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Return to Practice Practice Assessment Document (PAD)(Adult Nursing)Student Name______________________________________________________Start Date__________________________________________________________Practice Placement __________________________________________________Practice Hours to be completed_______________________________________IntroductionThis Assessment of Practice Document records the student’s progression and achievement of their practice competencies throughout the programme. It also provides information concerning the roles and responsibilities within the assessment process.This Assessment of Practice Document includes:-Glossary of termsA step by step guide to the Assessment ProcessPractice Learning AgreementRoles and ResponsibilitiesLearning ContractsCriteria for AssessmentThe assessment of practice document (APD)Records of Formative discussionSummative discussionTripartite discussionsFlow charts to illustratePractice Assessment Process‘Assessing my student’s progress’Process for Raising and Escalating ConcernsForm PIR [1]Glossary of TermsIndependent PracticeThe ability to practice at the level described within the competency statement without direct supervision, whilst recognising the limits of one’s own ability and seeking appropriate support and advice when required. SupportThe provision of guidance and learning opportunities to facilitate the achievement of the practice competencies.Direct SupervisionObservation of the student performing an activity (this may be on a one-to-one basis or part of group activity)MentorSign off mentorAn appropriately qualified individual identified to supervise and assess your practice competenceA mentor qualified to sign you off as competent to return to the professional registerProgramme DirectorThe academic leader of the Return to Practice Course. They are the first contact for queries relating to the module.Practice PlacementA department or practice area which supports your learning in practice.Formative discussionConstructive feedback given on the student’s progress towards the learning outcomesSummative discussionTripartite meetingFinal summary that provides the student with constructive feedback to inform their future learning experiencesMeeting between sign off mentor, student and tutor to review progressSummaries of meetingsAs part of the placement experience it is expected that the mentor and student will have formal initial, mid placement and end of placement interviews. At the initial meeting a learning contract should be agreed with review dates and a summary of the appropriate learning opportunities documented. A formative discussion of progress made towards the learning outcomes and competencies is discussed with the student in the mid-placement meeting with any constructive feedback that provides the student with a clear picture of their strengths and areas for development in relation to the competencies. Midway during the placement the student will arrange a date for a tripartite meeting between tutor, sign off mentor and student. The learning contract should be revised as appropriate and a summary of these meetings should be documented and signed by the mentor and student. The final meeting should contain a summary of the summative assessment that provides the student with constructive feedback that can be used to inform their future learning experiences. IMPORTANT PLEASE NOTE: ALL competencies MUST be initialled by the Mentor/sign off mentor at both formative and summative stages. Failure to do so will result in a fail. The final summative column MUST be signed and dated by the sign off mentor for all competencies in order to verify the pass or fail in each competency. ALL initials and signatures must be fully recorded in the record of signatures.Step by Step guide to the Assessment of Practice Process (APD)The process for ‘Assessment of Practice’ can be found on page 37.Step 1 The student completes the first section of their Learning Contract (p.11)Step 2 The Mentor and Student read and agree the ‘Learning and Assessment Agreement’ (p. 5)Step 3The Mentor and Student agree appropriate learning experiences to support achievement of the learning contract and practice competencies. They complete the second section of the Learning Contract and summarize the discussion in the Record of Meetings (p.13).Step 4Set date for ‘Formative’ discussion and tripartite meeting. These meetings should be approximately mid-way through the placement.Step 5Ongoing informal feedback will be given to support achievement of competencies.Step 6The student ticks on the APD in pencil whether they consider that they are practising the competencies detailed within the APD Independently or dependently for the formative assessment. The mentor confirm this or otherwise by initialling each competency as appropriate at formative and summative meetings.Step 7The Mentor uses student self-assessment as a basis for discussion within the Formative assessment. Mentor identifies whether the student is practising independently or dependently and summarizes comments to guide student development in the Record of Meetings.Step 8 Review and update the learning contract based on the discussions within Step 7Step 9Date for summative discussion and assessment is planned and documented.Step 10The student ticks in pencil on the APD whether they consider they have passed the competencies detailed within the APD, completes the diary of experience to demonstrate competence and writes their summative self-assessment in the box provided (see p 15).The mentor uses the student self-assessment as a basis for discussion within the Summative assessment. The mentor documents whether or not the student has passed the competencies, i.e. is practising independently, as detailed within the APD and Criteria for Assessment and provides constructive feedback in the box provided. The learning contract should also be signed to say that achievement has been agreed.Guidance on completion of the APTCOMPETENCY STATEMENTEssential skill cluster (ESC, 2010)):Care, Compassion and Communication ESC reference in redFormative AssessmentMidway (initial and date)Summative Assessment placement end(initial and date)Mentor please provide constructive feedback regarding individual aspects of competence. Final Summative assessmentSign off Mentor Signature and dateIndependentDependentPassFail11Demonstrates clinical confidence through sound knowledge, skills and understandingPlease use in conjunction with the levels of performance table and negotiate equivalent examples of skills in the learning contract where the specific example given is not appropriate to your practice areaIn this section the mentor can describe the progress the student has made, identify where evidence to support the assessment can be found and comment on why they have assessed the student as meeting or not meeting the standard required.The mentor’s initials/signature and date can be referenced against the record of signatories earlier in the documentEvidence to support Assessment of Practice LearningLevels of PerformanceIt is the student’s responsibility to provide evidence to the mentor that they are able to demonstrate skills and knowledge with a consistency and autonomy which will be sustained in future practice. Evidence must include the mentor’s own observations of the students but can be supported by the written or verbal testimony of others and the student’s ability to reflect on their practiceKnowledge and understandingDemonstrates a working understanding of the wider factors that underpin and impact on effective nursing practice and applies relevant knowledge and skills to more complex and unexpected situationsProblem-solving skillsDemonstrates sound problem-solving skills and clinical judgement to more complex and demanding clinical problems.Values and attitudesTakes an active role in leading own learning experience. Can interact effectively with patients, families and colleagues in more demanding situations. Acknowledges and works within the boundaries of their knowledge, skills and level of education. Manages and develops their own practice and that of others in accordance with the NMC (2008) Code of conduct. Clinical skillsPerforms core skills safely and more complex skills with minimal supervision and is able to guide a junior nurse to undertake essential core skillsPassing / Failing the studentStudents are required to pass all practice outcomes/competencies. If at any point the Mentor or student is concerned that the required standard will not be met for either the Formative or Summative assessment reference should be made to the Flow charts on pages 36 & 37 for advice on appropriate action to be taken. Orientation to practice placements The following has been explained / discussed / demonstrated to the satisfaction of both Mentor and student:Mentor initial and dateStudent initial and dateLayout of the clinical area Procedure in the event of FireWhat to do in the event of a collapse, cardiac or respiratory arrestMoving and Handling of people and equipmentAwareness of policies specific to the area of practice General information, shift patterns, members of team etc.Record of SignaturesThis document forms a record of the student’s competence. The ‘sign off’ mentor has overall responsibility for signing the student off as competent at the end of their placement. There may be other individuals involved in the assessment or feedback given to the student. For identification purposes, please write your name, signature and initials along with your job title in the boxes below:NameSignatureInitialsRegistration part e.g. RN adult nursing.Date of last mentor update;Date of last triennial review;Sign – off mentor;OthersStatus: mentor/sign off mentor/RN Practice Learning and Assessment AgreementStudent:Mentor:Area or Practice:Dates and Duration of Placement:Roles and Responsibilities:Student:Have a clear understanding of the learning outcomes and practice competencies for the moduleAssess your existing knowledge and skill and establish a baseline upon which to build a learning contractTo take advantage of learning opportunities and to review Learning Contract regularlyGain the necessary clinical experience to achieve the Practice CompetenciesTo provide evidence of competence in relation to the APDAlert Programme Director/Personal Tutor and Sign off Mentor if problems arise with the placement that might prevent progress or satisfactory completion.To arrange Tripartite meeting half way through placement.Mentor:Have a clear understanding of the learning outcomes and practice competencies for the module and is on the same part of the register as the student with due regard.Assist in the construction of an appropriate learning contract to enable the development of the student’s practiceFacilitate learning in line with the agreed plan Verify the evidence demonstrated through the APDMeet regularly (at least 3 times) to provide constructive feedback on progressSign off mentor:Review student progress and competences midway and end of placementMaintain an overview of achievement and professionalism in line with the standards for entering the professional register (NMC, 2010)Initiate tripartite meeting if any concerns.Sign the student off as competent to return to the professional register.Programme Director:Discuss the requirements of the module with the student and offer support for the assessment requirementsLiaise with and support the MentorEnsure adequacy of the learning environmentDate Learning agreement agreed:Student:Sign off Mentor:Co mentor:…………………………………………………………………………Hours to be completedThe numbers of hours a student will need to complete to reactivate their professional registration is determined by the number of years the student has been out of practice. Ultimately, the numbers of hours required will be a decision of the Programme Director in consultation with the student’s practice mentor and the University tutor. The table below provides a guideline. Years out of practiceMinimum practice hours required0 - 51006 – 1010011-1515016 – more200RETURN TO PRACTICETIME SHEET FOR SUPERVISED PRACTICE Student…………………………..Placement………………………...Hours to be completed…………………….WeekHours workedSupervisor SignatureStudent SignatureRunning TotalWeekHours workedSupervisor SignatureStudent SignatureRunning Total Total hours completedDiary of events and skills completedDateDiary of experienceDiary of experienceLearning contract Learning needs to achieve the practice competency:Learning needs to achieve the practice competencySpecific Actions that will meet learning needs:Specific Actions that will meet learning needs:Achievement Agreed(Signed and dated by Mentor+ Student)Achievement Agreed(Signed and dated by Mentor + Student)Date Learning Contract agreed:Mentor Signature:Student Signature:Record of Meetings and Feedback on Assessment of Practice Date for Initial meeting and development of learning contract:Summary of discussion:Mentor signature:Student signature:Date:Date for Mid-course meeting:Summary of Formative Feedback:Mentor signature:Student signature:Date:Date for Tripartite review meeting:Summary of progress:Mentor signature:Student signature:Tutor signature:Date:Date for final meeting:Student Self AssessmentSummary of Summative Feedback:Mentor signature:Student signature: Date:Criteria for Assessment: “All nurses must practice autonomously, compassionately, skilfully and safely and must maintain dignity and promote health and wellbeing” (NMC, 2010) (Standards for preregistration nurse education)Conditions of practice for the achievement of clinical competenciesLevel of performanceLevel of supervision/supportIndependentDependentIndependentPractices without direct supervision whilst recognising the limits of own ability and seeking appropriate support and advice when required.Practice is consistently safe, accurate & effective within each competency. Performance is skilful, co-ordinated and confident with economical use of time.Focuses primarily on the patient (rather than the task).Demonstrates responsive interpersonal skills.Is self directing & offers cues to assist others whilst achieving competency.Evaluates the use of the evidence base for practice.Omissions or inaccuracies are evident in performance.Lacks skill or co-ordination in performance of the competency. Demonstrates a lack of focus on patient needs.Demonstrates inappropriate interpersonal skills.Requires directive or supportive cues.Cannot articulate the evidence base for PETENCY STATEMENTEssential skill cluster (ESC, 2010)):Care, Compassion and CommunicationNB.Some competences may not be achievable in all areas. Essential competencies are asterixed. ESCFormative AssessmentMidway (initials and date)Summative Assessment placement end(initials and date)Mentor please provide constructive feedback regarding individual aspects of competence. Final Summative assessmentSign off Mentor Signature and dateIndependentDependentPassFail11Demonstrates clinical confidence through sound knowledge, skills and understanding21Articulates the underpinning values of the NMC(2008) The Code: Standards of conduct, performance and ethics for nurses and midwives32Takes a person centred approach to care, empowering individuals to make choices and works in partnership with patients, carers and familiesCOMPETENCY STATEMENTEssential skill cluster (ESC):Care, Compassion and Communication ESCFormative Assessment (initials and date)Summative Assessment (initials and date)Mentor please provide constructive feedback regarding individual aspects of competence. Final Summative assessmentMentor Signature and dateIndependentdependentPass Fail44Is proactive in maintaining dignity55Respects diversity and individual preference and uses appropriate strategies to empower and support choices for vulnerable or compromised patients.65Manages and diffuses challenging situationsCOMPETENCY STATEMENTEssential skill cluster (ESC):Care, Compassion and Communication ESCFormative Assessment (initials and date)Summative Assessment (initials and date)Mentor please provide constructive feedback regarding individual aspects of competence.Final Summative assessmentSign off Mentor Signature and dateIndependentDependentPassFail76Communicates effectively and sensitively in different settings, providing information that is clear, accurate, meaningful and free of jargon87Applies the principles of confidentiality98Works within legal frameworks when seeking consent and shares information according to agreed safeguarding and protection policies10Promote patient/carer individuality, informed choice and independenceCOMPETENCY STATEMENTEssential skill cluster (ESC):Organisational aspects of care ESCFormative Assessment (initials and date)Summative Assessment (initials and date)Mentor please provide constructive feedback regarding individual aspects of competence.Final Summative assessmentSign off Mentor Signature and dateIndependentDependentPassFail119Act autonomously and takes responsibility for collaborative assessment and planning of care delivery with the patient, their carers/family.1210Applies research based evidence to practice1313Responds appropriately when faced with an emergency or deterioration in a patients physical or psychological conditionArea of CompetenceEssential skill cluster:Organisational aspects of care ESCFormative Assessment (initials and date)Summative Assessment (initials and date)Mentor please provide constructive feedback regarding individual aspects of competence.Final Summative assessment Sign off Mentor Signature and dateIndependentDependentPassFail1414Promotes health and well being , self care and independence in coping with effects of treatment, ongoing condition including death and dying1515Measures, ,documents and interprets vital signs and acts autonomously and appropriately on findings.,1616Delivers nursing interventions safely and effectively, prioritising the needs of individuals.1717Detects, reports and records information taking appropriate action. 1817Evaluates the effect of interventions, taking account of physical, emotional and behavioural changes, involving patient/carer in plan of careArea of CompetenceEssential skill cluster:Organisational aspects of care ESCFormative Assessment (initials and date)Summative Assessment (initials and date) Mentor please provide constructive feedback regarding individual aspects of competence.Final Summative assessmentSign off Mentor Signature and dateIndependentDependentPassFail 1918Recognise and respond when adults or children are in vulnerable situations and at risk or in need of support or protection2019Works within legal frameworks and applies evidence based practice in the safe selection and use of medical devices.2120Can select and apply appropriate strategies and techniques for conflict resolution and de-escalation Area of CompetenceEssential skill cluster:Infection prevention and control ESCFormative Assessment (initials and date)Summative Assessment (initials and date) Mentor please provide constructive feedback regarding individual aspects of competence.Final Summative assessmentSign off Mentor Signature and dateIndependentDependentPassFail 2321Recognises infection risk and reports and acts in situations where there is need for health promotion and protection and public health strategies2422Maintains effective standard infection control precautions and apply and adapt these to needs and limitations in all environments.2523Assesses the needs of the infectious person, or people and applies appropriate isolation techniques.2624Adheres to local policy and national guidelines on dress code for prevention and control of infection,2725Applies a range of appropriate measures to prevent infection including application of safe and effective aseptic technique.2826Manages hazardous waste and spillages in accordance with local health and safety policies.Area of CompetenceEssential skill cluster:Nutrition and fluid management ESCFormative Assessment (initials and date)Summative Assessment (initials and date) Mentor please provide constructive feedback regarding individual aspects of competence.Final Summative assessmentSign off Mentor Signature and dateIndependentDependentPassFail2927Supports people to make appropriate the choices and changes to eating patterns, taking account of dietary preferences, religious and cultural requirements, treatment requirements and special diets needed for health reasons.3028Takes and records accurate measurements of weight, height, length, body mass index and other appropriate measures of nutritional status. 3128Makes a comprehensive assessment of people’s needs in relation to nutrition identifying, documenting and communicating level of risk. 3229Uses communications skills to encourage people who might be reluctant to drink to take adequate fluids. 3329Identifies signs of dehydration and acts to correct these. 3430Create an environment conducive to eating and drinking3531Works within legal and ethical frameworks taking account of personal choice but takes action to ensure that, where there are problems with eating and swallowing, nutritional status is not compromised. 3632Understands intravenous fluids and how they are prescribed and administered within local administration of medicines policy.Area of CompetenceEssential skill cluster:Medicines Management ESC.Formative Assessment (initials and date)Summative Assessment (initials and date) Mentor please provide constructive feedback regarding individual aspects of competence.Final Summative assessmentSign off Mentor Signature and dateIndependentDependentPassFail3733Is competent in drug calculations required to administer medicines safely via appropriate routes including specific requirements for different patient groups..3834Applies legislation to practice to safe and effective ordering, receiving, storing administering and disposal of medicines and drugs, including controlled drugs in both primary and secondary care settings and ensures others do the same.3935Works confidently as part of the team and, where relevant, as leader of the team to develop treatment options and choices with the person receiving care and their carers.4036Safely manages drug administration and monitors effects. 4137Orders, receives, stores and disposes of medicines safely (including controlled drugs).4238Safely and effectively administers and, where necessary, prepares medicines via routes and methods commonly used and maintains accurate records. Area of CompetenceEssential skill cluster:Medicines Management ESCFormative Assessment (initials and date)Summative Assessment (initials and date)Mentor please provide constructive feedback regarding individual aspects of competence.Final Summative assessmentSign off Mentor Signature and dateIndependentDependentPassFail4339Effectively keep records of medication administered and omitted, in a variety of care settings, including controlled drugs and ensures others do the same.4440Assists people to make safe and informed choices about their medicines.4541Demonstrates knowledge and application of the principles of administration under patient group directiveArea of CompetenceLeadership management and team working (NMC, 2010) Formative Assessment (initials and date)Summative Assessment (initials and date)Mentor please provide constructive feedback regarding individual aspects of competence.Final Summative assessmentSign off Mentor Signature and dateIndependentDependentPassFail46Can lone work safely and manage a case load47Promotes recovery and communicates optimism to patients and carers48Demonstrate personal accountability for practice, acknowledge limitations and seek guidance where appropriate49Be aware of nursing audit/evaluation methods and standards for clinical areaFINAL ASSESSMENT OF PROFICIENCYSign off Mentor Declaration:I confirm that Return to Practice student……………………………………HAS/HAS NOT* provided sufficient evidence to demonstrate that the NMC standards of proficiency for entrance to the register have been achieved.*Please delete as necessaryFINAL OUTCOME (please specify): PASS / FAIL Sign off mentor name (print):Full Signature: Date:Workplace: Summary of Tripartite assessment meetings (Tutor/Mentor/Student) For use when the mentor has raised concernsDate:Signatures:Date:Signatures:Action Plan to be completed if concerns are expressed during the assessment processIssue to be addressedAction to be takenBy whom and by whenRaising and escalating concerns for students on placementsPlease see the following link: part of your induction to the placement you will have familiarised yourself with the placement providers policy for ‘Raising and Escalating Concerns’-74739593345Assessing my students’ progress4000020000Assessing my students’ progress50806354182110NO00NO14859004733925NO (Dependent)00NO (Dependent)-2286001762125If student is making satisfactory progress in all areas, give constructive feedback to encourage further development.Update assessment documentation00If student is making satisfactory progress in all areas, give constructive feedback to encourage further development.Update assessment documentation342899324802500571499256222500-3429002790825SUMMATIVE ASSESSMENT00SUMMATIVE ASSESSMENT1485899804862500548639937052250027432001647825MentorPersonal reflection HAVE I?Negotiated a learning contract?Clarified my expectations?Given feedback?Provided the learning opportunity?Demonstrated appropriate practice?Shared my opinion with colleagues?Discussed with programme director/ Practice Educator?00MentorPersonal reflection HAVE I?Negotiated a learning contract?Clarified my expectations?Given feedback?Provided the learning opportunity?Demonstrated appropriate practice?Shared my opinion with colleagues?Discussed with programme director/ Practice Educator?-4572007320915PASS STUDENT00PASS STUDENT2743199336232500-4572003549015PASS STUDENT00PASS STUDENT46863004692015Mentor to address personal responsibilities00Mentor to address personal responsibilities37719007019925SUMMATIVE ASSESSMENT00SUMMATIVE ASSESSMENT35433005991225Formative assessment- constructive feedback /update assessment / new learning contract00Formative assessment- constructive feedback /update assessment / new learning contract4571999667702500468629973628250038862007591425PASS STUDENT00PASS STUDENT8001008391525Programme Director to organize resit opportunity00Programme Director to organize resit opportunity5715007248525FAIL STUDENTTripartite process with student, mentor and programme director00FAIL STUDENTTripartite process with student, mentor and programme director19431003476625 YES00 YES12573003819525Informal discussion of progress and concernsSet up a system to ensure adequate supportSet a review dateNotify the Module Leader00Informal discussion of progress and concernsSet up a system to ensure adequate supportSet a review dateNotify the Module Leader18802355715Do I have any concerns? 00Do I have any concerns? 34290005057140YES (Independent)00YES (Independent)1142999920115008001001162685YES00YES44576999201150041148001162685NO00NO1371599469201500-5715005149215Tripartite meeting with mentor, programme director and studentRenegotiate learning contractIdentify support systemSet review dateDocument meeting on Record of Discussion sheet00Tripartite meeting with mentor, programme director and studentRenegotiate learning contractIdentify support systemSet review dateDocument meeting on Record of Discussion sheet8000996292215001600199697801500-1143006635115SUMMATIVE ASSESSMENT00SUMMATIVE ASSESSMENT114299697801500445769914916150050806354142740NO00NO1142999149161500262889934861500914400577215Are the criteria within the APT being met?00Are the criteria within the APT being met?4114799469201500Process of Practice Assessment35433001823085Formal discussion and negotiation of learning contract related to APT with mentorAgree date of formative assessment and document on Learning Contract00Formal discussion and negotiation of learning contract related to APT with mentorAgree date of formative assessment and document on Learning Contract262889963950850020574005364480Tripartite meeting with programme director, mentor and student00Tripartite meeting with programme director, mentor and student50292004979670YES00YES-114300680085001485900108585Introduction to module and practice assessment documentation Student identifies learning needs to inform Learning Contract00Introduction to module and practice assessment documentation Student identifies learning needs to inform Learning Contract29718004500880NO00NO22859935864800035433005758180001257300612267000228599552958000571500747268000377190065582800049148994865370004914899303657000354330072898000102870048437800013716004500880FAILResit opportunity00FAILResit opportunity2971800450088000-4572004179570Summative meeting and completion of assessment with mentorPass / Fail00Summative meeting and completion of assessment with mentorPass / Fail-4572002268220Reflection on integration of theory with practice and identification of further learning needs00Reflection on integration of theory with practice and identification of further learning needs3429003722370PASS00PASS4572005665470YES00YES16002006465570NO00NO36576006050280NO00NO49149006922770YES00YES19431007151370Review and develop learning contract and set date for summative assessment00Review and develop learning contract and set date for summative assessment43434005322570Formative meeting and completion of assessmentTripartite meetingProgress satisfactory?00Formative meeting and completion of assessmentTripartite meetingProgress satisfactory?38862003608070Undertake self assessment in relation to progress referring to APT and Learning ContractStudent satisfied with progress / opportunities00Undertake self assessment in relation to progress referring to APT and Learning ContractStudent satisfied with progress / opportunities-5715006164580Student summative self-assessment in relation to progress referring to APT and Learning ContractStudent satisfied with progress / opportunities00Student summative self-assessment in relation to progress referring to APT and Learning ContractStudent satisfied with progress / opportunities50806354182110NO00NO ................
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