative selfassessment in relation to progress referring to APT and Learning Contract Student satisfied with progress / opportunities NO NO Provision of formative feedback. Progress satisfactory? YES Review and develop learning contract work towards identified summative assessment date.

43 Assessing my students progress Do I have any concerns? Are the criteria within the OAR being met? YES NO If student is making satisfactory progress in all areas, give constructive feedback to encourage further development. Update assessment documentation Mentor Personal reflection HAVE I? Negotiated a learning contract? Clarified my expectations? Given feedback? Provided the learning opportunity? Demonstrated appropriate practice? Shared my opinion with colleagues? Discussed with Academic Link / workplace facilitator? SUMMATIVE ASSESSMENT YES NO PASS STUDENT Informal discussion of progress and concerns Set up a system to ensure adequate support Set a review date Notify the Link Teacher Mentor to address personal NO responsibilities NO Not Met Tripartite meeting with mentor, Link Teacher and student Renegotiate learning contract Identify support system Set review date Document meeting on Record of Discussion Sheet YES met Formative assessment Constructive feedback /update assessment / new learning YES contract Met FAIL STUDENT Tripartite process with student mentor and Academic Link SUMMATIVE ASSESSMENT PASS STUDENT University to organise resit opportunity 43