assessment of practice: adult nursing · initial meeting with mentor initial interview of progress...

Updated SEPT 2015

Assessment of Practice:

Adult Nursing

Confidentiality Entries made in this practice assessment document must ensure the service users’ right to confidentiality is respected at all times

Assessment of Practice Name _______________________________ University ID number _______________________________ Intake/Group _______________________________ Field of Practice _______________________________ Personal Tutor _______________________________ Telephone _______________________________ Email _______________________________ Programme Leader _______________________________ Telephone _______________________________ Email _______________________________

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Contents

Content Page

YEAR 1 BLOCK 1

5-29

YEAR 1 BLOCK 2

ANTT PBA - pp43 -51

30-62

YEAR 2 BLOCK 1

COMMUNICATION PBA – pp76 - 86

63-97

YEAR 2 BLOCK 2

98-121

YEAR 3 BLOCK 1

MEDICINES MANAGEMENT PBA – pp139 - 149

122-160

YEAR 3 BLOCK 2

161-188

CLINICAL SKILLS EVIDENCE

Inc. MOVING & HANDLING YEARLY RECORDS

189-198

Ongoing Record of Achievement (ORA)

SIGN-OFF MENTOR DOCUMENTATION – pp210 - 214

199-209

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YEAR 1 Before commencing placement experience in Year 1 the student must have obtained DBS and Occupational Health clearance & Completed Mandatory Training

Verified by (print name and designation)

Signature: Date:

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YEAR 1 BLOCK 1

Placement area name ____________________________

Telephone number ____________________________

Checklist of responsibilities to be completed by mentor:

Read the guidance notes…………………………………………………………………...

Sign mentor signature sheet……………………………………………………………….

Complete and sign initial interview………………………………………………………...

Complete and sign practice induction……………………………………………………..

Complete and sign final interview………………………………………………………….

Sign practice hours record………………………………………………………………….

Complete Ongoing Record of Achievement……………………………………………...

Complete attitudinal assessment……………………………………...…………………..

Complete student / mentor contact sheet………………………………………………...

Formulate action plan with student (and tutor if student is referred)…………………..

This Placement Assessment Document is part of the summative assessment for the unit.

Students must photocopy the relevant ONGOING RECORD OF ACHIEVEMENT page for the block of placement that they have been assessed. This should be submitted to your Personal Tutor. Practice Hours records should be submitted to the Student Hub.

It is the responsibility of the student to keep this document safe and ensure that the document is made available during placement so that the mentor can complete the

appropriate parts of the form.

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Mentor signature sheet

All mentors signing student documentation must insert their details below

Name of Mentor (please print)

Registered qualification (i.e. ENB 998/prep for mentorship)

Work Telephone number and email Name of practice learning area Signature Sign off mentor Yes/No

Other Health Care Professional signature sheet

All health care professionals signing student documentation must insert their details below

Name of Health Care Professional (please print)

Profession Work Telephone number and email Name of practice learning area Signature

From now on the term mentor will be used throughout the document

STUDENT SELF ASSESSMENT

This section should be completed prior to starting your placement.

Fill in this section before you have your initial interview with your mentor

Please use the space below to identify and write down your interests or the issues you want to explore on this placement and to reflect upon your previous experience. You might want to wait a day or so before you meet with your mentor so you have the chance to think about the learning opportunities available within this area. You can always ‘firm up’ your ideas at the initial meeting with your mentor and, indeed, at later meetings.

The following questions may help to get you started.

What do I want to see/do?

Can I build upon previously identified strengths or work on previously identified weaknesses?

Where do my priorities lie (bearing in mind what stage you are in your course)?

What help do I need to pursue my interests/the issues I’ve identified?

What part should I play in following up my interest/the issues I’ve identified?

Who should take the lead?

If this is not your first placement experience, you should also use the learning opportunities you identified with your mentor at the end of your last placement.

Students interests, strengths and areas for development (identified by the student)

PERSONAL TUTOR SIGNATURE:

DATE:

STUDENT SIGNATURE:

DATE:

BOX

Please consider how you will develop your KEY SKILLS on this placement [Numeracy, IT, Problem Solving, Managing Own Learning, Working with Others, Communication Spoken and Written and Reading]

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Induction to the Placement

Induction to the placement environment to be completed on first day by a qualified member of the practice team.

Part 1 Part 2

Signature and date

Signature and date

Signature and date

Signature and date

1. Fire regulations discussed

2. Informed of BLS procedures, equipment, emergency number and student role

3. Health and safety policies discussed

4. Informed of assigned mentor’s name

5. Uniform policy discussed

6. Orientation programme/booklet provided

7. Practice Learning Environment philosophy discussed

8. Introduction to staff and environment

9. Informed of the PEF, PEL & ULL for the practice placement

10 The student’s role in the process of evaluating and auditing the learning environment is discussed

11. Sickness and absence protocols discussed

12. Evidence of student attending mandatory training applicable to their field of practice

13 Discussed any issues re – health, pregnancy or learning needs.

Signature: Date: Signature: Date:

Practice 1 Student Signature:

Signature of qualified member of staff:



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INITIAL MEETING WITH MENTOR

Initial Interview of progress – to be completed within two days of the start of practice experience

Completion of practice induction

Review of student self assessment

Identification of learning needs based on the competencies

Formulation of the action plan

Learning Needs based on the Competencies

Action plan

Personal Development Plan discussed Yes No

Specific Learning/Health needs discussed

Yes No

If YES complete a reasonable adjustments action plan

A risk assessment should be undertaken as necessary, especially for those students who are under 18 years of age, pregnant or 12 months post partum.

Mentor’s signature:

Date:

Student’s signature:

Date

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REASONABLE ADJUSTMENTS – STUDENTS WITH LEARNING OR HEALTH NEEDS

Good health & good character (NMC 2010) are fundamental to fitness to practice as a nurse or midwife. This guidance is to help NMC Approved Educational Institutions (AEI’s) and their service partners to ensure consistency in applying the NMC’s requirements for good health and good character. The NMC and the Equality Act (2010) UK and the Disability Discrimination Act for Northern Ireland (1995). These Acts make it clear that it is unlawful to not, make a reasonable adjustment for a person.

Reasonable adjustments can be made to practices, policies and procedures or to altering or avoiding premises and can also involve providing auxiliary aids and services.

There are several parts within the legislation which place different responsibilities on different kinds of organisations. The Disability Discrimination Act 1995 as amended (for Northern Ireland) and The Equality Act 2010 (England, Scotland & Wales) require public sector bodies to actively advance equality for disabled people.

The NMC has an obligation to advance equality in the way it sets education standards as well as ensuring that its registration processes are fair and do not discriminate against people with disabilities.

At the same time the NMC need to ensure that they are meeting the legislative responsibilities of safeguarding the health and wellbeing of people using or needing the services of nurses or midwives.

Where applicants to programmes, students or nurses or midwives declare disabilities or health conditions, impairment of fitness to practice is considered on an individual basis.

One person who has a particular health condition or disability may be affected differently to another person.

A reasonable adjustment which enables one person to practice effectively may not work for everyone. Therefore it is important for each individual case to be considered in the context of their circumstances.

Failure of a programme provider or employer to make reasonable adjustment for a disabled person can be unlawful discrimination.

Student Information If you have reasonable adjustments identified by your AEI it is in your interests to ensure that you disclose these to your mentor in practice.

A fair and equitable assessment may not be possible if the mentor is unaware of your individual needs.

The purpose of reasonable adjustments is to help you achieve in both theory and practice by utilising appropriate support in University and your Clinical Placement.

IF WE DO NOT KNOW WE CANNOT RESPOND TO YOUR NEEDS APPROPRIATELY.

Mentor Information Ask the student if they have had reasonable adjustments identified by the AEI.

You must discuss the disability or health need with the student and identify any current strategies they may have for managing these.

Actions need to be identified in relation to how it might be possible to accommodate the students learning or health needs plus their identified reasonable adjustments within the practice area.

There should be an ongoing assessment of the effectiveness of any interventions throughout the practice placement and this must be documented in the practice assessment booklet.

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MMU Students, who have a Personal Learning Plan in place, are required to undertake a Pre Placement Questionnaire with their Personal Tutor prior to EVERY placement. www.nmc-uk.org The RCN has information that may help mentors with this process www.rcn.org.uk Key words – reasonable adjustments on publications

http://www.nmc-uk.org/

http://www.rcn.org.uk/

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INTERIM / MID-PLACEMENT REVIEW OF PROGRESS AND DEVELOPMENT PLAN

Please note that this review point must be completed mid-way through the placement, to ensure that the student has time to improve by the end of placement. Students review of progress After discussion with your mentor, please summarise your views about your progress, including strengths, areas for development and identification of any issues affecting your performance

Mentors review of progress After discussion with the student, please summarise your views about her/his progress, including strengths, areas for development and identification of any issues affecting performance.

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INTERIM DEVELOPMENT PLAN (relating to competency statemen

Development Planning What additional actions must the student take in order to meet the competencies?

Criteria for Achievement? What evidence must the student produce to demonstrate that they have met the competencies?

Student signature: Date:

Mentor signature: Date:

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ATTITUDINAL ASSESSMENT – INTERIM As part of the INTERIM interview the mentor should tick the five statements from the following list that most accurately reflect the student’s development to date.

Displays a positive attitude

Valued team member who has gained respect

Demonstrates an empathetic approach to care

Actively supportive of clients/colleagues

Displays non-judgemental attitudes towards others

Reacts adversely to constructive criticism

Lack of confidence adversely inhibits performance

Lacks awareness of self and of effect of behaviour on others

Lacks maturity

Slow to settle

Lacks empathy

Needs to be more assertive

Appears over confident for stage of training

Willing to try

Has developed in confidence during placement

Has a pleasant and approachable manner

Displays a mature attitude

Fits well into the team

Well motivated and adaptable

Consistently displays confidence

Demonstrates a professional approach to work

Appears to lack motivation

Able to accept/use constructive criticism to improve performance

Willing to use initiative

Displays a negative attitude

Demonstrates self awareness

Behaves in an unprofessional manner

Considerate, demonstrates awareness of the needs of others

Open, accepting and values contribution of others

Blames circumstances for difficulties encountered


(Adapted from: Knight J (1998) A Fieldwork award: rewarding Excellence in Practice, British Journal of Occupational therapy, 61.7, 316-320). This is a formative tool designed to offer both the student & mentor guidance in relation to personal & professional development over the course of the practice experience. At the midpoint assessment areas of good practice and those requiring further development should be discussed and if required an action plan implemented to address any issues identified. Similarly, at the final assessment the tool should be used to guide the student towards improving performance in future practice areas

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SUMMATIVE ASSESSMENT OF PLACEMENT

Competencies to be achieved under Appropriate Supervision

First attempt Achieved

(Mentor/registrant signature & date)

Second attempt Achieved

(Mentor signature & date)

Progression Point 1 MID POINT FINAL MID POINT FINAL

YES Working towards

YES NO YES Working towards

YES NO

1. Demonstrates safe, basic, person-centred care, under supervision, for people who are unable to meet their own physical and emotional needs.

2. Meets people’s essential needs in relation to safety and security, wellbeing, comfort, bowel and bladder care, nutrition and fluid maintenance and personal hygiene, maintaining their dignity at all times.

3. Seeks help where people’s needs are not being met, or they are at risk.

4. Is able to recognise when a person’s physical or psychological condition is deteriorating, demonstrating how to act in an emergency and administer essential first aid

5. Demonstrates an understanding of how to work within legal and professional frameworks and local policies to safeguard and protect people, particularly children, young people, and vulnerable adults.

6. Is able to recognise, and work within, the limitations of their own knowledge and skills and professional boundaries, understanding that they are responsible for their own actions.

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Progression Point 1





MID POINT FINAL MID POINT FINAL

YES Working towards


YES NO

7. Demonstrates the ability to listen, seek clarity, and carry out instructions safely, and records information clearly and accurately on the basis of observation and communication.

8. Uses and disposes of medical devices safely under supervision according to local and national policy, reporting any incidents or near misses.

9. Understands and works within the laws governing health and safety at work. Demonstrates safe manual handling techniques, and understands how nurses can help reduce the risk of infection, including effective hand washing.

10. Recognises signs of aggression and takes appropriate action to keep themselves and others safe.

11. Safely and accurately carries out basic medicines calculations.

12. Demonstrates safe and effective communication skills, both orally and in writing.

13. Displays a professional image in their behaviour and appearance, showing respect for diversity and individual preferences.

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SUMMATIVE ASSESSMENT OF PRACTICE


Progression Point 1






YES Working towards


YES NO

14. Demonstrates respect for people’s rights and choices, and effectively communicates people’s stated needs and wishes to other professionals.

15. Acts in a manner that is attentive, kind, sensitive, compassionate and non-discriminatory, that values diversity and acts within professional boundaries.

16. Understands the principles of confidentiality and data protection. Treats information as confidential, except where sharing is required to safeguard and protect people.

17. Practices honestly and with integrity, applying the principles of The Code: Standards of conduct, performance and ethics for nurses and midwives (2008) and the Guidance on professional conduct for nursing and midwifery students (2010).

18. Acts in a way that values the roles and responsibilities of others in the team and interacts appropriately.

19. Is able to engage and disengage with people and build caring professional relationship

20. Uses support systems to recognise, manage and deal with own emotions.

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END OF PLACEMENT REVIEW

Students review of progress After discussion with your mentor, please summarise your views about your progress, including strengths, areas for development and identification of any issues affecting your performance




Mentor please ensure you complete the relevant Ongoing Record of Achievement page at this stage.

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SECOND ATTEMPT. This should only be completed if the student has not achieved all

competencies.

INITIAL INTERVIEW Discuss the competencies that need to be addressed, and ways to achieve the competencies



FINAL INTERVIEW Summary



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ATTITUDINAL ASSESSMENT – END OF PLACEMENT

As part of the FINAL interview the mentor should tick the five statements from the following list that most accurately reflect the student’s development to date.









Lacks maturity

Slow to settle

Lacks empathy



Willing to try


















(Adapted from: Knight J. (1998) A Fieldwork award: rewarding Excellence in Practice, British Journal of Occupational therapy, 61.7, 316-320).

This is a formative tool designed to offer both the student & mentor guidance in relation to personal & professional development over the course of the practice experience. At the midpoint assessment areas of good practice and those requiring further development should be discussed and if required an action plan implemented to address any issues identified. Similarly, at the final assessment the tool should be used to guide the student towards improving performance in future practice areas.

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STATEMENT OF ACHIEVEMENT YEAR 1 BLOCK 1

FIRST ATTEMPT CONFIRMATION Student signature:

Print Name: Date

I CONFIRM THAT THERE HAS BEEN NO FALSIFICATION OF EVIDENCE WITHIN THIS DOCUMENT.

SECOND ATTEMPT CONFIRMATION Student signature:

Print Name: Date

Student’s Name: University:

Programme (Course) : DEGREE University ID:

Competencies: To be completed by mentor

All competencies achieved: Yes No

I confirm that I hold live register status and have attended an annual update according to NMC guidance (2008)

Mentor signature:

SECOND ATTEMPT



Mentor signature:

Attendance: To be completed by mentor

NIGHT DUTY Hours

Date:

Total number of nights

Sign:

SICKNESS Hours

Date:

Total number of days

Sign:

ABSENCE: Hours

Date:

Total number of days Sign:

Validation by HEI FIRST ATTEMPT SECOND ATTEMPT

Tutor Name: Tutor Name:

(please print) (please print)

Tutor signature: Tutor signature:

Date: Date:

Successful Successful

Unsuccessful Unsuccessful

Defer Defer

Reason Reason

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STUDENT MENTOR and OTHER HEALTH CARE PROFESSIONALS CONTACT SHEET The contact sheet should be used to record meetings additional to the initial, mid and final interviews.

Date and length of time

Topic – Include opportunities for meeting EU requirements. and outcome for the student

Mentor/Health Care Professional Signature

Student signature

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RECORD OF PRACTICE LEARNING OPPORTUNITIES, INCLUDING STUDY DAYS

Date Topic – Include opportunities for meeting EU requirements. Mentor/Health Care Professional Signature

Student signature

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RECORD OF PRACTICE HOURS THIS IS A LEGAL DOCUMENT AND FRAUDULANT ACTIVITY WILL BE SUBJECT TO UNIVERSITY DISCIPLINARY PROCEDURES.


Programme

DEGREE University ID No:

Field of practice: Intake/Group

YEAR 1 BLOCK 1:

Please complete the hours on each shift worked. Otherwise, please select the correct key to indicate the reason for absence.

PLEASE SPECIFY NUMBER OF HOURS WORKED ON EACH SHIFT SHOWN BELOW

CS Certified sickness (Both the university and practice placement have been notified)

US Uncertified sickness (Both the university and practice placement have been notified)

UA Unauthorised Absence

SP Spoke Placement / Seminar

N Night Duty

MMU STUDENTS - EXTRA HOURS: IF YOU MAKE UP EXTRA OR OUTSTANDING HOURS PLEASE RECORD THEM IN THE END COLUMN FOR THE PLACEMENTS OFFICE.

WEEK ONE MON TUE WED THU FRI SAT SUN

EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:

WEEK TWO MON TUE WED THU FRI SAT SUN

EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:

WEEK THREE MON TUE WED THU FRI SAT SUN

EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:

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WEEK FOUR MON TUE WED THU FRI SAT SUN

EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:

WEEK FIVE MON TUE WED THU FRI SAT SUN

EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:

WEEK SIX MON TUE WED THU FRI SAT SUN

EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:

WEEK SEVEN MON TUE WED THU FRI SAT SUN

EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:

WEEK EIGHT MON TUE WED THU FRI SAT SUN

EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:

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WEEK NINE MON TUE WED THU FRI SAT SUN

EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:

WEEK TEN MON TUE WED THU FRI SAT SUN

EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:

WEEK ELEVEN MON TUE WED THU FRI SAT SUN

EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:

I certify that the total hours worked within this practice area is Hours

Cumulative total of night duty (in hours) Hours



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Service User/Carer/relative involvement in practice assessment of a student nurse. Consent must be gained from the service user/carer/relative with the mentor present to participate in this exercise. The mentor is asked to record the main points of the conversation on the form below. We would like to hear your views about the way nursing students have contributed to the care you have received. This is to help the students learn and develop their skills in caring and communicating with both service users and carers so that they develop good practice. The feedback you give will not affect the care you receive. If you are a carer please could you comment on the care your friend/relative received by the student as well as how you were looked after by them? We would like to thank you in advance for this invaluable help to the student learning experience in becoming a qualified nurse.

Student’s name

How long have you known the student?

Please state what they have done well, either in your care or in the care of your relative/friend.

Please state what they could do (if anything at all) to improve their communication skills, their professional manner, their participation in your care etc.

Please add any other information you think would be helpful to the student in their future practice


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SUMMARY OF PRACTICE PROGRESS BY PERSONAL TUTOR

Student Name: University: MMU

Programme (Course): DEGREE University ID No:

Field of practice: ADULT Intake / Group:

YEAR 1 BLOCK 1

Placement:

PERSONAL TUTOR’S COMMENTS

STUDENT’S COMMENTS

ACTIONS AGREED

Personal Tutor signature: Date:


30

Year 1 Block 2


















31

Mentor signature sheet All mentors signing student documentation must insert their details below









32















DATE:

STUDENT SIGNATURE:

DATE:

BOX


33



Part 1 Part 2

Signature and date

Signature and date

Signature and date

Signature and date



















34








Action plan



Yes No




Date:


Date

35



















36




37




38






39










Lacks maturity

Slow to settle

Lacks empathy



Willing to try


















(Adapted from: Knight J (1998) A Fieldwork award: rewarding Excellence in Practice, British Journal of Occupational therapy, 61.7, 316-320). This is a formative tool designed to offer both the student & mentor guidance in relation to personal & professional development over the course of the practice experience. At the midpoint assessment areas of good practice and those requiring further development should be discussed and if required an action plan implemented to address any issues identified. Similarly, at the final assessment the tool should be used to guide the student towards improving performance in future practice

40






(Mentor signature & date)

Progression Point 1 MID POINT FINAL MID POINT FINAL

YES Working towards


YES NO

1. Demonstrates safe, basic, person-centred care, under supervision, for people who are unable to meet their own physical and emotional needs.

2. Meets people’s essential needs in relation to safety and security, wellbeing, comfort, bowel and bladder care, nutrition and fluid maintenance and personal hygiene, maintaining their dignity at all times.

3. Seeks help where people’s needs are not being met, or they are at risk.

4. Is able to recognise when a person’s physical or psychological condition is deteriorating, demonstrating how to act in an emergency and administer essential first aid

5. Demonstrates an understanding of how to work within legal and professional frameworks and local policies to safeguard and protect people, particularly children, young people, and vulnerable adults.

6. Is able to recognise, and work within, the limitations of their own knowledge and skills and professional boundaries, understanding that they are responsible for their own actions.

41



Progression Point 1






YES Working towards


YES NO

7. Demonstrates the ability to listen, seek clarity, and carry out instructions safely, and records information clearly and accurately on the basis of observation and communication.

8. Uses and disposes of medical devices safely under supervision according to local and national policy, reporting any incidents or near misses.

9. Understands and works within the laws governing health and safety at work. Demonstrates safe manual handling techniques, and understands how nurses can help reduce the risk of infection, including effective hand washing.

10. Recognises signs of aggression and takes appropriate action to keep themselves and others safe.

11. Safely and accurately carries out basic medicines calculations.

12. Demonstrates safe and effective communication skills, both orally and in writing.

13. Displays a professional image in their behaviour and appearance, showing respect for diversity and individual preferences.

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SUMMATIVE ASSESSMENT OF PRACTICE


Progression Point 1






YES Working towards


YES NO

14. Demonstrates respect for people’s rights and choices, and effectively communicates people’s stated needs and wishes to other professionals.

15. Acts in a manner that is attentive, kind, sensitive, compassionate and non-discriminatory, that values diversity and acts within professional boundaries.

16. Understands the principles of confidentiality and data protection. Treats information as confidential, except where sharing is required to safeguard and protect people.

17. Practices honestly and with integrity, applying the principles of The Code: Standards of conduct, performance and ethics for nurses and midwives (2008) and the Guidance on professional conduct for nursing and midwifery students (2010).

18. Acts in a way that values the roles and responsibilities of others in the team and interacts appropriately.

19. Is able to engage and disengage with people and build caring professional relationship

20. Uses support systems to recognise, manage and deal with own emotions.

43

ASEPTIC NON TOUCH TECHNIQUE

PRACTICE BASED ASSESSMENT

YEAR 1 BLOCK 2

Student’s Name …………………………………………………….. Intake …………………………………………………….. Base Trust …………………………………………………….. Personal Tutor …………………….……………………………… Programme Leader ………………………………………………….....

Notes to assessor: This is a clinical assessment of the student’s ability to perform a

procedure utilising aseptic technique. They must achieve a pass in all areas to pass the overall assessment. The student must achieve a pass in order to successfully complete this placement.

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INSTRUCTIONS TO THE STUDENT AND MENTOR FOR THE PRACTICE BASED ASSESSMENT (PBA) The Assessment of Practice is seen as an integral to the BSc (Hons) Programme and is a means of integrating theory and practice. It is recognised that this will contribute to the student’s personal development of their Assessment of Practice. Learning Outcomes During this unit the student will be able to ‘Demonstrate the Principles of Asepsis’ This PBA has been mapped against the NMC Standards (2010) R5.6.2, R8.1.5. Competencies

PV,1, 1.1, 7, 9. NMC ESC (2010) 21:7, 8, 9, 10. 24:4. 25:1, 4, 5. 26:4, 5.

Mentor for the Student’s Placement The student’s named mentor for this practice placement is responsible for reviewing the student’s Personal Development Plan and the ‘Achievement and Verification Form’ then signing / countersigning this (where appropriate). Retrieval A student who did not achieve the outcomes for successful completion of the PBA at first attempt will undertake a 2nd attempt in the next placement. The student must inform their mentor at the initial interview of the requirement for this assessment to be completed in order for the student to successfully complete the placement. The student and mentor then need to plan accordingly how this will be achieved. Indicators to Achievement Indicators are given as a guide to achievement of the learning outcome, however, these are not meant to be exhaustive and other indicators may be identified. Verification with Personal Tutor is required before copying and submitting the Achievement and Verification Form.

Guidance Notes for Assessor

The assessment must be made by a Registered Nurse/ Mentor

Students will have received clinical skills/ theory input to support this assessment prior to undertaking their placement

Students will have undertaken a summative hand washing assessment within University prior to undertaking this assessment

Students will have the opportunity to retake the assessment should they be referred in practice. The PBA is subject to University assessment regulations.

The assessment can be undertaken in any area where the student is expected to perform procedures requiring the use of aseptic non touch technique.

Guidance notes on maintaining sterile field

Assessors should ensure that students maintain a sterile field at all times ensuring they:

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Don’t place sterile items near open windows or doors. Only place sterile items within the sterile field. Do not contaminate sterile items when opening, dispensing, or transferring them. Do not allow sterile personnel to reach across unsterile areas or to touch unsterile

items. Do not allow unsterile personnel to reach across a sterile area or touch sterile

equipment Recognize items which would be considered unsterile e.g. outside of packaging, wet

or torn items Opens sterile field using only the corners of the paper Ensure dressing is removed & disposed of appropriately if required and does not

contaminate sterile field Pours appropriate cleaning solution into sterile pot without contaminating it Drops sterile gloves onto sterile field Puts gloves on touching only the inside Ensures no contaminated material comes into contact with sterile field and is

disposed of correctly Maintains a non touch technique throughout Cleans wound or site from clean area to contaminated area Apply dressings appropriately if used

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ACTION PLANNING DOCUMENT

FOR YEAR 1 – BLOCK 2

Please complete prior to placement

Student Name:

Practice Placement: Student Self Assessment (Prior to Practice Placement) In relation to the indicators for achievement, identify `Where am I now' in relation to the learning outcome ‘Demonstrate the Principles of Asepsis’ What knowledge, skills and attitudes do I now have?

Action Planning In order to meet the learning outcome for the practice based assessment what `do I now need to know and do' to demonstrate my knowledge, skills, and attitudes to ‘Demonstrate the Principles of Asepsis’

Student Signature: Date

Personal Tutor Signature: Date

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Future Learning and Development From my evidence what `do I now need to know and / or do' in relation to the practice based assessment learning outcome, ‘Demonstrate the Principles of Asepsis’ What knowledge, skills and attitudes do I now have?

Student Signature: Date:

Mentor Signature: Date:

Evidence of Achievement Reflecting on my actions, what knowledge, skills and attitude `What do I now have' in relation to the practice based assessment learning outcome, ‘Demonstrate the Principles of Asepsis’ “What knowledge, skills and attitudes do I now have?” (Revisit self-assessment and action planning)



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ASSESSMENT CRITERIA

During this BLOCK the student will be able to ‘Demonstrate the Principles of Asepsis’

Mapped against the NMC Standards (2010) R5.6.2, R8.1.5. Competencies PV,1,1.1,7, 9. NMC

ESC (2010) 21:7,8,9,10. 24:4. 25:1,4,5. 26:4,5.

Pass Refer

1. Prepares patient adequately for procedure and gains consent

2. Identifies correct equipment required for procedure and checks appropriate expiry dates/ integrity of packaging to ensure sterility

3. Prepares and cleans the trolley/ area to be used for the procedure appropriately, placing equipment away from sterile area

4. Prepares self for procedure including use of correct protective clothing i.e., aprons, gloves which are appropriate to the procedure and cleans hands using appropriate technique/ solution

5. Positions the patient comfortably and prepares the area and ensures patient comfort throughout within the treatment room or at the bedside.

6. Carries out procedure maintaining a sterile field at all times ( see guidance notes for details)

7. Disengages from patient appropriately following procedure

8. Returns equipment and disposes of waste correctly

9. Cleans hands appropriately following procedure

10. Documents care within patient record ensuring any sterility labels/ appropriate reference numbers etc are recorded

Result:

Pass

Refer

Comments/ Action Plan Mentor Signature: Date: Student Signature: Date: Personal Tutor Signature: Date

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YEAR 1 BLOCK 2

ANTT ACHIEVEMENT AND VERIFICATION FORM

NAME: INTAKE / GROUP

PLACEMENT

Pass Refer

Learning Outcome: The student will be able to ‘Demonstrate the Principles of Asepsis’

Assessor Comments Student’s Comments

Personal Tutor’s Comments

Name: Name:

Signature: Signature: Signature:

Date: Date: Date:

Countersigned and dated by named Mentor (where applicable)

50

ASSESSMENT CRITERIA – ANTT SECOND ATTEMPT

During this BLOCK the student will be able to ‘Demonstrate the Principles of Asepsis’

Mapped against the NMC Standards (2010) R5.6.2, R8.1.5. Competencies PV,1,1.1,7, 9. NMC

ESC (2010) 21:7,8,9,10. 24:4. 25:1,4,5. 26:4,5.

Pass Refer

1. Prepares patient adequately for procedure and gains consent

2. Identifies correct equipment required for procedure and checks appropriate expiry dates/ integrity of packaging to ensure sterility

3. Prepares and cleans the trolley/ area to be used for the procedure appropriately, placing equipment away from sterile area

4. Prepares self for procedure including use of correct protective clothing i.e., aprons, gloves which are appropriate to the procedure and cleans hands using appropriate technique/ solution

5. Positions the patient comfortably and prepares the area and ensures patient comfort throughout within the treatment room or at the bedside.

6. Carries out procedure maintaining a sterile field at all times ( see guidance notes for details)

7. Disengages from patient appropriately following procedure

8. Returns equipment and disposes of waste correctly

9. Cleans hands appropriately following procedure

10. Documents care within patient record ensuring any sterility labels/ appropriate reference numbers etc are recorded

Result:

Pass

Refer

Comments/ Action Plan Mentor Signature: Date: Student Signature: Date: Personal Tutor Signature: Date

51

YEAR 1 BLOCK 2

ANTT ACHIEVEMENT AND VERIFICATION FORM 2nd Attempt


PLACEMENT

Pass Refer

Learning Outcome: The student will be able to ‘Demonstrate the Principles of Asepsis’



Name: Name:


Date: Date: Date:


52







53


competencies.







54











Lacks maturity

Slow to settle

Lacks empathy



Willing to try




















55



Print Name: Date



Print Name: Date






Mentor signature:

SECOND ATTEMPT



Mentor signature:


NIGHT DUTY Hours

Date:


Sign:

SICKNESS Hours

Date:


Sign:

ABSENCE: Hours

Date:






Date: Date:



Defer Defer

Reason Reason

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STUDENT MENTOR and OTHER HEALTH CARE PROFESSIONALS CONTACT SHEET The contact sheet should be used to record meetings additional to the initial, mid and final interview


Topic and outcome for the student Mentor/Health Care Professional Signature

Student signature

57



Student signature

58



Programme



YEAR 1 BLOCK 2:







N Night Duty



EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:


EXTRA HOURS

Date:

Hours:

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Date:

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Signed by mentor:

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EXTRA HOURS

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EXTRA HOURS

Date:

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Date:

Hours:

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YEAR 1 BLOCK 1

Placement:



ACTIONS AGREED



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Service User/Carer/relative involvement in practice assessment of a student nurse Consent must be gained from the service user/carer/relative with the mentor present to participate in this exercise. The mentor is asked to record the main points of the conversation on the form below. We would like to hear your views about the way nursing students have contributed to the care you have received. This is to help the students learn and develop their skills in caring and communicating with both service users and carers so that they develop good practice. The feedback you give will not affect the care you receive. If you are a carer please could you comment on the care your friend/relative received by the student as well as how you were looked after by them? We would like to thank you in advance for this invaluable help to the student learning experience in becoming a qualified nurse.

Student’s name






63

YEAR 2 BLOCK 1


















64











65















DATE:

STUDENT SIGNATURE:

DATE:

BOX BOX


66



Part 1 Part 2

Signature and date

Signature and date

Signature and date

Signature and date



















67








Action plan



Yes No




Date:


Date

68



















69




70




71






72










Lacks maturity

Slow to settle

Lacks empathy



Willing to try



















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SUMMATIVE ASSESSMENT OF PLACEMENT – GENERIC COMPETENCIES

The purpose of the assessment is for the students to demonstrate their ability to develop independent autonomous practice (NMC Standards p102) Competencies to be achieved under Appropriate Supervision




(Mentor/registrant signature & date) Progression Point 2 Works more independently, with less direct supervision, in a safe and increasingly confident manner

Demonstrates potential to work autonomously, making the most of opportunities to extend knowledge, skills and practice


YES Working towards


YES NO

1. Practices with developing confidence in accordance with The Code: standards of conduct performance and ethics for nurses and midwives (NMC, 2008) and within other recognised legal and ethical frameworks.

2. Recognizes the limits of own competence and knowledge, whilst working more independently with less direct supervision.

3. Initiates, maintains and disengages from therapeutic relationships, with support.

4. Uses a range of effective communication methods to be able to respond to individual needs.

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Progression Point 2 Works more independently, with less direct supervision, in a safe and increasingly confident manner



YES Working towards


YES NO

5. Participates in maintaining accurate, clear and complete records in line with current legislation.

6. Participates in a comprehensive assessment of an individual within own field of practice.

7. Participates in planning care for an individual within own field of practice.

8. Participates in the delivery of care for an individual within own field of practice.

9. Participates in the evaluation of care for an individual within own field of practice.

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SUMMATIVE ASSESSMENT OF PLACEMENT – FIELD SPECIFIC



(Mentor/registrant Signature & date)



Progression Point 2 Adult Works more independently, with less direct supervision, in a safe and increasingly confident manner Demonstrates potential to work autonomously, making the most of opportunities to extend knowledge, skills and practice

MID POINT FINAL MID POINT

YES Working towards


YES NO

1. Adult nurses must understand and apply current legislation to all service users, paying special attention to the protection of vulnerable people, including those with complex needs arising from ageing, cognitive impairment, long-term conditions and those approaching the end of life.

2. Adult nurses must promote the concept, knowledge and practice of self-care with people with acute and long-term conditions, using a range of communication skills and strategies.

3. Adult nurses must recognise the early signs of illness in people of all ages. They must make accurate assessments and start appropriate and timely management of those who are acutely ill, at risk of clinical deterioration, or require emergency care.

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COMMUNICATION & INTER-PERSONAL SKILLS DURING THE HANDOVER OF A PATIENT/PATIENTS

CLINICAL PRACTICE ASSESSMENT

YEAR 2 BLOCK1

Student’s Name

Intake

Base Trust

Personal Tutor

Programme Leader

This is a clinical assessment of the student’s ability to demonstrate effective communication and inter-personal skills during the handover of a patient/patients. They must achieve a pass in all areas to pass the overall assessment and also the placement.

Notes to assessor:

77

INSTRUCTIONS TO THE STUDENT AND MENTOR FOR THE PRACTICE BASED ASSESSMENT (PBA) The Assessment of Practice is seen as an integral to the BSc Hons Programme and is a means of integrating theory and practice. It is recognised that this will contribute to the student’s personal development of their Assessment of Practice. Learning Outcomes During this module the student is able to ‘Demonstrate their communication & inter – personal skills during the handover of a patient/patients’. This PBA has been mapped against the NMC Standards (2010) R5.6.2, R8.1.5 & Second

Progression Points 1 and 2. Competencies PV 2, 2.1, 7, 9. CIS, 1, 1.1, 2, 2.1, 3, 3.1, 4, 4.1, 5, 5.1,

6, 7, 8.

NMC ESC (2010) 1:6, 11, 12, 13. 3:4. 5:6, 7, 8, 10, 11. 6:6, 7, 9, 11, 12, 13. 11: 1, 2, 3. 7:6. 14:

5.

Healthcare Professionals and Patients (CHRE 2008) Mentor for the Student’s Placement The student’s named mentor for this practice placement is responsible for reviewing the student’s Personal Development Plan and the ‘Achievement and Verification Form’ then signing / countersigning this (where appropriate). Retrieval A student who did not achieve the outcomes for successful completion of the Clinical practice assessment at first attempt will undertake a 2nd attempt in the next placement. The student must inform their mentor at the initial interview of the requirement for this assessment to be completed in order for the student to successfully complete the placement. The student and mentor then need to plan accordingly how this will be achieved. Indicators to Achievement Indicators are given as a guide to achievement of the learning outcome, however, these are not meant to be exhaustive and other indicators may be identified. Verification with Personal Tutor is required before copying and submitting the Achievement and Verification Form. Guidance notes for Assessor. (This list is not meant to be exhaustive, others may be identified)

The assessment must be made by a Registered Nurse/mentor.

The assessment should be of a student nurse undertaking the handover of one or more patients using SBAR, and also communicating with the patient about their plan of care.

78

The student acknowledges the service user appropriately by name.

The student introduces themselves appropriately to the team and also to the patient when explaining the plan of care.

The student demonstrates the ability to use verbal/non verbal communication strategies appropriate to the needs of the individual. This may include the MDT, patient, client, child, parent, carer.

The student understands and demonstrates the need to ensure a safe environment when communicating with patients.

The student uses appropriate listening skills, e.g. eye contact. The student is able to watch for and respond to verbal and non-verbal cues.

The student is able to maintain clear communication with colleagues and patients at all times.

The student is able to identify any actual or potential barriers to effective communication and can explain how they would manage these (e.g. communicating with someone living with a stroke).

The student is familiar with and can discuss the nursing documentation used in the practice setting.

The student is familiar with and can discuss the professional, legal & ethical issues relating to record keeping.

The student is aware of how to recognise professional boundaries in a healthcare setting, how to recognise early warning signs of inappropriate behaviour, how to deal with such circumstances appropriately and where to seek advice.

The student is aware of how their own cultural and religious values and the cultural and religious values of patients and service users might affect boundary issues, for example around the acceptability of use of touch.

The student is aware of appropriate techniques for intimate and other examinations and history-taking

The student is familiar with and can discuss protocols for intimate examinations and the use of chaperones.

The student has understanding and respect for, the different needs of patients, including the needs of vulnerable groups of patients for whom boundary-setting may be especially hard

The student knows what to do and their duty to report, if they have concerns about other health professionals communicating in an inappropriate way.

79

ACTION PLANNING DOCUMENT YEAR 2 BLOCK 1

Please complete prior to placement

Student Name: Practice Placement:

Student Self Assessment (Prior to Practice Placement) In relation to the indicators for achievement, identify `Where am I now' in relation to the learning outcome ‘Demonstrate your communication & inter – personal skills during the handover of a patient/patients’. What knowledge, skills and attitudes do I now have?

Action Planning In order to meet the learning outcome for the clinical practice assessment what `do I now need to know and do' to demonstrate my knowledge, skills, and attitudes to ‘Demonstrate your communication & inter – personal skills during the handover of a patient/patients’.


Personal Tutor Signature: Date:

80

Future Learning and Development From my evidence what `do I now need to know and / or do' in relation to the practice based assessment learning outcome, ‘Demonstrate your communication & inter – personal skills during the handover of a patient/patients’ What knowledge, skills and attitudes do I now have?



Evidence of Achievement Reflecting on my actions, what knowledge, skills and attitude `What do I now have' in relation to the practice based assessment learning outcome, ‘ Demonstrate your communication & inter – personal skills during the handover of a patient/patients’“What knowledge, skills and attitudes do I now have?” (Revisit self-assessment and action planning)



81

ASSESSMENT CRITERIA

During this BLOCK the student will be able to ‘Demonstrate their communication and inter-personal skills during the handover of a

patient/patients’.

Mapped against NMC Standards (2010) R5.6.2, R8.1.5 & Second Progression Points 1 and 2 Competencies PV2, 2.1, 7, 9. CIS, 1, 1.1, 2, 2.1, 3,

3.1, 4, 4.1, 5, 5.1, 6, 7, 8.

NMC ESC (2010) 1:6, 11, 12, 13. 3:4. 5:6, 7, 8, 10, 11. 6:6, 7, 9, 11, 12, 13. 11: 1, 2, 3. 7:6. 14: 5.

Healthcare Professionals and Patients (CHRE 2008)

Pass Refer

1. Uses the skills of active listening, questioning, paraphrasing and reflection to support a therapeutic handover of a patient/patients, using SBAR.

2. Uses strategies to enhance communication with colleagues and service users, and remove barriers for effective communication.

3. Is proactive in enhancing communication and understanding, maintains clear communication with patients and where appropriate is able to convey complex patient needs.

4. Communicates with colleagues verbally, face-to-face and by telephone, and in writing and electronically in a way that the meaning is clear, and checks that the communication has been fully understood.

5. Makes appropriate use of touch when communicating plan of care with patient.

6. Initiates, maintains and closes professional relationships with all involved in the handover, including member of the MDT and patients, service users and carers.

7. Where appropriate, articulates the boundaries of working with vulnerable service users during the handover, and understands the professional impact of maintaining those boundaries.

8. Recognises and acts to overcome barriers in developing effective relationships with service users, carers and other professionals when exploring the patients plan of care.

9. Anticipates necessary care planning during a handover and responds with kindness and empathy to provide physical and emotional comfort to the patient.

10. Acts sensitively to ensure that personal judgements, prejudices, values, attitudes and beliefs do not compromise care.

11. Recognises circumstances that trigger personal negative responses and takes action to prevent this compromising care.

12. Works with the code (NMC 2015) and within the Guidance on professional conduct for nursing & midwifery students (2010) in

82

relation to confidentiality and professional boundaries.

13. Acts as a role model during the handover in developing trusting relationships, within professional boundaries.

14. Ensure communication and plan of care are legibly documented in the format applicable to the area (written/electronic).

Result:

Pass Refer

Comments/Action Plan Key areas of development: Mentor Signature: Date: Student Signature: Date: Personal Tutor Signature: Date:

83

YEAR 2 BLOCK 1 COMMUNICATION & INTERPERSONAL SKILLS DURING THE HANDOVER OF A PATIENT/PATIENTS

ACHIEVEMENT AND VERIFICATION FORM


PLACEMENT

Pass Refer

Learning Outcome: The student will be able to ‘Demonstrate their communication & interpersonal skills during the handover of a

patient/patients’



Name: Name:


Date: Date: Date:


84

ASSESSMENT CRITERIA- COMMUNICATION & INTER-PERSONAL SKILLS DURING THE HANDOVER OF A

PATIENT/PATIENTS SECOND ATTEMPT

During this BLOCK the student will be able to ‘Demonstrate their communication and inter-personal skills during a handover’.

Mapped against NMC Standards (2010) R5.6.2, R8.1.5 & Second Progression Points 1 and 2 Competencies PV2, 2.1, 7, 9. CIS, 1, 1.1,

2, 2.1, 3, 3.1, 4, 4.1, 5, 5.1, 6, 7, 8.

NMC ESC (2010) 1:6, 11, 12, 13. 3:4. 5:6, 7, 8, 10, 11. 6:6, 7, 9, 11, 12, 13. 11: 1, 2, 3. 7:6. 14: 5.

Healthcare Professionals and Patients (CHRE 2008)

Pass Refer

1. Uses the skills of active listening, questioning, paraphrasing and reflection to support a therapeutic handover of a patient/patients, using SBAR.

2. Uses strategies to enhance communication with colleagues and service users, and remove barriers for effective communication.

3. Is proactive in enhancing communication and understanding, maintains clear communication with patients and where appropriate is able to convey complex patient needs.

4. Communicates with colleagues verbally, face-to-face and by telephone, and in writing and electronically in a way that the meaning is clear, and checks that the communication has been fully understood.

5. Makes appropriate use of touch when communicating plan of care with patient.

6. Initiates, maintains and closes professional relationships with all involved in the handover, including member of the MDT and patients, service users and carers.

7. Where appropriate, articulates the boundaries of working with vulnerable service users during the handover, and understands the professional impact of maintaining those boundaries.

8. Recognises and acts to overcome barriers in developing effective relationships with service users, carers and other professionals when exploring the patients plan of care.

9. Anticipates necessary care planning during a handover and responds with kindness and empathy to provide physical and emotional comfort to the patient.

10. Acts sensitively to ensure that personal judgements, prejudices, values, attitudes and beliefs do not compromise care.

11. Recognises circumstances that trigger personal negative responses and takes action to prevent this compromising care.

12. Works with the code (NMC 2015) and within the Guidance on professional conduct for nursing & midwifery students (2010) in relation to confidentiality and professional boundaries.

85

13. Acts as a role model during the handover in developing trusting relationships, within professional boundaries.

14. Ensure communication and plan of care are legibly documented in the format applicable to the area (written/electronic).

Result:

Pass Refer

Comments/Action Plan Key areas of development: Mentor Signature: Date: Student Signature: Date: Personal Tutor Signature: Date:

86

YEAR 2 BLOCK 1

COMMUNICATION & INTERPERSONAL SKILLS DURING THE HANDOVER OF A PATIENT/PATIENTS ACHIEVEMENT AND VERIFICATION FORM 2nd Attempt


PLACEMENT

Pass Refer

Learning Outcome: The student will be able to ‘Demonstrate their communication & interpersonal skills during the handover of a

patient/patients’



Name: Name:


Date: Date: Date:


87







88


competencies.







89











Lacks maturity

Slow to settle

Lacks empathy



Willing to try




















90



Print Name: Date



Print Name: Date






Mentor signature:

SECOND ATTEMPT



Mentor signature:


NIGHT DUTY Hours

Date:


Sign:

SICKNESS Hours

Date:


Sign:

ABSENCE: Hours

Date:






Date: Date:



Defer Defer

Reason Reason

91




Student signature

92



Student signature

93



Programme



YEAR 2 BLOCK 1:







N Night Duty



EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:


EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:


EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:

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EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:


EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:


EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:


EXTRA HOURS

Date:

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EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:


EXTRA HOURS

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EXTRA HOURS

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Signed by mentor:





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Student’s name






97





YEAR 2 BLOCK 1

Placement:



ACTIONS AGREED



98

YEAR 2 BLOCK 2


















99











100















DATE:

STUDENT SIGNATURE:

DATE:

BOX


101



Part 1 Part 2

Signature and date

Signature and date

Signature and date

Signature and date



















102




Review of student self-assessment




Action plan



Yes No




Date:


Date

103



















104




105




106






107










Lacks maturity

Slow to settle

Lacks empathy



Willing to try



















108


The purpose of the assessment is for the students to demonstrate their ability to develop independent autonomous practice (NMC Standards p102) Competencies to be achieved under Appropriate Supervision




(Mentor/registrant signature & date) Progression Point 2 Works more independently, with less direct supervision, in a safe and increasingly confident manner



YES Working towards


YES NO

1. Practices with developing confidence in accordance with The Code: standards of conduct performance and ethics for nurses and midwives (NMC, 2008) and within other recognised legal and ethical frameworks.

2. Recognizes the limits of own competence and knowledge, whilst working more independently with less direct supervision.

3. Initiates, maintains and disengages from therapeutic relationships, with support.

4. Uses a range of effective communication methods to be able to respond to individual needs.

109







Progression Point 2 Works more independently, with less direct supervision, in a safe and increasingly confident manner



YES Working towards


YES NO

5. Participates in maintaining accurate, clear and complete records in line with current legislation.

6. Participates in a comprehensive assessment of an individual within own field of practice.

7. Participates in planning care for an individual within own field of practice.

8. Participates in the delivery of care for an individual within own field of practice.

9. Participates in the evaluation of care for an individual within own field of practice.

110







Progression Point 2 Adult Works more independently, with less direct supervision, in a safe and increasingly confident manner Demonstrates potential to work autonomously, making the most of opportunities to extend knowledge, skills and practice

MID POINT FINAL MID POINT

YES Working towards


YES NO




111







112


competencies.







113











Lacks maturity

Slow to settle

Lacks empathy



Willing to try




















114



Print Name: Date



Print Name: Date






Mentor signature:

SECOND ATTEMPT



Mentor signature:


NIGHT DUTY Hours

Date:


Sign:

SICKNESS Hours

Date:


Sign:

ABSENCE: Hours

Date:






Date: Date:



Defer Defer

Reason Reason

115




Student signature

116



Student signature

117



Programme



YEAR 2 BLOCK 2:







N Night Duty



EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:


EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:


EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:

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EXTRA HOURS

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EXTRA HOURS

Date:

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Signed by student:

Signed by mentor:


EXTRA HOURS

Date:

Hours:

Signed by student:

Signed by mentor:


EXTRA HOURS

Date:

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EXTRA HOURS

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Signed by mentor:


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Date:

Hours:

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120


Student’s name






121





YEAR 2 BLOCK 2

Placement:



ACTIONS AGREED



122

YEAR 3 BLOCK 1


















123











124















DATE:

STUDENT SIGNATURE:

DATE:

BOX


125



Part 1 Part 2

Signature and date

Signature and date

Signature and date

Signature and date



















126








Action plan



Yes No




Date:


Date

127



















128




129




130






131










Lacks maturity

Slow to settle

Lacks empathy



Willing to try



















132


The purpose of the assessment is for the students to demonstrate their ability to work as autonomous, independent practitioners and be able to apply to enter the professional register (NMC standards p102)





(Mentor/registrant signature & date) Entry to Register


YES Working towards


YES NO

1. Practices with confidence in accordance with The Code: standards of conduct performance and ethics for nurses and midwives (NMC, 2008) and within other recognised legal and ethical frameworks.

2. Practices in a holistic, non-judgmental, caring and sensitive manner and is able to challenge inequalities and discrimination within health care.

3. Supports and promotes the health, wellbeing, rights and dignity of people, groups, communities and populations.

4. Works in partnership with service users, carers, groups, communities and organizations, and manages risks.

5. Adapts practice to meet the changing needs of individuals within the field of practice, and works collaboratively.

6. Actively engages in continuing professional development.

7. Recognizes the limits of own competence and knowledge, whilst working more independently with minimum direct supervision.

133








YES Working towards


YES NO

8. Applies evidence in practice, and an ability to appraise research.

9. Initiates, maintains and disengages from therapeutic relationships, with minimal support.

10. Applies a range of effective communication methods to be able to respond to individual needs.

11. Recognizes when people are anxious or distressed and responds effectively .

12. Maintains accurate, clear and complete records in line with current legislation.

13. Has an in-depth knowledge of common physical and mental health problems and treatments within own field of practice.

14. Undertakes a comprehensive assessment of an individual within own field of practice

15. Undertakes the planning of care for an individual within own field of practice.

16. Awareness of public health principles, and adapts practice to meet changing needs.

17. Undertakes the delivery of care for an individual within own field of practice.

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YES Working towards


YES NO

18. Recognises and interprets signs of normal and deteriorating mental and physical health.

19. Recognises and takes action when an individual is at risk.

20. Undertakes the evaluation of care for an individual within own field of practice.

21. Participates in quality improvement and service delivery, through evaluation of care.

22. Ability to identify priorities and manage time effectively.

23. Facilitates the development of other nursing students.

24. Undertakes the coordination and delegation of care, under minimal supervision.

25. Awareness of the roles of other professionals and agencies and is able to refer an individual to services.

135







Entry to the register Adult MID POINT FINAL MID POINT FINAL

YES Working towards


YES NO



136







Entry to the register Adult


YES Working towards


YES NO

3. Adult nurses must be able to recognise and respond to the needs of all people who come into their care including babies, children and young people, pregnant and postnatal women, people with mental health problems, people with physical disabilities, people with learning disabilities, older people, and people with long term problems such as cognitive impairment.

4. Adult nurses must safely use a range of diagnostic skills, employing appropriate technology, to assess the needs of service users.

137








YES Working towards


YES NO

5. Adult nurses must safely use invasive and non-invasive procedures, medical devices, and current technological and pharmacological interventions, where relevant, in medical and surgical nursing practice, providing information and taking account of individual needs and preferences

6. Adult nurses must recognise and respond to the changing needs of adults, families and carers during terminal illness. They must be aware of how treatment goals and service users’ choices may change at different stages of progressive illness, loss and bereavement.


138








YES Working towards


YES NO

8. Adult nurses must understand the normal physiological and psychological processes of pregnancy and childbirth. They must work with the midwife and other professionals and agencies to provide basic nursing care to pregnant women and families during pregnancy and after childbirth. They must be able to respond safely and effectively in an emergency to safeguard the health of mother and baby.

9. Adult nurses must work in partnership with people who have long-term conditions that require medical or surgical nursing, and their families and carers, to provide therapeutic nursing interventions, optimise health and wellbeing, facilitate choice and maximise self-care and self-management.

139

MEDICINE ADMINISTRATION and MANAGEMENT

PRACTICE BASED ASSESSMENT

YEAR 3 BLOCK 1

Student’s Name …………………………………………………….. Intake …………………………………………………….. Base Trust …………………………………………………….. Personal Tutor …………………….……………………………… Programme Leader ………………………………………………….....

Notes to assessor: This is a clinical assessment of the student’s ability to demonstrate their Medicine Management skills. They must achieve a pass in all areas to pass the overall assessment. The student must achieve a pass in order to successfully complete this placement.

140

INSTRUCTIONS TO THE STUDENT, MENTOR AND PERSONAL TUTOR FOR THE PRACTICE BASED ASSESSMENT (PBA)

The assessment of practice is seen as an integral to the BSc (Hons) Programme and is a means of integrating theory and practice. This PBA has been mapped against:

NMC Standards for medicines management (2008)

NMC Standards (2010) R5.6.2, R8.1.5. Competencies PV 1, 1.1, 7, 9. CIS 7. NDPM 6, 6.1.

NMC ESC (2010) 33:2. 34:4, 5, 6. 35:3, 4. 36:2, 3, 4, 5. 372. 38:4, 5, 6.39:2. 40:2, 3, 4, 5. 41:2.

Student Learning Outcomes During this block the student is required to demonstrate their ‘Medicine Management’ skills. Prior to placement the student must complete the Self Assessment Action Plan in advance of the pre-placement tutorial with their Personal Tutor. Before the midpoint interview in practice the student must review their progress against the action plan. Following the assessment the student must complete the Achievement and Verification form. Mentor for the Student’s Placement The student’s named mentor for this practice placement is responsible for reviewing the student’s Self Assessment Action Plan at the initial and midpoint interviews, undertaking or countersigning the Assessment Criteria for a group of patients the student is managing, and completing the ‘Achievement and Verification Form’. Second attempt A student who did not achieve the outcomes for successful completion of the PBA at first attempt will undertake a 2nd attempt in the next placement. Personal Tutor The students’ Personal Tutor is required to countersign the students’ Self Assessment Action Plan prior to placement and the Achievement and Verification form following placement.

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ACTION PLANNING DOCUMENT

FOR YEAR 3 – BLOCK 1 Please complete prior to placement

Student Name:

Practice Placement: Student Self Assessment (Prior to Practice Placement) In relation to the indicators for achievement, identify `Where am I now' in relation to the learning outcome ‘Medicines Management’ What knowledge, skills and attitudes do I now have?

Action Planning In order to meet the learning outcome for the practice based assessment what `do I now need to know and do' to demonstrate my knowledge, skills, and attitudes to ‘Demonstrate their Medicines Management Skills’

Student Signature: Date

Personal Tutor Signature: Date

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Future Learning and Development From my evidence what `do I now need to know and / or do' in relation to the practice based assessment learning outcome, ‘Demonstrate their Medicines Management Skills’ What knowledge, skills and attitudes do I now have?



I

Evidence of Achievement Reflecting on my actions, what knowledge, skills and attitude `What do I now have' in relation to the practice based assessment learning outcome, ‘Demonstrate their Medicines Management Skills’“What knowledge, skills and attitudes do I now have?” (Revisit self-assessment and action planning)



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PRACTICE BASED ASSESSMENT CRITERIA

PART.1: MEDICINES MANAGEMENT

Pass Refer

1. Student recognises the differences between supply of medicines.

(Prescription only medicine (POM), general sales list (GSL) or pharmacy (P).

2. Student explains the different types of prescribing.

(Supplementary prescribing, Community practitioner nurse prescribing, Independent nurse prescribing)

3. Student can identify the methods of administering medicines by nurses.

(Medicines Administration Record, Medicines Act exemptions, Patient Group Directions, Patient Specific Directions, Standing Orders, Prescription Forms)

4. Student can identify how an unlicensed medicine may be administered

5. Student discusses how medicines are ordered, stored and transported and disposed of

safely in accordance with product instructions and legislation, including controlled drugs and patients’ own medication.

6. Student identifies the action to be taken if an error occurs in the administration of

medicines process. (prevent harm to patient, report, inform supervisor, document actions according to local policy)

7. Student lists what action should be taken if a patient experiences an adverse reaction to a

drug (prevent patient harm, record in notes, notify prescriber, yellow card scheme)

8. Student can identify what compliance aids are available and suitable for patients, with

consideration of ethical issues.

9. Student can explain their responsibilities for patients who are self administering

medications.

PART 2: MEDICINES ADMINISTRATION Student must administer medications for a group of patients they are caring

Pass

Refer

144

for under direct supervision Drugs round:

1. Checks patient identity and known allergies

2. Checks prescription is clearly written

3. Checks expiry date of medicine

4. Checks route of administration

5. Checks timing of administration

6. Describes therapeutic uses of the medicine

7. Identifies interactions and adverse effects of medication

(Student can identify how to access information if unsure)

8. Student demonstrates awareness of patients care plan or pathway

9. Student can identify reasons for medicine to be withheld

10. Contacts prescriber if contraindications to the medicine are discovered

11. Correct dose is calculated

12. Administers medication and does not delegate any part of administration task

13. Student gives clear and accurate information to the patient about the medications

14. Makes a clear, legible, accurate and immediate record of medicine administered Records reasons for medicine withheld or refused

15. Monitors effects of medications

16. Maintains hygiene and conforms to infection control policy

Controlled drugs:

1. Student administers controlled drugs in line with relevant legislation and local policy.

2. Student acts a second signatory in the administration of controlled drugs witnessing the whole administration process.

3. Student follows legal requirements and local policy during controlled drug

administration.

Intravenous drugs:

1. Student is involved in the process of preparing and administering medications for their group of patients.

2. Student can explain why medication should not be prepared in advance.

3. Student calculates doses and volumes required.

4. Student can use titrated doses.

5. Student can operate syringe drivers and infusion pumps.

Overall Result:

Pass

Refer

Comments/ Action Plan

145

Mentor Signature: Date: Student Signature: Date: Personal Tutor Signature: Date:

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147


148


competencies.







149











Lacks maturity

Slow to settle

Lacks empathy



Willing to try




















150



Print Name: Date



Print Name: Date






Mentor signature:

SECOND ATTEMPT



Mentor signature:


NIGHT DUTY Hours

Date:


Sign:

SICKNESS Hours

Date:


Sign:

ABSENCE: Hours

Date:






Date: Date:



Defer Defer

Reason Reason

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Student signature

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Student signature

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Programme



YEAR 3 BLOCK 1:







N Night Duty



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Student’s name






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YEAR 3 BLOCK 1

Placement:



ACTIONS AGREED



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YEAR 3 BLOCK 2


















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160















DATE:

STUDENT SIGNATURE:

DATE:

BOX


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Part 1 Part 2

Signature and date

Signature and date

Signature and date

Signature and date



















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Action plan



Yes No




Date:


Date

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165




166






167










Lacks maturity

Slow to settle

Lacks empathy



Willing to try



















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The purpose of the assessment is for the students to demonstrate their ability to work as autonomous, independent practitioners and be able to apply to enter the professional register (NMC standards p102)







YES Working towards


YES NO

1. Practices with confidence in accordance with The Code: standards of conduct performance and ethics for nurses and midwives (NMC, 2008) and within other recognised legal and ethical frameworks.

2. Practices in a holistic, non-judgmental, caring and sensitive manner and is able to challenge inequalities and discrimination within health care.

3. Supports and promotes the health, wellbeing, rights and dignity of people, groups, communities and populations.

4. Works in partnership with service users, carers, groups, communities and organizations, and manages risks.

5. Adapts practice to meet the changing needs of individuals within the field of practice, and works collaboratively.

6. Actively engages in continuing professional development.

7. Recognizes the limits of own competence and knowledge, whilst working more independently with minimum direct supervision.

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YES Working towards


YES NO

8. Applies evidence in practice, and an ability to appraise research.

9. Initiates, maintains and disengages from therapeutic relationships, with minimal support.

10. Applies a range of effective communication methods to be able to respond to individual needs.

11. Recognizes when people are anxious or distressed and responds effectively

.

12. Maintains accurate, clear and complete records in line with current legislation.

13. Has an in-depth knowledge of common physical and mental health problems and treatments within own field of practice.

14. Undertakes a comprehensive assessment of an individual within own field of practice

15. Undertakes the planning of care for an individual within own field of practice.

16. Awareness of public health principles, and adapts practice to meet changing needs.

17. Undertakes the delivery of care for an individual within own field of practice.

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YES Working towards


YES NO

18. Recognises and interprets signs of normal and deteriorating mental and physical health.

19. Recognises and takes action when an individual is at risk.

20. Undertakes the evaluation of care for an individual within own field of practice.

21. Participates in quality improvement and service delivery, through evaluation of care.

22. Ability to identify priorities and manage time effectively.

23. Facilitates the development of other nursing students.

24. Undertakes the coordination and delegation of care, under minimal supervision.

25. Awareness of the roles of other professionals and agencies and is able to refer an individual to services.

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YES Working towards


YES NO



172







Entry to the register Adult


YES Working towards


YES NO

3. Adult nurses must be able to recognise and respond to the needs of all people who come into their care including babies, children and young people, pregnant and postnatal women, people with mental health problems, people with physical disabilities, people with learning disabilities, older people, and people with long term problems such as cognitive impairment.

4. Adult nurses must safely use a range of diagnostic skills, employing appropriate technology, to assess the needs of service users.

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YES Working towards


YES NO

5. Adult nurses must safely use invasive and non-invasive procedures, medical devices, and current technological and pharmacological interventions, where relevant, in medical and surgical nursing practice, providing information and taking account of individual needs and preferences

6. Adult nurses must recognise and respond to the changing needs of adults, families and carers during terminal illness. They must be aware of how treatment goals and service users’ choices may change at different stages of progressive illness, loss and bereavement.


174








YES Working towards


YES NO

8. Adult nurses must understand the normal physiological and psychological processes of pregnancy and childbirth. They must work with the midwife and other professionals and agencies to provide basic nursing care to pregnant women and families during pregnancy and after childbirth. They must be able to respond safely and effectively in an emergency to safeguard the health of mother and baby.

9. Adult nurses must work in partnership with people who have long-term conditions that require medical or surgical nursing, and their families and carers, to provide therapeutic nursing interventions, optimise health and wellbeing, facilitate choice and maximise self-care and self-management.

175







176


competencies.







177











Lacks maturity

Slow to settle

Lacks empathy



Willing to try




















178



Print Name: Date



Print Name: Date






Mentor signature:

SECOND ATTEMPT



Mentor signature:


NIGHT DUTY Hours

Date:


Sign:

SICKNESS Hours

Date:


Sign:

ABSENCE: Hours

Date:






Date: Date:



Defer Defer

Reason Reason

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Student signature

180



Student signature

181



Programme



YEAR 3 BLOCK 2:







N Night Duty



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Hours:

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Signed by mentor:


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Signed by mentor:


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Signed by mentor:


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Student’s name






185





YEAR 3 BLOCK 2

Placement:



ACTIONS AGREED



186

SPECIFIC CLINICAL SKILLS

ACHIEVEMENT

187

Clinical Skills to be achieved under Appropriate Supervision

Demonstrated Competence

Progression Point 1 Achieved (Mentor / Tutors initials

& date)

YES NO

1. Hand washing

2. Bed making

3. Bed bathing

4. Oral hygiene

5. Eye care

6. Assisting patients with eating and drinking

7. Assisting with elimination needs (toileting, ensures privacy and dignity, catheter care and fluid balance recording,

8. Accurately records vital signs (temperature, pulse, blood pressure and respirations)

9. Demonstrates effective cardiopulmonary resuscitation, management of choking and use of the recovery position (demonstrated within university during simulation)

10. Demonstrates safe and effective knowledge and skills when moving and handling patients

11. Demonstrates safe and effective ANTT

12. Intramuscular injection (to be achieved by progression point 2)

13. Subcutaneous injection (to be achieved by progression point 2)

Mentor / Tutor comments

MENTOR SIGNATURE:

Date:


Date:

188

MOVING AND HANDLING RECORD YEAR 1

Date - Instructed and Practiced in the University

Trainer and Student Signature

Date - Practiced in Clinical Placement


1. Principles of Moving and Handling

2. Use of Moving and Handling Devises

Slide Sheets

Rotor stand

Hoists (Sitting and Lying

Pat Slides

Handling slings

3. Side assisted Stand

4. Assisting patients on and off beds, chairs, commodes or wheelchairs

5. Lifting and carrying any object

6. Bed Mobility - lateral transfers

7. Falling patient and assisting the fallen patient

189

Pre – Registration Nursing Student Moving and Handling Record

Year 1 Block …………………………..

This record MUST be produced to your mentor when you attend each placement. When you complete your initial and final interviews with your mentor, please include this document in your discussions and ask the mentor to sign per placement. PRINT NAME…………………………………………………………………………….. COHORT………………………………………………………………………………….

190



Progression Point 2 Achieved (Mentor / Tutors initials

& date)

YES NO


2. Demonstrates effective adult and paediatric cardiopulmonary resuscitation, management of choking and use of the recovery position (demonstrated within university during simulation)

3. Demonstrates safe and effective knowledge and skills when administering oxygen therapy (as prescribed)

4. Performs a 12 lead ECG

5. Demonstrates effective basic airway management using suction, head tilt chin lift, jaw thrust, guedal and nasal airways (demonstrated within university during simulation)



8. Enteral feeding


MENTOR SIGNATURE:

Date:


Date:

191








Slide Sheets

Rotor stand


Pat Slides

Handling slings






192


Year 2 Block …………………………..


193



Prior to registration (year 3) Achieved (Mentor / Tutors initials &

date)

YES NO


2. Demonstrates effective cardiopulmonary resuscitation, management of choking and use of the recovery position (demonstrated within university during simulation)

3. Demonstrates female or male catheterisation (competence is not a mandatory requirement)

4. Performs a 12 lead ECG

5. Demonstrates effective basic airway management using suction, head tilt chin lift, jaw thrust, Guedel and nasal airways (demonstrated within university during simulation)



8. Demonstrates safe and effective ANTT


MENTOR SIGNATURE:

Date:


Date:

194








Slide Sheets

Rotor stand


Pat Slides

Handling slings






195


Year 3 Block …………………………..


196

ONGOING RECORD OF ACHIEVEMENT

197

ONGOING RECORD OF ACHIEVEMENT, YEAR 1 BLOCK 1 Please provide short objective statements about the student’s performance in each of the categories listed below. These comments will aid the ‘sign off’ mentor to assess the student’s achievements during final placement.

STUDENT NAME: PERSONAL TUTOR:

Comments by Mentor

Motivation

Initiative

Student effort

Strengths

Areas for development

Recommendations

Information for Mentor’s Students are required to maintain an ongoing record of their progress and achievement. This should be available to their named mentor at the beginning of each placement experience and on request, thereafter. This document MUST be presented and made available to the mentor on commencement of each placement experience. This is to enable early discussion of strengths and areas identified for improvement at the official meeting, and aids subsequent discussions as required by the mentor or others involved in supporting the student. In the final placement in year three the sign off mentor will wish to see this completed document for every placement for years one, two and three and must sign the final assessment of competencies. This is to enable the sign off mentor to satisfy themselves that all competencies have been achieved for entry to the register.

Final outcome of placement If refer

Pass Refer Competencies not achieved - Number

I confirm that I hold Live Mentor status and have had an annual update according to the NMC Guidance (2008). Mentor Name: Signature: Date:

(Please Print) Mentor PIN number ________________________

198

ONGOING RECORD OF ACHIEVEMENT, YEAR 1 BLOCK 1 RETRIEVAL

Please provide short objective statements about the student’s performance in each of the categories listed below. These comments will aid the ‘sign off’ mentor to assess the student’s achievements during final placement.


Comments by Mentor

Motivation

Initiative

Student effort

Strengths


Recommendations






199



Comments by Mentor

Motivation

Initiative

Student effort

Strengths


Recommendations






200




Comments by Mentor

Motivation

Initiative

Student effort

Strengths


Recommendations






201



Comments by Mentor

Motivation

Initiative

Student effort

Strengths


Recommendations






202




Comments by Mentor

Motivation

Initiative

Student effort

Strengths


Recommendations






203



Comments by Mentor

Motivation

Initiative

Student effort

Strengths


Recommendations






204




Comments by Mentor

Motivation

Initiative

Student effort

Strengths


Recommendations






205



Comments by Mentor

Motivation

Initiative

Student effort

Strengths


Recommendations






206




Comments by Mentor

Motivation

Initiative

Student effort

Strengths


Recommendations






207

TO BE COMPLETED BY SIGN – OFF

MENTOR

208



Comments by Mentor

Motivation

Initiative

Student effort

Strengths


Recommendations






209




Comments by Mentor

Motivation

Initiative

Student effort

Strengths


Recommendations






210

FINAL ASSESSMENT OF COMPETENCY

Confirmation of Competency “The sign-off mentor, who has met the NMC additional criteria for assessing proficiency, is responsible and accountable for making the final overall assessment in practice, confirming that a student has successfully completed all practice requirements” (NMC, 2006 p32). Please refer to introductory section of this document outlining ‘signing off practice competency’ and the NMC (2006) Standards to Support Learning and Assessment in Practice, Section 3:2:6 p32 and 33.

Sign-off Mentor Declaration: I confirm that the named student HAS/HAS NOT*, provided sufficient evidence to demonstrate that the NMC standards of proficiency have been achieved on all Year 1, Year 2 and Year 3 practice 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 their progression. *please delete as appropriate

Final Outcome: PASS/FAIL (please specify)

Sign-Off Mentor Name (print):

Signature: Date:

NMC PIN NUMBER: Part of NMC Register: (please specify) Adult: Child: Mental Health: Learning Disability:

Work place:

Student Declaration:

I have discussed the final placement assessment with the sign-off mentor:

Student Name (print) :

Signature: Date:

Evidence seen by Mentor in support of final practice Assessment: (e.g. practice assessment document, PDP/Action Plans)

PERSONAL TUTOR VERIFICATION:

211

FINAL ASSESSMENT OF COMPETENCY

RETRIEVAL Confirmation of Competency “The sign-off mentor, who has met the NMC additional criteria for assessing proficiency, is responsible and accountable for making the final overall assessment in practice, confirming that a student has successfully completed all practice requirements” (NMC, 2006 p32). Please refer to introductory section of this document outlining ‘signing off practice competency’ and the NMC (2006) Standards to Support Learning and Assessment in Practice, Section 3:2:6 p32 and 33.

Sign-off Mentor Declaration: I confirm that the named student HAS/HAS NOT*, provided sufficient evidence to demonstrate that the NMC standards of proficiency have been achieved on all Year 1, Year 2 and Year 3 practice 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 their progression. *please delete as appropriate

Final Outcome: PASS/FAIL (please specify)

Sign-Off Mentor Name (print):

Signature: Date:

NMC PIN NUMBER: Part of NMC Register: (please specify) Adult: Child: Mental Health: Learning Disability:

Work place:

Student Declaration:

I have discussed the final placement assessment with the sign-off mentor:

Student Name (print) :

Signature: Date:

Evidence seen by Mentor in support of final practice Assessment: (e.g. practice assessment document, PDP/Action Plans)

PERSONAL TUTOR VERIFICATION: