PRACTICE ASSESSMENT DOCUMENT...Adult_3A_PAD August 2018 v4 Page 2 of 46 PRE-REGISTRATION BSc (Hons) NURSING (ADULT) - Placement 3A Student name: Student ID …

Adult_3A_PAD August 2018 v4 Page 1 of 46

BSC (HONS) NURSING WITH REGISTERED NURSE (ADULT)

SCHOOL OF HEALTH AND SOCIAL CARE

PRACTICE ASSESSMENT DOCUMENT

Student Name: ……………………………………………………………….

Student Number: ……………………………………………………………

Cohort: ………………………………………………………………


PRE-REGISTRATION BSc (Hons) NURSING (ADULT) - Placement 3A

Student name:

Student ID Number: Cohort:

Personal Tutor:

Module Code: 9 weeks of 30 hours – 270 hours 1 day a week release for module work

Hours approved by mentor:

Hours sick/absent: Occasions of sickness/absence:

Name of placement:

Placement dates: From: To:

Type of placement:

Contact Telephone:

Mentor name:

Mentor signature:

Associate mentor/assessor:

Associate mentor/assessor signature:

Action plan completed (if appropriate)

Yes N/A Follow up by Link Lecturer/personal tutor: Yes No

Cause for concern submitted (if appropriate)

Yes N/A Name of person following up & date notified:

For completion by module team – Action required if checklist criteria not met

Assessment criteria Has achieved at least a ‘3’ in all Part A criteria Yes/No

STUDENT Please ensure your mentor has completed all

boxes shaded yellow and you have completed all boxes shaded blue. Failure to do so could result

in a ‘refer’ on placement.

Contact for University [email protected]

Has achieved at least a ‘3’ in Part B criteria Yes/No Has achieved all required practice hours Yes/No All necessary signatures completed? Yes/No Preliminary, Intermediate and Final interviews and assessments are complete?

Yes/No

Overall Assessment (Pass/Refer)

mailto:[email protected]


List of Supervisor and mentor signature samples including insight visits

Name

(Please print)

Signature

Date of last

mentor update

Designation

Placement


Introduction to the Practice Assessment Document (PAD)

This PAD is comprised of:

1. Three interview records (preliminary, intermediate and final) 2. The Innovation to Transformation Project (pgs. 11 and 12) 3. Two assessments: Part A (including Essential Skills Clusters (ESCs) and Part B

Interview Records The preliminary interview (pg. 8) must take place by the end of the first week of placement following orientation and induction to placement. This is the opportunity for the mentor and student to discuss learning outcomes to be achieved during this placement. This interview should also be used to arrange learning experiences in other areas, insight visits, inter-professional learning and next meeting dates and times.

The intermediate interview (pg. 9) is designed to take stock of progress on the placement and complete the intermediate formative assessment relating to Part A of the assessment. It is also an opportunity to plan Part B assessments and consider other insight visits to enrich the learning experience. If any issues or concerns are identified, alert both the student and link lecturer early enough to allow the university link to attend this meeting. Feedback should reflect the progress in Part A.

The final interview (pg. 10) is designed to assess and record the achievement on this placement. The mentor should also identify areas for the student to focus on in the future. The feedback should reflect progress in Parts A and B. At this point mentors are required to sign a progression statement which should reflect the outcomes of Part A and Part B. Part A Assessment Part A assessment is comprised of 5 criterion:

1. Prioritise People (pg. 14) 2. Practice Effectively (pg. 15) 3. Preserve Safety (pg. 16) 4. Promote Professionalism and Trust (pg. 17) 5. Medicines Management (pg. 18)

Descriptors in each criterion will be assessed on a scale of 1-6 in accordance with the Skills Matrix, found on page 13. Part A is designed to assess the student continuously throughout the placement. By the end of the placement, students must achieve at least a ‘3’ in each descriptor for each criterion to pass overall. There is also a table identifying Essential Skills Clusters (ESCs) required over the full three years. As these can be attempted at any stage of the programme where opportunity presents during placement, mentors are asked to prepare and support the student in achievement of these skills and sign off as competent. Where students fail to achieve a ‘3’ or above in any descriptor this will indicate a ‘fail’ in that criteria. If this is anticipated at any stage, the mentor should contact the University Link Lecturer for support and direction regarding re-assessment of the criteria. Part B Assessment Part B consists of a Structured Situated Assessment based on an episode of care delivery: Episode of Care (EoC) (pg. 24) This assessment will be graded using the same 1-6 scale. Students must achieve a minimum of ‘3’ during this assessment to pass. This must be achieved by the end of the placement. A practice attempt is permitted during the placement period prior to the actual assessment. Any professional involved in assessing the student should include their name and signature on page 3 of this document.


Scheduled meetings and planning A formal meeting is required to discuss progress against the learning outcomes on three occasions:

First week of placement Intermediate point of placement Final week of placement • Orientation to placement

area: • Complete orientation

checklist. • Undertake placement

induction.

• Ensure student completes the formative self-assessment within this document with supporting evidence or experience to inform formative grade in each of the criteria.

• Ensure student completes their self-assessment within this document.

• Preliminary interview: • Ask to see the Ongoing

Achievement Record and review.

• Explore learning opportunities including other fields of nursing.

• Set learning objectives based on placement profile and ESCs required at each progression point.

• To support and inform your judgement, review the Ongoing Achievement Record during the assessment.

• Negotiate formative care episode, demonstrating required skills and discuss assessment

• Review Ongoing Achievement Record

• Seek confirmation of progress and achievement from insight/associate mentors.

Set dates for: • Intermediate interview. • Formative assessment. • Final interview.

• Assess all criteria and complete intermediate (I) assessment, providing clear and constructive feedback and recommendations for development

• Undertake final grading assessment of all criteria, provide clear and constructive feedback.

• The student may wish to undertake a Strengths, Weaknesses, Opportunities and Threats (SWOT) assessment to support identification of developmental needs and learning outcomes

• Set further learning objectives for remainder of placement including pre-negotiated episode of care summative assessment.

• Provide guidance for student and future practice mentor of skills/attributes required in future placement settings.

• A review of the student’s progress towards achieving their learning outcomes must take place at this point

• Obtain feedback from patients/service users and/or family/carers where possible.

• Obtain feedback from patient’s/service users and/or family/carers where possible

• Mentor and student to sign final declaration page at the end of the document.

A minimum of two assessment interviews are required, Intermediate (I), and Final (F) If you believe the student is not practising at a satisfactory level in one or more of the practice criteria, assess the student more than the minimum number during their placement. If necessary, an action plan can be developed and implemented as soon as problems are identified, at any stage during the placement. This must be communicated to the student and link lecturer. A blank action plan template can be found on page 35.


Additional Information

• Students will have completed all required mandatory training prior to commencing their placement.

• All students undertaking the pre-registration nursing programme have supernumerary status while on placement. This means they are additional to the workforce requirement and staffing figures.

• Every student nurse in the UK is required to receive both theory and practice experiences to meet the European Union Directive 2005/36/EC Article 31, amended by Directive 2013/55/EU. Students must be exposed to the following areas of clinical nursing care delivery during the three years of the programme:

1. Acute care 2. New born, paediatric and adolescent care 3. Maternal care 4. Long term care 5. General internal medicine and surgery 6. Mental health and psychiatric illness 7. Disability and care for disabled people 8. Geriatrics and care for the elderly 9. Primary health care, community care 10. Palliative care, end of life and pain management

• Student nurses, as part of a team and in direct contact with healthy or sick individuals and/or community,

will learn to plan, provide and assess the nursing care required of these patient groups. This requirement will be met through the placements allocation process with practice partners and the university providing the full range of opportunities across care pathways and the life span. Maternity and new born learning is achieved through prearranged placement dates, with a workbook and theoretical instruction from practicing midwives as part of our partnership arrangements. Competence will also be achieved through simulation activities delivered by the University.

• Contact the University on [email protected] as soon as you have any concerns

about a student’s performance or attendance, so that both the student and yourself can be supported and advised during the assessment process. Attendance and absences are all recorded via the Practice Placement Education Management System (PEMS) and mentors should let the University know of student absence using this method.

• Students should be continually assessed using feedback from the extended team, patients, service users and family/carers where appropriate.

• Attach any additional comments and/or action plans devised to assist a student to reach the required

standard to this document, ensuring they are dated and signed. This will provide evidence of an objective assessment.

• Students are required to complete the whole of the allocated placement. If the student is off sick or absent, they must notify the University and placement immediately via PEMS. The student must complete a minimum of four weeks (150 hours) of practice in order to have a valid summative assessment. Missed practice hours must be achieved. If students do not achieve the hours for the placement, they will refer/fail the placement. Students should not arrange additional placement weeks without contacting the placements office at the University.

• Please remember the student cannot question your professional judgement about their performance, but they can question the process. Therefore, the assessment process must be followed within the given timescales in order to uphold your assessment of the student. Early and clear feedback to the student is vital to ensure remedial action and robust assessment.

• If the student does not achieve the minimum grade 3 in any one criterion at the final assessment, then they will not achieve an overall pass. If the student does not pass the first attempt they are usually eligible for a further attempt in the early practice weeks of the next placement.

• Please refer to the Ongoing Achievement Record (OAR) as part of the preliminary, intermediate and final assessments. This document is kept by the student and should be presented to their mentor on each placement.



Placement 3A. Orientation

Student Signature/Date:

Mentor Signature/Date:

The following activities must be met within the first day of placement: An orientation to the practice placement setting has been undertaken including shift patterns, breaks, meal times, placement profile, nature of service, awareness of user group, intended interventions and clinical outcomes.

Placement specific fire procedures have been explained and student is aware of exit, alarms and fire safety equipment locations.

The student and mentor are aware of the university and trust escalation process and support mechanisms

The student understands and adheres to dress code, including Personal Protective Equipment (PPE) and local policy, and promotes a professional image

The student is aware of how to summon assistance in the case of emergency.

Resuscitation policy and procedures have been explained and the location and use of necessary equipment has been shown.

Information governance protocol including data protection, record keeping and confidentiality

The student is aware of where to find key policies and protocols for safe practise:

• Health and safety • Incident reporting • Infection prevention and control • Safeguarding and escalation of concerns • Lone working (as applicable) • Sickness and absence policy and reporting

procedure • Supply/administration/destruction/surrender of

controlled drugs including access to the most current version of the British National Formulary (BNF)

Practical arrangements such as: • Security access to practice area • Access to computer and learning resources • Storage of personal belongings • Break periods

The placement interface with other services or agencies and opportunities for inter-professional learning to inform opportunities, insight visits and learning plan.

Risk assessment and reasonable adjustments have been discussed and considered relating to disability/learning/pregnancy needs (where disclosed)

The following criteria must be met prior to student use: Any moving and handling equipment used in the practice area must be demonstrated in terms of safe use for student and service user/patient.

The student has had a demonstration of any medical devices and practices used in the practice area.


Placement 3A: Preliminary interview and learning agreement

This interview takes place within the first week of placement. A development plan, including learning outcomes to be achieved should be drawn up with reference to each criteria.

Prioritise people: Practice effectively: Preserve safety: Promote professionalism and trust: Medicines management: Mentor signature/date:

Student signature/date:

Agreed date for intermediate interview:

Agreed date for final interview:


Placement 3A: Intermediate Interview

To be completed mid-way through practice experience. Learning outcomes can be reviewed and changed as a result of this discussion. Any concerns about the student’s progress must be communicated to the academic link lecturer as soon as possible. The early warning checklist should be used to identify any concerns with the student’s performance (p 36).

Practice Mentor’s Comments. Agree new learning objectives as appropriate (continue on separate page if necessary) set date for part B assessment Prioritise People – Practice Effectively - Preserve Safety – Promote Professionalism and Trust - Medicines Management -

Student’s Comments (continue on separate page if necessary) Prioritise People – Practice Effectively - Preserve Safety – Promote Professionalism and Trust - Medicines Management - Summarise feedback from patients/relatives/carers/service users on the student’s performance.

Number of hours approved by mentor on PEMS to date:

Mentor signature/date:


Action plan initiated if necessary: (circle as appropriate)

YES

NO


Placement 3A: Final interview and statement of progression This final assessment of the student’s progress must include specific reference to their achievement of the identified learning outcomes. Please summarise the student’s overall performance and progress in the assessed criteria. If there are any concerns about this final assessment the link lecturer must be informed as soon as possible. As the mentor you are signing to confirm either: Sign: a) The student has passed all criteria to a minimum of grade 3 and passed

the episode of care assessment. Minimum hours are achieved. The student can progress to the next placement. OR

b) The student is not ready to progress to the next placement; is referred.

Based on the criteria: summarise the students level of achievement, professional development and developmental needs (including feedback from patients/relatives/carers/service users): Prioritise People – Practice Effectively - Preserve Safety – Promote Professionalism and Trust - Medicines Management -

Student comments: Prioritise People – Practice Effectively - Preserve Safety – Promote Professionalism and Trust - Medicines Management –

Number of hours approved by mentor on PEMS:

Mentor signature/date:


Action plan initiated if necessary: YES NO (circle as appropriate) Link Lecturer signature/date (if a tripartite meeting was held):


Innovation to Transformation in Nursing Practice: presentation feedback and marking

NUR3037M

Students will examine contemporary management and leadership issues that impact on health and social care. During the module and 3A placement, students will be encouraged to explore and evaluate a variety of approaches to management and leadership and reflect on personal styles and values based practice in a range of situations. The students will be encouraged to critically reflect on their own qualities as managers and their leadership and followership behaviours. This module will help them develop core skills in increasing their leadership potential to become a confident leader, follower and manager in their first career steps.

Specifically the students are required to engage in understanding the theory and practice of making a transformation in a clinical service, and design and evaluate a service transformation project.

During weeks nine to twenty, students must complete weekly action learning sets within their allocated groups. During weeks sixteen to twenty, students are required to design and present their ideas for a formal proposal of a service improvement project. They must present their ideas to their mentor for assessment and feedback no later than week twenty.

Students are required to:

• Attend weekly action learning sets and complete a journal detailing the action learning set discussions. The students will have one day a week (7.5 hours) away from practice to complete these. The student will only be required to complete 30 hours a week for this 9 week placement (total of 270 hours).

• Identify a potential problem within the area of practice that would be amenable to an innovative approach to improving practice. This should be discussed with their mentor.

• Review the literature in advance of the presentation in relation to theories of management and leadership, ensuring they deliver evidence-based proposals.

• Present to practice an outline of the problem they have identified and reflect on the approaches they would take to solve the problem within the services finite resources.

Please use the grading structure below to make your assessment of the student’s presentation

• The feedback and grading should be a collaborative effort of the audience, and at the minimum, should be the student’s assigned mentor.

Not competent Refer/Fail

Requires development

Refer/Fail

Satisfactory Meets the criteria to a satisfactory

standard

Good Meets the criteria to a standard higher

than expected

Very good Meets the criteria to a

high standard

Excellent Meets the

criteria to an exceptionally high standard

1 2 3 4 5 6 Please enter grade against each descriptor in the associated box

Assessment must be via direct observation


Assessment criteria for NUR3037M: Marking and Feedback Grid for in practice completion

Title of Transformation Project:

Name of Student: Student Number: Name(s) and designation of audience members:

Grade: 1. The student promotes a professional image, acts within

professional boundaries, values and understands the role of the multi-disciplinary team and interacts effectively, providing accurate and comprehensive written and verbal communication relevant to the proposed transformation project.

2. The student identifies and demonstrates an understanding of the problem and how the problem affects the service and its patients.

3. The students proposed project engages in such a way as to facilitate partnership approaches, recognising what current resources are available.

4. Creative skills: Evidence of clear structure to the presentation. Use of imagination and innovative thinking. Use of presentation aids such as handouts.

5. Interpersonal skills: Ability to manage self and others, engages the audience and is able to field questions. Demonstrates flexibility and improvisation if required.

6. Academic and thinking skills: Coherent and logical reasoning. Uses appropriate sources of data to support or refute assertions.

Audience feedback: Please detail what you felt the student did well. Please detail what you consider are important considerations for further development of this transformation project.

Sign: Date:


PART A Assessment

Part A Assessment Students are not required to produce a portfolio of evidence to supplement this PAD. The assessment should be carried out using direct observation, reflective discussion, question and answer, and discussion with the whole team and/or service users and carers as appropriate. Part A assessment is comprised of 5 criterion:

1. Prioritise People 2. Practice Effectively 3. Preserve Safety 4. Promote Professionalism and Trust 5. Medicines Management

Descriptors in each criterion will be assessed on a scale of 1-6. Part A is designed to assess the student continuously throughout the placement. By the end of the placement, students must achieve at least a ‘3’ in each descriptor for each criterion to pass overall. Students can achieve the whole range of grades across each placement. The Matrix below indicates the escalation of skills required at each level relating to each year of study, i.e. it is possible for a student to achieve a ‘6’ in year one, however the student will be expected to perform to a higher standard and with increased autonomy to achieve a ‘6’ in year three. The minimum grade to achieve in each placement in each year of practice is a “3”. Where students fail to achieve a ‘3’ or above in any descriptor this will indicate a ‘refer/fail’ in that criteria and placement, even if this has been met in a previous placement. If this is anticipated at any stage, the mentor should contact the University Link Lecturer as soon as possible for support and guidance.

Year 1

Year 2

Year 31

2

3

4

5

6Excellent

Very Good

Good

Satisfactory

Requires Development

Not Competent

Year 1 – Assimilating. High levels of directions and supervision

Year 2 – Engaging. Reducing levels of direction and supervision

Year 3 – Impacting. Minimal direction and supervision


Criterion 1 – Prioritise people Below expectations

Refer/Fail

1


Refer/Fail 2

Satisfactory Meets all of the

criteria and is safe to progress

3

Good Meets all of the

criteria to a standard higher than expected

4

Very good Meets all of the criteria to

a high standard

5

Excellent Meets all of the criteria

to an exceptionally high standard

6

Student and Mentor: Please insert indicative grade (see above) for intermediate and final grade Self Mentor 1. Confidently engages service users, carers and professionals, forms professional relationships,

initiating and ending episodes of care appropriately, based on experience, knowledge, skills relevant to the field

Intermediate Final

2. Interacts with patients/service users demonstrating sensitivity, respect, kindness, care and compassion across the lifespan, end of life and after death, in a range of settings as appropriate

Intermediate Final

3. Demonstrates effective written and spoken communication skills, ensuring information, privacy, dignity and confidentiality is upheld. Is able to challenge and defend practice, convey “unwelcome news”

Intermediate Final

4. Practices in accordance with Nursing and Midwifery Council (NMC)The Code – Professional standards of practice and behaviour for nurses and midwives (NMC, 2015); recognises confidentiality and is aware of when confidentiality must be breached, for example harm to self or others, acting in public interest subject to agreed safeguarding and protection procedures

Intermediate

Final

5. Empowers patient/service users in assessment, treatment and care decisions including individual choice, supports health promotion via information, facilitates self-care and management, the right to refuse care or treatment and partnership approaches to care delivery including complementary therapy

Intermediate Final

6. Assesses and recognises factors such as pain, anxiety or distress and responds and communicates appropriately, questioning, paraphrasing and reflecting to support therapeutic intervention

Intermediate Final

7. Represents the needs of patients/service users and their carer’s, working in partnership with colleagues and other care providers, Recognises own values and assumptions

Intermediate Final

8. Respects individual patient/service user preference, regardless of personal assumptions or beliefs. Is able to challenge others where rights are compromised.

Intermediate Final

9. Understands how culture, age, religion, spiritual beliefs, disability, gender and sexuality can impact on health, clinical outcomes, recovery and management of illness

Intermediate Final

10. Enhance communication recognising equality and diversity and factors inhibiting capacity, comprehension, interaction and understanding, involving carers and other professionals as appropriate

Intermediate Final

11. Identifies and uses strategies to enhance communication where barriers present, such as impairment, cognition, language, culture or pain for example

Intermediate Final

Intermediate


12. Ensures access to independent advocacy; upholds legal rights; acts autonomously and proactively in promoting care environments free from discrimination, harassment and exploitation

Final


Criterion 2 – Practice Effectively Below expectations

Refer/Fail 1


Refer/Fail 2

Satisfactory Meets all of the criteria and is safe to progress

3

Good Meets all of the criteria

to a standard higher than expected

4


a high standard

5



6

Student and Mentor: Please insert indicative grade (see above) for intermediate and final grade Self Mentor 1. Takes a person-centred approach to care, promoting self-management of conditions, delivering

interventions, empowering people to make informed choices, using a range of strategies, Intermediate

Final 2. Promotes well-being, prevents ill health and practices in a non-judgemental manner, maintains

privacy and dignity; is responsive, sensitive and compassionate towards patients/service users and carers

Intermediate

Final 3. Ensures clear and accurate records are kept, relevant to scope of practice, are countersigned and

maintains confidentiality aligned to information governance. Offers accurate, evidenced verbal reports Intermediate

Final 4. Confidently makes use of and links research and knowledge of anatomy, physiology, sociology &

psychology to assessment, care planning and multi-disciplinary care delivery; refers to agencies/services

Intermediate Final

5. Refers to best available evidence and uses and interprets data when undertaking a range of assessments linked to fundamentals of care. Distinguishes between relevant and irrelevant information

Intermediate Final

6. Has knowledge of reporting mechanisms and raising concerns process; manages and diffuses challenging situations; shares information with care professionals, seeks advice/supervision where service user/patient status is changed or where safety is in question

Intermediate Final

7. Confidently and consistently communicates effectively, active listening, questioning, paraphrasing and reflection to support therapeutic interventions. Records information, utilising manual assessment and recording mechanisms and technology, recognising emotional and physiological reactions and responds

Intermediate Final

8. Acts to ensure care assessment, intervention and communication is undertaken without undue delay, recognising limitations of own knowledge, skills and competence, seeking assistance where necessary

Intermediate Final

9. Delivers the fundamentals of care, autonomously measures and documents a range of observations, vital signs and diagnostics, carries out bio-psycho-social assessments including cultural and spiritual needs; acts on findings, confidently plans and evaluates care with minimum supervision, signposting as required

Intermediate Final

10. Undertakes comprehensive assessment of nutrition requirements; dietary and fluid intake and output; recognises signs of dehydration and acts to correct; monitors and records

Intermediate Final

Intermediate


11. Recognises signs and symptoms and prevents infection using a range of measures, understands the principles of wound management and aseptic techniques

Final


Criterion 3 – Preserve Safety Below expectations

Refer/Fail 1


Refer/Fail 2


criterion and is safe to progress

3


criterion to a standard higher than expected

4

Very good Meets all of the criterion to

a high standard 5

Excellent Meets all of the criterion to an

exceptional standard 6

Student and Mentor: Please insert indicative grade (see above) for intermediate and final grade Self Mentor

1. Works within the limitations of the role and recognises own level of knowledge, skills and competence and take action as necessary

Intermediate Final

2. With increasing autonomy, assesses risk and implements measures to manage risk within current sphere of knowledge and competence; recognises when situations are becoming unsafe, reporting appropriately and acting without delay where risk to public or patient safety is apparent including where this is a result of patient choice

Intermediate Final

3. Selects appropriate strategies for conflict resolution and de-escalation, minimising risk, escalating concerns and documenting. Recognises need for positive risk taking at times

Intermediate Final

4. Reports adverse incidents, near misses and “never events” to appropriate responsible staff member and records in required incident reporting logging system for such events

Intermediate Final

5. Responds with increasing autonomy to potential and actual signs of infection or deterioration of service users/patients and reports to relevant members of staff without undue delay, working as a team

Intermediate Final

6. Recognises potential and actual risk or harm to others and works within legal framework and local policies for safeguarding adults and children

Intermediate Final

7. Recognises risk factors from and to patients and members of the public where, for example alcohol, drugs, pain, confusion, dehydration, altered cognition such as anxiety or delirium are present and take direction and steps to minimise or refer to more expert/specialist individuals or services as necessary

Intermediate Final

8. Reports unsafe practice or professionalism of others (if occurs) or is aware of the mechanism to do so Intermediate Final

9. Ensures the meaning of capacity, consent and treatment is understood, ensures information is accurate and repeated if necessary, prepares patients/service users for treatment interventions or transfer

Intermediate Final

10. Understands and adheres to national and local health and safety requirements including infection prevention and control, hand/food hygiene, moving and handling, medical devices, and challenges/risks

Intermediate Final

11. Practices within appropriate clinical governance and organisational frameworks; participates in and acts on outcomes of clinical/quality audit to drive improved clinical outcomes and safety

Intermediate Final

12.Uses support systems as a means of developing strategies for managing own workload, stress, emotions and for sharing and promoting best practice, working safely and effectively

Intermediate Final

13.Acts autonomously and proactively in promoting culturally sensitive care environments, free from harassment and discrimination or exploitation

Intermediate Final



Criterion 4 – Promote professionalism and Trust Below expectations

Refer/Fail 1


Refer/Fail 2


criterion and is safe to progress

3


criterion to a standard higher than expected

4

Very good Meets all of the criterion to

a high standard 5

Excellent Meets all of the criterion to an

exceptional standard 6

Student and Mentor: Please insert indicative grade (see above) for intermediate grade and the final grade Self Mentor 1. Articulates the underpinning values of The Code: Professional standards of practice and

behaviour for nurses and midwives (NMC, 2015) Intermediate

Final 2. Practices with integrity, honesty and objectivity, promoting a professional image. Demonstrates

emerging leadership and management qualities, attributes and skills, provides clear direction and delegation working inter-professionally and autonomously to achieve optimum outcomes

Intermediate Final

3. Personal image, presentation and dress code is aligned to the organisation’s uniform and infection prevention and control policy

Intermediate Final

4. Maintains a consistent professional attitude, is punctual and communicates as required if absent; Is cognisant of behaviour and impact related to use of social media and risk to reputation of self and the profession

Intermediate Final

5. Adheres to policies, legal and ethical frameworks for information governance, seeking consent prior to sharing confidential information outside of the professional care team

Intermediate Final

6. Acts as a role model, demonstrating attitudes and values conducive to becoming a registered nurse, upholds the reputation of the profession at all times. Develops trusting relationships across professional and organisational boundaries

Intermediate Final

7. Accepts delegated activities within limitations of role, knowledge and skill, addresses deficits to make informed decisions. Demonstrates effective time and workload management, deals with competing priorities, reflects and learns from mistakes

Intermediate Final

8. Uses professional support structures to learn from experience and make appropriate adjustments, recognising and valuing others roles and responsibilities, promoting inter-professional learning, negotiating conflicting goals and priorities

Intermediate Final

9. Is self-aware, able to reflect, is self-confident and has insight into own practice, behaviours and beliefs and impact on others. Is able to defend clinical decision making appropriately and confidently, making use of available evidence and with reference to the patient/service user clinical need

Intermediate Final

10. Responds appropriately to feedback, complaints, comments, compliments and shares with the team to improve care, escalates as appropriate

Intermediate Final

11. Proactively seeks to extend knowledge and uses initiative and commitment to enhancing own learning, and professional development. Actively facilitates other’s learning – identifying strengths and attributes to help them achieve their goals and aspirations

Intermediate Final


Criterion 5 – Medicines Management Below expectations

Refer/Fail 1


Refer/Fail 2

Satisfactory Meets all of the criteria and is safe to progress

3

Good Meets all of the criteria

to a standard higher than expected

4


a high standard

5



6

Student and Mentor: Please insert indicative grade (see above) for intermediate and final grade Self Mentor 1. Is proficient in calculating prescribed dosages of increasingly complex medications accurately Intermediate

Final 2. Demonstrates understanding of National Institute for Health and Care Excellence (NICE) guidance,

legal and ethical frameworks relating to medicines management, requirements in relation to mental health and mental capacity, children and young people

Intermediate Final

3. Demonstrates and articulates an understanding of types of prescribing (for example, patient group/specific directions) types of prescribers and routes of administration with reference to the most current version of the British National Formulary (BNF)

Intermediate Final

4. Demonstrates ability to safely store and transport medicines under supervision– this may be in any care setting including residential or home

Intermediate Final

5. Understands how to use prescription charts and the importance of maintaining accurate records. Demonstrates the correct method of recording the administration of medicines.

Intermediate Final

6. Collaborates and communicates effectively with team members to discuss and enhance knowledge and safety, demonstrating awareness of roles and responsibilities of the Multi-Disciplinary Team (MDT) for medicines management

Intermediate Final

7. Is aware of the importance of and understands reconciliation of medications Intermediate Final

8. Involves patient’s/service users and carers in administration and self-administration of medicines, recognising expert patient roles

Intermediate Final

9. Is aware of a range of common medicine groups. Applies knowledge of basic pharmacology, how medicines act and interact, and their therapeutic action (including reasons for prescription, absorption, metabolism, side effects, duration, recording and potential risk).

Intermediate Final

10. Works confidently as part of the team to develop treatment options and choices. Is aware of circumstances under which medication may be withheld and/or withdrawn.

Intermediate Final

11. Demonstrates awareness of a range of commonly recognised approaches to managing symptoms, for example, relaxation, distraction and lifestyle advice; discusses referral options

Intermediate Final

12. Is able to describe the signs of adverse reaction to prescribed medication (for example anaphylaxis/ocular gyro crisis for example and action required), acts promptly where reactions occur

Intermediate Final

Intermediate


13. Is aware of and adheres to policy around infection prevention and control (for example safe disposal of waste and “sharps” and policy/action for needle-stick injury or exposure to infectious fluid or substances)

Final

Essential Skills Clusters (ESCs) Assessments

The student is required to achieve these specific skills by the progression point stated below, but they can attempt them at any stage of the programme.

Please document any comments and/or feedback on page 22. A student may have several attempts at these skills in each placement and additional documents may be requested as needed.

The student can make a comprehensive assessment of patients’ needs in relation to nutrition identifying, documenting and communicating level of risk in accordance with local policy (By end of Year 3)

Pass/Refer (please circle)

Mentor signature Date

1. Demonstrates a safe, professional, caring approach to the individual Pass Refer 2. Gains valid consent Pass Refer 3. Communicates effectively to gain an accurate patient / client history Pass Refer 4. Accurately completes a nutritional risk assessment Pass Refer 5. Recognises any actual or potential problem with the individual’s dietary intake Pass Refer 6. Communicates the level of risk to other appropriate professionals Pass Refer 7. Identifies when reassessment needs to take place Pass Refer 8. Documents the assessment appropriately Pass Refer 9. Can explain the local support and reporting systems to deal with nutritional problems Pass Refer

The student can identify signs of dehydration and acts to correct these in accordance with local policy (By end of Year 3)



1. Demonstrates a safe, professional, caring approach to the individual Pass Refer 2. Gains valid consent Pass Refer 3. Follows correct infection control procedures Pass Refer 4. Identifies signs and symptoms shown by the individual which indicate that they are dehydrated Pass Refer 5. Explains the possible reasons why the individual has become dehydrated Pass Refer 6. Takes appropriate action to correct the dehydration and prevent any further dehydration occurring in accordance with local policy

Pass Refer

7. Documents the assessment findings and adjusts the plan of care appropriately Pass Refer


Safely manages drug administration and monitors effects. The student safely and effectively prepares medicines where necessary, and administers via commonly used routes and methods, maintaining accurate records (By end of Year 3)

Pass/Refer (circle)


1. Demonstrates a safe, professional, caring approach to the individual Pass Refer 2. Gains valid consent Pass Refer 3. Follows correct infection prevention and control procedures whilst preparing and administering medicines

Pass Refer

4. Prepares equipment required (as appropriate) Pass Refer 5. Checks and Confirms:

a. The identity of the patient according to local policy and procedure b. Allergies and adverse effects related to the individual c. Weight if required

Pass Refer

6. Checks the patient specific direction (prescription): a. Date b. Time c. Start and review date as appropriate d. Name and form of the medicine to be given e. Last time dose given f. Dose prescribed g. Route of administration h. Signed by the prescriber i. Any additional advice e.g. after food j. Any once only or as required medicines needed

Pass Refer

7. Reports any errors or concerns about the prescription Pass Refer 8. Demonstrates knowledge of the therapeutic use, dose, routes, side effects, precautions, contraindications of the medicine with reference to the BNF, BNFC (children) or pharmacist

Pass Refer

9. Selects the correct medication, checks the label and dosage carefully against the prescription (including any diluent)

Pass Refer

10. Checks the expiry date of the medicine Pass Refer 11. Calculates the correct dose Pass Refer 12. Measures / dispenses the correct dose Pass Refer 13. Performs final check of individual identity Pass Refer 14. Administers medication and observes it is taken Pass Refer 15. Accurately completes documentation Pass Refer


16. Demonstrates knowledge of monitoring, reporting and recording of side effects, allergic reactions, effectiveness of medication

Pass Refer

17. Provides the individual with the appropriate information, advice and promotes concordance Pass Refer 18. Explains the correct disposal of unwanted medicines Pass Refer 19. Disposes of used equipment safely (if applicable) Pass Refer The student is competent to administer enteral feeds safely and maintains equipment in accordance with local policy (By end of Year 3)



1. Demonstrates a safe, professional, caring approach to the individual Pass Refer 2. Gains valid consent Pass Refer 3. Follows correct infection control procedures Pass Refer 4. Selects the correct feed, expiry date and condition of feed Pass Refer 6. Prepares the equipment Pass Refer 7. Places the individual in an appropriate position for feeding Pass Refer 8. Ascertains the enteral feeding tube is correctly sited and is patent using local policy Pass Refer 9. Attaches feeding tube to the administration equipment Pass Refer 10. Delivers the feed at the correct rate according to the feeding regime Pass Refer 12. On completion, flushes the enteral tube in accordance with local policy Pass Refer 11. Monitors the individual appropriately during feeding Pass Refer 13. Caps the end of the enteral tube and positions the tube for safety and comfort for the patient Pass Refer 14. Disposes / maintains equipment safely, documents accurately Pass Refer 16. Monitors the individual appropriately after feeding Pass Refer

The student can monitor and assess patients / clients receiving intravenous fluids (IV) and documents progress against prescription and markers of hydration according to local policy (By end of Year 3)



1. Demonstrates a safe, professional, caring approach to the individual Pass Refer 2. Gains valid consent Pass Refer 3. Follows correct infection control procedures Pass Refer 4. Checks the correct infusion is in place and is running to time Pass Refer 6. Monitors infusion site for signs of abnormality and pain Pass Refer 7. Checks date for IV giving set to be changed Pass Refer 8. Can evaluate and discuss the individuals hydration status Pass Refer 9. Monitors and is able to discuss the possible complications of IV fluid therapy Pass Refer 10. Explains how the individual receiving the IV therapy should be subsequently monitored Pass Refer 11. Completes all documentation accurately Pass Refer


Comments and/or Feedback on ESCs assessment attempts Mentor:


Student:


PART B

Structured Situational Assessment: Episode of Care (EoC)

Students are required to undertake a structured situational assessment in each placement and mentors are responsible for carrying out the assessment with their student. A formative assessment should occur in advance to help prepare the student and should be documented to support student reflection and self-assessment. The summative assessment is an episode of care which incorporates the 5 criterion skills and competencies:

Students can be given the opportunity to undertake the assessment in a formative way to develop their skills up to two weeks after intermediate interview, but in order to pass the placement and the module, a summative assessment must take place at a mutually negotiated date up to three weeks prior to the final interview. The summative assessment must be achieved before the final interview. In order to pass the assessment, students must achieve at least a level 3 or above in each of the criteria. The Episode of Care forms part of the assessment for the module. The grades given here will form 80% of the student mark (calculated at University). If they do not achieve at least level 3 during the summative attempt, they will be referred on this placement. If this is the case, the mentor should contact the University link. Moderation: The University link lecturers will randomly select a sample of students and observe these assessments for moderation purposes. If you would specifically like the link lecturer to moderate your assessments, please make contact with them.

As a mentor you must plan to observe and assess the student carrying out a pre-negotiated episode of care (EoC). Guidance is included in the following pages and essentially focusses on:

• Professional values; • Care, compassion and communication; • Nursing practice and decision making; • Enabling patients to actively participate in their care • Recognising and respecting the role of carers; • Infection prevention and control; • Nutrition and fluid management; • Medicines management • Organisational aspects of care; • Team working

The student must then reflect upon their practice and discuss this with you prior to completion of the assessment documentation. The student must demonstrate insight into own communication, empathy and compassion and the experience of the patient receiving care. They must discuss the knowledge underpinning their practice and decision making. They should also identify any limitations to their practice and skills and suggest how they may develop these in the future. If the student does not perform to the required standard, they should be given a further opportunity to repeat this assessment.

Where administration of medication is limited within the placement profile, the student must demonstrate knowledge underpinning their understanding of medicines management, and have knowledge of mentor identified drug groups, their expected effects, side effects and interactions. The student should also identify who needs to be involved in decisions around care and medication, collaborative partnership working and effective communication to improve outcomes and quality of life for the service user.


Structured Situated Assessment: An Episode of Care 3A

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The student promotes a professional image, acts within professional boundaries, values and understands the role of the multi-disciplinary team and interacts effectively when delegated work, providing accurate and comprehensive written and verbal communication relevant to the episode of care.

The student is aware of the reason for referral, is prepared for undertaking the episode of care and understands the medication prescribed, potential effect and side effects, interactions and monitoring requirements for the individual when medication is prescribed.

The student introduces themselves appropriately, aware of the impact of self on others and of the individual’s emotional and physical responses.

Maintains infection prevention and control and moving and handling requirements, for example according to local policy. Is aware of reporting mechanisms and raising concerns process.

The student engages in such a way as to preserve privacy, dignity and facilitates partnership approaches to care planning and decision making, recognising the right to refuse care.

The student nurse treats the individual and their carers’ in a person centred, non-judgmental, sensitive, dignified and respectful way.

The student demonstrates an understanding on how religion, culture, gender, age, disability, sexuality, spiritual beliefs for example can impact on health, illness and recovery.

The student explains the purpose of their involvement, gains consent, respects confidentiality, communicates effectively with appropriate listening, responding and questioning, offering information and reassurance as appropriate within their sphere of knowledge.

The student uses ways to maximise communication with individuals in their care, when factors such as hearing loss, cognitive impairment, confusion, anxiety, vision or ability to speak or understand is compromised.

Essential care may focus on: emotional and psychological health, nutrition, infection prevention and control, pain management, provides adequate and appropriate personal care, assesses effect of medication, side effects, recovery or deterioration. Ensures nutrition and hydration are adequate at all times if the patient is unable to manage this themselves, recognises mobility and communication factors, assesses risk; maintains patient safety.

Student reflects on own preparation, interactions and interventions and mentor and student assess. Further discussion may include: Who needs to be involved in decisions around care, what professionals, agencies, services, assessments, treatment options and accessibility?

Mentor: Consider the quality of the care delivered during the episode of care and to what level professional values, communication and compassion and decision making appropriate to the needs of the individual?

To what extent did the student act within their sphere of competence and skills, using initiative and evidence relevant to patient need? Has the student demonstrated insight into areas for future development and skills acquisition and the opportunities for this to occur?

Patient/Service User feedback of experience and recommendations to support assessment and future development – not graded

Mentor Name Mentor Signature Student Name Student Signature

Not competent Refer/Fail


Refer/Fail

Satisfactory Meets the criteria

and is safe to progress

Good Meets the criteria to a standard higher than

expected

Very good Meets the criteria to a

high standard

Excellent Meets the criteria

to an exceptionally high

standard 1 2 3 4 5 6

Mentor, please enter grade against each descriptor in the associated box Assessment can be either direct observation or indirect where privacy and dignity may be compromised



Patient/service user feedback form

A Mentor will approach service users in receipt of care to obtain consent and will be aware of the right to decline to participate

We are interested in your views about the way the student nurse has been looking after you and/or your carer. Your feedback will help the student nurse to learn and any feedback offered will not change or impact on the way you are looked after. Thank you

Tick if you are: A patient/service user A carer or relative How happy are you with the way the student nurse……

Very Happy Happy I’m not sure Unhappy Very unhappy

Cared for you?

Listened to you?

Talked to you?

Preserved privacy and dignity?

Demonstrated respect?

Undertook care assessment and delivery?

What did the student nurse do well? What could the student nurse have improved on? Mentor signature: Date:

Student signature: Date:


Mentor Comments and feedback Structured Situated Assessment: An Episode of Care

Description of the Episode of Care: Areas of good practice: Care based discussion summary: Areas for development: Service user feedback: Please circle Positive/Negative

Student Name:

Mentor Name:

Mentor Signature:

Date:


University of Lincoln Moderation

Structured Situated Assessment: An Episode of Care

Student Name: Statement for purpose of moderation: ‘We are looking to understand how you came to give the grades you have for each of the criteria for the Episode of Care’ Question to mentor: Can you tell me what the Episode of Care was – what did the student have to do? Discuss with mentor: Go through each EoC criteria and ask why that grade was awarded. Discuss with student: How did you feel about undertaking this EoC? (Did you get a chance to practice, was it arranged, how do you feel about the grades?) Moderator Name:

Moderator Signature:

Mentor Name:

Mentor Signature:

Date:

Grades Discussed:

Action Required:


DECLARATION PAGE

Student

I declare that this document is a true and accurate record of my time in practice

I declare that I have submitted all hours completed on this placement for approval by a mentor on PEMS

Mentor

I declare that this document is a true and accurate reflection of the student’s time in practice

I declare that I have approved all hours the student has submitted on PEMS

Student Name

Student Signature Date

Student Name

Student Signature Date Total number of hours submitted for the placement:

Mentor Name

Mentor Signature Date

Mentor Name

Mentor Signature Date Total number of hours approved for the placement:


STUDENT: please document any insight visits on the following pages. Please list here the learning opportunities you have experienced on this placement with reference to other fields (mental health, children, learning disability) and specialties of nursing (acute care; new born, paediatric and adolescent care; maternal care; long term care; general internal medicine and surgery; mental health and psychiatric illness; disability and care for disabled people; geriatrics and care for the elderly; primary health care, community care; palliative care, end of life and pain management) (EU requirements)



Evidence of additional learning experience/activity and/or inter-professional learning

• So as to capture the range of opportunities students should briefly outline any visits or experience that they or their mentor have arranged to complement their practice experience. This will include visits to observe procedures or therapies conducted away from the allocated experience, time spent with specialist nurses and/or working with and learning from members of other professions.

• Students should name the experience and identify the purpose of that experience • Student should summarise the activities of learning, give brief evidence of the learning and how this can be applied elsewhere. This may be detailed as

bullet points. • Should there be nothing of note to record, it is not mandatory during each placement, however is recommended that you seek alternative, inter-

professional learning across each year within insight or pathway placements to complement your learning. • This record should be kept with the practice learning assessment documentation (PAD) and should be used to contribute to discussion during the final

assessment. It may also be used to contribute to the student’s Ongoing Achievement Record.

Type of visit/experience and dates:

Student to identify purpose of learning experience.

Activities of learning. How can this be applied elsewhere?

Comments from supervisor of learning experience (to include professionalism, knowledge, attitudes, behaviour and skills).

Supervisor signature: Student signature: Hours completed:

















Activities of learning and evidence. How can this be applied elsewhere?












Action Plan template

This action plan is for use by mentors in practice with support from the University and should be completed if the student has received less than “satisfactory” grade in any criteria. Actions should be specific, measurable, achievable, relevant and timely. Where an action plan has been provided by an academic it must be attached to this document. Please use cause for concern early warning checklist to formulate the action plan. Use additional pages as necessary.

ACTION PLAN

PAD criteria

Action State who will do what, by when and to what

standard (where relevant)

Resources/support Date for review

Student name: Signature: Date:

Mentor name: Signature: Date:


Cause for Concern Early Warning Checklist If concerns are identified at any stage, these statements can be used to formulate an action plan in the template provided on page 35. Indicate a yes

against those statements best describing concerns; asterisk if individual. Where concerns differ from examples, document within action plan. Contact your link lecturer or the university on [email protected] to report a formal Cause for Concern and/or raise a Problem Resolution

Protocol (see Practice Handbook for guidance). PAD Criteria Early warning concern Yes Comments

Practice Effectively • Has no insight into weakness so unable to change following constructive feedback • Practical interpersonal and communication skills are not appropriate to their level of experience • Demonstrates inability to deal with difficult situations for their level of experience • Poor written record keeping • Lacks insight into the impact of their communication on others • Demonstrates a lack of empathy, respect, dignity and caring towards clients/carers and colleagues

Prioritise People • Is preoccupied with personal issues • Is not motivated and shows lack of interest • Does not respond appropriately to feedback • Is unable to effectively work within the team • Shares personal experiences with patients and clients inappropriately • Lacks insight into their behaviour towards others

Preserve Safety • Demonstrates inconsistent clinical performance to their level of experience • Has demonstrated unsafe clinical practice • Is unable to demonstrate preparation and organisational skills to their level of experience • Is unable to relate actions to potential risks re self, patients and colleagues • Misuse of IT and/or electronic patient records

Promote Professionalism and Trust

• Demonstrates poor professional behaviour and is unaware of professional boundaries • Is unreliable – i.e. persistent lateness/absence/sickness • Evidence of breaching confidentiality, of patients, peer group, placement or university staff • Evidence of inappropriate use of social media • Uses mobile phone to text while in clinical area • Does not adhere to uniform policy • Inappropriate use of electronic mail, text messaging and social network sites • Does not demonstrate respect for all members of the team



Medicines Management

• Does not have required knowledge for their level of experience • Has little or no ability to translate numerical calculations into drug administration • Unable to apply theory to practice • Does not meet the required level of competencies for their level of experience • Is unsafe in recognising need for storing, recording or monitoring side effects of medications for

example • Appears to have little understanding of legislation around medicines management, legal and ethical

frameworks • Does not use initiative in knowledge acquisition around drugs associated with patient profile for

placement area, routes of administration, side effects, adverse reactions for example