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Preceptorship Framework
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NewTrustPreceptorshopKS2009:CDDFT
PRECEPTORSHIP PATHWAY
NAME OF PRECEPTEE
……………………………
NAME OF PRECEPTOR
…………………………..
AREA OF WORK
…………………………..
DATE COMMENCED
………………………….
Amended May 2009 & March 2010
Preceptorship framework 2011KS 2008:CDDFT 2
Preceptorship framework 2011KS 2008:CDDFT 3
Contents page
Page Introduction
3
Preceptorship definitions
4
Preceptorship framework
5
Preceptorship contract
10
SWOT Analysis
11
Plan for supernumerary period
13
Three-month review document
14
Competencies
15-22
Reflection and self-evaluation
23-27
Action for non-achievement
28
Medicine Management Documentation A Competency Assessment for Qualified Nursing Staff
30-33
Plan for continual professional development
34
Completion of Preceptorship
35
Evaluation
36
Preceptorship framework 2011KS 2008:CDDFT 4
Introduction The Nursing and Midwifery Council (NMC, 2001, 2006) and The Health Professionals Council
(2008) strongly advocate the provision of preceptorship as a method for providing transitional
role support from student to qualified practitioner status, The Chief Nursing Officer and the
Chief Health Professionals Offices (DH 2010, p4) state 'the period of time following registration
as a health care professional, whether on completion of an educational programme or
following a break from practice can be a challenging time. We all know that good support and
guidance during this time is essential. Newly registered practitioners who manage the
transition successfully are able to provide effective care more quickly, feel better about their
role and more likely to remain in the profession. This means they make a greater contribution
to patient care, but also ensures the benefits from the investment in their education is
maximised'.
County Durham & Darlington Foundation Hospitals NHS Trust (CDDFT) actively encourages
the use of preceptorship as part of the Clinical Governance agenda to help employees achieve
their full potential, while promoting patient safety through the provision of evidence based high
quality care.
This pathway should be used in conjunction with the following documents and may
be cross referenced where appropriate to avoid duplication.
Knowledge and skills framework (KSF) outline for your post
KSF appraisal folder
Your personal professional portfolio
Local competency documents – where appropriate ITU, A+E COMMUNITY etc
Clinical updates available on the Trust Intranet
A preceptee is:
A newly registered practitioner who is entering practice for the first time
A practitioner entering a different field of practice by means of a second registration
A practitioner returning to practice following a break of five years or more
A practitioner newly admitted to the register from other European Economic
Area States and other nation states
In some instances a newly appointed member of staff changing their area of
practice if the line manager considers this to be beneficial
A preceptor is:
Preceptorship framework 2011KS 2008:CDDFT 5
A registered practitioner who has a minimum of twelve months (or equivalent part time)
post-registration experience within the same field of practice as the preceptee.
The approach to mentoring a newly qualified practitioner is significantly different to that we
use with pre-registration or undergraduate students. Whilst drawing on the same skills,
within the context of being a preceptor you are working with a registered practitioner as a
guide or “coach” rather than signing off a student’s competency.
Responsibilities The Ward/Department Manager should ensure that preceptorship is provided to staff by:
Ensuring that a preceptor is allocated to the preceptee before the commencement
date to allow the preceptor time to prepare and plan for the initial supernumerary period
programme.
Arrange the off duty to allow the preceptor and preceptee to work two shifts OR 40% their
time together per week for six weeks.
Providing the preceptee with the Trust Preceptorship Framework and supporting study day
timetable (if appropriate). Study time should be allocated for attendance on the
programme and progress meetings, which should take place once a month (lasting for one
hour).
Formally arranging to meet with the preceptor and preceptee at the beginning of the
programme, and again at three months, to discuss and agree the preceptee’s personal
development plan and any outstanding issues from the preceptorship programme.
**During this period of preceptorship the preceptee may be working towards the
foundation gateway for their post and will need clear guidance, through appraisal,
to enable accelerated transitional points to be achieved (if identified for that post)
Where areas of non-achievement are identified at any stage, which cannot be resolved by the Preceptee and Preceptor, a meeting should be arranged with the line manager to agree a course of action. To sign the completion of preceptorship section in the framework document and return it to the Senior Nurse Practice Placements (PPF) A copy should be retained in the personnel file. Discuss clinical supervision and the allocation of a supervisor.
Preceptorship framework 2011KS 2008:CDDFT 6
The preceptor has a responsibility to:
Following the NMC consultation on Fitness for Practice at the Point of Registration
(2006) the response suggests that preceptors should:
Facilitate the transition of newly qualified registrants from student to a
registrant who is confident in their practice, sensitive to the needs of the
patients, an effective team member and up-to-date with their practice and
knowledge
Provide positive feedback to new registrants on good performance.
Provide honest, constructive and objective feedback on performance that are a
cause for concern and provide support through action planning to remedy these
Facilitate new registrants to gain knowledge and skills
Be aware of the standards, competencies, or objectives set by the employer
that the ‘new registrant’ is required to achieve and support them in achieving these
(NMC 2006)
The preceptee has a responsibility to:
Practice in accordance with the **NMC (2008) The Code Standards of conduct,
performance and ethics for nurses and midwives or HPC regulations
Identify and meet with their preceptor as soon as possible on taking up post
Identify their specific learning needs and develop an action plan to address these
Be aware of the standards, competencies, or objectives set by their employer that
they are required to meet
Reflect on their practice and experience
Seek feedback from both their preceptor and other members of the team
Complete the Trust Preceptorship Framework and ensure that it is signed by both their
preceptor and line manager and added to their professional portfolio
Seek clinical supervision as the next step to support
Preceptees must take responsibility for their own learning and the identification of any
Deficits in their knowledge and skills although a preceptor will facilitate this.
** This only applies to newly qualified Staff Nurses
Preceptorship Contract Checklist
Checklist Signed Date
The two day Corporate Trust Induction has been undertaken where necessary to include:
Moving and handling Fire Basic life support
A copy of the Outline for the post and job description has been given to the preceptee
The preceptee has undertaken a SWOT Analysis of their current position to help them to identify areas for development/support
An initial programme has been drawn up for the supernumerary period and entered into this booklet
Conflict Resolution Training has been booked
A tri partite meeting has been booked with the preceptee,
preceptor and line manager for the first week in post to
discuss areas for development/support and initiate a Personal
Development Plan (PDP)
Off duty has been planned to allow for the preceptee and preceptor to work on the same shifts for two days per week (initially)
Dates to attend the Trust Preceptorship Training Days if appropriate.
Month One …………………………………….. Month two ……………………………………. Month three ……………………………………. Month four …………………………………….
NMC registration has been discussed and renewal date documented in the personal file by the line manager
A tripartite meeting has been booked for three months to discuss and
Preceptorship framework 2011KS 2008:CDDFT 7
update the PDP
Any other individual arrangements should be entered below
All Acute Adult areas a place on the Aims Course has been arranged and booked.
If working in a surgical area Epidural pump & P’cam training has been arranged and booked.
If working within paediatrics a level 2 child protection and PLS days have been arranged and booked.
Additional checklist add below any specific to area of work
Preceptorship framework 2011KS 2008:CDDFT 8
The Nursing and Midwifery pledge To deliver high quality care
Preceptorship framework 2011KS 2008:CDDFT 9
Nurses and midwives will lead and manage the delivery of high quality, compassionate
care. We will be at the leading edge of innovation, always challenging the status quo and
taking responsibility for creating new solutions.
Nurses and midwives, acknowledging that we are responsible for ensuring that health
care decisions are informed by our expertise, will engage more directly with policy-
making and decision-making. This includes decisions on funding priorities, health care
technologies, and the development of innovative models of care.
works' best.
Nurses and midwives, acknowledging the public investment in our education, training
and continuing professional development, will commit to delivering care that is evidence-
based and effective, and evaluating and researching it to expand our knowledge of what
Nurses and midwives, recognizing our important role in improving health and wellbeing
and reducing inequalities, will engage actively in the design, monitoring and delivery of
services to achieve this. We acknowledge that we are seen as role models of healthy
living and will try to live up to this responsibility.
and lifestyles that are health-promoting and sustainable.
Every nurse and midwife, acknowledging the huge public investment in the provision of
health care in the NHS and elsewhere, will act to ensure that these resources are used
to optimum effect for the benefit of service users and society. This includes making best
use of our own time and expertise, and developing and adopting practices, services
below the agreed standard.
Every nurse and midwife will uphold the Nursing and Midwifery Council Code and the
values of the NHS Constitution, wherever they work, and will accept responsibility for and
take charge of the quality of care, service and outcomes for every service user in their
care. Each one of us will speak out and act wherever and whenever care falls
Preceptorship framework 2011KS 2008:CDDFT 10
Preceptorship Contract
The Preceptee and Preceptor will initiate the Preceptorship by signing this contract, and
agreeing the way forward using the Preceptorship Pathway. The Preceptorship will last for a
minimum of four months, and the Preceptor and Preceptee will work the same shifts twice
weekly for the first six weeks For the remainder of the Preceptorship period, contact time will
be negotiated between both parties. A progress review meeting will take place each month
and time will be agreed, allocated and supported by the line manager. The Preceptee will
assume overall responsibility for ensuring that progress is regularly recorded and signed by
the Preceptor.
Details of agreed contract:
Preceptee signature …………………………… Preceptor signature …………………………… Line Managers’ signature………………………. Date agreed …………… At the beginning of your preceptorship complete this SWOT Analysis
Preceptorship framework 2011KS 2008:CDDFT 11
Do a self-assessment of how you feel now at the start of your period of preceptorship and
how you see yourself, both professionally and personally using a SWOT Analysis
Discuss this with your preceptor and ask for his/her opinion. Either write a summary of their
comments yourself or ask him/her to write something at the end of your reflection. Both of you
need to sign this.
Strengths
Weaknesses
Opportunities
Threats
Documentation of discussion – SWOT Analysis
Preceptorship framework 2011KS 2008:CDDFT 12
Preceptee signature ………………………… Date ..……………………….
Preceptor signature ………………………… Date ..……………………….
NewTrustPreceptorshopKS2009:CDDFT
Timetable for Supernumerary Period. (For newly qualified and those changing area role at the start of their role)
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Comments …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………… Signed…………………………………………………………………………………..Date………………………………………………………
Three Month Review by Ward Manager
Dimension No.
NHS/KSF Dimensions - Core
Level KSF Outline/JD (Please indicate)
Evidence Collected Comments
1
Communication
Foundation Gateway
Level
2nd Gateway Full Outline
Level
2
Personal and People Development
Level
Level
3
Health, Safety and Security
Level
Level
4
Service Improvement
Level
Level
5
Quality
Level
Level
6
Equality, Diversity
Level
Level
Preceptorship framework 2011KS 2008:CDDFT 14
Please add any specific competencies required by your manager/organization/area of work/KSF into this part of the portfolio as evidence
Preceptorship framework 2011KS 2009:CDDFT
15
Preceptorship framework 2011KS 2009:CDDFT
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Communication
Aim - To be able to effectively communicate with a range of people on a range of matters
Outcome Self -evaluation by Preceptee
Signature of Preceptor
Date Achieved
Comments
The preceptee: has demonstrated the following basic
communication skills: effective oral communication with a range of
people both face to face and on the telephone
write and maintain accurate, clear and succinct patient records in accordance with legal, NMC/HPC and Trust standards
has conducted effective handovers of information to colleagues and other health care professionals
has demonstrated an awareness of barriers to effective communication
has demonstrated awareness of legislation, policies and procedures regarding: o Complaints o Confidentiality o Data protection o Can competently use computer
technology to meet the needs of their role.
E-CAMIS/SYSTEM ONE training undertaken o Password obtained
Preceptorship framework 2011KS 2009:CDDFT
17
o Smartcard obtained (if appropriate)
Please add any further requirements
Preceptorship framework 2011KS2009CDDFT
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Personal and people development Aim – Develop own skills and knowledge and provide information to others to help their development
Outcome Self-evaluation by Preceptee
Signature of Preceptor
Date Achieved
Comments
The preceptee:
is familiar with the daily routine on the ward/department /locality/team
knows where to access policies and procedures in the event of needing to make direct reference to them
can explain what appropriate action they would take if a situation arose which was beyond their experience
identifies own learning needs and how to
address these through the development of a personal, professional portfolio
can explain their level of accountability within
their role contributes to the development other team
members/patients where appropriate
Personal and people development Aim – Develop own skills and knowledge and provide information to others to help their development
Outcome Self-evaluation by Preceptee
Signature of Preceptor
Date Achieved
Comments
The preceptee: has read the Health and Safety Policy has discussed with their Manager Health
and Safety issues relating to the department o Infection control o COSH o POVA o Safeguarding adults and children o IR1/Safeguard Reporting
carries out load management assessment and is familiar with the appropriate equipment which needs to be used to assist moving and handling
carries out their duties with working awareness of the Health and Safety Policy to ensure an environment which is safe
has attended the following statutory in-service training
o Corporate Trust Induction o Annual Mandatory Training
Preceptorship framework 2011KS2009CDDFT
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Outcome Self- evaluation by Preceptee
Signature of Preceptor
Date Achieved
Comments
Has discussed the principles of food hygiene with the Food Hygiene Supervisor in the area (where appropriate). Has booked/completed the Alert Course (where appropriate - all adult areas). Knows what is expected of them in the event of critical incident. Is aware of de-escalation techniques and personal safety guidelines for their clinical area. Has identified stress reducing and coping strategies for themselves
Preceptorship framework 2011KS2009CDDFT
20
Service improvement and quality Aim – Contribute to the improvement of services and improving quality
Outcome Self- evaluation by Preceptee
Signature of Preceptor
Date Achieved
Comments
has demonstrated awareness of national policy and targets
demonstrated understanding of the audit
process
is aware of how clinical supervision can be
used to enhance evidence based practice works as an effective and responsible team
member
Preceptorship framework 2011KS2009CDDFT
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Administration of Drugs
Aim - To safely administer patient medication. Outcome Self-evaluation by
Preceptee Signature of Preceptor
Date Achieved
Comments
The preceptee: understands the principles of medicines
management and safe drug administration
demonstrates safe practice of the administration of patient medication including calculations when required
completion of the Trust Medicines Management Booklet
(All newly qualified nurses must complete, others at the discretion of the Ward/Unit manager)
Discussed results with preceptor and line manager
Drawn up and had signed a
learning contract for further development if required
Supporting information NMC (2008) Standards for medicines management Trust Medicines Policy POL/MM/0001 Trust Medicines Administration Booklet
Preceptorship framework 2011KS2009CDDFT
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Patient Assessment and Planning of Care
Aim To be able to assess, plan, implement and evaluate patient care.
Outcome Date Signature of Preceptee
Signature of Preceptor
Comments
The Preceptee
• can effectively assess their patients’ progress on an ongoing basis and accurately document this on a care plan / care pathway • organizes patient / client care within their team according to the ward/department’s model and philosophy of care • can effectively evaluate their patients’ progress on an ongoing basis and accurately document this on the care plan / care pathway • has observed and participated in breaking bad news (where relevant to the ward / department) • can identify the key areas of knowledge required to deliver care for the different client groups (s)he is working with • can explain organization of their workload to ensure safe and effective care and demonstrate this in their daily work
Preceptorship framework 2011KS2009CDDFT
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Final Outcomes Aim - To facilitate transition from preceptorship to other support mechanisms. .
Outcome Date Signature of Preceptee
Signature of Preceptor
Comments
The preceptee:
Has consolidated their experience during their period of preceptorship
Has identified a clinical supervisor and has discussed how this will support them once preceptorship is completed
Has identified an action plan for any future professional, educational and clinical skills acquisition
Has attended a three month appraisal with their manager and updated their PDP.
Has been handed the academic component of preceptorship to Teesside university.
Reflection To help you reflect in a productive manner you should use a reflective cycle. There are several variations of this but we have suggested the model below, however you may use another if you are more comfortable with that. The simple tool below is included to assist you but should be adapted to meet your individual needs. Having reflected, learning objectives or an action plan may be needed; you should discuss this with your preceptor.
How to Analyze an Incident or Event
Questions to ask yourself
1. A brief description of the event or incident. 2. Why is the event/incident significant to you? 3. How did this make you feel? 4. Could this incident have been anticipated? 5. What was the outcome of the event/incident? 6. What, if anything, made this event/incident difficult for you? 7. With reflection would you handle the situation differently? 8. What will this event/incident do to your future practice? 9. In a similar event/incident how would you deal with the situation? 10. Is this an event/incident that others could benefit from? 11. Do you need to take further action or training as a result of this
event/incident? You can reflect on positive as well as negative situations to explore and analyze in greater depth the factors at play and your role within it. It may be: an event that was challenging an event that you value positively an event that did not go as planned incidents where your actions made a difference an incident that you will now do differently in the future. Since reflection is about learning from experience and applying theory to practice you should: Consider what key points you have learned and discuss how you would
use this in your practice. Apply referenced theory to the issues you are discussing in your reflections
NewTrustPreceptorshopKS2009:CDDFT
Preceptorship framework 2011KS2009CDDFT
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Reflection and self-evaluation supernumerary period
Preceptee signature …………………………
Preceptor signature …………………………
Date ..………………………. Copy to be forwarded to Line Manager: Signature…………………… date………………….
Preceptorship framework 2011KS2009CDDFT
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Reflection and self-evaluation Weeks 2 to 6
Preceptee signature …………………………..
Preceptor signatures …………………………………
Date………………………………….
Preceptorship framework 2011KS2009CDDFT
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Reflection and self-evaluation Week 7 to 10
Preceptee signature…………………………..
Preceptor signatures …………………………………
Date………………………………….
Preceptorship framework 2011KS2009CDDFT
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Reflection and self-evaluation Weeks 11 to 16
Preceptee …………………………..
Preceptor signatures …………………………………
Date………………………………….
Preceptorship framework 2011KS2009CDDFT
32
Reflection and evaluation for weeks 17 and onwards
Preceptee …………………………..
Preceptor signatures …………………………………
Date………………………………….
Preceptorship framework 2011KS2009CDDFT
33
Action for non-achievement of Preceptorship after three months
Where areas of non-achievement are identified at any stage, which cannot be resolved by the Preceptee and Preceptor, a meeting should be arranged with the line manager to agree a course of action. Cause for concern
Plan
Date for review …………………………… Comments
……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………… Preceptee signature ……………………… Preceptor signature ……………………… Line Manager signature ……………………… Date of Meeting …………
Preceptorship framework 2011KS2009CDDFT
34
Plan for continuing professional development Clinical Supervisor ………………………. Date for appraisal ……………………….
Preceptee signature ………………………………….
Preceptor signature …………………………………
Date ………………………………….
Preceptorship framework 2011KS2009CDDFT
35
Medicines Management
A Competency Assessment for
Qualified Nursing Staff
New to a Clinical Area/Trust
Or
Undertaking Preceptorship
Clinical Area …………………………… Name …………………………
Mentor ………………………………… Date…………………………..
Preceptorship framework 2011KS2009CDDFT
36
Relevant Information
This document may be used as a single assessment for anyone who is new to a clinical area or Trust. It is a tool for self-assessment and a quality assurance initiative that may be completed following discussion with your line manager. All newly qualified Staff Nurses undertaking the Trust Preceptorship Programme will complete this assessment as part of their competency framework. '' The administration of medicines is an important aspect of the professional register. It is not solely a mechanical task to be performed in strict compliance with the written prescription of a medical practitioner (it can now be an independent and supplementary prescriber). It requires thought and the exercise of professional judgment….'' (NMC 2008 p 1) As a registered nurse or midwife, you are accountable for your actions and omissions. It is therefore essential that you exercise your professional accountability in the best interests of your patients by applying appropriate knowledge and professional judgment during the preparation and administration of any medications. You should work your way through this document by discussing each section with your mentor/preceptor or other appropriate professional (pharmacist). Once you have demonstrated appropriate knowledge and understanding you may be signed off. On completed this document should be included in your Professional Portfolio as evidence of PREP and photocopied by your line Manager to be included in your personal file. References NMC (2008) Standards for medicines management London: Nursing and Midwifery Council. NMC (2008) The Code: Standards of conduct, performance and ethics. London: Nursing and Midwifery Council.
Preceptorship framework 2011KS2009CDDFT
37
Summary Sheet
1. Read and discuss the following Trust Policies
The Medicines policy The administration of IV medications The administration of blood and blood
products Local policy (please specify if any)
……………………………………………………. …………………………………………………….
…………………….. …………………….. …………………….. …………………….. ……………………..
2. Undertake drug calculation test
Create action plan (if appropriate) Set date to repeat test Repeat test
……………………… ……………………… ……………………… ………………………
3. Drug errors
………………………
4. Adverse drug reactions
……………………….
5. Ordering, Storage and administration of
controlled drugs
……………………….
6. Administration of oral, topical, intramuscular and
subcutaneous medications Demonstrate adequate knowledge of
administered drugs Demonstrate appropriate knowledge of
administration process Discuss accountability issues surrounding
drug administration
………………………. ……………………….. ……………………….. ……………………….
7. Training session for Intravenous Drug
administration.
……………………….
Preceptorship framework 2011KS2009CDDFT
38
Undertake supervised preparation and
administration of IV medication
Competent Yes No
8. Injection sites
……………………….
9. Unlicensed preparations
……………………..
10. Covert administration of medication
……………………..
11. Action plan for professional development in this
area
Preceptorship framework 2011KS2009CDDFT
39
Reflection and Self Evaluation
Module Code CCH 3071-N
Supporting professional Development through Preceptorship.
Assessment The student will engage in an assessment of his/her own reflection on their preceptorship and formulate a personal action plan to enhance personal effectiveness in his/her role. This will be presented in a written assignment of not more than 1500 words as part of the preceptorship portfolio. Assessment criteria
When writing this final section it is important that you:
Demonstrate a clear understanding of critical reflection. Present an analysis of your learning in relation to the Attitudes and
BehaviorsFramework & post outline. Show evidence of a critical exploration of the relevant supporting
literature. Include an action plan for personal and professional development. Present your work in accordance with School of Health & Social Care
Guidelines. Presentation - Referencing - Adhere to the School of Health & Social Care’s policy for
confidentiality and consent.
Preceptorship framework 2011KS2009CDDFT
40
Completion of Preceptor ship Name of preceptor (in BLOCK CAPITALS)
………………………………………………………………………………………….
The completed Preceptor ship Pathway should be added to the Professional
Portfolio as a record of achievement. The line manager should photocopy the
completed page and attach it to the personnel file.
Comments by Preceptor
Date of completion …………………… Preceptor …………………………….. Preceptor signatures ……………………. Seen evidence: Drugs calculation test passed (more than 80%) □ Submitted the Academic Component □ Comments Line Manager Signature…………………………. Date …………………….
Date Copy sent to Practice Placement Facilitator………………………………...
PPF Signature ……………….……….. Date Received ……………………
Certificate Sent ……………………………………………………………
Preceptorship framework 2011KS2009CDDFT
41
Evaluation Name…………………………………………………………….
Site……………………………………………………………….
Ward/Department………………………………………………
Date preceptor ship completed………………………………..
1. Did you feel the preceptor ship was beneficial to your integration onto the ward/department? Yes No Comments…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….
2. What aspects of the framework did you find useful? Comments…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….
3. What aspects did you find least useful? Comments……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
4. Do you feel you were supported? Yes No Comments……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
Any other comments …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………… Please send this page and your completion of preceptor ship to: Senior Nurse Practice Placements, Memorial Hall, Darlington Memorial Hospital, DL3 6HX. Telephone 01325 743536 email [email protected] [email protected]