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QA Level 6 Diploma inParamedic PracticeMentor Handbook
04 - 07
Mentor Briefing- Developing Professional Attitudes- Inter Professional Learning- Supporting Students who areFailing to Achieve
- Getting Involved
07 - 10
Welcome From MediPro- Our Core Values
- Getting Help- Support
11 - 13Student Uniform PolicyStudent ResponsibilitiesMentor Responsibilities
14 - 16Programme Overview/Learning Aims
Stage 1 (Year 1)- Learning Outcomes - Skills
- Learning Outcomes - Knowledge
17 - 18Programme Overview/Learning AimsStage 2 (Year 2)- Learning Outcomes - Skills- Learning Outcomes - Knowledge
19 - 21What will the programme consist of?
- Year 1 Modules- Clinical Placements, Stage 1
22 - 24Tutorial Support Processes- Year 2 Modules- Clinical Placements, Stage 2
Table of Contents
25 - 26
27 - 28
29 - 30
Scope of PracticeSkills Procedures- Airway- Cardiac- HaemorrhageControl
Scope of PracticeSkills Procedures
- Trauma- Patient Assessment
Scope of PracticeSkills Procedures- Formulary- Administrative/Drug Routes
31 - 36
Reflective Practice- Gibbs Reflective Cycle
- Example 1- Critical Case Log
- Cause For Concern Flowchart
37Placement OrientationRecords Example
38Frequently Asked Questions
39 - 47 HCPC Standards of Proficiency
Table of Contents (continued)
Mentor Briefing
Thank you for agreeing to support our student paramedics in their practicelearning. Our students are undertaking a challenging work based learningprogramme which, with your help, will develop the required skills and attributesrequired for professional paramedic practice.
The aim of this handbook is to help you understand the QA Level 6 Diploma inParamedic Practice (RQF) and to support you in the mentorship of our students.
The QA Level 6 Diploma in Paramedic Practice (RQF) consists of 2 stages, each ofwhich is equivalent to a year’s full-time study. This is a 40 week per year programmedue to the content and clinical placement requirements. Within the programme, allmodules are core and there are no option modules. To obtain a QA Level 6 Diploma inParamedic Practice (RQF), students must successfully complete all elements of theprogramme. Completion of the Diploma enables students to apply for registration asa Paramedic to the Health and Care Professions Council.
The programme has been developed to meet the Standards of Education andTraining (2014) as required by the Health and Care Professions Council (HCPC)with the curriculum content designed to reflect best practice guidance from theCollege of Paramedics (2014) and the Quality Assurance Agency subjectbenchmark for Paramedic Science (2014).
The work-based learning approach enables students to focus their learning ontheir workplace activities, enhancing the skills and abilities of individuals andproviding return on investment for employers.
As students work clinically, they will develop the knowledge, skills, abilities, attributesand professionalism required for paramedic practice. Work-based learning facilitatesthis and ensures that the learning obtained from work is assessed as part of thelearning programme – we call these ‘competencies’ and they are developed andassessed in clinical practice. Work-based learning helps develop the link betweentheory and practice.
Throughout this document learners on the programme will be referred to as"Students"
4
Developing Professional Attitudes
Mentors, are required by both their professional body and their employers todemonstrate attitudes and behaviours, which adhere to the relevant Codes andpromote a positive image of their profession and organisation. Students are expectedto develop these attitudes and behaviours over the course of their studies byobserving this positive role modelling provided by qualified practitioners. Where aMentor has concerns about the attitudes and behaviours displayed by students, orabout the health and fitness of students in terms of occupational health standards,they must discuss it with the student, record it, and report it appropriately, providingfeedback to the student and participate in managing the situation through MediProand Trust policies and procedures.
MediPro will ensure that there is an adequate number of appropriate qualified andexperience staff involved in practice based learning.
Inter-professional Learning
MediPro is committed to preparing all students to work inter-professionally. Allprogrammes of study actively encourage students to value the need for, and benefitsof, working within an inter-professional framework to provide a holistic approach toperson centred care.
Students need to develop the knowledge, skills, values, and attitudes needed to workas a team with other health and social care professionals for the best interests ofpatients / users. Though this process can be supported at MediPro, the best place forstudents to develop inter-professional skills is in practice. We need to ensure thatstudents have the opportunity to participate in inter-professional and multi-agencyapproaches to health and social care, whilst recognising individual scopes ofprofessional practice, and to encourage students to learn from this experience.Mentors play an important part in modelling this approach to learning and practice.
5
Supporting Students who are Failingto Achieve
Effective support is facilitated by identifying failing students as early as possible, andtaking appropriate action. This will include, where appropriate, seeking support frompractice education and / or MediPro staff. Whatever the specific situation, bothstudents and Mentors need to feel supported, rather than feeling that they are beingsubjected to further pressure.
This programme is based on a Pass/Fail model, wherein all elements must be passed inorder to complete the programme.
1. Speak discretely with the student, and help him/her to accept the reality of thesituation. Many students are anxious to deny that there is any problem. The studentmust recognise the problem and decide if they want to resolve it in order for there tobe real progress.
2. Once the problem has been identified focus on listening to the student, and then behonest and direct in your responses. Offer respect and encouragement. Pay attentionto what they say about course demands, personal / health problems, etc, and theirconfidence in working in placement. You may have only seen symptoms of the basicproblem, but not have any idea of its source.
3. Help the student to create a plan of action, from a reasonable starting place, andwith realistic goals. You may obtain assistance from identified practice support staff.Make sure that the student adopts the plan as his/her own set of goals andresponsibilities. Offer the student opportunities to make progress, and arrange forthese opportunities to be provided. Do not guarantee a pass grade.
4. Set regular times for a mutual review of the progress of the action plan. Take care tocongratulate the student on progress. If a student is not progressing, or evenregressing, be positive, but firm. It will be important to try to address any issues aroundmaintaining the student’s motivation. However, do not make negative comments infront of others.
5. Do not lower your standards to accommodate a student who is "working hard." Thisis commendable in the student, but will not help him/her, the profession or the public.Do not give a student a pass grade for trying hard. It only takes her/him to a harder,more impossible level.
6.Maintain a professional outlook. If you have followed these guidelines and acted ina genuinely supportive manner, you have done your best. The student is responsible forhis/her success or failure.
6
GETTING INVOLVED
WELCOME FROM MEDIPRO
As mentors you play a hugely important role within this programme and we would likeyou to get involved more. We encourage mentors to participate in the programme morein various ways, these can include:
- Assisting with student recruitment
- Provision of expert witness testimony
- Annual programme monitoring and overview meetings
- Faculty meetings
If you would like to be more involved, please feel free to contact us by email or phone.
EMAIL:[email protected]
PHONE:01325 609030
Welcome to MediPro. I hope that your time with us will be rewarding both academicallyand socially. Our aim is to provide you with high quality support, and the MentorHandbook makes a contribution to this by providing you with information you need toknow about regulations and procedures, including the programme learning outcomes.
Education is a two-way process requiring Mentors to be supportive and facilitating inhelping students take responsibility for their education. Being a student demandseffort, self-discipline and perseverance; there are deadlines to meet, readings toevaluate and presentations to prepare and deliver, which is why the Mentor role is soimportant. Your support is essential in ensuring that students find theirs studies asrewarding as possible.
If things are not quite right we will do our best to sort things out. However, noteverything may always be exactly as you wish. The staff in the Faculty are alwayswilling to listen and recognise that they can learn from your experiences andobservations.
Brian EnglishManaging Director
7
Our Core ValuesValues What it means as a core value What it doesn’t mean
• Enabling our students to confident ly deliveref fect ive care
• Promot ing an at t it ude of cont inuous learningamong our students and staf f
• Ident if ying best pract ice and embracing evidencebased pract ice
• Staying up to date with clinical developments• Providing appropriate and relevant clinical pract ice
• Creat ing a nurturing and support ive environmentfor our students
• Cont inually improving our academic stance andof fering
• Collaborat ing with academic partners to allowdiversification of programmes available
• To appreciate each student has their ownlearning st yle
• Proact ive planning• Learning from successes and being accountablefor our mistakes
• Creat ing sustainable systems
• Learning from our mistakes and limit s• Listening to our customers and students• Showing t rust and giving empowerment• Put t ing ‘We’ before ‘I’• Sharing success• Of fering st raight forward, reliable and consistentt raining packages
• Being clear about the requirements of our programmes
• Being open about the good and the bad• Understanding and respect ing our studentsand customers
• Fairness, decency and respect ing our students• Being ethical• Support
• Clinically competent and experienced• Pract ise what we preach• Giving responsibilit y and support ing decisions• Two way communicat ion and teamwork• Providing and embracing cont inuous professionaldevelopment
• Create a balanced working environment ofprofessionalism and fun
• Rewarding performance• Commitment to educat ion and loyalt y to our brand
• Pride and passion in what we do and stand for• Constant ly st riving to be at the front of clinicaleducat ion
• The embodiment of our values• Professionalism and dedicat ion• Clinically focused• Our image in the eyes of our students• Dynamic
• Relying solely on our own personalexperiences and opinions
• St icking rigidly to outdated pract ice
• Creat ing awards for ‘awards sake’• Producing courses that have no clearuse to the public
• Being one dimensional• Not planning for the student journey• Providing poor mentorship andlimited support
• Not listening• Not re-evaluat ing decisions• Second guessing decisions• Not standing up for what you believeor think
• Bullying students• Not respect ing dignit y or beliefs• A ‘can’t be bothered’ at t it ude• Blaming others• Being self righteous• Not being confi dent
• Taking the easy opt ion• Clones• In-experienced clinically• Tackling everything alone
• Arrogance• Complacency• Creat ing a cult -like environment
Clinical ExcellenceIs the foundat ion ofeverythingwe do
AcademicExcellenceRewarding successthrough regulatedawards
HonestyOur bond
RespectfulListen, learnand share
Our employeesThe right people in theright place
Our nameThe sum of our values
8
The programme team at MediPro are here to support you in your mentorship role;we are supported by our colleagues in Qualsafe Awards who will facilitate themanagement and delivery of the programme.
Please do not hesitate to contact us with any queries.
Thank you for supporting our student paramedics. We look forward to working with you
Getting Help
LibraryOut Of HoursContact
Brian EnglishProgramme [email protected] 609030
Melissa DicksonTraining [email protected] 609030
Rebecca Brannon-RobsonPractice Placement [email protected] 609030
Kirsty WhartonPastoral Support [email protected] 60903007812 114538
All students are given their own copy ofthe following text books:
MediPro's office hours are:Monday - Friday 9am - 5pm
In the event of any emergency contact01325 609030 and select option 1 to bedirected to our 24 hour clinical servicescontrol desk who will be able to assist you.
Year 2Emergency Care in the Street –Nancy Caroline
Year 1Ambulance PracticeJRCALC
In addition MediPro hold a number of additional text to encourage wider reading.
9
Getting Help
All students have access to MediPro I.T facilities as well as loanlaptops if required
I.T.
Counselling/pastoral supportMediPro offer a pastural support via a dedicated and experiencedclinical tutor. Contact details [email protected]
All students will undergo a occupational screening to prepare forA&E duties. Throughout the programme should any additionalsupport be required, this can be accessed via the training co-ordinator.
Occupational health
Any student who wishes to express a grievance should firstdiscuss the issue with their tutor. This provides an opportunity forissues to be resolved without recourse to the formal procedure.Should the matter not be resolved informally, or is felt to be moreserious, then the student has the right to raise the matterformally.
Student Complaints
Prior to each placement students will attend a preparatoryworkshop during which information will be provided about theplacement area and the learning objectives/outcomes to beachieved.
Student Preparation forPractice Placements
10
11
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Students are responsible for:
- Making known to the placements office any personalcircumstances which may impinge on the organisationof placements.
- Discussing their learning objectives with PracticeMentors and agreeing an initial plan, reviewing this planregularly within the tutorials
- Adhering to all rules, regulations,and policies when on placement.
- Contacting the MediPro practice placement facilitator 2 weeks prior tocommencement to ensure any practical arrangements are in order.
- Making known any areas of concern and under their duty ofcandour to refer those under the whistleblowing policy,placement concern policy or other policies at MediPro.
- Completing all assessment documents.
- Making good use of all placementopportunities during their placement.
- Providing evidence of learning. - Conducting themselves in aprofessional manner.
- Notifying MediPro and practice placement area of anyabsences.
- Making any arrangements for their clinical tutor to be present or visitwhere necessary.
12
Students are also responsible for:
- Ensuring that all administrative paperwork including the recording of hours are up todate.
- Completing any placement evaluations as required.
- Ensuring their health and well-being declarations are up to date and where necessaryseek support and guidance.
- Ensuring they meet MediPro’s and the practice placement providers requirements andfollow all uniform policies as issued by them.
- Ensuring that MediPro are made aware of any changes to their driving license or DBSstatus
Practice Mentors are responsible for:- Ensuring the student is inducted locally into the area- Conducting all assessments.- Dealing with any initial queries/questions from students.- Liaising with Clinical Tutor where necessary.- Working closely with the PPF (or other appointed practice placement link) fortheir organisation.- Facilitate learning experiences for the students.- Ensuring learning experiences fit with placement objectives/outcomes.
During each year of practice students must demonstrate specific competencies and skillsin order to progress to the following year. The competencies and skills for each year ofpractice are contained within their practice assessment document referred to as the‘PAD’. The skills and competencies in the programme are cumulative and they areexpected to demonstrate competence at higher levels as they progress through theprogramme.
Students are responsible for arranging their ownaccommodation, transport (and any vehicle insurance if
applicable) to/from placements.
13
Programme Overview and Learning Aims;What are the learning aims of the programme?The Level 6 Diploma in Paramedic Practice aims to:
Support, educate, and develop students into safe, enquiring and effectivepractitioners with the capacity to care for patients, families and colleagues in a rangeof challenging and unpredictable situations.
Develop an extensive intellectual knowledge and clinical skills base for the provisionof paramedic health care practice.
Foster the capacity for both advanced independent autonomous working andinterdisciplinary and, multidisciplinary team working, essential for professionalparamedic practice.
Promote an evidenced based approach to the field of multidisciplinary health andsocial care generally and specifically to paramedic practice.
Enable students to acquire the knowledge and skills to identify and implementeffective solutions to complex decision making issues within the context of paramedicpractice.
Equip students with advanced communication & reflective skills and the ability toutilise these skills at the front line of patient care in the context of paramedic practice.
Facilitate learning within a dynamic and progressive programme which will enablestudents to acquire heightened clinical and cognitive knowledge bases relevant toparamedic practice.
Engage in a unique and innovate relationship with programme stakeholders to ensurethe strategic direction and progressive development of the programme in line with
development of the professional paramedic role.
14
1STAGE
By the end of this Stage of the programme successful studentsshould know, understand or be able to do the following:
S1 Apply the principles of reflective practice to determine areasof personal and professional development.
S2 Adopt and utilise the appropriate interpersonal skills requiredfor effective clinical practice.
S3 Understand how to use and prepare essential emergencycare equipment and emergency medication, according torelevant clinical protocols.
S4 Take a relevant clinical and social history and perform astructured clinical examination.
S5 Perform diagnostic tests relevant to the clinical situation.
S6 Recognise their professional limitations and utilise the widerhealth care team for the benefit of the patient.
What will students know or be ableto do at each Stage of the programme?
Stage 1 (Year 1):
Learning Outcomes Stage 1 – Skills
15
By the end of this Stage of the programme successfulstudents should know, understand or be able to do thefollowing:
S1 Apply the principles of reflective practice to determineareas of personal and professional development.
S2 Adopt and utilise the appropriate interpersonal skillsrequired for effective clinical practice.
S3 Understand how to use and prepare essentialemergency care equipment and emergency medication,according to relevant clinical protocols.
S4 Take a relevant clinical and social history and performa structured clinical examination.
S5 Perform diagnostic tests relevant to the clinicalsituation.
S6 Recognise their professional limitations and utilisethe wider health care team for the benefit of the patient.
What will students know or be ableto do at each Stage of the programme?
Stage 1 (Year 1):
K1Understand the anatomy,physiology and changes inbodily systems across the
lifespan and thedevelopment of illness.
K2
Appreciate theinterrelationshipsbetween biological,
psychological and socialaspects of health and
illness.
K3
Understand therequirements to maintainprofessional standards,fitness to practice andpractice within legal andethical frameworks K4
Appreciate that evidencebased practice underpinsclinical care protocols,policies and guidelines.
Learning Outcomes Stage 1 - KnowledgeBy the end of this Stage of the programme successful students shouldknow, understand or be able to do the following:
16
2STAGE
By the end of this Stage of the programme successful studentsshould know, understand or be able to do the following:
S7 Demonstrate the ability to manage and coordinate a clinicalteam in paramedic practice.
S8 Utilise leadership theories in the context of clinicalsituations encountered in paramedic practice.
S9 Utilise incident debriefing and critical reflection in thedevelopment of paramedic practice.
S10 Take a focused clinical history and perform acomprehensive examination to formulate a provisional diagnosis.
S11 Interpret complex diagnostic data to guide emergencyinterventions.
S12 Demonstrate the ability to support labouring women andmanage challenging and unexpected circumstances in obstetriccare.
What will students know or be ableto do at each Stage of the programme?
Stage 2 (Year 2):
Learning Outcomes Stage 2 – Skills
17
Learning Outcomes Stage 2 - KnowledgeBy the end of this Stage of the programme successful students shouldknow, understand or be able to do the following:
A comprehensive understanding of the underlying pathophysiology andclinical presentation of a range of conditions encountered in paramedic
practice K5
Critical appraisal of research evidence to inform paramedic practice.K6
A critical understanding of the foundations of contemporaryparamedic practice. K7
A comprehensive understanding of service innovation and redesign inrelation to evolving roles in paramedic practice.K8
An understanding of personal resilience strategies and team support inchallenging and unpredictable situations. K9
A clear appreciation of the theoretical models of reflection used inclinical practice.K10
18
Understand the theoretical models of clinical decision making which impacton the management of patients in the context of paramedic practice. K11
WHAT WILL THE PROGRAMME CONSIST OF?
The QA Level 6 Diploma in Paramedic Practice (RQF) consists of 2 stages, each of whichis equivalent to a year’s full-time study. This is a 40 week per year programme due tothe content and clinical placement requirements.
Within the programme, all modules are core and there are no option modules inthe programme. To obtain a QA Level 6 Diploma in Paramedic Practice (RQF), studentsmust complete all elements of the programme.
The structure of core content modules within the QA Level 6 Diploma in ParamedicPractice (RQF) has been developed utilising best practice guidance from:
QAA subject benchmarks – Paramedic Science (2004)
College of Paramedics – Curriculum Guidance (2014)
HCPC Standards of Education and Training (2017)
HCPC Standards of Proficiency – Paramedics (2017)
Care Quality Commission (CQC) National Standards, 2014
The modules of study have been devised to ensure the programme fulfils the Standardsof Education and Training from the Professional Regulatory Statutory Body; the Healthand Care Professions Council.
Year 1 Modules Credits
PP01
PP02
PP03
PP04
PP05
PP06
Introduction to Ambulance Practice
Fundamentals of Trauma Care
Fundamentals of Emergency Medical Care
Principles of Clinical Practice inthe Pre-Hospital Environment
Applied Anatomy, Physiology and Pathophysiology
Unscheduled Care for Patients with Specific Needs
10
11
10
88
5
4
Stage 1
19
Stage one of the programme introduces students to the role of the emergency careparamedic and develops the knowledge and evidence base surrounding issues inemergency care.
Students will study human anatomy and physiology, health, wellbeing and thedevelopment of disease together with a focus on the conditions students will encounterin practice.
There is a strong focus on the development of professional identity, professionalstandards and the legal and ethical frameworks which underpin paramedic practice.Students will be introduced to reflective practice as a method of personal andprofessional development.
All students will be encouraged to develop in a structured way which supports personaland professional development allowing the consolidation of acquired knowledge, skillsand attitudes required for safe and effective paramedic practice.
Stage 1 introduces the student to evidence based practice and this is embeddedthroughout the programme, developing research appraisal skills and the ability toutilise evidence to support clinical practice.
The development of emergency care clinical skills and development of the requiredinterpersonal communication skills required for practice will be introduced andstudents will develop clinical assessment, examination and patient care skills and gainexposure to clinical practice situations via clinical placements.
Clinical Placements Stage 1A one week ‘orientation to practice placement’ in which students will gain anappreciation of the core communication, interpersonal and patient care skills requiredfor practice.
Minimum of 750 hours of ambulance based practice placement as part of the‘Foundations of Emergency Care Module’. Students will be placed with a qualifiedclinician (technician or paramedic) who will possess appropriate mentorship skills andoccupational competency.
The aims of the placement are to develop the key skills set required for safe practiceunder direct supervision. Students are required to demonstrate competency inpractice and via simulated learning opportunities and have Foundations of EmergencyCare Practice Competencies which will be ‘signed-off’ in practice by their mentor,progression and fitness to practise will be monitored via the tutorial and mentorshipprocesses. Students will be supported in practice to develop their clinical skills andthese will be formally recorded and documented within the Practice PlacementCompetency Document (contained within the PAD) .
20
Tutorial Support Processes
The tutorial process brings together the student and a clinical tutor to support thedevelopment of the individual student, monitor progression and also identify any areaswhich require support or additional interventions.
There will be a minimum of three tutorial meetings per year and additional meeting willbe held in the event of failure to progress of any clinical or operational issues whichimpact on the abilities or attitudes of the student, both in clinical practice and in theclassroom setting.
All meetings will be documented using a record sheet which is retained within thestudent’s portfolio, with a copy retained by the supporting clinical tutor.
Stage 2Progression to year 2 is dependent on meeting the full academic and clinicalrequirements of the programme for year 1.
Year 2 Modules Credits
PP07
PP08
PP09
PP10
PP11
PP12
17
58
41
8
14
17
Biosciences, Pharmacology and Pathophysiology
Advancing Clinical Practice
Advanced Trauma Life Support
Gynaecology, Obstetric and NeonatalEmergencies in the Pre-Hospital Environment
Development and PsychosocialConsiderations in Paramedic Practice
Professional, Ethical and Legal Aspects of Practice
22
Stage 2 of the programme aims to build upon the clinical, professional and leadershiprole of the paramedic and prepare students for the reality of autonomous clinicalpractice as a registered paramedic.
Consolidating knowledge from stage 1, students will gain advanced understanding ofthe disease processes, clinical presentation of disease, and the impact thatparamedic intervention can have in the management of physical and mental illnessand injury.
The role of the paramedic in the assessment, management and leadership withinthe trauma situation will be developed from participant observer from stage 1 topreparation for autonomous practice at the end of the programme.
Students will develop their critical appraisal skills in year 2 which are embeddedthroughout the programme which aims to promote evidence based care inparamedic practice as an intrinsic part of the programme. Students will be supportedin applying this to practice situations and in the interpretation of research andclinical guidelines to support care delivery.
Students will consolidate reflective practice skills and utilise these to supportcritical incident debriefing and critical reflection within the emergency care teamto develop and support clinical practice.
Stage 2 advanced emergency care skills teaching focuses on critical decision making,independent assessment of the clinical situation and the development of strategies forresolution, development of care pathways and the evaluation and review of clinicalinterventions. There is a focus on specialist obstetric management which will developspecific lifesaving skills via simulated learning.
Clinical placements in stage 2 will develop the specialist paramedic knowledge, skills,leadership and coordination required for professional practice and explore theadvancing role and remit of the registered paramedic.
Clinical Placements Stage 2Stage 2 will consist of minimum of 750 hours appropriate practice placements.
This will consist of a minimum of:
> 240 hours within an appropriate specialist care area
> 510 hours within an appropriate pre-hospital care area
Students will be supported by the same tutorial and mentorship arrangements as year1 and will have a range of Professional Paramedic Practice Competencies to meetduring their clinical placement (contained within the PAD document).
Specialist placements in year 2 expose the student to subject specific skills and workalongside clinical specialists to develop their skills, knowledge and application topractice. The specialist clinical placement areas may include (but not limited to):
23
> Elderly care
> Mental health care
> Minor injuries unit
> Emergency department
> Urgent care centre
> GP surgery
> Theatres
Scope of PracticeSkill Procedures
YearOne
YearTwo
AI
RW
AY
BVM
Neonate BVM
Paed BVM
Manual Airway
Jaw Thrust
OPA
NPA
Igel (supraglotic airway)
Adult Intubation
Needle Cricothyroidotomy
Surgical Airway
Suctioning
BURP
Foreign Body Management(Choking)
Pocket Mask
Recovery Position
Sp02 Monitoring
Venturi Mask
Peak Flow
End Tidal Capnography
Laryngoscope and Magill forceps
Needle thorocentisis
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25
Haem
orrhage
Control
Scope of PracticeSkill Procedures Year
OneYearTwo
Haemostaticagent/bandage
Tourniquet (CAT)
Trauma bandage
Chest Seal
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x
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AED Adult
CPR adult, infantand child
CPR new born
3 &12 lead ECGacquisition
3 & (assist with) 12Lead interpretation
Recognition ofDeath (ROLE - 20
minutes ALSparamedic only)
Cessation ofResuscitation
ManualDefibrillation
CA
RD
IA
C
26
Scope of PracticeSkill Procedures
YearOne
YearTwo
Pa
ti
en
tA
ss
es
sm
en
t
Undertake a primary survey
Undertake a Secondary survey
Assess pupils
Manual blood pressure reading
Blood Glucose assessment
Capillary refil test
Capacity evaluation
Resp rate
AVPU
Pulse Rate
Glasgow coma score
Temperature assessment
National Early warning score
FAST assessment
Chest auscultation
Pulse oximetry
PEFR
Rule of Nines
Abdo assessment
Neuro assessment
Mental assessment
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Scope of PracticeSkill Procedures Year
OneYearTwo
Fo
rm
ul
ar
y
Adrenaline 1:1000Adrenaline 1:10 000
AmiodaroneAspirin
AtropineBenzyl penicillinChlorphenamine
DiazmulsDiazepam (PR)
EntonoxFurosemide
GlucagonGlucose 10%
GTNHydrocortisone
IbuprofenIpratropium bromide
MetaclopramideMidazolam (pateints own)
MorphIne sulphateNaloxone hydrochloride
OxygenParacetamol (Oral Prep)
Paracetamol (IV)Salbutamol
Sodium chloride 0.9%Syntometrine
Tranxemic acid
√xx√xx√xx√x√x√√√√x√x√√√x√xxx
√√√√√√√√√√√√√√√√√√√√√√√√√√√√ 28
YearOne
YearTwo
√
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x
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√
x
Ad
min
istra
tiv
e
Patient Care Records (electronic or paper)
Safeguarding referrals
Drug administration record
Falls referrals
ROLE forms
Mental Capacity Forms
Direct (Clinician to Clinician) referrals
Independent Treat and discharge*
Scope of PracticeSkill Procedures
√
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√
x
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√
x
x
x
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√Dru
gR
ou
te
s
Buccall Route
IntramuscularInjection
Oral
Per Rectum
Sublingual
Per Nebuliser
Infusionmaintenance
Intra-osseous &Intravenous
Subcutaneous29
Tr
au
ma
YearOne
YearTwo
Active re-warming
Cervical collar application
Manual inline stabilisation (MILS)
Helmet removal
Log roll
Move and secure patient to a spinalboard
Move and secure pateint to a vacuummattress
Move and secure a patient to anorthopaedic stretcher (Scoop)
Apply Pelvic splint
KED
Traction splint
Rapid extraction
Spinal injury decision
Taser gun barb removal (TBC)
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Scope of PracticeSkill Procedures
30
All students will be given apersonal Scope of Practice
carry card
Reflective PracticeThroughout the programme, students are encouraged to engage in critical reflectionusing critical incidents and cases from practice. Students are encouraged to alignthese reflections to the competency statements/learning objectives for the clinicalplacement.
Description
Feelings
Evaluation
Analysis
Conclusion
Action Plan
GibbsReflective
Cycle
31
32
Reflective PracticeExample:
THIS MUST BE ANONYMISED TO TIME, PLACE AND PERSON.
Attended a car accident where there were numerous seriousinjuries.
Three cars involved in high speed collision. 5 casualties identified onarrival at scene.
One paramedic and one student paramedic in attendance first atscene.
Two patients with severe airway problems.
Paramedic intubated one patient whilst student maintained airwaypatency with oropharyngeal airway and bag-valve-mask untilassistance arrived.
Critical reading of airway management:
Resources used –Parr A, Higginson R (2013) Exploring Emergency Airway ManagementTechniques for Paramedics. Journal of Paramedic Practice, 5(7), p330-336.
UK Ambulance Services (2013) Clinical Practice Guidelines, Joint RoyalColleges Ambulance Liaison Committee.
Demonstrated awareness of own limitations in practice – unableto intubate at present due to student status.
Gained an understanding of airway management in practice.
Gained practice in preparing emergency airway managementequipment.
Standard 1 – Professional Standards:
Expectation: The Student will work within their scope of practiceat all times
Standard 4 - Core Emergency Care skills
Expectation: The student will be able to carry out essentialemergency care skills and report findings to the supervisingprofessional.
Case Overview/Description of
Events
Case AnalysisIncluded.SupportingEvidence
How will thisdevelop yourpractice?
Competencystandard.
Critical Case Log
Example:
THIS MUST BE ANONYMISED TO TIME, PLACE AND PERSON.
Case/Incident
Identificationof keylearning
experiences.Supportingtheories/evidence.
You are required to develop a critically reflective case log, detailing incidents/cases/keylearning opportunities encountered whilst on clinical placements.
At this stage, your logs should be demonstrating your ability to define a particular incidentof relevance and reflect on your developments as a student paramedic. Taking into accountthe application of key learning issues and experiences to the development of professionalpractice; understanding and applying the relevant supporting theories, evidence base andguidelines throughout; thus demonstrating a preparation for professional practice.
A patient with a life-limiting illness had to wait for an ambulancetransfer from home to hospital longer than was acceptable to thepatient and family.
Dealing with emotional distress, anger and aggression by usingenhanced communication skills.
Assessing the situation and using appropriate communication skillsto de-escalate the situation.
Drawing on theoretical knowledge of communication strategies andusing this evidence to de-escalate the situation and ensure thepatient feels supported and listened to. Supporting evidence:
Brown B (2006) Evidence Based Health Communication, OpenUniversity Press.
http://emergencymedicinecases.com/episode-51-effective-patient-communication-managing-difficult- patients/
33
34
Critical Case Log (Continued)Example:
THIS MUST BE ANONYMISED TO TIME, PLACE AND PERSON.
Implicationsfor Professional
ParamedicPractice
Competencystandard.
Collaborative working between control room and GP to ensurepatients are aware that ambulance transfers may be in a certaintime period.
Clear and honest discussion with patient and family, exploring issuesof concern.
Escalation of patient concern to practice mentor and criticaldiscussion of service provision, mechanisms of service developmentand redesign which may impact on waiting times.
Maintaining professional behaviours regardless of the situation.
Adhering to the HCPC Guidance on Conduct and Ethics for Students(2012)
Standard 3 – Research and evidenced based practice
Expectation: The student will be able to utilise and promoteevidence-based practice.
Standard 2 - Ethical and legal Standards
Expectation: The student will understand, maintain and promoteethical and legal standards of clinical care.
As a mentor you can facilitate reflective practice by:
- Engaging in discussion about particular cases
- Encouraging students to think about – what happened, why, what were the outcomes,what are the implications for practice and what could they do differently next time?
- Encouraging students to read around topic areas/literature relating to conditions,treatment options and issues in case management.
- Involve students in case discussions/case conferences/shift handovers.
Cause for Concern FlowchartSupporting Tutorial Mentorship
Student is struggling withelements of practice and
achievement of competence. Thisneeds to be identified early. Thismay early in the placement or at
any time prior to aformative/summative assessment
Serious concerns are apparentabout the student’s professionalbehaviour and/or there is a risk topatient & colleague safety, or a
serious incident occurs.
Mentor to discuss with student: Develop anaction plan (agree a date to review theaction plan). Document in student's
practice book. If required, arrange meetingwith student, mentor and MediPro PPF
Mentor to discuss with studentand complete either one or bothof the following (immediatelyfollowing the discussion):
Incident form in accordance withlocal policy; (employment) Cause
for Concern form MediPro
Mentor/Studentreview action planas per agreed date.Objectives met - nofurther action
Mentor/Studentreview action planas per agreed date.Objectives not met.
Document instudent's handbook
Mentor to contactLink Tutor. Informthat a Cause forConcern form hasbeen completed
Mentor/Co-mentor tocontact MediPro PPF within24 hours to inform that aCause for Concern form has
been completed
Link team toinform ProgrammeLead or equivalentwithin 2 workingdays and collectphotocopy of
Cause for Concernform
MediPro PPF to informProgramme Lead orequivalent within 2
working days and collectphotocopy of Cause for
Concern form
Investigationinitiated
MediPro Fitnessto PracticeProcedure
35
The student will bereferred again to OH sostudents should allow areasonable time for this totake place. With thestudent’s permission, OHmay need to contact theirGP for updatedinformation.
Students should also be awarethat return to study may only bepossible at certain times of theacademic cycle, depending onthe programme being studied.
In order to appeal any decisiontaken on this process, there willneed to be a written appealaddressed to the ManagingDirector. The ProgrammeCommittee will then review theevidence and make a finaldecision, which will be endorsedby the MD and final.
Fitness to Practice Flowchart
You may become aware of issuesaffecting a fellow student’shealth, safety, wellbeing or
behaviour.
Approach the student in anempathetic and non-
confrontational manner to try andascertain the issue and Inform
the Admin team.
You should suggest to the student that theycontact the Admin team for support.
The student may be asked tomoderate their behaviour or to
seek help.
The student will be invitedto attend an initial interview
with a member of themanagement team, within aconfidential environment.
MediPro may concludethat the student’sbehaviour is puttinghealth and safety,
wellbeing or academicprogress at risk and will
take action as
A mutually agreeablelearning plan will bedeveloped, which may
include utilisinginternal support
teams, but may alsoinclude referral to OH.
If the student refusesto co-operate or failsto adhere to the plan,the matter will be
escalated to the nextstage.
Once the plan isagreed with boththe student and
staff, a copy will beheld by Admin.
The suspension procedureis managed by the HR
Dept, and the student willbe notified formally in
writing.
Students areencouraged to maintaincontact with the AdminDept during their period
of suspension.
OH may contacttheir GP forinformation
regarding theirhealth.
36
Orientation Area DateSupervisorsignature
Studentsignature
This must be completed before the commencement of your placement.
Identification of supervisor(name and designation)
Changing facilities
Rest facilities
Meal breaks
Location of emergencyequipment and students role
What to do in case of a fireand students role
Lay out of physicalenvironment
Uniform requirements/policiesspecific to area
Information governance, dataprotection, confidentiality andconsent relevant to the area
Identification of zonedacademic for the area
Discussed learning objectivesand identification of learningopportunities within theplacement
Any further placementspecific information?
Students will be provided with a number of printed copies of this record and it is theresponsibility of the Mentor to complete them before each placement
Placement Orientation/Induction Record(example)
FAQ'sAre placements observational?
No all student placements are designed to give students the opportunity to practice theirknowledge and skills under direct supervision.
Can the student complete extra/additional shifts?
No. Students’ shifts are pre-programmed and pre-allocated. You should not negotiate oralter any shifts unless you discuss this with the MediPro practice placement facilitator.
Can students work weekend and night shifts?
Yes all MediPro students are able to work all shifts including weekend and nights.
What happens if my student is absent due to sickness?
You should let the MediPro placements facilitator know as soon as possible.
Are students insured to practice?
Yes, MediPro hold medical malpractice and indemnity insurance for all students.
Can students administer medications?
No. Students do not normally have access to your medicines. However, under yoursupervision they can draw up medicines and cross-check doses and dates with you. Theycan do all of the pre-administration checks with you but the final part of theadministration process – handing or injecting into a patient – can only be done by you as aregistered HCPC Paramedic. This also applies to ‘flushing’ cannulas as this is an injectablemedicine and only Paramedics have a POM Exemption for intravenous medicines.
However if your employer has appropriate PGD's in place, you may be able to administersome drugs.
Can students practice skills and invasive techniques?
Students can carry out invasive procedures under your direct supervision. They shouldhave their Practice Assessment Document (PAD) with them that details all of theirpractice skills that they can perform. We would encourage you to allow students to beable to demonstrate their skills in practice and provide them with some feedback on theirperformance
Who signs the PAD document off?
You as a mentor are able to sign the competencies but the final sign off will be completedby the clinical tutor.
38
Registrant paramedics must:
Be able to practise safely and effectively within their scope of practice
Know the limits of their practice and when to seek advice or refer to anotherprofessional
Recognise the need to manage their own workload and resources effectivelyand be able to practise accordingly
Be able to use a range of integrated skills and self-awareness to manageclinical challenges independently and effectively in unfamiliar andunpredictable circumstances or situations
Be able to work safely in challenging and unpredictable environments, includingbeing able to take appropriate action to assess and manage risk
Be able to practise within the legal and ethical boundaries of their profession
Understand the need to act in the best interests of service users at all times
Understand what is required of them by the Health and Care ProfessionsCouncil
Understand the need to respect and uphold the rights, dignity, values, andautonomy of service users including their role in the diagnostic and therapeuticprocess and in maintaining health and wellbeing
Recognise that relationships with service users should be based on mutualrespect and trust, and be able to maintain high standards of care even insituations of personal incompatibility
Know about current legislation applicable to the work of their profession
Be able to practise in accordance with current legislation governing the use ofmedicines by paramedics
Understand the importance of and be able to obtain informed consent
Be able to exercise a professional duty of care
1
1.1
1.2
1.3
1.4
2
2.1
2.2
2.3
2.4
2.5
2.6
2.7
2.8
HCPC Standards of proficiency
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40
Be able to maintain fitness to practise
Understand the need to maintain high standards of personal and professionalconduct
Understand the importance of maintaining their own health
Understand both the need to keep skills and knowledge up to date and theimportance of career-long learning
Be able to maintain a high standard of professional effectiveness by adoptingstrategies for physical and psychological self-care, critical self-awareness, andby being able to maintain a safe working environment
Recognise the need to engage in critical incident debriefing, reflection andreview to ensure that lessons are addressed for future patient safety andmanagement
Be able to practise as an autonomous professional, exercising their ownprofessional judgement
Be able to assess a professional situation, determine the nature and severity ofthe problem and call upon the required knowledge and experience to deal withthe problem
Be able to make reasoned decisions to initiate, continue, modify or ceasetreatment or the use of techniques or procedures, and record the decisions andreasoning appropriately
Be able to initiate resolution of problems and be able to exercise personalinitiative
Recognise that they are personally responsible for and must be able to justifytheir decisions
Be able to use a range of integrated skills and self-awareness to manageclinical challenges effectively in unfamiliar and unpredictable circumstances orsituations
Be able to make and receive appropriate referrals
Understand the importance of participation in training, supervision andmentoring
Be able to make a decision about the most appropriate care pathway for apatient and refer patients appropriately
3
3.1
3.2
3.3
3.4
3.5
4
4.1
4.2
4.3
4.4
4.5
4.6
4.7
4.8
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Be aware of the impact of culture, equality and diversity on practice
Understand the requirement to adapt practice to meet the needs of differentgroups and individuals
Understand the need to demonstrate sensitivity to the factors which shapelifestyle that may affect the individual’s health and the interaction between theservice user and paramedic
Be able to practise in a non-discriminatory manner
Understand the importance of and be able to maintain confidentiality
Be aware of the limits of the concept of confidentiality
Understand the principles of information governance and be aware of the safeand effective use of health and social care information
Be able to recognise and respond appropriately to situations where it isnecessary to share information to safeguard service users or the wider public
Be able to communicate effectively
Be able to demonstrate effective and appropriate verbal and non-verbal skills incommunicating information, advice, instruction and professional opinion toservice users, colleagues and others
Be able to communicate in English to the standard equivalent to level 7 of theInternational English Language Testing System, with no element below 6.5
Understand how communication skills affect assessment of, and engagementwith, service users and how the means of communication should be modified toaddress and take account of factors such as age, capacity, learning ability andphysical ability
Be able to identify anxiety and stress in patients, carers and others andrecognise the potential impact upon communication
Be able to select, move between and use appropriate forms of verbal and non-verbal communication with service users and others
Be aware of the characteristics and consequences of verbal and non-verbalcommunication and how this can be affected by factors such as age, culture,ethnicity, gender, socio-economic status and spiritual or religious beliefs
5
5.1
5.2
6
7
7.1
7.2
7.3
8
8.1
8.2
8.3
8.4
8.5
8.6
Understand the need to provide service users or people acting on their behalfwith the information necessary to enable them to make informed decisions
Understand the need to assist the communication needs of service users suchas through the use of an appropriate interpreter, wherever possible
Recognise the need to use interpersonal skills to encourage the activeparticipation of service users
Be able to work appropriately with others
Be able to work, where appropriate, in partnership with service users, otherprofessionals, support staff and others
Understand the need to build and sustain professional relationships as both anindependent practitioner and collaboratively as a member of a team
Understand the need to engage service users and carers in planning andevaluating diagnostics, treatments and interventions to meet their needs andgoals
Understand the range, scope and limitations of operational relationshipsbetween paramedics and other health and care professionals
Recognise the principles and practices of other health and care professionalsand health and care systems and how they interact with the role of a paramedic
Be able to contribute effectively to work undertaken as part of a multi-disciplinary team
Be able to maintain records appropriately
Be able to keep accurate, comprehensive and comprehensible records inaccordance with applicable legislation, protocols and guidelines
Recognise the need to manage records and all other information in accordancewith applicable legislation, protocols and guidelines
8.7
8.8
8.9
9
9.1
9.2
9.3
9.4
9.5
9.6
10
10.1
10.2
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Be able to reflect on and review practice
Understand the value of reflection on practice and the need to record theoutcome of such reflection
Recognise the value of case conferences and other methods of review
Be able to assure the quality of their practice
Be able to engage in evidence-based practice, evaluate practice systematicallyand participate in audit procedures
Be able to gather information, including qualitative and quantitative data, thathelps to evaluate the responses of service users to their care
Be aware of the role of audit and review in quality management, includingquality control, quality assurance and the use of appropriate outcome measures
Be able to maintain an effective audit trail and work towards continualimprovement
Be aware of, and be able to participate in, quality assurance programmes, whereappropriate
Be able to evaluate intervention plans using recognised outcome measures andrevise the plans as necessary in conjunction with the service user
Recognise the need to monitor and evaluate the quality of practice and thevalue of contributing to the generation of data for quality assurance andimprovement programmes
Understand the key concepts of the knowledge base relevant to theirprofession
Understand the structure and function of the human body, together withknowledge of health, disease, disorder and dysfunction, relevant to theparamedic profession
Be aware of the principles and applications of scientific enquiry, including theevaluation of treatment efficacy and the research process
Recognise the role of other professions in health and social care
11
11.1
11.2
12
12.1
12.2
12.3
12.4
12.5
12.6
12.7
13
13.1
13.2
13.3
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Understand the structure and function of health and social care services in theUK
Understand the concept of leadership and its application to practice
Understand the theoretical basis of, and the variety of approaches to,assessment and intervention
Understand human anatomy and physiology, sufficient to recognise the natureand effects of injury or illness, and to conduct assessment and observation inorder to form a differential diagnosis and establish patient managementstrategies
Understand the following aspects of biological science:
– Disease and trauma processes and how to apply this knowledge to developappropriate treatment plans for the patient's pre-hospital or out-of-hospitalcare
– Dow the application of paramedic practice may cause physiological andbehavioural change
– Human anatomy and physiology, especially the dynamic relationships ofhuman structure and function and the musculoskeletal, cardiovascular,respiratory, digestive, endocrine, urinary, reproductive, integumentary andnervous systems
– Human growth and development across the lifespan
– Normal and altered anatomy and physiology throughout the human lifespan
– Relevant physiological parameters and how to interpret changes from thenorm
– The factors influencing individual variations in human ability and healthfunction
– The main classes of pathogenic microorganisms, the spread of infection andthe use of universal precautions
– The main sequential stages of normal development, including cognitive,emotional and social measures of maturation through the human lifespan
– The role of nutrition in promoting health and preventing illness across the lifespectrum
13.4
13.5
13.6
13.7
13.8
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Understand the following aspects of physical science: –Principles and theories of physics, biomechanics, electronics and ergonomicsthat can be applied to paramedic practice
– The means by which the physical sciences can inform the understanding andanalysis of information used to determine a diagnosis
– The pathophysiological changes to normal homeostatic function and itsimplications
– The principles and application of measurement techniques based onbiomechanics and electrophysiology
Understand the following aspects of sociological, health and behaviouralscience:
– How aspects of psychology and sociology are fundamental to the role of theparamedic in developing and maintaining effective relationships
– How psychology and sociology can inform an understanding of physical andmental health, illness and health care in the context of paramedic practice andthe incorporation of this knowledge into paramedic practice
– Psychological and social factors that influence an individual in health andillness
Understand the following aspects of clinical science: –Pathological changes and related clinical features of conditions encountered inpre-hospital and out-of-hospital practice
– Physiological, pharmacological, structural, behavioural and functionalchanges in patient presentation
– Principles of evaluation and research methodologies which enable theintegration of theoretical perspectives and research evidence into the designand implementation of effective paramedic practice
– The theoretical basis of assessment, clinical decision making and appropriatetreatment plans, along with the scientific evaluation of their effectiveness
– The theories supporting problem solving and clinical reasoning
– Understand relevant pharmacology and the administration of therapeuticmedications, including pharmacodynamics and pharmacokinetics
13.9
13.10
13.11
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Be able to draw on appropriate knowledge and skills to inform practice
Know the theories and science that underpin the theory and principles ofparamedic practice
Be able to change practice as needed to take account of new developments orchanging contexts
Be able to conduct appropriate diagnostic or monitoring procedures, treatment,therapy or other actions safely and effectively
Know how to position or immobilise patients correctly for safe and effectiveinterventions
Know the indications and contra-indications of using specific paramedictechniques in pre-hospital and out-of-hospital care, including their limitationsand modifications
Be able to modify and adapt practice to meet the clinical needs of patientswithin the emergency and urgent care environment
Know how to select or modify approaches to meet the needs of patients, theirrelatives and carers, when presented in the emergency and urgent careenvironment
Be able to formulate specific and appropriate management plans including thesetting of timescales
Be able to gather appropriate information
Be able to select and use appropriate assessment techniques
Be able to undertake and record a thorough, sensitive and detailed assessment,using appropriate techniques and equipment
Be able to conduct a thorough and detailed physical examination of the patientusing appropriate skills to inform clinical reasoning and guide the formulationof a differential diagnosis across all age ranges
Be able to use observation to gather information about the functional abilitiesof patients
Understand the need to consider the assessment of both the health andpsycho-social care needs of patients and carers
Be able to undertake or arrange investigations as appropriate
Be able to analyse and critically evaluate the information collected
14
14.1
14.2
14.3
14.4
14.5
14.6
14.7
14.8
14.9
14.10
14.11
14.12
14.13
14.14
14.15
14.16 46
Be able to demonstrate a logical and systematic approach to problem solving
Be able to use research, reasoning and problem solving skills to determineappropriate actions
Recognise the value of research to the critical evaluation of practice
Be aware of a range of research methodologies
Be able to evaluate research and other evidence to inform their own practice
Be able to use information and communication technologies appropriate totheir practice
Understand the need to establish and maintain a safe practice environment
Understand the need to maintain the safety of both service users and thoseinvolved in their care
Be aware of applicable health and safety legislation, and any relevant safetypolicies and procedures in force at the workplace, such as incident reportingand be able to act in accordance with these
Be able to work safely, including being able to select appropriate hazard controland risk management, reduction or elimination techniques in a safe manner andin accordance with health and safety legislation
Be able to select appropriate personal protective equipment and use it correctly
Be able to establish safe environments for practice, which minimise risks toservice users, those treating them and others, including the use of hazardcontrol and particularly infection control
Understand and be able to apply appropriate moving and handling techniques
Understand the nature and purpose of sterile fields and the paramedic’s roleand responsibility for maintaining them
Be aware of the role of the paramedic in responding to hazardous or majorincidents
14.17
14.18
14.19
14.20
14.21
14.22
15
15.1
15.2
15.3
15.4
15.5
15.6
15.7
15.8
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