Skill Development Profile · the skills highlighted within the profile the reasons for this will be...

UNIVERSITY OF EAST ANGLIA

SCHOOL OF NURSING AND MIDWIFERY

FACULTY OF HEALTH

BSc/DipHE

ADULT NURSING

Skill Development Profile (Revised September 2007)

Student’s Name: .......................................................... Intake: ............. Academic Adviser: ............................................................................................. Practice of EACH SKILL must demonstrate: • Anti-discriminatory Practice.

• Maintenance of confidentiality of information.

• Promotion and support of individual rights and choices within service delivery.

• Acknowledgement of the individual’s personal beliefs and identity.

• Support of individuals through effective communication. © Copyright University of East Anglia, 2007

This material may not be reproduced in whole or in part without the written permission of the Hean of the School of Nursing and Midwifery of the University

1

INTRODUCTION

• Your skills development profile provides an overview of nursing skills relevant to your branch of nursing. You must have gained experience of the skills related to the Common Foundation Programme by the end of year one of the course. These skills are indicated within the profile by an asterix. The skills experienced by each student in the two year branch programme will vary to some degree. Therefore you should achieve competence in 95% of the total skills reflected in the profile by the end of the branch programme.

• This profile encourages you to take responsibility for managing your learning during

placements. Your skills development profile will form evidence towards the achievement of your practice learning outcomes in each placement. The specific nature of the skills recorded will depend on the needs of the patients/service users worked with during each practice placement. These placements represent 50% of your pre-registration nurse education.

• The profile will be kept with your portfolio and be particularly significant at certain

stages of the programme. It will be assessed as part of the end of year one Objective Structured Clinical Examination (OSCE). It also plays an important part at your end of year reviews with your academic adviser. If you are unable to achieve the skills highlighted within the profile the reasons for this will be explored at the end of year review with your Academic Adviser and an appropriate Learning Contract/Action Plan will be agreed. The skills development profile will form part of your ‘Student Passport’ (NMC 2006).

• The profile may also be used as a reference for students and practitioners once the

student has completed the programme. It can be used to identify areas of competence as well as deficits that can be addressed during both the preceptorship period and thereafter.

GUIDELINES FOR USE

• The record of each skill is divided into categories representing the nature of your role Observer or Participant Observer (Novice), Supervised Practitioner (S) and Competent (C). The criteria for these are overleaf, but it must be noted that whilst the criteria is described in a linear fashion, they are dynamic. Students may revert to an earlier phase of achievement when placed in unfamiliar situations.

• Although they may initially appear to be quite straight forward skills, which are

fundamental to nursing practice, they often have a complexity to their achievement. This means that it is unlikely that you will achieve competence in many skills until the latter part of the programme. This can be discussed in detail with your mentor and/or link lecturer as required. Each skill should be re-examined as the course progresses.

• Skills may also be completed and documented within the profile during the simulated

skills sessions which are part of the branch specific skills teaching weeks of the programme.

• The skills included within this profile are listed under the NMC (2006) Essential Skills

Clusters headings in alphabetical order. These skills clusters are: Care, Compassion and Communication; Organisational Aspects of Care; Infection Prevention and Control; Nutrition and Fluid Maintenance and Medicines Management.

2

• The skills have been printed within boxes in the profile for you to record your

achievements. A number is included linking each skill with the relevant NMC cluster. Additional skills maybe included in the profile at your discretion in collaboration with your mentor/supervising practitioner.

• A comments column is provided to enable you to document your experiences and

achievements in each skill. This may include the evidence base discussed and the number of times the skill has been practised. There are also columns for you and the mentor/supervising practitioner to sign and date the experiences.

The skills in this booklet are informed by: DoH (2001) The Essence of Care: Patient-focused benchmarking for health care practitioners, London, Department of Health; DoH (2004) The NHS Knowledge and Skills Framework, London, Department of Health; NMC (2004) Standards of proficiency for pre-registration nursing education, London, Nursing & Midwifery Council; NMC (2006) Essential Skills Clusters, London, Nursing & Midwifery Council.

3

Level of Practice to be demonstrated

• Applies knowledge, skills and attitudes learnt within the School setting, to the practice setting, demonstrating safe nursing care.

• Cannot always prioritise the care a patient/client needs. • Begins to link theory to practice. • Contributes to care under direct supervision, but manual dexterity and/or speed of response

may be limited. • Some skills may be observed only, with no opportunities for practice.

• Beginning to demonstrate the ability to transfer skills from one setting to another. • Can identify links between theory and practice. • Will actively participate in a variety of skills under close/direct supervision. • Manual dexterity and speed of response is improving.

• Beginning to recognise his/her actions in terms of long-range patient/client goals and plans of which the student is consciously aware.

• Will actively participate in/take the lead in performing a variety of skills with more distant supervision.

• Able to cope with and manage indeterminate situations that arise, but without the speed and flexibility of the proficient nurse.

• Manual dexterity, speed of response and anticipation is improving

Level of Achievement

Observer or Participant Observer (Novice) (O)

Supervised (S)

Competent (C)

4

FUNDAMENTAL NURSING SKILLS – ADULT HEALTH 1) Care, Compassion and Communication Breaks bad news. Cares for infusion pumps. Cares for the patient having cardiac monitoring. Carries out pressure area assessment. Carries out risk assessment – student to specify. Checks the understanding of patients/relatives. Commences an interaction with patients.* Communicates aetiology and nursing problems. Communicates prognosis. Communicates results of investigations. Communicates via I.T. Communicates via Telephone.* Communicates with individuals whose first language is not English. Communicates with individuals with altered levels of consciousness. Communicates with individuals with hearing impairment. Communicates with individuals with speech impairment. Communicates with individuals with visual impairment. Communicates with relatives/significant others. Copes with own emotions. Copes with stress – personal. Demonstrates active listening and attending skills.* Demonstrates assertiveness skills. Demonstrates assessment of pain. Demonstrates assessment skills of family history. Demonstrates assessment skills of patient’s perception of their problems. Demonstrates assessment skills of patient’s previous history. Demonstrates assessment skills of social history. Demonstrates awareness of and responds to body language. Demonstrates knowledge of common pathological investigations. Demonstrates moving and handling – repositioning of the patient in bed.* Demonstrates moving and handling – transfer of patient from bed to chair.* Demonstrates questioning skills.* Develops a therapeutic relationship. Ends interactions with others. Greets and leaves patients appropriately.* Implements skills of assisting patients with dressing.* Implements skills of observation of patient’s general health. Interprets common pathological results. Measures for, and application of, anti-embolism stockings. Observes male catheterisation. Observes seizures. Observes venous cannulation. Prevents/detects deep vein thrombosis. Recognises abnormal cardiac rhythms. Recognises constipation.* Recognises normal sinus rhythm. Records a 12 lead E.C.G. Uses therapeutic touch appropriately. Weighs patients.*

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2) Nutrition and Fluid Management Assesses fluid status of the patient. Assesses nutritional status of the patient. 3) Organisational Aspects of Care Accompanies members of the interprofessional team. Attends interprofessional meetings. Manages a nursing team. Plans the holistic care for a group of patients. Plans the holistic care for a patient. Prioritises care delivered. Utilises a systematic approach to care. 4) Infection Prevention and Control Cares for blood products. 5) Medicines Management Implements the skills of checking controlled drugs prior to administration – in accordance with local policy. Implements the skills of checking drugs prior to administration. * Implements the skills of reading prescriptions.* 6) Care, Compassion and Communication/Nutrition and Fluid Management Assists with feeding requirements.* 7) Care, Compassion and Communication/Organisationa l Aspects of Care Cares for the patient following anaesthesia – general. Cares for the patient following anaesthesia – spinal. Copes with emotions of patients. Copes with emotions of relatives. Copes with stress – in others. Demonstrates assessment skills of using a model of care/conceptual framework. Demonstrates evaluation skills of using a model of care/conceptual framework. Demonstrates planning skills of using a model of care/conceptual framework. Demonstrates positioning/moving of the unconscious patient. Demonstrates positioning/moving of the hemiplegic patient. Discharges planning. Documents all nursing information in line with NMC requirements. Gives constructive feedback to colleagues. Gives information to patients regarding investigations and/or treatments. Identifies barriers to change. Identifies realistic short/long term goals with and for the patient/relatives. Obtains valid consent from patients and/or relatives.* Prepares patient for surgery – student to specify. Takes and records apex beat. Takes and records blood pressure.* Takes and records neurological observations. Takes and records oxygen saturation.

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Takes and records pulse.* Takes and records respiration.* Works effectively with people in crisis. 8) Care, Compassion and Communication/Infection Preven tion and Control Administers suction. Assists with gastric lavage. Cares for a patient with a prosthesis. Cares for and observes patient during transfusion of blood/blood products. Cares for central/Hickman lines. Cares for drains – student to specify. Cares for incontinent patient.* Collects specimens – student to specify.* Demonstrates cardio-pulmonary resuscitation. Demonstrates effective first aid skills. Demonstrates health promotion skills. Demonstrates safe moving and handling – use of aids.* Implements the skills of barrier/isolation nursing. Implements the skills of bed bathing.* Implements the skills of bed making.* Implements the skills of disposal of linen.* Implements the skills of disposal of soiled linen.* Implements the skills of eye care. Implements the skills of general bath/shower.* Implements the skills of oral hygiene.* Implements the skills for the prevention of cross infection.* Inserts and cares for naso-gastric tubes. Performs urinalysis.* Provides catheter care. Provides last offices. Recognises diarrhoea. Removes skin closures – student to specify. Supports a patient to use a bedpan.* Supports a patient to use a commode.* Uses an airway. Uses an Ambu-bag. 9) Care, Compassion and Communication/Nutrition and Fluid Management/Infection Prevention and Control Cares for the patient receiving enteral feeding. Cares for the patient receiving intravenous fluids. 10) Care, Compassion and Communication/Organisation al Aspects of Care/Infection Prevention & Control Cares for the patient undergoing day surgery. Cares for the patient with a wound. Cares for wound drains – student to specify. Demonstrates stoma care – student to specify. Implements the skills of aseptic technique.* Prepares patient for investigations and/or treatments. Provides tracheostomy care.

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Takes and records blood glucose level. Takes and records central venous pressure. Takes and records peak flow. Takes and records temperature.* Undertakes a female catheterisation. 11) Care, Compassion and Communication/Infection Pr evention and Control/Medicines Management Administers eye, ear, nasal drops. Administers inhalers/nebulisers. Administers intramuscular injection. Administers oxygen. Administers pessaries. Administers subcutaneous injection. Administers suppositories. Administers tablets/liquids. Administers topical preparations. Cares for patient controlled analgesia. Cares for syringe pumps. Checks intravenous/epidural drugs

• Norwich students from Year 3, Term B onwards. • King’s Lynn students from Year 3, Term C onwards.

Checks transfusion of blood/blood products – from Year 3, Term A onwards. Injections – drawing up drug. 12) Care, Compassion and Communication/Nutrition an d Fluid Management/Organisational Aspects of Care/Infection Prevention and Control/Medicines Management Cares for the terminally ill patient. Cares for the unconscious patient. Provides palliative care. 13) Nutrition and Fluid Management/Medicines Manage ment Maintains fluid balance charts.* 14) Organisational Aspects of Care/Infection Preven tion and Control/Medicines Management Implements the skills of storage of drugs. *Must be completed in Common Foundation Programme to at least Observer or Participant Observer (Novice) level

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In order for you to progress into the branch, you must have achieved the identified skills on the followin g pages (8 – 18) to at least Observer/Participate Observer (Novice) level by the end of the Common Foundation Programme. You may also work on achieving other, branch appropriate skills. (Pages 19 – 58) Skill Level Comments Student

Signature and date

Practitioner signature and date

Placement Area

Assists with feeding requirements. (6)

O

S

C

Cares for incontinent patient. (8)

O

S

C

Collects specimens – student to specify. (8)

O

S

C

9

Skill Level Comments Student Signature and date


Placement Area

Commences an interaction with patients. (1)

O

S

C

Communicates via telephone. (1)

O

S

C

Demonstrates active listening and attending skills. (1)

O

S

C

10

Skill Level Comments Student

Signature and date


Placement Area

Demonstrates moving and handling – repositioning of the patient in bed. (1)

O

S

C

Demonstrates moving and handling – transfer of patient from bed to chair. (1)

O

S

C

Demonstrates questioning skills. (1)

O

S

C

11



Placement Area

Demonstrates safe moving and handling – use of aids. (8)

O

S

C

Greets and leaves patients appropriately. (1)

O

S

C

Implements skills of assisting patients with dressing. (1)

O

S

C

12



Placement Area

Implements the skills of aseptic technique. (10)

O

S

C

Implements the skills of bed bathing. (8)

O

S

C

Implements the skills of bed making. (8)

O

S

C

13


Signature and date


Placement Area

Implements the skills of checking drugs prior to administration. (5)

O

S

C

Implements the skills of disposal of linen. (8)

O

S

C

Implements the skills of disposal of soiled linen. (8)

O

S

C

14



Placement Area

Implements the skills of general bath/shower. (8)

O

S

C

Implements the skills of oral hygiene. (8)

O

S

C

Implements the skills for the prevention of cross infection. (8)

O

S

C

15


Practi tioner signature and date.

Placement Area

Implements the skills of reading prescriptions. (5)

O

S

C

Maintains fluid balance charts. (13)

O

S

C

Obtains valid consent from patients and/or relatives. (7)

O

S

C

16


Practi tioner signature and date.

Placement Area

Performs urinalysis. (8)

O

S

C

Recognises constipation. (1)

O

S

C

Supports a patient to use a bedpan. (8)

O

S

C

17


Practi tioner signature and date

Placement Area

Supports a patient to use a commode. (8)

O

S

C

Takes and records blood pressure. (7)

O

S

C

Takes and records pulse. (7)

O

S

C

18


Practitioner signature and date.

Placement Area

Takes and records respiration. (7)

O

S

C

Takes and records temperature. (10)

O

S

C

Weighs patients. (1) O

S

C

19

BRANCH SKILLS



Placement Area

Accompanies members of the interprofessional team. (3)

O

S

C

Administers tablets/liquids (11)

O

S

C

Administers eye, ear, nasal drops. (11)

O

S

C

20



Placement Area

Administers inhalers/nebulisers. (11)

O

S

C

Administers intramuscular injection. (11)

O

S

C

Administers oxygen. (11)

O

S

C

21



Placement Area

Administers pessaries. (11)

O

S

C

Administers subcutaneous injection. (11)

O

S

C

Administer s suction. (8)

O

S

C

22


Signature and date


Placement Area

Administers suppositories. (11)

O

S

C

Administers topical preparations. (11)

O

S

C

Assesses fluid status of the patient. (2)

O

S

C

23


Signature and date


Placement Area

Assesses nutritional status of the patient. (2)

O

S

C

Assists with gastric lavage. (8)

O

S

C

Attends interprofessional meetings. (3)

O

S

C

24


Signature and date


Placement Area

Breaks bad news. (1)

O

S

C

Cares for a patient with a prosthesis. (8)

O

S

C

Cares for and observes patient during transfusion of blood/blood products. (8)

O

S

C

25


Signature and date


Placement Area

Cares for blood products. (4)

O

S

C

Cares for central/Hickman lines. (8)

O

S

C

Cares for drains – student to specify. (8)

O

S

C

26


Signature and date


Placement Area

Cares for infusion pumps. (1)

O

S

C

Cares for patient controlled analgesia. (11)

O

S

C

Cares for syri nge pumps. (11)

O

S

C

27


Signature and date


Placement Area

Cares for the patient following anaesthesia – general. (7)

O

S

C

Cares for the patient following anaesthesia – spinal. (7)

O

S

C

Cares for the patient having cardiac monitoring. (1)

O

S

C

28


Signature and date


Placement Area

Cares f or the patient receiving enteral feeding. (9)

O

S

C

Cares for the patient receiving intravenous fluids. (9)

O

S

C

Cares for the patient undergoing day surgery. (10)

O

S

C

29


Signature and date


Placement Area

Cares for the patient with a wound. (10)

O

S

C

Cares for the terminally ill patient. (12)

O

S

C

Cares for the unconscious patient. (12)

O

S

C

30


Signature and date


Placement Area

Cares for wound drains – student to specify. (10)

O

S

C

Carries out pressure area assessment. (1)

O

S

C

Carries out risk assessment - student to specify. (1)

O

S

C

31


Signature and date


Placement Area

Checks intravenous/epidural drugs. (11)

O

S

C

Checks the understanding of patients/relatives. (1)

O

S

C

Checks transfusion of blood/blood products. (11)

O

S

C

32


Signature and date

Practitio ner signature and date

Placement Area

Communicates aetiology and nursing problems. (1)

O

S

C

Communicates prognosis. (1)

O

S

C

Communicates results of investigations. (1)

O

S

C

33

Ski ll Level Comments Student

Signature and date


Placement Area

Communicates via I.T. (1)

O

S

C

Communicates with individuals whose first language is not English. (1)

O

S

C

Commun icates with individuals with altered levels of consciousness. (1)

O

S

C

34


Signature and date


Placement Area

Communicates with individuals with hearing impairment. (1)

O

S

C

Communicates with individuals with speech impairment. (1)

O

S

C

Communicates with individuals with visual impairment. (1)

O

S

C

35


Signature and date


Placement Area

Communicates with relatives/significant others. (1)

O

S

C

Copes with emotions of patients. (7)

O

S

C

Copes with emotions of relatives. (7)

O

S

C

36


Signature and date


Placement Area

Copes with own emotions. (1)

O

S

C

Copes with stress – in others. (7)

O

S

C

Copes with stress – personal. (1)

O

S

C

37


Signature and date


Placement Area

Demonstrates assertiveness skills. (1)

O

S

C

Demonstrates assessment of pain. (1)

O

S

C

Demonstrates assessment skills of family history. (1)

O

S

C

38


Signature and date


Placement Area

Demonstrates assessment skills of patient’s perception of their problems. (1)

O

S

C

Demonstrates assessment skills of patient’s previous history. (1)

O

S

C

Demonstrates assessment skills of social history. (1)

O

S

C

39

Skill Level Comment s Student

Signature and date


Placement Area

Demonstrates assessment skills of using a model of care/conceptual framework. (7)

O

S

C

Demonstrates awareness of and responds to body language. (1)

O

S

C

Demonstrates cardio-pulmonary resuscitation. (8)

O

S

C

40


Signature and date


Placement Area

Demonstrates effective first aid skills. (8)

O

S

C

Demonstrates evaluation skills of using a model of care/conceptual framework. (7)

O

S

C

Demonstrates health promotion skills. (8)

O

S

C

41


Signature and date


Placement Area

Demonstrates knowledge of common pathological investigations. (1)

O

S

C

Demonstrates planning skills of using a model of care/conceptual framework. (7)

O

S

C

Demonstrates positioning/moving of the unconscious patient. (7)

O

S

C

42


Signature and date


Placement Area

Demonstrates positioning/moving of the hemiplegic patient. (7)

O

S

C

Demonstrates stoma care – student to specify. (10)

O

S

C

Develops a therapeutic relationship. (1)

O

S

C

43


Signature and date


Placement Area

Discharges planning. (7)

O

S

C

Documents all nursing information in line with NMC requirements. (7)

O

S

C

Ends interactions with others. (1)

O

S

C

44


Signature and date


Placement Area

Gives constructive feedback to colleagues. (7)

O

S

C

Gives information to patients regarding investigations and/or treatments. (7)

O

S

C

Identifies barriers to change. (7)

O

S

C

45


Signature and date


Placement Area

Identifies realistic short/long term goals with and for the patient/relatives. (7)

O

S

C

Implements skills of observation of patient’s general health. (1)

O

S

C

Implements the skills of barrier/isolation nursing. (8)

O

S

C

46


Signature and date


Placement Area

Implements the skills of checking controlled drugs prior to administration – in accordance with local policy. (5)

O

S

C

Implements the skills of eye care. (8)

O

S

C

Implements the skills of storage of drugs. (14)

O

S

C

47


Signature and date


Placement Area

Injections – drawing up drug. (11)

O

S

C

Inserts and cares for naso-gastric tubes. (8)

O

S

C

Interprets common pathological results. (1)

O

S

C

48


Signature and date


Placement Area

Manages a nursing team. (3)

O

S

C

Measures for, and applies anti-embolism stockings. (1)

O

S

C

Observes male catheterisation. (1)

O

S

C

49


Signature and date


Placement Area

Observes seizures. (1)

O

S

C

Observes venous cannulation. (1)

O

S

C

Plans the holistic care for a group of patients. (3)

O

S

C

50


Signature and date


Placement Area

Plans the holistic care for a patient. (3)

O

S

C

Prepares patient for surgery – student to specify. (7)

O

S

C

Prepares patient for investigations and/or treatments. (10)

O

S

C

51


Signature and date


Placement Area

Prevents/de tects deep vein thrombosis. (1)

O

S

C

Prioritises care delivered. (3)

O

S

C

Provides catheter care. (8)

O

S

C

52


Signature and date


Placement Area

Provides last offices. (8)

O

S

C

Provides palliative care. (12)

O

S

C

Provides tracheostomy care. (10)

O

S

C

53


Signature and date


Placement Area

Recognises abnormal cardiac rhythms. (1)

O

S

C

Recognises diarrhoea. (8)

O

S

C

Recognises normal sinus rhythm. (1)

O

S

C

54



Placement Area

Records a 12 lead E.C.G. (1)

O

S

C

Removes skin closures – student to specify. (8)

O

S

C

Takes and records apex beat. (7)

O

S

C

55


Signature and date


Placement Area

Takes and records blood glucose level. (10)

O

S

C

Takes and records central venous pressure. (10)

O

S

C

Takes and records neurological observations. (7)

O

S

C

56



Placement Area

Takes and records oxygen saturation. (7)

O

S

C

Takes and records peak flow. (10)

O

S

C

Undertakes a female catheterisation (10)

O

S

C

57



Placement Area

Uses an airway. (8) O

S

C

Uses an Ambu -bag. (8)

O

S

C

Uses therapeutic touch appropriately. (1)

O

S

C

58



Placement Area

Utilises a systematic approach to care. (3)

O

S

C

Works effectively with people in crisis. (7)

O

S

C

Skill Development Profile · the skills highlighted within the profile the reasons for this will be...

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