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HEA2233/3
157: S
urg
ical C
om
pete
ncie
s
Pra
ctic
e A
sse
ssm
en
t Do
cu
me
nt
(Com
pete
ncie
s)
Stu
de
nt N
am
e:
Edge H
ill Univ
ersity
Stu
dent N
um
ber:
Pro
fessio
nal R
egistra
tion:
Mid
-term
| Fu
ll-term
S
SA
| M
A |
SS
A |
MA
Ap
plied
Practi
ce fo
rms –
Co
mp
eten
cies.
This d
ocu
men
t con
tains all co
mp
etencies fo
r HEA
22
33
& H
EA31
57
Ho
w to
com
plete
the fo
rms:
First mee
t with
you
r allocated
men
tor an
d d
iscuss th
e best w
ay you
can m
eet th
e com
peten
-cies w
ithin
these fo
rms. Th
is will en
able yo
u to
gain an
un
derstan
din
g of w
hat is req
uired
to
dem
on
strate that yo
u can
practi
ce com
peten
tly and
con
sistent-
ly. The m
ento
r’s role is to
guid
e you
thro
ugh
the p
rocess an
d
facilitate op
po
rtun
ities fo
r you
to gain
eviden
ce to sh
ow
that
you
are a com
peten
t intra-o
perati
ve practi
tio
ner.
1. Yo
u sh
ou
ld start to
wo
rk alon
gside yo
ur co
lleagues an
d clin
icians an
d exp
lore yo
ur
kno
wled
ge in p
ractice b
y asking q
uesti
on
s. You
r men
tor w
ill wo
rk alon
g side yo
u in
itially
bu
t then
as you
pro
gress, they m
ay ado
pt a stan
ce of p
roxim
al sup
ervision
wh
ere yo
u
un
dertake clin
ical activiti
es on
you
r ow
n.
2. Th
rou
gho
ut th
is mo
du
le you
will b
e guid
ed to
ward
s key do
cum
ents th
at will fo
rm th
e core
of yo
ur p
ortf
olio
eviden
ce. You
will b
e advised
on
ho
w to
make b
est use o
f these d
ocu
-m
ents to
dem
on
strate you
r kno
wled
ge and
un
derstan
din
g that u
nd
erpin
s each clin
ical skill.
3. M
ake sure yo
u co
nti
nu
e to gen
erate po
rtfo
lio evid
ence to
sup
po
rt the claim
you
are m
aking at th
e end
of th
e mo
du
le. This is im
po
rtant as yo
ur m
ento
r will review
you
r p
rogress again
st each co
mp
etency n
ot ju
st by o
bservati
on
alon
e bu
t thro
ugh
the refl
ective
or o
ther typ
es of evid
ence co
ntain
ed in
you
r po
rtfo
lio.
4. In
the [A
ssessmen
t Meth
od
/Eviden
ce] colu
mn
you
sho
uld
ind
icate wh
at meth
od
of
assessmen
t has b
een u
sed an
d typ
e of evid
ence yo
u h
ave with
in yo
ur p
ortf
olio
(inclu
din
g lo
catio
n) to
sup
po
rt you
r claim th
at you
are co
mp
etent in
practi
ce. You
will n
ote th
at there
are alre
ady re
com
me
nd
ed m
etho
ds o
f assessm
ent listed
in th
is colu
mn
. These are in
clud
-ed
as a guid
e to yo
ur m
ento
r as to w
hat th
e mo
st app
rop
riate meth
od
s of assessm
ent m
ay b
e for th
at parti
cular skill statem
ent. Item
s listed in
BLO
CK
CA
PITA
LS are com
pu
lsory.
5. SSA
= Stud
ent Self A
ssessmen
t, MA
= Men
tor A
ssessmen
t. C
om
peten
ce is record
ed b
y markin
g a 0 [n
ot yet co
mp
etent] o
r a 6 [co
mp
etence]. Yo
u are
requ
ired to
self-assess you
r com
peten
ce prio
r to d
iscussio
n w
ith yo
ur m
ento
r. You
r m
ento
r will also
com
plete th
e MA
bo
xes with
[initi
alled] 0 o
r 5 (d
iplo
ma) o
r 6 (d
egree).
6. If (fo
r wh
atever reason
) you
are no
t com
pete
nt an
d a ze
ro is reco
rded
then
an acti
on
plan
is req
uired
. This is th
e case at Full-term
as mu
ch as at M
id-term
. Stud
ents w
ill be o
ffered
o
ne o
pp
ortu
nity to
be re
-assessed fo
llow
ing a fail-in
-practi
ce grade b
eing reco
rded
at full-
term assessm
ent. Th
ere is an
op
po
rtun
ity to reco
rd th
is actio
n p
lan o
n th
e reverse of th
e Fu
ll-term A
ssessmen
t record
(Page 6
). Please d
iscuss th
is matt
er furth
er with
you
r men
tor
and
/or yo
ur m
od
ule co
ord
inato
r; if this is u
nreso
lved. It m
ay be so
meth
ing sim
ple th
at can
easily be recti
fied
by arran
ging an
alternati
ve allocati
on
or stu
dy o
pp
ortu
nity. Yo
ur acti
on
p
lan w
ill reflect th
is discu
ssion
. Please n
ote: yo
u w
ill no
t pass th
is mo
du
le un
less you
are
0 0
6 6
dee
med
com
peten
t in A
LL skill ite
ms.
7. Th
e bo
x to th
e right o
f the co
mp
etency
(illustrated
) is to en
able yo
ur m
ento
r to sign
to reco
rd co
mp
etence again
st each skill item
. So
me circu
mstan
ces may d
ictate that an
assessor w
orkin
g in co
nju
ncti
on
with
you
r allo
cated m
ento
r sign th
is. If this is th
e case then
this m
ust b
e cou
nter sign
ed b
y you
r allo
cated m
ento
r. If you
have b
een
wo
rking w
ith ad
diti
on
al men
tors, th
ey too
sho
uld
sign
in th
is bo
x. This d
emo
nstrates b
oth
sets of m
ento
rs are in
agreem
ent w
ith o
ne an
oth
er.
Wh
at to d
o n
ext with
the ap
plied
practi
ce fo
rms?
These fo
rms h
ave to b
e sub
mitt
ed eth
er by h
and
or b
y po
stal mail to
ensu
re the au
then
ticity
of sign
atures. Th
e ou
tcom
es are then
record
ed at Ed
ge Hill U
niversity. Yo
ur fo
rms w
ill be
return
ed to
you
at a later date fo
r inclu
sion
in yo
ur p
ortf
olio
. They are im
po
rtant b
ecause
they w
ill dem
on
strate to yo
ur em
plo
yer you
r com
peten
cy. You
sho
uld
take cop
ies of yo
ur
do
cum
ents p
rior to
po
stin
g.
Ple
ase return
the d
ocu
men
t to yo
ur m
od
ule co
ord
inato
r at eithe
r add
ress (see sub
missio
n
date in
you
r han
db
oo
k):
Edge H
ill Un
iversity Facu
lty of H
ealth
Arm
stron
g Ho
use
Oxfo
rd R
oad
M
anch
ester M
1 7
ED
Ed
ge Hill U
niversity
Faculty o
f Health
St. H
elens R
oad
O
rmskirk
Lancash
ire L3
9 4
QP
.……
……
Me
nto
r/Assesso
r Signatu
re
Prelim
inary In
terview
: Th
e stud
ent an
d m
ento
r sho
uld
use th
is interview
to d
iscuss th
e com
peten
cy do
cum
ent as a
wh
ole an
d n
ote item
s for acti
on
plan
nin
g. It is extremely im
po
rtant th
at skill items th
at can
no
t be tau
ght an
d assessed
with
in th
e curren
t allocati
on
are no
ted an
d th
at the acti
on
plan
refl
ects this d
iscussio
n.
Stu
dent N
am
e:
Page 4
No
tes (P
lease referen
ce to
AC
TION
PLA
N):
Signed
…
Stu
den
t:
Men
tor:
Acad
em
ic Sup
ervisor:
Date
:
Date
:
Date
:
Mid
-term
Asse
ssmen
t: Th
e stud
ent an
d m
ento
r sho
uld
use m
id-term
assessmen
t to b
ench
mark w
hat h
as alread
y b
een
achieved
against th
e skill statemen
ts. This w
ill enab
le actio
n p
lann
ing fo
r ou
tstand
ing
skill items. U
se this p
age to n
ote an
y po
tenti
al pro
blem
areas. It is extrem
ely imp
ortan
t that
skill items th
at can n
ot b
e taugh
t and
assessed w
ithin
the cu
rrent allo
catio
n are
no
ted an
d
that th
e actio
n p
lan refl
ects this d
iscussio
n.
Stu
dent N
am
e:
Page 5
No
tes (P
lease referen
ce to
AC
TION
PLA
N):
Signed
…
Stu
den
t:
Men
tor:
Acad
em
ic Sup
ervisor:
Date
:
Date
:
Date
:
Full-te
rm A
ssessm
ent:
At fu
ll-term th
e stud
ent sh
ou
ld b
e com
peten
t in A
LL skill item
s. A statem
ent o
f un
con
diti
on
al co
mp
etence sh
ou
ld b
e mad
e (bo
tto
m o
f page) b
y bo
th th
e stud
ent an
d m
ento
r, signed
, dated
an
d acco
mp
anied
(validated
) by b
oth
the stu
den
t’s and
men
tor’s p
rofessio
nal registrati
on
n
um
bers. If th
is is no
t po
ssible th
en a fu
rther A
CTIO
N P
LAN
MU
ST BE C
ON
STRU
CTED
to
add
ress this. P
lease u
se the ad
diti
on
al form
(overleaf) to
record
the o
utco
me o
f any fu
rther
actio
n.
Stu
dent N
am
e:
Page 6
Sum
mary:
I con
firm
that I…
……
……
……
……
……
……
……
……
……
(stud
ent) *h
ave/have N
OT co
nsiste
ntly
dem
on
strated
com
pete
nce
in all o
f the en
closed
skill statemen
ts.
Stud
ent:
Date
: (P
IN: )
I con
firm
that …
……
……
……
……
……
……
……
……
……
(stud
ent) *h
as/has N
OT co
nsisten
tly d
emo
nstrate
d co
mp
eten
ce in
all of th
e enclo
sed skill statem
ents.
M
ento
r: D
ate:
(PIN
: )
PR
INT N
AM
E:
A
cade
mic Su
perviso
r: D
ate:
*Delete as ap
pro
priate
Full-te
rm A
ssessm
ent: R
EVIEW
o
f AC
TION
PLA
N to
com
plete
Co
mp
eten
cies P
lease list th
e ou
tstand
ing skill item
s in th
e table b
elow
and
record
the o
utco
me o
f the
Acti
on
plan
devised
to ad
dress th
ese: A
s with
the p
reviou
s form
, a statemen
t of u
nco
nd
itio
nal co
mp
etence sh
ou
ld b
e mad
e (b
ott
om
of p
age) by b
oth
the stu
den
t and
men
tor, sign
ed, d
ated an
d acco
mp
anied
(validated
) b
y bo
th th
e stud
ent’s an
d m
ento
r’s pro
fession
al registratio
n n
um
bers.
Stu
dent N
am
e:
Page 7
Sum
mary:
I con
firm
that I…
……
……
……
……
……
……
……
……
……
(stud
ent) *h
ave/have N
OT co
nsiste
ntly
dem
on
strated
com
pete
nce
in all o
f the en
closed
skill statemen
ts.
Stud
ent:
Date
: (P
IN: )
I con
firm
that …
……
……
……
……
……
……
……
……
……
(stud
ent) *h
as/has N
OT co
nsisten
tly d
emo
nstrate
d co
mp
eten
ce in
all of th
e enclo
sed skill statem
ents.
M
ento
r: D
ate:
(PIN
: )
PR
INT N
AM
E:
A
cade
mic Su
perviso
r: D
ate:
*Delete as ap
pro
priate
Sk
ill R
ef.
Sk
ill item
S
SA
M
A
Me
nto
r Sig
na
ture
Page 8
INSER
T Men
tor Fo
rm
HER
E
This document is adapted with permission from University of Manchester Principles of Operating Room Practice Clinical Competency Portfolio (2008) Intellectual Property of this document remains with University of Manchester .
Section 1 Preparation for Intra-operative Care
1.1 Competency Preparation of self and others for Intra-operative Roles
Knowledge and Skills Indicators Method/Evidence
Principles of asepsis. Rationale and evidence base for selection and application of each of the attire listed. Correct selection, application and use of each item in accordance with National Guidelines and local policy. This should include decontamination of non-disposable items:
Discuss selection of each item for use in the contexts of risk to: Patient (s) Practitioner
Discuss National Guidelines and local policy for theatre attire. Demonstrate and discuss correct application of theatre attire including:
Operating Room Clothing Hats Shoes Jewellery Masks Eye protection Aprons Lead aprons Scrubbed attire Gloves
Notes [ ]
DISCUSSION [ ] DIRECT OBSERVATION [ ]
Student Name: Page 9
Mid-term | Full-term
SSA | MA | SSA | MA
.…………Mentor/Assessor Signature [Performance Criteria on
reverse of this page]
This workforce competence was developed by Skills for Health
1.1 Competency Preparation of self and others for Intra-operative Roles
Performance Criteria
These performance criteria offer specific guidance to mentors and assessors regarding the way in which this competency should be demonstrated.
Notes
1. Apply standard precautions for infection prevention and control and other appropriate health and safety measures when preparing and dressing for scrubbed and non-scrubbed roles
2. Select and wear appropriate personal protective equipment in line with organisational policies and national guidance
3. Wash and dry your hands and arms effectively in accordance with organisational policies and protocols
4. Select and put on suitable size sterile gown and gloves according to approved procedures 5. Promptly change personal protective equipment which becomes unsuitable for use 6. Remove and dispose of all used personal protective equipment and theatre clothing in a way
which minimises the risk of cross-infection
Student Name: Page 10
This document is adapted with permission from University of Manchester Principles of Operating Room Practice Clinical Competency Portfolio (2008) Intellectual Property of this document remains with University of Manchester .
1.2 Competency Preparation of Environment for Intra-operative Care
Knowledge and Skills Indicators Method/Evidence
Preparation, checking and rectification of faults/issues with standard operating theatre equipment and equipment that is specialty specific. National and local requirements/recommendations in respect of optimal operating conditions. Decontamination, cleansing and traceability requirements between cases and between operating lists.
Discuss national/local guidelines for OR equipment Demonstrate and discuss the rationale behind routine check and preparation of the following:
Operating Lights & Camera Apparatus
Electro-surgical Equipment
Suction Apparatus
Heating and Ventilation Operating Tables and Attachments
Operating list distribution
Warming devices and anti-embolus devices
Microscopes
Audio-visual equipment (Camera stacks) Insufflation Devices
Patient Trolleys Stock Levels
Notes [ ]
Discussion [ ] DIRECT OBSERVATION [ ]
Student Name: Page 11
Mid-term | Full-term
SSA | MA | SSA | MA
.…………Mentor/Assessor Signature [Performance Criteria on
reverse of this page]
This workforce competence was developed by Skills for Health
1.2 Competency Preparation of Environment for Intra-operative Care
Performance Criteria Notes:
1. Apply standard precautions for infection prevention and control and other relevant health and safety measures
2. Ensure that your position and movements do not compromise the sterile field 3. Take appropriate action without delay if there is any breakdown of the sterile field 4. Obtain, prepare and position the requested medical devices and equipment 5. Correctly in an appropriate manner and time, according to the patient’s clinical status and as
requested 6. Take appropriate action where you identify a problem in relation to an item 7. Promptly clarify any uncertainty over requirements with a registered practitioner 8. Obtain the correct items, check and maintain integrity of items, and make selected item availa-
ble to the appropriate member of the team in the prescribed manner, manufacturers instruction and organisational policies and procedures
9. Monitor and count surgical items with the registered practitioner, in line with organisational policies and procedures
10.Handle and connect medical devices and equipment safely and correctly, in line with manufac-turers’ instructions and organisational policies
11.Ensure waste is disposed of appropriately 12.Correctly handle and manage contaminated items in line with organisational policies 13.Comply with organisational policies for replacing used items from stock and tracking and
traceability requirements
Student Name: Page 12
These performance criteria offer specific guidance to mentors and assessors regarding the way in which this competency should be demonstrated.
This document is adapted with permission from University of Manchester Principles of Operating Room Practice Clinical Competency Portfolio (2008) Intellectual Property of this document remains with University of Manchester .
1.3 Competency Preparation of Materials and Equipment for Intra-operative Care
Knowledge and Skills Indicators Method/Evidence
The types, purpose and function of surgical instruments and supplementary items in common use in the clinical specialties relevant to practice. The requirements for, and suitability of, surgical instru-ments and supplementary items for the clinical specialties relevant to practice. The factors to consider in selecting surgical instruments and supplementary items for individual patients:
Demonstrate preparation of, and discuss the rationale for items and equipment for a range of minor intermediate and major surgical procedures:
surgical instrumentation from sets or supplementary packs
peel packs, tape seal packs, fluids, sharps, patient implants and grafts, drainage systems, drugs, and swabs
sutures, dressings and drains power tools, endoscopic equipment, microscope,
exsanguinators drape packs, topical medicinal preparations
Notes [ ]
Discussion [ ] ANNOTATED Guidelines [ ]
ANNOTATED Instrument Checklist [ ] DIRECT OBSERVATION [ ]
Student Name: Page 13
Mid-term | Full-term
SSA | MA | SSA | MA
.…………Mentor/Assessor Signature [Performance Criteria on
reverse of this page]
This workforce competence was developed by Skills for Health
1.3 Competency Preparation of Materials and Equipment for Intra-operative Care
Performance Criteria Notes:
1. Apply standard precautions for infection prevention and control and other relevant health and safety measures
2. Prepare and maintain sterile instrumentation and supplementary items in a designated prepara-tion area to ensure asepsis
3. Select and prepare the correct surgical instrumentation and supplementary items according to the clinical specialty, the anticipated requirements of the operative procedure, and the patient’s individual needs
4. Check date controlled items and confirm them as being within their expiry date 5. Safely handle, move and check surgical instrumentation and supplementary items in line with
manufacturers instructions, confirming them as safe and functioning correctly before preparing them ready for use
6. Take the appropriate action to remedy or report any faults where you find surgical instrumenta-tion and supplementary items are faulty or unsafe during preparation
7. Correctly set up surgical equipment in line with manufacturer’s instructions, and to meet the needs of the operative procedure and the patients’ plans of care
8. Count and record instruments, needles, swabs and supplementary items in conjunction with a registered practitioner as the second authorised checker prior to commencing the case, in line with organisational policies and protocols
9. Prepare the surgical trolley, positioning surgical instrumentation and supplementary items in a way which facilitates their access and use, according to the anticipated sequence of the opera-tive procedure
Student Name: Page 14
These performance criteria offer specific guidance to mentors and assessors regarding the way in which this competency should be demonstrated.
This document is adapted with permission from University of Manchester Principles of Operating Room Practice Clinical Competency Portfolio (2008) Intellectual Property of this document remains with University of Manchester .
Method/Evidence
Section 2 Duties of the Scrubbed Practitioner
2.1 Competency Management of the Sterile Field
Knowledge and Skills Indicators
Demonstrate and discuss the management of the sterile field for a variety of surgical proce-dures within chosen speciality. Principles of asepsis in relation to the provision of surgical instrumentation and supplemen-tary items and the maintenance of the sterile field The risks posed to the sterile field and how these risks may be managed. Standard precautions and the instances whereby additional measures may be required by policy/guidelines e.g. CJD, MRSA
Demonstrate sterile technique. Demonstrate the ability to manage instruments in a way that promotes the maintenance a safe and effective sterile environ-ment. Discuss the risks of compromise to the sterile field and the ways in which
these may be reduced (in the context of own specialty) an intra-operative breach in asepsis may be safely
managed Discuss the instances whereby additional measures may be required to manage asepsis/sterility.
Notes [ ]
DISCUSSION [ ] DIRECT OBSERVATION [ ]
ANNOTATED Scrub Policy [ ] OPERATING ROOM LAYOUT for chosen
specialty [ ]
Student Name: Page 15
Mid-term | Full-term
SSA | MA | SSA | MA
.…………Mentor/Assessor Signature [Performance Criteria on
reverse of this page]
This workforce competence was developed by Skills for Health
2.1 Competency Management of the Sterile Field
Performance Criteria Notes:
1. Apply standard precautions for infection prevention and control and other relevant health and safety measures
2. Ensure your, position, posture and movements do not compromise the sterile field or patient safety
3. Communicate clearly and assertively with others, giving appropriate information, instruction and advice so that they do not compromise the sterile field
4. Effectively monitor the activities of the surgical team and anticipate their requirements for surgical instrumentation and supplementary items
5. Complete records accurately and legibly in accordance with national guidelines 6. Carefully remove drapes from the patient, ensuring their dignity and safety, and dispose of
drapes as appropriate
Student Name: Page 16
These performance criteria offer specific guidance to mentors and assessors regarding the way in which this competency should be demonstrated.
This document is adapted with permission from University of Manchester Principles of Operating Room Practice Clinical Competency Portfolio (2008) Intellectual Property of this document remains with University of Manchester .
2.2 Competency Management of Instrumentation, equipment and consumables
Knowledge and Skills Indicators Method/Evidence
In-depth knowledge of surgical procedures within chosen specialty and the instrumentation and equipment requirements of each. Understands the needs and requirements of the surgical team and can respond appropriately to changes in these needs. The risks posed by failure to manage instrumentation and how these risks may be minimised and managed. Manufacturers’ requirements for checking of instrumentation and procedures for managing defective and/or faulty instrumentation or equipment.
Apply principles of aseptic technique. Demonstrate the ability to manage instruments in a way that promotes the maintenance a safe and effective aseptic environ-ment. Demonstrate correct and safe checks of all equipment and instrumentation:
Swabs Needles/sutures Blades Instrumentation
Discuss the role of the scrubbed practitioner in anticipating the surgeon’s instrument requirements in a timely manner for:
Routine procedures Unexpected changes/complications to planned surgical
intervention Discuss the procedure to be followed when an item is missing. Demonstrate safe disposal of clinical waste and sharps in accord-ance with trust/hospital policy.
Notes [ ]
DISCUSSION [ ] DIRECT OBSERVATION [ ]
Student Name: Page 17
Mid-term | Full-term
SSA | MA | SSA | MA
.…………Mentor/Assessor Signature [Performance Criteria on
reverse of this page]
This workforce competence was developed by Skills for Health
2.2 Competency Management of Instrumentation, equipment and consumables
Performance Criteria Notes:
1. Apply standard precautions for infection prevention and control and other relevant health and safety measures
2. Ensure your, position, posture and movements do not compromise the sterile field or patient safety
3. Communicate clearly and assertively with others, giving appropriate information, instruction and advice so that they do not compromise the sterile field
4. Effectively monitor the activities of the surgical team and anticipate their requirements for surgical instrumentation and supplementary items
5. Handle surgical instrumentation and supplementary items correctly and safely, ensuring the sterile field and patient safety is not compromised when handing them to the surgical team
6. Promptly clarify any uncertainty over requirements with the appropriate member of the surgical team where you identify a problem in relation to: an instrument or item, the sterile field or contamination of instruments immediately report and take appropriate action
7. Provide the correct instrumentation and supplementary items to meet the surgical team’s needs according to the patient, the clinical specialty and procedure
8. Count and record instruments, needles, swabs and supplementary items in conjunction with a registered practitioner as the second authorised checker during the case and prior to closure and completion, in accordance with organisational policies and procedures
9. Clearly inform the surgical team of the instrumentation and supplementary item counts at appropriate stages of the procedure
10.Dispose of and transfer used instrumentation and supplementary items to the non-sterile area for accounting and compliance with tracing requirements for medical devices in line with local policies
11.Complete records accurately and legibly in accordance with national guidelines
Student Name: Page 18
These performance criteria offer specific guidance to mentors and assessors regarding the way in which this competency should be demonstrated.
This document is adapted with permission from University of Manchester Principles of Operating Room Practice Clinical Competency Portfolio (2008) Intellectual Property of this document remains with University of Manchester .
2.3 Competency Management of Specimens
Knowledge and Skills Indicators Method/Evidence
Knowledge of surgical proce-dures within chosen specialty and the specimens that may be taken within each. The types and management of each type of specimen. Understanding of the risks posed by contamination or mis-handling of specimens. The risks posed by failure to label and record specimens correctly and how these risks may be minimised and managed.
Discuss the management of specimens for each of the following types: dry containers, formalin, normal saline, charcoal medium, agar and Stuart’s medium, designated transplant media Discuss the procedure for labelling and recording each of the types of specimen listed above. Demonstrate the ability to follow correct procedure for speci-men management within: Scrubbed role Non-scrubbed (circulating) role Discuss the procedures to be followed to prevent mislabelling and misplacing of specimens within own hospital/trust.
Notes [ ]
DISCUSSION [ ] DIRECT OBSERVATION [ ]
ANNOTATED specimen policy
Student Name: Page 19
Mid-term | Full-term
SSA | MA | SSA | MA
.…………Mentor/Assessor Signature [Performance Criteria on
reverse of this page]
This workforce competence was developed by Skills for Health
2.3 Competency Management of Specimens
Performance Criteria Notes:
1. Apply standard precautions for infection prevention and control and other appropriate health and safety measures
2. Confirm the clinician’s requirements for the type of clinical specimen to be collected and that relevant consent has been obtained
3. Ensure the correct transport medium and container are available for the type of specimen being collected by the clinician/surgeon
4. Receive the specimen correctly and safely in line with organisational policies and procedures, place it in the appropriate container/transport medium, and pass it in a safe manner to the circulating practitioner, ensuring maintenance of the sterile field
5. Confirm that the circulating practitioner‘ labels specimen containers correctly and clearly with all relevant information and that necessary documentation has been completed
6. Confirm dispatch of the specimen to the correct destination for investigation 7. Clearly and accurately record information regarding specimen retrieval in the patient care plan/
theatre records
Student Name: Page 20
These performance criteria offer specific guidance to mentors and assessors regarding the way in which this competency should be demonstrated.
This document is adapted with permission from University of Manchester Principles of Operating Room Practice Clinical Competency Portfolio (2008) Intellectual Property of this document remains with University of Manchester .
[Note where it is not possible to observe transfer of a patient type (e.g.
unconscious) within the student’s chosen specialty SIMULATION should
be deployed as the assessment method]
Section 3 Maintain the Safety of the Peroperative Patient
3.1 Competency Transfer of the Surgical patient
Knowledge and Skills Indicators Method/Evidence
Equipment used for transfer procedure and for safely securing patients following transfer. Safe transfer of the surgical patient within policy/guidelines. Knowledge of Health and Safety policy/guidelines and how these affect patient positioning. The risks that manual handling of patients poses to the patient, staff and organisation.
Demonstrate management of safe transfer between trolley/bed and operating table:
conscious patients semi-conscious patients unconscious patients
Discuss the risks posed when transferring/positioning patients with:
intravenous infusions drains urinary catheters
Discuss procedures for managing adverse incidents occurring as a result of transfer or positioning procedures.
Notes [ ]
DISCUSSION [ ] DIRECT OBSERVATION [ ]
SIMULATION [ ]
Student Name: Page 21
Mid-term | Full-term
SSA | MA | SSA | MA
.…………Mentor/Assessor Signature [Performance Criteria on
reverse of this page]
This workforce competence was developed by Skills for Health
3.1 Competency Transfer of the Surgical patient
Performance Criteria Notes:
1. Apply standard precautions for infection prevention and control and take other appropriate health and safety measures when assisting in the transfer, movement and positioning of patients for perioperative procedures
2. Refer to the patient’s risk assessment documentation for pressure area scoring system to check position and equipment required
3. Ensure the required positioning equipment is available, fit for purpose and ready for use before beginning the positioning procedure
4. Prepare the immediate surroundings appropriately for the transfer, move and position required, removing any potential hazards
5. Inform the patient of the nature and purpose of the transfer, move or position in a manner which encourages their understanding and co-operation
6. Move and handle the patient during transfer, movement and positioning in a way which minimises their pain, discomfort and friction, maintains their safety and maximises their dignity, taking account of all ancillary equipment
7. Offer the patient information, support and reassurance in a manner sensitive to their needs and concerns 8. Follow instructions from the lead practitioner ensuring your actions are coordinated effectively 9. Use safe and suitable moving and handling techniques ensuring:
you avoid exceeding your personal weight and reach limits
endangering the patient
endangering other members of staff
causing damage to equipment or the environment 10. Use positioning equipment safely and correctly in line with manufacturers’ instructions and local policies 11. Promptly report any unexpected change in the patient’s condition to the appropriate member of the care team 12. Confirm with the registered practitioner that the patient is in the correct position to:
a) facilitate the clinical procedure
b) maintain skin integrity
c) avoid nerve damage 13 Use appropriate equipment:
a) for preventing injury
b) promoting patient comfort
c) preventing heat loss 10. Contribute to the assessment and evaluation of the patients skin integrity and document as appropriate
Student Name: Page 22
These performance criteria offer specific guidance to mentors and assessors regarding the way in which this competency should be demonstrated.
This document is adapted with permission from University of Manchester Principles of Operating Room Practice Clinical Competency Portfolio (2008) Intellectual Property of this document remains with University of Manchester .
Student Name:
3.2 Competency Positioning the Surgical patient
Knowledge and Skills Indicators Method/Evidence
Safe positioning of the surgical patient within policy/guidelines. Positioning of the surgical patient that optimises surgical access whilst maintaining the safety of the patient and access for the anaesthetic personnel.
Demonstrate the ability to manage the position of the surgical patient:
conscious patients semi-conscious patients unconscious patients
in the following positions:
supine prone lithotomy/lloyd davis trendelenberg/reverse trendelenberg lateral OTHER...please state
Discuss the risks posed when positioning patients with:
intravenous infusions drains urinary catheters
Discuss procedures for managing adverse incidents occurring as a result of transfer or positioning procedures.
Notes [ ]
DISCUSSION [ ] DIRECT OBSERVATION [ ]
SIMULATION [ ]
Page 23
Mid-term | Full-term
SSA | MA | SSA | MA
.…………Mentor/Assessor Signature
[OTHER...where the mentor deems it appropriate to assess additional
position (s) relevant to speciality ]
[Note where it is not possible to observe transfer of a patient type (e.g.
unconscious) within the student’s chosen specialty SIMULATION should
be deployed as the assessment method]
[Performance Criteria on reverse of this page]
This workforce competence was developed by Skills for Health
3.2 Competency Positioning the Surgical patient
Performance Criteria Notes:
1. Apply standard precautions for infection prevention and control and take other appropriate health and safety measures when assisting in the transfer, movement and positioning of patients for perioperative procedures
2. Refer to the patient’s risk assessment documentation for pressure area scoring system to check position and equipment required
3. Ensure the required positioning equipment is available, fit for purpose and ready for use before beginning the positioning procedure
4. Prepare the immediate surroundings appropriately for the transfer, move and position required, removing any potential hazards
5. Inform the patient of the nature and purpose of the transfer, move or position in a manner which encourages their understanding and co-operation
6. Move and handle the patient during transfer, movement and positioning in a way which minimises their pain, discomfort and friction, maintains their safety and maximises their dignity, taking account of all ancillary equipment
7. Offer the patient information, support and reassurance in a manner sensitive to their needs and concerns 8. Follow instructions from the lead practitioner ensuring your actions are coordinated effectively 9. Use safe and suitable moving and handling techniques ensuring:
you avoid exceeding your personal weight and reach limits
endangering the patient
endangering other members of staff
causing damage to equipment or the environment 10. Use positioning equipment safely and correctly in line with manufacturers’ instructions and local policies 11. Promptly report any unexpected change in the patient’s condition to the appropriate member of the care team 12. Confirm with the registered practitioner that the patient is in the correct position to:
a) facilitate the clinical procedure
b) maintain skin integrity
c) avoid nerve damage 13 Use appropriate equipment:
a) for preventing injury
b) promoting patient comfort
c) preventing heat loss 10. Contribute to the assessment and evaluation of the patients skin integrity and document as appropriate
Student Name: Page 24
These performance criteria offer specific guidance to mentors and assessors regarding the way in which this competency should be demonstrated.
This document is adapted with permission from University of Manchester Principles of Operating Room Practice Clinical Competency Portfolio (2008) Intellectual Property of this document remains with University of Manchester .
Section 4 Intra-operative Patient Care
4.1 Competency Able to complete routine pre-operative checklist
The local checklist applies, but must include the following categories of infor-mation: Patient identification; Fasting; Patient Preparation for Theatre Suite; Consent; Pre-operative investigations; Known Hazards; Allergies; Pre-medication.
The Perioperative Practitioner [PP] should understand the principles of obtaining or amending consent in pre-medicated patients, and should know the protocol for patients who are unable to give informed consent. The PP must understand infection risks and use standard precautions and appropriate additional precau-tions where relevant.
Knowledge and Skills Indicators Method/Evidence
Uses WHO Pre-operative Checklist: Accurately acquires information required to complete pre-operative checklist. Avoids leading questions. Correctly identifies those situa-tions when accuracy of infor-mation is likely to be compro-mised. Can highlight important aspects of checklist information and bring these to the attention of relevant team members – including where routine drug therapy has been given or withheld inappropriately. Systematically identifies the proposed site of operation and reports discrepancies to the
Discuss the rationale for the individual components of the local checklist.
Discuss national guidelines (AfPP / NATN, 2004). Demonstrates awareness of situations which compromise
patient checking procedures. Communicate information to the surgeon regarding admin-
istration of non-administration of drugs likely to impact on anaesthesia.
Systematically identifies the proposed site of operation and reports discrepancies.
DISCUSSION [ ]
DIRECT OBSERVATION [ ] ANNOTATED CHECKLIST [ ]
ANNOTATED WHO CHECKLIST [ ]
Student Name: Page 25
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4.2 Competency Understands legal issues surrounding informed consent for anaesthesia and surgery
Knowledge and Skills Indicators Method/Evidence
Theatre team members, roles and responsibilities in routine care and during emergencies. Knowledge of clinical ability of theatre personnel is an im-portant factor during clinical emergencies. Knowledge of (including scope of) specific non-medical periop-erative roles: Assistant Practitioners Advanced Scrub Practitioners Surgical Care Practitioners Anaesthetic Care Practitioners Emergency Care Practitioners
Discuss the PP’s role in communicating patient’s concerns in regard to consent to the appropriate members of the multidis-ciplinary team.
Demonstrate the rationale for patient identification and confirmation of consent with scrub practitioner.
Discuss the Adults with Incapacity Act (Scotland) 2000.
Discuss the law regarding consent for minors. Discuss the implications of Jehovah’s Witnesses with regard to
consent to receive blood products Demonstrate an awareness of the individual’s right to withhold
consent to receive blood products.
Utilise nationally produced guidelines to inform practice
REFLECTIONS ON SCENARIOS x 3 (Law & Ethics Unit) [ ]
DIRECT OBSERVATION [ ]
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.…………Mentor/Assessor Signature
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Demonstrate concern and respect for the individual patient.
Does not refer to patient by operation. Maintain patient dignity at all times.
Provides additional patient warming with appropriate equip-ment as required.
4.3 Competency Assesses, plans, implements and evaluates perioperative care
Knowledge and Skills Indicators Method/Evidence
Demonstrates the ability to plan and accurately document all aspects of a perioperative care plan for all patient groups. Is able to modify a care plan in response to changes in a pa-tient’s condition.
Utilises bio-psychosocial data where possible from pre-operative visits /pre-operative period to inform holistic care planning.
Anticipates individual patient care requirements. Assess, plan, implement and evaluate effectiveness of interven-
tions.
Annotated CARE DOCUMENTATION x 3
Minor [ ] Intermediate [ ]
Major [ ] DIRECT OBSERVATION [ ]
Questions [ ]
4.4 Competency Able to maintain patient’s comfort and dignity throughout the perioperative period
Knowledge and Skills Indicators Method/Evidence
Maintains privacy, comfort and dignity as far as possible through-out the perioperative period.
Annotated CARE DOCUMENTATION x 3
Minor [ ] Intermediate [ ]
Major [ ] DIRECT OBSERVATION [ ]
Questions [ ]
Student Name: Page 29
General Patient Care The Perioperative Practitioner [PP] must provide safe, holistic patient care, which is as far as possible, evidence-based. The professional practice of the PP must have a sound ethical and legal basis.
Mid-term | Full-term
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.…………Mentor/Assessor Signature
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.…………Mentor/Assessor Signature
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4.5 Competency Recognises signs of anxiety, describes their adverse effects, and offers reassurance
Knowledge and Skills Indicators Method/Evidence
Can assess a patient’s level of anxiety, offers appropriate reassurance. Recognises where anxiety may lead to patient harm, and acts appropriately to reduce anxiety where possible. Clinical effects of anxiety includ-ing altered drug dosages and increased risk of cardiac arrhyth-mias. Anxiety is common and may be distressing: the PP should ensure that they recognise anxiety and responds appropriately.
Demonstrate ability to recognise signs of patient anxiety.
Promote autonomy by encouraging active participation by the patient in their treatment and care where appropriate.
Provide information and the rationale to patients regarding anaesthetic procedures.
DIRECT OBSERVATION [ ]
Discussion [ ]
Student Name: Page 31
Mid-term | Full-term
SSA | MA | SSA | MA
.…………Mentor/Assessor Signature
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4.6 Competency Demonstrates personal and professional accountability in relation to the role of
Perioperative Practitioner
Knowledge and Skills Indicators Method/Evidence
Demonstrates the principles of accountability in professional practice. Practises within limitations of own scope of professional practice.
Behaves consistently with the NMC / HPC professional stand-ards
Recognise own limitations and seek advice from members of the multidisciplinary team.
Reflect on own performance.
Assume responsibility for personal development plan. Demonstrate knowledge of and apply to practice the following
(where relevant): Association for Perioperative Practice guidelines; NHS Policies and Guidelines;
NMC guidelines;
HPC guidelines; NES guidelines. www.nes.scot.nhs.uk/nursing/
publications NHS QIS standards and guidelines & Association of
Surgeons guidelines
SIGN Guidelines.
DIRECT OBSERVATION [ ]
REFLECTIONS ON SCENARIOS x 3 (Law & Ethics Unit) [ ]
Discussion [ ]
Student Name: Page 33
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SSA | MA | SSA | MA
.…………Mentor/Assessor Signature
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4.7, 4.8 Competencies Aware of management of confused patients or patients with incapacity Able to assess and manage patients with learning disabilities
Knowledge and Skills Indicators Method/Evidence
Shows an ability to assess the requirements of confused patients or patients with incapac-ity, and to protect them from undue distress. Is patient and caring at all times.
Demonstrate ability to apply the Adults with Incapacity Act (Scotland) 2000.(See also 2.2)
Demonstrate ability to assess and manage the requirements of confused patients or patients with incapacity
DIRECT OBSERVATION [ ]
Law & Ethics Scenario 3 [ ]
4.9 Competency Able to assess and manage elderly or paediatric patients (as relevant to scope of normal practice)
Knowledge and Skills Indicators Method/Evidence
Shows an ability to assess the requirements of elderly or paediatric patients (as normal practice), and to protect them from undue distress. Is patient and caring at all times.
Use appropriate patient care and communication skills to protect the patient from undue stress as far as is reasonably practicable.
DIRECT OBSERVATION [ ]
Law & Ethics Scenario 3 [ ]
This document is adapted from NHS Education for Scotland Portfolio of Core Competencies for Anaesthetic Assistants (2007). Copyright and Intellectual Property of this document remains with NHS Scotland.
Student Name: Page 35
Care for Specific Patients Confused, demented, or educationally impaired patients represent a challenge for the perioperative team. Management is highly individualised, and the PP must be able to play an appropriate part in assisting the surgeon. Carers, relatives, or interpreters may be permitted into the anaesthetic room and must be supported appropriately.
Mid-term | Full-term
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.…………Mentor/Assessor Signature
Mid-term | Full-term
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.…………Mentor/Assessor Signature
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