Post on 09-Apr-2020
Practice Assessment Document
PRACTICE ASSESSMENT DOCUMENT
NURSING ASSOCIATE PART 1 – Year 1
FdSc Healthcare Practice
This document has been adapted with permission from the Pan London Practice
Learning Group (PLPLG Oct 2014)
Please keep your Practice Assessment Document with you at all times in practice in order to review your progress with your Practice Assessor, Practice Educator and/or Academic Supervisor.
Name……………………………………………… Number………………………………………….. Cohort…………………………........................ Personal Tutor…………………………………
Practice Assessment Document
BLANK
Practice Assessment Document
1 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Contents Page
Welcome to your Practice Assessment Document (PAD)
2
Guidance for using the PAD
3
University Specific Guidelines
4
Descriptors for Assessing Trainees in Practice
7
List of Assessors/Practice Educators
8
Base placement 10
External placement 1 23
External placement 2
27
Verification sheet – HP4003Y Essence of care 1 51
External placement 3
53
Verification sheet – HP4005X Specialist Skills Development for the Workforce
67
External placement 4 (only to be completed for resit)
69
Verification sheet – (only to be completed for resit placement) 83
Assessment of Nursing Associate Domains 86
Action Plan
93
Record of Practice Clinical Experience Hours
95
Practice Assessment Document
2 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Welcome to your Practice Assessment Document (PAD) Nursing Associate Trainee responsibilities This Practice Assessment Document is designed to support and guide you towards successfully achieving the criteria set out in the Nursing Associate Curriculum Framework (HEE 2017). The PAD makes up a significant part of your overall programme assessment and is submitted as part
of the assessment requirements for the Essence of Care 1 and Specialist Skills Development for the
Workforce modules. It will need to be processed through formal University systems. Continuous
assessment is an integral aspect of assessment in practice and you are expected to show evidence of
consistent achievement.
Ensure you are familiar with your university assessment and submission processes for this document,
including the dates for submission and contact the academic representative from your university, or
refer to the intranet if you require support or advice on specific university procedures.
You are responsible for the safekeeping and maintenance of the PAD. It should be available to your
practice assessor/ practice educator at all times when you are in placement, together with the skills
book (PAD - part 2). Alterations should be made in this document by crossing through with one line,
with a signature and date.
You will have access to confidential information when in practice placements. The PAD should not contain any patient/service user/carer identifiable information. The contents must not be disclosed to any unauthorised person or removed, photocopied or used outside the placement or university. Practice assessor responsibilities As a practice assessor you have an important role in supporting and guiding the trainee through their learning experience. This includes facilitating any reasonable adjustments the trainee may need to get maximum benefit from the placement. As well as undertaking the required assessments, your role also includes identifying relevant learning opportunities and creating learning and development plans with the trainee. Duty rotas should support the development of the trainee/ assessor relationship and allow the facilitation of learning, particularly when they are on an external placement.
When assessing the trainee, take into account sources of evidence that encompass knowledge, skills,
attitudes and the views of those receiving care. Comments should acknowledge those exceptional
trainees who are exceeding expectations for their stage in practice or who have particularly
commendable attitudes, behaviours, knowledge or skills.
If the trainee is not meeting the required standards this should be highlighted as a development need.
If there is a cause for concern or a fitness for practice issue that requires prompt action an Action Plan
should be instigated to address specific needs or concerns with a specified timeframe. In this event,
seek guidance from the university representative and/or senior practice representative.
Practice Assessment Document
3 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Guidance for using the PAD to Facilitate and Guide Practice Learning
The practice assessment document (PAD) is designed to facilitate and guide practice learning throughout the programme. Assessment criteria are based on the Nursing Associate Curriculum Framework (HEE 2017). All assessors/ practice educators/other professionals who comment in this document should sign and give their details on the record page which can be found in the first section of this document.
Components of Assessment
Professional Values: These are assessed and must be achieved by the end of each external placement, and at the end of year 1 in the base placement. Domain Competence Statements: These can be assessed in a range of placements but need to be assessed as achieved at least once by the end of Year 1 of the programme. Patient/Service User/Carer Feedback Form: The practice assessor/ practice educator must give permission before the person receiving care is approached for feedback on the trainee’s performance. This is not formally assessed but may contribute to the practice assessor/ practice educator’s overall feedback. Recording Additional Experiences and Feedback: There are two additional forms (included in each placement section, the first of these relates to working with other healthcare professionals/inter-professional working and the second can be completed by any staff member (inc. academic representatives/link lecturer) who wish to record trainee progress.
Process of practice assessment
Action Plans: Action plans are instigated when there is a cause for concern or fitness to practice issue that requires prompt action. An action plan must involve the Practice Assessor/ Personal Practice Assessor/ Designated Practice Educator and an academic representative. Refer to page 93
Prior to placement (for External Placements) Trainee contacts the placement to obtain relevant information
and considers potential learning opportunities.
Final Interview Meeting to review progress and identify learning and development needs.
Initial Interview Trainee and practice assessor/ practice educator meet to identify learning and development needs and practice learning opportunities. A clear learning strategy/ plan is identified.
Mid-Point Interview Meeting to discuss progress and identify learning and development needs.
Placement Orientation – see orientation checklist (for External Placements) This provides specific placement information and health and safety regulations.
Practice Assessment Document
4 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
GUIDELINES FOR ASSESSMENT AND PROGRESSION
This Practice Assessment Document (PAD) provides guidance to both trainees and their practice assessors/ practice educator on trainee learning in practice and contains all the components for Year 1 of the FdSc Healthcare Practice – Nursing Associate programme. This document is adapted from the Practice Assessment Document designed for use across nine Universities for pre-registration nursing in 2014. Placement Trainees will undertake three external placements within each year of the Nursing Associate programme in a range of health and/or care settings. These will vary to provide opportunities to work in different settings and contexts, from the trainees base placement setting. External placements will last 4 weeks, with placement hours equating to 360 hours each year. Additional outreach experiences with the MDT are encouraged and can be recorded within this assessment document. Trainees are also advised to ask other staff involved in their supervision and learning for comments on their progress and performance by completing the ‘Ongoing Feedback From Staff in Practice’ pages. Assessment of Professional Values in Practice Professional values will be assessed in each placement, including the base placement, and following assessment must be achieved in order to progress. If any of the professional values are not achieved an opportunity to be reassessed will be given and the assessor informed. If a trainee does not achieve any of the professional values following reassessment then this may affect the trainee’s progression. The Course Director will be consulted and a referral to the Fitness for Practice Panel will be made. Assessment of Domain Competence Statements (PAD part 1) Trainees need to achieve all Domain Competence Statements by the end of year 1 of the programme in order to progress to year 2. It is expected that trainees will identify which Domain Competence Statements that they are planning to achieve at the start of each placement and document this within the initial interview. It is anticipated that trainees will complete a minimum of five Domain Competence Statements in each External Placement. Assessment of Skills (PAD part 2) Trainees need to achieve all Skills (at least once) by the end of the programme, and are expected to have achieved a minimum of 30skills in order to progress to year two. If the opportunity to be assessed on a particular skill is not available then the corresponding field is left blank. Further information relating to the skills can be found within the Skills book (PAD part 2) Submission Trainees will be required to submit pages from this assessment document at the end of each placement for the purposes of monitoring and support and will be advised regarding dates and processes for submission by the Course Director. Both parts of the PAD (part 1 – year 1 and part 2 - skills book) will need to be submitted as part of the assessments for the Essence of Care 1 and Specialist Skills Development module and trainees will be advised regarding dates and processes for submission by the relevant Module Leader. Access to Documents and Support Further information and access to the PADs can be found at http://www.healthcare.ac.uk/courses/nursing-midwifery-mentor-resources/ or via email to FDHCP@sgul.kingston.ac.uk Trainee information can be found in programme handbooks and via Moodle
Practice Assessment Document
5 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Kingston University & St George’s, University of London - Guidelines for Assessment and Progression
NURSING ASSOCIATE TRAINEE PLACEMENT
Initial Interview: Meeting between trainee and assessor – held within the first week of the placement (all trainees). Initial learning and development needs and agreement of a learning plan including domain competence statements and skills to be completed (orientation should occur on day 1). Date for mid-point review agreed.
Mid-Point: Both the trainee and assessor need to provide comments. If the assessor has concerns about trainee learning and progress, contact must be made with the Personal Practice Assessor / Practice Educator and the Personal Tutor. The Personal Tutor must inform the Course Director. An Action Plan will need to be developed and where possible a member of the programme team should be present.
Final Interview: If there have been concerns regarding the trainees’ performance then the Personal Practice Assessor/ Practice Educator and/ or the Personal Tutor should be invited to attend. Summative assessment completed.
Relevant assessment documentation submitted electronically by the trainee at the end of each placement. Module leader reviews documentation and actions, as necessary.
Refer Board of Examiners Pass
Programme Leader contacts the trainee and new placement area. Personal Tutor to initiate support if retrieval possible.
Decision options if the trainee does not achieve: 1. Referral of 1 placement = Retrieval of practice 2. Referral of 2 placements = Fail. Repeat Not Permitted on the Programme
Progress
A sample of all documentation will be reviewed through the Faculty Quality Assurance processes through a moderation committee.
Practice Assessment Document
6 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Kingston University & St George’s, University of London - Guidelines for addressing concerns about trainee’s performance
Assessor concerned about trainee’s performance
Personal/ professional behaviour
of serious concern
Not achieving outcomes or personal/
professional behaviour of minor concern
Contact Personal Practice
Assessor/ Practice Educator for
advice and support
Assessor and trainee discuss
concern. Discussion documented
in Practice Assessment Document
by assessor
Personal Practice Assessor/
Practice Educator / Assessor to
notify Personal Tutor of concerns
and for additional advice and
support
Personal Tutor to notify Course
Director
Course Director may
request assessor to
write statement or to
use assessment process
to manage concern
Contact Personal Practice Assessor/
Practice Educator for advice and support
Assessor and trainee discuss concern
Action plan developed
Personal Tutor contacted for advice if
required
Assessor and trainee continue assessment
process
Assessor passes
trainee Assessor
fails trainee
Personal Tutor to complete
trainee practice learning
opportunity record sheet,
which is logged at the
university
Practice Assessment Document
7 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Descriptors for Assessing Trainees in Practice
HEE has identified skills and professional behaviours that a trainee must demonstrate by the end of the programme These criteria broadly cover:
Safety, safeguarding and protection of people of all ages, their carers and their families
Professional values, expected attitudes and the behaviours that must be shown towards people, their carers, their families and others
Practice assessors are required to assess trainees at the level they are expected to achieve within the programme. These descriptors should be used when assessing Professional Values, Skills and Domain Competence statements
By the end of Year 1 the trainee needs to achieve all Professional Values and Domain Competence statements ‘Achieved’ must be obtained in all three criteria by the trainee Achieved Knowledge and
understanding Professional attitude Participation in care
and practical skill YES Is able to identify the
essential knowledge base, is safe, but may need to develop further understanding
Is able to demonstrate positive engagement with learning and respond appropriately to situations with some assistance
In commonly occurring situations is able to perform care and skills under direct supervision
NO Is not able to demonstrate an adequate knowledge base and has significant gaps in understanding, and/or demonstrates unsafe practice
Is not able to focus on the service user and/or appears disengaged from the activity or responds inappropriately to service users/carers or colleagues
With direct supervision is not able to demonstrate safe practice and is unable to perform the activity and/or follow instructions despite repeated guidance
Practice Assessment Document
8 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
List of Practice Assessors/ Practice Educators A sample signature must be obtained for all signatures within this document
(All assessors must have an NMC recognised mentorship qualification and have attended an annual update)
Name (please print)
Job Title Signature Initials Date of last Mentor Update/
Mentor ID Number
Placement
Practice Assessment Document
9 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
List of Practice Assessors/ Practice Educators A sample signature must be obtained for all signatures within this document
(All assessors must have an NMC recognised mentorship qualification and have attended an annual update)
Name (please print)
Job Title Signature Initials Date of last Mentor Update/
Mentor ID Number
Placement
Practice Assessment Document
10 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Base Placement (Usual place of work)
Placement Provider: (e.g. Trust) Name of Practice Area: Type of Experience: (e.g. Community/Ward based)
Practice Placement Telephone: Placement Contact Email:
No. of Hours worked per week…………………
Practice assessor/ Practice Educator Details: Name: Designation: Name: Designation: Other Practice Staff/Key Contacts: Name: Designation:
Academic Contact Details: (e.g. Link Lecturer) Name: Designation: Name: Designation:
Practice Assessment Document
11 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Base Placement: Initial Interview Area Name:
This interview takes place within the first month of year 1 of the programme
Trainee to identify learning and development needs, including which Skills (from PAD: Part 2) and Domain competence statements you plan to achieve (with guidance from the practice assessor)
Practice assessor to identify learning opportunities to enable the trainee to meet their learning and development needs and assessments
Practice assessor and trainee to negotiate and agree a learning plan -
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date:
Practice Assessment Document
12 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Professional Values in Practice Trainees are required to demonstrate high standards of professional conduct at all times during their placements. Trainees should work within legal frameworks, and be able to articulate the underpinning values of The Code (2015). Professional values expectations are reflected in the statements below.
Yes = Achieved, No = Not Achieved (Refer to Grade Descriptors on Page 7)
Professional attitude, behaviour and responsibility
Trainee Evidence / Comments
Achieved Mid-Point
Yes/No
Initial/ Date
Achieved Final
Yes/No
Initial/ Date (Final)
1. The trainee maintains confidentiality in accordance with the NMC code.
2. The trainee is non-judgemental, respectful and courteous at all times when interacting with patients/service users and all colleagues.
3. The trainee maintains an appropriate professional attitude regarding punctuality and communicates appropriately if unable to attend placement.
4. The trainee’s personal presentation and dress code is in accordance with the organisation’s uniform policy.
5. The trainee maintains the person’s privacy and dignity and advocates on their behalf.
6. The trainee demonstrates openness, trustworthiness and integrity.
7. The trainee makes a consistent effort to engage in evidence-based standards of care and learning, with awareness of relevant local/national policies.
Practice Assessment Document
13 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Safe and compassionate care
Trainee Evidence / Comments
Achieved Mid-Point
Yes/No
Initial/ Date
Achieved Final
Yes/No
Initial/ Date (Final)
8. The trainee is attentive, kind, compassionate and sensitive to the needs of others.
9. The trainee maintains consistent safe and person-centred practice.
10. The trainee reports any concerns to the appropriate professional member of staff when appropriate e.g. safeguarding.
11. The trainee demonstrates the ability to listen, seek clarification and carry out instructions safely.
12. The trainee is able to recognise and work within the limitations of own knowledge, skills and professional boundaries and understand that they are responsible for their own actions.
13. The trainee is able to work effectively within the multi-disciplinary team with the intent of building professional caring relationships.
Trainees can complete their evidence at any stage prior to the final interview. If there are any issues/areas for concern, these must be recorded in the Mid-Point or Final Interview as appropriate. ‘Not Achieved’ must trigger an Action Plan at the time of assessment and must be documented. The Action Plan template can be found on Page 93
Practice Assessment Document
14 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Base Placement : Mid-Point Interview This interview takes place half way through Year 1 of the Programme
Practice Assessor and Trainee to sign on the next page
Trainee’s self-assessment/reflection on progress Reflect on your overall progression referring to your personal learning needs, professional values and to the skills and Domain competence statements achieved at the mid-point. Identify your strengths and document areas for development.
Practice Assessor’s comments Discuss with the trainee their self-assessment and comment on their progress using the assessment descriptors below, detailing evidence used to come to your decision.
Knowledge:
Clinical and care skills:
Attitudes and behaviours:
Practice Assessment Document
15 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Base Placement: Mid-Point Interview Ongoing learning and development needs
To be agreed between Practice Assessor and Trainee – sign and date all entries below
Identify learning and development needs Refer to progress in achieving personal learning needs, professional values and remaining skills and Domain competence statements identified at initial interview.
Identify the learning opportunities/support to enable the trainee to meet their needs
Review Date: Sign when reviewed:
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date: Any outstanding learning and development needs are to be discussed and documented at the final interview.
If specific concerns have been raised about the trainee’s performance this should trigger an Action Plan at the time of assessment and should be documented. The action plan template can be found on Page 93
Practice Assessment Document
16 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Base Placement : Final Interview This should take place towards the end of the Year 1
Trainee’s self-assessment/reflection on progress Reflect on your overall progression referring to your personal learning needs, professional values skills and Domain competence statements. Identify your strengths and document areas for development.
Practice Assessor’s comments Discuss with the trainee their self-assessment and comment on their progress using the assessment descriptors below, detailing evidence used to come to your decision.
Knowledge:
Clinical and care skills:
Attitudes and behaviours:
Please record any further comments on the next page
Practice Assessment Document
17 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Learning and Development Needs To be agreed between the Practice Assessor and Trainee
Review learning and development needs identified at the Mid-Point Interview and those to take forward to the 2
nd year of the programme
Checklist for assessed documents Tick Assessor Initial
Trainee Initial
The Practice Assessor has signed the professional value statements at both Mid-Point and Final Interview
The Practice Assessor has signed the relevant Domain Competence statements the Trainee has achieved in this area (where applicable)
The Trainee and Practice Assessor have checked and signed the practice placement hours
The Practice Assessor and Trainee have completed all the interview records and development plans, as appropriate
The Practice Assessor has printed and signed their name on the List of Practice Assessor/ Practice Educator Record
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date:
Was an Action Plan required to support the trainee? YES / NO If Yes, was the Academic Representative informed? YES / NO The Action Plan can be found on Page 93
Practice Assessment Document
18 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Patient/Service User Feedback Form
We would like to hear your views about the way the Trainee Nursing Associate has looked after you.
Your feedback will help the Trainee Nursing Associate’s learning
The feedback you give will not change the way you are looked after
Thank you for your help This form has been designed by Service Users
Tick if you are: The Patient/Service User Carer/Relative
How happy were you with the way the Trainee Nursing Associate …
Very Happy
Happy
I’m not sure
Unhappy
Very unhappy
…cared for you?
…listened to your needs?
…understood the way you felt?
…talked to you?
…showed you respect?
What did the Nursing Associate Trainee do well?
What could the Nursing Associate Trainee have done differently?
Practice Assessor Signature: Date: Nursing Associate Trainee Signature: Date:
Practice Assessors should obtain consent from patients/service users who should feel able to decline to participate.
Practice Assessment Document
19 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Record of working with other health care professionals/inter-professional working Record reflections on your learning in outreach/short practice placements
or with members of the multi-disciplinary team. Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
More pages can be downloaded as per University guidelines
Practice Assessment Document
20 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Record of working with other health care professionals/inter-professional working Record reflections on your learning in outreach/short practice placements
or with members of the multi-disciplinary team. Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
More pages can be downloaded as per University guidelines
Practice Assessment Document
21 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Ongoing Feedback from Staff in Practice This can be completed by any individual involved in the trainee’s learning e.g. the practice
assessor, staff (other than the practice assessor), practice educator, link lecturer or personal tutor. This is in addition to the pages referring to Inter-professional Working, as above.
Date/time Signature/ Designation
Comments
Practice Assessment Document
22 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Ongoing Feedback from Staff in Practice This can be completed by any individual involved in the trainee’s learning e.g. the practice
assessor, staff (other than the practice assessor), practice educator, link lecturer or personal tutor. This is in addition to the pages referring to Inter-professional Working, as above.
Date/time Signature/ Designation
Comments
Practice Assessment Document
23 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 1 – 09/04/2018-06/05/2018
Placement Provider: (e.g. Trust) Name of Practice Area: Type of Experience: (e.g. Community/Ward based)
Practice Placement Telephone: Placement Contact Email:
Start Date………………….. End Date……….………. No. of Hours…………………
Practice assessor/ Practice Educator Details: Name: Designation: Name: Designation: Other Practice Staff/Key Contacts: Name: Designation:
Academic Contact Details: (e.g. Link Lecturer) Name: Designation: Name: Designation:
NB: For some trainees a placement may be split across two areas
Practice Assessment Document
24 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 1: Orientation
Name of Area 1 Name of Area 2 (if app.)
Name of Placement Area
Initial/Date (Trainee)
Initial/Date (Practice
Assessor)
Initial/Date (Trainee)
Initial/Date (Practice
Assessor)
The following criteria need to be met within the first day in placement
A general orientation to the health and social care placement setting has been undertaken
The local fire procedures have been explained Tel………………
The trainee has been shown the:
fire alarms
fire exits
fire extinguishers
Resuscitation policy and procedures have been explained Tel: ..........................
Resuscitation equipment has been shown and explained
The trainee knows how to summon help in the event of an emergency
The trainee is aware of where to find local policies
health and safety
incident reporting procedures
infection control
handling of messages and enquiries
other policies
The trainee has been made aware of information governance requirements
The shift times, meal times and reporting sick policies have been explained.
Policy regarding safeguarding has been explained
Lone working policy has been explained (if applicable)
Risk assessments/reasonable adjustments relating to disability/learning/pregnancy needs have been discussed (where disclosed)
The following criteria need to be met prior to use
The trainee has been shown and given a demonstration of the moving and handling equipment used in the clinical area
The trainee has been shown and given a demonstration of the medical devices used in the clinical area
Placement Provider induction/update complete, if applicable
Practice Assessment Document
25 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 1: Initial Interview
Area Name: This interview takes place within the first week of the placement
Trainee to identify learning and development needs, including which Skills (from PAD: Part 2) and Domain competence statements you plan to achieve (with guidance from the practice assessor)
Practice assessor to identify learning opportunities to enable the trainee to meet their learning and development needs and assessments
Practice assessor and trainee to negotiate and agree a learning plan -
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date:
Practice Assessment Document
26 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Professional Values in Practice
Trainees are required to demonstrate high standards of professional conduct at all times during their placements. Trainees should work within legal frameworks, and be able to articulate the underpinning values of The Code (2015). Professional values expectations are reflected in the statements below.
Yes = Achieved, No = Not Achieved (Refer to Grade Descriptors on Page 7)
Professional attitude, behaviour and responsibility
Trainee Evidence / Comments
Achieved Mid-Point
Yes/No
Initial/ Date
Achieved Final
Yes/No
Initial/ Date (Final)
1. The trainee maintains confidentiality in accordance with the NMC code.
2. The trainee is non-judgemental, respectful and courteous at all times when interacting with patients/service users and all colleagues.
3. The trainee maintains an appropriate professional attitude regarding punctuality and communicates appropriately if unable to attend placement.
4. The trainee’s personal presentation and dress code is in accordance with the organisation’s uniform policy.
5. The trainee maintains the person’s privacy and dignity and advocates on their behalf.
6. The trainee demonstrates openness, trustworthiness and integrity.
7. The trainee makes a consistent effort to engage in evidence-based standards of care and learning, with awareness of relevant local/national policies.
Practice Assessment Document
27 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Safe and compassionate care
Trainee Evidence / Comments
Achieved Mid-Point
Yes/No
Initial/ Date
Achieved Final
Yes/No
Initial/ Date (Final)
8. The trainee is attentive, kind, compassionate and sensitive to the needs of others.
9. The trainee maintains consistent safe and person-centred practice.
10. The trainee reports any concerns to the appropriate professional member of staff when appropriate e.g. safeguarding.
11. The trainee demonstrates the ability to listen, seek clarification and carry out instructions safely.
12. The trainee is able to recognise and work within the limitations of own knowledge, skills and professional boundaries and understand that they are responsible for their own actions.
13. The trainee is able to work effectively within the multi-disciplinary team with the intent of building professional caring relationships.
Trainees can complete their evidence at any stage prior to the final interview. If there are any issues/areas for concern, these must be recorded in the Mid-Point or Final Interview as appropriate. ‘Not Achieved’ must trigger an Action Plan at the time of assessment and must be documented. The Action Plan template can be found on Page 93
Practice Assessment Document
28 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 1: Mid-Point Interview This interview takes place half way through the placement
Practice Assessor and Trainee to sign on the next page
Trainee’s self-assessment/reflection on progress Reflect on your overall progression referring to your personal learning needs, professional values and to the skills and Domain competence statements achieved at the mid-point. Identify your strengths and document areas for development.
Practice Assessor’s comments Discuss with the trainee their self-assessment and comment on their progress using the assessment descriptors below, detailing evidence used to come to your decision.
Knowledge:
Clinical and care skills:
Attitudes and behaviours:
Practice Assessment Document
29 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 1: Mid-Point Interview Ongoing learning and development needs
To be agreed between Practice Assessor and Trainee – sign and date all entries below
Identify learning and development needs Refer to progress in achieving personal learning needs, professional values and remaining skills and Domain competence statements identified at initial interview.
Identify the learning opportunities/support to enable the trainee to meet their needs
Review Date: Sign when reviewed:
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date: Any outstanding learning and development needs are to be discussed and documented at the final interview.
If specific concerns have been raised about the trainee’s performance this should trigger an Action Plan at the time of assessment and should be documented. The action plan template can be found on Page 93
Practice Assessment Document
30 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 1: Final Interview This should take place towards the end of the placement
Trainee’s self-assessment/reflection on progress Reflect on your overall progression referring to your personal learning needs, professional values skills and Domain competence statements. Identify your strengths and document areas for development.
Practice Assessor’s comments Discuss with the trainee their self-assessment and comment on their progress using the assessment descriptors below, detailing evidence used to come to your decision.
Knowledge:
Clinical and care skills:
Attitudes and behaviours:
Please record any further comments on the next page
Practice Assessment Document
31 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Learning and Development Needs To be agreed between the Practice Assessor and Trainee
Review learning and development needs identified at the Mid-Point Interview and those to take forward to the next placement
Checklist for assessed documents Tick Assessor Initial
Trainee Initial
The Practice Assessor has signed the professional value statements at both Mid-Point and Final Interview
The Practice Assessor has signed the relevant Domain Competence statements the Trainee has achieved in this area (where applicable)
The Trainee and Practice Assessor have checked and signed the practice placement hours
The Practice Assessor and Trainee have completed all the interview records and development plans, as appropriate
The Practice Assessor has printed and signed their name on the List of Practice Assessor/ Practice Educator Record
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date:
Was an Action Plan required to support the trainee? YES / NO If Yes, was the Academic Representative informed? YES / NO The Action Plan can be found on Page 93
Practice Assessment Document
32 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Patient/Service User Feedback Form
We would like to hear your views about the way the Trainee Nursing Associate has looked after you.
Your feedback will help the Trainee Nursing Associate’s learning
The feedback you give will not change the way you are looked after
Thank you for your help This form has been designed by Service Users
Tick if you are: The Patient/Service User Carer/Relative
How happy were you with the way the Trainee Nursing Associate …
Very Happy
Happy
I’m not sure
Unhappy
Very unhappy
…cared for you?
…listened to your needs?
…understood the way you felt?
…talked to you?
…showed you respect?
What did the Nursing Associate Trainee do well?
What could the Nursing Associate Trainee have done differently?
Practice Assessor Signature: Date: Nursing Associate Trainee Signature: Date:
Practice Assessors should obtain consent from patients/service users who should feel able to decline to participate.
Practice Assessment Document
33 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Record of working with other health care professionals/inter-professional working Record reflections on your learning in outreach/short practice placements
or with members of the multi-disciplinary team. Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
More pages can be downloaded as per University guidelines
Practice Assessment Document
34 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Record of working with other health care professionals/inter-professional working Record reflections on your learning in outreach/short practice placements
or with members of the multi-disciplinary team. Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
More pages can be downloaded as per University guidelines
Practice Assessment Document
35 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Ongoing Feedback from Staff in Practice This can be completed by any individual involved in the trainee’s learning e.g. the practice
assessor, staff (other than the practice assessor), practice educator, link lecturer or personal tutor. This is in addition to the pages referring to Inter-professional Working, as above.
Date/time Signature/ Designation
Comments
Practice Assessment Document
36 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Ongoing Feedback from Staff in Practice This can be completed by any individual involved in the trainee’s learning e.g. the practice
assessor, staff (other than the practice assessor), practice educator, link lecturer or personal tutor. This is in addition to the pages referring to Inter-professional Working, as above.
Date/time Signature/ Designation
Comments
Practice Assessment Document
37 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 2 – 03/09/2018-30/09/2018
Placement Provider: (e.g. Trust) Name of Practice Area: Type of Experience: (e.g. Community/Ward based)
Practice Placement Telephone: Placement Contact Email:
Start Date………………….. End Date……….………. No. of Hours…………………
Practice assessor/ Practice Educator Details: Name: Designation: Name: Designation: Other Practice Staff/Key Contacts: Name: Designation:
Academic Contact Details: (e.g. Link Lecturer) Name: Designation: Name: Designation:
NB: For some trainees a placement may be split across two areas
Practice Assessment Document
38 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 2: Orientation
Name of Area 1 Name of Area 2 (if app.)
Name of Placement Area
Initial/Date (Trainee)
Initial/Date (Practice
Assessor)
Initial/Date (Trainee)
Initial/Date (Practice
Assessor)
The following criteria need to be met within the first day in placement
A general orientation to the health and social care placement setting has been undertaken
The local fire procedures have been explained Tel………………
The trainee has been shown the:
fire alarms
fire exits
fire extinguishers
Resuscitation policy and procedures have been explained Tel: ..........................
Resuscitation equipment has been shown and explained
The trainee knows how to summon help in the event of an emergency
The trainee is aware of where to find local policies
health and safety
incident reporting procedures
infection control
handling of messages and enquiries
other policies
The trainee has been made aware of information governance requirements
The shift times, meal times and reporting sick policies have been explained.
Policy regarding safeguarding has been explained
Lone working policy has been explained (if applicable)
Risk assessments/reasonable adjustments relating to disability/learning/pregnancy needs have been discussed (where disclosed)
The following criteria need to be met prior to use
The trainee has been shown and given a demonstration of the moving and handling equipment used in the clinical area
The trainee has been shown and given a demonstration of the medical devices used in the clinical area
Placement Provider induction/update complete, if applicable
Practice Assessment Document
39 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 2: Initial Interview
Area Name: This interview takes place within the first week of the placement
Trainee to identify learning and development needs, including which Skills (from PAD: Part 2) and Domain competence statements you plan to achieve (with guidance from the practice assessor)
Practice assessor to identify learning opportunities to enable the trainee to meet their learning and development needs and assessments
Practice assessor and trainee to negotiate and agree a learning plan -
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date:
Practice Assessment Document
40 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Professional Values in Practice
Trainees are required to demonstrate high standards of professional conduct at all times during their placements. Trainees should work within legal frameworks, and be able to articulate the underpinning values of The Code (2015). Professional values expectations are reflected in the statements below.
Yes = Achieved, No = Not Achieved (Refer to Grade Descriptors on Page 7)
Professional attitude, behaviour and responsibility
Trainee Evidence / Comments
Achieved Mid-Point
Yes/No
Initial/ Date
Achieved Final
Yes/No
Initial/ Date (Final)
1. The trainee maintains confidentiality in accordance with the NMC code.
2. The trainee is non-judgemental, respectful and courteous at all times when interacting with patients/service users and all colleagues.
3. The trainee maintains an appropriate professional attitude regarding punctuality and communicates appropriately if unable to attend placement.
4. The trainee’s personal presentation and dress code is in accordance with the organisation’s uniform policy.
5. The trainee maintains the person’s privacy and dignity and advocates on their behalf.
6. The trainee demonstrates openness, trustworthiness and integrity.
7. The trainee makes a consistent effort to engage in evidence-based standards of care and learning, with awareness of relevant local/national policies.
Practice Assessment Document
41 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Safe and compassionate care
Trainee Evidence / Comments
Achieved Mid-Point
Yes/No
Initial/ Date
Achieved Final
Yes/No
Initial/ Date (Final)
8. The trainee is attentive, kind, compassionate and sensitive to the needs of others.
9. The trainee maintains consistent safe and person-centred practice.
10. The trainee reports any concerns to the appropriate professional member of staff when appropriate e.g. safeguarding.
11. The trainee demonstrates the ability to listen, seek clarification and carry out instructions safely.
12. The trainee is able to recognise and work within the limitations of own knowledge, skills and professional boundaries and understand that they are responsible for their own actions.
13. The trainee is able to work effectively within the multi-disciplinary team with the intent of building professional caring relationships.
Trainees can complete their evidence at any stage prior to the final interview. If there are any issues/areas for concern, these must be recorded in the Mid-Point or Final Interview as appropriate. ‘Not Achieved’ must trigger an Action Plan at the time of assessment and must be documented. The Action Plan template can be found on Page 93
Practice Assessment Document
42 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 2: Mid-Point Interview This interview takes place half way through the placement
Practice Assessor and Trainee to sign on the next page
Trainee’s self-assessment/reflection on progress Reflect on your overall progression referring to your personal learning needs, professional values and to the skills and Domain competence statements achieved at the mid-point. Identify your strengths and document areas for development.
Practice Assessor’s comments Discuss with the trainee their self-assessment and comment on their progress using the assessment descriptors below, detailing evidence used to come to your decision.
Knowledge:
Clinical and care skills:
Attitudes and behaviours:
Practice Assessment Document
43 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 2: Mid-Point Interview Ongoing learning and development needs
To be agreed between Practice Assessor and Trainee – sign and date all entries below
Identify learning and development needs Refer to progress in achieving personal learning needs, professional values and remaining skills and Domain competence statements identified at initial interview.
Identify the learning opportunities/support to enable the trainee to meet their needs
Review Date: Sign when reviewed:
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date: Any outstanding learning and development needs are to be discussed and documented at the final interview.
If specific concerns have been raised about the trainee’s performance this should trigger an Action Plan at the time of assessment and should be documented. The action plan template can be found on Page 93
Practice Assessment Document
44 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 2: Final Interview This should take place towards the end of the placement
Trainee’s self-assessment/reflection on progress Reflect on your overall progression referring to your personal learning needs, professional values skills and Domain competence statements. Identify your strengths and document areas for development.
Practice Assessor’s comments Discuss with the trainee their self-assessment and comment on their progress using the assessment descriptors below, detailing evidence used to come to your decision.
Knowledge:
Clinical and care skills:
Attitudes and behaviours:
Please record any further comments on the next page
Practice Assessment Document
45 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Learning and Development Needs To be agreed between the Practice Assessor and Trainee
Review learning and development needs identified at the Mid-Point Interview and those to take forward to the next placement
Checklist for assessed documents Tick Assessor Initial
Trainee Initial
The Practice Assessor has signed the professional value statements at both Mid-Point and Final Interview
The Practice Assessor has signed the relevant Domain Competence statements the Trainee has achieved in this area (where applicable)
The Trainee and Practice Assessor have checked and signed the practice placement hours
The Practice Assessor and Trainee have completed all the interview records and development plans, as appropriate
The Practice Assessor has printed and signed their name on the List of Practice Assessor/ Practice Educator Record
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date:
Was an Action Plan required to support the trainee? YES / NO If Yes, was the Academic Representative informed? YES / NO The Action Plan can be found on Page 93
Practice Assessment Document
46 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Patient/Service User Feedback Form
We would like to hear your views about the way the Trainee Nursing Associate has looked after you.
Your feedback will help the Trainee Nursing Associate’s learning
The feedback you give will not change the way you are looked after
Thank you for your help This form has been designed by Service Users
Tick if you are: The Patient/Service User Carer/Relative
How happy were you with the way the Trainee Nursing Associate …
Very Happy
Happy
I’m not sure
Unhappy
Very unhappy
…cared for you?
…listened to your needs?
…understood the way you felt?
…talked to you?
…showed you respect?
What did the Nursing Associate Trainee do well?
What could the Nursing Associate Trainee have done differently?
Practice Assessor Signature: Date: Nursing Associate Trainee Signature: Date:
Practice Assessors should obtain consent from patients/service users who should feel able to decline to participate.
Practice Assessment Document
47 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Record of working with other health care professionals/inter-professional working Record reflections on your learning in outreach/short practice placements
or with members of the multi-disciplinary team. Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
More pages can be downloaded as per University guidelines
Practice Assessment Document
48 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Record of working with other health care professionals/inter-professional working Record reflections on your learning in outreach/short practice placements
or with members of the multi-disciplinary team. Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
More pages can be downloaded as per University guidelines
Practice Assessment Document
49 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Ongoing Feedback from Staff in Practice This can be completed by any individual involved in the trainee’s learning e.g. the practice
assessor, staff (other than the practice assessor), practice educator, link lecturer or personal tutor. This is in addition to the pages referring to Inter-professional Working, as above.
Date/time Signature/ Designation
Comments
Practice Assessment Document
50 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Ongoing Feedback from Staff in Practice This can be completed by any individual involved in the trainee’s learning e.g. the practice
assessor, staff (other than the practice assessor), practice educator, link lecturer or personal tutor. This is in addition to the pages referring to Inter-professional Working, as above.
Date/time Signature/ Designation
Comments
Practice Assessment Document
51 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Practice Assessment Document Verification Sheet (for Faculty use only) Module: HP4003Y Essence of Care 1 (External Placements 1 and 2) Submission date: 04/10/2018 1st attempt
Pass Fail Return for Completion
Verifier’s Name…................................................................................................................................................ Signature………………………………………………. Date........................... Practice Assessment Document – Part 1 will be returned for completion for one or more of the following reasons:
Incomplete Practice Assessor/ Practice Educator signatory page (p9-10)
Incomplete Professional Values in Practice
Insufficient external practice placement hours (120 hours/ 4 week placement)
External practice placement hours not signed by Trainee and/or Practice Assessor
Incomplete interview records and development plans (as appropriate)
A Fail result will be given if any of the Professional Values in Practice have been assessed as not being met at the Final Interview stage for each placement.
Outcome following return for completion:
Pass Fail
Verifier’s Name…................................................................................................................................................ Signature……………………………………………. Date..............................
Practice Assessment Document
52 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Practice Assessment Document Verification Sheet (for Faculty use only) Module: HP4003Y Essence of Care 1 (External Placements 1 and 2) Submission date: To be confirmed 2nd attempt
Pass Fail Return for Completion
Verifier’s Name…................................................................................................................................................ Signature………………………………………………. Date........................... Practice Assessment Document – Part 1 will be returned for completion for one or more of the following reasons:
Incomplete Practice Assessor/ Practice Educator signatory page (p9-10)
Incomplete Professional Values in Practice
Insufficient external practice placement hours (120 hours/ 4 week placement)
External practice placement hours not signed by Trainee and/or Practice Assessor
Incomplete interview records and development plans (as appropriate)
A Fail result will be given if any of the Professional Values in Practice have been assessed as not being met at the Final Interview stage for each placement.
Outcome following return for completion:
Pass Fail
Verifier’s Name…................................................................................................................................................ Signature……………………………………………. Date..............................
Practice Assessment Document
53 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 3 – 29/10/2018-25/11/2018
Placement Provider: (e.g. Trust) Name of Practice Area: Type of Experience: (e.g. Community/Ward based)
Practice Placement Telephone: Placement Contact Email:
Start Date………………….. End Date……….………. No. of Hours…………………
Practice assessor/ Practice Educator Details: Name: Designation: Name: Designation: Other Practice Staff/Key Contacts: Name: Designation:
Academic Contact Details: (e.g. Link Lecturer) Name: Designation: Name: Designation:
NB: For some trainees a placement may be split across two areas
Practice Assessment Document
54 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 3: Orientation
Name of Area 1 Name of Area 2 (if app.)
Name of Placement Area
Initial/Date (Trainee)
Initial/Date (Practice
Assessor)
Initial/Date (Trainee)
Initial/Date (Practice
Assessor)
The following criteria need to be met within the first day in placement
A general orientation to the health and social care placement setting has been undertaken
The local fire procedures have been explained Tel………………
The trainee has been shown the:
fire alarms
fire exits
fire extinguishers
Resuscitation policy and procedures have been explained Tel: ..........................
Resuscitation equipment has been shown and explained
The trainee knows how to summon help in the event of an emergency
The trainee is aware of where to find local policies
health and safety
incident reporting procedures
infection control
handling of messages and enquiries
other policies
The trainee has been made aware of information governance requirements
The shift times, meal times and reporting sick policies have been explained.
Policy regarding safeguarding has been explained
Lone working policy has been explained (if applicable)
Risk assessments/reasonable adjustments relating to disability/learning/pregnancy needs have been discussed (where disclosed)
The following criteria need to be met prior to use
The trainee has been shown and given a demonstration of the moving and handling equipment used in the clinical area
The trainee has been shown and given a demonstration of the medical devices used in the clinical area
Placement Provider induction/update complete, if applicable
Practice Assessment Document
55 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 3: Initial Interview
Area Name: This interview takes place within the first week of the placement
Trainee to identify learning and development needs, including which Skills (from PAD: Part 2) and Domain competence statements you plan to achieve (with guidance from the practice assessor)
Practice assessor to identify learning opportunities to enable the trainee to meet their learning and development needs and assessments
Practice assessor and trainee to negotiate and agree a learning plan -
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date:
Practice Assessment Document
56 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Professional Values in Practice
Trainees are required to demonstrate high standards of professional conduct at all times during their placements. Trainees should work within legal frameworks, and be able to articulate the underpinning values of The Code (2015). Professional values expectations are reflected in the statements below.
Yes = Achieved, No = Not Achieved (Refer to Grade Descriptors on Page 7)
Professional attitude, behaviour and responsibility
Trainee Evidence / Comments
Achieved Mid-Point
Yes/No
Initial/ Date
Achieved Final
Yes/No
Initial/ Date (Final)
1. The trainee maintains confidentiality in accordance with the NMC code.
2. The trainee is non-judgemental, respectful and courteous at all times when interacting with patients/service users and all colleagues.
3. The trainee maintains an appropriate professional attitude regarding punctuality and communicates appropriately if unable to attend placement.
4. The trainee’s personal presentation and dress code is in accordance with the organisation’s uniform policy.
5. The trainee maintains the person’s privacy and dignity and advocates on their behalf.
6. The trainee demonstrates openness, trustworthiness and integrity.
7. The trainee makes a consistent effort to engage in evidence-based standards of care and learning, with awareness of relevant local/national policies.
Practice Assessment Document
57 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Safe and compassionate care
Trainee Evidence / Comments
Achieved Mid-Point
Yes/No
Initial/ Date
Achieved Final
Yes/No
Initial/ Date (Final)
8. The trainee is attentive, kind, compassionate and sensitive to the needs of others.
9. The trainee maintains consistent safe and person-centred practice.
10. The trainee reports any concerns to the appropriate professional member of staff when appropriate e.g. safeguarding.
11. The trainee demonstrates the ability to listen, seek clarification and carry out instructions safely.
12. The trainee is able to recognise and work within the limitations of own knowledge, skills and professional boundaries and understand that they are responsible for their own actions.
13. The trainee is able to work effectively within the multi-disciplinary team with the intent of building professional caring relationships.
Trainees can complete their evidence at any stage prior to the final interview. If there are any issues/areas for concern, these must be recorded in the Mid-Point or Final Interview as appropriate. ‘Not Achieved’ must trigger an Action Plan at the time of assessment and must be documented. The Action Plan template can be found on Page 93
Practice Assessment Document
58 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 3: Mid-Point Interview This interview takes place half way through the placement
Practice Assessor and Trainee to sign on the next page
Trainee’s self-assessment/reflection on progress Reflect on your overall progression referring to your personal learning needs, professional values and to the skills and Domain competence statements achieved at the mid-point. Identify your strengths and document areas for development.
Practice Assessor’s comments Discuss with the trainee their self-assessment and comment on their progress using the assessment descriptors below, detailing evidence used to come to your decision.
Knowledge:
Clinical and care skills:
Attitudes and behaviours:
Practice Assessment Document
59 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 3: Mid-Point Interview Ongoing learning and development needs
To be agreed between Practice Assessor and Trainee – sign and date all entries below
Identify learning and development needs Refer to progress in achieving personal learning needs, professional values and remaining skills and Domain competence statements identified at initial interview.
Identify the learning opportunities/support to enable the trainee to meet their needs
Review Date: Sign when reviewed:
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date: Any outstanding learning and development needs are to be discussed and documented at the final interview.
If specific concerns have been raised about the trainee’s performance this should trigger an Action Plan at the time of assessment and should be documented. The action plan template can be found on Page 93
Practice Assessment Document
60 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 3: Final Interview This should take place towards the end of the placement
Trainee’s self-assessment/reflection on progress Reflect on your overall progression referring to your personal learning needs, professional values skills and Domain competence statements. Identify your strengths and document areas for development.
Practice Assessor’s comments Discuss with the trainee their self-assessment and comment on their progress using the assessment descriptors below, detailing evidence used to come to your decision.
Knowledge:
Clinical and care skills:
Attitudes and behaviours:
Please record any further comments on the next page
Practice Assessment Document
61 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Learning and Development Needs To be agreed between the Practice Assessor and Trainee
Review learning and development needs identified at the Mid-Point Interview and those to take forward to the next placement
Checklist for assessed documents Tick Assessor Initial
Trainee Initial
The Practice Assessor has signed the professional value statements at both Mid-Point and Final Interview
The Practice Assessor has signed the relevant Domain Competence statements the Trainee has achieved in this area (where applicable)
The Trainee and Practice Assessor have checked and signed the practice placement hours
The Practice Assessor and Trainee have completed all the interview records and development plans, as appropriate
The Practice Assessor has printed and signed their name on the List of Practice Assessor/ Practice Educator Record
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date:
Was an Action Plan required to support the trainee? YES / NO If Yes, was the Academic Representative informed? YES / NO The Action Plan can be found on Page 93
Practice Assessment Document
62 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Patient/Service User Feedback Form
We would like to hear your views about the way the Trainee Nursing Associate has looked after you.
Your feedback will help the Trainee Nursing Associate’s learning
The feedback you give will not change the way you are looked after
Thank you for your help This form has been designed by Service Users
Tick if you are: The Patient/Service User Carer/Relative
How happy were you with the way the Trainee Nursing Associate …
Very Happy
Happy
I’m not sure
Unhappy
Very unhappy
…cared for you?
…listened to your needs?
…understood the way you felt?
…talked to you?
…showed you respect?
What did the Nursing Associate Trainee do well?
What could the Nursing Associate Trainee have done differently?
Practice Assessor Signature: Date: Nursing Associate Trainee Signature: Date:
Practice Assessors should obtain consent from patients/service users who should feel able to decline to participate.
Practice Assessment Document
63 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Record of working with other health care professionals/inter-professional working Record reflections on your learning in outreach/short practice placements
or with members of the multi-disciplinary team. Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
More pages can be downloaded as per University guidelines
Practice Assessment Document
64 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Record of working with other health care professionals/inter-professional working Record reflections on your learning in outreach/short practice placements
or with members of the multi-disciplinary team. Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
More pages can be downloaded as per University guidelines
Practice Assessment Document
65 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Ongoing Feedback from Staff in Practice This can be completed by any individual involved in the trainee’s learning e.g. the practice
assessor, staff (other than the practice assessor), practice educator, link lecturer or personal tutor. This is in addition to the pages referring to Inter-professional Working, as above.
Date/time Signature/ Designation
Comments
Practice Assessment Document
66 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Ongoing Feedback from Staff in Practice This can be completed by any individual involved in the trainee’s learning e.g. the practice
assessor, staff (other than the practice assessor), practice educator, link lecturer or personal tutor. This is in addition to the pages referring to Inter-professional Working, as above.
Date/time Signature/ Designation
Comments
Practice Assessment Document
67 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Practice Assessment Document Verification Sheet (for Faculty use only) Module: HP4005X Specialist Skills Development for the Workforce (External Placement 3 and Base Placement) Submission date: 16/11/2017 1st attempt
Pass Fail Return for Completion
Verifier’s Name…................................................................................................................................................ Signature………………………………………………. Date........................... Practice Assessment Document – Part 1 will be returned for completion for one or more of the following reasons:
Incomplete Practice Assessor/ Practice Educator signatory page (p9-10)
Incomplete Professional Values in Practice
Insufficient external practice placement hours (120 hours/ 4 week placement)
External practice placement hours not signed by Trainee and/or Practice Assessor
Incomplete interview records and development plans (as appropriate)
A Fail result will be given if any of the Professional Values in Practice have been assessed as not being met at the Final Interview stage for each placement.
Outcome following return for completion:
Pass Fail
Verifier’s Name…................................................................................................................................................ Signature……………………………………………. Date..............................
Practice Assessment Document
68 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Practice Assessment Document Verification Sheet (for Faculty use only) Module: HP4005X Specialist Skills Development for the Workforce (External Placement 3 and Base Placement) Submission date: To be confirmed 2nd attempt
Pass Fail Return for Completion
Verifier’s Name…................................................................................................................................................ Signature………………………………………………. Date........................... Practice Assessment Document – Part 1 will be returned for completion for one or more of the following reasons:
Incomplete Practice Assessor/ Practice Educator signatory page (p9-10)
Incomplete Professional Values in Practice
Insufficient external practice placement hours (120 hours/ 4 week placement)
External practice placement hours not signed by Trainee and/or Practice Assessor
Incomplete interview records and development plans (as appropriate)
A Fail result will be given if any of the Professional Values in Practice have been assessed as not being met at the Final Interview stage for each placement.
Outcome following return for completion:
Pass Fail
Verifier’s Name…................................................................................................................................................ Signature……………………………………………. Date..............................
Practice Assessment Document
69 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 4 –
Placement Provider: (e.g. Trust) Name of Practice Area: Type of Experience: (e.g. Community/Ward based)
Practice Placement Telephone: Placement Contact Email:
Start Date………………….. End Date……….………. No. of Hours…………………
Practice assessor/ Practice Educator Details: Name: Designation: Name: Designation: Other Practice Staff/Key Contacts: Name: Designation:
Academic Contact Details: (e.g. Link Lecturer) Name: Designation: Name: Designation:
NB: This is only to be completed for trainees on a 2nd attempt placement
Practice Assessment Document
70 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 4: Orientation
Name of Area 1 Name of Area 2 (if app.)
Name of Placement Area
Initial/Date (Trainee)
Initial/Date (Practice
Assessor)
Initial/Date (Trainee)
Initial/Date (Practice
Assessor)
The following criteria need to be met within the first day in placement
A general orientation to the health and social care placement setting has been undertaken
The local fire procedures have been explained Tel………………
The trainee has been shown the:
fire alarms
fire exits
fire extinguishers
Resuscitation policy and procedures have been explained Tel: ..........................
Resuscitation equipment has been shown and explained
The trainee knows how to summon help in the event of an emergency
The trainee is aware of where to find local policies
health and safety
incident reporting procedures
infection control
handling of messages and enquiries
other policies
The trainee has been made aware of information governance requirements
The shift times, meal times and reporting sick policies have been explained.
Policy regarding safeguarding has been explained
Lone working policy has been explained (if applicable)
Risk assessments/reasonable adjustments relating to disability/learning/pregnancy needs have been discussed (where disclosed)
The following criteria need to be met prior to use
The trainee has been shown and given a demonstration of the moving and handling equipment used in the clinical area
The trainee has been shown and given a demonstration of the medical devices used in the clinical area
Placement Provider induction/update complete, if applicable
Practice Assessment Document
71 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 4: Initial Interview
Area Name: This interview takes place within the first week of the placement
Trainee to identify learning and development needs, including which Skills (from PAD: Part 2) and Domain competence statements you plan to achieve (with guidance from the practice assessor)
Practice assessor to identify learning opportunities to enable the trainee to meet their learning and development needs and assessments
Practice assessor and trainee to negotiate and agree a learning plan -
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date:
Practice Assessment Document
72 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Professional Values in Practice Trainees are required to demonstrate high standards of professional conduct at all times during their placements. Trainees should work within legal frameworks, and be able to articulate the underpinning values of The Code (2015). Professional values expectations are reflected in the statements below.
Yes = Achieved, No = Not Achieved (Refer to Grade Descriptors on Page 7)
Professional attitude, behaviour and responsibility
Trainee Evidence / Comments
Achieved Mid-Point
Yes/No
Initial/ Date
Achieved Final
Yes/No
Initial/ Date (Final)
1. The trainee maintains confidentiality in accordance with the NMC code.
2. The trainee is non-judgemental, respectful and courteous at all times when interacting with patients/service users and all colleagues.
3. The trainee maintains an appropriate professional attitude regarding punctuality and communicates appropriately if unable to attend placement.
4. The trainee’s personal presentation and dress code is in accordance with the organisation’s uniform policy.
5. The trainee maintains the person’s privacy and dignity and advocates on their behalf.
6. The trainee demonstrates openness, trustworthiness and integrity.
7. The trainee makes a consistent effort to engage in evidence-based standards of care and learning, with awareness of relevant local/national policies.
Practice Assessment Document
73 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Safe and compassionate care
Trainee Evidence / Comments
Achieved Mid-Point
Yes/No
Initial/ Date
Achieved Final
Yes/No
Initial/ Date (Final)
8. The trainee is attentive, kind, compassionate and sensitive to the needs of others.
9. The trainee maintains consistent safe and person-centred practice.
10. The trainee reports any concerns to the appropriate professional member of staff when appropriate e.g. safeguarding.
11. The trainee demonstrates the ability to listen, seek clarification and carry out instructions safely.
12. The trainee is able to recognise and work within the limitations of own knowledge, skills and professional boundaries and understand that they are responsible for their own actions.
13. The trainee is able to work effectively within the multi-disciplinary team with the intent of building professional caring relationships.
Trainees can complete their evidence at any stage prior to the final interview. If there are any issues/areas for concern, these must be recorded in the Mid-Point or Final Interview as appropriate. ‘Not Achieved’ must trigger an Action Plan at the time of assessment and must be documented. The Action Plan template can be found on Page 93
Practice Assessment Document
74 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 4: Mid-Point Interview This interview takes place half way through the placement
Practice Assessor and Trainee to sign on the next page
Trainee’s self-assessment/reflection on progress Reflect on your overall progression referring to your personal learning needs, professional values and to the skills and Domain competence statements achieved at the mid-point. Identify your strengths and document areas for development.
Practice Assessor’s comments Discuss with the trainee their self-assessment and comment on their progress using the assessment descriptors below, detailing evidence used to come to your decision.
Knowledge:
Clinical and care skills:
Attitudes and behaviours:
Practice Assessment Document
75 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 4: Mid-Point Interview Ongoing learning and development needs
To be agreed between Practice Assessor and Trainee – sign and date all entries below
Identify learning and development needs Refer to progress in achieving personal learning needs, professional values and remaining skills and Domain competence statements identified at initial interview.
Identify the learning opportunities/support to enable the trainee to meet their needs
Review Date: Sign when reviewed:
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date: Any outstanding learning and development needs are to be discussed and documented at the final interview.
If specific concerns have been raised about the trainee’s performance this should trigger an Action Plan at the time of assessment and should be documented. The action plan template can be found on Page 93
Practice Assessment Document
76 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
External Placement 4: Final Interview This should take place towards the end of the placement
Trainee’s self-assessment/reflection on progress Reflect on your overall progression referring to your personal learning needs, professional values skills and Domain competence statements. Identify your strengths and document areas for development.
Practice Assessor’s comments Discuss with the trainee their self-assessment and comment on their progress using the assessment descriptors below, detailing evidence used to come to your decision.
Knowledge:
Clinical and care skills:
Attitudes and behaviours:
Please record any further comments on the next page
Practice Assessment Document
77 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Learning and Development Needs To be agreed between the Practice Assessor and Trainee
Review learning and development needs identified at the Mid-Point Interview and those to take forward to the next placement
Checklist for assessed documents Tick Assessor Initial
Trainee Initial
The Practice Assessor has signed the professional value statements at both Mid-Point and Final Interview
The Practice Assessor has signed the relevant Domain Competence statement the Trainee has achieved in this area (where applicable)
The Trainee and Practice Assessor have checked and signed the practice placement hours
The Practice Assessor and Trainee have completed all the interview records and development plans, as appropriate
The Practice Assessor has printed and signed their name on the List of Practice Assessor/ Practice Educator Record
Trainee’s signature: Date: Practice Assessor’s signature: Date: Additional Signature (If Applicable): Date:
Was an Action Plan required to support the trainee? YES / NO If Yes, was the Academic Representative informed? YES / NO The Action Plan can be found on Page 93
Practice Assessment Document
78 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Patient/Service User Feedback Form
We would like to hear your views about the way the Trainee Nursing Associate has looked after you.
Your feedback will help the Trainee Nursing Associate’s learning
The feedback you give will not change the way you are looked after
Thank you for your help This form has been designed by Service Users
Tick if you are: The Patient/Service User Carer/Relative
How happy were you with the way the Trainee Nursing Associate …
Very Happy
Happy
I’m not sure
Unhappy
Very unhappy
…cared for you?
…listened to your needs?
…understood the way you felt?
…talked to you?
…showed you respect?
What did the Nursing Associate Trainee do well?
What could the Nursing Associate Trainee have done differently?
Practice Assessor Signature: Date: Nursing Associate Trainee Signature: Date:
Practice Assessors should obtain consent from patients/service users who should feel able to decline to participate.
Practice Assessment Document
79 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Record of working with other health care professionals/inter-professional working Record reflections on your learning in outreach/short practice placements
or with members of the multi-disciplinary team. Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
More pages can be downloaded as per University guidelines
Practice Assessment Document
80 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Record of working with other health care professionals/inter-professional working Record reflections on your learning in outreach/short practice placements
or with members of the multi-disciplinary team. Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
Date Time
spent Reflections on your learning
Details of your experience
Practice Educator’s comments and Signature
More pages can be downloaded as per University guidelines
Practice Assessment Document
81 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Ongoing Feedback from Staff in Practice This can be completed by any individual involved in the trainee’s learning e.g. the practice
assessor, staff (other than the practice assessor), practice educator, link lecturer or personal tutor. This is in addition to the pages referring to Inter-professional Working, as above.
Date/time Signature/ Designation
Comments
Practice Assessment Document
82 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Ongoing Feedback from Staff in Practice This can be completed by any individual involved in the trainee’s learning e.g. the practice
assessor, staff (other than the practice assessor), practice educator, link lecturer or personal tutor. This is in addition to the pages referring to Inter-professional Working, as above.
Date/time Signature/ Designation
Comments
Practice Assessment Document
83 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Practice Assessment Document Verification Sheet (for Faculty use only) Module: External Placement 4 (for trainees on a 2nd attempt placement only) Submission date: To be confirmed
Pass Fail Return for Completion
Verifier’s Name…................................................................................................................................................ Signature………………………………………………. Date........................... Practice Assessment Document – Part 1 will be returned for completion for one or more of the following reasons:
Incomplete Practice Assessor/ Practice Educator signatory page (p9-10)
Incomplete Professional Values in Practice
Insufficient external practice placement hours (120 hours/ 4 week placement)
External practice placement hours not signed by Trainee and/or Practice Assessor
Incomplete interview records and development plans (as appropriate)
A Fail result will be given if any of the Professional Values in Practice have been assessed as not being met at the Final Interview stage for each placement.
Outcome following return for completion:
Pass Fail
Verifier’s Name…................................................................................................................................................ Signature……………………………………………. Date..............................
Practice Assessment Document
84 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
BLANK
Practice Assessment Document
85 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Assessment of Nursing Associate Domains
Assessment of Nursing Associate Domain competence statements are undertaken across Year 1. These can be assessed in a range of placements, including your base placement. It is recommended that you complete at least 5 per placement and will need to be assessed as having achieved each Domain competence statement by the end of Year 1. If a Domain competence statement is assessed as Achieved early in the year it is expected that the trainee maintains that level of competence throughout the year. The Grade Descriptors for achievement of the Domain competence statement can be found on page 7.
NB. The competence statements for Domain 1: Professional Values and Parameters of Practice are assessed in each placement area with the ‘Professional Values in Practice’ section for each placement.
Practice Assessment Document
86 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Assessment of Nursing Associate Domain competence statements
Nursing Associate Domain 2: Person-centred Approaches to Care
Learning outcome: the trainee nursing associate will be able to exercise those skills, attitudes and behaviours that support the planning, delivery and evaluation of high quality person-centred, holistic care
Clinical and Care Skills Achieved
Sign Date
1. Demonstrate the fundamental principles of nursing practice, in the role of a nursing associate, including the ability to support the registered nurse, and/or other health or care professional in the assessment and delivery of care.
2. Use a holistic approach, at all times, to provide safe, effective, clinical care.
3. Support individuals to maintain their identity and self-esteem using person centred values that include: Individuality; Independence; Privacy; Partnership; Choice; Dignity; Respect; and Rights.
4. Work in partnership with individuals, carers, families and the wider healthcare team.
5. Act in partnership with the registered nurse, and/or other health or care professional to ensure that the rights of individuals are not overlooked or compromised and to resolve conflict in situations where there may be refusal of care by individuals or their families.
6. Demonstrate in practice person-centred nursing, care and support through a variety of means including obtaining valid consent and carrying out all appropriate assessments.
7. Work effectively, as a nursing associate trainee, as part of inter-professional/ multi-disciplinary teams.
If any skill has not been assessed or is not applicable to the Practice area, please leave blank.
Practice Assessment Document
87 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Nursing Associate Domain 3: Delivering Care
Learning outcome: By the end of the programme, the trainee nursing associate will be able to work across organisational boundaries/ in a range of health and care settings and apply, in practice, the range of nursing skills appropriate to their parameters of practice.
Clinical and Care Skills Achieved
Sign Date
1. Deliver planned nursing interventions under the direction and supervision of a registered nurse, delivering care at times in line with an agreed/ defined plan of care.
2. Using appropriate decision-making skills, support the registered nurse (or other appropriate healthcare professional), to assess and deliver care, communicate findings, influence change and promote health, independence and best practice.
3. Recognise and report in a timely manner, early signs and/ or deterioration using appropriate physiological assessments and observations.
4. Monitor and record nutritional status and discuss progress or change as appropriate with individuals, families/ carers and/ or multi-professional team.
5. Takes effective measures to prevent and control infection, within the parameters of their practice, in accordance with national and local policy.
6. Specifically, with regards to medicines and medication, under direct supervision:
a. administer medicines safely and in a timely manner; (N.B. nursing associate trainees will only administer medicines, if suitably trained and competent, in settings where it is deemed appropriate and where this is guided by organisational medicines management policies).
b. communicate any concerns about or errors in the administering of medicines.
c. work within legal and ethical frameworks that underpin safe medicines management.
If any skill has not been assessed or is not applicable to the Practice area, please leave blank.
Practice Assessment Document
88 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Clinical and Care Skills Achieved
Sign Date
d. correctly and safely receive, store and dispose of medications.
e. support individuals, and their families/ carers, in receiving medical treatments.
f. use up-to-date information on medicines management and work within local and national policy guidelines.
7. Safely use invasive and non-invasive procedures, medical devices, and current technological and pharmacological interventions.
8. Use sound numeracy skills for medicines management, assessment, measuring, monitoring and recording which recognise the particular vulnerability of individuals in relation to accurate medicines calculation.
9. Use sound literacy skills to record and document accurately interventions and episodes of care and administration of medicines.
10. Work safely and effectively by:
a. Minimizing risks to an individual and/or staff at all times
b. Ensuring that one’s own actions reduce risk
c. Managing and organising own workload and prioritising the delivery of care in accordance with planned care
11. Make appropriate use of digital and other technologies to:
a. Deliver high-quality care
b. Work efficiently
c. Support high quality decision-making
12. Demonstrate good overall digital literacy in relation to the requirements of work and learning.
If any skill has not been assessed or is not applicable to the Practice area, please leave blank.
Practice Assessment Document
89 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Nursing Associate Domain 4: Communication and Inter-personal Skills
Learning outcome: By the end of the programme, the trainee nursing associate will be able to communicate effectively across a wide range of channels and with a wide range of individuals, the public, health and social care professionals, maintaining the focus of communication on delivering and improving health and care services and will possess those inter-personal skills that promote clarity, compassion, empathy, respect and trust.
Clinical and Care Skills Achieved
Sign Date
1. Communicate information to a variety of health and care professionals through a range of appropriate techniques and strategies.
2. Utilise appropriate strategies for addressing communication issues, problems, conflict/aggression and complaints.
3. Respond appropriately to verbal and non-verbal communication.
4. Handle information and data appropriately (record, report and store data) in line with national and local policies and appropriate legislation.
5. Promote and use appropriate digital and other technologies to support effective communication and handling of data.
6. Demonstrate digital literacy in all appropriate aspects of work and learning.
7. Document nursing care in a comprehensive, timely, logical, accurate, clear and concise manner using appropriate terminologies.
If any skill has not been assessed or is not applicable to the Practice area, please leave blank.
Practice Assessment Document
90 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Nursing Associate Domain 5: Team-working and Leadership
Learning outcome: By the end of the programme, the trainee nursing associate will be able to explain the principles underpinning leadership frameworks and associated team-working and leadership competencies and will demonstrate a range of those competencies, attitudes and behaviours required of a nursing associate.
Clinical and Care Skills Achieved
Sign Date
1. Reflect on personal performance, acting to learn from experience and improve.
2. Work effectively with others in teams and/ or networks to deliver services.
3. Support quality improvement and productivity initiatives within the workplace, including service improvement, in order to enhance people’s well-being and experience of health and social care through the delivery of high-quality services.
4. Demonstrate ability to support the registered nurse, and/ or other health or care professional in the optimisation of resources for the benefit of improving services and promoting equity in health and social care access and delivery.
5. Assess and manage risk to individuals and use systematic ways of minimising risk.
If any skill has not been assessed or is not applicable to the Practice area, please leave blank.
Practice Assessment Document
91 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Nursing Associate Domain 6: Duty of Care, Candour, Equality and Diversity
Learning outcome: By the end of the programme, the trainee nursing associate will be able to explain the principles underpinning duty of care, equality and diversity and the need for candour and will demonstrate the application of those principles in a range of settings.
Clinical and Care Skills Achieved
Sign Date
1. Challenge areas of concern using appropriate behaviours and communication methods.
2. Recognise the signs of harm or abuse and act upon this appropriately.
3. Demonstrate the ability to treat all individuals, carers and colleagues with dignity and respect for their diversity, beliefs, culture, needs, values, privacy and preferences.
4. Work with individuals and others to reduce the likelihood of harm or abuse.
5. Demonstrate an ability to recognise and escalate any tensions/ conflicts arising between an individual’s rights and a duty of care.
6. Safeguard and protect adults and children.
7. Encourage people to share in and shape decisions about their own treatment and care.
8. Work actively to ensure a positive health and safety environment, both individually and collaboratively, by using opportunities to remove, reduce or control risk and harm.
If any skill has not been assessed or is not applicable to the Practice area, please leave blank.
Practice Assessment Document
92 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Nursing Associate Domain 8: Research, Development and Innovation
Learning outcome: By the end of the programme, the trainee nursing associate will be able to demonstrate the importance of being research aware, research and innovation, and their own role in this, across the health and care landscape in improving the quality of patient safety and care and in addressing the challenges faced within the context of rising public expectations.
Clinical and Care Skills Achieved
Sign Date
1. Demonstrate awareness of evidence-based practice.
2. Make use of existing and new technologies to support service improvement.
3. Applies evidence-based practice to delivery of care.
If any skill has not been assessed or is not applicable to the Practice area, please leave blank.
Practice Assessment Document
93 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Action Plan An action plan is required when a trainee’s performance causes concern
The assessor/ practice educator must liaise with the academic representative and senior practice representative
Date Placement Name
Date for Review
Area of Concern Note professional value or Essential Skill number if
appropriate
Criteria for Success / Support Available Review Meeting
Date: Reviewer: Comments:
Signed (Assessor)……………………………………….... Date……………….. Assessor’s Name (please print) Signed (Trainee) ……………………………………….. Date ……………...... ................................................ Signed (Academic Representative)…......................... Date………………...
Practice Assessment Document
94 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Action Plan An action plan is required when a trainee’s performance causes concern
The assessor/ practice educator must liaise with the academic representative and senior practice representative
Date Placement Name
Date for Review
Area of Concern Note professional value or Essential Skill number if
appropriate
Criteria for Success / Support Available Review Meeting
Date: Reviewer: Comments:
Signed (Assessor)……………………………………….... Date……………….. Assessor’s Name (please print) Signed (Trainee) ……………………………………….. Date ……………...... ................................................ Signed (Academic Representative)…......................... Date………………...
Practice Assessment Document
95 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Please start a new page per placement To be completed as per your local University Requirements
PRACTICE HOURS Please ensure all details are printed CLEARLY and sickness days identified. All alterations and totals
should be initialled by Assessor/ Practice Educator
Date Placement Total Hrs
Initials Shift Type
Date Placement Total Hrs
Initials Shift Type
Example of hours confirmation Sun 1/7/13 Pixie Ward 7.5 FF E
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Total hours completed on this page…. Figures Words
Signed: _____ (Assessor) Name (print):
Verification by Assessor: I have checked the hours of experience recorded by the trainee,
Clinical Area: _____ _____________________ Date:
Declaration by Trainee: I confirm that the hours recorded on this sheet are a true and accurate account of the shifts I have worked. Signed: _________ (Trainee) Date:
It is expected that the trainee will work a range of shifts to meet NMC Requirements
Shift Codes D = Day Shift, N= Night Shift, S= Sickness, A = Absent
Practice Assessment Document
96 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Please start a new page per placement To be completed as per your local University Requirements
PRACTICE HOURS Please ensure all details are printed CLEARLY and sickness days identified. All alterations and totals
should be initialled by Assessor/ Practice Educator
Date Placement Total Hrs
Initials Shift Type
Date Placement Total Hrs
Initials Shift Type
Example of hours confirmation Sun 1/7/13 Pixie Ward 7.5 FF D
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Total hours completed on this page…. Figures Words
Signed: _____ (Assessor) Name (print):
Verification by Assessor: I have checked the hours of experience recorded by the trainee,
Clinical Area: _____ _____________________ Date:
Declaration by Trainee: I confirm that the hours recorded on this sheet are a true and accurate account of the shifts I have worked. Signed: _________ (Trainee) Date:
It is expected that the trainee will work a range of shifts to meet NMC Requirements
Shift Codes D = Day Shift, N= Night Shift, S= Sickness, A = Absent
Practice Assessment Document
97 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Please start a new page per placement To be completed as per your local University Requirements
PRACTICE HOURS Please ensure all details are printed CLEARLY and sickness days identified. All alterations and totals
should be initialled by Assessor/ Practice Educator
Date Placement Total Hrs
Initials Shift Type
Date Placement Total Hrs
Initials Shift Type
Example of hours confirmation Sun 1/7/13 Pixie Ward 7.5 FF D
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Total hours completed on this page…. Figures Words
Signed: _____ (Assessor) Name (print):
Verification by Assessor: I have checked the hours of experience recorded by the trainee,
Clinical Area: _____ _____________________ Date:
Declaration by Trainee: I confirm that the hours recorded on this sheet are a true and accurate account of the shifts I have worked. Signed: _________ (Trainee) Date:
It is expected that the trainee will work a range of shifts to meet NMC Requirements
Shift Codes D = Day Shift, N= Night Shift, S= Sickness, A = Absent
Practice Assessment Document
98 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Please start a new page per placement To be completed as per your local University Requirements
PRACTICE HOURS Please ensure all details are printed CLEARLY and sickness days identified. All alterations and totals
should be initialled by Assessor/ Practice Educator
Date Placement Total Hrs
Initials Shift Type
Date Placement Total Hrs
Initials Shift Type
Example of hours confirmation Sun 1/7/13 Pixie Ward 7.5 FF D
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Total hours completed on this page…. Figures Words
Signed: _____ (Assessor) Name (print):
Verification by Assessor: I have checked the hours of experience recorded by the trainee,
Clinical Area: _____ _____________________ Date:
Declaration by Trainee: I confirm that the hours recorded on this sheet are a true and accurate account of the shifts I have worked. Signed: _________ (Trainee) Date:
It is expected that the trainee will work a range of shifts to meet NMC Requirements
Shift Codes D = Day Shift, N= Night Shift, S= Sickness, A = Absent
Practice Assessment Document
99 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Please start a new page per placement To be completed as per your local University Requirements
PRACTICE HOURS Please ensure all details are printed CLEARLY and sickness days identified. All alterations and totals
should be initialled by Assessor/ Practice Educator
Date Placement Total Hrs
Initials Shift Type
Date Placement Total Hrs
Initials Shift Type
Example of hours confirmation Sun 1/7/13 Pixie Ward 7.5 FF D
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Total hours completed on this page…. Figures Words
Signed: _____ (Assessor) Name (print):
Verification by Assessor: I have checked the hours of experience recorded by the trainee,
Clinical Area: _____ _____________________ Date:
Declaration by Trainee: I confirm that the hours recorded on this sheet are a true and accurate account of the shifts I have worked. Signed: _________ (Trainee) Date:
It is expected that the trainee will work a range of shifts to meet NMC Requirements
Shift Codes D = Day Shift, N= Night Shift, S= Sickness, A = Absent
Practice Assessment Document
100 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
Please start a new page per placement To be completed as per your local University Requirements
PRACTICE HOURS Please ensure all details are printed CLEARLY and sickness days identified. All alterations and totals
should be initialled by Assessor/ Practice Educator
Date Placement Total Hrs
Initials Shift Type
Date Placement Total Hrs
Initials Shift Type
Example of hours confirmation Sun 1/7/13 Pixie Ward 7.5 FF D
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Mon Mon
Tue Tue
Wed Wed
Thu Thu
Fri Fri
Sat Sat
Sun Sun
Weekly Total =
Weekly Total =
Total hours completed on this page…. Figures Words
Signed: _____ (Assessor) Name (print):
Verification by Assessor: I have checked the hours of experience recorded by the trainee,
Clinical Area: _____ _____________________ Date:
Declaration by Trainee: I confirm that the hours recorded on this sheet are a true and accurate account of the shifts I have worked. Signed: _________ (Trainee) Date:
It is expected that the trainee will work a range of shifts to meet NMC Requirements
Shift Codes D = Day Shift, N= Night Shift, S= Sickness, A = Absent
Practice Assessment Document
101 PAD Year 1 FDHCP Nursing Associate (Jan 2018 cohort) - KUSGUL
This PAD document has been based on the work developed by the Pan London Steering Group in collaboration with practice partners, mentors, academic staff, students and service users across the London Region.
Membership of the Pan London Practice Assessment Document Steering Group
Zoe Scullard, Principal Lecturer, Practice Learning, Buckinghamshire New University (Chair)
Joady Mitchell, Principal Lecturer Practice Learning & Clinical Skills Teaching, London South
Bank University (Vice Chair) (Child Lead & NMC Liaison)
Kath Sharples, Senior Lecturer Adult Nursing and Practice Innovation, Faculty of Health,
Social Care Sciences and Education, Kingston University and St George's, University of
London (Mentor Handbook)
Kathy Wilson, Head of Practice Based Learning, Middlesex University (Adult Lead)
Angela Parry, Director of Clinical Education, Florence Nightingale School of Nursing &
Midwifery, King’s College London (Adult Lead)
Michelle Ellis Senior Lecturer & Practice Lead, Child Health, City University London
(Child Lead)
Mark Jones, Senior Lecturer & Head of Practice Education. School of Health Sciences, City
University London
Nicki Fowler Programme Leader/Professional Lead, Learning Disabilities, University of
Greenwich (Mental Health Lead)
Matt Snowden, Director of Contracts, College of Nursing, Midwifery and Healthcare,
University of West London (Pan London Implementation Plan)
Alan Randle, Associate Dean (AQA-Practice Enhancement), University of Hertfordshire
(Learning Disability Lead)
Mark Statham, Head of Pre-Registration and CPPD, London LETB Shared Service.
David Marston, Senior Commissioning Manager Non-Medical Commissioning & Quality
Management, London LETB Shared Services
Chris Caldwell, Dean of Healthcare Professions, Health Education North Central and East
London (Representing London LETBs)
Louise Morton, Head of Nursing and Non-Medical Clinical Education & Acting Assistant Chief
Nurse, Great Ormond Street Hospital for Children NHS Foundation Trust, London
(Representing the London Directors’ of Nursing)
Sue West, Academic Dean, Faculty of Society & Health, Buckinghamshire New University
(Representing The Council of Deans)
Jane Fish, PLPAD Project Manager
Josee Soobadoo, PLPAD Project Team Associate
Ian Grant-Rowan PLPAD Project Administrator
The development of this document was funded by Health Education North Central and East
London, Health Education North West London and Health Education South London.
© PLPLG 2014 All rights reserved. No part of this work may be photocopied, recorded or
otherwise reproduced without the prior permission of the Pan London Practice Learning
Group.