bsc (hons) nursing in the home/ district nursing practice ... · this practice progress file should...

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BSc (HONS) NURSING IN

THE HOME/ DISTRICT NURSING

PRACTICE PROGRESS FILE

SEPTEMBER 2015



CONTENTS

Page 1 INTRODUCTION 1 2 THE TRIPARTITE APPROACH TO ASSESSMENT 1 IN PRACTICE 3 THE DIFFERENT ROLES WITHIN THE TRIPARTITE 2 RELATIONSHIP REFERENCES 5 APPENDICES 6 Appendix 1 Practice Outcomes 7 Appendix 2 Learning Contract 23 Appendix 3 360-degree Feedback Tool 24 Appendix 4 Prescribing Competency Framework 28 Appendix 5 Community Practitioner Prescribing Portfolio Document 40

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



1 INTRODUCTION Unprecedented changes in health and social care policy have enhanced the transition towards community and primary care-focused services. Effective and efficient community services are the foundation of health care in the National Health Service (NHS) (Department of Health (DH), 2009). Responding to such an agenda requires that you as a district nurse are able to move beyond competence to capability. This practice-centred programme will be delivered on a 50% taught theory and 50% taught practice basis and is designed to develop future district nurses who will assume responsibility for effective care and programme management, clinical practice leadership and clinical practice development. This will facilitate the development of you as a responsive and flexible practitioner who will be able to respond to the complex and changing health and social care environment providing a quality district nursing service for individuals, groups and communities. The programme has been designed to facilitate the development of district nurses that are fit for practice, fit for purpose, fit for the professional and academic award and who can take responsibility for the highest standards of professional conduct and ethical practice. The purpose of this Practice Progress File is to provide you with a framework through which you will demonstrate your personal and professional learning and development in the practice arena, and ultimately achievement of your practice outcomes. As a student on this programme you must have an agreement with a NHS Community Health Trust to provide a clinical placement and a Practice Teacher for the duration of your programme. Students who are fully sponsored by a NHS Trust will have had a clinical placement provided in negotiation with a community manager. A tripartite relationship will be used to support you in the formulation of learning in order to meet the practice outcomes and you will be required to reflect upon, utilise and develop learning from both the theoretical and practical aspects of the programme as you progress towards achievement. The tripartite meeting will also be used to review and verify that the practice outcomes have been achieved. This will be assessed on a pass/fail basis. 2 THE TRIPARTITE APPROACH TO ASSESSMENT IN PRACTICE The student, Practice Teacher and Academic Supervisor together form a tripartite relationship within the practice setting, to facilitate the integration of the theoretical and competency-based aspects of the programme. This dynamic and collaborative learning relationship is set within the workplace and enables you to reflect upon practice situations, problems and issues in order to develop a combination of action, reflection and evaluation. This tripartite approach will also be used to assess your learning. The support in practice that this provides is believed to be crucial in enabling you to achieve the outcomes by preparing you for professional practice and facilitating reflection in and on action. During the final tripartite meeting the Practice Teacher in partnership with the Academic Supervisor will judge whether or not you have achieved the practice outcomes (Appendix 1).



You must submit your Practice Progress File to your Academic Supervisor at your final tripartite meeting. You should also complete a receipt for submission of assignment form. The Academic Supervisor receiving the Practice Progress File should sign this form and the tear-off slip should be returned to you. Results will be confirmed and published following internal and external moderation, and the Assessment Board Meeting. Referral/Reassessment If you are referred on one or more of the practice outcomes you must demonstrate achievement of these outcomes at the designated point of reassessment. If this is the case you must devise a Learning Contract (Appendix 2) and Action Plan with your Academic Supervisor and Practice Teacher in order to address the outcomes involved. The decision regarding whether or not you have achieved this will be made by your Academic Supervisor and Practice Teacher within a further tripartite meeting. You will normally be expected to resubmit your Practice Progress File within four weeks, however this will be decided by the University Assesment Board.

3 THE DIFFERENT ROLES WITHIN THE TRIPARTITE RELATIONSHIP

Student You will be prepared for your practical experience during the theory hours of the modules. Your role within the tripartite approach is to take responsibility for your own learning and demonstrate a willingness to develop both academically and in practice. You will be expected to discuss your own learning needs with your Practice Teacher and Academic Supervisor. You must be willing to undertake honest self-assessment, articulate your learning needs, seek and accept formative feedback from them. You will need to recognise and appraise your own abilities and limitations. Further to this you will need to maintain contact with your Academic Supervisor and organise tripartite meetings. Practice Teacher Your Practice Teacher will provide honest, tactful and specific feedback, discussing and recognising your achievements as well as highlighting areas needed for further development. Your Practice Teacher will provide a patient/client-centred approach to caring in the clinical setting in which learning can be negotiated and facilitated. Overall, your Practice Teacher will facilitate, observe and assess your performance over the continuous period of the programme. Your Practice Teacher in partnership with your Academic Supervisor will judge whether or not you have achieved the practice outcomes. They will sign to verify this at the final tripartite meeting. Academic Supervisior Your Academic Supervisor will fulfil a dual role that also encompasses the Personal Academic role. The primary role of this is to give you and your Practice Teacher support and guidance as part of the practice experience. They will provide student-centred educational support both within the academic and practice settings. They will be involved in an initial discussion to clarify your learning needs whilst in practice placement. They will monitor progress and aid development of theory/practice links and participate in final discussions to verify achievement of practice outcomes based



on discussion with yourself and your Practice Teacher. Your Academic Supervisor provides you with advice and guidance in an approachable manner and will maintain close liaison with your Practice Teacher so that any issues may be clarified at an early stage. They must, together with your Practice Teacher, address and document any issues in order to arrange an appropriate Action Plan. Your Academic Supervisor in conjunction with your Practice Teacher will have an important role in judging whether any remedial action has been successful. Your Academic Supervisor will in partnership with your Practice Teacher judge whether or not practice outcomes have been achieved. Tripartite meetings will be held during each term of the programme. The first two tripartite meetings will consider your progression towards achievement of the practice outcomes. The final tripartite meeting will take place in Week 51 (Week 103 for part-time students) of your programme and will be a summative meeting in which you will demonstrate that you have achieved the practice outcomes. At this point you will be expected to demonstrate through reflection how you have achieved the outcomes. You will also provide evidence that you have successfully completed a Prescribing Competency Framework. You will be expected to utilise reflective skills to evaluate your progress and link your practice development to the evidence-base. This Practice Progress File should provide a documentary record illustrating this learning and the achievement of outcomes within your practice area. This process involves:

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

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

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

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

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

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

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

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

Your strengths.

Areas you would like to develop.

What you would like to achieve in the coming year.



The Learning Contract you have developed in conjunction with your Practice Teacher and Academic Supervisior.

Dialogue sheets from your tripartite meetings.

The final summative assessment will take place in the final tripartite meeting. It is your responsibility to negotiate an appropriate time to hold these. The Academic Supervisor and Practice Teacher are responsible for deciding whether or not you have achieved the practice outcomes. All the outcomes must be achieved at this point to successfully complete the programme. 360-degree Feedback Tool (Appendix 3) It is important that service users, their families and carers are involved in the development of any programme which prepares nurses for practice. The School of Health & Social Care (SOHSC) actively promotes this approach. This programme has been developed with this in mind (SOHSC Learning, Teaching & Assessment Strategy 2009-2012). This tool has been developed in conjunction with the user/carer group who informed the programme curriculum. Its purpose is to ensure that you can apply appropriate communication skills and include patients and their families under your care in any decisions made in relation to their care. The tool has been modified and based on good practice in the pre-registration nursing programme. Feedback from this group identified that service users, their families and carers do, in the main, want to actively participate in their care provision, and want a district nurse or indeed any nurse to exhibit high quality communication skills not only with them but with others who may be involved in their care. Your Practice Teacher will identify four appropriate patients or carers throughout the year, including the final 10 weeks of full-time practice whom you have provided care for, and with consent and ensuring confidentiality your Practice Teacher will facilitate the completion of this tool. You will not be informed of the individual’s identity in line with the guidelines for confidentiality and informed consent and to ensure that the patient and their family or carer is able to provide an honest assessment of your communication skills. There is an opportunity for you and your Practice Teacher to consider the responses and feed back your thoughts. You should include all documentation related to this in your Practice Progress File as evidence that this has been undertaken. Prescribing Competency Framework (Appendix 4) In addition to the specialist qualification awarded on successful completion of the programme, you will develop your prescribing practice and will gain a community prescribing qualification. In order to ensure that you are deemed capable to prescribe safely you must complete a Prescribing Competency Framework document which your Practice Teacher must verify. This document is evidence which is required as part of the practice module Specialist District Nursing Practice Project and you will submit this at your final tripartite. At final tripartite your Practice Progress File should include the following essential evidence:



Formulation and completion of a Learning Contract which identifies strategies to meet individual learning needs.

Self-assessment which identifies strengths and areas for development.

Evidence of achievement of all practice outcomes.

Evidence of achievement of the Prescribing Competency Framework.

Four completed service user/carer 360-degree Feedback Tools.

Completed Dialogue Sheets from each tripartite.

Completed timesheet.

Prescribing Portfolio Document – Module Community Practitioner Prescribing CCH3048-N (Appendix 5) This portfolio must be completed in full as part of your prescribing assessment for the Community Practitioner Prescribing module. It will be submitted in Week 35 of your programme. Your Practice Teacher will verify that you have met the module outcomes through ensuring that you have exposure to prescribing experiences. You will be required to reflect upon your prescribing experiences with patients therefore you will be required to ensure that you maintain confidentiality and obtain informed consent. Consent forms can be found in your programme handbook and on the Student e-directory. The Essential Evidence required for this portfolio includes:

A Learning Contract which identifies your individual learning needs and strategies to meet these needs.

A Learning Log that identifies prescribing experiences.

Evidence of achievement of learning outcomes verified by your Practice Teacher.

A critical reflection on an episode/s from your Learning Log.

Evidence of having passed a two-hour written examination which consists of 20 short answer and multi-choice questions (MCQ) and five questions which test numeracy.

This portfolio is separate from the Prescribing Competency Framework detailed above which must be completed and submitted at your final tripartite. REFERENCES Department of Health (2009b) The NHS Operating Framework for England for 2010/11. http://systems.hscic.gov.uk/infogov/links/operatingframework2010-2011.pdf (accessed 03/07/15) School of Health & Social Care (2009-2012) Implementation of the University Learning Teaching and Assessment Strategy (LTAS). Teesside University.

http://systems.hscic.gov.uk/infogov/links/operatingframework2010-2011.pdf



APPENDICES



APPENDIX 1

PRACTICE OUTCOMES

Outcome 1

Work in partnership with service users, their families and carers in assessing their holistic needs and identify and initiate appropriate steps for effective care.

Term 1 Formative Review of Development of Practice

Student Comments: Date: .......................................................... Signature Student: ..........................................................................

Practice Teacher Comments: Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ........................................................................................................................................

Term 2 Formative Review of Development in Practice

Student Comments: Date: ........................................................... Signature Student: .........................................................................

Practice Teacher Comments: Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ......................................................................................................................................

Term 3 Summative Assessment of Practice

Competent/Not Competent I am satisfied/not satisfied that the student has met the standard required through the following: observation, question and answer throughout the practice experience and discussion at the final tripartite meeting. The student demonstrates the necessary knowledge skills, attitudes and values to meet the outcome.

Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ...................................................................................................................................... Signature Student: ...........................................................................................................................................



Outcome 2

Assess, diagnose and treat specific conditions in accordance with agreed pathways of care.


Student Comments: Date: ........................................................... Signature Student: ..........................................................................




Practice Teacher Comments: Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: .....................................................................................................................................



Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ...................................................................................................................................... Signature Student: ................................................................................................................................................



Outcome 3

Assess, plan, provide and evaluate specialist clinical nursing care to meet the care needs of individuals in their own homes and other community settings.


Student Comments: Date: .......................................................... Signature Student: ...........................................................................




Practice Teacher Comments Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ......................................................................................................................................



Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ..................................................................................................................................... Signature Student: ...............................................................................................................................................



Outcome 4

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









Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ..................................................................................................................................... Signature Student: ..........................................................................................................................................



Outcome 5

Work in partnership with service users, families and carers, plan, implement and manage programmes of care for those with long-term health conditions.





Student Comments: Date: .......................................................... Signature Student: .........................................................................




Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ..................................................................................................................................... Signature Student: ............................................................................................................................................



Outcome 6

Reflect, respond and contribute to the contemporary public health agenda of integrated working, user involvement, improving access to primary care services and tackling social exclusion.









Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ...................................................................................................................................... Signature Student: ................................................................................................................................................



Outcome 7

Act in autonomous manner in order to play a key role in care management.









Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ..................................................................................................................................... Signature Student: ................................................................................................................................................



Outcome 8

Demonstrate the knowledge and skills required to prescribe from a nursing formulary, in accordance with current legislation.









Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ...................................................................................................................................... Signature Student: ...............................................................................................................................................



Outcome 9

Respond to and evaluate the local, regional and national key policies which impact upon effective care and programme management.












Outcome 10

Evidence a proactive response to the challenges and diversities of integrated working and foster effective professional relationships that promote partnership and quality care.









Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ...................................................................................................................................... Signature Student: .............................................................................................................................................



Outcome 11

Analyse and evaluate the potential for both clinical and personal risk using appropriate strategies to investigate, minimise and manage such risks.



Practice Teacher Comments: Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ....................................................................................................................................









Outcome 12

Lead and clinically direct the community nursing team to ensure the implementation of evidence-based quality care through the effective and efficient management of human and technological resources.









Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ...................................................................................................................................... Signature Student: .............................................................................................................................................



Outcome 13

Initiate analytical and innovative strategies to ensure service improvement measures are not only fostered, but also evaluated and disseminated.



Practice Teacher Comments Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ......................................................................................................................................






Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: .................................................................................................................................... Signature Student: ...............................................................................................................................................



Outcome 14

Utilise personal skills and work collaboratively with others to facilitate continuous quality service improvement.





Student Comments: Date: .......................................................... Signature Student: ...........................................................................




Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ......................................................................................................................................... Signature Student: ...............................................................................................................................................



Outcome 15

Demonstrate sound professional judgement working within approved codes of practice at all times.









Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: ........................................................................................................................................ Signature Student: ...............................................................................................................................................



Outcome 16

Communicate clearly and fluently in professional debate and present arguments in a reasoned manner in order to enhance integrated multi-professional working.






Practice Teacher Comments: Date: .......................................................... Signature Practice Teacher: ........................................................ Signature Academic: .........................................................................................................................................






APPENDIX 2

LEARNING CONTRACT

Name: Practice Teacher: Negotiated Learning Outcomes: Strategies: Resources: Date of Contract: ………….….….…To be completed by: …………….. Signature of Student: …………………………………………………….. Signature of Practice Teacher: …………………………………………...



CONFIDENTIAL

DISTRICT NURSING PRACTICE-BASED ASSESSMENT TO BE COMPLETED BY SERVICE USER OR CARER

Thank you for agreeing to help assess the district nursing student’s progress in managing your care needs. Communication is a vital skill which is important to all patients/service users and carers and by completing this questionnaire you are adding your contribution to the assessment process of the student. If you wish please ask the student’s Mentor (the nurse who gave you this form) or your family to help you complete this form. All questions are optional and the student will not know who has been asked to complete the form. The student will see your comments, however, please be assured that your identity will remain confidential.

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

Poor

OK

Good

Excellent

N/A

1. You were greeted in a friendly manner at each visit 2. You were given the opportunity to discuss and plan

your care needs

3. You were provided with a clear understanding of how your health and social care needs could be addressed

4. You were given information and choice about your care, which you could easily understand

5. The student district nurse worked with you in order to make appropriate decisions about your care and you were given the opportunity to ask questions and express your views concerning your care

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

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

8. The student district nurse was knowledgeable in providing the information you required

9. Your family or carers were included and involved in both the organisation and delivery of your care where appropriate

10. You were provided with the opportunity to be involved in any changes to your care and fully discussing these with you

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

APPENDIX 3

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



12. Is there anything that you felt the student did particularly well?

13. Are there any areas which you feel the student can improve?

Thank you for taking the time to complete this form



DISTRICT NURSING PRACTICE-BASED ASSESSMENT

Name of District Nurse Student: I confirm that informed consent has been obtained from the patient/client/service user/carer (delete as appropriate) completing this form. Name of Practice Teacher: ……………..................................................................... Signature of Practice Teacher: ……………............................................................... This assessment should ensure that the student can deliver safe, effective and efficient health information based on assessment of client need. Therefore the district nursing student should be able to:

Please rate how effective the service user/carer felt the student district nurse was in relation to the following areas by ticking one box for each statement:

Work in partnership with service users, their families and carers in assessing their holistic needs and identify and initiate appropriate steps for effective care

Please rate the student performance

Poor

OK

Good

Excellent

A demonstration of a clear understanding of how to address any identified health and social care needs

Enhanced observation skills

Effective interview/assessment skills

Working in partnership and respecting client/family/ carer views

Available resources – e.g. inclusion of or referral/ signpost to other more appropriate services if indicated

Demonstrate enhanced communication skills which facilitate a therapeutic relationship through:

Please rate the student performance Poor

OK

Good

Excellent

An open questioning style

Good listening skills

Appropriate empathy

Treated the client/service user/carer with dignity and demonstrated an open and honest approach throughout

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



Additional Information Was there any aspect of the assessment which the patient/client/service user/carer felt was particularly good?

Are there any areas which the patient/client/service user/carer felt required further development in order to improve their overall experience?

Practice Teacher comments

Practice Teacher signature: ……………………………………………………............... Date: ............................................................................................................................. Student comments:

Signature: ……………………….................................................................................... Date: .............................................................................................................................



APPENDIX 4

Prescribing Competency Framework 2015/2016

To be submitted at final tripartite Week 51

Student Name

Full-time/Part-time

Programme

Academic Supervisor

Practice Teacher

Placement Area

Placement Dates

Practice Teacher Signature Student Signature



1. CONSULTATION, DECISION-MAKING AND THERAPY, INCLUDING

REFERRAL

Learning Indicator Evidence of Progression

1.1 Accurate assessment, history-taking,

communication and consultation with patients/clients and their parents/carers.

1.2 Development of a management plan. 1.3 Diagnosis. 1.4 Prescribe, not to prescribe, non-drug treatment or

referral for treatment. 1.5 Numeracy and drug calculations. 1.6 The legal, cognitive, emotional and physical

differences between adults and children, and the implications for safe prescribing practice*.





2. INFLUENCES ON, AND PSYCHOLOGY OF, PRESCRIBING


2.1 Patient/client demand, and preference vs

patient/client need - knowing when to say ‘no’. 2.2 External influences, e.g. companies or colleagues. 2.3 Patient/client partnership in medicine-taking,

including awareness of cultural and ethnic needs. 2.4 Concordance as opposed to compliance.




3. PRESCRIBING IN A TEAM CONTEXT


3.1 Rationale, adherence to, and deviation from

national and local guidelines, local formularies, protocols, policies, decision support systems and formulae.

3.2 Understanding the role and functions of other team

members. 3.3 Documentation, with particular reference to

communication between team members, including electronic prescribing.

3.4 Auditing, monitoring and evaluating prescribing

practice. 3.5 Interface between multiple prescribers and

management of potential conflict. 3.6 Budgets and cost effectiveness. 3.7 Dispensing practice issues.




4. CLINICAL PHARMACOLOGY, INCLUDING THE EFFECTS OF CO- MORBIDITY


4.1 Anatomy and physiology as applied to prescribing

practice and community practitioner formulary. 4.2 Basic principles of drugs to be prescribed -

absorption, distribution, metabolism and excretion, including adverse drug reactions (ADR).

4.3 Interactions and reactions.

4.4 Patient/client compliance, concordance and drug

response.

4.5 Impact of physiological state on drug responses and safety, e.g. in elderly people, neonates, children and young people, pregnant or breast feeding women.




5. EVIDENCE-BASED PRACTICE AND CLINICAL GOVERNANCE IN RELATION TO NURSE PRESCRIBING


5.1 Rationale, adherence to and deviation from

national and local guidelines, protocols, policies, decision support systems and formulae.

5.2 Continuing professional development - role of self

and role of the organisation.

5.3 Management of change.

5.4 Risk assessment and management, including safe storage, handling and disposal.

5.5 Clinical supervision.

5.6 Reflective practice/peer review.

5.7 Critical appraisal skills.

5.8 Auditing practice and scrutinising data, systems monitoring.

5.9 Identify and report adverse drug reactions and near misses, and learn from mistakes.




6. LEGAL, POLICY AND ETHICAL ASPECTS


6.1 Sound understanding of legislation that impacts on

prescribing practice.

6.2 Legal basis for practice, liability and indemnity.

6.3 Legal implications of advice to self-medicate including the use of alternative therapies, complementary therapy and over the counter (OTC) medicines.

6.4 Safe-keeping of prescription pads, action if lost, writing

prescriptions and record keeping. 6.1 Awareness and reporting of fraud (recommendations from

the Shipman Inquiry, Fourth Report)

6.2 Drug licensing. 6.3 Yellow card reporting to the Committee of Safety on

Medicines (CSM) and reporting patient/client safety incidents to the National Patient Safety Agency (NPSA).

6.4 Prescribing in the policy context. 6.5 Manufacturer’s guidance relating to literature, licensing and

off-label. 6.6 Ethical basis of intervention. 6.7 Informed consent, with particular reference to client groups

in learning disability, mental health, children, critically ill people and emergency situations.




7.1 The NMC Code of Professional Conduct;

Standards for Conduct, Performance and Ethics.

7.2 NMC Standards for Prescribing Practice.

7.3 Ethical recommendations from the Shipman Inquiry, Fourth Report

7.4 Accountability and responsibility for assessment, diagnosis and prescribing.

7.5 Maintaining professional knowledge and competence in relation to prescribing.

7.6 Accountability and responsibility to the employer.

7. PROFESSIONAL ACCOUNTABILITY AND RESPONSIBILITY




8. PRESCRIBING IN THE PUBLIC HEALTH CONTEXT


8.1 Duty to patient/clients and society.

8.2 Inappropriate use of medication, including

misuse, under-use and over-use. 8.3 Inappropriate prescribing, over-prescribing and

under-prescribing.

8.4 Access to health care provisions and medicines.




Adapted from Standards of Proficiency for Nurse and Midwife Prescribers (NMC, 2012) http://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-standards-proficiency-nurse-and-midwife-prescribers.pdf And NMC (92007) 22/2007 Circular: http://www.nmc.org.uk/globalassets/sitedocuments/circulars/2007circulars/nmc-circular-22_2007.pdf (accessed 03/05/17)

http://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-standards-proficiency-nurse-and-midwife-prescribers.pdf

http://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-standards-proficiency-nurse-and-midwife-prescribers.pdf

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

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



FINAL Summative Practice Assessment in relation to ALL

PRESCRIBING COMPETENCIES

Practice Teacher Final Report

Practice Teacher Name Signature Date

Student comments

Student Name Signature Date




Verification of Competence as a Community Practitioner Prescriber

(To be completed by the Practice Teacher at final tripartite in Week 51)

Student:

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

If no, you must comment:

Practice Teacher Name Signature Date




APPENDIX 5

School of Health & Social Care

Community Practitioner Prescribing Portfolio Document



GUIDELINES FOR COMPLETION OF YOUR PORTFOLIO The purpose of this Portfolio is to provide a framework through which you can record and demonstrate your progress and achievements whilst studying. In order to demonstrate achievement of the module, you are required to present a Portfolio of Evidence that provides a documentary record of your learning and how this relates to the module outcomes. The portfolio-keeping process includes: Reflection upon existing knowledge and skills. Exploration of the module outcomes. Identification of learning needs. Identification of learning opportunities in your supervised practice area and

who can support you. Matching learning opportunities to learning needs. Development of a plan or Learning Contract to meet learning needs. Implementation of the plan/Learning Contract and collection of supporting

evidence. Keeping a practice Learning Log. Reflection upon learning and achievement of practice module outcomes. Presentation of the Portfolio at the end of the module. How to Compile your Portfolio Stage 1 - Identifying your Learning Needs The first step is to look at the practice outcomes and consider what you need to learn to achieve each one. You must have time aside with your Practice Teacher at the beginning of the practice placement and review the practice outcomes, consider how these can be achieved and consider your own self-assessment and how your learning needs can be met. A Learning Contract will be developed to show how these outcomes can be achieved. This contract can also be used as a framework for your critical reflection of learning. You will be utilising time within your tripartite meetings to review and document your progress towards achievement. Stage 2 - Feedback You must both set aside time to review progress and provide feedback on progress. This should be undertaken regularly and should involve discussing cases from practice experiences and reflecting upon and critically analysing. It is important that you consider how theoretical concepts are used to inform these discussions. Stage 3 At the end of the module, you will submit your Portfolio for verification of the award. Your Practice Teacher must sign and date the practice outcomes have been met and confirm final sign off of your competence. Your Portfolio must include the following:

Completion of Practice Placement Prescribing Support Information.



Practice Experience Signature list. A Learning Contract which identifies individual learning needs and strategies

to meet these. A Learning Log that identifies prescribing experiences and meets the learning

outcomes as detailed above.

Reflection on episode/s from the Learning Log that demonstrate an understanding of ethical issues, legal issues, team-working, record-keeping, writing a prescription and numeracy – and how these apply to their prescribing practice. (Assignment).

Evidence of achievement in the written examination.

Evidence of satisfactory completion of a period of practice experience with final sign-off.

Adhere to the SOHSC’s policy for confidentiality and consent and adhere to the SOHSC guidelines for presentation and referencing.

All your practice outcomes must be achieved by the end of the module and the Portfolio forwarded to your Module Leader for verification. If you are referred on one or more of the practice outcomes you must demonstrate achievement of this outcome at the designated point of negotiated reassessment. If this is the case you must devise a Learning Contract and Action Plan with your Practice Teacher and Field Leader in order to address the outcomes involved. The decision regarding whether or not you have achieved this Learning Contract will be made by your Practice Teacher. Your practice log can also be used as a tool to guide reflection on practice. By recording experiences, in particular those that create uncertainty and conflict, an opportunity for reflection on action can be created. Such reflection articulates the factors that underpin decision-making and facilitates the identification of alternative approaches. However, it is also essential that sustained observation in the practice environment is used to provide evidence of your competence in practice. It is important that you should collect your portfolio of evidence on an ongoing basis to demonstrate achievement of the practice outcomes. All portfolio components must be submitted. YOU MUST OBTAIN INFORMED CONSENT IN ORDER TO COMPLETE YOUR PORTFOLIO. The elements which need to be presented in the Practice Progress File at the end of the programme are:

Learning Contract

Learning Log reflecting on a minimum of 10 patients - this can be the Learning Log from your prescribing module or if you were already a prescriber when starting the programme, you will need to record a new Learning Log. Remember that it is essential to attach evidence that you gained informed consent for this.

Signed competencies from your prescribing module

A print out of the electronic feedback showing that you have passed the prescribing module.



The prescribing competency framework which will demonstrate you have maintained the prescribing skills and competencies since you were awarded the module until the end of the programme.



LEARNING CONTRACT Name: Practice Mentor: Negotiated Learning Outcomes: Strategies: Resources: Date of Contract: ……………………. To be completed by: ……………........................ Signature of Student: ……………………………………………………............................ Signature of Practice Teacher: …………………………………………............................



OBTAINING INFORMED CONSENT

Rationale As part of the assessment and portfolio-keeping process students are sometimes required to illustrate the relationship between theory and practice by using information relating to specific clients, e.g. care studies, care plans, assessments, projects and reflective pieces. In these circumstances obtaining informed consent is essential. In order to demonstrate compliance with the professional codes/bodies, the attached Obtaining Informed Consent Declaration Form must be completed and submitted with the work. Failure to obtain consent and/or submit the completed declaration form will result in automatic referral/failure and could lead to disciplinary action. Responsibilities The academic support teacher/module tutor supervising the piece of work is responsible for:

Directing the student to the site where they can access a copy of the Obtaining Informed Consent Declaration Form and Guidance Notes prior to the assessment.

Drawing the student’s attention to the Access to Health Records Act (1990), in particular: o Section 5.3, which states that third parties may only access the

patient’s records provided that information given by the patient and/or the results of examinations/investigations will not be disclosed.

o Section 5.1 which states that the information obtained from the patient’s health records must not be used in a way as to cause the patient serious physical or mental harm, or that the patient may be identified.

Drawing the student’s attention to the Data Protection Act (1998) in particular: o Reviewing the rationale and each point set out in the Obtaining

Informed Consent Declaration Form o Reminding the student that the completed Declaration Form must

accompany the assignment when submitted.



The Student is responsible for:

Informing the Practice Mentor/Supervisor of the nature of the assignment/ portfolio and the requirement to complete an Obtaining Informed Consent Declaration Form.

Seeking informed consent from the patient/client and/or patient/client representative and/or carers, and/or colleagues/staff in accordance with points 1-4, as set in the Declaration Form.

Themselves and the Practice Mentor/Supervisor ensuring the Declaration Form is completed.

Ensuring the completed Declaration Form is submitted with the assignment by the required date.

Ensuring that a pseudonym is used for client/patients, relatives, carers and staff mentioned in the assessment.

Ensuring that any documentation submitted as part of the assessment will be rewritten and not photocopied e.g. care plans, assessment forms.

The Practice Mentor/Supervisor is responsible for:

Providing the student with appropriate support and guidance whilst obtaining informed consent form the patient/client and/or patient/client representative.

Signing the Obtained Informed Consent Declaration Form, only if they are confident that the criteria have been met.



OBTAINING INFORMED CONSENT DECLARATION FORM

Student’s Name

Programme/Pathway/Cohort

Academic Support Teacher/ Module Tutor

DECLARATION BY STUDENT In order to comply with the requirements of the Access to Health Records Act (1990) and the Data Protection Act (1984), I confirm I have discussed the following with the patient/client* and/or the patient’s/client’s* representative, e.g. parent/guardian, next of kin, carers, colleagues/staff and have obtained permission to use personal relevant data: * Delete as appropriate 1. The nature of the assessment. 2. The reason I wish to use data relating to the patient/client. 3. That clients’/patients’, carers’, colleagues’/staff anonymity and confidentiality

in relation to any material gathered or produced in the course of this work will be maintained e.g.: a for all persons mentioned pseudonyms and/or general titles will be

used, not individual names. b the patient/client address and any information which could identify their

address will be omitted. c general terms will be used to describe occupation/workplace/school/

hobbies etc. d time, date and location of admission will be omitted; e information which may identify the patient/client/relatives/carer and

colleagues/staff will be omitted from documentation e.g. care plans, pathways of care, risk assessments etc.

4. Those who will have access to the work in addition to myself e.g. typist, teaching staff, other students, Board of Examiners.

S:\Modularity\Documentation Department\Approval Documentation\Programmes\Nursing in the Home-District Nursing, BSc (Hons)\Updated Documentation\2015-16\Practice Progress File.docx 48 ©TU-SOHSC (2015)

INFORMED CONSENT DECLARATION FORM N.B.: Patient/Client/Carer/Colleagues/Staff column should be completed by using a Code/Pseudonym e.g. Client/Patient A, Client/Patient B in order to provide anonymity and confidentiality. If names are used in the first column a pseudonym must be used and it must be clearly stated that this is a pseudonym. The Code/Pseudonyms used must be the same as those referred to in the assignment.

Patient/ Client/ Carer/

Colleague/Staff

Module Title

Academic Support Teacher

Informed Consent Gained

Practice/ Mentor

Supervisor Name

Practice/ Mentor

Supervisor Signature

Student Signature

Date

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Agreed at SASC 26 September 2012


Learning Log Student Name:

Date Patient Description of Event Outcomes Met Significant Learning


Learning Log Student Name: Date Patient Description of Event Outcomes

Met Significant Learning



Date Patient Description of Event Outcomes Met

Significant Learning


Learning Outcomes By the end of the module you will be able to:

Achieved in Practice (practice teacher

signature)

Not Achieved in Practice (practice teacher signature)

Student Signature

Date

1 Critically appraise and synthesise

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

2 Demonstrate a comprehensive

and detailed knowledge of drug actions in prescribing practice.

3 Analyse and evaluate the legal

and professional framework for accountability and responsibility in relation to prescribing practice.

4 Evaluate the factors involved in

effective history-taking, including medication history and current medication that will inform the diagnostic process.

5 Demonstrate a comprehensive

and detailed knowledge of the relevant legislation to the practice of nurse/midwife prescribing.

6 Critically appraise and synthesise

sources of information/advice and decision support systems in prescribing practice.


7 Demonstrate a critical reflective

approach to continuing professional development of prescribing practice.

8 Prescribe safely, appropriately

and cost effectively.

Achieved (PT Sig)

Not Achieved (PT Sig) Student Signature Date

9 Practice within a framework of

professional accountability and responsibility.

10 Assess and consult with

patients/clients, parents and carers.

11 Demonstrate the ability to monitor

response to medicines and modify treatment or refer the patient as appropriate.

12 Demonstrate a detailed and

comprehensive knowledge of the importance of record-keeping in the context of medicines management including

accurate recording in patient notes

reporting of near misses

adverse reactions

13 Demonstrate a detailed

knowledge of the roles and relationships of others involved in prescribing, supplying and administering medicines.


14 Demonstrate effective

partnership working with Independent Prescribers and the wider care team.

15 When working with children take

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

Achieved (PT Sig)

Not Achieved (PT Sig) Student Signature Date

16 Demonstrate appropriate

numeracy skills.

Competent/Not Competent I am satisfied/not satisfied that the student has met the outcomes of the module. This has been evidenced through observation, question and answer discussion throughout the practice experience Signature…………………………………………. Practice Teacher Name……………………………………………. Date……………………………………………..



Community Practitioner Prescribing Practice Experience Signature list

Please sign and print your name in the table below, if you are involved in supporting the practice education of the Community Practitioner Prescribing student, or provide any written information within this portfolio

Date Placement Name Signature



Practice Placement Prescribing Support Information

Placement type– i.e. ward/

community/practice setting

Practice Teacher

Student

Availability of other health care professionals working in the placement who can provide for prescribing student support

Members of the workplace team

Specialist expertise or interest offering learning opportunities for prescribing students

Number of practitioners seen

Medical Officers

Non-medical Independent/supplementary Prescribers Community Prescribers

Pharmacists

bsc (hons) nursing in the home/ district nursing practice ... · this practice progress file should...

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