Faculty of Health, Social Care and Education
RETURN TO PROFESSIONAL PRACTICE
MENTAL HEALTH NURSING
MOD004255
(Non-Credit Module)
Name of Student………………………………………… ID………….…………………….Trust……………………….
Personal Tutor…………………………………… ………E-mail……………………………..Tel no……..…………………...
Mentor Name
Confirmation of Mentor Status
(Please print)
Dates of
placement
MENTOR – To confirm validity of the student’s assessment please provide
the following details:
Education
Champion
Name
a. Mentor Signature……………………………………………………………
From
b. The date of your last mentorship update……………….........................
……………
c. The month and year of next triennial review………..............................
STUDENT - Within the first week of placement you must e-mail your personal tutor
the following information:
1. Name of your placement and education champion
2. Dates of placement allocation
3. Name of your mentor
4. The dates provided by your mentor in response to b and c above.
To
……………
Sign-Off
Mentor Name
(If different
from Mentor
above)
(Please print)
SIGN –OFF MENTOR – To confirm validity of the student’s assessment
please provide the following details:
a. Signature to confirm that you have achieved ‘sign-off’ proficiency:
…………………………………………………………………………………
b. The date of your last mentorship update……………….........................
c. The month and year of next triennial review………..............................
STUDENT - Within the first week of placement you must e-mail your personal tutor
the following information:
1. Name of your placement and education champion
2. Dates of placement allocation
3. Name of your mentor
4. The dates provided by your mentor in response to b and c above
PLEASE MAKE THIS DOCUMENT AVAILABLE TO YOUR MENTOR
Mentors must record that patient consent has been consistently gained prior to students undertaking patient care.
A review of all practice documents is carried out by the personal tutor and a sample of these will be reviewed by the
External Examiner.
©Anglia Ruskin University
1
Anglia Ruskin University is committed to the principles and values of the NHS Constitution (DH, 2013). This
details the following behaviours and values as those that patients and staff believe to be at the heart of our
NHS:
1. Respect and dignity
2. Commitment to quality of care
3. Compassion
4. Improving lives
5. Working together for patients
6. Everyone counts
Each competency in this practice assessment record has been mapped against the value(s)
embedded in the NHS Constitution.
The serious failures at Mid-Staffordshire NHS Foundation Trust (Francis 2013) is a stark reminder of how
critical these NHS values are in promoting a culture of care. The shared vision for nursing, midwifery and
health care workers (as set out in Table 1 below) (DH, 2012) also embraces these values, requiring ‘nurses,
midwives and health care staff to deliver high quality, compassionate care, and to achieve excellent health
and wellbeing outcomes’.
Table 1: Expected values and behaviours of nurses, midwives and health care staff (6C’s)
(DH, 2012)
Each of these values and behaviours are reflected in the practice competencies and interpersonal /
professional skills components of the student’s practice assessment.
Department of Health, 2013. The NHS Constitution for England. [online] Available at:
<https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/170656/NHS_Constitution.pdf >. [Accessed 3rd March
2014].
Department of Health, 2012. Compassion in practice. Nursing, midwifery and care staff our vision and strategy. [online] Available at:<
http://www.england.nhs.uk/wp-content/uploads/2012/12/compassion-in-practice.pdf> [Accessed 3rd March 2014]
Department in Health 2013 Compassion in practice one year on [online] Available at <http://www.england.nhs.uk/wpcontent/uploads/2013/11/comp-pract-1yr-on.pdf> [Accessed 3rd March 2014]
Francis, C. 2013. The Mid Staffordshire NHS Hospital Trust public enquiry. [online] Available at:<
http://www.midstaffspublicinquiry.com/report >[Accessed 3rd March, 2014]
CONTENTS
General Information (White)
Page
Purpose of this practice document ..................................................................................... 4
Key contacts ...................................................................................................................... 5
Information for students who have cause for concern arising from their placement ............ 6
Student responsibilities ...................................................................................................... 7
Attendance......................................................................................................................... 8
Clinical skills ...................................................................................................................... 9
Introduction to practice assessment ................................................................................. 10
Taxonomy of learning....................................................................................................... 11
Induction meeting with clinical staff .................................................................................. 12
Formal meetings with mentor ........................................................................................... 13
Learning contract example ............................................................................................... 14
Learning contract ............................................................................................................. 15
Record of progress and feedback from inter-professional team ....................................... 17
Views of service users ..................................................................................................... 18
Student’s reflections on views of service users ................................................................ 19
Formative assessment of interpersonal and professional skills profile .............................. 20
Student reflection on formative assessment of interpersonal/ professional skills profile.....22
Formative assessment of performance criteria ................................................................. 23
Student reflection on formative assessment of performance criteria…………………..……24
Action plan for formative assessment ............................................................................... 25
Performance criteria – care, compassion and communication.......................................... 31
Performance criteria – organisational aspects of care ...................................................... 33
Performance criteria – infection prevention and control .................................................... 35
Performance criteria – nutrition and fluid management .................................................... 36
Performance criteria – medicines management ............................................................... 37
Summative assessment of interpersonal and professional skills profile ............................ 39
Student reflection on summative assessment of interpersonal/professional skills profile...41
Summative assessment of performance criteria ............................................................... 42
Student reflection on summative assessment of performance criteria…………………..….43
Mentor summary of summative assessment ................................................................... .44
Cause for concern flow chart............................................................................................ 45
Cause for concern form.................................................................................................... 47
Personal tutor’s review of summative assessment .......................................................... 49
Sign- Off Mentor Record (Lilac)………………………………………………………………51
Declaration by sign-off mentor…………………………………………………………………..57
Standards for pre-registration nursing education: requirements for entry to the register
(NMC 2010)……………………………………………………………………………………….59
Documentation for students who fail practice assessment at the first attempt (Blue)
Action plans (2nd attempt)………..……………………………………………………………....73
Mentor summative assessment summary ........................................................................ 77
Personal tutor’s summative review of the module…………………………………………….79
Attendance sheets (White)
Guidance for use of attendance record sheets ................................................................ 81
Attendance record sheets ................................................................................................ 83
Purpose of this Practice Document
The NMC, through the publication of the Standards to Support Learning and Assessment in
Practice (2008), require a mentor to confirm students’ achievement of competencies.
This practice document offers guidance on the assessment of learning. Formative assessment
is used to inform and support the student in developing their practice. Learning that takes place
at this point is key to promoting a successful outcome at the summative assessment stage.
Formative Assessment:
The NMC requires that all Mentors should record and justify their decisions. Concerns with progress
must be recorded and guidance given. The mentor should also ensure that regular feedback is given.
Formative assessments should be conducted in a timely fashion to identify areas for development
and an appropriate timeframe to address these. Any cause for concern and action plans included in
this practice book can be used to document progress and is an important part of the audit trail.
Summative Assessment:
This summative assessment is carried out by the mentor at the end of the module to confirm the
achievement or non-achievement of all the criteria set. If a student has been unable to achieve the
criteria due to a lack of opportunity, it is acceptable for them to demonstrate their level of knowledge
through in-depth discussion.
Students must pass the two sections identified below at the summative stage of assessment:
1. Practice assessment criteria related to the
a) NMC Essential Skills Clusters.
Competencies detailed in the NMC (2010) Standards for pre-registration
nursing education.
b) Module learning outcomes.
These outcomes embrace the Key Domains of professional values,
communication and interpersonal skills, nursing practice and decision making,
leadership, management and team working.
2. An interpersonal and professional skills profile, which assesses professional behaviour
and attitude.
The term N/A should not be used in any aspect of the summative assessment
Guidelines for mentors and assessment can be located at www.anglia.ac.uk/mentors
4
Key Contacts
Title
Name
E-Mail
Telephone
Course Leader
Karen Pym
[email protected]
0845 196 4170
Module Tutor (Chelmsford)
Karen Pym
[email protected]
0845 196 4170
Module Tutor (Cambridge)
Jackie Bryan
[email protected] 0845 196 5300
Educational Champion
Module Administrator
Student Advisors
(Extensions, Mitigations and Appeals)
See local details or
visit www.anglia.ac.uk/placements
Sarah Brown
[email protected]
[email protected]
5
0845 684815
01245 686700
Information for students who have issues arising from their placement
1. If you have concerns related to your practice placement (e.g. not working with mentor,
have not received an induction, no opportunity for formative assessment, difficulty
achieving practice outcomes etc) the following line of contact should be followed:If possible, discuss with your mentor in the first instance.
If unresolved, you should try to approach the manager of your placement to discuss the issue.
If your issue remains unresolved after approaching the above, please contact your personal tutor to
explore the issues further.
If you do not receive a response within 5 days from your personal tutor, please contact
 The Course Leader for your Course
2. If you are involved in an accident/untoward incident whilst in practice the following must
all be informed: Your mentor and / or the nurse in charge of the placement (An incident form will have to be
completed).
 The education champion for the Trust / Organisation.
Visit www.anglia.ac.uk/placements for details of your Education Champion
 Your personal tutor (It may be necessary for this person to refer you to Occupational Health if the
accident / incident has resulted in injury and/or time off placement)
3. If you have any concerns about the safety of service users in your placement, the
following must be contacted immediately in priority order: Your mentor and / or the nurse in charge of the placement in the first instance.
 The education champion for the Trust / Organisation.
Visit www.anglia.ac.uk/placements for details of your Education Champion
 Your personal tutor.
If unable to contact the education champion or personal tutor please contact:
The Director of Health & Social Care Practice: Frances Weeley [email protected]
0845
1964127
Remember the ‘courage’ to speak up when things are wrong is a key value in
safeguarding our patients. Please follow the line of contact advised in section 3
of this page if you are concerned about the safety of service users in your placement.
N.B. You should make a personal record of your concerns as soon as possible after the incident as you may be
required to provide a statement. A member of the link team can support you in the process of writing a statement.
6
STUDENT RESPONSIBILITIES
Expectations of students in practice are:

That you inform patients/clients that you are a student nurse and that you receive
their verbal consent before participating in their care.

That you will make every effort to work all allocated shifts with your mentor and only change
your shift in extenuating circumstances.

That you will be punctual for your designated shifts.

That you will act in a professional manner at all times.

You will notify your clinical placement if you are unable to attend for any reason.

That you will act in accordance with local Trust policy: e.g. Uniform, Smoking, Mobile phone
usage etc

That you will recognise your own limitations and request appropriate assistance.

That you will take responsibility for your own learning and assessment by:
a. Requesting / initiating an initial interview with your mentor.
b. Informing your mentor of the time period for formative and summative meetings.
c. Ensuring the practice document is made available to your mentor for completion
of formative and summative assessments.
d. Following the appropriate process for submission of the completed practice
document by the due date to the University.
e. Discussing with your mentor and/or your tutor if there are any difficulties with this
process.
f.

Seeking an extension to submission of the practice document from the University
student advisor if there are legitimate difficulties in completing the practice
document (e.g. mentor sickness). Evidence must be provided by practice staff to
support this extension request. (N.B. Failing outcomes or the interpersonal
profile is not a legitimate reason for an extension to the submission of a practice
document).
You must inform your personal tutor and education champion, within five working
days, if you fail any component of the summative assessment. A member of the link
team will then facilitate a learning contract between you and your mentor.
7
Attendance
At the end of this document there are attendance record sheets which must be completed for
every month in practice. These attendance record sheets will be checked by the Personal Tutor
on a regular basis so that attendance can be recorded and absences investigated.
You must keep a copy of this form for your records.
Please note that all sickness and absence, from either theory or practice, will be monitored
throughout your programme, and should be supported with the appropriate certification.
When applying for jobs, your sickness and absence levels will be included in any references.
Any sickness and absence must be notified, as soon as possible, to:
-
Clinical Practice Area
Personal Tutor
E-mail [email protected]
or Tel 0845 196 4816
or TEXT the words ‘absence SID No and site with reason for absence to 07781472772
Seconded students must also inform their Seconding Manager
Shifts: Students are required to work a minimum of 15 hours per week whilst on
placement, with 200 practice hours to be completed over a 10 week period.
Where possible, shift patterns should coincide with the allocated mentor / sign-off
mentor.
8
CLINICAL SKILLS
Return to professional practice (Adult Nursing) students have been exposed to the following skills
within the clinical skills environment at Anglia Ruskin University:
Moving and handling
Basic and intermediate life support
General assessment skills and documentation (MUST, NEWS, MEOWS)
Assessing and responding to the deteriorating patient
Communication skills-( Including Dementia patients, SBAR)
Infection control (Including aseptic technique)
Medicines management
Simulated management exercise
9
PRACTICE ASSESSMENT
Students should be able to deliver a good standard of care, routinely reflect on and analyse their
experiences and make appropriate informed decisions about care. By the end of the placement,
mentors should feel able to trust the student to deliver their care with minimal supervision and should
be able to judge the student to be competent in their practice.
During the placement, there may be some clinical and management situations that are new to the
student and they will require support in developing associated skills.
Students should be aiming to practice appropriate skills autonomously by the end of the
placement, in preparation for their role as a registered nurse. This is commensurate with the
‘Internalisation’ level of Steinaker and Bell’s (1979) taxonomy of experiential learning as
follows:
Internalisation (Grade 4)




The student is able to reflect on previous experiences and show development of their practice
related to this outcome as a result.
The student’s performance in this outcome is good and requires minimal supervision.
Professional limitations are recognised.
The student will need little prompting and has the ability to consistently use their initiative, based
on their previous experience and/or level of knowledge.
The student is able to discuss and apply underpinning theory to their practice and consider any
discrepancies that may exist.
(See next page for full adapted taxonomy)
The NMC cluster skills form the framework for the competencies in this practice assessment
document.
Each of the competencies should be assessed according to the student’s ability to achieve these in
accordance with the ‘Internalisation’ stage (grade 4) of Steinaker and Bell’s (1979) framework.
To pass this module students must achieve grade 4 in all competencies by the end of the module.
10
Steinaker and Bell’s (1979) Taxonomy of Experiential Learning (Adapted)
Disengagement (Grade 0)


The student fails to show interest during observation of the skill / outcome.
The student fails to recognise and action their responsibilities in identifying sources and types of
information that may enhance their knowledge of the observed practice.
Exposure (Grade 1) All students will be in this stage when exposed to a skill or outcome for
the first time but must demonstrate development from this stage during the module.



On observing a competent practitioner, the student shows awareness but lacks knowledge and
skills.
The student demonstrates a willingness to listen, observe and ask questions related to the
outcome.
The student is able to react to the experience and recognise their responsibilities in identifying
sources and types of information that may enhance their knowledge of the observed practice.
Participation (Grade 2)



Under regular supervision, the student is able to participate in aspects of care related to the
outcome.
In relation to this outcome, the student is able to discuss rationale for care and explain their own
decisions in care delivery. Problem solving with guidance is evident.
The ability to acquire further information to support their practice in relation to this outcome is
evident.
Identification (Grade 3)



The student shows evidence of safely participating in the patient care related to this outcome with
less direct supervision. Their ability / attempts to problem-solve in relation to this outcome are
more prominent.
The student is able to identify areas of their knowledge related to this outcome that need to be
developed and demonstrates the motivation and skills to address this.
The student recognises their professional limitations in relation to this outcome and seeks advice
when appropriate.
Internalisation (Grade 4)




The student is able to reflect on previous experiences and show development of their practice
related to this outcome as a result.
The student’s performance in this outcome is good and requires minimal supervision.
Professional limitations are recognised.
The student will need little prompting and has the ability to consistently use their initiative, based
on their previous experience and/or level of knowledge.
The student is able to discuss and apply underpinning theory to their practice and consider any
discrepancies that may exist.
Dissemination (Grade 5)



The student is proficient in this outcome and is able to act as a role model, demonstrating the
ability to teach others (qualified nurses, other qualified allied health professionals, or junior
colleagues).
The student demonstrates a holistic understanding of the related outcome and is able to apply
higher-level skills of analysis, evaluation and appropriate decision making to this outcome.
The student may demonstrate the ability to achieve the outcome in complex and unfamiliar
situations.
11
.INDUCTION MEETING WITH CLINICAL STAFF
TRUST/ORGANISATION NAME (S): ___________________________________
PLACEMENT(S): ___________________________________________________
The following must take place
on first day of each placement
allocation :
Achieved on
first day of
placement
attendance
Yes/No
If not achieved on first day of placement
attendance, please identify placement
area and record date completed,
providing reason for non-achievement on
first day.
Allocation of mentor
Orientation to area
Advised of hours, shift pattern,
breaks
Made aware of trust / organisation
policies and procedures
Made aware of placement profile
and learning opportunities
Made aware of location of moving
and handling equipment & how to
use the relevant equipment
Made aware of fire and
resuscitation equipment
The procedure for receiving and
referring messages and enquiries
Made aware of responsibilities with
regard to health and safety at work
Made aware of responsibilities in
respect of infection control
Made aware of and how to contact
education champion
Signature of Mentor / Date _______________________________.
Signature of Student/Date________________________________
12
FORMAL MEETINGS WITH MENTOR
TRUST/ORGANISATION NAME: _________________________________
PLACEMENT: ________________________________________________
The following should take place within 3
days of attendance at placement :





Achieved
within 3 days
of attendance
at placement
Yes/No
If not achieved within 3 days of
placement attendance, please
provide date of completion and
reason for non-achievement.
Achieved by
mid- point of
placement.
If not achieved at mid-point of placement,
please provide date of completion and
reason for non-achievement.
Achieved by
end point of
placement.
If not achieved at end point of placement,
please provide date of completion and
reason for non-achievement.
Discussion of expectations of student
and mentor
Discussion of experiences available
in placement
Development of learning contract –
link to learning outcomes
Discussion of any specific learning
needs e.g. dyslexia, dyspraxia.
Identify dates for formative and
summative assessments
(Agreed date of formative
assessment………………………………)
The following should take place by
mid- point of placement




Formative assessment of
performance criteria (cluster skills)
Formative assessment of
Interpersonal skills profile
Review / development of action plan
Completion of service users’ views
and student’s reflections on these
views.
(Agreed date of summative
assessment………………………………….)
The following should take place by end
point of placement


Summative assessment of
performance criteria (cluster skills)
Summative assessment of
Interpersonal skills profile.
Signature of Mentor / Date _________________________________
Signature of Student/Date __________________________________
13
Learning contract (Example)
Student Name:
Date
_____________________________________ Mentor Name: ________________________________________________
Learning Outcomes
Learning Resources/Actions
Needs and interests, areas of
essential knowledge and skill.
Methods and situations for how
and when learning can occur.
Care of a patient receiving IM
injections.




Awareness of current social
policies affecting my
placement.



To understand how the multidisciplinary team works in the
area.




Evidence of achievement
Review Date
Achieved/Not
achieved
Talk with patients
Read Trust / organisation
policies regarding IM injections.
Observe Registered Nurse set
up and give IM injection.
Search internet for relevant
literature.

Will administer an IM
injection and be
observed as competent.
Discuss placement philosophy
with mentor and patient
profiles.
Review Trust/organisation
policy manual.
Search library and internet to
identify relevant national
Policies.

Discuss with mentor the
impact of local policies
for two patients in the
setting.
Discuss with mentor the
different professional inputs in
the area.
Attend team meetings.
Shadow different disciplines.
Accompany patients to a
variety of related departments.

Discuss with mentor 3
patients I have met and
consider how the multi
disciplinary team
contributes to their care
and management.
14
Mentor
signature
Student
signature
The Learning Contract (To be completed by student and mentor)
Student Name: ______________________________________ Mentor Name: ________________________________________________
Date
Learning Outcomes
Learning Resources/Actions
Evidence of achievement
Needs and interests, areas of Methods and situations for how
essential knowledge and skill. and when learning can occur.
Review Date
Achieved/Not
achieved
15
Mentor
signature
Student
signature
The Learning Contract (To be completed by student and mentor)
Student Name: ______________________________________ Mentor Name: ________________________________________________
Date
Learning Outcomes
Learning Resources/Actions
Evidence of achievement
Needs and interests, areas of Methods and situations for how
essential knowledge and skill. and when learning can occur.
Date
Achieved/Not
achieved
16
Mentor
signature
Student
signature
RECORD OF PROGRESS & FEEDBACK FROM INTERPROFESSIONAL TEAM
MEMBERS/OTHERS
This record is for progress comments and feedback from healthcare professionals/agencies other than the
mentor.
Date:
Name:
Designation:
Comments:
Signature: ...........................................................................
Date:
Name:
Designation:
Comments:
Signature: ...........................................................................
Date:
Name:
Designation:
Comments:
Signature: ...........................................................................
Date:
Name:
Designation:
Comments:
Signature: ...........................................................................
17
VIEWS of SERVICE USERS (Mid-point of placement)
Service users must remain anonymous and personal details should not be documented.
The mentor should identify 2 patients / clients or their relatives/carers and invite them to respond to
the question below.
Patient/Carer/Relative Views (1) (To be recorded below by mentor NOT patient/carer/relative)
Did the student nurse caring for you……
Please circle below
Poor
Treat you with dignity at all times
Communicate with you and your relatives
respectfully
Deliver care with compassion
Meet your basic care needs
Adequate
Good
Very Good
Excellent
1
1
2
2
3
3
4
4
5
5
1
1
2
2
3
3
4
4
5
5
Did the student request your permission to participate in your care? YES / NO
Are there any further comments you would like to make?
Patient/Carer/Relative Views (2) (To be recorded below by mentor NOT patient/carer/relative)
Did the student nurse caring for you……
Please circle below
Poor
Treat you with dignity at all times
Communicate with you and your relatives
respectfully
Deliver care with compassion
Meet your basic care needs
Adequate
Good
Excellent
1
1
2
2
3
3
4
4
5
5
1
1
2
2
3
3
4
4
5
5
Did the student request your permission to participate in your care? YES / NO
Are there any further comments you would like to make?
Views collected by Mentor (name)……………………………………………….
Signature……………………………………………………………………………..
18
Very Good
STUDENT’S REFLECTIONS ON SERVICE USERS VIEWS
Student’s reflection on views of Service Users
Signature of student……………………………………………..Date…………………………..
19
FORMATIVE ASSESSMENT OF THE INTERPERSONAL AND PROFESSIONAL SKILLS
The interpersonal /professional skills profile has been divided into 6 sections, each indicating statements around the values
underpinning the NHS Constitution and the 6C’s.
(F) Indicates a fail
STUDENT SID:
(P) Indicates a pass
Mentors should choose one statement from each of the 6C’s that best reflects the student’s interpersonal and professional
skills. Please indicate your chosen statement by signing in the corresponding box.
CARE
Please choose one statement below
Mentor
Please sign in one of the
boxes below to indicate
your choice of statement
for this value
Mentor
Reasons / evidence for choosing
this statement
Mentor
Please sign in one of the
boxes below to indicate
your choice of statement
for this value
Mentor
Reasons / evidence for choosing
this statement
Mentor
Mentor
Reasons / evidence for choosing
this statement
(F) 1. Fails to respond to patient needs.
(F) 2. Lacks consideration of patient comfort when
delivering care.
(F) 3. Ignores advice to improve patient care.
(P) 4. Demonstrates evidence based practice.
(P) 5. Approach to care enhances the patient
experience.
(P) 6. Ensures patient is central to care decisions.
(P) 7. Quality of care is commendable.
COMPASSION
Please choose one statement below
(F) 1. Fails to treat patients / carers / colleagues with
respect.
(F) 2. Lacks empathy / understanding towards patients’
concerns.
(F) 3. Fails to recognise opportunities to promote dignity in
care delivery.
(P) 4. Demonstrates compassion and understanding in
patient care.
(P) 5. Promotes dignity and respect in patient care.
(P) 6. Shows a mature understanding and an empathic
approach to care.
(P) 7. Champions patient dignity and encourages
colleagues to support this value.
COMPETENCE
Please choose one statement below
Please sign in one of the
boxes below to indicate
your choice of statement
for this value
(F) 1 Level of care is unsafe.
(F) 2. Blames circumstances for difficulties encountered.
(F) 3. Unable to define own learning needs.
(P) 4. Reflects on clinical practice and adapts accordingly.
(P) 5. Capable of informed decision making.
(P) 6. Delegates care effectively and with consideration
for patient safety.
(P) 7. Remains calm and professional in challenging
situations.
Statements revised in collaboration with service users and mentors (Sept 2012), amended to reflect 6C’s (March 2013) ©Anglia Ruskin University
Important: Student must submit one photocopy of this page
20
FORMATIVE ASSESSMENT OF THE INTERPERSONAL AND PROFESSIONAL SKILLS
(F) Indicates a fail
(P) Indicates a pass.
STUDENT SID:
Mentors should choose one statement from each of the 6C’s that best reflects the student’s interpersonal and professional
skills. Please indicate your chosen statement by signing in the corresponding box
COMMUNICATION
Please choose one statement below
Mentor
Please sign in one of the
boxes below to indicate
your choice of statement
for this value
Mentor
Reasons / evidence for choosing
this statement
Mentor
Please sign in one of the
boxes below to indicate
your choice of statement
for this value
Mentor
Reasons / evidence for choosing
this statement
Mentor
Please sign in one of the
boxes below to indicate
your choice of statement
for this value
Mentor
Reasons / evidence for choosing
this statement
(F) 1. Fails to communicate key aspects of patient care to
appropriate staff.
(F) 2. Reacts adversely to constructive criticism.
(F) 3. Lacks self awareness and the effect of behaviours
on others.
(P) 4. Has a pleasant and approachable manner.
(P) 5. Communicates effectively with patients and
relatives.
(P) 6. Uses interprofessional team working to support
effective patient care.
(P) 7. Encourages patients to participate in decisions
around their care.
COURAGE
Please choose one statement below
(F) 1. Demonstrates lack of interest regarding standards
of patient care.
(F) 2. Fails to respond to and report concerns of patients
and carers.
(F) 3. Poor advocate for patients / carers when
opportunity arises.
(P) 4. Accepts appropriate responsibility.
(P) 5. Shares appropriate experience and knowledge to
enhance patient care.
(P) 6. Acts as an advocate for patients.
(P) 7. Escalates concerns appropriately when the need
arises.
COMMITMENT
Please choose one statement below
(F) 1. Displays a negative attitude.
(F) 2. Behaves in an unprofessional manner.
(F) 3. Lacks motivation.
(P) 4. Actively seeks opportunities to develop own
learning.
(P) 5.Valued team member who has gained respect.
(P) 6. Well motivated and adaptable.
(P) 7.Consistently acts as a professional role model.
Statements revised in collaboration with service users and mentors (Sept 2012) amended to reflect 6C’s ( March 2013) ©Anglia Ruskin University
Important: Student must submit one photocopy of this page
21
STUDENT SID:
FORMATIVE ASSESSMENT OF INTERPERSONAL and PROFESSIONAL SKILLS
PROFILE
Student reflection on statements chosen by mentor
Student signature …………………………………………Date……………………………….
PLACEMENT AREA…………………………………………………….
TRUST / ORGANISATION………………………………………………
EDUCATION CHAMPION……………………………………………….
Important: Student must submit one photocopy of this page
22
STUDENT SID:
FORMATIVE ASSESSMENT OF PERFORMANCE CRITERIA (Mid-point of placement)
Mentor summary of evidence to support formative feedback of performance criteria
Please provide student with advice on how outstanding competencies in each of the cluster skills may be achieved at
grade 4 . Areas of concern MUST be addressed in the Formative Action Plan
Care, compassion and
communication
Organisational aspects of
care
Infection prevention and
control
Nutrition and fluid
maintenance
Medicines management
Mentor Name…………………………………………Signature…………………………….……
Student Signature……………………………………Date…………………………………………
Both parties must be present when completing this assessment.
The feedback above will form the basis of the formative action plan (to be completed for ALL students)
PLACEMENT AREA………………………………TRUST / ORGANISATION…………………...
EDUCATION CHAMPION……………………………………………….
Important: Student must submit one photocopy of this page
23
STUDENT SID:
FORMATIVE ASSESSMENT OF PERFORMANCE CRITERIA (Mid-point of placement)
Student reflection on comments made by mentor
Student signature …………………………………………Date……………………………….
PLACEMENT AREA…………………………………………………….
TRUST / ORGANISATION………………………………………………
EDUCATION CHAMPION……………………………………………….
Important: Student must submit one photocopy of this page
24
STUDENT SID:
Formative Action Plan
Student Name:
Date
(To be completed by mentor)
_____________________________________ Mentor Name: ________________________________________________
Learning Outcomes
Learning Resources/Actions
Evidence of
achievement
Needs and interests, areas of
Essential knowledge and skill.
Methods and situations for how and
when learning can occur.
Important: Student must submit one photocopy of this page
25
Review Date
Achieved/Not
achieved
Mentor
signature
Student signature
Formative Action Plan (To be completed by mentor)
Student Name:
Date
_____________________________________ Mentor Name: ________________________________________________
Learning Outcomes
Learning Resources/Actions
Evidence of
achievement
Needs and interests, areas of
Essential knowledge and skill.
Methods and situations for how and
when learning can occur.
Important: Student must submit one photocopy of this page
26
Review Date
Achieved/Not
achieved
Mentor
signature
Student signature
If appropriate, please use this section for ongoing progress comments related to the action plan
Mentor signature:
Date:
Mentor signature:
Date:
Mentor signature:
Date:
Mentor signature:
Date:
If appropriate, please use this section for ongoing progress comments related to action plan
27
Mentor signature:
Date:
Mentor signature:
Date:
Mentor signature:
Date:
Mentor signature:
Date:
28
RETURN TO PROFESSIONAL
PRACTICE COURSE
PRACTICE COMPETENCIES
MENTAL HEALTH NURSING
29
30
Cluster skill – Care, compassion and communication
This summative assessment must be completed towards the end of the placement by
registered mentor.
a
‘live’
Where appropriate, if a student has been unable to achieve the criteria due to a lack of opportunity, it is
acceptable for them to demonstrate their level of knowledge through in-depth discussion.
The numbers in brackets indicate which of the following behaviours and values underpinned by the NHS
Constitution are reflected in the outcome.
1.
Respect and
dignity
2.
Compassion
3.
Improving
lives
4.
Working together
for patients
Summative
Assessment
(Grade 0-5)
The student is able to:
1
2
3
4
5
6
7
8
Please write
number in full
Respond with competence, care and compassion to the
changing needs of service users, families and carers: promoting
and maintaining dignity at all times. (NHS values:1,2,6)
Act as a role model when developing trusting relationships with
service users, families and carers: maintaining professional
boundaries and demonstrating respect and dignity at all times.
(NHS values: 1,2,4,6)
With appropriate consent, engage in and develop an empathic
and person centred approach to care, supporting and
empowering service users and their carers to make informed
choices about how their needs are met. In doing so, embrace
the NHS ’no decision about me without me’ pledge to patients.
(NHS values: 1,2,4,5)
Using a range of strategies, communicate effectively and
respectfully with service users, carers, colleagues and interprofessional team members (including across boundaries) to
promote safe, competent and compassionate care for service
users. (NHS Values:1,2,4,6)
Accurately record and communicate service user care using
professional terminology (NHS Value:6)
Demonstrate understanding of tools available to promote safe
communication with other health care professionals and, where
available, use these tools effectively
( e.g. SBAR, MEWS, NEWS, etc.)
Demonstrate respect for the religious, cultural and spiritual
beliefs of service users and promote an environment that is free
from discrimination, harassment and exploitation. (NHS values:
1,2,4,5)
Demonstrate an understanding of accountability and the
changing role of the nurse in healthcare (NHS values: 4,6)
9
Demonstrate knowledge and adherence to the NMC Code
(2008) (NHS values: 1,2,3,4,5,6)
10
Demonstrate self-awareness and recognise own limitations in
practice and take appropriate actions. (NHS Value:6)
11
Respond appropriately to constructive feedback related to
knowledge, skills, attitude and behaviour. (NHS values: 1,6)
Consider the scenario on ‘raising concerns and safeguarding of
vulnerable adults’ available on the VLE. Write a 500 word
reflection on learning from this scenario and demonstrate
understanding of related key issues, guidance, national and local
policies (NHS Value: 6)
12
5.
Everyone
counts
31
6.
Commitment to
quality of care
Mentor Name
& Signature
Date
Please provide reasons for grades awarded
I confirm that consent from patients/service users has been consistently gained for this student.
Mentor Signature______________________________________
32
Cluster skill – Organisational aspects of care
This summative assessment must be completed towards the end of the placement by a ‘live’ registered
mentor.
Where appropriate, if a student has been unable to achieve the criteria due to a lack of opportunity, it is
acceptable for them to demonstrate their level of knowledge through in-depth discussion.
The numbers in brackets indicate which of the following behaviours and values underpinned by the NHS
Constitution are reflected in the outcome.
1.
Respect and
dignity
2.
Compassion
3.
Improving
lives
4.
Working
together for
patients
Summative
Assessment
(Grade 0-5)
The student is able to:
1
2
3
4
5
6
7
8
9
10
11
11
5.
Everyone
counts
Please write
number in full)
Undertake systematic, holistic assessments on service users, using
the preferred model/framework of the clinical area (NHS Values:1,6)
Demonstrate understanding of a range of assessment tools that aid
the planning of nursing care and demonstrate competence in utilising
these tools. (NHS Value:6)
Demonstrate understanding and use of assessment tools used to
identify, monitor and support the care of the deteriorating patient
(NHS Values:3,6)
In partnership with the service user and inter-professional team,
develop and deliver a plan of care, explaining the rationale for the
interventions chosen and evaluate the effectiveness of this care. This
should be undertaken with 4-6 patients. (NHS Values: 4,5,6)
Using appropriate knowledge and skill, demonstrate the ability to
deliver confident, competent evidence based care and prioritise the
needs of service users during a shift.
Please support this student in undertaking this outcome on as many
shifts as possible. (NHS Values:4,6)
Accurately perform routine tests to aid assessment and respond
appropriately to abnormal findings. (NHS Value: 6)
In accordance with Trust /organisation policy take an effective role
within the team adopting a leadership role in monitoring quality in the
delivery of care, reporting as appropriate where standards are not
being met. (NHS Value:6)
Demonstrate the practice of safe handling policies, including the
assessment of service users’ needs. (NHS Value: 6)
Explore risk assessment in relation to care delivery and participate in
the mechanisms available to monitor quality of care. (NHS Value:4)
Adhere to legal / ethical frameworks and local policies in the
promotion of service user safety and delivery of competent care.
(NHS Value:6)
Demonstrate understanding of the resuscitation process, including
understanding of resuscitation equipment, the Resuscitation
Council’s guidelines for resuscitation and Trust /organisation policies/
guidelines on ‘Do Not Resuscitate’ and ‘Witnessed Resuscitation’/
support of relatives.(NHS Value: 6)
Consider the scenario on ‘the deteriorating patient’ available on the
VLE. Write a 500 word reflection on learning from this scenario and
demonstrate understanding of related key issues, guidance, national
and local policies (NHS Value: 6)
33
6.
Commitment to
quality of care
Mentor
Name &
Signature
Date
Please provide reasons for grades awarded
I confirm that consent from patients/service users has been consistently gained for this student.
Mentor Signature______________________________________
34
Cluster skill – Infection prevention and control
This summative assessment must be completed towards the end of the placement by a
‘live’
registered mentor. Where appropriate, if a student has been unable to achieve the criteria due to a lack of
opportunity, it is acceptable for them to demonstrate their level of knowledge through in-depth discussion.
The numbers in brackets indicate which of the following behaviours and values underpinned by the NHS
Constitution are reflected in the outcome.
1.
Respect
and dignity
2.
Compassion
3.
Improving
lives
4.
Working together
for patients
5.
Everyone
counts
Summative
Assessment
(Grade 0-5)
The student is able to:
6.
Commitment to
quality of care
Mentor Name
& Signature
Please write
number in full
1
Identify specific infection risks for service users in your
clinical area. (NHS Value: 6)
2
Demonstrate understanding and evidence based techniques
of appropriate precautions and actions when undertaking
infection control procedures e.g.
Hand hygiene; use of personal protective equipment; safe
use (including needle safe devices) and disposal of sharps;
wound management; general asepsis; disposal of clinical and
hazardous waste and manage spillage. (NHS Value: 6)
3
Act as a role model by adhering to, advising and challenging
others regarding infection control / prevention procedures at
all times in accordance with good practice guidelines, local
and national policies. (NHS Values:3,4,6)
4
Recognise and act upon the need to refer to specialist
advisors as appropriate; utilise the knowledge of the infection
control lead for the practice setting.(NHS Values: 3,4)
5
Demonstrate safe and effective aseptic technique. (NHS
Value: 6)
6
Undertake wound care for service users and discuss the
evidence base rationale to support your interventions.(NHS
Value:6)
7
Demonstrate an understanding of the use of single versus
multi use equipment and the appropriate disposal versus
decontamination methods for that equipment. (NHS Value: 6)
8
Assess the risk to self and others, providing accurate
information to service users and carers on the management
of hazardous waste spillage; safe disposal soiled linen,
sharps, blood and other body fluids within your placement
setting. (NHS Values: 4,5,6)
9
Fully comply with hygiene, uniform and dress codes to limit,
prevent and control infection in accordance with local policy
(NHS Value:6)
Please provide reasons for grades awarded
I confirm that consent from patients/service users has been consistently gained for this
student.
Mentor Signature______________________________________
35
Date
Cluster skill – Nutrition and fluid management
This summative assessment must be completed towards the end of the placement by a ‘live’ registered
mentor.
Where appropriate, if a student has been unable to achieve the criteria due to a lack of opportunity, it is
acceptable for them to demonstrate their level of knowledge through in-depth discussion.
The numbers in brackets indicate which of the following behaviours and values underpinned by the NHS
Constitution are reflected in the outcome.
1.
Respect
and dignity
2.
Compassion
3.
Improving
lives
4.
Working together
for patients
Summative
Assessment
(Grade 0-5)
The student is able to:
1
2
3
4
5
6
7
8
9
10
5.
Everyone
counts
6.
Commitment to
quality of care
Mentor Name
& Signature
Date
Please write
number in full
Using an appropriate tool, carry out a nutritional
assessment on service users, identifying and responding to
deviations from the norm. (NHS Values:3,6)
Demonstrate the ability to recognise and take action when
there should be a referral to a specialist team to ensure
appropriate nutrition and fluid support for the patient. (NHS
Values:4,6)
Assess record and report the physiological signs of
dehydration / over-hydration, its effect on the service user
and using evidence based knowledge, implement a plan of
care in conjunction with the inter-professional team. (NHS
Values:3,4,5,6)
Demonstrate blood glucose monitoring and recording (in
accordance with the manufacturer’s guidelines and local
Trust / organisation policy). (NHS Value 6)
Respond appropriately to the needs of service users whose
blood glucose levels are outside of normal parameters.
(NHS Value:6)
Promote dignity when assisting service users with dietary /
feeding requirements, ensuring religious, cultural, personal
needs and specialist advice are supported. (NHS Values:
1,5,6)
Accurately record and maintain fluid balance and food
charts where required, responding appropriately to
concerns evident. (NHS Value:6)
Understand (and where appropriate apply) alternative
means of enteral feeding (other than oral ) (NHS Value:6)
Respecting service users’ rights, cultural and religious
choices; consistently deliver health promotion, and
education advice for their fluid and nutrition intake to
prevent malnutrition. (NHS Values:1,3,4,5,6)
Understanding and considering people’s personal
preferences and specific religious need ensure appropriate
food and fluid are available to patients as required (NHS
Value:6)
Please provide reasons for grades awarded
I confirm that consent from patients/service users has been consistently gained for this student.
Mentor Signature______________________________________
36
Cluster skill – Medicines Management
‘live’
This summative assessment must be completed towards the end of the placement by a
registered mentor.
Where appropriate, if a student has been unable to achieve the criteria due to a lack of opportunity, it is
acceptable for them to demonstrate their level of knowledge through in-depth discussion.
The numbers in brackets indicate which of the following behaviours and values underpinned by the NHS
Constitution are reflected in the outcome.
1.
Respect
and dignity
2.
Compassion
3.
Improving
lives
4.
Working together
for patients
Summative
Assessment
(Grade 0-5)
The student is able to:
1
2
3
4
5
6
7
8
9
10
11
12
5.
Everyone
counts
Please write
number in full
Explain the therapeutic use of the most commonly
administered drugs in your practice area, how they act on the
body and their indication for use, the dosages, cautions and
contraindications. (NHS Value: 6)
Under the supervision of the mentor, demonstrate safe and
accurate calculation and administration of medicines(including
a variety of prescribed routes) within local and national policies
(NHS Values:5,6)
Demonstrate knowledge of treating anaphylaxis and adverse
reactions recording and reporting as per local and national
policies.(NHS Value:6)
Comply with the requirements of accurate record keeping in
medicines management in accordance with the nursing and
midwifery council guidelines and local policy. (NHS Value:6)
Demonstrates understanding of legal and ethical frameworks
and associated local policies relating to the prescription,
ordering, storage administration, withholding, omission, covert
administration, crushing and safe storage of drugs. (NHS
Value:6)
Demonstrate and discuss the methods of achieving
concordance with treatment regimens taking into account
cultural, religious, linguistic and ethical considerations of the
service user and their families. (NHS Values:3,5,6)
Demonstrate clear and accurate use of prescription charts and
use of documentation consistent with legal and ethical
frameworks of medicines in practice e.g. Mental Health Act
(including medication given without service users consent and
rapid tranquilisation). (NHS Values:2, 6).
Evaluate the effectiveness, and side effects, of
pharmacological therapies in partnership with service users
(and carers). (NHS Value:6)
Discuss the procedures for recording and reporting drug
prescribing and administration errors. (NHS Vaules:4,6)
Undertake a formal drug round assessment[s] in line with
clinical placement/organisations policy and procedure. (NHS
Value:6)
Identify commonly administered medicines for the management
of side effects and adverse reactions to prescribed
psychotropic medications. (NHS vaule:6)
Consider the scenario on ‘dealing with a drug error’ available
on the VLE. Write a 500 word reflection on learning from this
scenario and demonstrate understanding of related key issues,
guidance, national and local policies (NHS Value: 6)
37
6.
Commitment to
quality of care
Mentor Name
& Signature
Date
Please provide reasons for grades awarded
I confirm that consent from patients/service users has been consistently gained for this student.
Mentor Signature______________________________________
38
SUMMATIVE ASSESSMENT OF THE INTERPERSONAL AND PROFESSIONAL SKILLS
The interpersonal /professional skills profile has been divided into 6 sections, each indicating statements around the values
underpinning the NHS Constitution and the 6C’s.
(F) Indicates a fail
STUDENT SID:
(P) Indicates a pass
Mentors should choose one statement from each of the 6C’s that best reflects the student’s interpersonal and professional
skills. Please indicate your chosen statement by signing in the corresponding box.
CARE
Please choose one statement below
Mentor
Please sign in one of the
boxes below to indicate
your choice of statement
for this value
Mentor
Reasons / evidence for choosing
this statement
Mentor
Please sign in one of the
boxes below to indicate
your choice of statement
for this value
Mentor
Reasons / evidence for choosing
this statement
Mentor
Please sign in one of the
boxes below to indicate
your choice of statement
for this value
Mentor
Reasons / evidence for choosing
this statement
(F) 1. Fails to respond to patient needs.
(F) 2. Lacks consideration of patient comfort when
delivering care.
(F) 3. Ignores advice to improve patient care.
(P) 4. Demonstrates evidence based practice.
(P) 5. Approach to care enhances the patient
experience.
(P) 6. Ensures patient is central to care decisions.
(P) 7. Quality of care is commendable.
COMPASSION
Please choose one statement below
(F) 1. Fails to treat patients / carers / colleagues with
respect.
(F) 2. Lacks empathy / understanding towards patients’
concerns.
(F) 3. Fails to recognise opportunities to promote dignity in
care delivery.
(P) 4. Demonstrates compassion and understanding in
patient care.
(P) 5. Promotes dignity and respect in patient care.
(P) 6. Shows a mature understanding and an empathic
approach to care.
(P) 7. Champions patient dignity and encourages
colleagues to support this value.
COMPETENCE
Please choose one statement below
(F) 1 Level of care is unsafe.
(F) 2. Blames circumstances for difficulties encountered.
(F) 3. Unable to define own learning needs.
(P) 4. Reflects on clinical practice and adapts accordingly.
(P) 5. Capable of informed decision making.
(P) 6. Delegates care effectively and with consideration
for patient safety.
(P) 7. Remains calm and professional in challenging
situations.
Statements revised in collaboration with service users and mentors (Sept 2012), amended to reflect 6C’s (March 2013) ©Anglia Ruskin University
Important: Student must submit one photocopy of this page
39
SUMMATIVE ASSESSMENT OF THE INTERPERSONAL AND PROFESSIONAL SKILLS
(F) Indicates a fail
(P) Indicates a pass.
STUDENT SID:
Mentors should choose one statement from each of the 6C’s that best reflects the student’s interpersonal and professional
skills. Please indicate your chosen statement by signing in the corresponding box
COMMUNICATION
Please choose one statement below
Mentor
Please sign in one of the
boxes below to indicate
your choice of statement
for this value
Mentor
Reasons / evidence for choosing
this statement
Mentor
Please sign in one of the
boxes below to indicate
your choice of statement
for this value
Mentor
Reasons / evidence for choosing
this statement
Mentor
Please sign in one of the
boxes below to indicate
your choice of statement
for this value
Mentor
Reasons / evidence for choosing
this statement
(F) 1. Fails to communicate key aspects of patient care to
appropriate staff.
(F) 2. Reacts adversely to constructive criticism.
(F) 3. Lacks self awareness and the effect of behaviours
on others.
(P) 4. Has a pleasant and approachable manner.
(P) 5. Communicates effectively with patients and
relatives.
(P) 6. Uses interprofessional team working to support
effective patient care.
(P) 7. Encourages patients to participate in decisions
around their care.
COURAGE
Please choose one statement below
(F) 1. Demonstrates lack of interest regarding standards
of patient care.
(F) 2. Fails to respond to and report concerns of patients
and carers.
(F) 3. Poor advocate for patients / carers when
opportunity arises.
(P) 4. Accepts appropriate responsibility.
(P) 5. Shares appropriate experience and knowledge to
enhance patient care.
(P) 6. Acts as an advocate for patients.
(P) 7. Escalates concerns appropriately when the need
arises.
COMMITMENT
Please choose one statement below
(F) 1. Displays a negative attitude.
(F) 2. Behaves in an unprofessional manner.
(F) 3. Lacks motivation.
(P) 4. Actively seeks opportunities to develop own
learning.
(P) 5.Valued team member who has gained respect.
(P) 6. Well motivated and adaptable.
(P) 7.Consistently acts as a professional role model.
Statements revised in collaboration with service users and mentors (Sept 2012) amended to reflect 6C’s (March 2013) ©Anglia Ruskin University
Important: Student must submit one photocopy of this page
40
STUDENT SID:
SUMMATIVE ASSESSMENT OF INTERPERSONAL and PROFESSIONAL SKILLS PROFILE
Student reflection on statements chosen by mentor
Student signature …………………………………………Date……………………………….
PLACEMENT AREA…………………………………………………….
TRUST / ORGANISATION………………………………………………
EDUCATION CHAMPION……………………………………………….
Important: Student must submit one photocopy of this page
41
STUDENT SID:
SUMMATIVE ASSESSMENT OF PERFORMANCE CRITERIA (End-point of placement)
Mentor summary of evidence to support summative feedback of performance criteria
Please provide student with advice on how competencies in each of the cluster skills may be achieved and identify any
concerns with specific competencies. Areas of concern MUST be addressed in the Formative Action Plan
Care, compassion and
communication
Organisational aspects of
care
Infection prevention and
control
Nutrition and fluid
maintenance
Medicines management
Mentor Name…………………………………………Signature…………………………….……
Student Signature……………………………………Date…………………………………………
Both parties must be present when completing this assessment.
The feedback above will form the basis of the formative action plan (to be completed for ALL students)
PLACEMENT AREA………………………………TRUST / ORGANISATION…………………...
EDUCATION CHAMPION……………………………………………….
Important: Student must submit one photocopy of this page
42
STUDENT SID:
SUMMATIVE ASSESSMENT OF PERFORMANCE CRITERIA (End-point of placement)
Student reflection on comments made by mentor
Student signature …………………………………………Date……………………………….
PLACEMENT AREA…………………………………………………….
TRUST / ORGANISATION………………………………………………
EDUCATION CHAMPION……………………………………………….
Important: Student must submit one photocopy of this page
43
MENTOR SUMMATIVE ASSESSMENT SUMMARY
This section must be completed by a ‘live’ registered mentor who has worked with
the student on a placement allocation of no less than 4 weeks.
Has the student achieved a Pass in each of the ‘Values’ in the interpersonal skills profile? YES/NO
Have the performance criteria related to the cluster skills been achieved?
YES /NO
Care, compassion and communication (page 31)
YES /NO
Organisational aspects of care (page 33)
YES /NO
Infection prevention and control (page 35)
YES /NO
Nutrition and fluid maintenance (page 36)
YES /NO
Medicines management (page 37)
YES /NO
Has there been a need to complete a ‘cause for concern’ form? (page 47)
YES/NO
I confirm that consent from patients / service users has been consistently gained for this student.
Mentor’s Name (please print clearly)………………………………………………………………..
Mentor’s Signature………………………………………………………Date……………………..
Student’s Name (please print clearly)………………………………………………………………
Student’s signature………………………………………………………Date……………………………
STUDENTS PLEASE NOTE THE FOLLOWING
1. Important: Student must submit one photocopy of this page
2. Inform your personal tutor of non-achievement of any part of the summative assessment within 5
working days of receiving summative assessment feedback. A formal learning contract will then be
created in collaboration with the student, mentor and a member of the link team.
44
45
46
Cause for Concern form (Professional behaviour / Competency issues)
Trust / Organisation Details
Trust / Organisation Name:
Clinical Area:
Mentor Details
Student Details
Name:
Name:
Email:
Cohort:
Education Champion ARU:
Trust/Organisation Placement Education Lead:
Key Issues: Please list in the form of bullet points below:
Actions taken to date: Please mark responses below:
An action plan is completed in the Practice Document and directly relates to student
performance:
Written formative feedback for Interpersonal Skills/Practice outcome assessment is evident in
the Practice document, directly relating to the action plan/student performance:
Summative feedback for Interpersonal Skills/Practice outcome assessment is evident in the
Practice document, directly relating to student performance:
Verbal feedback given:
YES
NO
YES
NO
YES
NO
YES
NO
MENTOR ACTION
On completion please photocopy this form with supporting evidence, if required, and submit to the Education
Champion/Link team.
Date Education Champion / Link team contacted:
EDUCATION CHAMPION ACTION
On receiving the photocopy of this form, please check if supporting evidence is required and forward to the Course
Lead.
Name of Course Lead:
Date Course Lead contacted:
MENTOR: Please see mentor portal: www.anglia.ac.uk/mentors for template for additional supporting evidence
Please do not remove this form from the Practice Assessment Document
47
48
STUDENT SID:
PERSONAL TUTOR’S REVIEW OF SUMMATIVE ASSESSMENT
I confirm that I have undertaken the following:
Checked each’ Value’ has been passed in the summative assessment of the Interpersonal profile.
Checked each of the performance criteria the summative assessment has been passed.
Recorded below, areas of the interpersonal profile or performance criteria that the student has ‘failed’.
Read the comments made by the student and their mentor.
Received photocopies of pages 27-39
Checked if a ‘Cause for Concern’ form has been completed and am aware of the outcome.
Completed the ‘Practice Assessment Moderation’ documentation for this practice document.
(Please forward this on to the appropriate Education Champion).
Personal tutor’s comments on student’s performance in practice:
Personal Tutor name___________________________________________
Personal Tutor signature_____________________________________Date_________
(Personal Tutor - PLEASE REMOVE FOR STUDENT FILE)
49
50
Sign-Off Mentor Record
51
52
GUIDELINES FOR SIGN OFF MENTORS IN THE SUPERVISION AND ASSESSMENT OF RETURN TO PRACTICE
STUDENTS
The return to practice student requires a sign-off mentor, who has met additional criteria and is annotated on the
placement provider’s “Live” register, to assess the student’s proficiency in practice. The sign-off mentor must be on the
same part of the register that the student is aiming to be readmitted to.The sign-off mentor will be responsible for
confirming that the student has achieved the required NMC (2010) standards for entry to the register. Please ensure
all comments are clearly legible and dated.
The sign-off mentor is only required to review the practice elements of the student’s performance throughout
the programme.
Theory aspects of the programme will be confirmed by the Awards Board at the University.
The sign-off mentor needs to know:
The student has met all of the NMC (2010) standards required for entry to the Register.
This evidence will come from:
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Own observation of the student’s practice
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The student’s practice assessment document / portfolio
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Feedback from mentors who have worked with the student during the final placement
In order for the assessment to be accurate and fair students must always:
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Be provided with suitable opportunities and sufficient time to achieve their learning outcomes
Be made fully aware of deficiencies in their knowledge and skills and provided with appropriate opportunities,
time and support to overcome them
Receive a clear written explanation of reasons for lack of progress and/or failure of practice assessment.
Receive acknowledgement for their achievements in practice and encouragement to increase their knowledge
and skills
Meet with their sign off mentor for one hour per week of protected time in this placement.
If the sign-off mentor has any concerns about the student, they should contact the personal tutor/link tutor for guidance.
The sign off mentor must be satisfied that the student has passed all performance criteria and the interpersonal /
professional skills profile within the practice portfolio. These have been mapped against the NMC standards for entry
to the register.
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Record of contact between sign-off mentor and student
(The NMC standards state that the sign-off mentor will spend the equivalent of one hour per student per week during
the final placement to reflect, give feedback and keep records of student achievement).
Mentor - Please summarise the content of these meetings below and keep a copy for your personal records
Date:
Comments:
Time and duration:
Sign-Off Mentor Signature:
Date:
Comments:
Time and duration:
Sign-Off Mentor Signature:
Date:
Comments:
Time and duration:
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Date:
Comments:
Time and duration:
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Date:
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Time and duration:
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Date:
Comments:
Time and duration:
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Date:
Comments:
Time and duration:
Sign-Off Mentor Signature:
Date:
Comments:
Time and duration:
Sign-Off Mentor Signature:
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Comments:
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Sign-Off Mentor Signature
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Declaration by Sign-Off Mentor
I declare that this assessment has been undertaken following a series of weekly meetings between the sign off mentor
and the student, and a review of the evidence contained within the student’s portfolio.
I declare that I have made a final assessment of practice on …………………………………………………………. (full
name of student).
Please complete the appropriate box:
I declare that this student has achieved the NMC Standards (2010) for entry to
the Register and that to the best of my knowledge is fit for safe and effective
practice.
Signature:
Date:
I declare that this student has not achieved the NMC Standards (2010) for
entry to the Register and that to the best of my knowledge is not fit for safe and
effective practice without supervision.
Signature:
Date:
Name of sign-off mentor ………………………………..……… PIN …………………………………
Organisation (eg Trust)...………….……………………………….
Date:
Ward/Department……………………………………………………
Work Telephone Number…………………………………………..
Students: Please make a photocopy of this page, submit the original to your personal tutor and place the copy
in your professional portfolio)
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Standards for pre-registration nursing education; requirements for entry to the register (NMC 2010)
Essential skills cluster: Care, compassion and communication
The newly qualified graduate nurse should demonstrate the following skills and behaviours. They should be used to develop learning outcomes for each progression point and for
outcomes to be achieved before entering the register.
1. As partners in the care process, people can trust a newly registered graduate nurse to provide collaborative care based on the highest standards, knowledge and
competence.
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Demonstrates clinical confidence through sound knowledge, skills and understanding relevant to field.
Is self- aware and self- confident, knows own limitations and is able to take appropriate action.
Acts as a role model in promoting a professional image.
Acts as a role model in developing trusting relationships, within professional boundaries.
Recognises and acts to overcome barriers in developing effective relationships with service users and carers.
Initiates, maintains and closes professional relationships with service users and carers.
Uses professional support structures to develop self- awareness, challenge own prejudices and enable professional relationships, so that care is delivered without
compromise.
2. People can trust the newly registered graduate nurse to engage in person centred care empowering people to make choices about how their needs are met when
they are unable to meet them for themselves.
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Is sensitive and empowers people to meet their own needs and make choices and considers with the person and their carer(s) their capability to care.
Ensures access to independent advocacy.
Recognises situations and acts appropriately when a person’s choice may compromise their safety or the safety of others.
Uses strategies to manage situations where a person’s wishes conflict with nursing interventions necessary for the person’s safety.
Acts with dignity and respect to ensure that people who are unable to meet their activities of living have choices about how these are met and feel empowered to do as
much as possible for themselves.
Works autonomously, confidently and in partnership with people, their families and carers to ensure that needs are met through care planning and delivery, including
strategies for self- care and peer support.
Actively helps people to identify and use their strengths to achieve their goals and aspirations.
3. People can trust the newly registered graduate nurse to respect them as individuals and strive to help them the preserve their dignity at all times.
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Acts professionally to ensure that personal judgements, prejudices, values, attitudes and beliefs do not compromise care.
Is proactive in promoting and maintaining dignity.
Acts autonomously to challenge situations or others when someone’s dignity may be compromised.
Uses appropriate strategies to empower and support their choice.
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4. People can trust a newly qualified graduate nurse to engage with them and their family or carers within their cultural environments in an acceptant and antidiscriminatory manner free from harassment and exploitation.
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Upholds people’s legal rights and speaks out when these are at risk of being compromised.
Is acceptant of differing cultural traditions, beliefs, UK legal frameworks and professional ethics when planning care with people and their families and carers.
Acts autonomously and proactively in promoting care environments that are culturally sensitive and free from discrimination, harassment and exploitation.
Manages and diffuses challenging situations effectively.
5. People can trust the newly registered graduate nurse to engage with them in a warm, sensitive and compassionate way.
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Anticipates how people might feel in a given situation and responds with kindness and empathy to provide physical and emotional comfort.
Makes appropriate use of touch.
Listens to, watches for, and responds to verbal and non-verbal cues.
Engages with people in the planning and provision of care that recognises personalised needs and provides practical and emotional support.
Has insight into own values and how these may impact on interactions with others.
Recognises circumstances that trigger personal negative responses and takes action to prevent this compromising care.
Recognises and acts autonomously to respond to own emotional discomfort or distress in self and others.
Through reflection and evaluation demonstrates commitment to personal and professional development and lifelong learning.
6. People can trust the newly registered graduate nurse to engage therapeutically and actively listen to their needs and concerns, responding using skills that are
helpful, providing information that is clear, accurate, meaningful and free from jargon.
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Consistently shows ability to communicate safely and effectively with people providing guidance for others.
Communicates effectively and sensitively in different settings, using a range of methods and skills.
Provides accurate and comprehensive written and verbal reports based on best available evidence.
Acts autonomously to reduce and challenge barriers to effective communication and understanding.
Is proactive and creative in enhancing communication and understanding.
Uses the skills of active listening, questioning, paraphrasing and reflection to support a therapeutic intervention.
Uses appropriate and relevant communication skills to deal with difficult and challenging circumstances, for example, responding to
emergencies, unexpected occurrences, saying “no”, dealing with complaints, resolving disputes, deescalating aggression, conveying ‘unwelcome news’.
7. People can trust the newly registered graduate nurse to protect and keep as confidential all information relating to them.
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Acts professionally and autonomously in situations where there may be limits to confidentiality, for example, public interest and protection from harm.
Recognises the significance of information and acts in relation to who does or does not need to know.
Acts appropriately in sharing information to enable and enhance care (carers, MDT and across agency boundaries).
Works within the legal frameworks for data protection including access to and storage of records.
Acts within the law when confidential information has to be shared with others.
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8. People can trust the newly registered graduate nurse to gain their consent based on sound understanding and informed choice prior to any intervention and that
their rights in decision making and consent will be respected and upheld.
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Uses helpful and therapeutic strategies to enable people to understand treatments and other interventions in order to give informed consent.
Works within legal frameworks when seeking consent.
Assesses and responds to the needs and wishes of carers and relatives in relation to information and consent.
Demonstrates respect for the autonomy and rights of people to withhold consent in relation to treatment within legal frameworks and in relation to people’s safety.
Essential skills cluster: Organisational aspects of care
The newly qualified graduate nurse should demonstrate the following skills and behaviours. They should be used to develop learning outcomes for each progression point and for
outcomes to be achieved before entering the register.
9. People can trust the newly registered graduate nurse to treat them as partners and work with them to make a holistic and systematic assessment of their needs; to
develop a personalised plan that is based on mutual understanding and respect for their individual situation promoting health and well-being, minimising risk of
harm and promoting their safety at all times.
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In partnership with the person, their carers and their families, makes a holistic, person centred and systematic assessment of physical, emotional, psychological, social,
cultural and spiritual needs, including risk, and together, develops a comprehensive personalised plan of nursing care.
Acts autonomously and takes responsibility for collaborative assessment and planning of care delivery with the person, their cares and their family.
Applies research based evidence to practice.
Works within the context of a multi-professional team and works collaboratively with other agencies when needed to enhance the care of people, communities and
populations.
Promotes health and well-being, self- care and independence by teaching and empowering people and carers to make choices in coping with the effects of treatment and
the on-going nature and likely consequences of a condition including death and dying.
Uses a range of techniques to discuss treatment options with people.
Discusses sensitive issues in relation to public health and provides appropriate advice and guidance to individuals, communities and populations for example,
contraception, substance misuse, smoking, obesity.
Refers to specialists when required.
Acts autonomously and appropriately when faced with sudden deterioration in people’s physical or psychological condition or emergency situations, abnormal vital signs,
collapse, cardiac arrest, self-harm, extremely challenging behaviour, attempted suicide.
Measures, documents and interprets vital signs and acts autonomously and appropriately on findings.
Works within a public health framework to assess needs and plan care for individuals, communities and populations.
10. People can trust the newly registered graduate nurse to deliver nursing interventions and evaluate their effectiveness against the agreed assessment and care
plan.
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Provides safe and effective care in partnership with people and their carers within the context of people’s ages, conditions and developmental stages.
Prioritises the needs of groups of people and individuals in order to provide care effectively and efficiently.
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Detects records and reports if necessary, deterioration or improvement and takes appropriate action autonomously.
Evaluates the effect of interventions, taking account of people’s and carers’ interpretation of physical, emotional, and behavioural changes
Involves the person in review and adjustments to their care, communicating changes to colleagues.
11. People can trust the newly registered graduate nurse to safeguard children and adults from vulnerable situations and support and protect them from harm.
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Recognises and responds when people are in vulnerable situations and at risk, or in need of support and protection.
Shares information safely with colleagues and across agency boundaries for the protection of individuals and the public.
Makes effective referrals to safeguard and protect children and adults requiring support and protection.
Works collaboratively with other agencies to develop, implement and monitor strategies to safeguard and protect individuals and groups who are in vulnerable situations.
Supports people in asserting their human rights.
Challenges practices which do not safeguard those in need of support and protection.
12. People can trust the newly registered graduate nurse to respond to their feedback and a wide range of other sources to learn, develop and improve services.
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Shares complaints, compliments and comments with the team in order to improve care.
Actively responds to feedback.
Supports people who wish to complain.
As an individual team member and team leader, actively seeks and learns from feedback to enhance care and own and others professional development.
Works within ethical and legal frameworks and local policies to deal with complaints, compliments and concerns.
13. People can trust the newly registered, graduate nurse to promote continuity when their care is to be transferred to another service or person.
14. People can trust the newly registered graduate nurse to be an autonomous and confident member of the multi-disciplinary or multi agency team and to inspire
confidence in others.
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Actively consults and explores solutions and ideas with others to enhance care.
Challenges the practice of self and others across the multi-professional team.
Takes effective role within the team adopting the leadership role when appropriate.
Act as an effective role model in decision making, taking action and supporting others.
Works inter-professionally and autonomously as a means of achieving optimum outcomes for people.
Safeguards the safety of self and others, and adheres to lone working policies when working in the community setting and in people’s homes.
15. People can trust the newly registered graduate nurse to safely delegate to others and to respond appropriately when a task is delegated to them.
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Works within the requirements of the code (NMC 2008) in delegating care and when care is delegated to them.
Takes responsibility and accountable for delegating care to others.
Prepares supports and supervises those to whom care has been delegated.
Recognises and addresses deficits in knowledge and skill in self and others and takes appropriate action.
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16. People can trust the newly registered graduate nurse to safely lead, co-ordinate and manage care.
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Inspires confidence and provides clear direction to others.
Takes decisions and is able to answer for these decisions when required.
Bases decisions on evidence and uses experience to guide decision-making.
Acts as a positive role model for others.
Manages time effectively.
Negotiates with others in relation to balancing competing and conflicting priorities.
17. People can trust the newly registered graduate nurse to work safely under pressure and maintain the safety of service users at all times.
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Demonstrates effective time management.
Prioritises own workload and manages competing and conflicting priorities.
Appropriately reports concerns regarding staffing and skill-mix and acts to resolve issues that may impact on the safety of service users within local policy frameworks.
Recognises stress in others and provides appropriate support or guidance ensuring safety to people at all times.
Enables others to identify and manage their stress.
Works within local policies when working in the community setting including in people’s homes and ensures the safety of others.
18. People can trust a newly registered graduate nurse to enhance the safety of service users and identify and actively manage risk and uncertainty in relation to
people, the environment, self and others.
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Reflects on and learns from safety incidents as an autonomous individual and as a team member and contributes to team learning.
Participates in clinical audit to improve the safety of service users.
Assesses and implements measures to manage, reduce or remove risk that could be detrimental to people, self and others.
Assesses, evaluates and interprets risk indicators and balances risks against benefits, taking account of the level of risk people are prepared to take.
Works within legal and ethical frameworks to promote safety and positive risk taking.
Works within policies to protect self and others in all care settings including in the home care setting.
Takes steps not to cross professional boundaries and put self or colleagues at risk.
19. People can trust the newly registered graduate nurse to work to prevent and resolve conflict and maintain a safe environment.
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Selects and applies appropriate strategies and techniques for conflict resolution, de-escalation and physical intervention in the management of potential violence and
aggression.
20. People can trust the newly registered graduate nurse to select and manage medical devices safely.
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Works within legal frameworks and applies evidence based practice in the safe selection and use of medical devices.
Safely uses and maintains a range of medical devices appropriate to the area of work, including ensuring regular servicing, maintenance and calibration including
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reporting adverse incidents relating to medical devices.
Keeps appropriate records in relation to the use and maintenance of medical devices and the decontamination processes required as per local and national guidelines.
Explains the devices to people and carers and checks understanding.
Essential skills cluster: Infection prevention and control
The newly qualified graduate nurse should demonstrate the following skills and behaviours. They should be used to develop learning outcomes for each progression point and for
outcomes to be achieved before entering the register.
21. People can trust the newly registered graduate nurse to identify and take effective measures to prevent and control infection in accordance with local and
national policy.
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Works within the code (NMC 2008) and in keeping with the Guidance on professional conduct for nursing and midwifery students (NMC 2010) and in collaboration with
people and their carers to meet responsibilities for prevention and control of infection.
In partnership with people and their carers, plans, delivers and documents care that demonstrates effective risk assessment, infection prevention and control.
Identifies, recognises and refers to the appropriate clinical expert.
Explains risks to people, relatives, carers and colleagues and educates them in prevention and control of infection.
Recognises infection risk and reports and acts in situations where there is need for health promotion and protection and public health strategies.
22. People can trust the newly registered graduate nurse to maintain effective standard infection control precautions and apply and adapt these to needs and
limitations in all environments.
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Initiates and maintains appropriate measures to prevent and control infection according to route of transmission of micro-organism, in order to protect service users,
members of the public and other staff.
Applies legislation that relates to the management of specific infection risk at a local and national level.
Adheres to infection prevention and control policies and procedures at all times and ensures that colleagues work according to good practice guidelines.
Challenges the practice of other care workers who put themselves and others at risk of infection.
Manages overall environment to minimise risk.
23. People can trust a newly registered graduate nurse to provide effective nursing interventions when someone has an infectious disease including the use of
standard isolation techniques.
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Recognises and acts upon the need to refer to specialist advisers as appropriate.
Assesses the needs of the infectious person, or people and applies appropriate isolation techniques.
Ensures that people including colleagues are aware of and adhere to local policies in relation to isolation and infection control procedures.
Identifies suitable alternatives when isolation facilities are unavailable and principles have to be applied in unplanned circumstances.
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24. People can trust a newly registered graduate nurse to fully comply with hygiene, uniform and dress codes in order to limit, prevent and control infection.
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Acts as a role model to others and ensures colleagues work within local policy.
25. People can trust a newly registered graduate nurse to safely apply the principles of asepsis when performing invasive procedures and be competent in aseptic
technique in a variety of settings.
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Applies a range of appropriate measures to prevent infection including application of safe and effective aseptic technique.
Safely performs wound care, applying non-touch or aseptic techniques in a variety of settings.
Able to communicate potential risks to others and advise people on the management of their device, site or wound to prevent and control infection and to promote healing.
26. People can trust the newly qualified nurse to act, in a variety of environments including the home care setting, to reduce risk when handling waste, including
sharps, contaminated linen and when dealing with spillages of blood and other body fluids.
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Manages hazardous waste and spillages in accordance with local health and safety policies.
Instructs others to do the same.
Essential skills cluster: Nutrition and fluid management
The newly qualified graduate nurse should demonstrate the following skills and behaviours. They should be used to develop learning outcomes for each progression point and for
outcomes to be achieved before entering the register.
27. People can trust the newly registered graduate nurse to assist them to choose a diet that provides an adequate nutritional and fluid intake.
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Uses knowledge of dietary, physical, social and psychological factors to inform practice being aware of those that can contribute to poor diet, cause or be caused by ill
health.
Supports people to make appropriate the choices and changes to eating patterns, taking account of dietary preferences, religious and cultural requirements, treatment
requirements and special diets needed for health reasons.
Refers to specialist members of the multi-disciplinary team for additional or specialist advice.
Discusses in a non-judgemental way how diet can improve health and the risks associated with not eating appropriately.
In liaison with a registered midwife provides essential advice and support to mothers who are breast feeding.
Provides support and advice to carers when the person they are caring for has specific dietary needs.
28. People can trust the newly registered graduate nurse to assess and monitor their nutritional status and in partnership, formulate an effective plan of care.
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Makes a comprehensive assessment of people’s needs in relation to nutrition identifying, documenting and communicating level of risk.
Seeks specialist advice as required in order to formulate an appropriate care plan.
Provides information to people and their carers.
Monitors and records progress against the plan.
Discusses progress and changes in condition with the person, carers and the multi-disciplinary team.
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Acts autonomously to initiate appropriate action when malnutrition is identified or where a person’s nutritional status worsens, and report this as an adverse event.
29. People can trust a newly registered graduate nurse to assess and monitor their fluid status and in partnership with them, formulate an effective plan of care.
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Uses negotiating and other skills to encourage people who might be reluctant to drink to take adequate fluids.
Identifies signs of dehydration and acts to correct these.
Works collaboratively with the person their carers and the multi-disciplinary team to ensure an adequate fluid intake and output.
30. People can trust the newly qualified graduate nurse to assist them in creating an environment that is conducive to eating and drinking.
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Challenges others who do not follow procedures.
Ensures appropriate assistance and support is available to enable people to eat.
Ensures provision is made for replacement meals for anyone who is unable to eat at the usual time, or unable to prepare their own meals.
Ensures that appropriate food and fluids are available as required.
31. People can trust the newly qualified graduate nurse to ensure that those unable to take food by mouth receive adequate fluid and nutrition to meet their needs.
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Takes action to ensure that, where there are problems with eating and swallowing, nutritional status is not compromised.
Administers enteral feeds safely and maintains equipment in accordance with local policy.
Safely, maintains and uses nasogastric, PEG and other feeding devices.
Works within legal and ethical frameworks taking account of personal choice.
32. People can trust the newly registered graduate nurse to safely administer fluids when fluids cannot be taken independently.
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Understands and applies knowledge of intravenous fluids and how they are prescribed and administered within local administration of medicines policy.
Monitors and assesses people receiving intravenous fluids.
Documents progress against prescription and markers of hydration.
Monitors infusion site for signs of abnormality, and takes the required action reporting and documenting signs and actions taken.
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Essential skills cluster: Medicines management
Medicines management is “the clinical cost effective and safe use of medicines to ensure patients get maximum benefit from the medicines they need while at the same time
minimising potential harm” (MHRA 2004). As the administration of a medicinal product is only part of the process, these ESCs reflect the process from prescribing, through to
dispensing, storage, administration and disposal.
The newly qualified graduate nurse should demonstrate the following skills and behaviours. They should be used to develop learning outcomes for each progression point and for
outcomes to be achieved before entering the register.
33. People can trust the newly registered graduate nurse to correctly and safely undertake medicines calculations.
A Medicinal product is “Any substance or combination of substances presented for treating or preventing disease in human beings or in animals. Any substance or combination of
substances which may be administered to human beings or animals with a view to making a medical diagnosis or to restoring, correcting or modifying physiological functions in
human beings or animals is likewise considered a medicinal product” (Council Directive 65/65/EEC).
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Is competent in the process of medication-related calculation in nursing field involving:
1. tablets and capsules
2. liquid medicines
3. injections
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IV infusions including:
unit dose
sub and multiple unit dose
complex calculations
SI unit conversion.
34. People can trust the newly registered graduate nurse to work within legal and ethical frameworks that underpin safe and effective medicines management.
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Applies legislation to practice to safe and effective ordering, receiving, storing administering and disposal of medicines and drugs, including controlled drugs in both
primary and secondary care settings and ensures others do the same.
Fully understands all methods of supplying medicines, for example, Medicines Act exemptions, patient group directions (PGDs), clinical management plans and other
forms of prescribing.
Fully understands the different types of prescribing including supplementary prescribing, community practitioner nurse prescribing and independent nurse prescribing.
(Nursing students cannot supply or administer under a PGD (Standards for medicines management (NMC 2007)).
35. People can trust the newly registered graduate nurse to work as part of a team to offer holistic care and a range of treatment options of which medicines may
form a part.
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Works confidently as part of the team and, where relevant, as leader of the team to develop treatment options and choices with the person receiving care and their carers.
Questions, critically appraises, takes into account ethical considerations and the preferences of the person receiving care and uses evidence to support an argument in
determining when medicines may or may not be an appropriate choice of treatment.
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36. People can trust the newly registered graduate nurse to ensure safe and effective practice in medicines management through comprehensive knowledge of
medicines, their actions, risks and benefits.
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Applies knowledge of basic pharmacology, how medicines act and interact in the systems of the body, and their therapeutic action.
Understands common routes and techniques of medicine administration including absorption, metabolism, adverse reactions and interactions.
Safely manages drug administration and monitors effects.
Reports adverse incidents and near misses.
Safely manages anaphylaxis.
37. People can trust the newly registered graduate nurse to safely order, receive, store and dispose of medicines (including controlled drugs) in any setting.
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Orders, receives, stores and disposes of medicines safely (including controlled drugs).
38. People can trust the newly registered graduate nurse to administer medicines safely and in a timely manner, including controlled drugs.
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Safely and effectively administers and, where necessary, prepares medicines via routes and methods commonly used and maintains accurate records.
Supervises and teaches others to do the same.
Understands the legal requirements.
39. People can trust a newly registered graduate nurse to keep and maintain accurate records using information technology, where appropriate, within a multidisciplinary framework as a leader and as part of a team and in a variety of care settings including at home.
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Effectively keep records of medication administered and omitted, in a variety of care settings, including controlled drugs and ensures others do the same.
40. People can trust a newly registered graduate nurse to work in partnership with people receiving medical treatments and their carers.
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Works with people and carers to provide clear and accurate information.
Gives clear instruction and explanation and checks that the person understands the use of medicines and treatment options.
Assesses the person’s ability to safely self-administer their medicines.
Assists people to make safe and informed choices about their medicines.
41. People can trust the newly registered graduate nurse to use and evaluate up-to-date information on medicines management and work within national and local
policy guidelines.
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Works within national and local policies and ensures others do the same.
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42. People can trust the newly registered graduate nurse to demonstrate understanding and knowledge to supply and administer via a patient group direction.
(Achieved in skills sessions at University)
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Through simulation and course work demonstrates knowledge and application of the principles required for safe and effective supply and administration via a patient
group direction including an understanding of role and accountability.
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Through simulation and course work demonstrates how to supply and administer via a patient group direction.
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Return to Professional Practice
Second Attempt Action Plans
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2nd Attempt Action Plan
(To be completed by mentor/sign-off mentor at start of 2nd attempt)
Student Name: ______________________________________ Mentor Name: ________________________________________________
Date
Learning Outcomes
Learning Resources/Actions
Needs and interests, areas of
Essential knowledge and skill.
Methods and situations for how and
when learning can occur.
Evidence of
achievement
Review Date
Achieved/Not
achieved
Important: Student must submit one photocopy of this page
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Mentor
signature
Student signature
2nd Attempt Action Plan
(To be completed by mentor/sign-off mentor at start of 2nd attempt)
Student Name: ______________________________________ Mentor Name: ________________________________________________
Date
Learning Outcomes
Learning Resources/Actions
Needs and interests, areas of
Essential knowledge and skill.
Methods and situations for how and
when learning can occur.
Evidence of
achievement
Review Date
Achieved/Not
achieved
Important: Student must submit one photocopy of this page
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Mentor
signature
Student signature
STUDENT SID:
Formative Action Plan (To be completed by mentor / sign-off mentor to be completed at mid-point of 2nd attempt)
Student Name: ______________________________________ Mentor Name: ________________________________________________
Date
Learning Outcomes
Learning Resources/Actions
Needs and interests, areas of
Essential knowledge and skill.
Methods and situations for how and
when learning can occur.
Evidence of
achievement
Review Date
Achieved/Not
achieved
Important: Student must submit one photocopy of this page
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Mentor
signature
Student signature
STUDENT SID:
Formative Action Plan (To be completed by mentor / sign-off mentor to be completed at mid-point of 2nd attempt)
Student Name: ______________________________________ Mentor Name: ________________________________________________
Date
Learning Outcomes
Learning Resources/Actions
Needs and interests, areas of
Essential knowledge and skill.
Methods and situations for how and
when learning can occur.
Evidence of
achievement
Review Date
Achieved/Not
achieved
Important: Student must submit one photocopy of this page
76
Mentor
signature
Student signature
MENTOR SUMMATIVE ASSESSMENT SUMMARY (2nd Attempt)
This section must be completed by a ‘live’ registered mentor who has worked with
the student on a placement allocation of no less than 4 weeks.
Has the student achieved a Pass in each of the ‘Values’ in the interpersonal skills profile? YES/NO
Have the performance criteria related to the cluster skills been achieved?
YES /NO
Care, compassion and communication (page 31)
YES /NO
Organisational aspects of care (page 33)
YES /NO
Infection prevention and control (page 35)
YES /NO
Nutrition and fluid maintenance (page 36)
YES /NO
Medicines management (page 37)
YES /NO
Has there been a need to complete a ‘cause for concern’ form? (page 47)
YES/NO
Mentor’s Name (please print clearly)………………………………………………………………..
Mentor’s Signature………………………………………………………Date……………………..
Student’s Name (please print clearly)………………………………………………………………
Student’s signature………………………………………………………Date……………………………
STUDENTS PLEASE NOTE THE FOLLOWING
1. Important: Student must submit one photocopy of this page
2. Inform your personal tutor of non-achievement of any part of the summative assessment within 5
working days of receiving summative assessment feedback. A formal learning contract will then be
created in collaboration with the student, mentor and a member of the link team.
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78
PERSONAL TUTOR’S SUMMATIVE REVIEW
STUDENT SID:
I confirm that I have undertaken the following:
Checked each value has been passed in the summative interpersonal profile
Checked the grades achieved in the summative assessment of performance criteria
I have read the comments made by the student and their mentor
Personal tutor’s comments on student’s performance in practice:
I confirm I have checked if a ‘Cause for Concern’ form has been completed and am aware of the
outcome
Personal Tutor Name ………………………………………………………
Personal Tutor Signature ………………………………………………….
Date……………………………………………………………………..
(Personal tutor -PLEASE REMOVE FOR STUDENT FILE)
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GUIDANCE FOR COMPLETION OF ATTENDANCE RECORD SHEETS
It is a mandatory requirement of pre-registration nursing courses that all students, including seconded Health
Care Assistants, complete a practice attendance register every month.
It is the student's responsibility to ensure that the register is completed on a daily basis and
forwarded to the placements department each month.
The following are instructions for completion of each of the columns overleaf.
(1)
(2)
(3)
(4)
Please insert relevant month and year.
Contains all week dates including Saturdays and Sundays
Please insert the exact time that you started the day/night shift even if this varies from the shift time
that you had been allocated.
Please insert the actual time that you completed the day/night shift. Please use the following codes
for the days that you are not working in the clinical area.
DO = Day Off. This denotes a day when you are not required to be in the clinical area. You are
allocated 2 days off per week.
SD = Study day. This denotes a day when you are in the University or are on a coursework day.
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
Please insert the total number of hours worked each shift
Please insert an S in this column for any days taken as sick days.
Please insert an A in this column for any days taken as absence.
Please insert A/L in each day taken as annual leave
The mentor should sign here to verify the number of hours at the end of each shift.
The mentor should print their name in this column
The mentor should write the actual number of hours they spent observing or directly working with the
student in practice in this column.
The student should calculate the total number of hours they have worked and write this in the
corresponding right hand column.
The student should calculate the total number of hours their mentor has observed / supervised or
worked directly with them and write this in the corresponding right hand column.
The student should calculate the % of the total student hours worked during the month that have
been observed by/ worked with their mentor and write this in the corresponding right hand column.
It is recommended that students retain a copy of the completed register so that any queries can be resolved.
N.B. Every line of the attendance record must be completed
Any sickness or absence must be notified to the clinical area at least one hour prior to the start of the shift.
Seconded students must also inform their seconding manager. All medical certificates must be forwarded to
the placements department. Seconded students must send a copy of any medical certificate to the
seconding manager and a copy to the placements department.
Night duty should be noted in red ink.
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82
PRACTICE PLACEMENT ATTENDANCE RECORD: (1) MONTH………………….YEAR…….
TRUST / SITE……………………………… NURSING FIELD …………………………INTAKE……………………..
Hours
Date
From
To
Hours
Total
(2)
(3)
(4)
(5)
1
st
2
nd
3
rd
4
th
5
th
6
th
7
th
8
th
9
th
10
th
11
th
12
th
13
th
14
th
15
th
16
th
17
th
18
th
19
th
20
th
21
st
22
nd
23
rd
24
th
25
th
26
th
27
th
28
th
29
th
30
th
31
st
Sickness Absence
A
S
(6)
(7)
Signature
(Supervisor / Mentor)
Each shift must be
signed
A/L
(8)
Print Name
(Supervisor/
Mentor)
(9)
(10)
Main Mentor
Please indicate
below the actual
number of hours
per shift that you
have supervised
this student.
(11)
(12) Total number of hours worked by student this month
(13) Actual number of hours that mentor has observed or worked directly with the student
(14) % of total student hours worked that have been observed by/ worked with mentor
STUDENT NAME (Please Print )
STUDENT SIGNATURE
Total Hours For This Month
MENTOR
SIGNATURE
Practice Team Only
(Shortage of hours this month)
83
84
PRACTICE PLACEMENT ATTENDANCE RECORD: (1) MONTH………………….YEAR…….
TRUST / SITE……………………………… NURSING FIELD …………………………INTAKE……………………..
Hours
Date
From
To
Hours
Total
(2)
(3)
(4)
(5)
1
st
2
nd
3
rd
4
th
5
th
6
th
7
th
8
th
9
th
10
th
11
th
12
th
13
th
14
th
15
th
16
th
17
th
18
th
19
th
20
th
21
st
22
nd
23
rd
24
th
25
th
26
th
27
th
28
th
29
th
30
th
31
st
Sickness Absence
A
S
(6)
(7)
Signature
(Supervisor / Mentor)
Each shift must be
signed
A/L
(8)
(9)
Print Name
(Supervisor/
Mentor)
(10)
Main Mentor
Please indicate
below the actual
number of hours
per shift that you
have supervised
this student.
(11)
(12) Total number of hours worked by student this month
(13) Actual number of hours that mentor has observed or worked directly with the student
(14) % of total student hours worked that have been observed by/ worked with mentor
STUDENT NAME (Please Print )
STUDENT SIGNATURE
Total Hours For This Month
MENTOR
SIGNATURE
Practice Team Only
(Shortage of hours this month)
85
86
PRACTICE PLACEMENT ATTENDANCE RECORD: (1) MONTH………………….YEAR…….
TRUST / SITE……………………………… NURSING FIELD …………………………INTAKE……………………..
Hours
Date
From
To
Hours
Total
(2)
(3)
(4)
(5)
1
st
2
nd
3
rd
4
th
5
th
6
th
7
th
8
th
9
th
10
th
11
th
12
th
13
th
14
th
15
th
16
th
17
th
18
th
19
th
20
th
21
st
22
nd
23
rd
24
th
25
th
26
th
27
th
28
th
29
th
30
th
31
st
Sickness Absence
A
S
(6)
(7)
Signature
(Supervisor / Mentor)
Each shift must be
signed
A/L
(8)
(9)
Print Name
(Supervisor/
Mentor)
(10)
Main Mentor
Please indicate
below the actual
number of hours
per shift that you
have supervised
this student.
(11)
(12) Total number of hours worked by student this month
(13) Actual number of hours that mentor has observed or worked directly with the student
(14) % of total student hours worked that have been observed by/ worked with mentor
STUDENT NAME (Please Print )
STUDENT SIGNATURE
Total Hours For This Month
MENTOR
SIGNATURE
Practice Team Only
(Shortage of hours this month)
87
88
PRACTICE PLACEMENT ATTENDANCE RECORD: (1) MONTH………………….YEAR…….
TRUST / SITE……………………………… NURSING FIELD …………………………INTAKE……………………..
Hours
Date
From
To
Hours
Total
(2)
(3)
(4)
(5)
1
st
2
nd
3
rd
4
th
5
th
6
th
7
th
8
th
9
th
10
th
11
th
12
th
13
th
14
th
15
th
16
th
17
th
18
th
19
th
20
th
21
st
22
nd
23
rd
24
th
25
th
26
th
27
th
28
th
29
th
30
th
31
st
Sickness Absence
A
S
(6)
(7)
Signature
(Supervisor / Mentor)
Each shift must be
signed
A/L
(8)
(9)
Print Name
(Supervisor/
Mentor)
(10)
Main Mentor
Please indicate
below the actual
number of hours
per shift that you
have supervised
this student.
(11)
(12) Total number of hours worked by student this month
(13) Actual number of hours that mentor has observed or worked directly with the student
(14) % of total student hours worked that have been observed by/ worked with mentor
STUDENT NAME (Please Print )
STUDENT SIGNATURE
Total Hours For This Month
MENTOR
SIGNATURE
Practice Team Only
(Shortage of hours this month)
89
90