FACULTY OF HEALTH AND LIFE SCIENCES

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					FACULTY OF HEALTH AND LIFE SCIENCES
DEPARTMENT OF NURSING, MIDWIFERY AND HEALTH CARE

BSc (Hons) / Diploma in Adult Nursing

Practice Grid

Adult Practice 2 (Branch)
Faculty of Health and Life Sciences

                            STUDENT and PLACEMENT DETAILS


STUDENT NAME


COHORT/BRANCH


MODULE LEADER


PLACEMENT DETAILS


PLACEMENT
CONTACT DETAILS


MENTOR DETAILS


PRACTICE EDUCATOR/
FACILITATOR


PERSONAL TUTOR
CONTACT DETAILS

    Student to consider providing personal contact details to mentor or
           manager, in line with lone worker policy statements.

This document remains the property of Coventry University and is to be
submitted for review by the module leader and/or personal tutor at the
      end of the placement and at any other time it is requested.
       If required, the grid must be made available to mentors on subsequent placements.
                                  Please do not separate pages.

 You are advised to keep this document safe within your portfolio as proof of
        completion of outcomes during your placement and course.
 IT IS GOOD PRACTICE TO RETAIN A PHOTOCOPY OF THIS DOCUMENT
        AND ALL DOCUMENTS PERTAINING TO YOUR TRAINING.




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                                                    CONTENTS


Glossary of Terms ........................................................................................


Health and Safety Check and Orientation.....................................................                            1


Guidance for completion of this Grid ............................................................                       2


Student Check List ......................................................................................               6


Mentor Check List ........................................................................................              7


Preliminary Interview ....................................................................................              8


Midway Interview..........................................................................................              9


Interpersonal Profile .....................................................................................             11


NMC Outcomes and Grid .............................................................................                     13


Final Interview .............................................................................................           28


Link Tutor/Practice Facilitator Comments .....................................................                          29


Record of Signatures....................................................................................                30


Record of Achievement ...............................................................................                   31




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GLOSSARY OF TERMS

MENTOR: is a registered nurse, midwife or health visitor who has met the NMC
standards (2006) (to support learning and assessment in practice), facilitates
learning, supervises and assesses students in the practice setting.

PRACTICE EDUCATOR/FACILITATOR/INTER-PROFESSIONAL: is a health or
social care professional who is responsible for supporting mentors and students in
practice as part of their role.

LINK TUTOR: is normally a nurse lecturer within the Faculty of Health and Life
Sciences who is responsible for supporting mentors and students in practice as part
of their role.

PERSONAL TUTOR: is a nurse lecturer who is responsible for facilitating the
student’s learning throughout the course.

MODULE LEADER: is normally a lecturer who is responsible for planning and
organising a module or unit of learning.

COURSE TUTOR: is normally a lecturer who is responsible for ‘managing’ a course.

PROGRAMME MANAGER: is responsible for the quality enhancement of a
programme or group of courses.

PLACEMENT DEVELOPMENT MANAGER: is responsible for developing,
negotiating and co-ordinating student practice placements.

VERIFIER: is any professional mentor or associate from any discipline that signs
the skills inventory to show practical ability and understanding of skills being judged.

SIGN OFF MENTOR: is an experienced mentor who having met the additional
criteria outlined in standards for learning and assessment in practice (NMC 2006)
may confirm that students at the end of the course have met the relevant standards
of proficiency for a particular programme leading to registration on the NMC register.
The sign off mentor must be on the same part of the register and working in the same
field that the student intends to qualify.

CLINICAL LIAISON TEAM: is a group of lecturers who are responsible for providing
support to mentors and students for an identified clinical area.




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HEALTH AND SAFETY CHECK AND ORIENTATION
(complete on first day of attendance)
                                                                     (pleasebox    )
1     WARD/DEPARTMENT LAYOUT                                             
2     EXITS TO BUILDING                                                  
3     FIRE PROCEDURE                                                     
4     Toilets/staff kitchen                                              
5     Any relevant health and safety issues                              
6     Professional Conduct e.g. attendance,                              
      communication, dress code.

In addition to the mentor check list, I have completed the health and safety induction for this
placement with my mentor

Student Signature:___________________________

Mentor Signature:___________________________                           Date: ____________




            Clinical Incidents that require Statements from Student Nurses

Student nurses may be involved in clinical incidents while in clinical practice for which
they will be required to give a witness statement (oral and/or written).

If this happens, mentors are required to contact a University representative for
support, BEFORE the student is asked to provide a statement. This may be a
practice educator/facilitator, link tutor, practice module leader. An incident form must
be completed in a timely manner.

This will ensure the student is offered appropriate advice, support and guidance, and
possible referral to a union or legal representative. In all circumstances, Registered
Health Professionals should remember that they remain accountable for the practice
of student nurses.




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Practice grid Introduction

Introduction
Your practice modules have been designed to enable you to build your skills repertoire and
use this learning to deliver safe and effective nursing care. Each practice module builds on
the previous one and contributes towards your achievement of nursing practice which is
evidenced through your ability to meet The Standards of Proficiency (NMC 2004) and to
cover the Essential Skills Clusters (NMC 2007) at the end of the course. Your practice will be
assessed in each practice module.

The practice grid is the method of assessment used to assess your practice. The practice
grid contains:

            A set of learning outcomes.
            An interpersonal profile.

Together they formulate the assessment of practice. The completed practice grid provides
you with a profile for your portfolio which shows your development and understanding of the
four domains of nursing care –professional and ethical practice, care delivery, care
management and personal and professional development. As well as the practice grid you
will also have an essential skills inventory for your branch (year 2 and 3) which contains a
number of skills which you are required to develop and achieve. You will be expected to
develop some of your skills within every placement, however the choice of skill development
will depend on the learning opportunities available.

Assessment
During your practice placement you will be allocated a mentor who will provide you with
support and guidance for your learning.

Your identified mentor will be responsible for assessing your nursing practice against the
identified learning outcomes and the statements within the interpersonal profile. Different
methods will be used to assess your practice. These are Direct Observation, Questioning
and Answering and Work Products.

Direct Observation (DO): Direct observation of the student is undertaken while working
under supervision of a registered nurse / registered health professional. Observation should
take place as part of the everyday normal working role of the student, and it is for the mentor
/ registered health professional to satisfy themselves that the student has achieved an
acceptable level of performance. Therefore, the majority of learning outcomes will have DO
as an assessment method.

Questioning and Answering (Q): Questioning and answering is appropriate in most areas
of assessment to assess the underpinning knowledge and level of understanding the student
is required to demonstrate in applicable situations.

Work Product (WP): Work products can be defined as sources of evidence produced by the
student within the practice placement that demonstrate their clinical ability, such as
completed care plans, moving and handling / pressure sore risk assessment tools, fluid
balance charts, written statements from other professionals.

You will be assessed in each outcome using two methods of assessment, one of
which will be direct observation unless this is not appropriate. Your mentor is responsible
for the overall assessment of your performance. However, in reality, as it will normally be
any registered nurse /registered health professional who will directly observe you


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undertaking your practice outcomes they can sign the practice grid in the direct observation
column against the appropriate outcome if they consider that you have demonstrated
achievement of the outcome. As each outcome has to be assessed using two methods the
mentor will be responsible for assessing you using one other method. The mentor MUST
sign for the second method of assessment as well as countersigning the direct observation
as evidence of your achievement of the outcome.

Active involvement in your Learning
Each practice grid contains sections where you, the student, will write the plans of
achievement. You must use these plans of achievement to show how you are going to meet
the learning outcomes which enables you to personalise your learning to meet your
individual needs. It is your responsibility to complete a plan of achievement for each of the
outcomes and to complete sections one and two of the preliminary interview schedule. The
plans of achievement must clearly state how you intend to meet your learning outcome.

Self Assessment
During your practice placement you will be expected to assess your performance against
the learning outcomes to identify your level of knowledge, understanding and ability prior to
being assessed by your mentor. You will be expected to complete the self assessment
column in the grid. Self assessment helps you to become skilled at accurately judging your
level of competence which you will be expected to know and act upon when you become a
registered nurse.

Interpersonal Profile (IP)
The interpersonal profile is divided into four sections, A, B, C and D. Each section contains
a list of minimum standards that must be achieved by you. You will be assessed against
these minimum standards normally twice during a placement. The initial assessment is to
identify your strengths or any areas of concern. The final assessment will normally take
place in the final week. If you have not achieved the minimum standards at the midway
assessment you and the mentor, together with a member of the clinical liaison team, will
then develop an action plan to help you with your identified weaknesses. To be awarded a
‘pass’ in the interpersonal profile you have to achieve ALL the minimum standards that have
been identified in the four sections. Any minimum standard not achieved by the end of the
placement will mean that you have failed the interpersonal profile and therefore fail this
module.

In addition, a further list is identified in each section which contains ‘statements of
distinction’. For students who are working consistently above the minimum standards in
aspects of their work, this can be recognised by indicating this under the appropriate
‘statements of distinction’ at the end of the placement.

Essential Skills Inventory
The Essential Skills Inventory (Branch) provides evidence of essential skills and contributes
in part to the achievement of outcome 8 in your practice grid.

Ongoing Record of Achievement
This document summarises your learning in practice and enables you and your mentor to
see at a glance the progress you are making. The ongoing record of achievement
contributes to the evidence required by your sign off mentor in your final placement, to sign
off your practice. Your summary of learning will be reviewed by your mentor during your first
interview. You must therefore ensure that you bring this document to this interview.

The summary of your learning will be completed by your mentor at the final interview. You
must therefore ensure that you have this document available at that interview.


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Failure to complete your summaries may jeopardise your progress through the course.

Attendance Record
As part of the criteria for registering to become a nurse you must demonstrate that you have
completed 2300 hours in practice (NMC 2004). As part of the assessment of your practice
module you will be required to submit a completed attendance record for each placement.
This is a record of when you attended placement including the hours worked. This must be
signed daily by the professional supervisor for that day. Your attendance record must be
reviewed and signed by your mentor at the end of the placement. You must keep a
photocopy of each attendance record before submitting it with your practice grid.

Completion of the Documentation
Timescale for completion:

You need to complete sections 1 and 2 of the preliminary interview schedule before you start
the practice placement.

Day 1 / Week 1:
The Health and Safety Check and Orientation are completed.
The mentor completes the first section of the Mentor Check List and reviews ongoing record
of achievement.
Preliminary Interview / Overseeing development of Plans of Achievement.
The mentor and you meet to discuss the learning outcomes and personal achievement plan,
identifying the learning opportunities that are available to enable you to achieve the
outcomes.

Midway Interview (where appropriate):
You will have worked with your mentor and / or other practitioners to develop knowledge,
skills and attitudes that are necessary and appropriate for achieving the outcomes, and this
interview is to discuss your progress and levels of achievement and good performance as
well as areas requiring further development. The mentor will complete the grid as
appropriate and will complete the Midway interview schedule. Where the mentor is
concerned about your progress the mentor will collaborate with you to complete and agree
action plans to support your learning needs. When the mentor deems that you are under
achieving a member of the clinical liaison team i.e. Practice Educator / Clinical Link Tutor /
Personal Tutor / Module Leader should be contacted promptly so that appropriate support
can be given. You and the mentor agree a date for meeting to discuss the final assessment
of your overall performance in relation to the grid

Final Interview
This final interview includes completing:

        All the interview schedules
        The attendance sheet including sickness and absence
        Interpersonal profile
        Learning outcomes
        The ongoing record of achievement

This should normally be done before the final day of the placement. You will be expected to
submit your completed practice grid and attendance sheet as per instructions within your
module guide.




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Criteria for Pass

          Pass in all four sections of Interpersonal Profile in the final week column
          Student writes plans of achievement for all learning outcomes
          Achievement of all identified learning outcomes (using 2 methods of assessment)
          Completed attendance record

In the event of you failing to meet this criteria your mentor will inform the practice
educators/clinical link tutor and practice module leader of this decision.

You will have opportunity to collect your practice grid after the assessment boards have
taken place. It is important that you retrieve your practice grid and file it in your portfolio.




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STUDENT CHECK LIST

At the start of the placement have you......?
                                                                        Signature of
                                                                        Student
Completed student and placement details
Completed sections 1 and 2 of the preliminary interview schedule
Swapped contact numbers if necessary
Discussed and written your plans of achievement
Discussed your Essential Skills Inventory and development
Discussed and set a date for your midway interview
Date and signed your preliminary interview
Had your ongoing record of achievement reviewed

At midway have you......?
Filled in your attendance record including any sickness or absence
Collated and presented your evidence to support your personal
plans of achievement
Made available your practice grid and essential skills inventory as a
basis for discussion of your development
Signed and dated the midway interview schedule

At the end of the practice placement have you......?

Completed your attendance record including any sickness or
absence
Collated and presented further evidence to support your personal
plans of achievement.
Made available your practice grid and essential skills inventory for
review by your mentor
Signed and dated the final interview schedule
Collected the record of signatures
Have you made available your ongoing record of achievement for
completion

Have you …….?

Handed in your practice grid and attendance record according to the
arrangements within your module guide




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MENTOR CHECK LIST:
At the start of the placement have you......?
                                                                             Signature of
                                                                             Mentor/Tick
Met with student, orientated them to the area
Introduced them to other staff
Explained shift times/breaks/uniform/local rules or policies
Planned their duty rota
Health and safety information:
FIRE
Resuscitation/emergency procedure
Policy and Procedures
Swapped contact numbers if necessary
Discussed how you will work/learn together
Agreed ground rules
Reviewed the student’s ongoing record of achievement practice grid and
essential skills inventory
Asked about their personal learning needs/ambitions/previous
experience
Worked with the student in devising plans of achievement
Discussed when and how you will meet up to discuss progress
At midway have you......?
Maintained student attendance record and noted any sickness or
absence on attendance record
Completed the midway interview in the grid
Continuously assessed your student’s performance
Given your student feedback on their progress
Reviewed essential skills inventory and given feedback
Reviewed plans of achievement for progress, including Interpersonal
Profile
Informed the student of any concerns you might have and develop an
action plan where necessary
Informed the Practice Educator of any concerns you might have
Informed the Link Tutor of any concerns you might have (if necessary)
At the end of the practice placement have you......?
Completed the final interview in the grid and given feedback and
comments to the student
Had further discussion with Practice Educator or Link Tutor (if necessary)
Completed student attendance record and noted any further sickness
and absence on attendance record
Reviewed essential skills inventory and given feedback
Completed the students ongoing record of achievement document
Received feedback on your performance as an assessor




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                                    Coventry University
                             Faculty of Health and Life Sciences
                             BSc (Hons) / Diploma in Nursing


                                PRELIMINARY INTERVIEW
What previous experience have you had?
(to be completed by student)




What expectations and concerns do you have?
(to be completed by student)




What learning opportunities are available in this placement?
(to be completed by mentor)




Student Name and Signature……………………………………Date: ………………..


Mentor Name and Signature…………………………………….Date: ………………..




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                                      MIDWAY INTERVIEW

The aim of this meeting is to meet with the student to:

          Discuss the student’s progress
          Identify the student’s strengths and achievement of learning needs
          Review plans of achievement
          If necessary, contact member of the Clinical Liaison Team for additional
          support
          Review and discuss progress re the Essential Skills Inventory

It is the student’s responsibility to provide evidence of the progress made
towards the achievement of the plans they have made.

Review progress and student generated evidence to support learning
outcomes to date




Comment on and discuss specific areas of achievement and areas requiring
further attention and development




Date of Midway Interview


Signature of Student


Signature of Mentor

Agreed date of FINAL interview




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                                           STUDENT’S ACTION PLAN: IMPROVING OUTCOMES
                            (To be used if formative assessment of Outcomes indicates Student not achieving)


     Actions required to achieve:     Support / Resources to be        Success criteria and „to be
                                               utilised:                  achieved by‟ date:



                                                                                                           Signature of Student


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



                                                                                                           Signature of Mentor


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



                                                                                                         Signature of Member of
                                                                                                          Clinical Liaison Team


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




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      Faculty of Health and Life Sciences                                                       11
YEAR TWO INTERPERSONAL PROFILE
Please complete by circling ‘pass’ or ‘fail’ against each of the minimum standards under the relevant column ie:
midway or final. In addition for students who are working consistently above the minimum standards in aspects
of their work please indicate by circling a ’D’ under the appropriate ‘statement of distinction’.
Section A – PROFESSIONALISM – Minimum Standards                                     Midway        Final Week
Meets the professional expectations for a second year student nurse             Pass       Fail     Pass    Fail
Reliable and punctual, good time management                                     Pass       Fail     Pass    Fail
Practice is underpinned by professional codes of conduct and organisational Pass           Fail     Pass    Fail
policies
Takes responsibility appropriate for a second year student nurse                Pass       Fail     Pass    Fail
Demonstrates appropriate social, cultural, religious and ethical sensitivity    Pass       Fail     Pass    Fail
Respects patient dignity at all times                                           Pass       Fail     Pass    Fail
OUTCOME                                                                         PASS FAIL          PASS     FAIL
STATEMENT OF DISTINCTION
Applies concepts of professional nursing                                                             D
Consistently works at a higher level than expected                                                   D
Section B – PERSONAL QUALITIES AND APROACH TO LEARNING – Minimum Standards
Displays an empathic, kind and positive caring attitude                          Pass      Fail      Pass    Fail
Recognises own learning needs and writes plans of achievement                    Pass      Fail      Pass    Fail
Utilises constructive criticism and/or complaints positively                     Pass      Fail      Pass    Fail
Shows self awareness and evaluates the effect of their behaviour on others Pass            Fail      Pass    Fail
Identify and uses learning opportunities                                         Pass      Fail      Pass    Fail
Assimilates new information appropriately                                        Pass      Fail      Pass    Fail
Well motivated and adaptable and maintains work life balance                     Pass      Fail      Pass    Fail
Actively engages in personal reflection and supervision seeking support as Pass            Fail      Pass    Fail
necessary
OVERALL OUTCOME                                                                 PASS FAIL            PASS FAIL
STATEMENTS OF DISTINCTION
Offers informed and considered opinions                                                              D
Innovative, develops fresh ideas                                                                     D
Analytical in approach, drawing from a wide range of sources                                         D
Section C – PRACTICAL PERFORMANCE – Minimum Standards
Demonstrates a positive contribution to practice                                 Pass      Fail     Pass     Fail
Demonstrates confidence appropriate to a second year student nurse               Pass      Fail     Pass     Fail
Capable of informed decision making appropriate for a second year student Pass             Fail     Pass     Fail
nurse
Accepts appropriate responsibility and works within professional boundaries Pass           Fail     Pass     Fail
OVERALL OUTCOME                                                                 PASS FAIL          PASS     FAIL
STATEMENTS OF DISTINCTION
Acts on initiative appropriate to a second year student nurse                                          D
Consistently works to a higher level than expected                                                     D
Realistically evaluates own performance                                                                D
Section D – TEAM WORKING – Minimum Standards
Has worked flexibly to make an effective contribution to the work of the team Pass         Fail       Pass Fail
Contributes effectively to the work of the team                                  Pass      Fail       Pass Fail
Demonstrates ability to work as a member of the nursing team                     Pass      Fail       Pass Fail
Communicates effectively with members of the team appropriate for a Pass                   Fail       Pass Fail
second year student nurse
OVERALL OUTCOME                                                                 PASS FAIL            PASS FAIL
STATEMENTS OF DISTINCTION
Initiates appropriate information with members of the team                                             D
A valued team member who has gained respect                                                            D
TOTAL NUMBER OF DISTINCTIONS
Signature of Mentor                                                 Signature:
(Please sign and date at Midway and at Final Week)                        Date:
 OUTCOME Minimum Standards               PASS       FAIL         Signature of Mentor
 Total number of Distinctions                                    Signature of Mentor
  Signature of Student:                                    Date:
NB: ANY FAIL IN THE FINAL WEEK COLUMN WILL REQUIRE THE STUDENT TO HAVE A
SECOND ATTEMPT AT THIS MODULE. FAIL AT SECOND ATTEMPT WILL RESULT IN THE
STUDENT FAILING STANDARD FOR THE COURSE.

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                               STUDENT’S ACTION PLAN: IMPROVING INTERPERSONAL SKILLS PROFILE
                                   [To be used if formative assessment of IP indicates any FAIL statements]



                                   Support / Resources to be            Success criteria and
Actions required to achieve:
                                   utilised:                            “to be achieved by” date:
                                                                                                              Signature of Student

                                                                                                              ………………………



                                                                                                              Signature of Mentor

                                                                                                              ………………………



                                                                                                              Signature of Member of
                                                                                                              Clinical Liaison Team

                                                                                                              ………………………




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DOMAIN: Professional and Ethical Practice
        Manage oneself, one’s practice, and practice of others, in accordance with NMC code of professional conduct, standards for conduct, performance and ethics,
1       recognising one’s own abilities and limitations
                                                                               Student Self-
Minimum of 2 methods of assessment required to assess                                                       DO                   Q                    WP
                                                                               Assessment
each outcome, e.g. DO & Q; WP & Q
                                                                               Date / Sign                  Date / Sign          Date / Sign          Date / Sign
Practises in
accordance with
the NMC’s Code of
Professional
Conduct: standards
for conduct,          Guidance: Demonstrates an understanding of the
performance and       NMC Code of Professional Conduct and practises
ethics                accordingly / is able to identify own needs to improve
Consults with a       skills and knowledge / knows when to refer and to
registered nurse      whom
when nursing care
requires expertise
beyond student’s
own current scope
of competence


                                               STUDENT’S PLAN FOR ACHIEVEMENT OF OUTCOMES
                                                                                                                Success criteria and
Actions required for achievement                       Support / Resources to be utilised
                                                                                                                “to be achieved by” date




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DOMAIN: Professional and Ethical Practice
2       Practise in accordance with an ethical and legal framework which ensures primacy of patient and client interest and well-being and respects confidentiality
                                                                                  Student Self-
Minimum of 2 methods of assessment required to assess                                                         DO                    Q                    WP
                                                                                  Assessment
each outcome, e.g. DO & Q; WP & Q
                                                                                  Date / Sign                 Date / Sign           Date / Sign          Date / Sign
                       Guidance: Demonstrates an awareness of the
Acts appropriately     individual’s values and beliefs / acts in an appropriate
when seeking           manner within the client’s own home / gains consent
access to caring for   and shows awareness of who is able to give consent
patients and clients   fore a client / introduces oneself appropriately to
                       clients and families/ speaks appropriately.
                       professionally and tactfully to clients and families

                                                 STUDENT’S PLAN FOR ACHIEVEMENT OF OUTCOMES
                                                                                        Success criteria and
Actions required for achievement                     Support / Resources to be utilised
                                                                                        “to be achieved by” date




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DOMAIN: Care Delivery
4       Engage in, develop and disengage from therapeutic relationships through the use of appropriate communication and interpersonal skills
                                                                               Student Self-
Minimum of 2 methods of assessment required to assess                                                       DO                   Q              WP
                                                                               Assessment
each outcome, e.g. DO & Q; WP & Q
                                                                               Date / Sign                  Date / Sign          Date / Sign    Date / Sign


                      Guidance: Using communication strategies that are
                      appropriate for the individual client’s ability /
Utilises a range of   communicating at an appropriate level for client’s and
effective and         their families, other disciplines and agencies /
appropriate           demonstrating awareness of “need to know” / using
communication and     and giving response to verbal and non-verbal
engagement skills     communication / effective use of interpreters / knows
                      how to access written information e.g. health
                      promotion materials



                                               STUDENT’S PLAN FOR ACHIEVEMENT OF OUTCOMES
                                                                                                                Success criteria and
Actions required for achievement                      Support / Resources to be utilised
                                                                                                                “to be achieved by” date




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DOMAIN: Care Delivery
5       Create and utilise opportunities to promote the health and well-being of patients, clients and groups
                                                                                   Student Self-
Minimum of 2 methods of assessment required to assess                                                           DO            Q             WP
                                                                                   Assessment
each outcome, e.g. DO & Q; WP & Q
                                                                                   Date / Sign                  Date / Sign   Date / Sign   Date / Sign
Consults
sensitively with
patients, clients and
groups to identify
their need and
desire for health
promotion advice
Provides relevant
and current health
information to          Guidance: Giving education one to one / giving
patients, clients and   appropriate lifestyle advice / facilitating the health
groups in a form        education of clients and educating carers and families /
which facilitates       knows how and why specialists may be contacted and
their understanding     the appropriate channels of referral to do so
and acknowledges
choice/individual
preference
Provides support
and education in
the development
and/or maintenance
of independent
living skills
Seeks
specialist/expert
advice as
appropriate




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                                   STUDENT’S PLAN FOR ACHIEVEMENT OF OUTCOMES
                                                                            Success criteria and
Actions required for achievement       Support / Resources to be utilised
                                                                            “to be achieved by” date




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DOMAIN: Care Delivery
        Undertake and document a comprehensive, systematic and accurate nursing assessment of the physical, psychological, social and spiritual needs of patients,
6       clients and communities
                                                                               Student Self-
Minimum of 2 methods of assessment required to assess                                                        DO                   Q                    WP
                                                                               Assessment
each outcome, e.g. DO & Q; WP & Q
                                                                               Date / Sign                   Date / Sign          Date / Sign          Date / Sign

Analyses and          Guidance: Records observations accurately, knowing
interprets data       when and how to respond / using appropriate
accurately to         recording charts / Incorporating client, carer’s and
inform nursing care   family’s beliefs into care and treatment plans /
and to take           contributes to reports/referrals for other agencies,
appropriate action    disciplines, sectors e.g. social services


                                               STUDENT’S PLAN FOR ACHIEVEMENT OF OUTCOMES
                                                                                      Success criteria and
Actions required for achievement                   Support / Resources to be utilised
                                                                                      “to be achieved by” date




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DOMAIN: Care Delivery
         Formulate and document a plan of care, where possible, in partnership with patients, clients, their carers and family and friends, within a framework of
7        informed consent
                                                                                Student Self-
Minimum of 2 methods of assessment required to assess                                                             DO                   Q                   WP
                                                                                Assessment
each outcome, e.g. DO & Q; WP & Q                                               Date / Sign                       Date / Sign          Date / Sign         Date / Sign
Can identify the
need to establish
priorities for care
based on individual
or group needs
Understands the
need to develop
and document a
plan of care based
on assessment and
current nursing       Guidance: Use of common assessment framework /
knowledge             assesses all aspect of client’s life I.e. physical,
Recognises the        psychological and social history / contributes to action
need to identify      planning of care or treatment plans / contributes to
expected outcomes, implementation and reassessment of care planning /
taking account of     contributes to audit and/or clinical practice
patients strengths,   benchmarking
including a time
frame for
achievement of
their goals and/or
review alongside
patients, clients,
carers, family and
with members of
the inter-
professional team




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                                   STUDENT’S PLAN FOR ACHIEVEMENT OF OUTCOMES
                                                                            Success criteria and
Actions required for achievement       Support / Resources to be utilised
                                                                            “to be achieved by” date




644.2 doc   January 2010                                                                               20
DOMAIN: Care Delivery
8       Based on the best available evidence, apply knowledge and an appropriate repertoire of skills indicative of safe and effective nursing practice
                                                                              Student Self-
Minimum of 2 methods of assessment required to assess                                                          DO                    Q                    WP
                                                                              Assessment
each outcome, e.g. DO & Q; WP & Q                                             Date / Sign                      Date / Sign           Date / Sign          Date / Sign
                      Guidance: Is aware of guidelines and changes to
Can identify and      guidelines concerning clinical; procedures / teaching
respond to patients’ any procedures and changes to other practitioners,
and clients’          agencies, carers / demonstrates the use of evidence-
continuing learning based practice / demonstrates understanding of the
and care needs        need to use current and up-to-date practice /
                      understands why current information is needed to
                      inform practice
                      Refer to Essential Skills Inventory for examples.




                                                STUDENT’S PLAN FOR ACHIEVEMENT OF OUTCOMES
                                                                                       Success criteria and
Actions required for achievement                    Support / Resources to be utilised
                                                                                       “to be achieved by” date




644.2 doc   January 2010                                                                                                                                         21
DOMAIN: Care Delivery
10      Evaluate and document outcomes of nursing and other interventions
                                                                                   Student Self-
Minimum of 2 methods of assessment required to assess                                              DO            Q             WP
                                                                                   Assessment
each outcome, e.g. DO & Q; WP & Q
                                                                                   Date / Sign     Date / Sign   Date / Sign   Date / Sign
Recognises the
need to collaborate
with patients and
clients, and when
appropriate
additional carers, to
review and monitor
the progress of
individuals or
                        Guidance: Contributes to the care planning process
groups towards
                        that is formulated with the patient and carer (as
planned outcomes
                        appropriate) / Informs others of changes in treatment /
Identifies that
                        contributes to the evaluation process of care/treatment,
expected outcomes,
                        including others / able to recognise changes and take
nursing
                        appropriate action
interventions and
priorities should be
analysed and
revised in
accordance with
changes in an
individual’s
condition, needs or
circumstances




644.2 doc   January 2010                                                                                                            22
                                   STUDENT’S PLAN FOR ACHIEVEMENT OF OUTCOMES
                                                                          Success criteria and
Actions required for achievement       Support / Resources to be utilised
                                                                          “to be achieved by” date




644.2 doc   January 2010                                                                             23
DOMAIN: Care Management
12      Contribute to public protection by creating and maintaining a safe environment of care through the use of quality assurance and risk management strategies
                                                                                  Student Self-
Minimum of 2 methods of assessment required to assess                                                        DO                   Q                     WP
                                                                                  Assessment
each outcome, e.g. DO & Q; WP & Q
                                                                                  Date / Sign                Date / Sign          Date / Sign           Date / Sign
Uses appropriate
risk assessment        Guidance: Generic and individual risk assessment /
tools to identify      knowledge of environmental safety / demonstrates
actual and potential   development of the ability to judge potential risk
risks                  situations and to justify and clarify reasons for this /
Identifies             has developed a knowledge of the methods used to
environmental          lessen risks/ safe handling of infected materials /
hazards and            awareness of infection control procedures and policies
eliminates and/or      / identifies why environments may need assessment for
prevents them          suitability prior to commencing treatments
where possible

                                                 STUDENT’S PLAN FOR ACHIEVEMENT OF OUTCOMES
                                                                                        Success criteria and
Actions required for achievement                     Support / Resources to be utilised
                                                                                        “to be achieved by” date




644.2 doc   January 2010                                                                                                                                       24
DOMAIN: Care Management
        Demonstrate knowledge of effective inter-professional working practices which respect and utilise the contributions of members of the health and social care
13      team
                                                                                Student Self-
Minimum of 2 methods of assessment required to assess                                                         DO                   Q                    WP
                                                                                Assessment
each outcome, e.g. DO & Q; WP & Q
                                                                                Date / Sign                   Date / Sign          Date / Sign          Date / Sign
Establishes and
maintains
                      Contributes to team meetings / works alongside other
collaborative
                      health and social care professionals / identifies the
working
                      need for referral including how and when to refer /
relationships with
                      shows awareness of other agencies, disciplines etc.
members of the
health and social
care team and
others

                                               STUDENT’S PLAN FOR ACHIEVEMENT OF OUTCOMES
                                                                                      Success criteria and
Actions required for achievement                   Support / Resources to be utilised
                                                                                      “to be achieved by” date




644.2 doc   January 2010                                                                                                                                         25
DOMAIN: Care Management
15       Demonstrate key skills
                                                                               Student Self-
Minimum of 2 methods of assessment required to assess                                          DO            Q             WP
                                                                               Assessment
each outcome, e.g. DO & Q; WP & Q
                                                                               Date / Sign     Date / Sign   Date / Sign   Date / Sign
Information
technology and
management- Can
interpret and utilise   Guidance: Computerised drug calculation and
data and                administration / use of electronic equipment such as
technology, taking      syringe drivers, feeding pumps / uses computer
into account legal,     technology to obtain investigation results / uses
ethical and safety      electronic media to locate and access evidence and
considerations, in      information to inform care
the delivery and
enhancement of
care

                                                 STUDENT’S PLAN FOR ACHIEVEMENT OF OUTCOMES
                                                                                        Success criteria and
Actions required for achievement                     Support / Resources to be utilised
                                                                                        “to be achieved by” date




644.2 doc    January 2010                                                                                                       26
DOMAIN: Personal and Professional Development
        Demonstrate a commitment to the need for continuing professional development and personal supervision activities in order to enhance knowledge, skills,
16      values and attitudes needed for safe and effective nursing practice
                                                                                 Student Self-
Minimum of 2 methods of assessment required to assess                                                       DO                   Q                    WP
                                                                                 Assessment
each outcome, e.g. DO & Q; WP & Q
                                                                                 Date / Sign                Date / Sign          Date / Sign          Date / Sign
Is able to identify
own learning needs
by reflecting on
practice
                       Guidance: Participates in peer and mentor clinical
experiences
                       supervision / helps to formulate action plans from
Shares experiences
                       supervision sessions / demonstrates an awareness of
with colleagues and
                       own strengths and weaknesses and takes appropriate
patients and clients
                       action to overcome weaknesses / participates in one to
to identify
                       one supervision / demonstrates an understanding of
additional
                       clinical governance / contributes to near miss analysis
knowledge and
skills needed to
manage unfamiliar
situations



                                                STUDENT’S PLAN FOR ACHIEVEMENT OF OUTCOMES
                                                                                       Success criteria and
Actions required for achievement                    Support / Resources to be utilised
                                                                                       “to be achieved by” date




644.2 doc   January 2010                                                                                                                                      27
28                                                    Faculty of Health and Life Sciences


FINAL INTERVIEW – at end of 12 weeks

The aim of this final meeting is to meet with the student and:

        Review and discuss the overall achievements of the student
        Comment on the student’s overall performance in relation to the
        plans of achievement for NMC outcomes
        Comment on the student’s attitude as identified by the IP
        Check that documentation is complete
        Review and discuss progress re the Essential Skills Inventory
        Review and summarise learning needs and please document in the
        student’s Record of Achievement (ORA)

Summarise student’s ongoing learning achievement




Date of Interview


Signature of Student




644.2 doc                                                                  January 2010
Faculty of Health and Life Sciences                                                                      29




                                       MENTOR MARKING SHEET

                                      ADULT PRACTICE 2 (BRANCH)


STUDENT NAME: _______________________                  COHORT: ___________________



CRITERIA FOR PASS (please complete by circling yes or no)

Did student pass all four sections of interpersonal profile in final             Yes                  No
week column

Did student write plans of achievement                                           Yes                  No

Did the student achieve all the identified outcomes (using 2                     Yes                  No
methods of assessment)

Has the Ongoing Record of Achievement been completed by                          Yes                  No
mentor (including signature)



The overall outcome of this placement is:                                   PASS                FAIL




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




644.2 doc                                                                                    January 2010
30                                                      Faculty of Health and Life Sciences


            Link Tutor / Practice Educator - Facilitator Comments




Signature                                        Date




Signature                                        Date




Signature                                        Date




Signature                                        Date




Signature                                        Date




644.2 doc                                                                    January 2010
Faculty of Health and Life Sciences                                31

Record of Signatures

NAME (PRINT)                      SIGNATURE   INITIALS   CLINICAL
                                                         AREA




644.2 doc                                                 January 2010

				
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