professional graduate certificate/ bsc … · 2017-09-28 · verify achievement of practice...

S:\Modularity\Documentation Department\Approval Documentation\Programmes\Specialist Practice in District Nursing, BSc (Hons), PgDip, MSc\Approved July 2016\Updated documentation\2017_18\Practice Portfolio.docx

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PROFESSIONAL GRADUATE

CERTIFICATE/ BSc (HONS)/PgDip/MSc SPECIALIST PRACTICE IN DISTRICT NURSING

PRACTICE PORTFOLIO

SEPTEMBER 2017


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CONTENTS

Page 1 INTRODUCTION 1

2 THE TRIPARTITE APPROACH TO ASSESSMENT IN PRACTICE 1 3 THE DIFFERENT ROLES WITHIN THE TRIPARTITE RELATIONSHIP 2 4 COMPETENCIES AND ESSENTIAL EVIDENCE WITHIN THE

PRACTICE PORTFOLIO 4 5 REFERENCES 8 APPENDICES Appendix 1 Record of change of placement and/or Practice Teacher/Sign-off

Mentor 10 Appendix 2 Template for recording meetings between Practice Teacher/

Sign-off Mentor and student 12 Appendix 3 Mapping of QNI/QNIS Voluntary Standards to NMC standards 14 Appendix 4 Professional Competencies 18 Appendix 5 Self-assessment and Learning Contract 43 Appendix 6 Reflection 45 Appendix 7 360-degree Feedback Tools 46 Appendix 8 Prescribing Verification Framework 62 Appendix 9 Student Attendance Sheets 67 Appendix 10 Disclosure and Barring Service (DBS) Status Verification 68

DISCLAIMER The information contained in this handbook is, as far as possible, accurate and up to date at the time of printing. The express permission of Teesside University must be obtained to reproduce any, or all of this publication, other than for personal use or for those purposes permitted by law.


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1 INTRODUCTION Demand for high quality nursing care in the community is increasing with the changing demography leading to more people with complex long-term conditions, and a rising population of very elderly. This is coupled with the need to provide person-centred care and the shift to more care in the community within the National Health Service (NHS) (Department of Health (DH), 2014). Responding to such an agenda requires that you as a district nurse are able to rise to these challenges demonstrating competence and capability in both managing and caring for a complex caseload of patients and their families, as well as leading a team of colleagues in navigating the challenges the health and social care structures present. These practice-centred programmes will be delivered on a 50% taught theory and 50% taught practice basis and are designed to develop future district nurses who will assume responsibility for effective care and programme management, clinical practice leadership and clinical practice development. The programmes have been designed to facilitate the development of district nurses that are fit for practice, fit for purpose, fit for the professional and academic award and who can take responsibility for the highest standards of professional conduct and ethical practice. The purpose of this Practice Portfolio is to provide you with a framework through which you will evidence your personal and professional learning and development in the practice arena, and ultimately achievement of your practice outcomes. As a student on one of these programmes you must have an agreement with an employer who is commissioned to provide community services to the NHS to provide a clinical placement and a Practice Teacher or Sign-off Mentor for the duration of your programme. A tripartite relationship will be used to support you in the formulation of learning in order to meet the practice outcomes and you will be required to reflect upon, utilise and develop learning from both the theoretical and practical aspects of the programme as you progress towards achievement. The tripartite meetings will also be used to review and verify that the practice outcomes have been achieved. This will be assessed on a pass/fail basis at the final tripartite meeting. 2 THE TRIPARTITE APPROACH TO ASSESSMENT IN PRACTICE The student, Practice Teacher or Sign-off Mentor and Academic Supervisor together form a tripartite relationship within the practice setting to facilitate the integration of the theoretical and competency-based aspects of the programme. This dynamic and collaborative learning relationship is set within the workplace and enables you to reflect upon practice situations, problems and issues in order to develop a combination of action, reflection and evaluation. This tripartite approach will also be used to assess your learning. The support in practice that this provides is believed to be crucial in enabling you to achieve the competencies by preparing you for professional practice and facilitating reflection in and on action. There is a mid-point tripartite which has a formative assessment of practice with specified competencies of which you are expected to be able to evidence achievement. If these are not evidenced, then you will need to develop a Learning


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Contract and Action Plan specifically focused on achievement of these competencies within the next four weeks. During the final tripartite meeting the Practice Teacher/ Sign-off Mentor in partnership with the Academic Supervisor will judge whether or not you have evidenced achievement of the all Practice Competencies and can sustain them all at the same time. You must submit your Practice Progress File to your Academic Supervisor at your final tripartite meeting. You should also complete a receipt for submission of assignment form. The Academic Supervisor receiving the Practice Progress File should sign this form and the carbonated duplicate should be returned to you. Results will be confirmed and published following internal and external moderation, and the Assessment Board meeting. Referral/Reassessment If you are referred on one or more of the Practice Competencies you must demonstrate achievement of these competencies at the designated point of reassessment. If this is the case you must devise a Learning Contract and Action Plan with your Academic Supervisor and Practice Teacher/Sign-off Mentor in order to address the competencies involved. The decision regarding whether or not you have achieved this will be made by your Academic Supervisor and Practice Teacher/ Sign-off Mentor within a further tripartite meeting. You will normally be expected to resubmit your Practice Portfolio within four weeks, however this will be decided by the University Assesment Board. 3 THE DIFFERENT ROLES WITHIN THE TRIPARTITE RELATIONSHIP

Student Whilst a student embarking on a programme of study leading to a professional qualification, there are requirements upon you from our professional body. These are set out in the Student Essential Guide which is available via the Student Intranet. You will be prepared for your practical experience during the theory hours of the modules. Your role within the tripartite approach is to take responsibility for your own learning and demonstrate a willingness to develop both academically and in practice. You will be expected to discuss your own learning needs with your Practice Teacher/Sign-off Mentor and Academic Supervisor. You must be willing to undertake honest self-assessment, articulate your learning needs, seek and accept formative feedback from them. You will need to recognise and appraise your own abilities and limitations. Further to this you will need to maintain contact with your Academic Supervisor and organise tripartite meetings. Practice Teacher/Sign-off Mentor As a student district nurse, you need to be supported and assessed by a nurse who meets certain criteria specified by our professional body. These are set out in the Practice Teacher Handbook, and the programme team along with your sponsoring Trust ensure that you are placed with a Practice Teacher/Sign-off Mentor who meets these criteria. Your Practice Teacher/Sign-off Mentor will provide honest, tactful and specific feedback, discussing and recognising your achievements as well as highlighting areas needed for further development. Your Practice Teacher/Sign-off Mentor will provide a person-centred approach to caring in the clinical setting in


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which learning can be negotiated and facilitated. Overall, your Practice Teacher/ Sign-off Mentor will facilitate, observe and assess your performance over the continuous period of the programme. These informal meetings can be recorded on the tempate provided in Appendix 2 if this facilitates objective reflection and analysis of all aspects of progress. Your Practice Teacher/Sign-off Mentor in partnership with your Academic Supervisor will judge whether or not you have achieved the practice outcomes. They will sign to verify this at the final tripartite meeting. Your Practice Teacher/Sign-off Mentor will also sign to state that at the point when your placements end you have maintained your competency since the final tripartite. Academic Supervisior Your Academic Supervisor is also required to meet certain regulatory requirements in order to fulfil their role. These are to be recorded as having the SPQ in district nursing, to be (or be working towards being) a nurse tutor and to have a qualification in teaching in Higher Education. The Academic Supervisor will fulfil a dual role that also encompasses the Personal Tutor role. The primary function of this is to give you and your Practice Teacher support and guidance as part of the practice experience. They will provide student-centred educational support both within the academic and practice settings. They will be involved in an initial discussion to clarify your learning needs whilst in practice placement. They will monitor progress and aid development of theory/practice links and participate in final discussions to verify achievement of practice outcomes based on discussion with yourself and your Practice Teacher/Sign-off Mentor. Your Academic Supervisor provides you with advice and guidance in an approachable manner and will maintain close liaison with your Practice Teacher/Sign-off Mentor so that any issues may be clarified at an early stage. They must, together with your Practice Teacher/Sign-off Mentor, address and document any issues in order to arrange an appropriate Action Plan. Your Academic Supervisor in conjunction with your Practice Teacher/Sign-off Mentor will have an important role in judging whether any remedial action has been successful. Your Academic Supervisor will, in partnership with your Practice Teacher/Sign-off Mentor, judge whether or not practice outcomes have been achieved. Tripartite meetings will be held during each term of the programme. The first two tripartite meetings will consider your progression towards achievement of the practice outcomes. The mid-point tripartite meeting will incorporate a formative assessment and will take place in Week 28 of the programme (Week 28 for part-time students). Within this meeting you will be expected to demonstrate achievement of a specified number of competencies. The final tripartite meeting will take place in Week 38 (Week 82 for part-time students) of your programme and will be a summative meeting in which you will demonstrate that you have achieved the practice outcomes. At this point you will be expected to demonstrate through reflection how you have achieved the outcomes and that you can sustain them all simultaneously.


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4 COMPETENCIES AND ESSENTIAL EVIDENCE WITHIN THE PRACTICE PORTFOLIO

Competencies You will develop competency and capability in district nursing over the duration of the programme. All the elements of the programme are designed to support this progression in a co-ordinated and complementary way. The standards against which competency is measured for the Nursing anf Midwifery Council (NMC) are the standards set in the Specialist Education and Practice (NMC, 2001) document for the Specialist Practice Qualification in Nursing in the Home/District Nursing. These are core and achievement of these is essential for you to be recorded on the register as a district nurse. In recognition of the changes that have occurred in nursing in the community since these were published, Voluntary Standards have been developed by the Queen’s Nursing Institute (QNI) and the Queen’s Nursing Institute for Scotland (QNIS) (QNI/QNIS, 2015). These new standards are the competencies used in the portfolio and they have been mapped to the NMC Standards (see Appendix 3). Health Education England is committed to ensuring that all programmes offering the SPQ in Nursing in the Home/District Nursing adopts the new Voluntary Standards and embed them in their programmes. Local commissioners, service leads, Practice Teachers, Sign-off Mentors and students have all supported the relevance and language of these new standards. You will develop competence across all the competencies throughout the year. At each triparite your progress against all the competencies will be discussed and documented (Appendix 4). At the mid-point tripartite there will be a formative assessment. You will be expected to have demonstrated significant progress towards the following competencies specifically and to have made some progress across all other competencies:

Clinical care outcomes 1.10 and 1.13

Leadership and management outcome 2.8

Facilitation of Learning Outcomes 3.1 and 3.1.1

Evidence, research and development 4.1

You will then be required to demonstrate achievement of all the competencies by the final tripartite. The Academic Supervisor and Practice Teacher/Sign-off Mentor are responsible for deciding whether or not you have achieved the practice outcomes. It is your responsibility to negotiate an appropriate time and place to hold these meetings. Essential Evidence You will provide all the Essential Evidence required to meet the requirements of the module within which these competencies sit. These are:

A self-assessment and associated Learning Contract to reflect progress over each term within the programme (three of each).

A set of completed 360 ̊tools for each term (one each from the service user, carer, Practice Teacher/Sign-off Mentor and self with an overall reflection) which is three sets in total.


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Dialogue Sheets from each of the three tripartite meetings.

Evidence to confirm achievement of prescribing qualification Community Practitioner Prescriber (V100) as specified in Prescribing Verification Framework.

Demonstration of achievement of Level 3 skills in Brief Interventions.

Timesheets evidencing a minimum of 80 days in clinical practice over the duration of the programme.

DBS Status Verification. Self-assessment and Learning Contracts (Appendix 5) You will be expected to utilise reflective skills to evaluate your progress and link your practice development to the evidence base. This Practice Portfolio should provide a documentary record illustrating this learning and the achievement of outcomes within your practice area. This process involves:

The use of an appropriate model to reflect upon existing competence, knowledge, skills attitudes and values.

An evaluation of your strengths and areas for development in relation to the practice outcomes. This is designed to enable you to identify the knowledge and skills you bring with you into the programme and clarify what you are required to achieve.

An identification of your learning needs in order to achieve practice outcomes.

Establishment of a plan or Learning Contract to meet learning needs.

Formative and summative evaluation of progression and achievement of the practice outcomes.

Identification of future learning needs. You will undertake an honest self-assessment, articulate and document your learning needs as well as seek and accept formative feedback from your Practice Teacher/Sign-off Mentor and Academic Supervisor. As such you will need to recognise and appraise your own abilities and limitations. Therefore this section should include:

A personal assessment of the knowledge and skills you have acquired during your professional career to date.

An evaluation of your strengths and areas for development in relation to the practice outcomes.

Your strengths.

Areas you would like to develop.

What you would like to achieve in the coming year.

The Learning Contract you have developed in conjunction with your Practice Teacher/Sign-off Mentor and Academic Supervisior.

During the programme, you will have access to a wide variety of learning opportunities which are unique to the placement area, to the issues in your Trust and to your own professional interests. These contribute to your development significantly in that they enable you to gain a much broader view of nursing practice


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through critically considering policies and organisational or clinical issues and applying the knowledge and understanding gained to your own district nursing practice. A template has been provided for you to record a reflection of the diverse learning opportunities (Appendix 6). This is not Essential Evidence but may enhance your discussions in tripartites and may also contribute to evidence for your revalidation with the NMC when it is due. 360-degree Tools (Appendix 7) It is important that service users, their families and carers are involved in your development as a nurse in order to embed a person-centred approach and to ensure your practice recognises the vital and demanding role carers take up. We are required to incorporate the service user/carer voice within the all programmes which prepares nurses for practice by the professional body (NMC, 2015). The School of Health & Social Care (SOHSC) actively promotes this approach. This tool has been developed in conjunction with the user/carer group who informed the programme curriculum. Its purpose is to ensure that you can apply appropriate communication skills and include service users and carers for whom you care in any decisions made in relation to their care. The tool has been modified having been originally based on good practice in the pre-registration nursing programme. Feedback from this group identified that service users, their families and carers do, in the main, want to actively participate in their care provision, and want a district nurse or indeed any nurse to exhibit high quality communication skills not only with them, but with others who may be involved in their care. Your Practice Teacher/Sign-off Mentor will identify three appropriate service users and three carers each term with whom you have been involved. The forms for the service users and carers to complete will be given to them and collected from them without you, the student, being present. They are completed anonymously but with the service user and carers consent thus protecting their confidentiality. This is to ensure that the patient and their family or carer is able to provide an honest assessment of your communication skills. There is an assessment tool for both you and your Practice Teacher/Sign-off Mentor to complete. Once these are completed, you will use these reflecting on the feedback, to consider areas for future development. Dialogue Sheets The discussions in each tripartite meeting will be documented using the School of Health & Social Care Dialogue Sheets which are carbonated, enabling a copy to be held by the you in your portfolio and a copy to be held by the University in the each student’s personal file. These are stored securely for six years after completion of the student’s programme and can be drawn upon at a later date for a reference if requested. Each person in the tripartite meeting will complete a Dialogue Sheet for that meeting, a minimum of three per tripartite meeting. Prescribing Verification Framework (Appendix 8) In addition to the specialist qualification in district nursing awarded, on successful completion of the programme you will develop your prescribing practice and will gain a Community Prescribing qualification. In order to ensure that you evidence you are


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capable to prescribe safely, immediately prior to the final tripartite you must complete a Prescribing Verification Framework document in which your Practice Teacher confirms the prescribing competency has been demonstrated and maintained. The evidence required for the Prescribing Verification Framework is:

Confirmation of successful completion of the prescribing module (CCH3048-N or CCH4033-N). If you are already recorded as a prescriber on the NMC register, then you will need to provide a printout of your statement of entry demonstrating this and confirmation of successful application to RPL this qualification.

Reflective Learning Logs demonstrating application of the Learning Outcomes in the practice setting.

Statement of verification of competency against the Learning Outcomes for prescribing for the V100 by the Practice Teacher/Sign-off Mentor at the time of the final tripartite.

N.B.: The Specialist Practice Qualification in District Nursing has the V100 prescribing qualification integral within it. As such students who complete the prescribing module (CCH3048-N at Level 6 and CCH4033-N at Level 7) within their programme can only be deemed a qualified prescriber if they are also successful in their overall programme of study leading to the award of the Specialist Practice Qualification in Nursing in the Home/District Nursing. On successful completion of their programme students are not initially legally able to prescribe and therefore must not do so. They can only prescribe once they have received notification from the NMC that their prescribing qualification has been recorded on the register. Students must record their prescribing qualification within 12 months of completing the programme. Brief Interventions The need for a greater public health focus in nursing and health care in general has been taken up in the Five Year Forward View (DH, 2014) with the focus moving to preventative health care and increased consideration of how we as nurses, can support service users to be more effective in self-care and self-management. This is reflected in both the Voluntary Standards of Competency (QNI/QNIS, 2015) and in the District Nurse Career Framework (HEE, 2015). You will undertake specific education in delivering brief interventions for behaviour change as part of your programme and receive a certificate confirming your achievement of competency at Level 3 in brief interventions for your portfolio. This is Essential Evidence for your portfolio. Timesheets (Appendix 9) During this programme you are sponsored by your employer to study, remaining employed by them as well as being a student at Teesside University. As part of the collaborative commitment to the sponsoring employers, it is essential that your attendance at University is recorded accurately and also your time in clinical practice. You must follow the SOHSC policies around attendance which are in the Student Essential Guide. The programme has a requirement from the NMC to ensure that their standards are met in terms of hours in practice. For this


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programme the minimum period is 80 days (600 hours) (NMC, 2001). You must complete the timesheets provided to evidence that you have undertaken at least this period of time in clinical practice and submit these at your final tripartite. DBS Status Verification (Appendix 10) This is an aspect of your programme which is viewed as very important by Teesside University and by the professional and regulatory body, the NMC. As you are an employee whilst you are on the programme and undertaking placements, your DBS is usually the responsibility of your employer. As such the University cannot request to see this. It is therefore important that you commit to inform us if there are any changes which occur during the period of your programme that may impact on the status of your DBS. This form enables you to document this commitment and must be completed at the start of the programme. 5 REFERENCES Department of Health (2014) The NHS Five Year Forward View available at: https://www.england.nhs.uk/ourwork/futurenhs/ (Accessed on 05/11/15) Health Education England (2015) District Nursing and General Practice Nursing Service Education and Career Framework available online at: National Institute for Clinical and Healthcare Excellence (2014) Behaviour Change- Individual Approaches available online at: http://www.nice.org.uk/guidance/ph49 (Accessed on 05/11/15) Nursing and Midwifery Council (2015) Quality Assurance Framework for Nursing and Midwifery Education and Local Supervising Authorities available online at: http://www.nmc.org.uk/education/quality-assurance-of-education/qa-framework-for-education/ (Accessed on 05/11/15) Nursing and Midwifery Council (2015) Standards of Proficiency for Nurse and Midwife Prescribers available online at: http://www.nmc.org.uk/standards/additional-standards/standards-of-proficiency-for-nurse-and-midwife-prescribers/ (Accessed on 18/01/16) Nursing and Midwifery Council (2001) Standards for Specialist Education and Practice available online at: http://www.nmc.org.uk/standards/additional-standards/standards-for-specialist-education-and-practice/ (Accessed on 05/07/16) Queen’s Nursing Institute/Queen’s Nursing Institute for Scotland (2015) The QNI/QNIS Voluntary Standards for District Nurse Education and Practice available online at: http://www.qni.org.uk/for_nurses/policy_and_practice/district_nurse_standards (Accessed on 05/11/15)

https://www.england.nhs.uk/ourwork/futurenhs/

http://www.nice.org.uk/guidance/ph49

http://www.nmc.org.uk/education/quality-assurance-of-education/qa-framework-for-education/

http://www.nmc.org.uk/education/quality-assurance-of-education/qa-framework-for-education/

http://www.nmc.org.uk/standards/additional-standards/standards-of-proficiency-for-nurse-and-midwife-prescribers/

http://www.nmc.org.uk/standards/additional-standards/standards-of-proficiency-for-nurse-and-midwife-prescribers/

http://www.nmc.org.uk/standards/additional-standards/standards-for-specialist-education-and-practice/

http://www.nmc.org.uk/standards/additional-standards/standards-for-specialist-education-and-practice/

http://www.qni.org.uk/for_nurses/policy_and_practice/district_nurse_standards


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APPENDICES


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Record of Change of Placement or Change of

Practice Teacher/Sign-Off Mentor The student undertakes a placement which is in one base with one Practice Teacher /Sign-off Mentor for the duration of the programme. It is recognised that during this time, unforeseen circumstances may arise which lead to a change of placement or of Practice Teacher/Sign-off Mentor. However, this can be a disruptive experience and to minimise this, it must be planned. This document is to enable the transition and planning process to be recorded. A. Change of Placement

Reason for Change:

…………………………………………………………………………………………………………

…………………………………………………………………………………………

It is essential that this transition is planned and undertaken with appropriate preparation. This includes:

Discussion with the Academic Supervisor regarding the change

A visit to the new base to identify the facilities

An introduction to any core staff in the new area with whom you will be interacting (e.g. staff nurses, receptionists)

A discussion with your Practice Teacher/Sign-off Mentor regarding the community profile of the new area and implications for practice

The agreement of a Learning Contract in relation to developing confidence and knowledge of the new area, the new nursing and wider multi-professional team and new caseload

Please sign below to confirm that the actions above have taken place and attach a copy of the associated Learning Contract. Name of Student: …………………………………………………………….……………… Signature of Student: …………………………………………………Date: .............…….. Name of Practice Teacher/Sign-off Mentor: ……………………………………………….

Signature of Practice Teacher/Sign-off Mentor: …………………….. Date: ..................

Name and address of original placement (nurse base): Dates for this placement: From: ………………To: ……………….

Name and address of new placement (nurse base): Dates for this placement: From: ………………To: …………………

APPENDIX 1


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B. Change of Practice Teacher/Sign-off Mentor

Reason for Change: ……………………………………………………………………………………………………………

………………………………………………………………………………………

It is essential that this transition is planned and undertaken with appropriate preparation. This includes:

Discussion with the Academic Supervisor regarding the change

An introductory meeting between the district nurse student and the new Practice Teacher/Sign-off Mentor where possible facilitated by the original Practice Teacher/ Sign-off Mentor

Completion of Appendix 2 by the new Practice Teacher/Sign-off Mentor

The agreement of a Learning Contract in relation to progression on the programme and in particular in relation to achievement of the professional competencies with priorities for achievement identified

Please sign below to confirm that the actions above have taken place and attach a copy of the associated Learning Contract as well as inserting a new version of Appendix 2 for the new Practice Teacher/Sign-off Mentor. Name of Student: …………………………………………………………………………… Signature of Student: …………………………………………………Date: .............……. Name of new Practice Teacher/Sign-off Mentor: ……………………………………….... Signature of new Practice Teacher/Sign-off Mentor: ……………………Date: ..............

Name of original Practice Teacher/Sign-off Mentor: Dates for the placement with this PT/SoM: From: ………………To: …………………

Name of new Practice Teacher/Sign-off Mentor: Dates for the placement with this PT/SoM: From: ………………To: …………………


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Template for Recording Meetings between Practice Teacher/Sign-off Mentor and Student

(NOT TO BE USED FOR TRIPARTITES)

Name of Student: ………………………………… Year of Study: ………………… The headings below reflect areas of development for the student district nurse and can aid discussions regarding progress in practice. There is space for recording of these discussions under each heading. Attitude and Motivation to Learn: Placement Issues: Caseload Management Skills:

APPENDIX 2


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Leadership Skills: Development and Achievement of Specialist Practitioner Qualification (DN) Competencies: Development and Achievement of Relevant Practice Skills including Prescribing: Any Other Comments: Signature of Student: ………………………….….. Date: …………… Name of Practice Teacher/Sign-off Mentor: ………………………....................... Signature: ………………………………..…………. Date: ……………


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Mapping the QNI/QNIS Voluntary Standards for District Nursing to the NMC Standards for Specialist Practice in Nursing in the Home/District Nursing

QNI/QNIS Voluntary Standards

NMC Specialist Practice Standards

1.1

13.1 Assess the health and health-related needs of patients, clients, their families and other carers and identify and initiate appropriate steps for effective care for individuals, groups and communities

13.2 Plan, provide and evaluate skilled nursing care in differing environments with varied resources. Specialist community nurses must be able to adapt to working in people’s homes and also small institutions, health centres, surgeries, schools and places of work

13.4 Assess and manage care needs in a range of settings. These are complex activities which call for informed judgement to distinguish between health and social needs recognising that the distinction is often a fine, but critical, one

28.3 Assess, plan, provide and evaluate specialist clinical nursing care to meet care needs of individual patients in their own homes

28.5 Manage programmes of care for patients with chronic disease

1.2 13.1 Assess the health and health-related needs of patients, clients, their families and other carers and identify and initiate appropriate steps for effective care for individuals, groups and communities

28.1 Assess the health and health-related needs of patients, clients, their families and other carers and identify and initiate appropriate steps for effective care for individuals and groups

28.2 Assess, diagnose and treat specific diseases in accordance with agreed nursing/medical protocols



1.3 13.1 Assess the health and health-related needs of patients, clients, their families and other carers and identify and initiate appropriate steps for effective care for individuals, groups and communities

13.3 Support informal carers in a partnership for the giving of care. The majority of care in the community is given by informal carers. They need guidance, support and resources to carry out tasks so that there is continuity of care for the patient

13.4 Assess and manage care needs in a range of settings. These are complex activities which call for informed judgement to distinguish between health and social needs recognising that the distinction is often a fine, but critical, one

13.5 Provide counselling and psychological support for individuals and their carers

1.4 13.2 Plan, provide and evaluate skilled nursing care in differing environments with varied resources. Specialist community nurses must be able to adapt to working in people’s homes and also small institutions, health centres, surgeries, schools and places of work

APPENDIX 3


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28.6 Play a key role in care management as appropriate

1.5 13.4 Assess and manage care needs in a range of settings. These are complex activities which call for informed judgement to distinguish between health and social needs recognising that the distinction is often a fine, but critical, one

13.14 Identify and select from a range of health and social agencies, those which will assist and improve the care of individuals, groups and communities

1.6 1.6.1

1.7

1.8

28.4 Contribute to strategies designed to promote and improve health and prevent disease in individuals and groups

28.2 Assess, diagnose and treat specific diseases in accordance with agreed nursing/medical protocols

1.9 1.9.1

1.10

13.6 Facilitate learning in relation to identified health needs for patients, clients and their carers

13.13 Stimulate an awareness of health and care needs at both individual and structural levels. Activities will include work with individuals, families, groups and communities and will relate to those who are well, ill, dying or disabled. Those who are able should be assisted to recognise their own health needs in order to decide on action appropriate to their own lifestyle. Those who are not able will require skilled and sensitive help

13.17 Empower people to take appropriate action to influence health policies. Individuals, families and groups must have a say in how they live their lives and must know about the services they need to help them to do so


1.11 1.11.1

13.8 Act independently within a multidisciplinary/multi-agency context and 28.4 contribute to strategies designed to promote and improve health and

prevent disease in individuals and groups

1.12 13.8 Act independently within a multidisciplinary/multi-agency context 13.9 Support and empower patients, clients and their carers to influence

and use available services, information and skills to the full and to participate in decisions concerning their care

13.19 Act as a source of expert advice in clinical nursing practice to the primary health care team and others

28.6 Play a key role in care management as appropriate

1.13 13.5 Provide counselling and psychological support for individuals and their carers

1.14 13.7 Prescribe from a nursing formulary where the legislation permits

2.1 13.13 Stimulate an awareness of health and care needs at both individual and structural levels. Activities will include work with individuals, families, groups and communities and will relate to those who are well, ill, dying or disabled. Those who are able should be assisted to recognise their own health needs in order to decide on action appropriate to their own lifestyle. Those who are not able will require skilled and sensitive help


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13.18 Provide accurate and rigorously collated health data to employing authorities and purchasers through health profiles in order to inform health policies and the provision of health care. Clinical practice leadership


2.2 2.2.1

13.20 Lead and clinically direct the professional team to ensure the implementation and monitoring of quality assured standards of care by effective and efficient management of finite resources

13.21 Identify individual potential in registered nurses and specialist practitioners, through effective appraisal system. As a clinical expert, advise on educational opportunities that will facilitate the development and support their specialist knowledge and skills to ensure they develop their clinical practice

13.27 Explore and implement strategies for staff appraisal, quality assurance and quality audit. Determine criteria against which they should be judged, how success might be measured and who should measure success

2.3 13.11 Recognise ethical and legal issues which have implications for nursing practice and take appropriate action

13.12 Identify the social, political and economic factors which influence patient/client care and impact on health

2.4

2.5 13.20 Lead and clinically direct the professional team to ensure the implementation and monitoring of quality assured standards of care by effective and efficient management of finite resources

2.6

2.7 13.8 Act independently within a multidisciplinary/multi-agency context 13.12 Identify the social, political and economic factors which influence

patient/client care and impact on health 13.14 Identify and select from a range of health and social agencies, those

which will assist and improve the care of individuals, groups and communities

13.15 Search out and identify evolving health care needs and situations hazardous to health and take appropriate action. This is a continuous activity and involves being proactive, it must not be dependent on waiting for people to request care

13.16 Initiate and contribute to strategies designed to promote and improve health and prevent disease in individuals, groups and communities


2.8 13.10 Advise on the range of services available to assist with care. The services may be at local, regional or national levels. Knowledge of these services will need to be kept up-to-date and advice given to people on how to access and use them

13.18 Provide accurate and rigorously collated health data to employing authorities and purchasers through health profiles in order to inform health policies and the provision of health care. Clinical practice leadership

2.9 13.19 Act as a source of expert advice in clinical nursing practice to the primary health care team and others


©TU-SOHSC (2017) 17

2.10 13.15 Search out and identify evolving health care needs and situations hazardous to health and take appropriate action. This is a continuous activity and involves being proactive, it must not be dependent on waiting for people to request care

2.11 13.12 Identify the social, political and economic factors which influence patient/client care and impact on health

13.17 Empower people to take appropriate action to influence health policies. Individuals, families and groups must have a say in how they live their lives and must know about the services they need to help them to do so

3.1 13.22 Ensure effective learning experiences and opportunity to achieve learning outcomes for students through preceptorship, mentorship, counselling, clinical supervision and provision of an educational environment

13.26 Create an environment in which clinical practice development is fostered, evaluated and disseminated

3.2

3.3 13.26 Create an environment in which clinical practice development is fostered, evaluated and disseminated

3.4 13.23 Initiate and lead practice developments to enhance the nursing contribution and quality of care

13.25 Undertake audit review and appropriate quality assurance activities 13.26 Create an environment in which clinical practice development is

fostered, evaluated and disseminated

4.1 13.24 Identify, apply and disseminate research findings relating to specialist nursing practice

4.2 13.18 Provide accurate and rigorously collated health data to employing authorities and purchasers through health profiles in order to inform health policies and the provision of health care. Clinical practice leadership

13.23 Initiate and lead practice developments to enhance the nursing contribution and quality of care

13.25 Undertake audit review and appropriate quality assurance activities

4.3 13.23 Initiate and lead practice developments to enhance the nursing contribution and quality of care

13.27 Explore and implement strategies for staff appraisal, quality assurance and quality audit. Determine criteria against which they should be judged, how success might be measured and who should measure success.

4.4

Taken from QNI/QNIS (2015) The QNI/QNIS Voluntary Standards for District Nurse Education and Practice available online at: http://www.qni.org.uk/for_nurses/policy_and_practice/district_nurse_standards. (Accessed on 05/07/16)

http://www.qni.org.uk/for_nurses/policy_and_practice/district_nurse_standards


©TU-SOHSC (2017) 18

Professional Competencies for Specialist Practice in District Nursing

CLINICAL DOMAIN 1: CLINICAL CARE

Benchmark PT/SoM Signature to Confirm Achievement

Demonstrated Formative Assessment Date:

Summative Assessment Date:

1.1 Demonstrate a broad range of specialist district nursing clinical expertise that supports high quality person-centred care for the caseload population in a variety of community settings.

1.2 Use appropriate physical and clinical examination skills to undertake the assessment of individuals with complex health care needs or those presenting with more acute illnesses, using a range of evidence-based assessment tools and consultation models to enable accurate diagnostic decision-making and recognition of other potential differential diagnoses.

1.3 Assess the health-related needs of families and other informal carers, developing therapeutic relationships and using creative problem-solving that enables shared decision-making for the development of care plans, anticipatory care and delivery of care packages.

1.4 1.4.1

Supervise the delivery of person-centred care plans by the district nursing team ensuring regular evaluation of care and develop systems to support staff interventions and care quality. Support all staff to use tools to identify changes in health status and maximise the skills of the District Nurse to support complex assessment where the patient is showing signs of deteriorating health or new symptoms.

1.5

Assess when additional expertise is necessary and make objective and appropriate referrals, whilst maintaining overall responsibility for management and co-ordination of care.

APPENDIX 4


©TU-SOHSC (2017) 19

1.5.1 Ensure clear lines of accountability with respect to delegation, supervision and mechanisms for the assurance of clinical and care governance including antimicrobial stewardship.

1.6 1.6.1

Source and utilise eHealth technology and technology-assisted learning systems to support self-care and improve efficiency and effectiveness of the district nursing service. Work collaboratively with others to identify individuals who would benefit from technology with ongoing support and management.

1.7 Promote the mental health and wellbeing of people and carers in conjunction with mental health professionals and GPs, identifying needs and mental capacity, using recognised assessment and referral pathways and best interest decision-making and providing appropriate emotional support.

1.8 1.8.1

Apply the principles of risk stratification and case management to enable identification of those at most risk of poor health outcomes. Where appropriate, undertake the case management of people with complex needs, with the support of the multidisciplinary team, to improve anticipatory care, self-management, facilitate timely discharges and reduce avoidable hospital admissions to enable care to be delivered closer to, or at home.

1.9 1.9.1

Assess and evaluate risk using a variety of tools across a broad spectrum of often unpredictable situations, including staff, and people within their home environments.

Develop and implement risk management strategies that take account of people’s views and responsibilities whilst promoting patient and staff safety and preventing avoidable harm to individuals, carers and staff.

1.10 Work in partnership with individuals, formal and informal carers and other services to promote the concept of self-care and patient-led care where possible, providing appropriate education and support to maximise the individual’s independence and understanding of their condition(s) in achieving their health outcomes.

1.11 1.11.1

Analyse and use appropriate approaches to support the individual’s health and wellbeing and promote self-care in addressing their short or long-term health conditions. Support the team to facilitate behaviour change interventions for individuals.


©TU-SOHSC (2017) 20

1.12 Explore and apply the principles of effective collaboration within a multi-agency, multi-professional context facilitating integration of health and social care and services, ensuring person-centred care is co-ordinated and anticipated across the whole of the person’s journey.

1.13 Demonstrate advanced communication skills engaging and involving people and their carers that foster therapeutic relationships and enable confident management of complex interpersonal issues and conflicts between individuals, carers and members of the caring team.

1.14 Prescribe from the appropriate formulary relevant to the type of prescribing being undertaken, following assessment of patient need and according to legislative frameworks and local policy.

Formative Mid-point Assessment Date:

Significant progress towards achievement of competency in Domain 1: Clinical Care Outcomes 1.10 and 1.13 has/has not been demonstrated by student district nurse ……………………………………………. (Name)

This is confirmed by:

Practice Teacher/Sign-off Mentor (Signature):

Academic Supervisor (Signature):

Student District Nurse (Signature):

If sufficient progress towards achievement of this competency has not been demonstrated, then a Learning Contract must be developed to establish an approach to support achievement within four weeks of the mid-point assessment, at which point another tripartite must be arranged in which this can be reassessed.


©TU-SOHSC (2017) 21

Domain 1: Clinical Care

Student District Nurse Name:

Reflection by Student on Competencies for Domain 1

Feedback from PT/SoM on Competencies for Domain 1

Agreed Forward Planning Regarding Achievement of Competencies for Domain 1

Tripartite 1

Date:

Signatures:

Student: PT/SoM: Academic Supervisor:


©TU-SOHSC (2017) 22

Tripartite 2 Reflection by Student on Competencies for Domain 1



Date:

Signatures:



©TU-SOHSC (2017) 23




Final Tripartite COMPETENT/NOT COMPETENT Date:

I am satisfied/not satisfied that the student district nurse has met the required standard through the following: observation, question and answer throughout the practice experience, discussion and submission of Essential Evidence at the final tripartite meeting. The student demonstrates/does not demonstrate the necessary knowledge, skills, attitudes and values to meet the competency in all the elements of Domain 1 of the QNI/QNIS Voluntary Standards as mapped against the NMC Standards for Specialist Practice in District Nursing.

Signatures:

Practice Teacher/Sign-off Mentor: …………………….. Student District Nurse: …………………..

Academic Supervisor: …………………………………...


©TU-SOHSC (2017) 24

CLINICAL DOMAIN 2: LEADERSHIP AND ORGANISATIONAL MANAGEMENT

Benchmark PT/SoM Signature to Confirm Achievement



2.1 Contribute to public health initiatives and surveillance, working from an assets-based approach that enables and supports people to maximise their health and wellbeing at home, increasing their self-efficacy and contributing to community developments.

2.2 2.2.1

Lead, support, clinically supervise, manage and appraise a mixed skill/discipline team to provide community nursing interventions in a range of settings to meet known and anticipatory needs, appraising those staff reporting directly to the District Nurse whilst retaining accountability for the caseload and work of the team. Enable other team members to appraise, support and develop others in the team and develop strategies for addressing poor practice.

2.3 Manage the district nursing team within regulatory, professional, legal, ethical and policy frameworks ensuring staff feel valued and developed.

2.4 Facilitate an analytical approach to the safe and effective distribution of workload through delegation, empowerment and education which recognises skills, regulatory parameters and the changing nature of district nursing whilst establishing and maintaining the continuity of caring relationships.

2.5 Lead, manage, monitor and analyse clinical caseloads, workload and team capacity to assure safe staffing levels in care delivery, using effective resource and budgetary management.

2.6 Manage and co-ordinate programmes of care, for individuals with acute and long-term conditions, ensuring their patient journey is seamless between mental and physical health care, hospital and community services and between primary and community care.

2.7 Collaborate with other agencies to evaluate public health principles, priorities and practice and implement these policies in the context of the district nursing service and the needs of the local community.

2.8 Participate in the collation of a community profile, nurturing networks that support the delivery of locally relevant resources for health improvement and analysing and adapting practice in response to this.


©TU-SOHSC (2017) 25

2.9 Articulate the role and unique contribution of the district nursing service in meeting health care needs of the population in the community and the evidence that supports this in local areas.

2.10 Ensure all staff are able to recognise vulnerability of adults and children and understand their responsibilities and those of other organisations in terms of safeguarding legislation, policies and procedures.

2.11

Use knowledge and awareness of social, political and economic policies and drivers to analyse how these may impact on district nursing services and the wider health care community. Where appropriate participate in organisational responses and use this knowledge when advocating for people or resources.


Significant progress towards achievement of competency in Domain 2: Leadership and Organisational Management 2.8 has/has not been demonstrated by Student District Nurse ……………………………………………. (Name)


Practice Teacher/Sign-off Mentor (Signature): ………………………………………………… Academic Supervisor (Signature): ………………………………………………………………. Student District Nurse (Signature): ……………………………………………………………….



©TU-SOHSC (2017) 26

Domain 2: Leadership and Operational Management


Reflection by Student on Competencies for Domain 2



Tripartite 1

Date:

Signatures: Student: PT/SoM: Academic Supervisor:


©TU-SOHSC (2017) 27




Date:

Signatures:



©TU-SOHSC (2017) 28


Feedback from on Competencies for Domain 2


Final Tripartite COMPETENT/NOT COMPETENT Date:

I am satisfied/not satisfied that the student district nurse has met the required standard through the following: observation, question and answer throughout the practice experience, discussion and submission of Essential Evidence at the final tripartite meeting. The student demonstrates/does not demonstrate the necessary knowledge, skills, attitudes and values to meet the competency in all the elements of Domain 2 of the QNI/QNIS Voluntary Standards as mapped against the NMC Standards for Specialist Practice in District Nursing. Signatures: Practice Teacher/Sign-off Mentor: …………………… Student District Nurse: …………………… Academic Supervisor: ……………………….


©TU-SOHSC (2017) 29

CLINICAL DOMAIN 3: FACILITATION OF LEARNING

Benchmark Signature of PT/SoM to Confirm Achievement

Demonstrated

Formative Assessment Date:


3.1 3.1.1

Promote and model effective team working within the district nursing team and the wider multidisciplinary team and primary care. Use creative problem-solving to develop a positive teaching/learning environment and workplace for supporting disciplines and professions learning about caring for people in the community and the interdependency of integrated service provision.

3.2

Demonstrate the values of high quality, compassionate nursing and support the ongoing development of these values in others whilst demonstrating resilience and autonomy in the context of increasing demand, managing change to meet the evolving shape of services through flexibility, innovation and strategic leadership.

3.3 Lead and foster a culture of openness and recognition of duty of candour in which each team member is valued, supported and developed, inspiring a shared purpose to support the delivery of high quality effective care.

3.4 Contribute to the development, collation, monitoring and evaluation of data relating to service improvement and development, quality assurance, quality improvement and governance, reporting incidents and developments related to district nursing ensuring that learning from these, where appropriate, is disseminated to a wider audience to improve patient care.


©TU-SOHSC (2017) 30


Significant progress towards achievement of competency in Domain 3: Facilitation of Learning 3.1 and 3.1.1 has/has not been demonstrated by Student District Nurse ……………………………………………. (Name)


Practice Teacher/Sign-off Mentor (Signature): ……………………………………………………

Academic Supervisor (Signature): ………………………………………………………………….

Student District Nurse (Signature): ………………………………………………………………… If sufficient progress towards achievement of competency has not been demonstrated, then a Learning Contract must be developed to establish an approach to support achievement within four weeks of the mid-point assessment, at which point another tripartite must be arranged in which this can be reassessed.


©TU-SOHSC (2017) 31

Domain 3: Facilitation of Learning Student District Nurse Name: Reflection by Student on

Competencies in Domain 3 Feedback from PT/SoM on Competencies in Domain 3


Tripartite 1

Date:

Signatures: Student:

PT/SoM: Academic Supervisor:


©TU-SOHSC (2017) 32

Tripartite 2 Reflection by Student on Competencies in Domain 3

Feedback from PT/SoM on Competencies in Domain 3


Date:

Signatures:



©TU-SOHSC (2017) 33




Final Tripartite COMPETENT/NOT COMPETENT Date: I am satisfied/not satisfied that the student district nurse has met the required standard through the following: observation, question and answer throughout the practice experience, discussion and submission of Essential Evidence at the final tripartite meeting. The student demonstrates/does not demonstrate the necessary knowledge, skills, attitudes and values to meet the competency in all the elements of Domain 3 of the QNI/QNIS Voluntary Standards as mapped against the NMC Standards for Specialist Practice in District Nursing.

Signatures:

Practice Teacher/Sign-off Mentor: ………………… Student District Nurse: …………………… Academic Supervisor: …………………


©TU-SOHSC (2017) 34

CLINICAL DOMAIN 4: EVIDENCE, RESEARCH AND DEVELOPMENT

Benchmark Signature of PT/SoM to Confirm Achievement



4.1 4.1.1

Ensure care is based on all available evidence/research or best practice.

Demonstrate high level skills in discerning between different forms of evidence and managing uncertainty in clinical practice.

4.2 4.2.1

Identify trends in the characteristics and demands on the district nursing service and use this, where appropriate, to inform workload and workforce planning and strategic decision-making. Produce operational plans, supported objectively by data that identify key risks and future management strategies.

4.3 4.3.1

Use a range of change management, practice development, service and quality improvement methodologies, evaluating the underpinning evidence of successful approaches that support the implementation of service developments to improve patient care. Participate in the development and implementation of organisational systems to enable individuals, family and carers to share their experiences of care confidentially. Develop processes for systematically improving services in response to feedback.

4.4 Apply the principles of project management to enable local projects to be planned, implemented and evaluated.


©TU-SOHSC (2017) 35


Significant progress towards achievement of competency in Domain 4: Evidence, Research and Development 4.1 has/has not been demonstrated by student district nurse ……………………………………………. (Name)


Practice Teacher/Sign-off Mentor (Signature): ……………………………………………………

Academic Supervisor (Signature): …………………………………………………………………

Student District Nurse (Signature): …………………………………………………………………



©TU-SOHSC (2017) 36

Domain 4: Evidence, Research and Development


Tripartite 1

Reflection by Student on Competencies in Domain 4


Agreed Forward Planning Regarding Achievement of Competencies in Domain 4

Date:

Signatures:



©TU-SOHSC (2017) 37




Date:

Signatures:



©TU-SOHSC (2017) 38




Final Tripartite COMPETENT/NOT COMPETENT Date: I am satisfied/not satisfied that the student district nurse has met the required standard through the following: observation, question and answer throughout the practice experience, discussion and submission of Essential Evidence at the final tripartite meeting. The student demonstrates/does not demonstrate the necessary knowledge, skills, attitudes and values to meet the competency in all the elements of Domain 3 of the QNI/QNIS Voluntary Standards as mapped against the NMC Standards for Specialist Practice in District Nursing. Signatures: Practice Teacher/Sign-off Mentor: …………………… Student District Nurse: ………………………… Academic Supervisor: ……………………


©TU-SOHSC (2017) 39

Reassessment Form Student District Nurse Name:

Reflection by Student Feedback from Practice Teacher/ Sign-off Mentor

Agreed Forward Planning

Date:

State Domain and Benchmarks:

Signatures:



©TU-SOHSC (2017) 40



Date: State Domain and Benchmarks:

Signatures:



©TU-SOHSC (2017) 41



Date:

State Domain and Benchmarks:

Reassessment Tripartite COMPETENT/NOT COMPETENT Date:

I am satisfied/not satisfied that the student district nurse has met the required standard through the following: observation, question and answer throughout the practice experience, discussion and submission of Essential Evidence at the final tripartite meeting. The student demonstrates/does not demonstrate the necessary knowledge, skills, attitudes and values to meet the competency in all the elements of Domains of the QNI/QNIS Voluntary Standards as mapped against the NMC Standards for Specialist Practice in District Nursing. Signatures: Practice Teacher/Sign-off Mentor: ……………………… Student District Nurse: ……………………… Academic Supervisor ……………………..


©TU-SOHSC (2017) 42

FINAL DECLARATION OF COMPETENCY AS A SPECIALIST PRACTITIONER IN DISTRICT NURSING

(This form is to be completed on the student district nurse’s last day in the practice placement setting at the end of the programme to confirm whether or not the student district nurse has maintained their competency since the final tripartite.)

Date:

The student district nurse (name of student) ………………………………………….. has/has not demonstrated that they are able to achieve and maintain competency across all of the Voluntary Standards as set out by the QNI/QNIS (2015) and the regulatory standards as set by the NMC (2001) for Specialist Practitioner Qualification in District Nursing and the V100 Prescribing NMC (2006). (Delete as appropriate)

This is confirmed as agreed by the following:

Practice Teacher/Sign-off Mentor

Name:

Signature:

Student District Nurse

Name:

Signature:

Supervising Practice Teacher (only required if the Practice Teacher has not yet achieved sign-off status)

Name: Signature:


©TU-SOHSC (2017) 43

Self-Assessment and Learning Contract Templates

Self-assessment

Name of Student District Nurse: ……………………………………………………………. Date: ………………………………….

Context of Self-assessment: ……………………………………………………………………………………………………………..

INT

ER

NA

L

FA

CT

OR

S

STRENGTHS

WEAKNESSES

EX

TE

RN

AL

FA

CT

OR

S

OPPORTUNITIES

THREATS

APPENDIX 5


©TU-SOHSC (2017) 44

Learning Contract

Name of Student District Nurse: ……………………………………………………………. Date: ………………………………….

Context for Learning Contract: ………………………………………………………………………………………………………….

Overall Aim Where am I? Where do I want to be? How will I get there? How will I know that I am there?

Learning Contract agreed with Practice Teacher/Sign-off Mentor and Academic Supervisor:

Signatures to Confirm

Student District Nurse: ……….…….. Practice Teacher/Sign-off Mentor: ………………. Academic Supervisor: …………………...


©TU-SOHSC (2017) 45

Reflection

Name of District Nursing Student: Date: Brief factual description of the event/issue:

Issues raised:

The link between these issues and relevant literature and evidence:

How this reflection will influence my future practice:

(Using Kolb’s model: Kolb D.A. (1984) Experiential Learning: Experience as the Source of Learning and Development. Englewood Cliffs, NJ: Prentice Hall)

APPENDIX 6


©TU-SOHSC (2017) 46

CONFIDENTIAL

District Nursing Practice-based Assessment To be Completed by Service User/Patient

Teesside University greatly values the involvement of service users/patients and carers in the learning and development of student nurses. This form helps us to assess their learning. These students must demonstrate an approach to care which reflects their understanding of your needs as a service user/patient and as a person and that they have prioritised these preferences where at all possible. It is important to all patients/service users and carers that nurses are skilled in communication and by completing this questionnaire you are adding your contribution to the assessment process of the student. If you consent to completing this form, the nurse who has given it to you will write their name and sign in the box below to indicate that you have given your informed consent.

Thank you for agreeing to help assess the district nursing student’s progress in managing your nursing care needs. If you wish, please ask the district nurse student’s Mentor (the nurse who gave you this form) or your family to help you complete this form. All questions are optional and the student will not know who has been asked to complete the form. The student will see your comments, however, please be assured that your identity will remain confidential.

Please see over the page.

The nurse who has given this form to you should explain the purpose of this request with you before you complete it. It is essential that your informed consent is given freely.

I confirm that informed consent has been obtained from the patient/client/ service user/carer (delete as appropriate) completing this form. Name of Practice Teacher/Sign-off Mentor: ……........................................... Signature of Practice Teacher/Sign-off Mentor: …….....................................

APPENDIX 7


©TU-SOHSC (2017) 47

Please rate how effective you felt the district nursing student was in relation to the following areas by ticking one box for each statement:

Poor

OK

Good

Excellent

N/A

1. The student district nurse introduced themselves when they first met you, ensuring they gave you their name

2. You were greeted in a friendly manner at each visit

3. The student district nurse used words and language which you could understand and made you feel valued

4. The student district nurse’s whole approach (how they stood, whether they smiled, etc.) made you feel at ease

5. You were given the opportunity to explain how your health problems were affecting you and what was important to you

6. You were provided with a clear and understandable explanation of how your health and social care needs could be addressed

7. The student district nurse gave you choices in relation to what was available regarding your care

8. The student district nurse worked with you in order to make appropriate decisions about your care and the plan was agreed between you both

9. You felt supported in your decisions and made to feel that your views and choices were respected

10. You were encouraged to share with the student district nurse your views as to how you satisfied you were with the outcome of the care interventions

11. You were advised on other services which could support you and how to access these

12. The student district nurse was knowledgeable and made you feel safe in their care

13. If you were given a prescription for any treatment the student district nurse was able advise you what this was for and how to use the product or medication


©TU-SOHSC (2017) 48

Please see next page

14. Your family or carers were included and involved in both the organisation and delivery of your care in a way that was appropriate

15. The student district nurse encouraged you to consider a way in which you could improve your own health; even a small change is relevant

16. You were treated with dignity and listened to at all times throughout your care

17. You were cared for with compassion at all times


©TU-SOHSC (2017) 49

18. Is there anything the student district nurse did particularly well?

19. Are there any areas where you feel the student could develop?

Thank you for your help in supporting the learning of this student - it is greatly

appreciated


©TU-SOHSC (2017) 50

CONFIDENTIAL

District Nursing Practice-based Assessment To be Completed by Carer

Teesside University greatly values the involvement of service users/patients and carers in the learning and development of student nurses. This form helps us to assess their learning. These students must demonstrate an approach to care which reflects their understanding of your needs as a carer and as a person and that they have prioritised these preferences where at all possible. It is important to all patients/service users and carers that nurses are skilled in communication and by completing this questionnaire you are adding your contribution to the assessment process of the student. If you consent to completing this form, the nurse who has given it to you will write their name and sign in the box below to indicate that you have given your informed consent.

Thank you for agreeing to help assess the district nursing student’s progress in supporting your needs as a carer. If you wish, please ask the district nurse student’s Mentor (the nurse who gave you this form) or your family to help you complete this form. All questions are optional and the student will not know who has been asked to complete the form. The student will see your comments, however, please be assured that your identity will remain confidential.

Please see over the page

The nurse who has given this form to you should explain the purpose of this request with you before you complete it. It is essential that your informed consent is given freely.

I confirm that informed consent has been obtained from the patient/client/ service user/carer (delete as appropriate) completing this form. Name of Practice Teacher/Sign-off Mentor: ……........................................... Signature of Practice Teacher/Sign-off Mentor: …….....................................

http://www.tees.ac.uk/


©TU-SOHSC (2017) 51


Poor

OK

Good

Excellent

N/A

1. The student district nurse introduced themselves when they first met you, ensuring they gave you their name

2. You were greeted in a friendly manner at each visit

3. The student district nurse used words and language which you could understand and made you feel valued

4. The student district nurse’s whole approach (how they stood, whether they smiled, etc.) made you feel at ease

5. You were given the opportunity to explain how your caring role was affecting you and what was important to you

6. You were provided with a clear and understandable explanation of how your health and social care needs could be addressed

7. The student district nurse gave you choices in relation to what was available to support you in your role as a carer

8. The student district nurse worked with you in order to make appropriate decisions about your role as a carer and the plan was agreed between you both

9. You felt supported in your decisions and made to feel that your views and choices were respected

10. You were encouraged to share with the student district nurse your views as to how you satisfied you were with the outcome of the plans which were agreed

11. You were advised on other services which could support you and how to access these

12. The student district nurse was knowledgeable and made you feel both you and the person you care for is safe in their care


©TU-SOHSC (2017) 52

Please see next page

13. The person you care for and your family or other significant person were included and involved in a way that was appropriate

14. The student district nurse encouraged you to consider a way in which you could improve your own health; even a small change is relevant

15. You were treated with dignity and listened to at all times throughout your care

16. You were cared for with compassion at all times


©TU-SOHSC (2017) 53

17. Is there anything the student district nurse did particularly well?

18. Are there any areas where you feel the student could develop?

Thank you for your help in supporting the learning of this student - it is greatly

appreciated


©TU-SOHSC (2017) 54

District Nursing Practice-based Assessment of Communication Skills

To be completed by Practice Teacher/Sign-off Mentor

This tool should facilitate assessment of the student district nurse’s ability to communicate with the service users/patients and carers in their care. Underpinning evidence to support the areas assessed include:

NMC (2015) The Code

DH (2013) NHS Constitution

NMC (2001) Standards for Specialist Education and Practice

NMC (2006) Standards of Proficiency for Nurse and Midwife Prescribers Please use the table below to provide an assessment of the student’s abilities in the areas identified. You can reflect on either one individual interaction or a combination of interactions by the student district nurse. Please ensure that you assess them towards the time of their tripartite meeting so that discussion of this form within that meeting reflects their performance at that time. Name of Student District Nurse: …………………………………………………………… Programme being studied: …………………………………………………………………. Date of completion of form: …………………………………………………………………


Poor

OK

Good

Excellent

N/A

1. The student district nurse introduced themselves to the service user or carer when they first met, ensuring they gave their name

2. They conducted themselves in a friendly manner at each visit

3. The student district nurse used language appropriate for the setting and made the service user or carer feel valued

4. The student district nurse’s non-verbal communication was effective in establishing a therapeutic relationship

http://www.tees.ac.uk/


©TU-SOHSC (2017) 55

5. The service user or carer was given the opportunity to explain their health problems and their perceived relevance by the service user or carer

6. The student district nurse provided a clear and understandable explanation of the health and social care needs which could be addressed

7. The student district nurse gave choices in relation to what was available regarding care

8. The student district nurse took a partnership approach to care planning

9. Within the context of prescribing the student district nurse gave appropriate information relating to safe and effective prescribing

10. The service user or carer’s decisions were respected and valued

11. The student district nurse sought feedback on the care and support they had provided

12. The student district nurse demonstrated knowledge of the range of services available in the local area which could be accessed by the service user or carer and encouraged accessing these

13. The student district nurse demonstrated competency and confidence in the delivery of care

14. The student district nurse’s approach was inclusive of all those significant in the patient’s care and the carer’s support

15. Every contact was made to count in terms of health improvement

16. The core values of dignity and respect were upheld at all times

17. The student district nurse demonstrated compassion in all care given


©TU-SOHSC (2017) 56

Please give a summary of areas on which the student needs to focus in order to develop their practice and also of the areas in which they are demonstrating good practice:

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

Name of Practice Teacher/Sign-off Mentor: …………………………………………. Signature of Practice Teacher/Sign-off Mentor: …………………….......................


©TU-SOHSC (2017) 57


To be Completed by Student District Nurse

This tool should facilitate assessment of your ability to communicate with the service users/patients and carers in your care. Underpinning evidence to support the areas assessed include:

NMC (2015) The Code



NMC (2006) Standards of Proficiency for Nurse and Midwife Prescribers Please use the table below to provide a self-assessment of your abilities in the areas identified. You can reflect on either one individual interaction or a combination of interactions you have had with service users and carers. Please undertake this self-assessment towards the time of your tripartite meeting so that discussion of this form within that meeting reflects your performance at that time. Name of Student District Nurse: …………………………………………………………… Programme being studied: ………………………………………………………………….. Date of completion of form: …………………………………………………………………

Please rate how effective you felt you were in relation to the following areas by ticking one box for each statement:

Poor

OK

Good

Excellent

N/A

1. You introduced yourself to the service user or carer when you first met, ensuring you gave them your name

2. You conducted yourself in a friendly manner at each visit

3. You used language appropriate for the setting and made the service user or carer feel valued

4. Your non-verbal communication was effective in establishing a therapeutic relationship


©TU-SOHSC (2017) 58

Please give a summary of areas on which you feel you need to focus in order to develop your practice and also of the areas in which you feel you are demonstrating good practice:

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

Signature of Student District Nurse: ……………………..........................................

5. The service user or carer was given the opportunity to explain their health problems and their perceived relevance by the service user or carer

6. You provided a clear and understandable explanation of the health and social care needs which could be addressed

7. You gave choices in relation to what was available regarding care

8. You took a partnership approach to care planning

9. The service user or carer’s decisions were respected and valued

10. You sought feedback on the care and support you had provided

11. You demonstrated knowledge of the range of services available in the local area which could be accessed by the service user or carer and encouraged accessing these

12. You demonstrated competency and confidence in the delivery of care including episodes of prescribing practice

13. Your approach was inclusive of all those significant in the patient’s care and the carer’s support

14. Every contact was made to count in terms of health improvement

15. The core values of dignity and respect were upheld at all times

16. You demonstrated compassion in all care given


©TU-SOHSC (2017) 59


Summary Reflection

To be Completed by Student District Nurse

Please use this form to reflect on your communication skills and demonstration of professional attitudes and values in clinical practice. You will need the following in order to do this: Practice-based assessment of communication skills by:

Service user

Carer

Practice Teacher/Sign-off Mentor

Self-assessment You may also want to draw upon the standards upon which this assessment has been developed. These are:

NMC (2015) The Code



NMC (2006) Standards of Proficiency for Nurse and Midwife Prescribers This form must be completed in advance of the tripartite meeting and brought to that meeting for discussion. Name of Student District Nurse: …………………………………………………………… Programme studied: …………………………………………………………………………. Date form completed: ………………………………………………………………………..


©TU-SOHSC (2017) 60

1. Discuss the common themes which are evident across the assessment form, including any discrepancies in the way you have been perceived by others and by yourself.

2. What factors may have affected your assessment by the different people?

3. Why are the issues which have been identified in this tool important in district nursing?


©TU-SOHSC (2017) 61

4. Identify key learning objectives for the next period based on these reflections.

Signature of Student District Nurse: ……………………………………………………


©TU-SOHSC (2017) 62

Prescribing Verification Framework

This framework is to ensure that your competency as a nurse prescriber is evidenced at the point of assessment for your overall competency as a specialist practitioner in district nursing. The evidence required is:

Confirmation of successful completion of the prescribing module (CCH3048-N or CCH4033-N). If you are already recorded as a prescriber on the NMC register, then you will need to provide a printout of your statement of entry demonstrating this and confirmation of successful application to RPL this qualification. Please insert this in this section.

Reflective Learning Logs demonstrating application of the prescribing Learning Outcomes in the practice setting.

Statement of verification of competency against the Learning Outcomes for prescribing for the V100 by the Practice Teacher/Sign-off Mentor at the time of the final tripartite.

APPENDIX 8


©TU-SOHSC (2017) 63

Learning Logs Demonstrating Competency in Prescribing from the Community Practitioner Formulary

Date Patient/Practice Experience

Description of Event Learning Outcome Met

Significant Learning


©TU-SOHSC (2017) 64

Outcome Community Practitioner Prescribing Outcomes CCH3048-N

1 Critically appraise and synthesise the influences that can affect prescribing practice and demonstrate understanding by managing prescribing practice in an ethical way.

2 Demonstrate a comprehensive and detailed knowledge of drug actions in prescribing practice.

3 Analyse and evaluate the legal and professional framework for accountability and responsibility in relation to prescribing practice.

4 Evaluate the factors involved in effective history-taking including medication history and current medication that will inform the diagnostic process.

5 Demonstrate a comprehensive and detailed knowledge of the relevant legislation to the practice of nurse/midwife prescribing.

6 Critically appraise and synthesise sources of information/advice and decision support systems in prescribing practice.

7 Demonstrate a critical reflective approach to Continuing Professional Development of prescribing practice.

8 Prescribe safely, appropriately and cost effectively.

9 Practice within a framework of professional accountability and responsibility.

10 Assess and consult with patients/clients, parents and carers.

11 Demonstrate the ability to monitor response to medicines and modify treatment or refer the patient as appropriate.

12 Demonstrate a detailed and comprehensive knowledge of the importance of record-keeping in the context of medicines management including:

Accurate recording in patient notes

Reporting of near misses

Adverse reactions

13 Demonstrate a detailed knowledge of the roles and relationships of others involved in prescribing, supplying and administering medicines.

14 Demonstrate effective partnership working with Independent Prescribers and the wider care team.

15 When working with children take an appropriate history, undertake a clinical assessment, and make an appropriate diagnosis, having considered the legal, cognitive, emotional and physical differences between children and adults.

16 Demonstrate appropriate numeracy skills.


©TU-SOHSC (2017) 65

Outcome Advancing Community Practitioner Prescribing Outcomes CCH4033-N

1 Critically evaluate the influences that can affect prescribing practice at individual, local and national levels.

2 Demonstrate a systematic and critical understanding of the need to lead prescribing practice in an ethical way in order to enhance service improvement.

3 Demonstrate a comprehensive and critical knowledge of drug actions in prescribing practice.

4 Critically evaluate the legal and professional framework for accountability and responsibility in relation to prescribing practice.

5 Critically evaluate the factors involved in effective history-taking including medication history and current medication that will inform the diagnostic process.

6 Integrate and synthesise diverse sources of information/advice and decision support systems in prescribing practice.

7 Able to challenge decisions to formulate alternative approaches as appropriate.

8 Prescribe safely, appropriately and cost-effectively.

9 Practice within a framework of professional accountability and responsibility.

10 Assess and consult with patients/clients, parents and carers.

11 Demonstrate the ability to monitor response to medicines and modify treatment or refer the patient as appropriate.

12 Demonstrate a comprehensive and critical understanding of the importance of record-keeping in the context of medicines management including:

Accurate recording in patient notes

Reporting of near misses

Adverse reactions

13 Demonstrate a comprehensive and critical understanding of the roles and relationships of others involved in prescribing, supplying and administering medicines.

14 Act autonomously in planning and implementing effective partnership-working with independent prescribers and the wider care team.

15 When working with children take an appropriate history, undertake a clinical assessment and make an appropriate diagnosis, having considered the legal, cognitive, emotional and physical differences between children and adults.

16 Be competent in the numeracy skills commensurate with the demands of ensuring safe prescribing practice.

17 Demonstrate a critical and systematic reflective approach to Continuing Professional Development and leading prescribing practice.

S:\Modularity\Documentation Department\Approval Documentation\Programmes\Specialist Practice in District Nursing, BSc (Hons), PgDip, MSc\Approved July

2016\Updated documentation\2017_18\Practice Portfolio.docx 66 ©TU-SOHSC (2017)

Verification of Competency as a Community Practitioner Prescriber

To be Completed by the Practice Teacher at Final Tripartite

Student District Nurse:

Considering the student’s demonstration of skills, knowledge, attributes and professionalism is the student competent to practice as a Community Practitioner Prescriber? YES/NO

If no, you must comment:

Adapted from Standards of Proficiency for Nurse and Midwife Prescribers (NMC, 2006) http://www.nmc-uk.org/Documents/Standards/nmcStandardsofProficiencyForNurseAndMidwifePrescribers.pdf (Accessed on 21/04/15) And NMC (92007) 22/2007 Circular: http://www.nmc.org.uk/globalassets/sitedocuments/circulars/2007circulars/nmc-circular-22_2007.pdf (Accessed on 21/04/15)

Practice Teacher/Sign-off Mentor Name

Signature Date

Student District Nurse Name

Signature Date

http://www.nmc-uk.org/Documents/Standards/nmcStandardsofProficiencyForNurseAndMidwifePrescribers.pdf



http://www.nmc.org.uk/globalassets/sitedocuments/circulars/2007circulars/nmc-circular-22_2007.pdf

http://www.nmc.org.uk/globalassets/sitedocuments/circulars/2007circulars/nmc-circular-22_2007.pdf



ATTENDANCE SHEET

PRE-REG NURSING, MIDWIFERY, RADIOGRAPHY, PHYSIOTHERAPY, OCCUPATIONAL THERAPY, DENTAL, ODP & PARAMEDIC PRACTICE

Surname ………………………………………………………………………………………

Forename …………….…………………………………………..

Student Number

Cohort …………….

Month ………………

Year ……….………

Date (Day of Month)

Shifts Total Hours

Worked/ Sick

Code Clinician / Mentor Full Signature to

verify time worked

Shift worked with mentor (Initials)

(for Nursing, Midwifery & Dental Cert HE

students only)

Code Time Started

Time Finished

1st ND – Night Duty DO – Day Off AL – Annual Leave S – Sick A – Absent U – University / Theory

P – Placement

Hours Relate to placements only and should include the time started and finished. Please note that you must subtract your meal break from the total hours worked column. Hours per week Nursing 37.5 Midwifery 3yr 37.5 Radiography 28 Physiotherapy 37.5 Occ Therapy 37.5 Dental 22.5 ODP 37.5 Paramedic 37.5

2nd 3rd 4th 5th 6th 7th 8th 9th

10th 11th 12th 13th 14th 15th 16th 17th 18th 19th 20th 21st 22nd 23rd 24th 25th 26th 27th 28th 29th 30th 31st

Student Signature MUST BE DATED …..…………………………………………………………. Date …………………………………………………….

Practice Mentor / Educator / Supervisor’s Signature MUST BE DATED

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

Date …………………………………………………….

The form should be signed by the student and countersigned by the Practice Mentor / Educator / Site Co-ordinator each month. In addition they will be checked by the Academic Mentor at the end of the tripartite meeting (nursing / midwifery) / at the end of the placement (OT) / at the final bipartite meeting (DR). Note: Nursing/Midwifery/DR/Dental/ODP - the student must keep a copy of the completed “Student Attendance Sheet” in their portfolio as well as submit a copy of this with their travel expense form to verify eligibility of claim. OT/PT – the original must be submitted with the Assessment Form and a copy submitted with travel expenses

APPENDIX 9



Disclosure and Barring Service (DBS) Status Verification

I confirm that there have been no changes to my DBS Status for the duration of the specialist practice in my studies on the District Nursing programme at Teesside University. Name: Signature: Date: DBS Certificate Number: DBS Date of Certificate: Part of the Update Service: YES/NO

APPENDIX 10