Record of Achievement in Practice - Welcome to City · the midwife ... Record of Achievement in Practice Year 1> Introduction ... *Advisory notes for mentors re students who need

Record of Achievement in PracticePortfolio of Practice

School of Community and Health Sciences

Pre-Registration BSc (Hons) Midwifery – 3 year Programme

Year 1

Student Name:

Community of Practice:

Personal Tutor:

‘Sign-off Mentor’:

Contents >Page

Section 1 – Introduction to the Portfolio ...........................1

Section 2 – Assessment of Portfolio .................................2

Sign off mentor arrangements...........................................2

Overall assessment of practice..........................................5

Declaration of good character Year 1 .................................6

Framework for continuous assessment.............................7

Section 3 – Placement Records.........................................9

Orientation to the practice environment ...........................9

Placement and mentor details...........................................10

Placement checklist ..........................................................12

Record of student and mentor meetings ...........................13

Record of teaching/discussion sessions attended............17

Record of assessors/mentors/supervisors .......................19

Record of attendance on placement..................................21

Sickness and absence .......................................................24

Section 4 – Essential Skills Clusters ................................25

Levels of Performance .......................................................25

Care, compassion and communication..............................26

Initial consultation between the woman and the midwife .......................................................................29

Normal labour and birth....................................................30

Initiation and continuance of breast feeding.....................33

Medicines Management....................................................35

Section 5 – Effective Midwifery Practice Activities and Mentor Comments .....................................................37

Activity 1: Assessing the nutritional status ofwomen deemed to be at low risk.......................................38

Activity 2: Health promotion..............................................39

Activity 3: Antenatal care...................................................40

Activity 4: Care of the labouring woman............................41

Activity 5: Providing comfort in labour ..............................43

Acitivity 6: The second stage of labour..............................45

Activity 7: The third stage of labour...................................46

Activity 8: the normal newborn infant ...............................47

Activity 9: Postpartum care ...............................................49

Activity 10: Transfer and referral to the community ...........51

Activity 11: Screening of the normal baby..........................52

Activity 12: Care around infant nutrition............................53

Activity 13: Meeting the cultural needs of your client........56

Activity 14: Confidentiality.................................................57

Activity 15: Records and documentation ...........................58

Activity 16: Infection control and the use ofuniversal precautions........................................................59

Activity 17: Moving and handling.......................................60

Activity 18: Drug administration ........................................61

Activity 19: Midwifery supervision.....................................63

Section 6 – EC Midwifery Directives Case/Patient Log ....64

Antenatal mothers.............................................................64

Postnatal mothers.............................................................67

Examination of newborn babies ........................................70

Care and supervision in labour..........................................73

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Record of Achievement in Practice Year 1 >

Introduction

This Portfolio is designed to enable you to demonstrate achievement of the Standards for Pre Registration Midwifery Education andEssential Skills Clusters (NMC 2007, 2009) which will allow you entry to the midwifery part of the NMC register. It is designed to help youapply theoretical knowledge to the practice of midwifery.

Your Portfolio of Practice contributes towards your ability to meet the requirements of a midwife as laid down in the definition of a midwifeand would comply with the European Union Midwives Directive 80/155/EEC Article 4 and as amended by Article 40 (a) (b) 2005/36/EU.

The aim of this portfolio is to guide your learning in practice. It will aid your assessors and mentors to provide appropriate learningexperiences. It will also provide clear direction for the assessment of your practice.

The Portfolio of Practice contains activities for you to complete whilst in the practice area. These are designed to help you:

• Learn and practice clinical skills

• Develop your practical skills

• Apply theoretical knowledge gained relating to the five components of holistic care (physical, psychological, spiritual, cultural and social)

• Work inter-professionally

• Reflect upon your learning and experiences.

Your assessor(s) in practice will be monitoring your progress throughout the year and gain documented evidence from your mentor(s). Thefinal summative assessment of year one will be undertaken at the end of your practice experience to ensure you have achieved all the NMCStandards and ESC to enable you to progress to year two.

Pass mark

The expected level of performance in all skills and activities is ‘Satisfactory (C)’.is the minimum acceptable standard to pass the Portfolio ofPractice

The NMC Standards (NMC, 2009) will be assessed under the four domains:

• Effective Midwifery Practice

• Professional and Ethical Practice

• Developing the Individual Midwife and Others

• Achieving Quality Care through Evaluation and Research

- using the Professional Behaviour and Practice Assessment Framework tool (Parker, 2004).

All activities must be completed and all will need to be undertaken several times in order to demonstrate understanding, application andacquisition of skills. You should aim to undertake each activity several times under supervision as appropriate PRIOR to a formalassessment by your mentor which will then be documented. You should document your learning in this portfolio at the formal assessmentstage.

Please ensure your attendance sheet in this Portfolio is completed prior to the final submission. This forms a record of your clinical hoursrequired by the NMC in order for you to complete year one.

Record of Attendance

Your attendance must be recorded each day (see pages 9-12) and the total number of hours required must be completed prior tosubmission at the end of your final placement in year 1. This forms a record of your clinical hours required by the NMC in order for you toregister on completion of the programme. If you are off sick or absent for any other reason this should be noted on page 12 and any hoursworked to make up sickness/absence should be recorded on page 12. The total hours worked must be stated on page 12.

‘Sign-off Mentors’

The Nursing and Midwifery Council requires you to be supervised and assessed by a ‘sign-off mentor’ at different periods in your three yearplacement (Standards to Support Learning and Assessment in Practice – (NMC, 2008). Your ‘sign-off mentor’ has undertaken a supervisedsign-off course and is there to assess your safety and effectiveness in relation to the stage of your programme.

Record of Student and Mentor Meetings

Student and mentor meetings should take place at the beginning of the placement, half way through to review progress and again at theend of the placement. A summary of these meetings should be documented using pages 67-69.

2

Record of Teaching and Discussion Sessions Attended

Within the Record of Student and Mentor Meetings, a page is provided in each placement to make a note of any teaching sessions ormeetings with Link Lecturers.

Overall Assessment of Practice

Overall Assessment of Practice (Page 7) will be signed at the end of your final placement in Year 1 to indicate that you have achieved all theNMC Standards and ESC. Your mentor must have a recognised qualification (ENB 997/998, Teaching and Assessing in Clinical Practice orPreparation for Mentorship) in order to undertake this assessment.

Take your Portfolio of Practice Experience to all practice reflection seminars (group sessions organised by the university that you arerequired to attend whilst on your placement) and the Link Lecturer for your placement area will ask to see your Portfolio and will be able tohelp you with any questions or problems that you have.

How does it relate to the Essential Skills Clusters & NMC Standards?

You will be using a range of clinical and communication skills as you complete the activities in the Portfolio. This icon is there to remind youto ask your mentor to sign when you are confident with the skills and when you have completed activities designed to demonstrateachievement of the NMC Standards.

Reflection is an important part of each activity as it helps you to really think about what you have learnt and what you still need to learn.

3

Section 2 - Assessment of Portfolio >

Sign Off Mentor Arrangements

NMC Circular 2/2008 requires all students to be “signed off” as safe and effective for progressing to the next phase of your Programmeor to be suitable for entry on the Midwives part of the Register.

Method

*Advisory notes for mentors re students who need tripartite early.

Where there is an indication of any student needing more support to achieve the required learning outcomes, the mentor should discussthis with the student and arrange an early tripartite meeting to agree a way forward. “Tripartite” meeting could be two of the followingpeople with the student: Mentor, student, Personal Tutor, Link Lecturer, and Practice Facilitator.

Periodplacement

Activity Comments

Week 1-2 (of every placement) • Allocation of mentor

• Formulation of learning objectives

• Named “sign off” mentor allocated

• Orientation to placement and portfolio

Is an action plan necessary?

Week 10 Mentor documents in portfolio student’sstrengths and areas for further work to betaken to next phase.

E.g., refer to

Week 20 Mentor documents similar to week 10.

Week 30 • Revision of areas identified for further work

• Same as week 10

Week 40-46 Tripartite “sign off” meeting*:

Sign off mentorStudent

Practice FacilitatorOrPersonal TutorOrLink Lecturer

The outcome:

Recommendation for ProgressionOrAction Plan.

Agree Outcome/Decision

Draw Action Plan (12 week NMC rule 2008)

4

Name of Student:

‘During this Supervised Practice Experience the above student has demonstrated standards and behaviours that are consistent with the standards and requirements outlined by ‘The Code: standards for conduct, performance and ethics for nurses and midwives’(Nursing & Midwifery Council, 2008).

Sign Off Mentor(print name)

Date of Mentor Qualificationand Update

Signature Date

Clinical Practice Facilitator(print name)


Signature Date

Additional Assessor(print name)


Signature Date

5

Overall Assessment of Practice >

To be completed in the final ‘sign off’ interview /meeting for year 1.( week40-46)

The above student’s performance has been (Please ✓ one)

* NB Fail (D) grades must be accompanied by comments to identify areas that need improvement.

Name of Student:

Excellent (A): Outstanding performance well above that expected at this stage in the programme

Good (B): Performance above that expected at this stage in the programme

Satisfactory (C): Performance at the level expected at this stage in the programme

Fail* (D) Performance well below that expected at this stage in the programme. Has failed to meet the required standard.

Comments to enable student to improve

Signature

Date:

For university use only:A = 70%; B = 60%; C = 50%; D = 35% (Fail)

Declaration of Good Character – Year 1 >

To be completed by the Personal Tutor at the final summative assessment

*If you do not agree with this statement you must state your reasons in the box below and provide page numbers to indicate theskills/areas in which the student needs to improve.

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Student Name:

‘During this Supervised Practice Experience the above student has demonstrated standards and behaviours that are consistent with thestandards and requirements outlined by ‘The Code: standards for conduct, performance and ethics for nurses and midwives’ (Nursing &Midwifery Council, 2008).

I agree*/do not agree* with the above statement (*Please delete as applicable – see below)

Personal Tutor Signature (Please print name & sign):

………………………………………………………………………………………………..

Date:

Comments

Personal Tutor Signature (Please print name & sign)

Date:

7

Framework for Continuous Assessment >

Notes for Assessor(s)/Mentor(s)

The framework below should be used to assess the competency and safety of your student in practice. This chart clearly indicates theexpectations of a year 3 student midwife at the end of the first year in relation to the NMC Standards that they have been working towardsthroughout the year whilst undertaking practice activities. This is the students’ final summative practice assessment for year 1 and theassessor is verifying achievement of the NMC proficiencies.

Professional Behaviour and Practice Framework for the Year 1 Midwifery Programme (Parker 2004)

Professional and Practice Behaviour Framework (Parker 2004) NMC Standards for First Progression Point (NMC 2009)

Professional Behaviour

• Awareness of the Code of Conduct;

• Appearance is professional i.e. correct uniform;

• Maintains punctuality;

• Follows correct procedure for absence/sickness;

• Maintains confidentiality;

• Follows instructions;

• Maintains safety at all times;

• Demonstrates respect and dignity for all;

• Is able to identify areas for development

B1. Practise in accordance with the NMC code of professionalconduct: standards for conduct, performance and ethics(NMC 2004), within the limitations of the individual’s owncompetence, knowledge and sphere of professional practice,consistent with the legislation relating to midwifery practice.B2. Practise in a way, which respects, promotes andsupports individual’s rights, interests, preferences, beliefsand cultures.

B3. Practise in accordance with relevant legislation

B4. Maintain confidentiality of information

(ESC1-5)

Teamwork

Aware of different nursing/midwifery roles;

Knows their own role within the team;

Is aware of the team’s way of working;

Knows how the team functions;

Always gives information to senior staff;

Is flexible;

Is dependable; Is supportive

A4. Provide seamless care, and where appropriate interventions,in partnership with women and other care providers duringthe antenatal period

A9. Work in partnership with women and other care providersduring the postnatal period to provide seamless care andinterventions

C2. Demonstrate effective working across professionalboundaries and develop professional networks

(ESC1-5)

Student interest, motivation and enthusiasm

Asks questions;

Gets involved;

Uses opportunities;

Is willing to participate;

Is aware of learning needs;

Is interested in what is happening;

Demonstrates knowledge in relation to the practice undertaken;

Knows about resources;

Requests ‘hands on’ practice

Has undertaken preparatory reading

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Requests for help

Open to feedback;

Acts on feedback;

Needs guidance with practical tasks;

Reflects on performance;

Works with supervision;

Requests help appropriately;

Is assertive;

Knows limitations in practice;

Recognises areas to develop;

Is aware of where to find information and resources.

B1. Practise in accordance with the NMC code of professionalconduct: standards for conduct, performance and ethics(NMC 2004), within the limitations of the individual’s owncompetence, knowledge and sphere of professional practice,consistent with the legislation relating to midwifery practice.(Professional & Ethical Practice Domain)

(ESC1-5)

Application of Theory to Practice

Asks rationale for actions;

Demonstrates knowledge in relation to the practiceundertaken;

Understands principles of midwifery practice;

Can provide knowledge for different care;

Remembers what is taught;

Responds to feedback

A2. Diagnose pregnancy, assess and monitor women holisticallythroughout the pre-conception, antenatal, intrapartum andpostnatal period through the use of a range of assessmentmethods and reach valid, reliable and comprehensiveconclusions. (Effective Midwifery Practice Domain)

A6. Care for, monitor and support women during labour andmonitor the condition of the fetus and support spontaneousbirths. (Effective Midwifery Practice Domain)

A8. Examine and care for babies immediately following birth.(Effective Midwifery Practice Domain)

A11. Care for and monitor women during the puerperium, offeringthe necessary evidence-based advice and support regardingthe baby self-care. (Effective Midwifery Practice Domain)

A12. Select, acquire and administer safely, a range of permitteddrugs consistent with legislation, applying knowledge andskills to the situation which pertains at the time. (EffectiveMidwifery Practice Domain)

A13. Complete, store and retain records of practice (EffectiveMidwifery Practice Domain)

A15. Contribute to enhancing the health and social well-being ofindividuals and their communities. (Effective MidwiferyPractice Domain)

B7. Support the creation and maintenance of environments thatpromote the health, safety and well-being of women, babiesand others (Professional & Ethical Practice Domain)

(Professional & Ethical Practice Domain)

D3. Manage and develop care utilising the most appropriateinformation technology (IT) systems. (Achieving QualityCare through Evaluation and Research Domain)

(ESC1-5)

Communication

Able to communicate verbally and clearly to all;

Can complete basic observations with supervision;

Able to identify some non-verbal communication cues;

Able to form relationships;

Listens to others;

Respects others views

A1. Communicate effectively with women and their familiesthroughout the pre-conception, antenatal, intrapartum andpostnatal periods. (Effective Midwifery Practice Domain)

9

Section 3 - Placement Records City University >

Orientation to the Practice Environment

Students should complete the Risk Assessment with mentors within the first week of each placement.

Please refer to next page for placement details and mentor signatures.

The Mentor(s) must ensure that the student is familiar with the following:

Emergency Procedures Area 1 Area 2 Area 3 Area 4 Area 5

Fire alarm tests are carried out regularly: Yes No Yes No Yes No Yes No Yes No

The Assembly Point has been shown to me: Yes No Yes No Yes No Yes No Yes No

I have been informed of the Emergency Telephone Number and I am aware of the location of the Fire Equipment:

Yes No Yes No Yes No Yes No Yes No

I have been informed of the Major Incident Procedure: Yes No Yes No Yes No Yes No Yes No

Actions to be taken by the student:

Security Area 1 Area 2 Area 3 Area 4 Area 5

I have been informed of the Emergency Telephone Number in the event of a security risk:


Emergency Resuscitation Area 1 Area 2 Area 3 Area 4 Area 5

I have been informed of the Emergency ResuscitationTelephone Number:


I have been informed of where the ResuscitationEquipment is stored:



Psychiatric Emergencies Area 1 Area 2 Area 3 Area 4 Area 5

I have been informed of the telephone number for the Rapid Response Team:


I have been informed of the Incident Procedure: Yes No Yes No Yes No Yes No Yes No


Location of First Aid Information Area 1 Area 2 Area 3 Area 4 Area 5

I am aware of the contact name or number for the FirstAider: (if your First Aider is not available call thenominated deputy) or understand the procedure shoulda First Aider be required:


Orientation Risk Assessment to Practice Environmentcontinued >

Placement and Mentor Details

After having completed the form on the preceding 2 pages, Mentors should complete and sign here to confirm that the Risk Assessment hasbeen undertaken.

Practice Environment 1




10

I confirm that I have discussed the Risk Assessment list with the student and explained their responsibilities in this placement:

Mentor Signature:

Mentor Name: (please print)

Name of Practice Environment:

Date:


Mentor Signature:



Date:


Mentor Signature:



Date:


Mentor Signature:



Date:

11



Mentor Signature:



Date:

Placement Checklist: Information, Policies and Procedures

Students should read and consider the checklist below and sign to confirm that they understand their responsibilities in the placementareas.

12

I have read this list and understand my responsibilities as a student Midwife for my placements throughout the year:

Signature of Student:

Name of Student: (please print)

Date:

Accident/Emergency Reporting

• You are responsible for ensuring that an accident/incident is reported to the person in charge of your placement, your personaltutor/or link lecturer or practice facilitator

Information about Health and Safety

You are responsible for ensuring that you are aware of, understand and comply with the following:

• Specific procedures for placement activities/tasks allocated e.g. use of equipment or machinery such as for manual handling

• Use of equipment e.g. administration of specific medications such as cytotoxic drugs

• External activities e.g. lone worker policies when visiting patients/clients in their own home etc

Policies and Protocols such as and including:


• Administration of medicines, infection control, handling biological materials

• Visiting

• Storage of valuables

• Confidentiality of patient records, including computerised records

• Personal security

• Blood glucose monitoring

Education Related Policies


• Induction to placement area and staff

• Procedure for reporting sickness or absence

• Duty times and mentoring-working arrangements

• Planning placement experience

• Learning contract: dates for review and feedback sessions

Occupational Health Referral Procedure

You are responsible for ensuring that you are aware of, understand and comply with the following (if applicable):

• Services available e.g. counselling

• Immunisation (where relevant)

• Risk assessment: e.g. students who are pregnant or breast feeding; students with special needs

Security Issues

• You must carry your identity badge with you at all times whilst in the placement area

13

Record of Student and Mentor Meetings >

You are also required to meet with your ‘sign-off mentor’ in the first few weeks of practice to identify a date for your final ‘sign-off’assessment between weeks 40 and 46 (please see your course plan)

A note of each initial interview, interim and end of placement meeting between you and your named mentor should be recorded to helpplan objectives and review progress.

First discussion with named mentor ( weeks 1-2 of placement)

The following points and objectives were discussed at the first student/mentor meeting.

Date:

Assessor/Named Mentor Signature and date:

Student Signature and date:

2nd Meeting with mentor (week 10)

The following points and objectives were discussed at the interim student/mentor meeting.

14

Date:



15

3rd Meeting with mentor (week20)

The following points and objectives were discussed at the interim student/mentor meeting.

Date:



Tripartite Summative ‘sign off’ meeting

The following points and objectives were discussed at the summative meeting by student and ‘sign-off team.

16

Date:



17

Record of Teaching/Discussion Sessions Attended >

Please give details of any teaching or discussion sessions attended whilst in this placement area.

Teaching/Discussion session about/with:

Signature: Date:


Signature: Date:


Signature: Date:


Signature: Date:


Signature: Date:

Record of Teaching/Discussion Sessions Attended >

Please give details of any teaching or discussion sessions attended whilst in this placement area.

18


Signature: Date:


Signature: Date:


Signature: Date:


Signature: Date:


Signature: Date:

19

Record of Assessors/Mentors undertaking formalsupervision and supervisors signing attendance sheets >

Please record Mentor/Assessor details below for verification of names and signatures.

Assessor/Mentor/Supervisor (print name)

Date of Mentor Qualificationand Update (if applicable)

Signature Practice Area

20

Assessor/Mentor/Supervisor (print name)

Date of Mentor Qualificationand Update (if applicable)

Signature Practice Area

21

RECORD OF ATTENDANCE ON PLACEMENT >

YEAR 1 – BSc (Hons) Midwifery

• You must complete all weeks of clinical practice.

• Each shift must be recorded on the pages overleaf. A qualified practitioner or equivalent* must sign this form at the end of each shift

• Sickness or absence and any days worked to make this up must be recorded on pages 24. If you are sick or absent for more than 5 daysin the year you will be required to make an appointment to see the programme leader.

• First Year students are not permitted to work long days (12-hour shifts).

• Bank Holidays if a Bank Holiday falls while you are on placement you are not required to work the day of the Bank Holiday

Student Name: Cohort:

Midwifery: Student Number:

Placement area: Placement area:

Date Weeks Signature Date Weeks Signature

Total Total

Total this page

22





Total Total

Total this page





Total Total

23





Total Total

Total this page





Total Total

Sickness and Absence >

Days worked to make up for sickness/Absence >





Total Total

24

Total Weeks completed in Year 1:

……………………..



Total Total

25

Section 4 - Assessment Of Students PerformanceAgainst Essential Skills Clusters (NMC 2009) >

A

(Excellent)

• Outstanding performance well above that expected at this stage in the programme

• Can perform this activity satisfactorily without assistance, prompting or direct supervision, with acceptablespeed and quality of work

• Cognitive and affective components of the skill are integrated

• Is aware of his/her limitations and seeks help and advice appropriately

• With guidance, is able to reflect on performance to identify strengths and learning needs

B

(Good)

• Performance above that expected at this stage in the programme

• Can perform this activity without assistance or prompting and does not require direct supervision

• Awareness of some knowledge and reasoning

• Is aware of his/her limitations and seeks help and advice appropriately

• With guidance, is able to reflect on performance to identify strengths and learning needs

C

(Satisfactory)

(expected level)

• Performance is at the level expected at this stage in the programme

• Can perform this activity satisfactorily under direct supervision but requires some prompting/assistance

• Is able to perform the skills

• Limited knowledge

• With guidance, is able to reflect on performance and identify learning needs

D

(Fail)

• Performance is below that expected at his/her stage in the programme

• Is not able to perform this activity even when prompted

• Fails to demonstrate knowledge and reasoning

• Unable to demonstrate skill

• Is unable to reflect on own performance or identify learning needs

NB All Essential skills are expected to be achieved at Level C (Satisfactory)

All mentors must write their full name, signature & designation on page 19 to enable their initials to be identified.

Essential Skills Clusters For Midwifery Practice >

SECTION 1: Care, Compassion and Communication

26

Skill LevelAchieved

Mentor

Signature & date

(followed by initials)

Student selfassessment

Comments

1.1 Greeting & Leave-taking skills

a Introducing self and others

b Familiarising with the care environment

c Is able to initiate and close a conversationwith women

d Recognises the appropriateness of silence incertain situations

e Talks in a manner that is interpreted bythewoman as warm sensitive, kind andcompassionate

1.2 Team working skills

a Work collaboratively with others in thehealthcare team

b Communicates the needs and wishes of thewoman to other professionals

c Seek help/advice appropriately

1.3 Maintaining Respect & Dignity

a Promotes environmental & physical dignity

b Demonstrates effective listening

c Participates in working in partnerships withwomen that is sensitive to age, culture,religion, spiritual beliefs, disability, genderand sexual orientation.

d Takes a woman centred approach

e Seeks consent and respects a woman’srights & choices

1.4 Maintains confidentiality

a Applies the principles of confidentiality

b Applies the principles of data protection

c Maintains confidentiality of clients records

d Demonstrates assertiveness when necessary

27

Skill LevelAchieved

Mentor

Signature & date



Comments

1.5 Record Keeping and Documentation Skills

a Accurately documents clinical observations,fluid balance etc

b Under supervision, contributes to careplanning & evaluation

c Ensures all documentation is countersignedby RM

d Safely disposes of personal notes aboutclients

1.6 Informed choice

a Uses open questions +

b Uses closed questions +

c Explains intended actions

d Participates in sharing evidenced basedinformation with women

1.7 Communicating where barriers exist

a Uses appropriate language

b Assists clients who speak a differentlanguage

c Access interpretation services

d Answers the telephone appropriately

e Reports information received by telephone

f Gives information over the telephoneappropriately

1.8 Informed consent

a Applies the principles of informed consent inaccordance with the NMC Code (2008)

b Works within the legal framework whenseeking consent

c Participates in ensuring that the meaning ofconsent is understood by the woman

28

Skill LevelAchieved

Mentor

Signature & date



Comments

1.9 Infection prevention and control

a Washes hands & uses Alcohol hand rubcorrectly

b Wears aprons & gloves as required

c Handles and disposes waste and sharpssafely

d Knows the procedure for spillage blood &body fluids

e Complies with local & national guidelineswith regarding infection prevention andcontrol.

f Complies with hygiene, uniform and dresscodes

g Understands the standard isolationtechniques

1.10 Reflecting on Practice

a Reviews practice through discussion &reflection

b Actively seeks to extend skills & knowledge

c Seeks and responds to feedback fromsupervisors/mentors

29

SECTION 2: Initial consultation between the woman and the midwife

Skill LevelAchieved

Mentor

Signature & date



Comments

2.1 Be confident in sharing in formation about antenatal screening tests

a Is aware of the main NHS-managed antenatalscreening programmes that are offered topregnant women

b Participates in sharing information withwomen about common antenatal screeningtests

2.2 Accurately complete an initial consultation ensuring women are the centre of care

a Ensures consent is obtained before any careis initiated

b Participates in explaining to women the aimof the initial consultation relevant togestation

c Participates in explaining findings in asensitive manner and encourages women toask questions

d Participates in assessing maternal and fetalwellbeing, relevant to the stage of pregnancy

e Participates in explaining to women lifestyleconsiderations in relation to diet, smokingand drugs

2.3 Work collaboratively other practitioners and external agencies

Works alongside other practitioners whoinput into antenatal care

2.4 Be first point of contact when women seek advice or information about being pregnant

Demonstrates how and where midwives canbe accessed as the first point of contact

SECTION 3: Normal labour and birth

30

Skill LevelAchieved

Mentor

Signature & date



Comments

3.1 Work in partnerships with women to facilitate a birth environment that supports their needs

a Ensures a woman-centred approach to care

b Is sensitive to cultural and social factorswhen providing care for women

c Respects the rights of women

d Ensures privacy and provides care withdignity making appropriate use of theenvironment

e Participates in ‘being with women’ duringtheir labour and birth to provide safe andsensitive care

f Incorporates birth plans or writteninstructions that identify the wishes ofwomen, in any care provided

g Respects silence

h Actively participates in changing the physicalenvironment to meet the needs of women,such as lighting, furniture, temperature

3.2 Be attentive to the comfort needs of women before, during and after the birth

a Participates in ensuring the comfort needs ofwomen are met, such as:

• bladder care

• appropriate hydration

• nutritional intake

• hygiene requirements

• prevention of infection

• assessment of skin integrity

b Participates in working with women todetermine their coping strategies in order tosupport their preferences

• for pain management,

• mobilising,

• different positions,

• use of water in labour,

3.3 Determine the onset of labour

a Participates in using observation, historytaking and clinical assessment to thedetermine onset of labour

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Skill LevelAchieved

Mentor

Signature & date



Comments

3.4 Determine the well being of women and their unborn baby

a Participates in the monitoring of maternalvital signs:

• maternal pulse

• blood pressure

• temperature

b Participates in monitoring fetal wellbeingwhich includes:

• assessment of liquor volume and colour

• intermittent auscultation of the fetalheart using a pinnard stethoscope

3.5 Measure, assess and facilitate the progress of normal labour

a Participates in assessing the progress oflabour using:

• observation, such as behaviour

• abdominal examination

• vaginal examination where appropriate

b Participates in sensitively informing womenof their progress, giving feedback in apositive manner

c Seeks informed consent prior to undertakingany procedure

d Assists in supporting women to use a varietyof birthing aids, such as birthing balls

3.6 Support women and their partners in the birth of their baby

a Recognises the importance of offeringchoices related to this phase and sensitivelyinform women of their progress

b Recognises the latent and active phases ofbirth

c Assists in preparing environment andequipment for the birth

d Assists in monitoring maternal and fetalwellbeing

3.7 Facilitate the mother and baby to remain together

a Assists in assessing the wellbeing of thebaby

b Supports feeding when the baby is ready,including skin to skin contact.

c Delay any unnecessary separation of motherand baby, avoiding early routine proceduressuch as weighing

32

Skill LevelAchieved

Mentor

Signature & date



Comments

3.8 Identify and safely manage appropriate emergency procedures

a Participates in ‘drills and skills’ proceduresrelated to the resuscitation of the mother

b Participates in initiating basic emergency callprocedures relevant to local policy andguidelines

3.9 Works collaboratively with other practitioners

a Acts in accordance with the NMC Codestandards for conduct: standards,performance and ethics for nurses andmidwives

3.10 Keep accurate records

a Assists in keeping accurate and legiblerecords.

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SECTION 4: Initiation and continuance of breast feeding

Skill LevelAchieved

Mentor

Signature & date



Comments

4.1 Understand and share information that is clear, accurate and meaningful at a level which women, their partners and family canunderstand

a Participates in communicating sensitively theimportance of breastfeeding, and theconsequences of not breastfeeding, in termsof health outcomes (BFI)

b Demonstrates an understanding of the whereinformation sharing with regards to infantfeeding.

4.2 Respect social and cultural factors that may influence the decision to breastfeed

a Has an awareness of how own thoughts andopinions can influence infant feeding.

b Demonstrates sensitivity to issues ofdiversity when sharing information withwomen

c Respects the rights of women to make theirown choices.

4.3 Effectively support women to breastfeed

a Shows willingness to learn from women

b Assists in ensuring that the needs of womenare met in developing a clear care pathway

c Participates in explaining to women theimportance of baby-led feeding in relation tothe establishment and maintenance ofbreastfeeding (BFI)

d Can recognise effective positioning,attachment, suckling and milk transfer

e Is able to help teach mothers the necessaryskills to enable them to effectively positionand attach their baby for breastfeeding (BFI)

f Explains to women the importance of theirbaby rooming-in with them and baby holdingin the postnatal period as a means offacilitating breastfeeding (BFI)

g Recognises common complications ofbreastfeeding, how these arise anddemonstrate how women may be helped toavoid them (BFI)

h Participates in teaching women how to handexpress their breast milk and how to store,freeze and warm it with consideration toaspects of infection control (BFI)

34

Skill LevelAchieved

Mentor

Signature & date



Comments

4.4 Recognise appropriate infant growth and development, including where referral for further advice / action is required

a Participates in assessing appropriate growthand development of the neonate

b Participates in carrying out physicalexaminations as necessary, with parent’sconsent

c Informs women of the findings from anyassessment / examination performed, in amanner that is understood by the women

4.5 Work collaboratively with other practitioners and external agencies

a Actively works as a team member

b Values others’ roles and responsibilities insupporting women to breastfeed

c Shares information about national and localagencies and networks that are available tosupport women in the continuation ofbreastfeeding, such as:

• Lactation Consultants,

• National Childbirth Trust

• La Leche League for example

4.6 Support women to breastfeed in challenging circumstances

a Is aware of the limited number of situationsin which exclusive breastfeeding is notpossible and participate in supportingwomen to partially breastfeed or artificiallyfeed (BFI)

b Demonstrates sensitivity to the needs ofwomen and their partners

35

SECTION 5: Medicines Management

Skill LevelAchieved

Mentor

Signature & date



Comments

5.1 Within the parameters of normal childbirth, ensure safe and effective practice through comprehensive knowledge of medicinalproducts, their actions, risks and benefits including the ability to recognise and respond safely to adverse drug reactions andadverse drug events

a Has awareness of the correct storage ofmedicines

b Has an awareness for checking theprocedures for administration of medicines

c Can undertake basic drug calculations

d Safely administers oral medicines to womenunder direct supervision

e Has an awareness of the Patient GroupDirection (PGD)

f Can identify major medicine groups e.g.analgesics, laxatives, antibiotics

g Can administer controlled drugs under directsupervision +

h Can administering Subcutaneous injectionunder direct supervision

I Can administer Intra muscular injectionunder direct supervision

J Utilises and safely disposes of equipment .

5.2 Keep and maintain accurate records, which includes when working within a multi-disciplinary framework and as part of a team

a Demonstrates an understanding ofprofessional responsibility in maintainingaccurate records including regulation,national and local policy and guidelines

b Under supervision is able to take a medicinehistory

5.3 Work within the legal and ethical framework that underpins safe and effective medicinal products management, as well as inconjunction with national guidelines, and local policies

a Demonstrates an understanding of the legaland ethical frameworks relating to safeadministration of medicines.

5.4 Work in partnership with women to share information in assisting them to make safe and informed choices about medicinalproducts related to herself, her unborn infant of baby

a Participates in involving women inadministration and/or self-administration ofmedicines

5.5 Work in partnership with women to share information about alternative approaches to using medication, where appropriate

a Demonstrates awareness of a range ofcommonly recognised approaches tosupporting women throughout childbirth e.g.relaxation, distraction, life style advice

36

Skill LevelAchieved

Mentor

Signature & date



Comments

5.6 Order, receive, store, transport and dispose of medicinal products safely and in accordance with relevant legislation, in anymidwifery setting (including controlled drugs)

a Applies knowledge of local policies to safestorage and transport of medicinal products

b Demonstrates an ability to safely storemedicinal products

5.7 Uses and evaluates up-to-date information on medicinal products management and work within national and local policies andguidelines using appropriate reference

a Is able to access commonly used evidencebased sources of information relating to thesafe and effective management of medicinalproducts

37

Section 5 - Effective Midwifery Practice Activities and Mentor Comments >

Effective Midwifery Practice Domain

The following are a number of activities that you must undertake in hospital and/or in the community, prior to assessment. These activitieswill help you to achieve the following Standards of Proficiency.

A. Effective Midwifery Practice

A.1 Communicate effectively with women and their families throughout

Preconception, antenatal, intrapartum and postnatal periods

Use strategies o enhance communication and remove barriers in order to make communication effective (ESC1.1.2)

Reflects on own practice and discusses issues with other members of the team to enhance learning (ESC8.7)

Be confident in their role within a multi-disciplinary team (ESC5.2)

A.2 Diagnose pregnancy, contribute to the assessment and monitoring of women holistically throughout the preconception, antenatal,intrapartum and postnatal period through the use of a range of assessment methods

A.3 Participate in the provision of programmes of care and support for women

A.4 Contribute to the provision of seamless care, where interventions are required, in partnership with women and other care providersduring the antenatal period

A.5 Recognise women who would benefit from the skills and knowledge of other individuals

A.6 Within limited autonomy, care for, monitor and support women during labour and monitor the condition of the fetus and supportspontaneous births

A.7 Respond appropriately to emergency situations to meet the health needs of women and babies

A.8 Examine and care for babies immediately following birth

A.9 Work in partnership with women and other care providers during the postnatal period to provide seamless care and interventions

A.11 Within a limited range of standards, care for and monitor women during the puerperium and provide support regarding the baby andself-care

A.12 Demonstrate safe administration of a range of permitted drugs consistent with legislation, applying factual knowledge and skills to thesituation that pertain at the time

A.13 Participate in the completion, storage and retention of records of practice

A.14 Explore and evaluate the effectiveness of programmes of care and revise them to improve the outcomes for women, babies and theirfamilies

A.15 Contribute to enhancing the health and social well-being of individuals and their communities.

* The numbers attached to the A relate to the Standards for Pre Registration Midwifery Education (NMC, 2094) and The Essential SkillsClusters (2009).

A. Effective Midwifery Practice Activities

No. 1 This activity is about assessing the nutritional status of women deemed to be at low risk.

(ESC: All ESCs in section one)

• For clients not in labour, measure her weight, height and calculate her BMI

• Drawing on your knowledge to date make suggestions for maintenance, improvement and continuing care of each client

• Record an example of the key points from the findings to feedback to your mentor

38

39

Assessor/Mentor Signature and date: Signature:

Date:

The student has completed the above activity (please tick)

Yes No

Has achieved the above activities at an appropriate levelfor a year 1 student midwife

(please tick)

Yes No

No. 2 This activity is about Health Promotion


Identify and apply the principles of health promotion as they relate to a woman or baby.

Reflect on your experiences whilst doing these activities and identify what you have learnt

Mentor Comments and Action Plan as required on Activities 1 & 2

Comments on strengths and areas for improvement

No. 3 The following activities relate to Antenatal Care

(ESC: All ESCs in sections one and two)

• Identify and record the investigations and vital signs undertaken by the midwife and yourself during a "routine" antenatal examination

• Undertake and record the findings of an abdominal examination on a woman you have been involved in the care of. Include yourrationale for undertaking this part of the antenatal assessment, and how you carried this out

• Record how fetal wellbeing was monitored during her pregnancy

• Reflect on your experiences whilst doing these activities and identify what you have learnt

40

41

No. 4 The following activity relates to Care of the labouring woman

(ESC: All ESCs in sections one and three)

Select a woman in your care who is experiencing normal labour and reflect on her needs (physical, psychological, educational and social,perhaps) and how these were addressed you may wish to include the following points…

• Ask about her experience of this pregnancy to date

• Identify, undertake and record the baseline observations that assess the onset of labour

• Discuss your plan of care for this woman with her and your mentor

Vaginal Examination is one method of assessing progress in labour

• Gain informed consent before carrying this out

• Prepare the woman for this procedure

• Perform the assessment

• Record your findings

• Discuss your findings with the woman




42


Date:


Yes No


(please tick)

Yes No

43

No. 5 (a) The following activities are about providing comfort in labour


• Present to a labouring woman, the non-pharmacological options that are available to her

• How did you facilitate the woman’s choice?

• Reflect on the outcome of this activity and discuss with your mentor

5 (b) Present to a labouring woman, the pharmacological options that are available to her and the effect of these on the fetus

(ESC: All ESCs in section five)

• Gain informed consent and facilitate her choice

• Document the effectiveness of the chosen method of the women

• Discuss your practice with your mentor

44

45


Date:


Yes No


(please tick)

Yes No

No. 6 This activity relates to the Second Stage of Labour

(ESC: All ESCs in section one and three)

• State how you recognise the signs of the second stage of labour

• Identify a woman in your care (experiencing normal labour)

• Discuss how the woman was prepared for birthing

• Think about how fetal observations were made

• How are the principles of asepsis maintained during the second stage?

• Describe how the second stage was managed include here details about the length of the second stage and position for delivery

• Reflect on the effectiveness of the care given to the woman



No. 7 (a) The following activities are about the third stage of labour


• Document the discussion and decision made around care at this time

• How was the woman’s blood loss estimated?

• Write about the woman's experience of her third stage

7(b)

• Document the discussion and decision making surrounding an active 3rd stage

• Explain the observations made and the care provided in this instance

• Write about the woman's experience of her third stage

46

47

No. 8 (a) This activity is about the normal newborn infant

(ESC: All ESCs in section three)

• Identify the observations made and care given, following the birth of the baby with the rationale for this

• What are the statutory duties of a midwife in relation to the notification and registration of births?


8 (b)

• Choose a normal baby

• Undertake the daily examination of the baby

• Discuss findings with the parents



48


Date:


Yes No


(please tick)

Yes No

49

No. 9 (a) The following activities relate to Postpartum Care


• Describe the postnatal assessment of the woman

• Carry out the postnatal assessment of the client in your care

• Document your findings and the significance of these

• Discuss the care you provided with your mentor

9 (b)

• Identify psychological issues that may relate to women during the first 10 days following birth

• Provide appropriate advice and support for the mother

• Write about 4 items, regarding the woman's experience of her birth

50

51

No. 10 This activity is about transfer and referral to the community


• Undertake a social assessment of your client and identify their social needs

• State how you will prepare the woman and her baby for transfer from hospital to community care, identifying referrals that may need tobe made

• Outline the advice and information you have given to a woman and discuss this with your mentor

• Identify factors that contribute to the development of the maternal infant relationship

52


Date:


Yes No


(please tick)

Yes No

No 11. The following activities relate to the Screening of the Normal Baby


Select a baby in your care

• Identify the conditions neonates are screened for

• Describe the procedure for obtaining a capillary blood sample from the heel

• Carry out the test and discuss this process with your mentor

Mentor Comments and Action Plan as required on Activities 9, 10 & 11


53

No. 12 (a) These activities are about Care around Infant Nutrition

(ESC: All ESCs in sections one and four)

Select a mother who is breast feeding her infant. (You need to be observed undertaking this skill)

• Discuss with the woman, how she arrived at her decision to breastfeed her infant

• Does the woman know of the advantages of breastfeeding?

• Summarise the physiology of lactation with her

• Summarise the principles of breastfeeding with her

• Use opportunities to assist the woman with feeding

• Reflect on this activity with your mentor

54


Date:


Yes No


(please tick)

Yes No

12 (b) Select a mother who is formula feeding her infant

• Explain how a feed is correctly reconstituted and rationale

• Summarise the principles of formula feeding

• Write about 4 facts which indicate that the baby is thriving on formula milk

• Reflect on your experiences whilst doing these activities and identify what you have learnt.

Mentor Comments and Action Plan as required on Activity 12


55

Professional and Ethical Practice Domain >

Following are a number of activities that you must undertake at least 6 times, in hospital and or in the community, prior to assessment.These activities will help you to achieve the following Standards of for pre-registration midwifery education

B. Professional and Ethical Practice

B1. Practise in accordance with the NMC code of professional conduct: standards for conduct, performance and ethics (NMC 2008), withinthe limitations of the individual's own competence, knowledge and sphere of professional practice, consistent with the legislation relatingto midwifery practice

B2. Practise in a way, which respects, promotes and supports individual's rights,

interests, preferences, beliefs and cultures

B3. Practise in accordance with relevant legislation

B4. Maintain confidentiality of information

B5. Work collaboratively with other practitioners and agencies

B6. Can take responsibility for own learning with appropriate support

B7. Demonstrate an awareness of environments that promote the health, safety and well-being of women, babies and others

Can respect the decision women to decline services or treatment(ESC2.1)

Accurately completes a initial consultation (ESC2.1)

Treat women with respect with dignity and respect as individuals (ESC1.5)

Provide care that is delivered in a warm, sensitive and compassionate manner (ESC7.5)

B. Professional and Ethical Practice Activities

No. 13 This activity relates to meeting the cultural needs of your client


• Identify the different cultures you have been involved with in your practice experience

• Describe a cultural issue which occurred (this could have to do with food, sleep, religion,…)

• What were the diverse needs of one of your clients and how did you meet these needs?

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57


Date:


Yes No


(please tick)

Yes No

No. 14 This activity relates to Confidentiality


• Think about a confidentiality issue which you faced or observed in practice (telephone information, records, personal details orinformation which the woman wished to remain confidential)

• How did you maintain, or how was confidentiality maintained?

• Why is this important within midwifery practice? (confidentiality)

• Discuss this with your mentor and summarise here how good practices were carried out



No. 15 This activity is about records and documentation


Select a woman in your care who is experiencing what both she and her

professional carers consider to be normal pregnancy and undertake the

following activities:

• Introduce yourself

• Ask about her experience of care to date

• Engage her in discussions about her views about holding her own records

• Find out and comment below on who has access to her records

• What investigatory reports are found in the records and what are these for?

• Observe and comment on the features of what you consider to be “good record keeping”

• Outline the legal implications of documentation and record keeping (that you are aware of at this stage)

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59


Date:


Yes No


(please tick)

Yes No

No. 16 The following activities are about Infection Control and the Use of Universal Precautions

(ESC: All ESCs in section three)

• Using a full range of universal precautions give actual examples of how infection control can be achieved.

• Explain your understanding of why mothers and newborn babies are at particular risk of acquiring an infection.

• Identify here particular procedures and practices, which you observed to be in place to minimise cross infection in maternityenvironments.



60


Date:


Yes No


(please tick)

Yes No

No. 17 This activity is related to Moving and Handling

Mandatory

• Select a client in your care (she could be at any stage of pregnancy or following birth) and undertake the following risk assessment:

• Using *TILE identify the risks you must consider when undertaking moving and handling (*Task, Individual, Load and Environment)

• Briefly describe how the risks can be minimised or avoided for both client and midwife

• Reflect on your experiences whilst doing this activity and identify what you have learnt



61

C. Developing the Individual Midwife and Others Activities (includes Inter-professional Practice)

C1 Has a factual knowledge of the nature of midwifery knowledge, skills and fitness to practice

C2 Demonstrate awareness of effective working across professional boundaries and can meet obligations to others e.g. colleagues andpeers

C3 Is aware of the main NHS-managed antenatal screening programmes that are offered to pregnant women (ESC2.1.1)

No. 18 This activity is about drug administration

(ESC: All ESCs in section five)

• What do you know about good practice regarding drug administration?

• What do midwives ensure before, during and after giving a drug?

• Describe the regulations around storage and administration of medicines

• Discuss the practices you have observed with your mentor and reflect on this

• Select a woman in your care taking oral medication and write a summary which includes the following information: (Why was a drug prescribed what were the effects of this, what are the side-effects and contraindications of the drug?)

Calculate the following:



62

Medication and dosage Patient requires Number of tablets / amount ofmillilitres to give

Paracetamol 500mgs Paracetamol 1g

Warfarin 2mgs Warfarin 10mgs

Olanzapine 2.5mgs Olanzapine 17.5mgs

Calpol 120mgs/5mls Calpol 240mgs

Insulin (Human Actrapid)

100units per ml

Insulin (Human Actrapid)

16units

Ferrous Sulphate

200 mg

Ferrous Sulphate 600mg

Folic Acid 400 μg Folic Acid 0.4mg


Date:


Yes No


(please tick)

Yes No

63


Date:


Yes No


(please tick)

Yes No

D. Achieving Quality care through Evaluation and Research Activities

D1 Apply relevant knowledge to the midwife’s own practice in structured ways which are capable of evaluation

D2 Is able to act within limited autonomy and under direction and within defined guidelines and can apply given tools such as reflection onpractice

D3 Manage and develop care utilising the most appropriate information technology

Applies the principles of data protection(ESC2.3)

No. 19 This activity is about midwifery supervision


• Write a summary here of your own understanding of midwifery supervision ( explain the role of the midwifery supervisor)

• Summarise the meeting you have had with your Midwifery supervisor here:

(You must make an appointment with her/him before the end of year one)



Section 6 - EC Midwifery Directives Case Patient Log >

Case/Patient Log

EU Midwifery Directives (2005/36/EU)

Please record your findings using the tables below

Care of 30 Antenatal Mothers

64

Number Date Mother’sInitial

Brief Summary of Findings Midwife’s Signature

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

65

Care of 30 Antenatal Mothers continued



11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

Care of 30 Antenatal Mothers continued

66



21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

67

Care of 30 Postnatal mothers



1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Care of 30 Postnatal Mothers continued

68



11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

69

Care of 30 Postnatal Mothers continued



21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

Care and Examination of 30 Newborn Babies

70

Number Date Baby’sInitial


1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

71

Care and Examination of 30 Newborn Babies continued



11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

Care and Examination of 30 Newborn Babies continued

72



21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

73

Care and Supervision of 15 Women in Normal Labour



1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

Care, Supervision and Delivery of at least 10 Women In Normal Labour

74



1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

75

Care, Supervision and Delivery of at least 10 Women In Normal Labour continued



11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

Care and Supervision of 5 Women Who Experience Abnormal Conditions Either in the Antenatal, Labour orPostnatal Period

76



1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

77

Any Other Experience Student Has Achieved, E.g. Care Of Sick Neonate, Episiotomy or Suturing Undertaken



1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

78

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Revised and rewritten by: Gulu Hussein, Adele Hamilton, Dora Opoku and Michelle Steptoe

Original development by: Val Dimmock, Michelle Ellis, Gulu Hussein, Di Lear, Michelle Lyne, Maggie Maxwell and Soo Moore

School of Community and Health Sciences, 20 Bartholomew Close, London, EC1A 7QN.

Tel: 020 7040 5780

www.city.ac.uk/communityandhealth

Documents

Record of Achievement in Practice - Welcome to City · the midwife ... Record of Achievement in Practice Year 1> Introduction ... *Advisory notes for mentors re students who need