Barts Health NHS NHS Trust
Name: ......
Level 1 Emergency Department Nursing Competencies Whipps Cross Hospital
This booklet contains: • The RCN National Curriculum and Competency Framework for Emergency Nursing • Whipps Cross specific competencies
Level 1 Emergency Department Nursing Competencies Whipps Cross Hospital
This booklet contains: • The RCN National Curriculum and Competency Framework for Emergency Nursing • Whipps Cross specific competencies WHAT IS THIS PACK FOR?
This pack is intended to provide you with clear milestones for your first year as a nurse in Whipps Cross University Hospital Emergency Department. You will be assigned to both the preceptorship program (if newly qualified) and to an A&E team for support and training. Whipps Cross offers a variety of learning and professional development opportunities for you to take advantage of in your time here. Included in this pack are competencies for you to be signed off by yourself, the senior nursing staff, your team leader and the PDN team to ensure you get the most out of your emergency experience in Whipps Cross Hospital.
First published March 2019
Produced and sponsored by BOE Publishing Limited – All rights reserved
Whilst every care has been taken in the preparation of this reference work neither the Authors nor Publisher can accept any liability for claims or losses arising from the information herein contained. This material has been compiled, collated and printed by BOE Publishing Ltd in conjunction with Barts Health NHS Trust. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of Barts Health NHS Trust and BOE Publishing Ltd. ii Whipps Cross Hospital CONTENTS
SECTION 1 - GENERAL INFORMATION Whipps Cross Hospital...... 1 - 1 Emergency Department Management Structure ...... 1 - 2 Our Department is Like One Big Sorting Office...... 1 - 3 Patient Flow Within the Emergency Department...... 1 - 4 Route Planning - Nursing in ED WXH...... 1 - 5 Frequently Asked Questions...... 1 - 6 Expectations of Our Team...... 1 - 7 SBAR - Situation, Background, Assessment, Recommendation...... 1 - 11 SECTION 2 - LEARNING CHECKLISTS 12 Month Estimated Basic Study Plan...... 2 - 1 6 Month Estimated Basic Study Plan for Barts Health Rotation...... 2 - 1 Level 1 Milestones...... 2 - 2 Team Days Attend During the One Year Period...... 2 - 2 3 Week Induction Plan and Management Plan...... 2 - 3 Specific Day by Day/Month by Month Sign-Offs ...... 2 - 4 Days 1–2...... 2 - 4 Days 3–16...... 2 - 5 Months 1–4...... 2 - 7 Months 4–8...... 2 - 9 Months 8–12...... 2 - 10 Month 12 +...... 2 - 11 SECTION 3 - ROYAL COLLEGE OF NURSING (RCN) CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) 1 INTRODUCTION...... 3 - 5 Preceptorship and induction...... 3 - 5 Glossary of nursing roles...... 3 - 6 Emergency nurse development pathway...... 3 - 7 Foundation practice – Working to Level 1 competencies...... 3 - 8 Emergency nurses – Working to Level 2 competencies...... 3 - 8 Emergency nurse development – Beyond Level 2...... 3 - 8 The competence framework...... 3 - 9 Good nursing practice...... 3 - 10 Cross-cutting themes...... 3 - 11 Emergency care clinical domains...... 3 - 12 Competence assessment...... 3 - 13 The role of the clinical supervisor/assessor/mentor...... 3 - 14
iii 2 LEVEL 1 COMPETENCIES
Good nursing practice Level 1...... 3 - 15 GNP1 – Professional behaviour...... 3 - 16 GNP2 – Team working...... 3 - 17 GNP3 – Communication...... 3 - 18 GNP4 – Leadership and management...... 3 - 19 GNP5 – Education...... 3 - 20 GNP6 – Evidence-based practice...... 3 - 21 GNP7 – Legal and ethical dilemmas and decision making...... 3 - 22 GNP8 – Service evaluation and improvement...... 3 - 23
Cross-cutting themes Level 1...... 3 - 24 CCT1 – Patient assessment ...... 3 - 25 CCT2 – Pain assessment and management...... 3 - 27 CCT3 – Medicines management...... 3 - 28 CCT4 – Moving and handling...... 3 - 30 CCT5 – Infection prevention and control...... 3 - 31 CCT6 – Safeguarding children and adults...... 3 - 32 CCT7 – Documentation and record keeping...... 3 - 34 CCT8 – Preventing and controlling violence and aggression...... 3 - 35
Clinical domains Level 1...... 3 - 36 CD1 – Caring for acutely ill adults...... 3 - 36 CD2 – Caring for adults requiring resuscitation...... 3 - 52 CD3 – Caring for adults with minor illness or injury...... 3 - 62 CD4 – Caring for children and young people...... 3 - 70 CD5 – Caring for people with mental health needs...... 3 - 82 CD6 – Caring for older people...... 3 - 87 CD7 – Emergency planning and disaster management...... 3 - 93 SECTION 4 - NMTNG: NURSING AND AHP TRAUMA COMPETENCIES IN THE ED – ADULT LEVEL 1 – APRIL 2016 1. Introduction...... 4 - 2 2. Using this Document...... 4 - 2 3. Overview of the educational and competency standard...... 4 - 3 4. Educational and competency standard structure, Levels 1 – 3...... 4 - 4 The competencies: Section 1: Organisational aspects...... 4 - 5 Section 2: Clinical and technical skills...... 4 - 6 2A - Preparation and Reception...... 4 - 6
iv Whipps Cross Hospital 2B - Primary survey:
v Male Catheterisation Competency ...... 5 - 23 Male Catheterisation Competency ...... 5 - 24 Laerdal Suction Unit (LSU) Competency...... 5 - 26 Ranger 245 Blood/Fluid Warmer Competency ...... 5 - 28 Baxter Colleague Infusion Pump Competency...... 5 - 30 FK Injectomat/SP Infusion Pump Competency...... 5 - 32 FK Volumat/VP Infusion Pump Competency...... 5 - 34 Lifepak 20 Defibrillator Competency...... 5 - 36 LUCAS Competency...... 5 - 37 Mortara ECG Competency...... 5 - 38 Bair Hugger 775 Competency...... 5 - 40 Level 1 Rapid Infuser...... 5 - 42 Welch Allyn 1500 Patient Monitor Competency...... 5 - 44
vi Level 1 Emergency Department Nursing Competencies Whipps Cross Hospital
Section 1 General Information
Whipps Cross Hospital WHIPPS CROSS HOSPITAL
Established in 1894 and renamed to Whipps Cross hospital in 1917, this hospital found its origins providing care for servicemen wounded in the war. Whipps has continued a strong tradition of high-quality care since then and had a newly refurbished A&E department in the wake of the 2012 Olympics. The hospital merged to form a combined Trust with St Bart’s hospital, Royal London hospital, and Newham University hospital under the umbrella of Barts Health NHS Trust, the largest NHS Trust in the country providing specialised trauma, cardiology, and renal services.
WELCOME TO OUR EMERGENCY DEPARTMENT! We have an OUTSTANDING vision for our ED!
Welcome to WXH ED! Great to have you on-board. We are delighted you have chosen to work with us and we are looking forward to developing you on our route pathways. This programme has been designed to help you to become an ED Nurse with the full complement of skills and experiences needed to support patients with a wide range of ED problems. If throughout the programme you are struggling, your Practice Development Nurses (PDNs) and Band 6s and 7s will support you and guide you until you are both competent and confident. After completing this booklet there are many more developmental opportunities that you could choose to further enhance your career, from university courses to promotional opportunities. During this period of learning about ED, you will be allocated to a team with a Band 7 team leader both this person and the PDNs will monitor and support you through this period and if you have any concerns about anything else, please speak to your Band 7. Looking forward to having you as part of the team and a big welcome!
Alice Green & Fiona McCreesh Matrons [email protected] [email protected]
Section 1 - 1 General Information EMERGENCY DEPARTMENT MANAGEMENT STRUCTURE
Clark Richardson Alice Green Fiona McCreesh Service Manager Matron Matron Emergency and Acute Medicine Emergency Medicine Emergency Medicine
Advanced Clinical Service Manager Matrons Practioners
Emergency Nurse PDNs Team Leaders Trainee ACPs Practioners
Sisters/Charge Trainee ENPs Nurses
Admin & Clerical Staff Nurse
Receptionists HCAs
SERCO Housekeepers Porters
The structure within the department is that your immediate line manager is your team leader who will meet with you regularly and should be your first point of contact. However, you are ultimately accountable to the matrons.
Section 1 - 2 Whipps Cross Hospital OUR DEPARTMENT IS LIKE ONE BIG SORTING OFFICE
We stabilise patients, reduce their pain, make them comfortable, find out what is wrong with them and then… sort them off into areas of the hospital or back into the community.
As Registered Nurses in our department, your role is to: zz See, assess, triage, implement care, keep people comfortable and safe, manage acute illness, treat people with a wide range of medical illness and injury zz Give people holistic and balanced care zz Support one another. We are one TEAM! #TEAMED zz Escalate all your concerns to Doctors, Nurses, Safeguarding, CNS’s and other relevant bodies.
Whipps Cross Hospital Site map and wayfinding system
Key to Symbols:
Male, female & disabled toilets To Whipps Accident & Cross Road Emergency Lift Entrance Stairs 4 Teabar (or drinks vending machine) AMBULANCES ONLY
Restaurant BUS ROUTE Payphone Social Sorbus Workers EUCC House Unit
Just Learning Unit Tomswood Help Desk Nursery Accident & Bike Park Emergency BACK ROAD To James Lane Pay & Display Car Park AMBULANCES ONLY Emergency Medical NO ACCESS Car Park for Disabled People Centre A&E Drop Off Bus Stop Bus Route MRI ICU Byron
Entrance Medical ONE WAY TRAFFIC ONE Margaret Woodlands Photography CT Day Unit NO ACCESS Centre Main = Temporarily closed Social Shop Entrance Workers
1 2 3 4 5 6 7 8 BRIDGE 9 10 11 12 13 14 Connaught Emergency Day Hospital Assessment 1 Unit The Retreat X-Ray BUS ROUTE & Quiet Area GP and HDU Acorn Unit Outpatient X-Ray Board Chest Clinic Restaurant Room Learning Continence GROUND FLOOR GROUND
Centre Advisory Service NO ACCESS Pre OperativePre Unit Assessment Medical Education Centre Education Medical HOSPITAL ROAD Whipps Cross Hospital To James Lane BUS ROUTE HOSPITAL ROAD BUS ROUTE
BUS ROUTE
2 A&E Eye Treatment Children’s Bus Drop Off
Site map and wayfindingFIRST FLOOR system Centre Outpatients Outpatients 3 Reception Maternity Key to Symbols:
To Whipps Renal Plane Tree A & B EGUAccident & Male, female & disabled toilets Cross Road Unit Outpatients Emergency Lift 1st Floor 2nd Floor Entrance Stairs 1st Floor Rowan Ward Sage Ward 4 Poplar Ward 1st Floor 1st Floor Therapies Department of Sexual Health 1st Floor AMBULANCES ONLY Teabar (or drinks vending machine) Primrose Ward 2nd Floor Syringa Ward 2nd Floor
Restaurant BUS ROUTE Sycamore Ward Payphone Social Sorbus Workers EUCC House Unit
Just Learning Unit Tomswood Help Desk Nursery Accident & Bike Park Emergency BACK ROAD To James Lane Pay & Display Car Park AMBULANCES ONLY Emergency Medical NO ACCESS Car Park for Disabled People Centre A&E Drop Off Bus Stop Bus Route MRI ICU Byron
Entrance Medical ONE WAY TRAFFIC ONE Margaret Woodlands Photography CT Day Unit NO ACCESS Centre Main = Temporarily closed Social Shop Entrance Workers
1 2 3 4 5 6 7 8 BRIDGE 9 10 11 12 13 14 Connaught Emergency Day Hospital Assessment Section 1 - 3 1 Unit The Retreat X-Ray BUS ROUTE & Quiet Area GP and HDU Acorn Unit Outpatient X-Ray Board Chest Clinic Restaurant Room Learning Continence GROUND FLOOR GROUND
Centre Advisory Service NO ACCESS Pre OperativePre Unit Assessment Medical Education Centre Education Medical HOSPITAL ROAD To James Lane BUS ROUTE HOSPITAL ROAD BUS ROUTE
BUS ROUTE
2 A&E Eye Treatment Children’s Bus Drop Off Centre Outpatients FIRST FLOOR Outpatients 3 Reception Maternity
Renal A & B EGU Unit Plane Tree Outpatients
1st Floor 2nd Floor 1st Floor Rowan Ward Sage Ward Poplar Ward 1st Floor 1st Floor 1st Floor Therapies Department of Sexual Health Primrose Ward 2nd Floor Syringa Ward 2nd Floor Sycamore Ward General Information PATIENT FLOW WITHIN THE EMERGENCY DEPARTMENT
This diagram shows the percentages of people that present and by which route and ultimately their end destination.
Section 1 - 4 Whipps Cross Hospital ROUTE PLANNING - NURSING IN ED WXH
Leadership Pathway Clinical Pathway
Head/Associate/Director Nurse Consultant/Lead
Lead Nurse Advanced Clinical Prac
Operational/Large Staff Management Master’s Degree
Matron Trainee ACP
Master’s Degree Emergency Nurse Prac
Departmental Manager of the Shift Post Graduate Training
Team Lead Sister/Charge Nurse Senior Sister/Charge Nurse Level 1 Level 1 Level 2 Level 2 ED Trauma ED Trauma Post Grad Leadership Training Nursing Nursing (RCN) (RCN) Champion of Innovation Lead 6-18 12 6-12 12 Months Months Months Months Team/Shop Floor Management Staff Nurse Operational Management Training
Level 2 Trauma Degree in Nursing
Level 2 ED Nursing (RCN) On-going support continues with clinical innovation and excellence. Sister/Charge Nurse Nursing Associate
Level 1 Level 1 Level 2 Level 2 Support with university placement ED Trauma ED Trauma Nursing Nursing onto a Trainee Nursing Associate (RCN) (RCN) programme to further your skills
6-18 12 6-12 12 Months Months Months Months Care Certificate
Staff Nurse Health Care Assistant
Section 1 - 5 General Information FREQUENTLY ASKED QUESTIONS
Question Answer Policies All on the intranet, please familiarise yourself with: zz Study Leave Policy zz Sickness Absence Policy zz Performance and Capability Policy Protocols Protocols, pathways and local policies help to shape how we run this complex department. They can be found on the blue light icon or via the S:Drive. \\swxnas01.fhtworld.local\shared\Emergency Department WX\Clinical & Shop Floor - Open This for Up To Date Guidelines\Homepage\Departmental Home Page.htm Study Leave You are entitled to a minimum of 5 Study Days a year for Team Days. Anything over this is at the discretion of your team leader, the PDN team and/or the Matrons. When you first start, you will go on a plethora of study days to ensure you are fully skilled to complete your role. This is managed under the performance capability and you will be measured against this via the milestones set out in this document. Failure to complete study days without reasonable justification to the Matron will mean a failure to perform to the role required as an ED Nurse. Therefore, we take study days and education very seriously. The basic rules for study is: zz Request your own study leave as soon as you know the dates. zz Turn up early to study (lateness means you don’t complete, the unit gets charged, you get unpaid unauthorised leave, and you need to complete again in own time, so don’t run the risk). zz If you are sick or have an extenuating circumstance why you can’t attend study, then you need to ring the Matron or Nurse in Charge and email the PDNs and Team Leader Sickness Policy You are required to ring the Nurse in Charge or Matron as soon as you know you are going to be sick. This gives us chance to fill the shift. You will be monitored on your sickness/absence/lateness and this is followed up by the sickness absence policy. This policy ensures we are adequately supporting you. Sickness cannot be helped but you will be expected to have a return to work sickness meeting so that we can ensure, as a department, we are doing all we can to support you and ensure you are getting the right help for your sickness needs.
Shifts/Roster 4 Requests a Month. 3 Swaps a Month (Must be to same skill level or above). Can only swap with authority of team leader. To escalate all roster concerns to team leader at first instance. Emergency Leave to be granted by Matrons only. Try to book annual leave quickly to not be disappointed and wait for this to be approved before booking anything! Uniform Issuing Each member of staff will be issued with 3 sets of uniforms it is your responsibility to take care of them, if they become damaged for whatever reason we reserve the right to issue a £10 levy for replacement uniforms.
Section 1 - 6 Whipps Cross Hospital EXPECTATIONS OF OUR TEAM
STUDY AND PRACTICE DEVELOPMENT PDNs PDNs to over-see whole workforce development. PDNs to manage external courses, team days, training and provide shop floor competency training and sign offs. Manage student Nurse, mentorship PDN is 60% Development, 20% Clinical Cover, 20% Clinical Guideline Development. Band 5s ensure you complete To competencies daily. ensure that your To training records are placed back in your files daily and are not taken home. ensure that you don’t To lose your documentation, in doing this, you are at risk of falling behind and having performance concerns raised. ensure that you attend To all Study Leave days. ensure you complete To Stat & Mand training yearly. Band 6 Leaders ensure that Band 5s To are actively signing off competency packs daily. ensure that your To providing training to Band 5s/2s daily. ensure that you are To completing Level 2/Training work so that you become competent and remain up- to-date with training. ensure you complete To Stat & Mand training yearly. Band 7 Team Leaders Band 7 Team Complete initial IPR with Staff Member within 1 Month of start. Update Database when competencies have been signed off. Liaise with PDNs about support mechanisms and extra development to struggling staff. Every shift should be signing off competencies of staff. Band 7s need to have total awareness of each their staffs milestones and developments. If staff are not meeting milestones, this needs to escalated PDNs & Matron. A plan Respective needs to be put in place. ensure you complete Stat To & Mand training yearly. ensure you support in To development by delivery of training. Matrons Support PDNs Monthly 1-1s with Band 7 and go over the database with them. Have plans in place for all staff and their development. ensure all training and To management skills are partake in up to date. To training and development at all levels. Matron is 40% Clinical Shop Floor Leadership and 60% Administrative. Section 1 - 7 General Information DUTY STANDARDS (MINIMUM STANDARDS EXPECTED) HK ensure the stock, To store rooms and clinical areas are fit for purpose. ensure all stock To is present and accounted for. ensure any To broken equipment is logged. HCAs ensure that To all patients are comfortable and are provided with the right care. Ensuring they escalate concerns. ensure that care To rounding’s are done every 2 hours. help maintain To the environment and stock control. assist with flow To out of department. Band 5s ensure that all To patients receive timely, effective, safe care. That patients are assessed, treated, and implementation completed. care is of document all To actions on CRS and ensure all To fundamental standards of care are being met. Hydration, nutrition, pain management, infection control, management of illness and comfort and safety. escalate To concerns. assist with flow To out of department Band 6/7 Area Leaders Band 6/7 Ensure departmental areas are run effectively, using the trigger system to escalate concerns and manage surges appropriately. Offer the most effective leadership, planning and making dynamic risk assessments and having clear plans for these as the shift develops. All staff need to maintain the environment, keeping areas clean, stocked and safe. Nurse in Charge Complete all checks in the morning. Maintain the highest levels of environmental care, ensure all Nurses are working optimally and are well rested and supported, prompting them to ensure all standards are met. Ensure that staff are deployed to areas that meet the needs of the environment based on skill and competence. as the most Act advanced and skilled person on shift, ensuring that patient care is outstanding and the department is flowing. Clinical Matron Oversees and supports the overall department in areas like: Safety Quality Care Patient Risks Flow Performance Key Indicators Staff Well-Being Auditing Representing the department at operational meetings. ensure that Will each area is working optimally with NIC. Shift Aim of Aim of Section 1 - 8 Whipps Cross Hospital To help train new To staff (including Nurses) in all areas. be included To in training and development on the shop floor. Assist with Care Rounding. To help train new To staff (including Nurses) in all areas. be included To in training and development on the shop floor. Clean areas, re- stock and assist with Band 5s/6s/7s. To ensure that To booklets and/ or competencies are taken to the shop floor and competencies are signed off in real time. ensure booklets To go back to the Sisters office in the filing cabinet at the end of shift. not lose this To documentation. Doing so may result in a capability. Clean areas, re- stock and assist with Band 6s/7s. Ensure they are getting their Level 2 Booklet not lose signed off. To this documentation and to ensure it is back in the filing cabinet at end of shift. Sign off Level 1 Competencies. Should be signing at least 5 off per shift. Manage 2 band 5s, ensure conversations and 1-1s are logged with Band 7s via email. Check emails. Develop areas and champion ideas of change. Train Band 6s Train to take charge in the morning, showing them all areas of checklists, management, databases, meetings etc. Sign off Level 2 booklets/ competencies. ensure that all To booklets are placed back in the Sisters office at end of shift. Complete 1-1s with staff. Ensure they are working to meet objectives. Check and respond to emails. Develop areas and champion ideas of change. Ensures that daily we are allocating to ensure staff are working optimally and learning new skills. Ensures daily competency sign offs are being performed. support NIC Will with staffing and administrative tasks that support the day to day functionality of the department. Mix Periods Study & Skill- During Quiet Section 1 - 9 General Information PERSONAL AND PROFESSIONAL DEVELOPMENT
Matrons Band 7 Team Leaders Band 6 Leaders Band 5s Monthly 1-1s with Band To complete new To ensure that they To meet with your team 7s starter, first 6 months are the champions of leader once a year (as a and yearly IPRs with all freedom to speak. minimum). staff. Monthly 1-1s with staff To place objectives and To support the Band 5s To ensure that you are members who required outcomes on one sheet and 2s in managing day meeting your objectives intensive support of all and place this within to day work, ensuring and if not, that you grades. the database so we can that their ideas are escalate these. monitor this progress. listened to and action is taken to ensure they are met. IPRs yearly (or when If staff are not To challenge and To ensure that you needed). performing, to have escalate all levels poor provide feedback structured supervisions practice. of areas we could with staff and inform improve. the respective Matron. Management of study If staff continue to To meet with your Team To participate in the to ensure our Band 7s under-perform, Band 7s Leaders a minimum of team ethos of our have the best courses will need to commence once a year. department. and offers given to an informal Action Plan them for improvement. (informing the Matron in monthly 1-1s) Work with wider To check emails daily. To ensure that you are To check emails weekly hospital team to ensure meeting objectives set for updates. that all opportunities in these reviews. are presented to the ED team. To check emails daily.
Section 1 - 10 Whipps Cross Hospital SBAR - SITUATION, BACKGROUND, ASSESSMENT, RECOMMENDATION
This is a tool that is used across every discipline within the NHS. It enables staff to have a clear structure when escalating or handing over to colleagues to continue a patient’s treatment. Familiarise yourself with the following graphic it will help you to structure your handover and give a clear and concise message to the recipient about why you are escalating to the relevant team.
Situation: I am (name), (X) nurse on ward (X) I am calling about (patient X) I am calling because I am concerned that... (e.g. BP is low/high, pulse is XX, temperature is XX, Early S Warning Score is XX) Background: Patient (X) was admitted on (XX date) with... (e.g. MI/chest infection) They have had (X operation/procedure/investigation) Patient (X)’s condition has changed in the last (XX mins) Their last set of obs were (XX) Patient (X)’s normal condition is... B (e.g. alert/drowsy/confused, pain free)
Assessment: I think the problem is (XXX) And I have...
(e.g. given O2/analgesia, stopped the infusion) OR I am not sure what the problem is but patient (X) is deteriorating A OR I don’t know what’s wrong but I am really worried
Recommendation: I need you to... Come to see the patient in the next (XX mins) AND Is there anything I need to do in the mean time? R (e.g. stop the fluid/repeat the obs) Ask receiver to repeat key information to ensure understanding
The SBAR tool originated from the US Navy and was adapted for use in healthcare by Dr M Leonard and colleagues from Kaiser Permanente, Colorado, USA
Section 1 - 11 General Information
Section 1 - 12 Level 1 Emergency Department Nursing Competencies Whipps Cross Hospital
Section 2 Learning Checklists
Whipps Cross Hospital 12 MONTH ESTIMATED BASIC STUDY PLAN
(Initial when complete)
Months 1 2 3 4 5 6 7 8 9 10 11 12 Trust Induction Clinical Induction E-Learning BLS Manual Handling Oral Meds Bloods/Cannula/Cultures IV Meds ILS Majors/CDU Competencies EA/IA Competencies Triage Plaster Course Resus Competencies
Level 1 Trauma TILS Level 1 Trauma NIV
6 MONTH ESTIMATED BASIC STUDY PLAN FOR BARTS HEALTH ROTATION
Months 1 2 3 4 5 6 Trust Induction Clinical Induction E-Learning BLS Manual Handling Bloods/Cannula Oral Meds IV Meds ILS TILS Majors/CDU EA/IA Resus
After 1 Year – You may go into Paeds ED to complete your RCN Competencies. Section 2 - 1 Learning Checklists LEVEL 1 MILESTONES
(May vary depending on skill & competence)
Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Trust IV Meds IV Meds Immediate Life EA/IA EA/IA Stat & Mand Course Competencies Support Competencies Oral Drugs Bloods/ Bloods/ Blood Cannulation/ Cannulation/ Fridge/Barcode Blood Cultures Blood Cultures Competencies Majors/CDU Allocation EA IA
Month 7 Month 8 Month 9 Month 10 Month 11 Month 12 Triage Course Triage Triage POP/Minor Trauma Non-Invasive Competencies Competencies Injuries Immediate Life Ventilation Support EA IA Minors Resus
Yearly Updates (Minimum): Stat & Mand Immediate Life Support Trauma Immediate Life Support Safeguarding Level 2
TEAM DAYS ATTEND DURING THE ONE YEAR PERIOD
Months 1 2 3 4 5 6 7 8 9 10 11 12 Team 1 Team 2 Team 3 IPRs Due Team 4 Dates Team 5 No Team Team 6 - Paeds Days Team 7 - Paeds Team 8 - Paeds
Team Day Topic Day A Major Incidents Day B Clinical Day Day C TILS Day D Stat & Mand & Hot Topics
Section 2 - 2 Whipps Cross Hospital 3 WEEK INDUCTION PLAN AND MANAGEMENT PLAN
Week 1 Initial 2 Days Induction zz Co-operate zz Clinical 1 Day Day with PDNs zz ID and name badge zz Uniform zz Barts Health Network access zz Create PDN File/Matron File zz PDN new starter presentation zz Bar code zz Level 1 book/competencies 1 Day Majors Cubicles Allocated to work with an experienced nurse in majors cubicles by PDN or NIC 1 Day EA Purpose of EA 4 hours RAG Scoring Initial work ups IA Purpose of IA 4 hours RAG Scoring Work Ups & Continual Care in IA Week 2 Initial 1 Day Majors Cubicles Purpose of Majors Paperwork and Assurances Drugs Care and Communication Environment Board Nurse 1 Day 1 hours Streaming Understand importance of streaming 2 hours Paeds How to do a safeguarding referral 2 hour in Minors Role of the nurse in minors 2.5 hours Resus Purpose of Resus RAG Scoring To re-stock and check bays To review resus stores with experience nurse regarding different equipment 1 Day 4 hours CDU Purpose of CDU 4 hours Majors Cubicles Work with a nurse and look after 2 cubicles under their supervision 1 Day E-Learning Stat&mand CRS 1 Day Majors Cubicles zz Assess progress Meet with PDN’s zz Finalise any outstanding issues zz Go through competencies zz Final Day in Majors, look after allocated cubicles Week 3 Outstanding Learning/Skills Commence Competencies zz During your induction make contact with your team leader and arrange a meeting with them zz Annual Leave Requested for 20 days Section 2 - 3 Learning Checklists SPECIFIC DAY BY DAY/MONTH BY MONTH SIGN-OFFS
DAYS 1–2 zz Trust wide induction program
Corporate induction Date: ......
Clinical Induction Date: ......
Includes 0.5 day Basic Life Support Training, 0.5 day Manual Handling Own Initials Team Leader Training
Section 2 - 4 Whipps Cross Hospital DAYS 3–16
You will attend work Monday-Friday 8am-4pm for supernumerary work experience building up to being ready for starting work at the end of the two week period. During this time your responsibilities are as follows; To meet with your Team Leader who should allocate you a buddy nurse, however if you are uncertain who this is then please contact your PDNs
Team & Team Leaders Name: ...... Own Initials Team Leader
Ensure you have had experience in each of the 9 following areas. Ensure that you follow your orientation plan and have had this signed by the senior nurse in charge daily so that they allocated correctly. zz Ambulance Arrivals (Emergency Assessment) (4 Hours) hh Re-Stock a Cubicle hh Learn about RAG Scores hh Learn about initial work up zz CDU (1 Hour) hh Paperwork & Phone Numbers zz Initial Assessment (4 Hours) hh Triage Basics hh Care in IA zz Injuries/Minors (1 Hour) zz Majors (6 Hours) hh Paperwork hh Infection Control hh Drugs hh Transfers zz Paediatrics (1 Hour) zz Streaming (1 Hour) zz Resus (4 Hours) hh Re-Stock a Bay Own Initials hh Check Resus Store Cupboard with PDN
Section 2 - 5 Learning Checklists Area Competency Your Initials Ambulance Arrivals Understand the type of patient sent to Ambulance Arrivals area (EA) Understand role of EA lead nurse Be familiar with expectations of Band 5 nurse in EA area CDU Become familiar with CDU admission criteria. These can be found on the intranet. Click the red “Emergency Department WX” icon à CDU à Clinical Pathways Initial Assessment (IA) Understand the type of patient sent to IA area Understand role of IA lead nurse Be familiar with expectations of Band 5 nurse in IA area Injuries/Minors Work with Injuries Triage nurse to gain insight into role Spend time with Emergency Nurse Practitioner Gain awareness of environment and know how to Stock and Replenish Majors Clearly understand role of Band 5 providing care to 4 allocated patients in Majors area Understand local policies and practices for time of overcrowding. Discuss with Board nurse or colleagues if unsure. Learn environmental safety check and ensure clean environment. See cleaning schedule on wall in bays. It is YOUR responsibility to clean area between patients. Paediatrics Understand how to raise CYF guarding concern re: children and how to enter details onto a safeguarding spreadsheet. Open Shared Drive S: à WX ED Safeguarding Children’s spreadsheet à ED MDT Spreadsheet *Note: this will also be a relevant skill to nurses caring for adults with safeguarding concerns who have access to children* Be aware of admission criteria for paediatric CDU. Click on the red “Emergency Department WX” icon à Paeds CDU à clinical pathways Pods Gain awareness of streaming pathways accessible on intranet. Click on the red “Emergency Department WX” icon à Clinical guidelines. Or these pathways can be found in a hard copy folder in the Pod Resus Become familiar with location for emergency equipment and where to source additional stock. Be able to fully check and stock a Resus bay. Checklist in a folder in each bay. Participate in direct care of a patient
Eensure you have signed off all of the competencies for your first two supernumerary weeks in ED shown in the table above Own Initials Section 2 - 6 Whipps Cross Hospital MONTHS 1–4
Commence Trust Preceptorship Program (for newly qualified nurses) If you have not been booked on this then please contact the PDN team.
Own Initials Team Leader Don’t forget to request the leave via the PDNs/Band 7s/Matrons
Meet with your team leader at 2 months for a formative review of your progress so far. Own Initials Team Leader
Pass oral Drug Administration Competencies Book onto IV Medication Course Own Initials Team Leader
Ensure you have access to all necessary electronic resources. Contact emails provided for whom to be in touch with if you have not yet got access. zz NHS.net email [email protected] zz WX Emergency Department icon & Access to shared S: drive [email protected] zz Health Roster [email protected] [email protected] Own Initials Team Leader
Section 2 - 7 Learning Checklists
Ensure you have submitted requests for at least 20 of your 27 days of annual leave for the course of the year. You run the risk of not being able to take all of your owed leave if you do not submit your requests well in advance Own Initials
Ensure you have submitted one Datix report Intranet à “I want to” à Report an Incident (Datix) Own Initials Team Leader
Ensure you know how to find out what the Significant Incidents of the department have been. Red “Emergency Department WX” icon à SI reports Own Initials
Meet with your team leader at 4 months for a Summative review of your progress so far. Own Initials Team Leader
Section 2 - 8 Whipps Cross Hospital MONTHS 4–8
Submit request for Immediate Life Support (ILS) course. This is run in the Trust. It is free unless you do not turn up to your booked course. Book by contacting the PDNs. Own Initials
Complete directly observed assessment by Senior Nurse in patient AàG assessment in EA or IA and document examination on Cerner patient notes. Own Initials Team Leader
Meet with your team leader at 6 months for a Formative review of your progress so far. Own Initials Team Leader
Meet with your team leader at 8 months for a Formative review of your progress so far. Own Initials Team Leader
Section 2 - 9 Learning Checklists MONTHS 8–12
Complete Triage course, you should be allocated to this If not then please contact the PDNS. Own Initials Team Leader
Once you have attended the course ensure you have been signed off for your Triage competencies you have 3 months from attending the course to do this. Own Initials Team Leader
Attend the Trusts Plaster of Paris course and achieve competences You have 3 months to achieve this. Own Initials Team Leader
Meet with your team leader at 12 months for a Summative review of your progression so far. Own Initials Team Leader
Section 2 - 10 Whipps Cross Hospital MONTH 12 +
Completion of A&E course Programme. Capital Nurse is paid for by the department but you must ensure you discuss it with the PDN team first to ensure funding is arranged. Own Initials
Complete end of year Appraisal with Team Leader. Own Initials Team Leader
Complete forward looking personal education and professional development plan Own Initials Team Leader
Section 2 - 11 Learning Checklists
Section 2 - 12 Level 1 Emergency Department Nursing Competencies Whipps Cross Hospital
Section 3 National Curriculum and Competency Framework Emergency Nursing (Level 1)
Whipps Cross Hospital and illness Caring for adults with minor injury Caring for resuscitation adults requiring sment ain and P se s Medicines Caring for a s management children and management young people tient a and e P Moving handling assessment g acti c n acutely io n ill adults Good ol s Caring for oll i nursing s p r r e and e ention t ection and v n ont r enting e c o v n In f e p r o i g d d c t P r n n i violen c agg r or o r a d en r e c a eeping k eg u needs child r f and r and adults a Caring f S Docu me nt a people with mental health y er t gen c or disa s Eme r planning and management Caring f older people Emergency Care Association Care Emergency June 2017 National Curriculum and Competency Framework Competency and Curriculum National 1) Nursing (Level Emergency
Section 3 - 1 National Curriculum and Competency Framework Emergency Nursing (Level 1) ACKNOWLEDGEMENTS RCN Legal Disclaimer This publication contains information, advice and guidance help to members of the RCN. It is intended for use within the UK but readers are advised that practices may vary in each country and outside the UK. The information in this booklet has been compiled from professional sources, but its accuracy is not guaranteed. Whilst every effort has been madeto ensure the RCN provides accurate and expert information and guidance, it is impossible predict to all the circumstances in which it may be used. Accordingly, the RCN shall not be liable any to person or entity with respect any to loss or damage caused or alleged be to caused directly or indirectly what by is contained in or left out of this website information and guidance. Published the by Royal College of Nursing, 20 Cavendish Square, London W1G 0RN © 2017 Royal College of Nursing. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or any by means electronic, mechanical, photocopying, recording or otherwise, without prior permission of the Publishers. This publication may not be lent, resold, hired out or otherwise disposed ways of by of trade in any form of binding or cover other than that in which it is published, without the prior consent of the Publishers. Chair, RCN Emergency Care Association (ECA), Emergency Nurse Consultant, Trust Foundation NHS Huddersfield and Calderdale Consultant Nurse in Emergency Care, Hampshire Hospitals NHS Foundation Trust, Hampshire and Isle of Wight Air Ambulance Advanced Nurse Practitioner, Royal Infirmary Edinburgh Royal College of Nursing (RCN) Professional Lead for Acute, Emergency and Critical Care ECA Committee Member, Lead Nurse for Emergency Departments, South Eastern Health and Social Care Trust, Northern Ireland ECA Committee Member, Trainee Specialist Practitioner – Critical Care, South Western Ambulance Service NHS Foundation Trust ECA Committee Member, Principal Lecturer University of Hertfordshire Morgannwg Bro Abertawe Bridgend, Department, Emergency Nurse/ANP Lead University Health Board Hospitals Lincolnshire Consultant, Nurse Emergency Improvement Care Emergency Nurse, Consultant Member, Committee ECA Programme ANP/Matron, University Hospitals Leicester/Paramedic Consultant, Yorkshire Service Ambulance Emergency Nurse Consultant, Portsmouth, Chair Wessex Emergency Care Collaboration RCN Fellow, Lecturer Practitioner, Salford University/Salford Royal NHS Foundation Trust
COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Bruce Armstrong OBE ClarkJasmin Anna Crossley Devlin Roisin Hammett Owen Jacky Price Kevin Randall Rudd Michelle Rumley-Bus Mandy Standen Simon Dr Anne Welling Jill Windle In addition individual to work, the development of this framework would not have been possible without the preceding work shared or published various by organisations; in particular the Wessex Emergency Care Collaboration, the Faculty of Emergency Nursing and the Intercollegiate Board for Training in Pre-Hospital Emergency Medicine (IBTPHEM). Acknowledgements This Royal College Nursing of (RCN) curriculum and competency framework for emergency nursing was produced a working by party emergency of nursing representatives from across the United Kingdom. Special thanks go the to individuals who their gave time and expertise to make this possible. party members Working Youd Janet Contents | Introduction | Level 1 competencies | Level | Introduction Contents 2
Section 3 - 2 Whipps Cross Hospital FOREWORD COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Contents | Introduction | Level 1 competencies | Level | Introduction Contents Foreword Over 20 million patients access emergency and urgent care in the NHS each year in a range of settings and services. Central each to these of services are the nursing teams working alongside other professional colleagues ensure to that these patients and their families receive world-class care. The increasing demands and challenges on the NHS emergency care system seen have it significantlyevolve in the last twentyyears in the United Kingdom.Technological and clinical advances, coupled with the introduction integrated of emergency care networks, involving major trauma centres, and other centres excellence, of with emergency departments and urgent care centres, ensure patients can expect receive to quality and compassionate care responsive to their needs. Alongside these clinical and service developments, emergency nursing has also progressed, both in terms its of ability improve outcomes to for patients and their families, and enrich to the profession nursing of itself, through evidence-base and role development. There is now an increasing diversity nursing of roles required in emergency care settings, demanding specialist and advanced skills and knowledge. Each brings a significantcontribution to the multi- professional team in the modern emergency care environment. This framework, developed leading by emergency nursing experts, is founded on nursing philosophy and details the depth and breadth knowledge of and skills required emergency of nurses. It offers longoverdue clarity on the nomenclatureof nursingroles in emergency care settings and provides a clear career structure for those wishing advance to in the specialism. It will facilitate consistency and continuity educational of preparation emergency of nursing teams, as well as future workforce planning, and will be an extremely valuable resource for both individual nurses and organisations. Ruth May Executive Director Nursing of Improvement NHS 3
Section 3 - 3 National Curriculum and Competency Framework Emergency Nursing (Level 1) 31 27 52 32 87 25 35 82 28 62 93 36 70 34 30 36 24 CONTENTS
CD4 – Caring for children and young people CD3 – Caring for adults with minor illness or injury CD2 – Caring for adults requiring resuscitation CD5 – Caring for people with mental health needs CCT1 – Patient assessment CD1 – Caring for acutely ill adults CCT2 – Pain assessment and management CD6 – Caring for older people – EmergencyCD7 planning and disaster management CCT3 – Medicines management CCT5 – Infection prevention and control CCT4 – Moving andCCT4 handling CCT6 – Safeguarding children and adults CCT7 – Documentation and record keeping CCT8 – Preventing and controlling violence and aggression Cross-cutting themes 1 Level Clinical domains 1 Level
7 11 5 5 8 8 8 6 9 17 12 21 18 19 16 10 13 22 23 14 15 20
Good nursing practice GNP1 – Professional behaviour GNP2 working – Team GNP3 – Communication Cross-cuttingthemes Emergency care clinical domains GNP4 – Leadership and management GNP5 – Education GNP6 – Evidence-based practice GNP7 – Legal and ethical dilemmas and decision making GNP8 – Service evaluation and improvement supervisor/assessor/mentor clinical the of The role 1 competencies:Level Good nursing 1 practice Level Preceptorship and induction Preceptorship Glossary nursing roles of Emergency pathway nurse development Introduction 1 competencies Level to – Working practice Foundation 2 competencies Level to Emergency nurses – Working 2 Level Emergency – Beyond nurse development framework The competence assessment Competence COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: 2
Contents | Introduction | Level 1 competencies | Level | Introduction Contents Contents 1 4
Section 3 - 4 Whipps Cross Hospital INTRODUCTION . London: DH. Preceptorship All nurses joining the NMC register demonstrated have their ability undertake to a wide range of core nursing skills with competence. This framework recognises the acquisition these of skills and seeks build to specificcompetence in emergency nursing. The guidance provided in the Preceptorship framework for newly registered nurses, midwives and allied health professions (DH, 2009), should act as a useful resource. Induction A period structured of support is vital for all nurses who are the new to emergency care environment. For nurses who clinical have experience elsewhere, their transition into emergency care be may less challenging, and their progress in achieving the competencies be may accelerated in comparison that to the of newly qualified nurse. The emergency care environment is stressful and challenging and for emergency nurses to develop and work effectively, they needto maintain personalwellbeing. To developresilience, emergency nurses should feel supported in exploring their experiences, enable to reflection and learning. The need for emotional support at any stage in an emergency nurse’s career should never be underestimated. References Department Health of (2009) Preceptorship framework for newly registered nurses, midwives and allied health professions
COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Contents | Introduction | Level 1 competencies | Level | Introduction Contents 1. Introduction This framework was produced in response a demand to from RCN Emergency Care Association members for clarity in the competencies expected nurses of working in emergency care settings across the UK. Whilst its development focused on the needs nurses of working in emergency departments the framework (EDs), will also be applicable nurses to working in a wide range of urgent and emergency care settings and also other health care professionals who are required to care for patients in emergency care settings. The aim encourage is to professional development, leadership skills, and career progression in emergency nursing; promoting high quality patient care and a culture that supports recruitment and retention emergency of nurses. The framework is designed support to nurses from newly qualified to or the new specialty(foundation staff throughnurse) more to experienced emergency nurses working with patients all of ages. Nurses working in emergency care settings that receive trauma should also follow the trauma competency framework developed the by National Major Nursing Trauma Group. These competencies can be found at: www.tquins.nhs.uk/?menu=resources Competencies for advanced clinical practitioners in emergency care been have developed the by Royal College Emergency of Medicine (RCEM) and Health Education England (HEE). These have been endorsed the by RCN and are available at: www.rcem.ac.uk/RCEM/Exams_Training/ Emergency_Care_ACP/RCEM/Exams_Training/Emergency_Care_ACP/Emergency_Care_ACP. aspx?hkey=8244ccaf-e85a-4b1e-8f8d-152484810137 5
Section 3 - 5 National Curriculum and Competency Framework Emergency Nursing (Level 1) INTRODUCTION : A clinical expert in emergency nursing with responsibility for : This is an emergency nurse having completed 2 Level : This is an emergency nurse having completed 2 competencies Level who : This is an emergency nurse having completed 2 competencies Level who This is an emergency nurse having completed 2 competencies Level who is responsible Practice educator facilitates educational opportunities in the emergency care setting. They provide supervision in practice, deliver training sessions and assessment of competencies. They often teach on nationally recognised courses example, (for advanced life support). They should be working towards education-specificcompetencies and/or qualifications. Typically, theyare Band 6 or 7 depending on the leadership responsibilities the of role. Practice development lead competencies who leads the education strategy for the emergency care setting. They will provide supervision in practice and deliver some training sessions, whilst establishing the training requirements in the setting ensure to the necessary workforce skill mix. They will link the education strategy for the emergency care setting with the overall strategy for education in the organisation. They will work closely with the lead nurse manager, the medical clinical director and other education providers, including higher education institutes They will (HEIs). typically be Band 7 or 8a. Lead nurse manager is responsible for the day-to-day operational management the of emergency care setting, including workforce management and implementation local of policy and clinical guidelines. Band 7 orTypically, 8a. Matron: for quality assurance and quality improvement in the emergency care setting; including responding patient to feedback and ensuring clinical incidents are investigated and any recommendations actioned. Band 8a. Typically, consultant nurse Emergency emergency care leadership; including strategic development policy of and practice, research, education and advanced clinical practice. Band 8b Typically, or 8c. : An emergency nurse who has completed level 2 competencies, is a : A registered nurse who is either newly qualified to or emergencynew : A registered nurse who has completed preceptorship and has achieved COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: the 1 competencies. Level They can work with individual patients or groups patients of without direct supervision in the emergency care setting. This includes initial assessment and the provision treatment of (but not diagnosis) for patients. In EDs, this is likely include to working with patients in the resuscitation room, those with major illness or injury and those with minor presentations. They should be working complete to the 2 competencies. Level they Typically, would be Band 5 or 6. Emergency charge nurse clinical expert and proactively develops themselves and others. They lead and supervise the clinical work others of and can manage the emergency care setting as a whole; managing patient flow and delegating care accordingly. In EDs they shouldwork in close partnership with the emergency medicine consultant ensure to safety patients of and best use resources. of They should focus on more in-depth leadership, educational and/or research competencies, which are beyond the scope this of framework. they would be senior Typically, Band 6 or 7. Emergency nurse practitioner (ENP) : A registered nurse who has undertaken specific additional training in order assess, to diagnose and prescribe treatment for patients who present with minor injuries and or illness. The role emergency of nurse practitioner is subject local to variation in education and practice provision, therefore this framework does not provide the competencies required for they this would role. be Band Typically, 6 or 7. Advanced clinical practitioner (ACP) : An emergency nurse or other registered allied health professional who has undergone masters level education in examination, diagnosis and treatment and can provide a clinical consultation for any patient presenting emergency to care. They should be working the to Royal College Emergency of Medicine/Health Education England emergency care competency ACP standards. they would be Band Typically, 8a or 8b. nursing; has not acquired yet the competencies an of emergency nurse. These nurses require supervision in practice, ranging from direct supervision in their initial weeks, indirect to supervision as they near the accomplishment an of emergency nurse. They should be working to complete the 1 competencies. Level they would be Band Typically, 5. nurse Emergency Contents | Introduction | Level 1 competencies | Level | Introduction Contents in the emergency of nursing roles Glossary setting care Foundation staff nurse 6
Section 3 - 6 Whipps Cross Hospital INTRODUCTION manager Band 8b+ Band 8b+ Emergency Emergency (DHoN/HoN) Senior nursing nurse consultant ACP ACP Band 8a Matron Matron Band 8a Band 8a development Lead practice practice Lead T-ACP T-ACP Band 7 Band 7 Band 7 educator nurse manager Senior practice Senior practice Senior sister/lead Senior sister/lead ENP Education pathway Education Band 7 Management pathway Advancing clinical practice pathway clinical practice Advancing nurse Band 6 Band 6 Practice Practice educator ENP Sister/charge Sister/charge Band 6 Career development pathway overview pathway development Career Emergency nurse Emergency (Band 5) 2) Level to (Working COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Newly qualified nurse Newly staff (Foundation nurse Band 5) 1 Level to Working specialty nurse to New staff (Foundation nurse Band 5) 1 Level to Working Contents | Introduction | Level 1 competencies | Level | Introduction Contents pathway nurse development Emergency A clearly defined development enablespathway nursesto identify their position on a career journey, consider future options and plan the steps required achieve to their career aims. Figure 1 maps the professional development into management, pathways education or clinical specialist roles for emergency nurses. Defining stages within the not pathway only facilitates career progression, but also may inform workforce development. overview pathway development 1: Career Figure 7
Section 3 - 7 National Curriculum and Competency Framework Emergency Nursing (Level 1) INTRODUCTION ability lead to the provision evidence-based of holistic care for groups patients, of from initial assessment discharge to or admission teaching and supervising less experienced staff and students developingin-depth knowledge about specific areas interest of and effectively communicating this colleagues, to for example, link nurse role advancing clinical skills and knowledge, developing teaching and assessing skills, and qualities. leadership developing operational management (emergency nurse/matron) sister/charge education specialist (practice educator/lead for practice development) practitioner). nurse practitioner/advanced nurse (emergency specialist clinical Emergency nurses – Working to Level 2 Level to nurses – Working Emergency competencies These nurses should form the largest nursing group in the emergency care setting. Provided they hadhave a structured foundation period, with appropriate education and supervision, they should be able care to for patients in all areas the of environment without direct supervision. These nurses successfully will have completed the Foundation practice 1 competencies Level and be working complete to the 2 competencies. Level include: to likely nurses are of emergency milestones Developmental • • • • – Beyond nurse development Emergency 2 Level It is important recognise to that developing competence as an emergency nurse is the fundamental platform on which all domains Depending evolve. on the aspirations and chosen career direction, practice beyond that an of emergency nurse follow may a specific or pathway crossover between domains Figure (see 1): • • • Competencies for these are pathways outside the scope this of document. COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Be familiar with the environment and work as a member the of team caring for patients under supervision an of emergency nurse. Understand operational and patient processes in the various areas the of environment. Start develop to good nursing practice and competencies cross-cutting of themes 1. at Level Recognise limitations, own seeking help and advice when needed. Function as a member the of team in various areas the of setting, taking responsibility for planning, implementing and evaluating individual patient care. furtherAchieve good nursing practice, cross-cutting themes and specific competencies the of clinical practice domains 1. at Level Manage allocated patients in various settings. In the emergency department, this is likely to include majors, minors and resus. Safely undertake the initial assessment patients of and triage appropriately. Complete good nursing practice, cross-cutting themes and specific competencies clinical of practice domains 1. at Level Mentor student nurses and act as a guide less to experienced staff. Contents | Introduction | Level 1 competencies | Level | Introduction Contents 1 Level to – Working practice Foundation competencies The newly qualified nurserequires at least 12 monthsconsolidateto their nurse training in addition developing to the competencies be to an emergency nurse. In total, it take may them up twoto years become to an emergency nurse. Nurses the new to emergency care environment, but with previous nursing experience, should aim complete to their Foundation 1 competencies Level within 12 months. They achieve may them sooner if their previous experience is in an acute or critical care environment. nurse staff of foundation milestones Developmental Three months • • • • • • • • • • Six months 12 months to two (up years for newly qualified) 8
Section 3 - 8 Whipps Cross Hospital INTRODUCTION and illness Caring for adults with minor injury Caring for resuscitation adults requiring sment ain and P se s Medicines Caring for a s management children and management young people tient a and e P Moving handling assessment g acti c n acutely io n ill adults Good ol s Caring for oll i nursing s p r r e and e ention t ection and v n ont r enting e c o v n In f e p r o i g d d c t P r n n i violen c agg r or o r a d en r e c a eeping k eg u needs child r f and r and adults a Caring f S Docu me nt a people with mental health y er t gen c or disa s Eme r planning and management Caring f older people Figure 2: The competency framework competency 2: The Figure COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Good nursing practice – centre (GNP) (core). Cross-cutting themes (CCT) – inner wheel. Clinical – outer domains wheel. (CD) Contents | Introduction | Level 1 competencies | Level | Introduction Contents framework competency The The national curriculum and competency framework for emergency nursing is demonstrated in Figure 2. • • • These sections appear in both 1 and Level 2 competency Level sets. 9
Section 3 - 9 National Curriculum and Competency Framework Emergency Nursing (Level 1) INTRODUCTION and illness and illness Caring for Caring for adults with adults with minor injury minor injury Caring for Caring for resuscitation resuscitation adults requiring adults requiring sment ain and P se s Medicines Caring for Caring for a s management children and children and management young people young people tient a and e e P Moving handling assessment g acti c acti c n acutely acutely io n ill adults ill adults Good Good ol s Caring for Caring for oll i nursing nursing s p r p r r e and e ention t ection and v n ont r enting e c o v n In f e p r o i g d d c t P r n n i violen c agg r or or o r a d en r e c a eeping k eg u needs needs child r f and r and adults a Caring f Caring f S Docu me nt a people with people with mental health mental health y y er er t t gen c gen c or or disa s disa s Eme r Eme r planning and planning and management management Caring f Caring f older people older people Figure 3: Good nursing practice Figure COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: GNP1 – Professional behaviour GNP2 working – Team GNP3 – Communication GNP4 – Leadership and management GNP5 – Education GNP6 – Evidence-based practice GNP7 – Legal and ethical dilemmas and decision making GNP8 – Service evaluation and improvement. Contents | Introduction | Level 1 competencies | Level | Introduction Contents Good nursing practice Good nursing practice forms (GNP) the basis all of nursing care and is central the to NMC Code. The behaviours outlined in GNP should be applied when approaching the other competencies within the framework. The domains GNP of competencies cover in: • • • • • • • • 10
Section 3 - 10 Whipps Cross Hospital INTRODUCTION and illness and illness Caring for Caring for adults with adults with minor injury minor injury Caring for Caring for resuscitation resuscitation adults requiring adults requiring sment ain and P se s Medicines Caring for Caring for a s management children and children and management young people young people tient a and e e P Moving handling assessment g acti c acti c n acutely acutely io n ill adults ill adults Good Good ol s Caring for Caring for oll i nursing nursing s p r p r r e and e ention t ection and v n ont r enting e c o v n In f e p r o i g d d c t P r n n i violen c agg r or or o r a d en r e c a eeping k eg u needs needs child r f and r and adults a Caring f Caring f S Docu me nt a people with people with mental health mental health y y er er t t gen c gen c or or disa s disa s Eme r Eme r planning and planning and management management Caring f Caring f older people older people Figure 4: Cross-cutting themes 4: Cross-cutting Figure COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CCT1 – Patient assessment CCT2 – Pain assessment and management CCT3 – Medicines management – Moving andCCT4 handling CCT5 – Infection prevention and control CCT6 – Safeguarding children and adults CCT7 – Documentation and record keeping CCT8 – Preventing and controlling violence and aggression. Contents | Introduction | Level 1 competencies | Level | Introduction Contents themes Cross-cutting These generic themes apply patients to in any emergency care setting irrespective their of presenting complaint. The cross-cutting themes (CCT) in Figure 4 are grouped into competencies relating to: • • • • • • • • 11
Section 3 - 11 National Curriculum and Competency Framework Emergency Nursing (Level 1) INTRODUCTION and illness and illness Caring for Caring for adults with adults with minor injury minor injury Caring for Caring for resuscitation resuscitation adults requiring adults requiring sment sment ain ain and and P P se s se s Medicines Medicines Caring for Caring for a s a s management management children and children and management management young people young people tient tient a a and and e e P P Moving Moving handling handling assessment assessment g g acti c acti c n n acutely acutely io n io n ill adults ill adults Good Good ol ol s s Caring for Caring for oll i oll i nursing nursing s s p r p r r r e and e and e e ention ention t t ection ection and and v v n n ont r ont r enting enting e e c c o o v v n n In f In f e e p r p r o o i i g g d d d c d c t t P r P r n n n n i i violen c violen c agg r agg r or or o r o r a a d d en en r r e c e c a a eeping eeping k k eg u eg u needs needs child r child r f f and r and r and adults and adults a a Caring f Caring f S S Docu me nt a Docu me nt a people with people with mental health mental health y y er er t t gen c gen c or or disa s disa s Eme r Eme r planning and planning and management management Caring f Caring f older people older people Figure 5: Emergency care care 5: Emergency Figure clinical domains COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 – Caring for acutely ill adults CD2 – Caring for adults requiring resuscitation – CaringCD3 for adults with minor injury and illness CD4 – Caring for children and young people CD5 – Caring for people with mental health needs CD6 – Caring for older people – EmergencyCD7 planning and disaster management. Contents | Introduction | Level 1 competencies | Level | Introduction Contents clinical domains care Emergency The clinical in Figure domains 5 specify (CD) the competencies required care to for emergency patients across the lifespan. There are seven clinical domains: • • • • • • • 12
Section 3 - 12 Whipps Cross Hospital . Menlo INTRODUCTION Description No experience in the situation in which they are expected to perform and perform to expected are in which they in the situation No experience to demonstrate Lacks confidence guide their actions. depend on rules to cues. and physical verbal continual and requires practice safe has because the nurse performance acceptable marginally Demonstrates needs help setting Often situations. in actual had prior experience in complex important is most sort out what priorities and cannot reliably prioritise. help to and will require situations in their confidence and has co-ordinated is efficiency, Demonstrates are of a situation which aspects plan and determine Able to actions. lacks practitioner This or delayed. and which can be ignored important an show but they practitioner of a proficient the speed and flexibility of practice. with and manage contingencies cope to ability than in parts. as a whole rather the situation Someone who perceives for which makes of clinical situations understanding a holistic have They options fewer consider decision making. They accurate quick and more of the problem. issues and quickly hone in on accurate the understand rapidly to on rules, guidelines, etc. No longer relies an demonstrates of experience background an extensive With problem. region on the accurate focus They situations. of complex grasp intuitive possibilities. considering fruitless without first of the problem Novice to expert expert to Novice continuum Novice or beginner Novice beginner Advanced Competent Proficient Expert Novice (N): some I have awareness but little knowledge or skill in this competency. Advanced beginner basic I have (AB): knowledge or skill in this competency and need supervision. Competent the I have knowledge (C): and skills relevant for the competency and could complete without supervision. Proficient (P): I am experienced in the knowledge and skills relevant for the competency and could supervise or teach others. Expert (E): I am leading developments in this competency. Code N AB C P E Benner P (1984) From novice expert: to Excellence and power in clinical nursing practice • • • • • Park: Addison-Wesley. Each competency starts with a self-assessment that helps identify to individual learning needs. Figure 6: Benner’s of clinical competence Figure stages . COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Level 1 competenciesLevel are intended for the foundation staff nurse complete. to 2 competenciesLevel are intended for the emergency nurse complete. to Contents | Introduction | Level 1 competencies | Level | Introduction Contents assessment Competence The competencies in this framework are presented in two levels. This publication covers competencies 1 and Level publication 005 923 covers competencies 2 Level • • It is recognised that prior the to introduction this of framework, many nurses worked will have in emergency care for many years. It would be reasonable for them go to straight 2 Level to competencies rather than start 1. with Level For this reason, many the of 1 competencies Level are duplicated 2 where in Level they are still required 2 emergency a Level of nurse. For those who completedhave level 1, some evidence will be transferable the 2 framework, to Level where the competencies remain the same. the majority However, will require demonstration a higher of level achievementof within the taxonomy as described opposite. Competencies should be assessed using Benner’s stages clinical of competence (Figure 6). This taxonomy is widely known and the definitions are easyto apply. 13
Section 3 - 13 National Curriculum and Competency Framework Emergency Nursing (Level 1) INTRODUCTION question and answer (Q&A) anonymised clinical case notes (CCN) feedback from colleagues and/or patients (F) nationally recognised courses (RC). • • • • It would be acceptable put to these abbreviated codes in the evidence column the of competency framework demonstrate to the type evidence of that has been generated. Regular are reviews essential highlight to and resolve any difficulties in achieving or maintaining competence. They also provide support for individuals, helping them reach to their potential without being restricted traditionalby time-bound progression limits. It would be overwhelming for anyone try to address to all the competencies simultaneously; it is recommended that realistic developmental goals are set at each one-to-one meeting and reviewed in a timely manner. It be may helpful put to the the date of next meeting in the ‘expected achievement date’ column those of competencies which should be prioritised, leaving blank those competencies which will be done at a future date. During the firstyear of employment in the emergency care setting,would it realisticbe to meet with a mentor/assessor after the first month, then at three monthly intervals with an appraisal at the end the of first yearIn year. would it two, realisticbe to meet at six-monthly intervals, with annual appraisals and development planning thereafter. eachAt meeting, there should be an agreement on which specificcompetencies beenhave achieved or maintained and which need be to progressed before the next meeting. It be may decided that some competencies are not applicable the to emergency care environment in which the individual is working. should In this case be marked ‘N/A’ against them. This will allow the individual use to their competency framework as a passport should another to they move emergency care workplace and continue their development. COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: direct observation practice of (DOPS) case-based discussion (CBD) simulation (S) reflective report (RR) Contents | Introduction | Level 1 competencies | Level | Introduction Contents For each competency, minimum achievement criteria are set for successful completion. However, this should be regarded as a minimum and not stifle those who wishto progress beyond this, for which they should be given recognition. Whilst some competencies will be unique each to level, others identical have wording in 1 and Levels 2, but the minimum achievement criteria For differ. example, beginner’ 1 ‘Advanced at Level be may required, whilst 2 ‘Proficiency’ at Level may be required. of the clinical supervisor/assessor/ role The mentor A foundation staff nurse should an have emergency nurse as a supervisor (havingcompleted 1 asLevel a minimum). The supervisor should undergone have specific training in supervision and assessment others of and, typically, would be a senior emergency nurse, emergency charge nurse or practice educator. For emergency nurses, a supervisor should be beyond 2. Level Typically, they would be an emergency charge nurse or practice educator. It is recognised that when an emergency care setting starts use to this curriculum, there may be insufficient nurses havethat achieved Level 1 and 2 competencies to supervise the development foundation of staff nurses and emergency nurses. Until suchtime, a a pragmatic approach should be applied and senior nurses should be allowed supervise to others commensurate with their current role. Whilst self-assessment helps direct to learning, support development and provides a baseline for subsequent assessment, objective formal assessment competence of should be undertaken for quality assurance purposes and should include individual professional feedback. Assessment should be based on objective evidence. Due the to diverse nature the of competencies, no one type evidence of can meet all the statements. It is important that a variety evidence of types are used demonstrate to the knowledge, skills and behaviours required. Evidence include, may but would not be limited to: • • • • 14
Section 3 - 14 Whipps Cross Hospital and illness and illness Caring for Caring for adults with adults with minor injury minor injury Caring for Caring for resuscitation resuscitation adults requiring adults requiring sment ain and P GOOD NURSING PRACTICE (GNP) LEVEL 1 (GNP) GOOD NURSING PRACTICE se s Medicines Caring for Caring for a s management children and children and management young people young people tient a and e e P Moving handling assessment g acti c acti c n acutely acutely io n ill adults ill adults Good Good ol s Caring for Caring for oll i nursing nursing s p r p r r e and e ention t ection and v n ont r enting e c o v n In f e p r o i g d d c t P r n n i violen c agg r or or o r a d en r e c a eeping k eg u needs needs child r f and r and adults a Caring f Caring f S Docu me nt a people with people with mental health mental health y y er er t t gen c gen c or or disa s disa s Eme r Eme r planning and planning and management management Caring f Caring f older people older people COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Contents 1 competencies Level 1 Level (GNP) Good nursing practice 15
Section 3 - 15 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level achieved Level achieved Level Level achieved Level GOOD NURSING PRACTICE (GNP) LEVEL 1 (GNP) GOOD NURSING PRACTICE Date of completion Date of completion Date Date of completion Date Evidence submitted Evidence Evidence submitted Evidence Evidence submitted Evidence Expected date of date Expected achievement Expected date of date Expected achievement Expected date of date Expected achievement Minimum standard for for Minimum standard achievement Competent for Minimum standard achievement Competent Competent Competent for Minimum standard achievement Competent Competent Competent Competent Competent Self-assessment (circle (circle Self-assessment as appropriate) N, AB, C, P, E C, P, N, AB, (circle Self-assessment as appropriate) E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, (circle Self-assessment as appropriate) E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, GNP1 – Professional behaviour – Level 1 – Level behaviour GNP1 – Professional nursing of professional a high standard project to skills and behaviour the knowledge, Demonstrate Knowledge Skills Understand the NMC Code and the NMC Code Understand within clinical its application practice personal own to Contribute preparing process, appraisal on and reflecting documents practice Identify own developmental developmental own Identify needs Behaviour Alter pace of work according to to according of work pace Alter of the clinical situation urgency or demands of the emergency setting care in limitations Acknowledge skills and behaviour knowledge, Demonstrate a positive attitude attitude a positive Demonstrate learning and the development to of self and others Promote multi-professional team team multi-professional Promote working Build a professional relationship relationship Build a professional other and/or with students on attachment professionals Act as a role model to others; others; model to as a role Act image a professional projecting all times at COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: GNP 1.1.1 (L1) GNP 1.1.1 (L1) GNP 1.2.1 GNP 1.2.2 (L1) GNP 1.2.3 (L1) (L1) GNP 1.3.1 GNP 1.3.2 (L1) GNP 1.3.3 (L1) GNP 1.3.4 (L1) GNP 1.3.4 GNP 1.3.5 (L1) Contents 1 – Level (GNP) skills: Good nursing practice Core 16
Section 3 - 16 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print sign-off Mentor and sign) (print Level achieved Level achieved Level GOOD NURSING PRACTICE (GNP) LEVEL 1 (GNP) GOOD NURSING PRACTICE Date of completion Date of completion Date Evidence submitted Evidence submitted Evidence Expected date of date Expected achievement of date Expected achievement Minimum standard for for Minimum standard achievement Competent for Minimum standard achievement beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Competent Competent Self-assessment (circle (circle Self-assessment as appropriate) N, AB, C, P, E C, P, N, AB, (circle Self-assessment as appropriate) E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, GNP2 – Team working – Level 1 – Level working GNP2 – Team working team effective to Contribute Knowledge Skills Understand the concepts the concepts Understand and human factors to relating management; resource team and error awareness situational theory and or stressful stress Identify self for situations Identify stress and or stressful and or stressful stress Identify others for situations Identify individual coping individual coping Identify dealing with mechanisms for stress Demonstrate the ability to work work to the ability Demonstrate team in a effectively Demonstrate the ability to lead a to the ability Demonstrate small team COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: GNP 2.1.1 (L1) GNP 2.1.1 (L1) GNP 2.2.1 GNP 2.2.2 (L1) GNP 2.2.3 (L1) GNP 2.2.4 (L1) GNP 2.2.4 GNP 2.2.5 (L1) Contents 1 – Level (GNP) skills: Good nursing practice Core 17
Section 3 - 17 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level achieved Level Level achieved Level GOOD NURSING PRACTICE (GNP) LEVEL 1 (GNP) GOOD NURSING PRACTICE Date of completion Date Date of completion Date Evidence submitted Evidence Evidence submitted Evidence Expected date of date Expected achievement Expected date of date Expected achievement Minimum standard Minimum standard achievement for Competent Competent Competent beginner Advanced Minimum standard achievement for Competent beginner Advanced Competent Competent beginner Advanced Self-assessment (circle (circle Self-assessment as appropriate) N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, (circle Self-assessment as appropriate) N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, GNP3 – Communication – Level 1 – Level GNP3 – Communication communication effective Ensure Knowledge Understand factors that influence influence that factors Understand barriers and common communication communication effective to aid to available strategies Discuss individuals who for communication sensory impairment have aid to available strategies Discuss with individuals who communication speak languages other than English and tools Describe and evaluate the improve to available strategies between of communication quality health professionals Skills Demonstrate effective effective Demonstrate both with colleagues communication the to and external internal setting care emergency effective Demonstrate agencies partner with communication effective Demonstrate of all with patients communication ages and their families/carers/those including the patient, to important plans on care updates regular services use of interpreting Facilitate in line with local policy with effectively Communicate visual individuals with audio and/or impairment COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: GNP 3.1.1 (L1) GNP 3.1.1 (L1) GNP 3.1.2 (L1) GNP 3.1.3 (L1) GNP 3.1.4 GNP 3.2.1 (L1) GNP 3.2.1 GNP 3.2.2 (L1) GNP 3.2.3 (L1) (L1) GNP 3.2.4 (L1) GNP 3.4.5 Contents 1 – Level (GNP) skills: Good nursing practice Core 18
Section 3 - 18 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level achieved Level Level achieved Level GOOD NURSING PRACTICE (GNP) LEVEL 1 (GNP) GOOD NURSING PRACTICE Date of completion Date Date of completion Date Evidence submitted Evidence Evidence submitted Evidence Expected date of date Expected achievement Expected date of date Expected achievement Minimum standard for for Minimum standard achievement Competent Advanced beginner Advanced for Minimum standard achievement Competent Competent Competent Competent Competent Self-assessment (circle (circle Self-assessment as appropriate) N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, (circle Self-assessment as appropriate) N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, GNP4 – Leadership and management – Level 1 and management – Level GNP4 – Leadership of patients individuals or small groups to care nursing of emergency and manage the provision Lead Knowledge Discuss the use of local and Discuss of indicators quality national care emergency Skills Discuss theories of leadership Discuss Respond appropriately to patient patient to appropriately Respond and concerns satisfaction complaints Manage own time effectively, time effectively, Manage own skill in prioritising demonstrating workload Demonstrate ability to manage to ability Demonstrate of of small groups the care of the within one area patients setting care Demonstrate the ability to to the ability Demonstrate trajectory patient’s the anticipate setting the care through Identify and escalate concerns concerns and escalate Identify safety patient to relating local policy to according COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: GNP 4.1.1 (L1) GNP 4.1.1 GNP 4.1.2 (L1) GNP 4.1.2 GNP 4.2.1 (L1) GNP 4.2.1 GNP 4.2.2 (L1) GNP 4.2.3 (L1) GNP 4.2.4 (L1) GNP 4.2.4 GNP 4.2.5 (L1) Contents 1 – Level (GNP) skills: Good nursing practice Core 19
Section 3 - 19 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level achieved Level Level achieved Level GOOD NURSING PRACTICE (GNP) LEVEL 1 (GNP) GOOD NURSING PRACTICE Date of completion Date Date of completion Date Evidence submitted Evidence Evidence submitted Evidence Expected date of date Expected achievement Expected date of date Expected achievement Minimum standard for for Minimum standard achievement Advanced beginner Advanced Competent for Minimum standard achievement Competent Advanced beginner Advanced Self-assessment (circle (circle Self-assessment as appropriate) N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, (circle Self-assessment as appropriate) N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, GNP5 – Education – Level 1 – Level GNP5 – Education setting care within the emergency and mentorship training of education, Support the delivery Knowledge Understand the theories that the theories that Understand and underpin clinical education including learning mentorship, theories style Skills Discuss patient education education patient Discuss strategies Select and implement strategies strategies and implement Select education patient facilitate to Demonstrate skill at teaching teaching skill at Demonstrate in approach modifying others, learning style to response COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: GNP 5.1.1 (L1) GNP 5.1.1 GNP 5.1.2 (L1) GNP 5.1.2 GNP 5.2.1 (L1) GNP 5.2.1 GNP 5.2.2 (L1) Contents 1 – Level (GNP) skills: Good nursing practice Core 20
Section 3 - 20 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level achieved Level Level achieved Level GOOD NURSING PRACTICE (GNP) LEVEL 1 (GNP) GOOD NURSING PRACTICE Date of completion Date Date of completion Date Evidence submitted Evidence Evidence submitted Evidence Expected date of date Expected achievement Expected date of date Expected achievement Minimum standard for for Minimum standard achievement Competent Competent Competent Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced for Minimum standard achievement Competent Advanced beginner Advanced Advanced beginner Advanced Novice Novice Self-assessment (circle (circle Self-assessment as appropriate) N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, (circle Self-assessment as appropriate) N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, GNP6 – Evidence-based practice – Level 1 – Level practice GNP6 – Evidence-based practice evidence-based of application through care and effective safe Ensure Knowledge Understand the theory of Understand practice evidence-based Describe how evidence can be evidence Describe how and accessed identified Describe how evidence should evidence Describe how and evaluated be reviewed Understand the local process for for the local process Understand based on best changing practice evidence Understand the principles to be the principles to Understand when individual care considered standard from deviation requires guidelines practice Skills Understand the principles of Understand audit process Demonstrate ability to critically to ability Demonstrate from literature appraise and or academic professional sources Demonstrate ability to make a make to ability Demonstrate about the judgement the to of a study applicability clinical environment Contribute to developing developing to Contribute patient evidence-based and guidelines protocols Contribute to the audit process the audit process to Contribute within the clinical setting Identify topics for audit and/or audit and/or for topics Identify research COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: GNP 6.1.1 (L1) GNP 6.1.1 GNP 6.1.2 (L1) GNP 6.1.2 GNP 6.1.3 (L1) GNP 6.1.3 GNP 6.1.4 (L1) GNP 6.1.4 GNP 6.1.5 (L1) GNP 6.1.5 GNP 6.1.6 (L1) GNP 6.1.6 GNP 6.2.1 (L1) GNP 6.2.1 GNP 6.2.2 (L1) GNP 6.2.3 (L1) GNP 6.2.4 (L1) GNP 6.2.4 GNP 6.2.5 (L1) Contents 1 – Level (GNP) skills: Good nursing practice Core 21
Section 3 - 21 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved GOOD NURSING PRACTICE (GNP) LEVEL 1 (GNP) GOOD NURSING PRACTICE Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Advanced beginner Advanced beginner Advanced beginner Advanced Competent Competent beginner Advanced beginner Advanced Minimum standard Minimum standard achievement for Competent Competent beginner Advanced Competent beginner Advanced beginner Advanced beginner Advanced Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment (circle (circle Self-assessment as appropriate) N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment (circle (circle Self-assessment as appropriate) Demonstrate the ability to undertake and document an and document undertake to the ability Demonstrate capacity of mental assessment skill in applying the principles of Mental Demonstrate of practice) country to (according Act Capacity is a requirement when there identify to ability Demonstrate confidentiality breach to in treatment for consent gain lawful to ability Demonstrate setting care the emergency provide to it is necessary where situations Recognise to the process and implement without consent treatment this is lawful ensure establish to proceedings initiate to ability Demonstrate in country equivalent (or safeguards of Liberty Deprivation of practice) is required when legal advice identify to ability Demonstrate senior clinician to and escalate Skills Demonstrate understanding of the legal and ethical of the legal and ethical understanding Demonstrate all age groups for consent to related frameworks of the legal and ethical understanding Demonstrate for all age groups confidentiality to related frameworks in equivalent (or Act Describe the principles of Equality practice for and the implications of practice) country including Act, Capacity Describe the principles of Mental and the implications Safeguards of Liberty the Deprivation of practice) in country equivalent (or practice for of (in country Act Describe the principles of Children and the local implications practice), (in Health Act of the Mental understanding Demonstrate and the local implications of practice) country and legal dilemmas ethical, moral analytically on Reflect within clinical practice GNP7 – Legal and ethical dilemmas and decision making – Level 1 – Level and ethical dilemmas decision making GNP7 – Legal principles and ethical on legal frameworks is founded practice Ensure Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: GNP 7.2.1 (L1) GNP 7.2.1 (L1) GNP 7.2.2 (L1) GNP 7.2.3 (L1) GNP 7.2.4 (L1) GNP 7.2.5 (L1) GNP 7.2.6 (L1) GNP 7.2.7 GNP 7.1.1 (L1) GNP 7.1.1 (L1) GNP 7.1.2 (L1) GNP 7.1.3 (L1) GNP 7.1.4 (L1) GNP 7.1.5 (L1) GNP 7.1.6 (L1) GNP 7.1.7 Contents 1 – Level (GNP) skills: Good nursing practice Core 22
Section 3 - 22 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level achieved Level Level achieved Level GOOD NURSING PRACTICE (GNP) LEVEL 1 (GNP) GOOD NURSING PRACTICE Date of completion Date Date of completion Date Evidence submitted Evidence Evidence submitted Evidence Expected date of date Expected achievement Expected date of date Expected achievement Minimum standard for for Minimum standard achievement Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced for Minimum standard achievement Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Self-assessment (circle (circle Self-assessment as appropriate) N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, (circle Self-assessment as appropriate) N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, GNP8 – Service evaluation and improvement – Level 1 – Level and improvement evaluation GNP8 – Service initiatives and improvement evaluation service to Contribute Knowledge Demonstrate an understanding an understanding Demonstrate of the policies which influence care high quality cost-effective, Understand how quality is quality how Understand setting in the care measured Understand local processes for for local processes Understand evaluation service Skills Understand local service local service Understand processes improvement Engage with patients/carers to to Engage with patients/carers development service inform Communicate ideas for service service ideas for Communicate using local improvement frameworks governance Contribute to service service to Contribute projects improvement COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: GNP 8.1.1 (L1) GNP 8.1.1 GNP 8.1.2 (L1) GNP 8.1.2 GNP 8.1.3 (L1) GNP 8.1.3 GNP 8.1.4 (L1) GNP 8.1.4 GNP 8.2.1 (L1) GNP 8.2.1 GNP 8.2.2 (L1) GNP 8.2.3 (L1) Contents 1 – Level (GNP) skills: Good nursing practice Core 23
Section 3 - 23 National Curriculum and Competency Framework Emergency Nursing (Level 1) and illness and illness Caring for Caring for adults with adults with minor injury minor injury Caring for Caring for resuscitation resuscitation adults requiring adults requiring sment ain CROSS-CUTTING THEMES (CCT) LEVEL 1 THEMES (CCT) CROSS-CUTTING and P se s Medicines Caring for Caring for a s management children and children and management young people young people tient a and e e P Moving handling assessment g acti c acti c n acutely acutely io n ill adults ill adults Good Good ol s Caring for Caring for oll i nursing nursing s p r p r r e and e ention t ection and v n ont r enting e c o v n In f e p r o i g d d c t P r n n i violen c agg r or or o r a d en r e c a eeping k eg u needs needs child r f and r and adults a Caring f Caring f S Docu me nt a people with people with mental health mental health y y er er t t gen c gen c or or disa s disa s Eme r Eme r planning and planning and management management Caring f Caring f older people older people COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Contents 1 competencies Level 1 Level themes (CCT) Cross-cutting 24
Section 3 - 24 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CROSS-CUTTING THEMES (CCT) LEVEL 1 THEMES (CCT) CROSS-CUTTING Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Competent Competent Advanced beginner Advanced Competent Competent Competent Competent Minimum standard achievement for Advanced beginner Advanced Competent Competent Competent Competent Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle respiration saturations oxygen (manual) heart rate blood pressure temperature rate flow expiratory Peak Safely and accurately record clinical observations including: clinical observations record and accurately Safely • • • • • • Use a structured A-E approach to undertake patient assessment patient undertake to approach A-E Use a structured Direct/move patients to appropriate areas, teams and services teams areas, appropriate to patients Direct/move Effectively determine patient priority based on assessment based on assessment priority patient determine Effectively (triage) Use a structured approach to gather and document the clinical and document gather to approach Use a structured history Effectively receive handover from pre-hospital personnel and personnel pre-hospital from handover receive Effectively appropriately document Skills Understand the system in place to prioritise a patient according according prioritise a patient to in place the system Understand clinical need to Discuss the use of clinical assessment tools the use of clinical assessment Discuss Understand the elements underpinning the structured approach approach underpinning the structured the elements Understand Disability, Circulation, Breathing, (Airway, assessment patient to Exposure) Understand the importance of obtaining a comprehensive clinical of obtaining a comprehensive the importance Understand person-centred plan appropriate to in order and social history care Understand the factors that affect communication or act as a or act communication affect that the factors Understand be used to may that and strategies barrier, communication GNP3) to them (Cross-reference overcome Understand the value of pre-hospital care information care of pre-hospital the value Understand CCT1 – Patient assessment – Level 1 – Level assessment – Patient CCT1 patients assess and systematically, Holistically Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CCT 1.2.6 (L1) CCT CCT 1.2.5 (L1) CCT CCT 1.2.4 (L1) 1.2.4 CCT CCT 1.2.3 (L1) CCT CCT 1.2.2 (L1) CCT CCT 1.2.1 (L1) 1.2.1 CCT CCT 1.1.6 (L1) 1.1.6 CCT CCT 1.1.5 (L1) 1.1.5 CCT CCT 1.1.4 (L1) 1.1.4 CCT CCT 1.1.3 (L1) 1.1.3 CCT CCT 1.1.2 (L1) 1.1.2 CCT CCT 1.1.1 (L1) 1.1.1 CCT Contents 1 Level themes (CCT) Cross-cutting 25
Section 3 - 25 National Curriculum and Competency Framework Emergency Nursing (Level 1) CROSS-CUTTING THEMES (CCT) LEVEL 1 THEMES (CCT) CROSS-CUTTING Competent Competent Competent N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, ECG monitoring ECG capillary blood glucose urinalysis testing pregnancy Safely and effectively conduct cannulation and venipuncture in venipuncture and cannulation conduct and effectively Safely with local guidelines accordance Safely and accurately conduct the following investigations: the following conduct and accurately Safely • • • • Use the National Early Warning Score (or local variant) and act as and act local variant) (or Score Early Warning Use the National per guidelines depending on score COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CCT 1.2.9 (L1) CCT CCT 1.2.8 (L1) CCT CCT 1.2.7 (L1) 1.2.7 CCT Contents 26
Section 3 - 26 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CROSS-CUTTING THEMES (CCT) LEVEL 1 THEMES (CCT) CROSS-CUTTING Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Competent Competent Competent Competent Competent Competent Competent Minimum standard achievement for Competent Competent Competent Competent Advanced beginner Advanced Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle Evaluate the effectiveness of analgesia at appropriate times at appropriate of analgesia the effectiveness Evaluate pain where appropriately and escalate administration following unmanaged remains Use Entonox safely and appropriately safely Use Entonox If using PGDs: select appropriate drug and route for effective pain effective for drug and route appropriate If using PGDs: select approach and step-wise using systematic management Administer prescribed analgesia via a variety of routes analgesia via a variety prescribed Administer Apply appropriate non-pharmacologic strategies for the for strategies non-pharmacologic Apply appropriate positioning, dressings) splinting, of pain (i.e. management Use pain assessment tools to objectively assess pain assess objectively to tools Use pain assessment Skills Understand locally agreed Patient Group Directions (PGDs) for for (PGDs) Directions Group Patient locally agreed Understand relevant) analgesia (where nurse-led Discuss the pharmacological and non-pharmacological strategies strategies and non-pharmacological the pharmacological Discuss managing pain for Discuss how pain assessment relates to triage priority to relates pain assessment how Discuss Discuss the tools available to assess and objectively measure pain measure and objectively assess to available the tools Discuss 1) see CD 4.2 - Level children in adults (for Understand the principles of pain management Understand Understand the physiology of pain the physiology Understand CCT2 – Pain assessment and management – Level 1 and management – Level assessment – Pain CCT2 with pain patients for care holistic Provide Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CCT 2.2.6 (L1) CCT CCT 2.2.5 (L1) CCT CCT 2.2.4 (L1) 2.2.4 CCT CCT 2.2.3 (L1) CCT CCT 2.2.2 (L1) CCT CCT 2.2.1 (L1) 2.2.1 CCT CCT 2.1.6 (L1) 2.1.6 CCT CCT 2.1.5 (L1) 2.1.5 CCT CCT 2.1.4 (L1) 2.1.4 CCT CCT 2.1.3 (L1) 2.1.3 CCT CCT 2.1.2 (L1) 2.1.2 CCT CCT 2.1.1 (L1) 2.1.1 CCT Contents 1 Level themes (CCT) Cross-cutting 27
Section 3 - 27 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CROSS-CUTTING THEMES (CCT) LEVEL 1 THEMES (CCT) CROSS-CUTTING Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Competent Competent Competent Competent Competent Competent Minimum standard achievement for Competent Competent Competent Competent Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle oral intravenous intramuscular subcutaneous inhaled rectal buccal topical ophthalmic aural Recognise and take appropriate action when a patient when a patient action appropriate and take Recognise or reactions allergic drug reactions, adverse experiences anaphylaxis Administer controlled drugs as per local policy controlled Administer Select appropriate equipment and safely administer medications medications administer and safely equipment appropriate Select via: as prescribed • • • • • • • • • • Store medication safely medication Store Follow local policies on drug administration and the NMC local policies on drug administration Follow of medicines the administration guidelines for Skills Understand drug error or near miss reporting reporting or near miss drug error Understand Understand the immunisation schedule and its importance schedule and its importance the immunisation Understand Describe how to find additional information about medicines (e.g. (e.g. about medicines find additional information to Describe how Formulary) British National Understand locally agreed policies, procedures and guidelines policies, procedures locally agreed Understand of disposal and recording administration, the storage, to relating medicines Understand the NMC standards for medicines management and medicines management for the NMC standards Understand their local application CCT3 – Medicines management – Level 1 – Medicines management Level CCT3 and local policy standards in line with NMC and effectively safely and dispose of medications administer Store, Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CCT 3.2.5 (L1) CCT CCT 3.2.4 (L1) 3.2.4 CCT CCT 3.2.3 (L1) CCT CCT 3.2.2 (L1) CCT CCT 3.2.1 (L1) 3.2.1 CCT CCT 3.1.5 (L1) 3.1.5 CCT CCT 3.1.4 (L1) 3.1.4 CCT CCT 3.1.3 (L1) 3.1.3 CCT CCT 3.1.2 (L1) 3.1.2 CCT CCT 3.1.1 (L1) 3.1.1 CCT Contents 1 Level themes (CCT) Cross-cutting 28
Section 3 - 28 Whipps Cross Hospital CROSS-CUTTING THEMES (CCT) LEVEL 1 THEMES (CCT) CROSS-CUTTING Competent Competent Competent Competent N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Ensure adequate information for patients about medication prior about medication patients for information adequate Ensure discharge to Report medicine-related adverse incidents or ‘near-miss’ events events or ‘near-miss’ incidents adverse medicine-related Report Administer medications using PGDs as per local policy medications Administer Document and communicate appropriately when patients refuse refuse when patients appropriately and communicate Document medications COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CCT 3.2.9 (L1) CCT CCT 3.2.8 (L1) CCT CCT 3.2.7 (L1) 3.2.7 CCT CCT 3.2.6 (L1) CCT Contents 29
Section 3 - 29 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CROSS-CUTTING THEMES (CCT) LEVEL 1 THEMES (CCT) CROSS-CUTTING Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Competent Competent Competent Competent Minimum standard achievement for Competent Competent Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle Safely use locally available moving and handling aids moving use locally available Safely Assess and plan patient moving and handling needs moving and plan patient Assess Adhere to local health and safety guidance when moving when moving guidance local health and safety to Adhere such as consumables and resources, equipment Skills Understand the equipment available within the local organisation, within the local organisation, available the equipment Understand including its benefits and limitations Discuss the tools available to aid the assessment of moving and of moving aid the assessment to available the tools Discuss handling tasks Understand the principles of safe moving and handling moving the principles of safe Understand CCT4 – Moving and handling – Level 1 and handling – Level – Moving CCT4 setting care in the emergency and equipment and handling of patients moving safe Ensure Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CCT 4.2.3 (L1) CCT CCT 4.2.2 (L1) CCT CCT 4.2.1 (L1) 4.2.1 CCT CCT 4.1.3 (L1) 4.1.3 CCT CCT 4.1.2 (L1) 4.1.2 CCT CCT 4.1.1 (L1) 4.1.1 CCT Contents 1 Level themes (CCT) Cross-cutting 30
Section 3 - 30 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CROSS-CUTTING THEMES (CCT) LEVEL 1 THEMES (CCT) CROSS-CUTTING Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Advanced beginner Advanced beginner Advanced Competent beginner Advanced Competent beginner Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced Minimum standard achievement for Competent Competent Competent Competent Competent Self-assessment Self-assessment as appropriate) (circle Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, CCT5 – Infection prevention and control – Level 1 – Level and control prevention – Infection CCT5 principles and control prevention infection to with due regard patients for Care Knowledge Skills Understand the role of the infection prevention and control (IPC) and control prevention of the infection the role Understand team IPC resources the local IPC policies and identify Discuss and the policy of the hand hygiene the importance Understand (PPE) Equipment Protective use of Personal correct in and local initiatives/target/data regional Explain national, (IPC) and control prevention infection to relation it can of how examples and give of infection’ Describe the ‘chain be broken in role and the nurse’s resistance antimicrobial Understand safeguarding antibiotic diseases of communicable awareness Have plan plan and major incident the local pandemic infection Discuss CD 7.1) (see control infection to related plan and isolation of the department implementation Understand implications associated and equipment decontaminate to when and how Understand areas department Apply the isolation, waste, linen, standard precautions and sharps precautions linen, standard waste, Apply the isolation, policies PPE safely Apply and remove hands effectively Decontaminate Aseptic Non-Touch i.e. the use of aseptic technique. Demonstrate (ANTT) Technique the providers, with other health care communicate, Effectively of patients status infection COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CCT 5.1.1 (L1) 5.1.1 CCT (L1) 5.1.2 CCT (L1) 5.1.3 CCT (L1) 5.1.4 CCT (L1) 5.1.5 CCT (L1) 5.1.6 CCT (L1) 5.1.7 CCT (L1) 5.1.8 CCT (L1) 5.1.9 CCT (L1) 5.1.10 CCT CCT 5.2.1 (L1) 5.2.1 CCT 5.2.2 (L1) CCT 5.2.3 (L1) CCT (L1) 5.2.4 CCT 5.2.5 (L1) CCT Contents 1 Level themes (CCT) Cross-cutting 31
Section 3 - 31 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Level Level achieved CROSS-CUTTING THEMES (CCT) LEVEL 1 THEMES (CCT) CROSS-CUTTING Date of Date completion Evidence submitted Evidence Expected date date Expected of achievement Competent Competent Competent Competent Competent Competent beginner Advanced Competent beginner Advanced beginner Advanced Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle physical physical emotional (including exploitation) sexual genital mutilation female neglect abuse domestic violence honour-based Identify the named nurse for safeguarding adults and children and adults and children safeguarding for the named nurse Identify their role understand abuse, to susceptible who are the needs of persons Understand risk from or at disability physical disability, mental either through self or carer (or Act Capacity the principles of Mental Understand (Also and its implementation. of practice) in country equivalent see GNP 7) of Deprivation for the principles and legal implications Understand of in country legislation or capacity (DOLS) Safeguards Liberty see GNP 7) (Also practice. of abuse: the signs and symptoms Discuss • • • • • • • safeguard adequately to sharing in order information Discuss or adults children dependents a patient’s of safeguarding the role Understand from suffering a person/family the challenges of caring for Discuss abuse domestic agencies external to referral for local processes Recognise Understand local guidelines and policies on safeguarding adults local guidelines and policies on safeguarding Understand support access to and how and children CCT6 – Safeguarding children and adults – Level 1 and adults – Level children – Safeguarding CCT6 and adults of children the safety Protect Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CCT 6.1.2 (L1) 6.1.2 CCT (L1) 6.1.3 CCT (L1) 6.1.4 CCT (L1) 6.1.5 CCT (L1) 6.1.6 CCT (L1) 6.1.7 CCT (L1) 6.1.8 CCT (L1) 6.1.9 CCT (L1) 6.1.10 CCT CCT 6.1.1 (L1) 6.1.1 CCT Contents 1 Level themes (CCT) Cross-cutting 32
Section 3 - 32 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Level Level achieved CROSS-CUTTING THEMES (CCT) LEVEL 1 THEMES (CCT) CROSS-CUTTING Date of Date completion Evidence submitted Evidence Expected date date Expected of achievement Competent Competent Competent Competent beginner Advanced beginner Advanced Competent Competent Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle Respond appropriately to situations which necessitate immediate immediate which necessitate situations to appropriately Respond or adults children safeguard to action children safeguarding for the local policy and implement Access and adults safeguarding in conducting support and advice Access interventions a local multi-agency and initiate a risk assessment Undertake abuse referral domestic risk at who are persons for available resources appropriate Identify of abuse with local commensurate level training safeguarding Complete policy supervision Engage in safeguarding Identify children or parents in need of social support and initiate in need of social support and initiate or parents children Identify action appropriate Skills COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CCT 6.2.2 (L1) CCT 6.2.3 (L1) CCT (L1) 6.2.4 CCT 6.2.5 (L1) CCT 6.2.6 (L1) CCT (L1) 6.2.7 CCT 6.2.8 (L1) CCT CCT 6.2.1 (L1) 6.2.1 CCT Contents 33
Section 3 - 33 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print sign-off Mentor and sign) (print Level Level achieved Level achieved CROSS-CUTTING THEMES (CCT) LEVEL 1 THEMES (CCT) CROSS-CUTTING Date of Date completion of Date completion Evidence submitted Evidence submitted Evidence Expected date date Expected of achievement Minimum standard Minimum standard achievement for Competent Competent Minimum standard achievement for Competent Competent Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, Self-assessment as appropriate) (circle E C, P, N, AB, E C, P, N, AB, CCT7 – Documentation and record keeping – Level 1 – Level keeping and record – Documentation CCT7 keeping record for standards in line with NMC care document Effectively Knowledge Skills Understand the NMC standards and local policy for documentation documentation for and local policy the NMC standards Understand keeping and record of patient- and the safekeeping confidentiality patient Discuss Act Protection of the Data including application data identifiable of practice) in country equivalent 1998 (or and legibly in accordance accurately all documentation Complete and local guidelines with national remain secure records patient-identifiable that Ensure COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CCT 7.1.1 (L1) 7.1.1 CCT (L1) 7.1.2 CCT (L1) 7.2.1 CCT (L1) 7.2.2 CCT Contents 1 Level themes (CCT) Cross-cutting 34
Section 3 - 34 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CROSS-CUTTING THEMES (CCT) LEVEL 1 THEMES (CCT) CROSS-CUTTING Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Competent Competent beginner Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced Advanced beginner Advanced Competent Competent beginner Advanced beginner Advanced Competent Minimum standard achievement for Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle Recognise signs of increasing emotion or agitation and use emotion or agitation signs of increasing Recognise of in the management techniques de-escalation appropriate and aggression violence safety own maintain to techniques breakaway Use safe safely, implemented are procedures practice restrictive any Ensure of risk, with assessment and based on an appropriate effectively during the monitoring and appropriate necessary minimum force restraint and with episodes of violence assist to support services Contact as per local policy aggression and rapid tranquilisation with assist and effectively Safely patient of the sedated care nursing appropriate undertake episodes of violence report to system Use local risk management or staff to relating about issues concerns or raise and aggression safety patient of all people wellbeing the mental for the implications Recognise and seek or aggression an episode of violence following involved support appropriate Skills Demonstrate an understanding of clinical conditions that increase increase that of clinical conditions an understanding Demonstrate or agitation and aggression the risk of violence and aggressive violent for triggers the potential Understand behaviour and danger signs of aggressive the warning and discuss Identify behaviour and violent and both physical on restraint, the local policy Understand chemical and police of security involvement for the local policy Understand services techniques breakaway Describe the use of safe CCT8 – Preventing and controlling violence and aggression – Level 1 – Level and aggression violence and controlling – Preventing CCT8 behaviour aggressive and/or violent when individuals display and patients of staff safety Ensure Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CCT 8.2.1 (L1) 8.2.1 CCT 8.2.2 (L1) CCT 8.2.3 (L1) CCT (L1) 8.2.4 CCT 8.2.5 (L1) CCT 8.2.6 (L1) CCT (L1) 8.2.7 CCT CCT 8.1.1 (L1) 8.1.1 CCT (L1) 8.1.2 CCT (L1) 8.1.3 CCT (L1) 8.1.4 CCT (L1) 8.1.5 CCT (L1) 8.1.6 CCT Contents 1 Level themes (CCT) Cross-cutting 35
Section 3 - 35 National Curriculum and Competency Framework Emergency Nursing (Level 1) and illness and illness and illness Caring for Caring for Caring for adults with adults with adults with minor injury minor injury minor injury Caring for Caring for Caring for resuscitation resuscitation resuscitation adults requiring adults requiring adults requiring CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) sment sment sment ain ain ain and and and P P P se s se s se s Medicines Medicines Medicines Caring for Caring for Caring for a s a s a s management management management children and children and children and management management management young people young people young people tient tient tient a a a and and and e e e P P P Moving Moving Moving handling handling handling assessment assessment assessment g g g acti c acti c acti c n n n acutely acutely acutely io n io n io n ill adults ill adults ill adults Good Good Good ol ol ol s s s Caring for Caring for Caring for oll i oll i oll i nursing nursing nursing s s s p r p r p r r r r e and e and e and e e e ention ention ention t t t ection ection ection and and and v v v n n n ont r ont r ont r enting enting enting e e e c c c o o o v v v n n n In f In f In f e e e p r p r p r o o o i i i g g g d d d d c d c d c t t t P r P r P r n n n n n n i i i violen c violen c violen c agg r agg r agg r or or or o r o r o r a a a d d d en en en r r r e c e c e c a a a eeping eeping eeping k k k eg u eg u eg u needs needs needs child r child r child r f f f and r and r and r and adults and adults and adults a a a Caring f Caring f Caring f S S S Docu me nt a Docu me nt a Docu me nt a people with people with people with mental health mental health mental health y y y er er er t t t gen c gen c gen c or or or disa s disa s disa s Eme r Eme r Eme r planning and planning and planning and management management management Caring f Caring f Caring f older people older people older people COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Contents 1 competencies Level 1 Level Clinical domains (CD) ill adults acutely Caring for 36
Section 3 - 36 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Date of Date completion Evidence submitted Evidence Expected date date Expected of achievement Minimum standard Minimum standard achievement for Competent Competent Competent Competent Competent Competent Competent beginner Advanced Competent Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, acute breathlessness breathlessness acute failure 1 respiratory type failure 2 respiratory type pulmonary embolism (PE) and pneumonia infection tract respiratory asthma COPD CD1.1 – Adults with problems affecting the respiratory system – Level 1 Level – system respiratory the affecting with problems – Adults CD1.1 competencies: respiratory trauma-specific 1 for level Competencies Nursing Major Trauma Also see National compromise. system respiratory and/or with airway patients for Care https://www.tquins.nhs.uk/?menu=resources Knowledge Understand the normal anatomy and physiology of the respiratory of the respiratory and physiology the normal anatomy Understand system function used) of respiratory the principles (and tools Understand assessment or potential with actual associated the conditions Understand signs and and the associated of the upper airway obstruction noises airway with: of patients and clinical presentation the features Discuss • • • of: with the illnesses associated the pathophysiology Understand • • • • therapy oxygen guidelines for the local and national Understand supporting for therapy oxygen of delivering methods Discuss ventilation and tension of a pneumothorax Describe the pathophysiology and describe the principles possible pneumothorax, of treatment complications and distress of respiratory the signs and symptoms Understand clinical appropriate ensure to processes the local escalation support COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 1.1.1 (L1) CD1 1.1.1 (L1) CD1 1.1.2 (L1) CD1 1.1.3 (L1) CD1 1.1.4 (L1) CD1 1.1.5 (L1) CD1 1.1.6 (L1) CD1 1.1.7 (L1) CD1 1.1.8 (L1) CD1 1.1.9 Contents 1 ill adults – Level acutely CD1 – Caring for 37
Section 3 - 37 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Date of Date completion Evidence submitted Evidence Expected date date Expected of achievement Minimum standard Minimum standard achievement for Competent Competent Competent Competent Competent Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, actual or potential airway obstruction airway or potential actual depth and pattern rate, respiratory which affect of situations awareness having saturations, oxygen of readings reliability rate flow peak expiratory stridor wheeze expiratory nasal cannulae masks flow variable masks high-concentration masks tracheostomy device) and without spacer dose inhaler (with metered nebuliser device Skills As part of a structured A-E assessment, assess and record: assess assessment, A-E As part of a structured • • • • to: appropriately and respond Recognise • • of devices: using a range therapy oxygen Deliver • • • • via: inhaled medication Deliver • • chest undergoing and support a patient equipment Prepare a pneumothorax insertion for drain or chest aspiration COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 1.2.1 (L1) CD1 1.2.1 CD1 1.2.2 (L1) CD1 1.2.3 (L1) (L1) CD1 1.2.4 CD1 1.2.5 (L1) Contents 38
Section 3 - 38 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Competent beginner Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced Minimum standard achievement for Competent Competent Competent beginner Advanced Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, pericarditis pericarditis pulmonary embolism pneumothorax pleuritic pain pain chest musculoskeletal ischaemic limb pain synchronised cardioversion synchronised pacing transcutaneous CD1.2 – Adults with problems affecting the cardiovascular system – Level 1 Level – system the cardiovascular affecting with problems CD1.2 – Adults problems with cardiovascular for patients care Effectively Knowledge Skills Understand the normal anatomy and physiology of the and physiology the normal anatomy Understand system cardiovascular and the features cycle the cardiac conduction, cardiac Understand of the normal ECG managing algorithms for support (ALS) life the advanced Discuss patient with significant associated rhythms abnormal cardiac compromise cardiovascular coronary with acute changes associated ECG Understand and appropriate infarction, myocardial and/or (ACS) syndromes pathways escalation of: the pathophysiology Discuss • • • • • • anaemia and of sickle cell the pathophysiology Understand cardiovascular to crisis in relation sickle cell for treatment problems Undertake a structured approach to the assessment of patients of patients the assessment to approach a structured Undertake of care priority pain and determine with chest presenting recordings where and troubleshoot 12 lead ECG perform Correctly etc.) baseline, wandering as artefact, (such of poor quality are including failure, heart in acute to patients care effective Provide of clinical monitoring medication, of prescribed administration support of psychological and provision condition requiring: of patients with care and assist equipment Prepare • • COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 2.1.1 (L1) CD1 2.1.1 (L1) CD1 2.1.2 (L1) CD1 2.1.3 (L1) CD1 2.1.4 (L1) CD1 2.1.5 (L1) CD1 2.1.6 CD1 2.2.1 (L1) CD1 2.2.1 CD1 2.2.2 (L1) CD1 2.2.3 (L1) CD1 2.2.5 (L1) Contents 1 ill adults – Level acutely CD1 – Caring for 39
Section 3 - 39 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced Minimum standard achievement for Advanced beginner Advanced Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, principal brain areas and their function areas principal brain pathways sensory and motor stroke haemorrhage, haemorrhage (subarachnoid intracranial haemorrhage) subdural haemorrhage, extradural epilepsy disease Parkinson’s syndrome Guillain–Barré gravis Myasthenia stroke head injury disease Parkinson’s back pain pressure intracranial raised cauda-equina CD1.3 Neurological system – Level 1 – Level system CD1.3 Neurological problems with neurological for patients care Effectively Knowledge Skills Understand basic anatomy and physiology of the central nervous nervous of the central and physiology basic anatomy Understand including: system • • with the following associated the pathophysiology Understand medical conditions: • • • • • • guidelines for: national Understand • • • • intervention: emergency requiring the signs of conditions Discuss • • Recognise and act appropriately when mechanism of injury or appropriately and act Recognise neurological acute suggest may complaint of presenting history insult COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 3.1.1 (L1) CD1 3.1.1 (L1) CD1 3.1.2 (L1) CD1 3.1.3 (L1) CD1 3.1.4 CD1 3.2.1 (L1) CD1 3.2.1 Contents 1 ill adults – Level acutely CD1 – Caring for 40
Section 3 - 40 Whipps Cross Hospital CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Competent Competent beginner Advanced N, AB, C, P, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, stroke haemorrhage intracranial seizures of consciousness levels altered assessment of conscious level using ‘alert, voice, pain, voice, using ‘alert, level of conscious assessment scale(AVPU) unresponsive’ and tone power motor of sensation, basic assessment Score Coma Glasgow and reaction of pupillary size assessment Apply local and national clinical guidelines in the care of clinical guidelines in the care Apply local and national • • • • combative and/or of the agitated care and effective safe Provide patient Undertake a neurological assessment to include: to assessment a neurological Undertake • • • • COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 3.2.3 (L1) (L1) CD1 3.2.4 CD1 3.2.2 (L1) Contents 41
Section 3 - 41 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Competent Competent Competent beginner Advanced beginner Advanced beginner Advanced Minimum standard achievement for Competent beginner Advanced Competent Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, GI bleeding sepsis, including pancreatitis intra-abdominal gastroenteritis acute abdominal aortic aneurism ischaemic bowel vomiting and/or per rectum loss of frank or occult blood or occult of frank loss per rectum and/or vomiting vomiting faecal abdomen rigid/distended abdominal bruising CD1.4 - Gastrointestinal system – Level 1 – Level system CD1.4 - Gastrointestinal problems gastrointestinal with abdominal pain and/or for patients care Effectively Knowledge Skills Understand the anatomy and physiology of the gastrointestinal of the gastrointestinal and physiology the anatomy Understand system (GI) with the following associated the pathophysiology Understand presentations: emergency • • • • • with patients when assessing required specific information Discuss abdominal pain in order and/or symptoms gastrointestinal acute clinical priority determine to common local clinical guidelines pertaining to Understand GI bleeding) (e.g. presentations emergency gastrointestinal tube in this insertion of nasogastric for the rationale Understand tube placement for and local guidelines/policy of patients group with in patients undertaken commonly Describe the investigations presentations abdominal pain or gastrointestinal Demonstrate initial assessment and prioritisation of patients of patients and prioritisation initial assessment Demonstrate pain relief appropriate with abdominal pain, initiating presenting aid further clinical assessment to and investigations of: symptoms flag’ signs and ‘red and report Recognise • • • • with patients for and privacy dignity to with respect care Provide of skin integrity awareness having diarrhoea and or vomiting; with diarrhoea in patients problems COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 4.1.1 (L1) CD1 4.1.1 (L1) CD1 4.1.2 (L1) CD1 4.1.3 (L1) CD1 4.1.4 (L1) CD1 4.1.5 (L1) CD1 4.1.6 CD1 4.2.1 (L1) CD1 4.2.1 CD1 4.2.2 (L1) CD1 4.2.3 (L1) Contents 1 ill adults – Level acutely CD1 – Caring for 42
Section 3 - 42 Whipps Cross Hospital CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Competent Competent Competent Competent N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Recognise and locate the equipment used to control variceal variceal control used to the equipment and locate Recognise bleeding risk and control pose an infection who may patients Recognise those with diarrhoea and or (e.g. procedures isolation implement vomiting) appropriate samples and send for of stool collection Undertake investigations Demonstrate the ability to safely and effectively insert a wide bore insert a wide bore and effectively safely to the ability Demonstrate tube nasogastric COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 4.2.5 (L1) CD1 4.2.6 (L1) (L1) CD1 4.2.7 CD1 4.2.4 (L1) CD1 4.2.4 Contents 43
Section 3 - 43 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Competent beginner Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced Minimum standard achievement for Advanced beginner Advanced beginner Advanced beginner Advanced Competent Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Pyelonephritis colic renal and haematuria urine retention tract renal and/or the kidney to trauma hyper/hypokalemia hyper/hyponatremia hypomagnesemia injury kidney AKI – acute disease kidney CKD – chronic acute kidney injury kidney acute disease kidney chronic CD1.5 – Renal system – Level 1 – Level system CD1.5 – Renal renal problems with for patients care Effectively Knowledge Skills Understand the anatomy and physiology of the kidneys and renal and renal of the kidneys and physiology the anatomy Understand tract with the common associated the pathophysiology Understand presentations: renal • • • • with the following associated the pathophysiology Discuss system: the renal to and their relationship presentations • • • and signs and symptoms the presenting Understand with: associated pathophysiology • • and and electrolytes urea for the normal values Recognise of derangement the significance understand guidelines (including NICE the local and national Understand AKI and CKD to in relation guidelines) Implement safe and effective care in patients with: in patients care and effective safe Implement • • in line with locally patients in female catheters Insert urethral policies and procedures agreed in line with locally agreed in male patients catheters Insert urethral policies and procedures concerns and escalate urine output and fluid intake Monitor appropriately COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 5.1.1 (L1) CD1 5.1.1 (L1) CD1 5.1.2 (L1) CD1 5.1.3 (L1) CD1 5.1.4 (L1) CD1 5.1.5 (L1) CD1 5.1.6 CD1 5.2.1 (L1) CD1 5.2.1 CD1 5.2.2 (L1) CD1 5.2.3 (L1) (L1) CD1 5.2.4 Contents 1 ill adults – Level acutely CD1 – Caring for 44
Section 3 - 44 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced Minimum standard achievement for Advanced beginner Advanced Competent Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, pancreas – diabetes and glycaemic emergencies and glycaemic – diabetes pancreas and hypothyroidism – thyrotoxicosis thyroid insipidus pituitary – diabetes disease – Addison’s adrenal hyperglycaemia (DKA) ketoacidosis diabetic hypoglycaemia Crisis Addisonian capillary blood glucose monitoring capillary blood glucose monitoring capillary blood ketone urinalysis CD1.6 – Endocrine system – Level 1 – Level CD1.6 – Endocrine system with endocrine problems for patients care Effectively Knowledge Skills Understand the anatomy and physiology associated with the associated and physiology the anatomy Understand endocrine system with conditions associated the pathophysiology Understand in particular: system, the endocrine affecting • • • • presentations: of the following Describe the signs and symptoms • • • • manage endocrine emergency the local guidelines to Understand presentations blood blood glucose, for ranges the normal reference Understand and blood gases pH, lactate Recognise ‘red flag’ endocrine presentations and escalate and escalate flag’ endocrine presentations ‘red Recognise clinician an appropriate to concerns with presenting of patients assessment and effective safe Provide system, the endocrine affecting problems or potential actual investigations: the following undertake to including the ability • • • COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 6.1.1 (L1) CD1 6.1.1 (L1) CD1 6.1.2 (L1) CD1 6.1.3 (L1) CD1 6.1.4 (L1) CD1 6.1.5 CD1 6.2.1 (L1) CD1 6.2.1 CD1 6.2.2 (L1) Contents 1 ill adults – Level acutely CD1 – Caring for 45
Section 3 - 45 National Curriculum and Competency Framework Emergency Nursing (Level 1) CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Advanced beginner Advanced N, AB, C, P, E C, P, N, AB, hyperglycaemia DKA hypoglycaemia Crisis Addison’s Provide safe and effective care to patients with endocrine to patients care and effective safe Provide of: in particular the management emergencies, • • • • COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 6.2.3 (L1) Contents 46
Section 3 - 46 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Evidence submitted Evidence Expected date date Expected of achievement Competent Advanced beginner Advanced Competent Advanced beginner Advanced Advanced beginner Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Competent Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle breast and testicular self-examination self-examination and testicular breast health vulval smears cervical vaccination human papilloma virus (HPV) mammography and examination assessment prostate Discuss the legal and professional responsibilities of the responsibilities the legal and professional Discuss (FGM) genital mutilation female to in relation nurse emergency Understand the assessment, treatment options, health advice and options, health advice treatment the assessment, Understand emergency requesting women for health promotion sexual contraception Discuss the specific assessment related to female reproductive reproductive female to related the specific assessment Discuss clinical priority determine to presentations system Describe the primary symptoms of potential cancer diagnosis cancer of potential Describe the primary symptoms Female-specific competency knowledge competency Female-specific the and maturity, development reproductive Understand of normal menopausal changes and the features cycle menstrual Describe the health promotion and screening available for for available and screening Describe the health promotion including: men and women for health surveillance reproductive • • • • • • Discuss the signs, symptoms and presentation of sexually of sexually and presentation the signs, symptoms Discuss and the their management (STIs), infections transmitted available resources and referral information Understand the emotional and physical care of women and men of women care the emotional and physical Understand or rape assault of sexual with injuries as a result who present Understand the assessment and management of vaginal and rectal and rectal of vaginal and management the assessment Understand bodies foreign Understand the normal anatomy and physiology of the male and and physiology the normal anatomy Understand system reproductive female CD1.7 – Reproductive system – Level 1 – Level system – Reproductive CD1.7 problems system reproductive with for patients care Effectively Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 7.1.10 (L1) CD1 7.1.10 CD1 7.1.9 (L1) CD1 7.1.9 CD1 7.1.8 (L1) CD1 7.1.8 CD1 7.1.7 (L1) CD1 7.1.7 CD1 7.1.6 (L1) CD1 7.1.6 CD1 7.1.5 (L1) CD1 7.1.5 CD1 7.1.4 (L1) CD1 7.1.4 CD1 7.1.3 (L1) CD1 7.1.3 CD1 7.1.2 (L1) CD1 7.1.2 CD1 7.1.1 (L1) CD1 7.1.1 Contents 1 ill adults – Level acutely CD1 – Caring for 47
Section 3 - 47 National Curriculum and Competency Framework Emergency Nursing (Level 1) CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Advanced beginner Advanced Advanced beginner Advanced beginner Advanced Advanced beginner Advanced Competent Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Competent N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, trauma post-coital post-menopausal torsion or rupture of ovarian cysts cysts of ovarian or rupture torsion salpingitis disorders pelvic inflammatory dysmenorrhoea hyperstimulation) (ovarian conditions IVF associated miscarriage pregnancy ectopic delivery emergency Understand the features and management of abnormal vaginal of abnormal vaginal and management the features Understand bleeding from: • • • Gynaecological conditions Gynaecological of: and management the features Understand • • • • • Understand common complications which arise in the third which arise in the third complications common Understand diabetes) gestational pre-eclampsia, (e.g. of pregnancy trimester Understand the assessment and management of women of women and management the assessment Understand of pregnancy termination post with complications presenting Understand the physical and emotional impact of early and emotional impact the physical Understand of and the importance pregnancy miscarriage and ectopic available counselling and support and specific services empathy, Describe local policy for investigating and/or disposing of and/or investigating for Describe local policy setting care in the emergency of conception products Understand the local guidance relating to: to: relating the local guidance Understand • • • Understand the signs and symptoms and management of and management the signs and symptoms Understand hyperemesis Describe the development of the foetus within the first 16 weeks 16 within the first of the foetus Describe the development in early pregnancy health guidance and the related Pregnancy-specific competency knowledge competency Pregnancy-specific in the pregnancy of establishing the significance Understand based negatives false for and the potential setting care emergency on hormonal irregularities COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 7.1.20 (L1) CD1 7.1.20 CD1 7.1.19 (L1) CD1 7.1.19 CD1 7.1.18 (L1) CD1 7.1.18 CD1 7.1.17 (L1) CD1 7.1.17 CD1 7.1.16 (L1) CD1 7.1.16 CD1 7.1.15 (L1) CD1 7.1.15 CD1 7.1.14 (L1) CD1 7.1.14 CD1 7.1.13 (L1) CD1 7.1.13 CD1 7.1.12 (L1) CD1 7.1.12 CD1 7.1.11 (L1) CD1 7.1.11 Contents 48
Section 3 - 48 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Evidence submitted Evidence Expected date date Expected of achievement Competent Competent Competent Competent Competent Competent Competent Competent Advanced beginner Advanced Minimum standard achievement for Competent Advanced beginner Advanced N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, torsion of the testes torsion hydrocele epididymo-orchitis penile trauma penile fracture balanitis paraphymosis priaprism Demonstrate a non-judgemental approach to issues of sexual of sexual issues to approach a non-judgemental Demonstrate transmitted and sexually rape assault, harm, including FGM, infection Demonstrate compassion and empathy when communicating with when communicating and empathy compassion Demonstrate be experiencing them, who may to and those important patients, pregnancy of an unexpected or news of a pregnancy the loss Prepare equipment and support men undergoing examination of examination and support men undergoing equipment Prepare of a male the presence and ensure system, the reproductive chaperone Undertake a structured approach to the initial assessment of men the initial assessment to approach a structured Undertake and symptoms associated with reproductive/genital presenting prioritise appropriately Identify location and prepare equipment required in the event of in the event required equipment and prepare location Identify bleeding vaginal from haemorrhagic shock resulting Prepare equipment and support women undergoing vaginal vaginal undergoing and support women equipment Prepare chaperone of a female the presence and ensure examination Undertake a structured approach to the initial assessment of the initial assessment to approach a structured Undertake and prioritise symptoms with gynaecological presenting women appropriately Undertake a structured approach to the initial assessment of the initial assessment to approach a structured Undertake and with pregnancy associated with problems presenting women (triage) prioritise appropriately Skills Understand the signs and symptoms and management of: and management the signs and symptoms Understand • • • • • • • • Describe the specific assessment related to the male reproductive reproductive to the male related Describe the specific assessment clinical priority determine to system Male-specific competency knowledge competency Male-specific maturity and sexual development reproductive Understand COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 7.2.8 (L1) CD1 7.2.8 CD1 7.2.7 (L1) CD1 7.2.7 CD1 7.2.6 (L1) CD1 7.2.6 CD1 7.2.5 (L1) CD1 7.2.5 CD1 7.2.4 (L1) CD1 7.2.4 CD1 7.2.3 (L1) CD1 7.2.3 CD1 7.2.2 (L1) CD1 7.2.2 CD1 7.2.1 (L1) CD1 7.2.1 CD1 7.1.23 (L1) CD1 7.1.23 CD1 7.1.22 (L1) CD1 7.1.22 CD1 7.1.21 (L1) CD1 7.1.21 Contents 49
Section 3 - 49 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print ) CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Competent Competent Competent Competent Competent beginner Advanced beginner Advanced beginner Advanced Minimum standard achievement for Competent Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, major fractures – pelvis, hip and long bones major fractures spinal injury cauda-equina dislocation major joint CD1.8 – Illness affecting the musculoskeletal system – Level 1 Level – system the musculoskeletal affecting CD1.8 – Illness www.tquins.nhs.uk/?menu=resources at: 1, which can be found Level competencies Nursing Group Major Trauma (also see the National problems with major musculoskeletal for patients care Effectively Knowledge Skills Understand the anatomy and physiology of the musculoskeletal of the musculoskeletal and physiology the anatomy Understand system of catastrophic management the immediate Understand injuries with musculoskeletal haemorrhage associated or limb-threatening of life Describe the signs and symptoms injuries musculoskeletal problems, of major musculoskeletal Describe the initial assessment of mechanism injury including the relevance of major musculoskeletal the pathophysiology Understand including: problems • • • • the assessment guidelines for the local and national Understand local (e.g. problems of major musculoskeletal and management guidelines) network trauma of venous and treatment the assessment Understand (VTE) thromboembolism with in patients prevention on VTE Describe local policy immobilised limbs Undertake a structured initial assessment of patients with of patients initial assessment a structured Undertake (triage) appropriately care prioritise and problems musculoskeletal COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 8.1.1 (L1) CD1 8.1.1 (L1) CD1 8.1.2 (L1) CD1 8.1.3 (L1) CD1 8.1.4 (L1) CD1 8.1.5 (L1) CD1 8.1.6 (L1) CD1 8.1.7 (L1) CD1 8.1.8 CD1 8.2.1 (L1) CD1 8.2.1 Contents 1 ill adults – Level acutely CD1 – Caring for 50
Section 3 - 50 Whipps Cross Hospital CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Competent Competent beginner Advanced beginner Advanced beginner Advanced beginner Advanced N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, major pelvic injury neck of femur fractured shaft femoral fractured dislocation major joint spinal injury Identify the need for emergency manipulations of fractures and of fractures manipulations emergency the need for Identify supply or skin neurovascular to pose a threat that dislocations appropriately and escalate integrity, support major fractures to of splints Apply a range splints traction Apply femoral Apply a pelvic splint spinal immobilisation safe and demonstrate the need for, Identify of patients Provide safe and effective care for patients with: for patients care and effective safe Provide • • • • • COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD1 8.2.3 (L1) (L1) CD1 8.2.4 CD1 8.2.5 (L1) CD1 8.2.6 (L1) (L1) CD1 8.2.7 CD1 8.2.2 (L1) Contents 51
Section 3 - 51 National Curriculum and Competency Framework Emergency Nursing (Level 1) and illness and illness and illness Caring for Caring for Caring for adults with adults with adults with minor injury minor injury minor injury Caring for Caring for Caring for resuscitation resuscitation resuscitation adults requiring adults requiring adults requiring CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) sment sment sment ain ain ain and and and P P P se s se s se s Medicines Medicines Medicines Caring for Caring for Caring for a s a s a s management management management children and children and children and management management management young people young people young people tient tient tient a a a and and and e e e P P P Moving Moving Moving handling handling handling assessment assessment assessment g g g acti c acti c acti c n n n acutely acutely acutely io n io n io n ill adults ill adults ill adults Good Good Good ol ol ol s s s Caring for Caring for Caring for oll i oll i oll i nursing nursing nursing s s s p r p r p r r r r e and e and e and e e e ention ention ention t t t ection ection ection and and and v v v n n n ont r ont r ont r enting enting enting e e e c c c o o o v v v n n n In f In f In f e e e p r p r p r o o o i i i g g g d d d d c d c d c t t t P r P r P r n n n n n n i i i violen c violen c violen c agg r agg r agg r or or or o r o r o r a a a d d d en en en r r r e c e c e c a a a eeping eeping eeping k k k eg u eg u eg u needs needs needs child r child r child r f f f and r and r and r and adults and adults and adults a a a Caring f Caring f Caring f S S S Docu me nt a Docu me nt a Docu me nt a people with people with people with mental health mental health mental health y y y er er er t t t gen c gen c gen c or or or disa s disa s disa s Eme r Eme r Eme r planning and planning and planning and management management management Caring f Caring f Caring f older people older people older people COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Contents 1 competencies Level 1 Level Clinical domains (CD) adults requiring Caring for resuscitation please also see the National patients trauma nurses caring for For at: available competencies, Nursing Group Major Trauma www.tquins.nhs.uk/?menu=resources 52
Section 3 - 52 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Advanced beginner Advanced Competent Competent Competent beginner Advanced beginner Advanced Minimum standard achievement for Competent Competent beginner Advanced Competent Competent Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, CD2.1 – Anaphylaxis – Level 1 – Level – Anaphylaxis CD2.1 anaphylaxis suffering patients for appropriately Care Knowledge Skills Understand the pathophysiology of anaphylaxis the pathophysiology Understand differentiating the clinical signs and symptoms Understand and anaphylaxis reaction allergic between causes of anaphylaxis the common Discuss support to assistance summon emergency to Describe how care emergency immediate the emergency and local guidelines for the national Understand of anaphylaxis management with in patients of investigations the importance Understand tryptase) cell mast blood gas, lactate, venous (e.g. anaphylaxis Recognise signs of anaphylaxis (bronchospasm, hypotension, hypotension, (bronchospasm, signs of anaphylaxis Recognise clinical support angio-oedema) and summon appropriate and IM adrenaline – oxygen resuscitation emergency Initiate (in steroids and IV fluids, antihistamine timely IV access, Ensure procedures) and locally agreed guidance with national accordance monitoring physiological appropriate Establish capable clinical area, in an appropriate is placed the patient Ensure of observation needs and level of supporting their physiological COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD2 1.1.1 (L1) CD2 1.1.1 (L1) CD2 1.1.2 (L1) CD2 1.1.3 (L1) CD2 1.1.4 (L1) CD2 1.1.5 (L1) CD2 1.1.6 CD2 1.2.1 (L1) CD2 1.2.1 CD2 1.2.2 (L1) CD2 1.2.3 (L1) (L1) CD2 1.2.4 CD2 1.2.5 (L1) Contents 1 – Level resuscitation adults requiring CD2 – Caring for 53
Section 3 - 53 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print sign-off Mentor and sign) (print Level Level achieved Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion of Date completion Evidence submitted Evidence submitted Evidence Expected date date Expected of achievement date Expected of achievement Minimum standard Minimum standard achievement for Competent Competent Competent Competent beginner Advanced beginner Advanced beginner Advanced Minimum standard achievement for Competent Competent Competent Competent Competent Competent Competent beginner Advanced beginner Advanced Self-assessment Self-assessment as appropriate) (circle E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment as appropriate) (circle E C, P, N, AB, Understand the UK Resuscitation Council guidelines for in-hospital guidelines for Council the UK Resuscitation Understand resuscitation of drugs used methods and delivery the indications Understand algorithm support (ALS) life within the advanced equipment resuscitation use of emergency Describe the safe and arrest causes of cardiorespiratory the major reversible Discuss their treatment or continuation to relating the decision-making process Understand in the event be taken to and the actions of resuscitation, termination resuscitation of unsuccessful donation and tissue organ to relating procedures Understand clinical support to and summon appropriate critical illness Recognise arrest) of cardiorespiratory (prevention early management instigate with the Resuscitation support in accordance basic life Perform basic airway compressions, chest UK guidelines – effective Council ventilation and bag-valve-mask management status provider equivalent) Support (or Life Intermediate of the drugs as per instructions resuscitation and administer Prepare leader team team resuscitation as part of the and effectively safely Perform following investigations or facilitate and perform monitoring Establish output (also see CD2.6) cardiac of spontaneous the return of emotional support during the process appropriate Provide and empathy sensitivity demonstrate bad news; breaking with local guidelines in accordance patient the deceased for Care CD2.2 – Cardiorespiratory arrest – Level 1 – Level arrest CD2.2 – Cardiorespiratory at: available guidelines (2015), Council with the UK Resuscitation in accordance support procedures life and instigate arrest or cardiorespiratory in respiratory patients Identify www.resus.org.uk/resuscitation-guidelines Knowledge Understand the causes of cardiac arrest, including special situations including special situations arrest, the causes of cardiac Understand hypothermia) overdose, (e.g. approach adopting a structured patient, the collapsed Rapidly assess Skills COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD2 2.1.2 (L1) CD2 2.1.2 (L1) CD2 2.1.3 (L1) CD2 2.1.4 (L1) CD2 2.1.5 (L1) CD2 2.1.6 (L1) CD2 2.1.7 CD2 2.2.2 (L1) CD2 2.2.3 (L1) (L1) CD2 2.2.4 CD2 2.2.5 (L1) CD2 2.2.6 (L1) (L1) CD2 2.2.7 CD2 2.2.8 (L1) CD2 2.2.9 (L1) CD2 2.1.1 (L1) CD2 2.1.1 (L1) CD2 2.2.1 Contents 1 – Level resuscitation adults requiring CD2 – Caring for 54
Section 3 - 54 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Competent Competent Competent Competent Competent beginner Advanced Competent beginner Advanced Advanced beginner Advanced beginner Advanced beginner Advanced Competent Minimum standard achievement for Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle Identify patients with signs of sepsis and report to senior clinician to with signs of sepsis and report patients Identify baseline observations record monitoring, physiological Instigate patient and assign score early warning calculate and accurately (triage) priority and in saturations oxygen to titrated therapy oxygen Initiate guidelines with agreed accordance blood samples, and obtain appropriate IV access Establish – in line with locally agreed blood cultures including venous procedures and in as prescribed fluid and antibiotics intravenous Administer with guidelines and local policy accordance abnormal results and escalate tests of near patient results Evaluate appropriately monitoring fluid balance accurate Maintain liaising with condition, of patient’s close observation Maintain in line with local guidelines and support as required critical care procedures Skills Understand the potential causes of sepsis the potential Understand of sepsis, including its identifying the pathophysiology Understand clinical features such as: lactate investigations of patient Describe the significance count cell and white levels relating guidelines and documentation locally agreed Understand sepsis to CD2.3 – Managing sepsis – Level 1 CD2.3 – Managing sepsis Level with sepsis patients for care appropriate Provide Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD2 3.2.1 (L1) CD2 3.2.1 CD2 3.2.2 (L1) CD2 3.2.3 (L1) (L1) CD2 3.2.4 CD2 3.2.5 (L1) CD2 3.2.6 (L1) (L1) CD2 3.2.7 CD2 3.2.8 (L1) CD2 3.1.1 (L1) CD2 3.1.1 (L1) CD2 3.1.2 (L1) CD2 3.1.3 (L1) CD2 3.1.4 Contents 1 – Level resuscitation adults requiring CD2 – Caring for 55
Section 3 - 55 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Advanced beginner Advanced beginner Advanced beginner Advanced Competent Minimum standard achievement for Competent Competent Competent Competent Competent Competent Competent Competent Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, hypovolemic shock hypovolemic shock cardiogenic septic shock shock anaphylactic shock neurogenic CD2.4 – The shocked patient – Level 1 – Level patient shocked CD2.4 – The competencies Group Major Trauma CD2.3 Sepsis and the National Anaphylaxis, Also see CD2.1 states. with ‘shock’ patients for care appropriate Provide Knowledge Define ‘shock’ and discuss the pathophysiology and presenting and presenting the pathophysiology ‘shock’ and discuss Define from: resulting signs and symptoms • • • • • Skills Understand the progression of shock and the resulting of shock and the resulting the progression Understand and blood values of signs, symptoms manifestation forms of shock listed of the different the management Understand above bleeding minimise external to Describe methods Identify and report evidence of catastrophic haemorrhage of catastrophic evidence and report Identify Instigate physiological monitoring, record baseline observations baseline observations record monitoring, physiological Instigate patient and assign score early warning calculate and accurately (triage) priority with local and national in accordance therapy oxygen Initiate guidance blood samples, in line and obtain appropriate IV access Establish procedures with locally agreed as of blood products transfusion fluids and/or intravenous Initiate with guidelines and local policy and in accordance prescribed abnormal results and communicate blood results Evaluate appropriately monitoring fluid balance accurate Maintains to timely communicate and of interventions effect Evaluate as per local guidelines deterioration clinician. Escalate responsible COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD2 4.1.1 (L1) CD2 4.1.1 CD2 4.1.2 (L1) CD2 4.1.2 (L1) CD2 4.1.3 (L1) CD2 4.1.4 CD2 4.2.1 (L1) CD2 4.2.1 CD2 4.2.2 (L1) CD2 4.2.3 (L1) (L1) CD2 4.2.4 CD2 4.2.5 (L1) CD2 4.2.6 (L1) (L1) CD2 4.2.7 CD2 4.2.8 (L1) Contents 1 – Level resuscitation adults requiring CD2 – Caring for 56
Section 3 - 56 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Advanced beginner Advanced Competent Competent beginner Advanced beginner Advanced beginner Advanced Competent Minimum standard achievement for Competent Competent Competent Competent Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, positioning – chin lift/head tilt and/or jaw thrust jaw positioning – chin lift/head tilt and/or (OPA) airways use of oropharyngeal (NPA) use of nasopharyngeal airway of the oropharynx suctioning CD2.5 – The unconscious patient – Level 1 – Level patient unconscious CD2.5 – The of consciousness level with reduced presenting patients for care holistic Provide Knowledge Discuss the potential causes of unconsciousness the potential Discuss Skills Describe the systematic assessment of patients with altered levels levels with altered of patients assessment Describe the systematic of consciousness Coma and describe the Glasgow ‘AVPU’ the terms Understand (GCS) Score cause and establish to required Describe the investigations of levels with altered patients for treatment possible consciousness medical on relevant of obtaining information Describe methods medic alerts, telephone) (e.g. patients in unconscious history patients for services specialist to the local pathways Understand haemorrhage or stroke) cerebral injury (e.g. with brain meet to care nursing comprehensive the need for Understand and mobility and general), eye (oral, hygiene hydration, do so themselves unable to needs in patients communication Recognise patients who are unable to maintain their own airway airway their own maintain unable to who are patients Recognise skills: basic airway the following and implement • • • • Escalate promptly and effectively concerns about any patient with patient about any concerns and effectively promptly Escalate is there or where their airway, or maintain protect to the inability parameters of physiological or deterioration derangement initial a structured undertake to the ability Demonstrate and prioritise level, conscious with altered of a patient assessment (triage) appropriately care monitoring physiological appropriate Establish COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD2 5.1.1 (L1) CD2 5.1.1 CD2 5.1.2 (L1) CD2 5.1.2 (L1) CD2 5.1.3 (L1) CD2 5.1.4 (L1) CD2 5.1.5 (L1) CD2 5.1.6 (L1) CD2 5.1.7 CD2 5.2.1 (L1) CD2 5.2.1 CD2 5.2.2 (L1) CD2 5.2.3 (L1) (L1) CD2 5.2.4 Contents 1 – Level resuscitation adults requiring CD2 – Caring for 57
Section 3 - 57 National Curriculum and Competency Framework Emergency Nursing (Level 1) CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Competent Competent Competent beginner Advanced N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Demonstrate effective patient positioning, having due regard for regard due positioning, having patient effective Demonstrate monitoring area pressure Conduct eye and mouth care once initial assessment and initial assessment once and mouth care eye Conduct has been completed evaluation and privacy for with due regard met needs are hygiene Ensure dignity significant and contact of patients identity establish to steps Take others COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD2 5.2.5 (L1) CD2 5.2.6 (L1) (L1) CD2 5.2.7 CD2 5.2.8 (L1) Contents 58
Section 3 - 58 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Evidence submitted Evidence Expected date date Expected of achievement Minimum standard Minimum standard achievement for Competent beginner Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced Competent beginner Advanced Competent Competent Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, CD2.6 – Emergency airway and ventilation management – Level 1 management – Level and ventilation airway CD2.6 – Emergency ventilation and/or intervention airway emergency requiring patients for care holistic Provide Knowledge Understand the principles of bag-valve-mask ventilation ventilation the principles of bag-valve-mask Understand and the principles of management airway Describe emergency (RSI) induction sequence rapid of monitoring minimum standards the guidelines for Understand and the local patients ventilated for parameters of physiological used equipment and guidelines procedures operating Describe the standard of each and the roles management airway emergency to relating member team and the normal (ETCO2) monitoring end-tidal CO2 Understand values normal blood gas values Understand inadequate change due to blood gas values how Understand perfusion inadequate and/or ventilation location, identifying the use of mechanical ventilator; Discuss and principles of tubing, filters) (e.g. equipment associated functioning and/or who is under-sedated the signs of a patient Understand further paralysis requires and associated suctioning of endotracheal the process Discuss complications to be difficult to predicted of patients the features Understand ventilate bag-valve-mask and/or intubate airway’ of ‘difficult and components Describe the location equipment airway’ of ‘surgical and components Describe the location equipment COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD2 6.1.1 (L1) CD2 6.1.1 (L1) CD2 6.1.2 (L1) CD2 6.1.3 (L1) CD2 6.1.4 (L1) CD2 6.1.5 (L1) CD2 6.1.6 (L1) CD2 6.1.7 (L1) CD2 6.1.8 (L1) CD2 6.1.9 (L1) CD2 6.1.10 (L1) CD2 6.1.11 (L1) CD2 6.1.12 (L1) CD2 6.1.13 Contents 1 – Level resuscitation adults requiring CD2 – Caring for 59
Section 3 - 59 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Evidence submitted Evidence Expected date date Expected of achievement Minimum standard Minimum standard achievement for Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Skills Establish physiological monitoring and prepare ETC02 equipment ETC02 and prepare monitoring physiological Establish with local RSI in accordance for the drugs prescribed Prepare guidelines and procedures with the clinician in discussion intubation for equipment Prepare the patient who will intubate a undertake use and effectively for the ventilator Prepare procedures agreed to check according functional parameters physiological the patient’s monitor Effectively concerns and escalate and ventilation post-intubation appropriately of the preparation for procedure the correct Demonstrate and on-going anaesthesia drugs for maintenance prescribed paralysis COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD2 6.2.1 (L1) CD2 6.2.1 CD2 6.2.2 (L1) CD2 6.2.3 (L1) (L1) CD2 6.2.4 CD2 6.2.5 (L1) CD2 6.2.6 (L1) Contents 60
Section 3 - 60 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced beginner Advanced Minimum standard achievement for Advanced beginner Advanced Competent beginner Advanced beginner Advanced beginner Advanced Competent Self-assessment Self-assessment as appropriate) (circle Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, CD2.7 – The patient requiring invasive monitoring (central venous access and arterial lines) – Level 1 – Level lines) and arterial access venous (central monitoring invasive requiring patient – The CD2.7 lines arterial and/or access venous using central monitoring invasive requiring patients for care holistic Provide Knowledge Skills Demonstrate understanding of the indications and rational for the for and rational of the indications understanding Demonstrate and catheters, or arterial catheters venous of central placement of insertion risks and complications the potential and the placement local policies and guidelines for Understand lines and arterial access venous use of central the for necessary of the equipment an understanding Demonstrate of and the types catheters, and arterial venous insertion of central inserted lines commonly insertion for sites of the common an understanding Demonstrate and arterial venous insertion of central for and the procedure catheters equipment transducer of pressure an understanding Demonstrate facilitate to monitor of the multi-modality and the configuration pressures and arterial of CVP and monitoring recording, of the risks and complications an understanding Demonstrate lines, and their and arterial access venous with central associated insertion Correctly assemble the equipment necessary for central venous or venous central for necessary the equipment assemble Correctly whilst trolley the procedure insertion and prepare catheter arterial aseptic technique maintaining of the is fully informed the patient ensure possible, Where support psychological and provide procedure proposed and assemble with the insertion procedure assist Correctly labelled correctly ensuring lines are equipment, transducer of and configuration patient to connection correct Demonstrate of the multi-modality including configuration monitoring, CVP the line ‘zero’ to and ability monitor and/or access venous central to relating care document Correctly lines arterial or line complications to in response appropriately Escalate action immediate appropriate – take emergencies COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD2 8.1.1 (L1) CD2 8.1.1 (L1) CD2 8.1.2 (L1) CD2 8.1.3 (L1) CD2 8.1.4 (L1) CD2 8.1.5 (L1) CD2 8.1.6 CD2 8.2.1 (L1) CD2 8.2.1 CD2 8.2.2 (L1) CD2 8.2.3 (L1) (L1) CD2 8.2.4 CD2 8.2.5 (L1) CD2 8.2.6 (L1) Contents 1 – Level resuscitation adults requiring CD2 – Caring for 61
Section 3 - 61 National Curriculum and Competency Framework Emergency Nursing (Level 1) and illness and illness and illness Caring for Caring for Caring for adults with adults with adults with minor injury minor injury minor injury Caring for Caring for Caring for resuscitation resuscitation resuscitation adults requiring adults requiring adults requiring CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) sment sment sment ain ain ain and and and P P P se s se s se s Medicines Medicines Medicines Caring for Caring for Caring for a s a s a s management management management children and children and children and management management management young people young people young people tient tient tient a a a and and and e e e P P P Moving Moving Moving handling handling handling assessment assessment assessment g g g acti c acti c acti c n n n acutely acutely acutely io n io n io n ill adults ill adults ill adults Good Good Good ol ol ol s s s Caring for Caring for Caring for oll i oll i oll i nursing nursing nursing s s s p r p r p r r r r e and e and e and e e e ention ention ention t t t ection ection ection and and and v v v n n n ont r ont r ont r enting enting enting e e e c c c o o o v v v n n n In f In f In f e e e p r p r p r o o o i i i g g g d d d d c d c d c t t t P r P r P r n n n n n n i i i violen c violen c violen c agg r agg r agg r or or or o r o r o r a a a d d d en en en r r r e c e c e c a a a eeping eeping eeping k k k eg u eg u eg u needs needs needs child r child r child r f f f and r and r and r and adults and adults and adults a a a Caring f Caring f Caring f S S S Docu me nt a Docu me nt a Docu me nt a people with people with people with mental health mental health mental health y y y er er er t t t gen c gen c gen c or or or disa s disa s disa s Eme r Eme r Eme r planning and planning and planning and management management management Caring f Caring f Caring f older people older people older people COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Contents 1 competencies Level 1 Level Clinical domains (CD) adults with minor injury Caring for or illness 62
Section 3 - 62 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Competent Competent Competent Competent Competent Competent Competent Competent Minimum standard achievement for Competent Competent Competent Competent Competent Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, CD3.1 – Limb injuries – Level 1 – Limb injuries Level CD3.1 limb injuries with upper and lower presenting patients for care holistic Provide Knowledge Skills Describe the basic anatomy of the upper and lower limb of the upper and lower Describe the basic anatomy of ‘mechanism of injury’ and the significance Describe the term patients this when assessing with injuries associated symptoms flag signs and Describe the red or limb life risk to a possible represent that and risk assessment (VTE) thromoboembolism Describe venous when this is indicated with limb associated Describe the risks and complications immobilisation limb managing upper and lower for available Describe treatments and complications injuries, including their indications a limb-immobilised patient needed by the advice Understand as an present may illness systemic significant how Understand minor injury apparent Assess patients with upper and lower limb injuries and prioritise with upper and lower patients Assess (triage) appropriately care neurovascular carry out and document to ability Demonstrate injury site to on limbs distal observations of rings removal for technique Use correct medical systemic detailed more who require patients Recognise of the injury assessment beyond assessment the to of fracture with signs and symptoms patients Recognise (NOF) neck or femur COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD3 1.1.1 (L1) CD3 1.1.1 (L1) CD3 1.1.2 (L1) CD3 1.1.3 (L1) CD3 1.1.4 (L1) CD3 1.1.5 (L1) CD3 1.1.6 (L1) CD3 1.1.7 (L1) CD3 1.1.8 CD3 1.2.1 (L1) CD3 1.2.1 (L1) CD3 1.1.2 (L1) CD3 1.1.3 (L1) CD3 1.1.4 (L1) CD3 1.1.5 Contents 1 – Level adults with minor injury or illness CD3 – Caring for 63
Section 3 - 63 National Curriculum and Competency Framework Emergency Nursing (Level 1) CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Competent Competent Competent Competent beginner Advanced Competent Competent Competent N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, wool and crepe bandage and crepe wool knee splint ankle splint knee and ankle to sprains foot and bones of the ankle tibia/fibula to fractures broad-arm sling broad-arm sling high-arm and cuff collar splint wrist neighbour strapping splint) thumb immobilisation thumb spica (or splints Mallet/Zimmer Demonstrate the correct application to lower limbs of: lower to application the correct Demonstrate • • • or locally used of Paris (Plaster limb casts Apply upper and lower and adopting procedures locally agreed following equivalent), practice best national of a cast application following advice appropriate Give risk assessment a VTE Undertake aids walking appropriate sized, with correctly patients Provide and instructions, stick) walking Zimmer frame, crutches, (e.g. safely can use the device ensuring they lower following patients to advice discharge appropriate Provide example: limb injuries. For • • with locally agreed up (in accordance follow outpatient Ensure guidelines and procedures) Demonstrate the correct application and provision of appropriate of appropriate and provision application the correct Demonstrate following: advice • • • • • • • COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD3 1.1.7 (L1) CD3 1.1.7 (L1) CD3 1.1.8 (L1) CD3 1.1.9 (L1) CD3 1.1.10 (L1) CD3 1.1.11 (L1) CD3 1.1.12 (L1) CD3 1.1.13 CD3 1.1.6 (L1) CD3 1.1.6 Contents 64
Section 3 - 64 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Competent Competent Competent Advanced beginner Advanced beginner Advanced Competent Competent Competent Competent Competent Competent Competent Competent Competent Minimum standard achievement for Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle foreign body to the eye body to foreign cornea to abrasion injury chemical eye visual acuity assessing pH measuring eye for rationale Initially assess and prioritise patients presenting with an ENT presenting and prioritise patients Initially assess problem injuries with facial presenting and prioritise patients Initially assess Initially assess and prioritise patients presenting with an eye with an eye presenting and prioritise patients Initially assess of visual acuity) (including the assessment problem Skills Describe the normal anatomy and physiology of the ear, nose and of the ear, and physiology Describe the normal anatomy throat with: Describe the mechanism of injury associated • • • with perforated Describe the mechanism of injury associated (traumatic) membrane tympanic fractures with facial Describe the mechanism of injury associated treatment and immediate symptoms flag signs or Describe the red emergency threatening of an eye of an ENT emergency symptoms flag signs or Describe the red with ophthalmic patients for process Describe the assessment including: presentations, • • with ENT patients for process the assessment Understand presentations ENT and obtaining ophthalmic, for Describe local processes referral specialist maxillofacial or ENT in eye manifest may illnesses systemic how Understand symptoms Describe the normal anatomy and physiology of the eye and physiology Describe the normal anatomy CD3.2 – Head and neck – Level 1 CD3.2 – Head and neck Level (ENT) problems nose and throat or ear, maxillofacial, with ophthalmic, presenting patients for care holistic Provide Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD3 2.2.2 (L1) CD3 2.2.3 (L1) CD3 2.2.1 (L1) CD3 2.2.1 CD3 2.1.2 (L1) CD3 2.1.2 (L1) CD3 2.1.3 (L1) CD3 2.1.4 (L1) CD3 2.1.5 (L1) CD3 2.1.6 (L1) CD3 2.1.7 (L1) CD3 2.1.8 (L1) CD3 2.1.9 (L1) CD3 2.1.10 (L1) CD3 2.1.11 CD3 2.1.1 (L1) CD3 2.1.1 Contents 1 – Level adults with minor injury or illness CD3 – Caring for 65
Section 3 - 65 National Curriculum and Competency Framework Emergency Nursing (Level 1) CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Competent Competent Competent Competent beginner Advanced N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Measure and record eye pH eye and record Measure Undertake effective eye irrigation irrigation eye effective Undertake medications eye Administer to manage an epistaxis steps aid first Provide in other specialties or health professionals to with a referral Assist pathways line with locally agreed COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD3 2.2.4 (L1) CD3 2.2.4 CD3 2.2.5 (L1) CD3 2.2.6 (L1) (L1) CD3 2.2.7 CD3 2.2.8 (L1) Contents 66
Section 3 - 66 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Competent Competent Competent Competent Competent Competent Minimum standard achievement for Competent Competent Competent Advanced Beginner Advanced Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle Provide appropriate discharge advice to patients with patients to advice discharge appropriate Provide back pain musculoskeletal Facilitate appropriate pain management (see CCT2) (see pain management appropriate Facilitate Identify patients with back pain symptoms who may require require who may with back pain symptoms patients Identify and report of other body systems clinical assessment urgent appropriately concerns Identify any new neurological deficit and report concerns concerns report deficit and neurological new any Identify appropriately Assess patients presenting with acute back problems and back problems with acute presenting patients Assess prioritise appropriately Skills Understand how pathology of other systems may result in the result may of other systems pathology how Understand pneumonia, abdominal aortic of back pain (e.g. experience aneurysm) Understand the psychological and social implication for patients patients for and social implication the psychological Understand back pain and chronic with acute Describe the local guidelines for spine immobilisation Describe the local guidelines for Describe the red flags indicating spinal pathology flags indicating Describe the red Describe the normal anatomy of the back and spine Describe the normal anatomy CD3.3 – Back problems – Level 1 – Level CD3.3 – Back problems with back problems presenting patients to care holistic Provide Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD3 3.2.5 (L1) CD3 3.2.4 (L1) CD3 3.2.4 CD3 3.2.3 (L1) CD3 3.2.2 (L1) CD3 3.2.1 (L1) CD3 3.2.1 CD3 3.1.5 (L1) CD3 3.1.5 CD3 3.1.4 (L1) CD3 3.1.4 CD3 3.1.3 (L1) CD3 3.1.3 CD3 3.1.2 (L1) CD3 3.1.2 CD3 3.1.1 (L1) CD3 3.1.1 Contents 1 – Level adults with minor injury or illness CD3 – Caring for 67
Section 3 - 67 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Competent Competent Competent Minimum standard achievement for Competent Competent Competent Competent Competent Competent Competent Competent Advanced beginner Advanced Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle laceration incision graze scald full thickness partial thickness superficial Initiate first aid treatment of wounds and burns of aid treatment first Initiate Demonstrate the initial assessment of patients with wounds and with wounds of patients the initial assessment Demonstrate (triage) burns and prioritise appropriately Skills Understand how the presence of wounds, burns or other minor of wounds, the presence how Understand CTT6) (see concerns safeguarding rise to give injuries may Describe the local guidelines relating to wound and burn wound to Describe the local guidelines relating management Describe recognised immediate and delayed complications arising complications and delayed immediate Describe recognised and burns wounds from Describe the properties of dressings used to facilitate wound and wound facilitate used to of dressings Describe the properties burn healing Understand the normal wound and burn healing processes and the and burn healing processes the normal wound Understand this affect may that factors Understand how seemingly small wounds or burns may have have or burns may seemingly small wounds how Understand site anatomical due to serious consequences Describe wound and burn assessment including red flags including red and burn assessment Describe wound Understand the terminology associated with wounds and burns with wounds associated the terminology Understand including: • • • • • • • Describe mechanisms of injury that may result in wounds and/or and/or in wounds result may Describe mechanisms of injury that burns Describe the normal anatomy of the skin Describe the normal anatomy CD3.4 – Wounds and burns – Level 1 and burns – Level CD3.4 – Wounds competencies) Group Nursing Major Trauma the National to major burns refer and burns (for with minor wounds presenting patients to care holistic Provide Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD3 4.2.2 (L1) CD3 4.2.1 (L1) CD3 4.2.1 CD3 4.1.10 (L1) CD3 4.1.10 CD3 4.1.9 (L1) CD3 4.1.9 CD3 4.1.8 (L1) CD3 4.1.8 CD3 4.1.7 (L1) CD3 4.1.7 CD3 4.1.6 (L1) CD3 4.1.6 CD3 4.1.5 (L1) CD3 4.1.5 CD3 4.1.4 (L1) CD3 4.1.4 CD3 4.1.3 (L1) CD3 4.1.3 CD3 4.1.2 (L1) CD3 4.1.2 CD3 4.1.1 (L1) CD3 4.1.1 Contents 1 – Level adults with minor injury or illness CD3 – Caring for 68
Section 3 - 68 Whipps Cross Hospital CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Competent Competent Competent Competent Competent Competent N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, tissue adhesive tissue strips steri staples sutures Provide appropriate wound care advice, including when to seek including when to advice, care wound appropriate Provide clinical attention urgent Recognise when a wound or burn requires more detailed clinical detailed more or burn requires when a wound Recognise appropriately concerns and report exploration/assessment Apply prescribed dressings to wounds and burns (as per local wounds to dressings Apply prescribed guidelines) Demonstrate ability to de-roof blisters according to local to according blisters de-roof to ability Demonstrate guidelines Following local policy, clean and close an uncomplicated wound wound clean and close an uncomplicated local policy, Following with: • • • • Undertake wound cleaning following local guidelines cleaning following wound Undertake COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD3 4.2.8 (L1) CD3 4.2.7 (L1) CD3 4.2.7 CD3 4.2.6 (L1) CD3 4.2.5 (L1) CD3 4.2.4 (L1) CD3 4.2.4 CD3 4.2.3 (L1) Contents 69
Section 3 - 69 National Curriculum and Competency Framework Emergency Nursing (Level 1) and illness and illness and illness Caring for Caring for Caring for adults with adults with adults with minor injury minor injury minor injury Caring for Caring for Caring for resuscitation resuscitation resuscitation adults requiring adults requiring adults requiring CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) sment sment sment ain ain ain and and and P P P se s se s se s Medicines Medicines Medicines Caring for Caring for Caring for a s a s a s management management management children and children and children and management management management young people young people young people tient tient tient a a a and and and e e e P P P Moving Moving Moving handling handling handling assessment assessment assessment g g g acti c acti c acti c n n n acutely acutely acutely io n io n io n ill adults ill adults ill adults Good Good Good ol ol ol s s s Caring for Caring for Caring for oll i oll i oll i nursing nursing nursing s s s p r p r p r r r r e and e and e and e e e ention ention ention t t t ection ection ection and and and v v v n n n ont r ont r ont r enting enting enting e e e c c c o o o v v v n n n In f In f In f e e e p r p r p r o o o i i i g g g d d d d c d c d c t t t P r P r P r n n n n n n i i i violen c violen c violen c agg r agg r agg r or or or o r o r o r a a a d d d en en en r r r e c e c e c a a a eeping eeping eeping k k k eg u eg u eg u needs needs needs child r child r child r f f f and r and r and r and adults and adults and adults a a a Caring f Caring f Caring f S S S Docu me nt a Docu me nt a Docu me nt a people with people with people with mental health mental health mental health y y y er er er t t t gen c gen c gen c or or or disa s disa s disa s Eme r Eme r Eme r planning and planning and planning and management management management Caring f Caring f Caring f older people older people older people COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Contents 1 competencies Level 1 Level Clinical domains (CD) people and young children Caring for Theme and Cross-Cutting Good Nursing Practice The adults and nurses caring for apply equally to competencies people and young children nurses caring for However, children. on safeguarding competencies of CCT6 prioritise completion must and adults. children please also major trauma, following children nurses caring for For Competencies Nursing Group Major Trauma see the National www.tquins.nhs.uk/?menu=resources at: available 70
Section 3 - 70 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Competent Competent Competent Competent Competent Competent Minimum standard achievement for Competent Competent Competent Competent Self-assessment Self-assessment as appropriate) (circle Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, CD4.1 – Assessing children and young people – Level 1 people – Level and young children – Assessing CD4.1 the age spectrum people through and young children assess and systematically Holistically Knowledge Skills Describe the major differences in anatomy and physiology and physiology in anatomy Describe the major differences adults and children between impact differences and physiological anatomical how Understand and injury manifestations on illness of and emotional development cognitive Describe normal motor, adulthood to birth through from children and psychological physiological anatomical, Describe how assessment on nursing impact differences of various of children of weight Describe the normal parameters weight estimate to formulae recognised ages, and understand blood rate, respiratory of heart rate, normal values Explain how with age and urine output vary pressure Demonstrate a systematic method of assessing children and young young and children assessing of method systematic a Demonstrate circulation, breathing, (airway, A-E a structured people following approach and exposure) disability and or seriously injured unwell acutely who are children Identify appropriately concerns escalate (triage) accurately and prioritise children Initially assess in a calm and age- children assess to the ability Demonstrate manner appropriate COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD4 1.1.1 (L1) CD4 1.1.1 (L1) CD4 1.1.2 (L1) CD4 1.1.3 (L1) CD4 1.1.4 (L1) CD4 1.1.5 (L1) CD4 1.1.6 CD4 1.2.1 (L1) CD4 1.2.1 CD4 1.2.2 (L1) CD4 1.2.3 (L1) (L1) CD4 1.2.4 Contents 1 people – Level and young children CD4 – Caring for 71
Section 3 - 71 National Curriculum and Competency Framework Emergency Nursing (Level 1) CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Competent Competent Competent Competent Competent Competent N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, respiratory rate respiratory saturations oxygen heart rate blood pressure (CRT) time capillary refill (GCS) Score Coma Glasgow (BM) measurement blood glucose temperature Correctly calculate and document the locally used paediatric early the locally used paediatric and document calculate Correctly score warning in all ages of techniques urine collection appropriate Demonstrate children of babies and of weight measurement appropriate Demonstrate children strategies and interaction communication effective Demonstrate assessment facilitate to to information pertinent gather to and carers Engage with parents assessment enhance For children of all ages, appropriately measure and record the and record measure of all ages, appropriately children For and investigation: observations physiological following • • • • • • • • COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD4 1.2.6 (L1) (L1) CD4 1.2.7 CD4 1.2.8 (L1) CD4 1.2.9 (L1) (L1) CD4 1.2.10 CD4 1.2.5 (L1) Contents 72
Section 3 - 72 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Competent Competent Competent Competent Competent Competent Competent Minimum standard achievement for Competent Competent Competent Competent Competent Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle oral rectal intranasal inhaled intravenous topical Demonstrate evaluation of pain after interventions and respond and respond interventions of pain after evaluation Demonstrate appropriately Demonstrate effective strategies for safe administration of administration for safe strategies effective Demonstrate of routes: via a variety children analgesia to • • • • • • Where available locally, use PGDs appropriately to administer administer to use PGDs appropriately locally, available Where children timely analgesia to Demonstrate weight-based drug calculations for children for drug calculations weight-based Demonstrate Demonstrate non-pharmacological methods of pain management of pain management methods non-pharmacological Demonstrate children for Demonstrate a systematic method of pain assessment of children of children of pain assessment method a systematic Demonstrate tools people using appropriate and young Skills Describe non-pharmacological pain management strategies pain management Describe non-pharmacological Describe how to find additional information about medicines for about medicines find additional information to Describe how children Discuss the factors affecting administration of medicines to of medicines administration affecting the factors Discuss people and young children Discuss the principles of analgesia selection based on pain the principles of analgesia selection Discuss assessment Discuss how pain assessment relates to triage priority to relates pain assessment how Discuss Understand local pain management guidelines for children guidelines for local pain management Understand CD4.2 – Assessment and management of pain in children (including medicines management) – Level 1 (including medicines management) – Level and management of pain in children CD4.2 – Assessment and manage pain in children assess Safely Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD4 2.2.6 (L1) CD4 2.2.5 (L1) CD4 2.2.4 (L1) CD4 2.2.4 CD4 2.2.3 (L1) CD4 2.2.2 (L1) CD4 2.2.1 (L1) CD4 2.2.1 CD4 2.1.6 (L1) CD4 2.1.6 CD4 2.1.5 (L1) CD4 2.1.5 CD4 2.1.4 (L1) CD4 2.1.4 CD4 2.1.3 (L1) CD4 2.1.3 CD4 2.1.2 (L1) CD4 2.1.2 CD4 2.1.1 (L1) CD4 2.1.1 Contents 1 people – Level and young children CD4 – Caring for 73
Section 3 - 73 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Competent Competent Competent Competent Competent Competent Competent Competent beginner Advanced Competent beginner Advanced Minimum standard achievement for Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle airway obstruction airway anaphylaxis failure respiratory shock including hypovolaemic compromise circulatory sepsis child the fitting Recognise a fitting child and summons appropriate help and child and summons appropriate a fitting Recognise if needed management airway immediate instigate safely and children infants support in neonates, basic life Perform and effectively team as a member of the resuscitation Function Life Intermediate of Paediatric status provider Demonstrate equivalent) Support (or Identify respiratory failure, circulatory compromise and cardiac and cardiac compromise circulatory failure, respiratory Identify appropriately and respond in children arrest Describe the emergency treatment for: treatment Describe the emergency • • • • • • and infants neonates, support guidelines for Describe the basic life children and infants support guidelines for life advanced Understand arrest in cardiac children team resuscitation of the paediatric Describe the roles in self and/or emotional distress Describe signs of possible child and know a critically ill or injured when caring for colleagues support access to how Skills Describe the signs and symptoms of the child with impending or Describe the signs and symptoms compromise or circulatory failure respiratory actual CD4.3 – Children requiring resuscitation – Level 1 – Level resuscitation requiring CD4.3 – Children resuscitation requiring children for holistically Care Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD4 3.2.2 (L1) CD4 3.2.3 (L1) (L1) CD4 3.2.4 CD4 3.2.5 (L1) CD4 3.2.1 (L1) CD4 3.2.1 CD4 3.1.2 (L1) CD4 3.1.2 (L1) CD4 3.1.3 (L1) CD4 3.1.4 (L1) CD4 3.1.5 (L1) CD4 3.1.6 CD4 3.1.1 (L1) CD4 3.1.1 Contents 1 people – Level and young children CD4 – Caring for 74
Section 3 - 74 Whipps Cross Hospital CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Competent Competent Competent N, AB, C, P, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, preparation of equipment for intravenous or intraosseous or intraosseous intravenous for of equipment preparation cannulation fluid boluses weight-based calculate to ability including fluid medications, of prescribed administration therapy manual manoeuvres airway insertion of oropharyngeal insertion of nasopharyngeal airway suctioning use of oropharyngeal monitoring saturation oxygen therapy oxygen nebuliser therapy ventilation bag-valve-mask two-person Locate equipment and implement emergency circulatory support, circulatory emergency and implement equipment Locate include the following: to • • • children emotions when caring for of own awareness Demonstrate and seek support when needed and families Locate equipment and implement age-appropriate emergency emergency age-appropriate and implement equipment Locate include the following: to management, airway • • • • • • • • COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD4 3.2.7 (L1) CD4 3.2.7 CD4 3.2.8 (L1) CD4 3.2.6 (L1) Contents 75
Section 3 - 75 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Evidence submitted Evidence Expected date date Expected of achievement Competent Competent Competent Competent Competent Competent Competent Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle gastroenteritis constipation body foreign swallowed appendicitis head injury convulsions febrile epilepsy including DKA diabetes, hypoglycaemia bronchiolitis croup asthma pneumonia Demonstrate an understanding of the pathophysiology and of the pathophysiology an understanding Demonstrate gastrointestinal of common signs and symptoms associated example: For in children. presentations • • • • and of the pathophysiology an understanding Demonstrate neurological of common signs and symptoms associated example: For in children. presentations • • • and of the pathophysiology an understanding Demonstrate endocrine of common signs and symptoms associated example: For in children. presentations • • of unknown of a child with fever and care Describe the assessment and local guidelines national to origin with reference away in an environment need nursing Describe when a child may immunity reduced due to other patients from away in an environment need nursing Describe when a child may of infection spread prevent to other patients from Demonstrate an understanding of the pathophysiology and of the pathophysiology an understanding Demonstrate in illnesses respiratory of common signs and symptoms associated example: For children. • • • • CD4.4 – Caring for acutely ill children – Level 1 – Level ill children acutely CD4.4 – Caring for illness with acute people presenting and young children for holistically Care Knowledge COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD4 4.1.2 (L1) CD4 4.1.2 (L1) CD4 4.1.3 (L1) CD4 4.1.4 (L1) CD4 4.1.5 (L1) CD4 4.1.6 (L1) CD4 4.1.7 CD4 4.1.1 (L1) CD4 4.1.1 Contents 1 people – Level and young children CD4 – Caring for 76
Section 3 - 76 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Evidence submitted Evidence Expected date date Expected of achievement Competent Competent Competent Minimum standard Minimum standard achievement for N, AB, C, P, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle regular recording of vital signs and early warning score score of vital signs and early warning recording regular of concerns escalation with appropriate calculations or sepsis signs of meningism, dehydration for assessment of results with interpretation urinalysis conducting fluid intake ensuring adequate interventions local anti-pyretic to adherence respiratory problems respiratory problems gastrointestinal ENT problems problems neurological endocrine problems diseases infectious Give appropriate discharge advice to carers of children who have who have of children carers to advice discharge appropriate Give return of when to including ‘safety-netting’ with illness, presented of with fever children for and care assess to ability Demonstrate origin. Including: unknown • • • • • Implement clinical care (following local and national guidance) for for guidance) local and national (following clinical care Implement with: presenting and adolescents children infants, • • • • • • Skills COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD4 4.2.2 (L1) CD4 4.2.3 (L1) CD4 4.2.1 (L1) CD4 4.2.1 Contents 77
Section 3 - 77 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Competent Competent Competent Competent Competent Competent Competent Competent Minimum standard achievement for Competent Competent Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, pulled elbow (including the clavicle) upper limb fractures upper limb sprain the hand and digits injuries to the limping child limb fractures lower limb sprains lower and toes the foot injuries to CD4.5 – Children with minor injuries and limb problems – Level 1 – Level with minor injuries and limb problems CD4.5 – Children with minor injuries and limb problems people presenting and young children for holistically Care Knowledge Understand the signs, symptoms and pathophysiology of common of common and pathophysiology the signs, symptoms Understand example: For in children. upper limb presentations • • • • Skills Understand the signs, symptoms and pathophysiology of common of common and pathophysiology the signs, symptoms Understand example: For in children. limb presentations lower • • • • injury of brain Describe the signs and symptoms and burns in children, of wounds the pathophysiology Understand and the and depth of injury, to the area relation specifically in structures of associated involvement and and burn assessment the principles of wound Understand and intervention escalation immediate describe signs requiring and the factors and burn healing processes Describe the wound these in children affect may that wound to guidelines relating and national Describe local, regional including in children, and management and burn assessment services tertiary to referral for criteria rise to give of minor injuries may the presence how Understand CCT6) (see concerns safeguarding Perform and document neurovascular observations on limbs distal on limbs distal observations neurovascular and document Perform injury site to Initiate immediate first aid to wounds/burns to aid first immediate Initiate COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD4 5.1.1 (L1) CD4 5.1.1 CD4 5.1.2 (L1) CD4 5.1.2 (L1) CD4 5.1.3 (L1) CD4 5.1.4 (L1) CD4 5.1.5 (L1) CD4 5.1.6 (L1) CD4 5.1.7 (L1) CD4 5.1.8 CD4 5.2.1 (L1) CD4 5.2.1 CD4 5.2.2 (L1) Contents 1 people – Level and young children CD4 – Caring for 78
Section 3 - 78 Whipps Cross Hospital CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Competent Competent Competent Competent Competent Competent Competent Competent Competent N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Splint upper and lower limbs in children, selecting appropriate appropriate selecting limbs in children, upper and lower Splint of child, including use and size area anatomical for equipment casts of Paris Plaster Accurately assess the size of a burn or wound in a child of a burn or wound the size assess Accurately and burns in wounds for dressings and apply appropriate Select local guidelines and policies following children injury when children of brain signs or symptoms Recognise and report a seemingly minor head injury, following present appropriately concerns closure wound and apply appropriate select to ability Demonstrate techniques and their families children to advice discharge appropriate Provide seek or burn, including when to a wound for treatment following clinical attention urgent and their families children to advice discharge appropriate Provide seek urgent including when to of a limb injury, treatment following clinical attention and their families children to advice discharge appropriate Provide seek including when to of a head injury, treatment following clinical attention urgent to advice promotional safety/health appropriate Communicate and their families children COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD4 5.2.3 (L1) CD4 5.2.4 (L1) CD4 5.2.4 CD4 5.2.5 (L1) CD4 5.2.6 (L1) (L1) CD4 5.2.7 CD4 5.2.8 (L1) CD4 5.2.9 (L1) (L1) CD4 5.2.10 (L1) CD4 5.2.11 Contents 79
Section 3 - 79 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print Level Level achieved Level Level achieved CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Minimum standard Minimum standard achievement for Competent Competent Competent beginner Advanced beginner Advanced beginner Advanced Competent beginner Advanced Competent Competent Minimum standard achievement for Competent Competent Self-assessment Self-assessment as appropriate) (circle Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, E C, P, N, AB, depression anxiety suicide ideation self-harm disorders eating psychosis CD4.6 – Psychological and mental health aspects of care of children – Level 1 (also see CD5.1) – Level of children and mental health aspects of care CD4.6 – Psychological people and young children for health care and mental psychological safe Provide Knowledge Skills Discuss the role of play in relation to normal development to in relation of play the role Discuss of and management in the assessment of play the role Discuss hospital to presenting children of various in children fear to contribute may that Describe factors stages developmental that symptoms and psychological the behavioural Understand health issues with mental children by be experienced may affecting health problems mental the common Understand people including: and young children • • • • • • risk assessment the principles of a suicide/self-harm Understand person with a young Health Services Mental Describe local Child and Adolescent people young for (CAMHS) and young with children Health Act the use of Mental Discuss equivalent) country people (or children for misuse services and substance Describe local alcohol people and young in health problems mental between the association Recognise CCT6) (see issues safeguarding and potential children Demonstrate the appropriate use of distraction methods in methods use of distraction the appropriate Demonstrate stages developmental of various children and as part of the assessment the use of play Demonstrate or injury with illness presenting of children management COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD4 6.1.1 (L1) CD4 6.1.1 (L1) CD4 6.1.2 (L1) CD4 6.1.3 (L1) CD4 6.1.4 (L1) CD4 6.1.5 (L1) CD4 6.1.6 (L1) CD4 6.1.7 (L1) CD4 6.1.8 (L1) CD4 6.1.9 (L1) CD4 6.1.10 CD4 6.2.1 (L1) CD4 6.2.1 CD4 6.2.2 (L1) Contents 1 people – Level and young children CD4 – Caring for 80
Section 3 - 80 Whipps Cross Hospital CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Competent beginner Advanced Competent beginner Advanced beginner Advanced Competent N, AB, C, P, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, E C, P, N, AB, Identify young people who present with a high risk of harm to self with a high risk of harm to people who present young Identify senior clinician to and escalate or others people and their young for and empathy compassion Demonstrate health concerns with mental who present families misuse and substance local alcohol to referrals appropriate Make services Liaise with local CAMHs as per guidelines when appropriate children for as per local policy interventions safeguarding Instigate misuse problems substance health and/or with mental Demonstrate effective communication and interaction strategies strategies and interaction communication effective Demonstrate and their families with both children COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD4 6.2.4 (L1) CD4 6.2.4 CD4 6.2.5 (L1) CD4 6.2.6 (L1) (L1) CD4 6.2.7 CD4 6.2.8 (L1) CD4 6.2.3 (L1) Contents 81
Section 3 - 81 National Curriculum and Competency Framework Emergency Nursing (Level 1) and illness and illness and illness Caring for Caring for Caring for adults with adults with adults with minor injury minor injury minor injury Caring for Caring for Caring for resuscitation resuscitation resuscitation adults requiring adults requiring adults requiring CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) sment sment sment ain ain ain and and and P P P se s se s se s Medicines Medicines Medicines Caring for Caring for Caring for a s a s a s management management management children and children and children and management management management young people young people young people tient tient tient a a a and and and e e e P P P Moving Moving Moving handling handling handling assessment assessment assessment g g g acti c acti c acti c n n n acutely acutely acutely io n io n io n ill adults ill adults ill adults Good Good Good ol ol ol s s s Caring for Caring for Caring for oll i oll i oll i nursing nursing nursing s s s p r p r p r r r r e and e and e and e e e ention ention ention t t t ection ection ection and and and v v v n n n ont r ont r ont r enting enting enting e e e c c c o o o v v v n n n In f In f In f e e e p r p r p r o o o i i i g g g d d d d c d c d c t t t P r P r P r n n n n n n i i i violen c violen c violen c agg r agg r agg r or or or o r o r o r a a a d d d en en en r r r e c e c e c a a a eeping eeping eeping k k k eg u eg u eg u needs needs needs child r child r child r f f f and r and r and r and adults and adults and adults a a a Caring f Caring f Caring f S S S Docu me nt a Docu me nt a Docu me nt a people with people with people with mental health mental health mental health y y y er er er t t t gen c gen c gen c or or or disa s disa s disa s Eme r Eme r Eme r planning and planning and planning and management management management Caring f Caring f Caring f older people older people older people COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Contents 1 competencies Level 1 Level Clinical domains (CD) people with mental Caring for health needs 82
Section 3 - 82 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Date of Date completion Evidence submitted Evidence Expected date date Expected of achievement Competent Competent Competent Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Competent Competent Competent Competent Competent Minimum standard Minimum standard achievement for Competent N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle E C, P, N, AB, depression anxiety disorders eating bipolar disorder schizophrenia Describe local policy for reporting and escalating concerns of a concerns and escalating reporting for Describe local policy patient’ ‘missing/absconded Understand how acute mental illness may impair the ability of impair the ability may illness mental acute how Understand dependents for adequately care to patients Understand how mental illness may impair a patient’s ability to to ability impair a patient’s may illness mental how Understand themselves safeguard Understand how emotional distress may result in verbal and/or and/or in verbal result may emotional distress how Understand and safety Describe principles of de-escalation violence. physical Understand the use of the Mental Health Act (or legislation in legislation (or Health Act the use of Mental Understand setting care in the emergency of practice) country Discuss the correlation between mental health conditions and health conditions mental between the correlation Discuss as manifest one may how appreciating conditions, physiological the other Understand the signs or symptoms of mental illness that require require that illness of mental the signs or symptoms Understand intervention or urgent immediate Describe the signs and symptoms of the common mental illnesses, illnesses, mental of the common Describe the signs and symptoms including: • • • • • Describe assessment frameworks and tools used to support used to and tools frameworks Describe assessment health assessment mental emergency Discuss how mental health problems may impact on the impact may health problems mental how Discuss this may and how effectively communicate to ability individual’s capacity impair mental Understand the behavioural and psychological symptoms that that symptoms and psychological the behavioural Understand health issues with mental patients by be experienced may CD5.1 – Assessing adults with mental health problems – Level 1 (for children and young people see CD4.6) and young children 1 (for – Level adults with mental health problems – Assessing CD5.1 health problems adults with mental assess and systematically Holistically Knowledge Discuss factors that influence mental health and psychological health and psychological mental influence that factors Discuss wellbeing COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD5 1.1.12 (L1) CD5 1.1.12 CD5 1.1.11 (L1) CD5 1.1.11 CD5 1.1.10 (L1) CD5 1.1.10 CD5 1.1.9 (L1) CD5 1.1.9 CD5 1.1.8 (L1) CD5 1.1.8 CD5 1.1.7 (L1) CD5 1.1.7 CD5 1.1.6 (L1) CD5 1.1.6 CD5 1.1.5 (L1) CD5 1.1.5 CD5 1.1.4 (L1) CD5 1.1.4 CD5 1.1.3 (L1) CD5 1.1.3 CD5 1.1.2 (L1) CD5 1.1.2 CD5 1.1.1 (L1) CD5 1.1.1 Contents 1 people with mental health needs – Level CD5 – Caring for 83
Section 3 - 83 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Date of Date completion Evidence submitted Evidence Expected date date Expected of achievement Competent Competent Competent Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Minimum standard Minimum standard achievement for Competent N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle E C, P, N, AB, Act in line with local policy to safeguard dependents of patients of patients dependents safeguard to in line with local policy Act do so themselves to ability with impaired Act in line with local policy to safeguard patients with mental with mental patients safeguard to in line with local policy Act illness Use effective strategies, including the inclusion or withdrawal of including the inclusion or withdrawal strategies, Use effective to calm highly emotional situations others, significant Recognise when a patient presenting with a mental health with a mental presenting when a patient Recognise and illness of a physical symptoms be experiencing may problem appropriately report Recognise when a patient presenting with a physical illness may may illness with a physical presenting when a patient Recognise and report illness of a mental symptoms be experiencing appropriately Evaluate patient behaviour in relationship to actual and/or and/or actual to in relationship behaviour patient Evaluate mitigate to action and take self or others risk of harm to potential the risk Skills Use a structured approach to initially assess and prioritise patients and prioritise patients initially assess to approach Use a structured Use a (triage). health problems mental with acute presenting to steps taking appropriate tool(s), assessment locally agreed safety maintain COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD5 1.2.7 (L1) CD5 1.2.7 CD5 1.2.6 (L1) CD5 1.2.5 (L1) CD5 1.2.4 (L1) CD5 1.2.4 CD5 1.2.3 (L1) CD5 1.2.2 (L1) CD5 1.2.1 (L1) CD5 1.2.1 Contents 84
Section 3 - 84 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Competent Competent Competent Competent Competent Minimum standard achievement for Competent Advanced beginner Advanced Competent Competent Competent Minimum standard Minimum standard achievement for beginner Advanced N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle E C, P, N, AB, Use locally approved pathways and guidelines when caring for and guidelines when caring for pathways Use locally approved guidance person including local missing with self-harm, patients Ensure senior clinicians are alerted to patients requiring immediate immediate requiring patients to alerted senior clinicians are Ensure injury or self-poisoning for treatment Instigate first aid for significant injuries for significant aid first Instigate Use a structured approach to initially assess patients who present who present patients initially assess to approach Use a structured using a locally priority appropriate and assign self-harm, following system approved Skills Understand local processes and pathways for ensuring patients ensuring patients for and pathways local processes Understand assessment psycho-social formal receive with self-harm who have patients to and dignity Engage with empathy (and their families) self-harmed Discuss the need for a timely mental health assessment a timely mental the need for Discuss Understand the nursing care required for a patient with drug a patient for required care the nursing Understand toxicity Discuss the issues surrounding repeated attendance for self-harm for attendance repeated surrounding the issues Discuss Understand the physical management of self-poisoning and of self-poisoning management the physical Understand self-injury CD5.2 – Self-harm – Level 1 CD5.2 – Self-harm Level with self-harm presenting patients for holistically Care Knowledge Discuss national guidance on management of self-harm patients patients of self-harm on management guidance national Discuss local practice for and implications COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD5 2.2.5 (L1) CD5 2.2.4 (L1) CD5 2.2.4 CD5 2.2.3 (L1) CD5 2.2.2 (L1) CD5 2.1.6 (L1) CD5 2.1.6 (L1) CD5 2.2.1 CD5 2.1.5 (L1) CD5 2.1.5 CD5 2.1.4 (L1) CD5 2.1.4 CD5 2.1.3 (L1) CD5 2.1.3 CD5 2.1.2 (L1) CD5 2.1.2 CD5 2.1.1 (L1) CD5 2.1.1 Contents 1 people with mental health needs – Level CD5 – Caring for 85
Section 3 - 85 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Advanced beginner Advanced Competent Advanced beginner Advanced Competent Competent Minimum standard achievement for Competent Competent Competent Competent Minimum standard Minimum standard achievement for Competent N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle E C, P, N, AB, Make appropriate referrals to local alcohol and substance misuse and substance local alcohol to referrals appropriate Make services Provide effective clinical care to patients with alcohol or substance or substance with alcohol to patients clinical care effective Provide or withdrawal intoxication dependence, Use locally approved assessment tools and pathways for alcohol alcohol for and pathways tools assessment Use locally approved withdrawal and alcohol intoxication alcohol dependence, Use a structured approach to assess and manage patients and manage patients assess to approach Use a structured intoxication or substance alcohol with acute presenting Skills Describe local alcohol and substance misuse services and their misuse services and substance Describe local alcohol processes referral and manage patients assess to approach Use a structured symptoms withdrawal or substance with alcohol presenting Describe the signs and symptoms of acute alcohol withdrawal and withdrawal alcohol of acute Describe the signs and symptoms management the emergency understand Understand how alcohol or substance misuse may affect mental mental affect misuse may or substance alcohol how Understand care on nursing and the implications capacity Understand the medical conditions that may manifest as manifest may that the medical conditions Understand intoxication CD5.3 – Patients with alcohol problems – Level 1 – Level problems with alcohol CD5.3 – Patients misuse or substance alcohol to relating with problems presenting patients for holistically Care Knowledge Understand the impact of alcohol or substance misuse on both or substance of alcohol the impact Understand health and mental physical COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD5 3.2.5 (L1) CD5 3.2.4 (L1) CD5 3.2.4 CD5 3.2.3 (L1) CD5 3.2.2 (L1) CD5 3.1.5 (L1) CD5 3.1.5 (L1) CD5 3.2.1 CD5 3.1.4 (L1) CD5 3.1.4 CD5 3.1.3 (L1) CD5 3.1.3 CD5 3.1.2 (L1) CD5 3.1.2 CD5 3.1.1 (L1) CD5 3.1.1 Contents 1 people with mental health needs – Level CD5 – Caring for 86
Section 3 - 86 Whipps Cross Hospital and illness and illness and illness Caring for Caring for Caring for adults with adults with adults with minor injury minor injury minor injury Caring for Caring for Caring for resuscitation resuscitation resuscitation adults requiring adults requiring adults requiring CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) sment sment sment ain ain ain and and and P P P se s se s se s Medicines Medicines Medicines Caring for Caring for Caring for a s a s a s management management management children and children and children and management management management young people young people young people tient tient tient a a a and and and e e e P P P Moving Moving Moving handling handling handling assessment assessment assessment g g g acti c acti c acti c n n n acutely acutely acutely io n io n io n ill adults ill adults ill adults Good Good Good ol ol ol s s s Caring for Caring for Caring for oll i oll i oll i nursing nursing nursing s s s p r p r p r r r r e and e and e and e e e ention ention ention t t t ection ection ection and and and v v v n n n ont r ont r ont r enting enting enting e e e c c c o o o v v v n n n In f In f In f e e e p r p r p r o o o i i i g g g d d d d c d c d c t t t P r P r P r n n n n n n i i i violen c violen c violen c agg r agg r agg r or or or o r o r o r a a a d d d en en en r r r e c e c e c a a a eeping eeping eeping k k k eg u eg u eg u needs needs needs child r child r child r f f f and r and r and r and adults and adults and adults a a a Caring f Caring f Caring f S S S Docu me nt a Docu me nt a Docu me nt a people with people with people with mental health mental health mental health y y y er er er t t t gen c gen c gen c or or or disa s disa s disa s Eme r Eme r Eme r planning and planning and planning and management management management Caring f Caring f Caring f older people older people older people COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Contents 1 competencies Level 1 Level Clinical domains (CD) older people Caring for 87
Section 3 - 87 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Competent Competent Competent Competent Competent Competent Competent Minimum standard achievement for Competent Advanced beginner Advanced Advanced beginner Advanced Competent Competent Competent Competent Minimum standard Minimum standard achievement for Competent N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle E C, P, N, AB, Sepsis delirium hypotension postural dehydration Demonstrate ability to assess the older adult for frailty the older adult for assess to ability Demonstrate Assess nutritional and fluid requirements and provide appropriate appropriate and provide requirements nutritional and fluid Assess needed where assistance Assess continence and plan appropriate care and plan appropriate continence Assess Conduct a pressure area risk assessment and document a and document risk assessment area a pressure Conduct plan care nursing subsequent Conduct a falls risk assessment and document subsequent nursing nursing subsequent and document risk assessment a falls Conduct plan care Recognise and respond appropriately to the following common common the following to appropriately and respond Recognise in an older adult: conditions • • • • Skills Discuss quality standards to be followed when caring for older when caring for be followed to standards quality Discuss Book) Silver (e.g. setting care people in the emergency and of the older person initial assessment a systematic Conduct (triage) appropriately prioritise care Understand the impact of polypharmacy in older adults of polypharmacy the impact Understand Understand how the ageing process influences pharmacology in pharmacology influences the ageing process how Understand older adults Understand how the ageing process impacts on the body’s ability ability on the body’s impacts the ageing process how Understand and injury illness for compensate to Understand the impact of psychological and/or social influences social influences and/or of psychological the impact Understand on the older adult Understand frailty and its impact on older adults and its impact frailty Understand CD6.1 – Assessing older people – Level 1 older people – Level – Assessing CD6.1 the needs of older person assess and systematically Holistically Knowledge Understand the anatomical and physiological changes in the older and physiological the anatomical Understand adult COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD6 1.2.7 (L1) CD6 1.2.7 CD6 1.2.6 (L1) CD6 1.2.5 (L1) CD6 1.2.4 (L1) CD6 1.2.4 CD6 1.2.3 (L1) CD6 1.2.2 (L1) CD6 1.1.7 (L1) CD6 1.1.7 (L1) CD6 1.2.1 CD6 1.1.6 (L1) CD6 1.1.6 CD6 1.1.5 (L1) CD6 1.1.5 CD6 1.1.4 (L1) CD6 1.1.4 CD6 1.1.3 (L1) CD6 1.1.3 CD6 1.1.2 (L1) CD6 1.1.2 CD6 1.1.1 (L1) CD6 1.1.1 Contents 1 older people – Level CD6 – Caring for 88
Section 3 - 88 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Advanced beginner Advanced Competent Competent Minimum standard achievement for Competent Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Competent Competent Competent Minimum standard Minimum standard achievement for Competent N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle E C, P, N, AB, end of life care care end of life DNA CPR independently live to ability and abuse neglect drive to ability Identify signs and symptoms of potential undiagnosed dementia undiagnosed dementia of potential signs and symptoms Identify setting health care within own and escalate Promote dignity when caring for older adults when caring for dignity Promote Skills Describe the possible causes of acute confusion in the older confusion causes of acute Describe the possible person to relevant assessment capacity a mental and document Conduct having to consent decisions (e.g. related care nursing immediate needs met) hygiene Discuss why it is important to have discussions which may be which may discussions have to it is important why Discuss example: For life-changing. and/or distressing • • • • • Understand the legal principles when someone has a Lasting the legal principles when someone has a Lasting Understand equivalent) country (or of Attorney Power Describe local support services for people with dementia and people with dementia for Describe local support services them to those important Understand how dementia affects physiological, psychological and psychological physiological, affects dementia how Understand and their families in patients social wellbeing Understand safeguarding principles of adults specific to the older principles of adults specific safeguarding Understand (also see CCT6) person Understand the Principles of Deprivation of Liberty Safeguards Safeguards of Liberty the Principles of Deprivation Understand (also see GNP7) of practice in country or the equivalent (DoLS) CD6.2 – Psychological and social care of older adults – Level 1 of older adults – Level and social care CD6.2 – Psychological older people for and social care psychological of holistic the provision Ensure Knowledge Understand the application of the Mental Capacity Act, including Act, Capacity of the Mental the application Understand (or Advocate Capacity Mental of the Independent the role (also see GNP7) of practice) in country equivalent COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD6 2.2.3 (L1) CD6 2.2.2 (L1) CD6 2.1.8 (L1) CD6 2.1.8 (L1) CD6 2.2.1 CD6 2.1.7 (L1) CD6 2.1.7 CD6 2.1.6 (L1) CD6 2.1.6 CD6 2.1.5 (L1) CD6 2.1.5 CD6 2.1.4 (L1) CD6 2.1.4 CD6 2.1.3 (L1) CD6 2.1.3 CD6 2.1.2 (L1) CD6 2.1.2 CD6 2.1.1 (L1) CD6 2.1.1 Contents 1 older people – Level CD6 – Caring for 89
Section 3 - 89 National Curriculum and Competency Framework Emergency Nursing (Level 1) CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Competent Competent Competent Advanced beginner Advanced Advanced beginner Advanced N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Communicate effectively with patients who have sensory who have with patients effectively Communicate (also see GNP3) impairment Select and use appropriate distraction techniques for older people for techniques distraction and use appropriate Select or distressed be agitated who may Assess the older person for neglect and/or self-harm and act as and act self-harm and/or neglect for the older person Assess adult guidance per local safeguarding Identify the need for, and instigate, a social services referral for an for referral a social services and instigate, the need for, Identify as appropriate older person Identify when existing support services (including unpaid carers) (including unpaid carers) support services when existing Identify the needs of an older person meet unable to are COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD6 2.2.8 (L1) CD6 2.2.7 (L1) CD6 2.2.7 CD6 2.2.6 (L1) CD6 2.2.5 (L1) CD6 2.2.4 (L1) CD6 2.2.4 Contents 90
Section 3 - 90 Whipps Cross Hospital Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Advanced beginner Advanced Competent Minimum standard achievement for Competent Minimum standard Minimum standard achievement for beginner Advanced N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle E C, P, N, AB, Evaluate physiological data with reference to medication and medication to with reference data physiological Evaluate co-morbidities Skills Describe how mechanism of injury and frailty relate to actual or actual to relate mechanism of injury and frailty Describe how seemingly minor in the older adult (i.e. injury patterns potential trauma) in significant result mechanism of injury may and in the older person the signs of deterioration Recognise appropriately escalate CD6.3 – Critically ill older people – Level 1 CD6.3 – Critically ill older people Level competencies) Group Nursing Major Trauma the National critically ill older people (also see CD1 and CD2 in addition to for holistically Care Knowledge Understand how altered physiology may mask critical illness in the mask critical illness may physiology altered how Understand older person COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD6 3.2.2 (L1) CD6 3.1.2 (L1) CD6 3.1.2 (L1) CD6 3.2.1 CD6 3.1.1 (L1) CD6 3.1.1 Contents 1 older people – Level CD6 – Caring for 91
Section 3 - 91 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Competent Advanced beginner Advanced Competent Competent Competent Advanced beginner Advanced Minimum standard achievement for Competent Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Minimum standard Minimum standard achievement for beginner Advanced N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle E C, P, N, AB, Follow local procedures for safe transfer of the deceased person person of the deceased transfer safe for local procedures Follow the mortuary to Discuss with people important to the person, their wishes the person, to with people important Discuss to persons relevant and contact donation organ regarding this facilitate Provide an appropriate environment for the person at the end of at the person for environment an appropriate Provide spiritual and cultural meeting dignity, privacy, maintaining life, needs Ensure contemporaneous documentation of discussions and of discussions documentation contemporaneous Ensure them to and those important the patient to provided information Support the carers and families of patients who are at the end of at who are of patients and families Support the carers services bereavement relevant them to and signpost their life Skills Discuss the policies and procedures relating to transfer of the transfer to relating the policies and procedures Discuss and cultural the mortuary and meeting to person deceased beliefs religious them to the wishes of people and those important Respect care end of life regarding Understand the need to consider the person’s wishes around wishes around the person’s consider the need to Understand donation organ Describe the legal framework around advanced directives in the directives advanced around Describe the legal framework of practice country Understand local, regional and national guidelines and procedures guidelines and procedures and national local, regional Understand care end of life to relating Discuss the challenges of providing both anticipated end of life end of life both anticipated the challenges of providing Discuss care end of life and unexpected/traumatic care CD6.4 – End of life care – Level 1 – Level care CD6.4 – End of life to them and those important for patients care end of life dignified holistic Provide Knowledge Describe the principles of decision making in end of life care care Describe the principles of decision making in end life planning COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD6 4.2.6 (L1) 4.2.6 CD6 CD6 4.2.5 (L1) CD6 4.2.4 (L1) 4.2.4 CD6 CD6 4.2.3 (L1) CD6 4.2.2 (L1) CD6 4.1.6 (L1) CD6 4.1.6 (L1) CD6 4.2.1 CD6 4.1.5 (L1) CD6 4.1.5 CD6 4.1.4 (L1) CD6 4.1.4 CD6 4.1.3 (L1) CD6 4.1.3 CD6 4.1.2 (L1) CD6 4.1.2 CD6 4.1.1 (L1) CD6 4.1.1 Contents 1 older people – Level CD6 – Caring for 92
Section 3 - 92 Whipps Cross Hospital and illness and illness and illness Caring for Caring for Caring for adults with adults with adults with minor injury minor injury minor injury Caring for Caring for Caring for resuscitation resuscitation resuscitation adults requiring adults requiring adults requiring CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) sment sment sment ain ain ain and and and P P P se s se s se s Medicines Medicines Medicines Caring for Caring for Caring for a s a s a s management management management children and children and children and management management management young people young people young people tient tient tient a a a and and and e e e P P P Moving Moving Moving handling handling handling assessment assessment assessment g g g acti c acti c acti c n n n acutely acutely acutely io n io n io n ill adults ill adults ill adults Good Good Good ol ol ol s s s Caring for Caring for Caring for oll i oll i oll i nursing nursing nursing s s s p r p r p r r r r e and e and e and e e e ention ention ention t t t ection ection ection and and and v v v n n n ont r ont r ont r enting enting enting e e e c c c o o o v v v n n n In f In f In f e e e p r p r p r o o o i i i g g g d d d d c d c d c t t t P r P r P r n n n n n n i i i violen c violen c violen c agg r agg r agg r or or or o r o r o r a a a d d d en en en r r r e c e c e c a a a eeping eeping eeping k k k eg u eg u eg u needs needs needs child r child r child r f f f and r and r and r and adults and adults and adults a a a Caring f Caring f Caring f S S S Docu me nt a Docu me nt a Docu me nt a people with people with people with mental health mental health mental health y y y er er er t t t gen c gen c gen c or or or disa s disa s disa s Eme r Eme r Eme r planning and planning and planning and management management management Caring f Caring f Caring f older people older people older people COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: Contents 1 competencies Level 1 Level Clinical domains (CD) planning and disaster Emergency management 93
Section 3 - 93 National Curriculum and Competency Framework Emergency Nursing (Level 1) Mentor sign-off Mentor and sign) (print Mentor sign-off Mentor and sign) (print CLINICAL DOMAINS (CD) LEVEL 1 CLINICAL DOMAINS (CD) Level Level achieved Level Level achieved Date of Date completion Date of Date completion Evidence submitted Evidence Evidence submitted Evidence Expected date date Expected of achievement Expected date date Expected of achievement Competent Competent Competent Competent Advanced beginner Advanced Minimum standard achievement for Competent Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Advanced beginner Advanced Minimum standard Minimum standard achievement for beginner Advanced N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle N, AB, C, P, E C, P, N, AB, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, N, AB, C, P, E C, P, N, AB, Self-assessment Self-assessment as appropriate) (circle E C, P, N, AB, Undertake major incident training as per local policy training major incident Undertake Identify and report situations which may indicate serious risk to serious risk to indicate which may situations and report Identify or patients of staff safety Escalate concerns if asked to undertake tasks beyond personal personal tasks beyond undertake to if asked concerns Escalate competence Effectively respond to instructions to undertake specific tasks as to undertake to instructions respond Effectively of the incident the duration for part of the team Skills Understand the principles and indications for decontamination, decontamination, for the principles and indications Understand and personnel including use of equipment personal apply and remove safely to ability Demonstrate the specific incident to in response required equipment protective Understand the principles of a CBRN (chemical, biological, the principles of a CBRN (chemical, Understand of these and specific management nuclear) incident radiological, events Understand how to access and use major incident documentation and use major incident access to how Understand Understand the use of equipment specific to major incident to major incident specific the use of equipment Understand it access to and how management Understand communication strategies used during a major strategies communication Understand incident Understand the role of other emergency services as part of the services of other emergency the role Understand plan major incident Understand the purpose and location of local survivor reception reception of local survivor the purpose and location Understand centres Understand triage in the context of a major incident triage in the context Understand Understand the local major incident plan and how to access it access to plan and how the local major incident Understand CD7.1 – Emergency planning and disaster management – Level 1 management – Level planning and disaster – Emergency CD7.1 of a major incident event plan in the of the organisational to the implementation effectively Contribute Knowledge Define the term major incident Define the COMPETENCIES: NATIONAL CURRICULUM AND COMPETENCY FRAMEWORK FOR EMERGENCY NURSING (LEVEL 1) EMERGENCY FOR FRAMEWORK AND COMPETENCY CURRICULUM NATIONAL COMPETENCIES: CD7 1.2.5 (L1) CD7 1.2.4 (L1) CD7 1.2.4 CD7 1.2.3 (L1) CD7 1.2.2 (L1) CD7 1.1.10 (L1) CD7 1.1.10 (L1) CD7 1.2.1 CD7 1.1.9 (L1) CD7 1.1.9 CD7 1.1.8 (L1) CD7 1.1.8 CD7 1.1.7 (L1) CD7 1.1.7 CD7 1.1.6 (L1) CD7 1.1.6 CD7 1.1.5 (L1) CD7 1.1.5 CD7 1.1.4 (L1) CD7 1.1.4 CD7 1.1.3 (L1) CD7 1.1.3 CD7 1.1.2 (L1) CD7 1.1.2 CD7 1.1.1 (L1) CD7 1.1.1 Contents 1 management – Level planning and disaster CD7 – Emergency 94
Section 3 - 94 Whipps Cross Hospital and illness Caring for adults with minor injury Caring for resuscitation adults requiring sment ain and P se s Medicines Caring for a s management children and management young people tient a and e P Moving handling assessment g acti c n acutely io n ill adults Good ol s Caring for oll i nursing s p r r e and ention e t ection and v n ont r enting e c o v n In f e p r o i g d d c t P r n n i violen c agg r or o r a d en r e c a eeping k eg u needs child r f and r and adults a Caring f S Docu me nt a people with mental health y er t s gen c or disa Eme r planning and management Caring f older people
www.facebook.com/royalcollegeofnursing www.twitter.com/thercn www.youtube.com/rcnonline The RCN represents nurses and nursing, promotes excellence in practice and shapes health policies June 2017 Publication code: 005 883 The Royal College of Nursing would like thank to NHS Improvement for its support in the production of this publication. Review date: June 2019 RCN Online www.rcn.org.uk RCN Direct www.rcn.org.uk/direct 0345 772 6100 Published the Royal by College of Nursing 20 Cavendish Square London W1G 0RN 3333020 7409
Section 3 - 95 National Curriculum and Competency Framework Emergency Nursing (Level 1)
Section 3 - 96 Level 1 Emergency Department Nursing Competencies Whipps Cross Hospital
Section 4 NMTNG: Nursing and AHP Trauma Competencies in the ED Adult Level 1 - April 2016
Whipps Cross Hospital s p 1 2016 April Adult Level Competency sign off record National Major Trauma Nursing Grou Nursing and Allied Health Professional Trauma Competencies in the Emergency Department commenced: Name: Date
Section 4 - 1 NMTNG: Nursing and AHP trauma competencies in the ED – Adult level 1 – April 2016
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to employ n. sh io cy. It t the me at ils en y wi ilit ce in the care of th ce in the grou , wh ma cognition and de en ks ri eten re r that a pe s ex clea nd of comp e a dg . cord of achievement in compet le re 2014 it is mplate l 1 - competency sign off record a ow ’ in as kn es d asur nde dult Leve ce is required. Me cies form a part G - A en practi TN to develop a thorough ‘trauma measure’ detailing the ed g their work. However, there wa cies. It is recognised that printing off maintaining th nd d in NM a en re jor Trauma ng qui Ma re arni for shar s le k r wa TNG recognise that individual departments/networ mme: TNG brought together representation from 17 major trauma networ TNG compet ce in practice. With the wealth of furthe e cy has not yet been achieved please utilise the action plan record at end en er en wh Review Progra cy has been achieved. This document is inte cies where the nurse/AHP is actively encouraged to self-assess and reflect on their prac cy Department of which these compet l Peer cies in the Emergency Department provide a national te en en na en io at ‘N to be used alongside the NM d nd, the Emergen gla nde in : En nt tended. cy achievement. Where a compet at e NHS en s t: : mponent of the compet docume en
of th urse n for trauma care ey co ssm ms to represent and develop national standards for trauma nursing from the point of injury through rehab io e co g this ai at /AHP should use this section to record as and when they feel are ready be assessed in a particular compet in troduction -asse up lf ampl In Us towards compet ex assessment process has not been included. However, the NM Assessor record of achievement: The assessor records when the compet nurse 1. The nursing and AHP trauma compet pub lic act as a record of achievement and/or to indicate Se This is a k trained nurse 24/7 in the Emergency Department, more work through to the Advanced Clinical Practitioner (ACP). The NM Trusts, professional organisations and groups to whom we than standard 2. This sign off record is inte gro creating and establishing a shared standard of compet
Section 4 - 2 Whipps Cross Hospital
TNG TNG tialing by the en
cine - Emergency ed di Me level 2. level 1. cy at at en k k t in all domains of the NM t in all domains of the NM rg en en on of and cr leti of Eme
comp cy framewor cy framewor llege en en tion to level 1: tion to level 2: ssful l Co ddi ddi ya a a Ro Care Advanced Clinical Practitioner Curriculum and Assessment. Succe Competency standard In Assessed as compet compet In compet Assessed as compet
s : l . ia er : educational and competency standard e course which has been assessed as compliant, by peer th ce to at least PGDip leve
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practi ew of
culum and assessment crit on vi e tr ed rri er er nc id Ov spok va cognised trauma course prov ad
ll in Life Support (TILS) fu n Levels 1 - 3 adult and paediatric educational competency standard e a education programme io on of a re on of a be as
g the NMTNG cu leti leti en ducat tr auma comp comp meetin level e s tion to level 2: tion to level 1: -house ssful ssful er Trauma Immediat ATLS observer ETC nurse/AHP observer In Advanced Trauma Nursing Course (ATNC) Trauma Nursing Core Course (TNCC) European Trauma Course (ETC)
ddi ddi st view, in a a
· · · In Advanced Clinical Practitioner (ACP): Ma In Succe · · Educational standard Has attended a trauma educational programme, such as: · When undertak Or · Succe re 1 2 3 l Level Level Level Leve
Section 4 - 3 NMTNG: Nursing and AHP trauma competencies in the ED – Adult level 1 – April 2016 -
and co
ams ch level. This ea at d cte pe ce in practice. Thus the levels were en tion they will be able to lead te ddi a . . . In ng ce or compet am am ni en ai te te ri torship period. pe ce in emergency care is ex t’ (RCEM. HEE. RCN. 2015) and credentialing by the Royal en auma auma ecep ri en to ex g ACP tr pr
pe e tr e tr in h t e ssm ex se of of th of th
el v ce prior to commenc en ri pe -limiting. lf se . . . g to the care tive care in . e ni fi ices en . rv er se
. for de ad al it le an pl am hosp te or e- Emergency Department. Emergency Department. This is in addition to the 12 mont pr cy Care Advanced Clinical Practitioner Curriculum and As an an
en auma nd in in rg a e tr re
e th y ca cal procedures needed e ‘Eme id ar im ongs practi pr al on of th as g the in leti in well d as ille t work comp s TNG were cognisant that banding varied across the country and does not necessarily rela en ltie ssful to be able provide evidence based and holistic care for the major trauma patient as part to be able provide evidence based and holistic care for the major trauma patient as part and sk d d ecia n io cte cte sp ts with a wide range of pathologies from the life-threat at tify who needs admission and can be safely sent home pe pe en nt cies the NM it ie en en cy standard structure, Levels 1 – 3: susc jor trauma pati r pati cine. The nurse/AHP would normally have at least 5 years of emergency care ex en -pat di re afte tify the critically ill and injured, providing safe effective immediat e in Me
e in en is ll th compet correctly id id rt look ce is achieved by succe ce achieved within 36 months of commencing work ce achieved within 12 months of commencing work of the ma nd pe re en en en le to le to l a le to with a mply as level 1, 2 and 3. Whilst bands cannot be applied to the levels directly we can provide guidance on what le ab ab na ab si rk ve ex e e io e d the ca ha ar ar ar pe s ey ey ucat ey ey wo nate velo Ed de 3. When developing the compet • Level 3: Level 3 compet College of Emergency ii. Th Level 1 nurses/AHPs would be ex • Level 2: Level 2 compet Level 2 nurses/AHPs would be ex ordi The ACP role outline: i. ACP iii. Th iv. They establish the diagnosis and differential rapidly, initiate applies to both adult and paediatric practice. • Level 1: Level 1 compet v. Th vi. Th RCEM, HEE, RCN (2015, page 4)
Section 4 - 4 Whipps Cross Hospital n Assessor - Print name, date and sig on plan ti s: ac e - se ed ev onal aspect ti achi t ye t Organisa No ction 1: Se ssment f Asse el
s and the with em st sy sS k partme nt s ) d twor gn Ps ne si l ctivation of the trauma own de (SO
m n onal aspect : gica sustai es ti hi
lo for a es io wit dur ia ct to cial circumstances chanis ys er juri spe am In Me Organisa Local Trauma Ne te - Ph - - - Spe National guidance and standard Local guidelines and standard operating proce centralisation of trauma services . Crit re
Section 4 - 5 NMTNG: Nursing and AHP trauma competencies in the ED – Adult level 1 – April 2016 n Assessor - Print name, date and sig on plan ti ills: ac e - se hnical sk ed ev tec achi t ye t No Clinical and ction 2: Se ssment f Asse el
ices receive
rv nS se y to y partme nt ba nc de n
ge io
at the it emer l to t : condary trauma susc va l in nd se mily members, carers or re a va management of the patient, nt e al e nd it g fa t and Escalation on arri y a e th er geme on arri ar ar hosp al eetin nds na e- im ep e- trauma patien ie Gr 2A - Preparation and Receptio assessment principles - a pr staff fr Pr Immediat Ma Pr Pr
Section 4 - 6 Whipps Cross Hospital n Assessor - Print name, date and sig on plan ti ac e - se ed ev achi t ye t No lf Assessment Se ge DE
ge r >ABC : Section 4 - 7 NMTNG: Nursing and AHP trauma competencies in the ED – Adult level 1 – April 2016 n Assessor - Print name, date and sig on plan ti ac e - se ed ev achi t ye t No lf Assessment Se ed l and ro ) SI the airway y ss cont on (R sse and ventilat n t otom d id en nducti ro w to a y e i t pati ho nc e othy ay and c-spine liver ic t insufflatio st que de auma je l cr ay t rway se le ai – Airw d gica ed monstrat ygen pi w thru the tr 2Bii Ne Sur care of the intubate trauma patien Clearing the airway Ox Chin lif Ja Oral Nasopharyngeal airway Ra Clinical assessment and management of airw De in Section 4 - 8 Whipps Cross Hospital n Assessor - Print name, date and sig on plan ti ac e - se ed ev achi t ye t No lf Assessment Se n chniques am al te in t x ry sp toring auma imet safe ni ing and Ventilatio y e tr es th nt mo compression 2 umothora M ing and ventilation ea me de of th th BV pne le – Br ea thing assessmen nage en ed monstrat part ea Thoracotom Safe spinal immobilisation and ma Thoracostomy Chest drains Op Use of CO Clinical assessment and management Ne De immobilisation and sliding te as 2Biii of br Br Use of Use of pulse ox Section 4 - 9 NMTNG: Nursing and AHP trauma competencies in the ED – Adult level 1 – April 2016 n Assessor - Print name, date and sig on plan ti ac e - se ed ev achi t ye t No lf Assessment Se ss k t l ntro cognise shoc s ion and Haemorrhage re te e co n si ion and haemorrhage nd io e a at pl l it be orrhag T – Circulat scri em AS susc Contro 2Biv IV IO Circulatory management – fluid re Circulatory management – ha Circulatory management – monitoring Clinical assessment and management of circulat 5 princi eF Circulatory management - acce and care control Circulatory assessmen De Section 4 - 10 Whipps Cross Hospital n Assessor - Print name, date and sig on plan ti ac e - se ed ev achi t ye t No lf Assessment Se l t e ur tien at er pa and care mp ma nt au t t tr en e nt t geme th ssm mperature management ty en na in nt sse geme ty ssm posure and Te me na l osure and temperature contro sse – Ex – Disabili a ma nage – Pain asse ssment and exp in in sab ility a sab ility ma 2Bv Clinical assessment and management of disabili Di Di 2Bvi of Exposure assessmen of pain Pa Pa ma Clinical assessment and management Contro Clinical assessment and management Exposure – te 2C Section 4 - 11 NMTNG: Nursing and AHP trauma competencies in the ED – Adult level 1 – April 2016 n Assessor - Print name, date and sig on plan ti ac e - se ed ev achi t ye t No lf Assessment Se t in in t ns ns t y io io at at s er er id id ns ns s ey co ey co ection C-s l circumstance em gy gy ecia lo lo t io io -mort en – Sp ii – The pregnant trauma patien i – The elderly trauma patien ys ys ri C compression 2D the care of pregnant trauma pati Pe IV Ph C-spine modification the care of an elderly trauma patien Comorbidities and polypharmac Ph 2D Can outline the k Can outline the k 2D Section 4 - 12 Whipps Cross Hospital n Assessor - Print name, date and sig on plan ti ac e - se ed ev achi t ye t No lf Assessment Se t in t ns t io at er id C ns y s lle ey co E cts on AB CD s er ffe t of a tro f l e ia ad timation nt relie tr ansf es x lo iii – The burns trauma patien iv – The bariatric trauma patien te in ze 2D Effects on AB Si Equipmen Pa the care of burns trauma patien Local burns centre Local policie 2D Po Ma Safe Can outline the k Section 4 - 13 NMTNG: Nursing and AHP trauma competencies in the ED – Adult level 1 – April 2016 n Assessor - Print name, date and sig on plan ti ac e - se ed ev achi t ye t No lf Assessment Se t nd in in a ns ns ed io io at at red patien er er t t ju id id ns ns a s xi e ey co ey co and symptoms spinal cord in confused, agitated & s e e gn t on si en sk v – Th vi – Th dati curity and polic 2D aggressive trauma patien the care of spinal cord injured pati Temperature regulation Autonomic dysrefle Can outline the k Ma the care of confused, agitat aggressive trauma patien Causes Se C-spine modification Se 2D Can outline the k Section 4 - 14 Whipps Cross Hospital n Assessor - Print name, date and sig on plan ti ac e - se ed ev achi t ye t No lf Assessment Se t in ma ns au io tr at with t er s s id h of a communication tien ns e at s de pa e eed ey co ma th l n au na of tr io e ot t em vii – Th viii - Care tien communication difficultie 2D the care of a trauma patient with pa Care of the deceased trauma patien Care of the bereaved Own communication difficultie Techniques to facilitat 2D Can outline the k Section 4 - 15 NMTNG: Nursing and AHP trauma competencies in the ED – Adult level 1 – April 2016 n Assessor - Print name, date and sig on plan ti ac e - se ed ev achi t ye t No lf Assessment Se l ia nt ey s ood and Bl il 2013) ood and ess of the k (Apr milies of pote bl ey en 2013) nt ar gy – DOH & NHS la Transplantation to aw arch – NHS n g the fa tification and Referral of es in en Organ Donors-NHS l Orga condary surv ia ng nt proach ki – Se iX – Tissue and organ donation monstrat te ood and transp 2D considerations in respect to organ and tissue donation Awareness of national document De • Timely id Po Transplant (2012) • Ap 2020: A UK strate organ donors Transplant (M • Ta Bl 2E The secondary survey Section 4 - 16 Whipps Cross Hospital n Assessor - Print name, date and sig on plan ti ac e - se ed ev achi t ye t No lf Assessment Se l t safe e tien th pa in ma in the Hospita am au te tr n e io er with th er of a t r of ntat er ciples of safe transfer as part – Transf t in ansf 2F – Transf 2Fi Ac tr Pr Equipmen Handove Docume Section 4 - 17 NMTNG: Nursing and AHP trauma competencies in the ED – Adult level 1 – April 2016 t safe s e tien th pa in ma am au te tr n e io th of a t l e r of ntat condary transfer (out of l) er dur ta – Se as part t rsonne condary transfer protocol condary transfer policy and ansf hospi Ac tr 2Fii Se Docume Se proce Equipmen Pe Handove Section 4 - 18 Whipps Cross Hospital n Assessor - Print name, date and sig on plan ti ac e ills - se ed ev hnical sk tec achi t n- ye No t No ction 3: Se lf Assessment Se thin mber, the ely wi in ills ss am me communication stre l e hnical sk n gica io tec lo at n- of trauma it ho No yc ns f io susc ps effectively as a te at gies ct role s lic in am re st cluding appropriat tuational awareness during a trauma trauma patient, family, carers, friends and staf Si strate Relieve imp Ethical, legal and professional Ability to perform appropriat the Trauma Team, maintaining a di in te Work Section 4 - 19 NMTNG: Nursing and AHP trauma competencies in the ED – Adult level 1 – April 2016 T objectives: AR on SM d base be ld shou ans Pl d. on plan ti Ac Action plan tic and Time-bound. lis e, Rea bl cy number and name, such as 2Diii – The burns trauma patient, the specific area which is addresse r be eten num le, Ach ieva the comp asurab Me record se cific, Spe Plea Competency name/ Section 4 - 20 Whipps Cross Hospital on plan ti Ac r be num Competency name/ Section 4 - 21 NMTNG: Nursing and AHP trauma competencies in the ED – Adult level 1 – April 2016 on plan ti Ac r be num Competency name/ Section 4 - 22 Level 1 Emergency Department Nursing Competencies Whipps Cross Hospital Section 5 WXH Specific Competencies Whipps Cross Hospital LEVEL 1 NURSE SHOULD BE COMPETENT OR HAVE ATTENDED TRAINING FOR ALL OF THE FOLLOWING Competency Mentor signature Date Comment Complete a Datix CRS Training How to do safeguarding and vulnerable adult referral Attended ILS/PILS Safeguarding Level 3 EGU referral Point of care training and barcode Blood fridge TILS SIREN REACT Rhythm recognition Male catheterisations Section 5 - 1 Whipps Cross Hospital Specific Competencies CHECKLIST OF TRAINING (QUICK REFERENCE) Page Training/competency Completion Comments date 5 - 3 Medications Competency 5 - 4 Dressings Competency 5 - 5 Wound Closure Competency 5 - 6 Suturing Competency 5 - 8 Cannulation Venepuncture Competency 5 - 10 Blood Culture Sampling Competency 5 - 12 Plaster of Paris Competency 5 - 14 Continuous Positive Airway Pressure (CPAP) Competency 5 - 15 Bilevel Non-Invasive Ventilation Competency 5 - 16 Naso-Gastric Tube (NGT) Competency 5 - 18 Blood Components CollectionTraining and Competency Assessment 5 - 22 Patient Group Direction Competency 5 - 23 Male Catheterisation Competency 5 - 26 Laerdal Suction Unit (LSU) Competency 5 - 28 Ranger 245 Blood/Fluid Warmer Competency 5 - 30 Baxter Colleague Infusion Pump Competency 5 - 32 FK Injectomat/SP Infusion Pump Competency 5 - 34 FK Volumat/VP Infusion Pump Competency 5 - 36 Lifepak 20 Defibrillator Competency 5 - 37 LUCAS Competency 5 - 38 Mortara ECG Competency 5 - 40 Bair Hugger 775 Competency 5 - 42 Level 1 Rapid Infuser 5 - 44 Welch Allyn 1500 Patient Monitor Competency Section 5 - 2 Whipps Cross Hospital MEDICATIONS COMPETENCY RECORD OF COMPETENCE Medication Date Date PDN signature & comments competency competency given finished Oral Medications Intravenous Medications Named Nurse: ...... Has successfully completed the Trusts oral and intravenous medication competencies. The medication competencies have been seen by myself and signed off as competent and a copy put in their personal file. Practice Development Nurse signature: ...... Print Name: ...... Designation: ...... Date: ...... Section 5 - 3 Whipps Cross Hospital Specific Competencies DRESSINGS COMPETENCY RECORD OF COMPETENCE Type of Closure Date Assessor signature & comments Finger dressing Finger dressing Burn dressing Burn dressing Other dressing Other dressing Assessor Signature: ...... Print Name: ...... Designation: ...... Date: ...... Section 5 - 4 Whipps Cross Hospital WOUND CLOSURE COMPETENCY RECORD OF COMPETENCE Type of Closure Date Assessor signature & comments Glue Glue Glue Steristrip Steristrip Steristrip Assessor Signature: ...... Print Name: ...... Designation: ...... Date: ...... Section 5 - 5 Whipps Cross Hospital Specific Competencies SUTURING COMPETENCY The candidate has demonstrated the following: zz An ability to assess the wound in relation to the structures involved zz Has selected the appropriate materials and equipment for wound closure and ensured appropriate conditions zz Has infiltrated the wound appropriately with an appropriate anaesthetic agent zz Has explored the wound adequately, thoroughly cleansed and removed any debris zz Has closed the wound using safe and effective technique zz Has provided the patient with appropriate information and advice for wound care and follow up, ensured tetanus status Date Assessor Comments Section 5 - 6 Whipps Cross Hospital CANNULATION VENEPUNCTURE - GUIDE FOR ASSESSORS Competency Indicator Best Practice Clean hands zz Uses 6 stage hand washing technique and dries hand thoroughly before appropriately before and gathering equipment after procedure zz Decontaminates hands with alcohol gel if they become contaminated during procedure zz Washes hands at end of procedure as gloves cause hands to sweat encouraging bacteria proliferation Collects appropriate zz Practitioner should have all equipment needed with them and not have equipment to run back for something they have forgotten zz They should have sharps bin with them Appropriate explanation zz Introduce self to patient to patient, informed zz Explain why the patient needs bloods or a cannula consent gained zz Ask the patient if they understand and are happy for them to commence Prepares environment zz Makes sure there is adequate lighting appropriately zz Make sure the patient is comfortable zz Make sure the patient’s privacy and dignity is maintained throughout procedure Encourage venous zz The tourniquet should be 10 cm above the proposed site filling using appropriate zz The practitioner should NOT smack or tap the patients arm technique Cleans skin appropriately zz Should clean skin with alcohol for 30 seconds zz Allows skin to dry zz Must not touched the area after it has been cleaned Inserts blood taking zz Insert cannula/needle at 15 degree angle device observing the first zz Immediately lowers cannula/needle to patient’s skin as soon as first and second flashback flashback is seen zz Advances cannula 1–2 mm before withdrawing the stylet to observe second flashback zz Applies digital pressure and removes stylet zz Applies cap to end of cannula Disposes of sharp and zz Dispose of the needle immediately do not put on the tray and throw other waste according to away later trust policy Appropriately secures the zz If blood leaked on to the skin this should be cleaned before a dressing cannula with dressing is applied Checks Cannulas patency zz Cannula should be flushed with 5 ml of 0.9% saline in a 10 ml syringe zz If using octopus should be locked under positive pressure Date and time of zz Cannula insertion date and time documented on dressing insertion documented zz Cannula date, time and location of insertion documented in the notes Section 5 - 7 Whipps Cross Hospital Specific Competencies CANNULATION VENEPUNCTURE COMPETENCY FORMAL ASSESSMENT Name: ...... CANNULATION 1. Date: ...... I certify that the above named competently and unaided sited a peripheral intravenous cannula in line with the criteria specified in the trust policy Signed: ...... Name & Title: ...... 2. Date: ...... I certify that the above named competently and unaided sited a peripheral intravenous cannula in line with the criteria specified in the trust policy Signed: ...... Name & Title: ...... VENAPUNCTURE 1. Date: ...... I certify that the above named competently & unaided performed a venepuncture in line with the criteria specified in the trust policy Signed: ...... Name & Title: ...... 2. Date: ...... I certify that the above named competently & unaided performed a venepuncture in line with the criteria specified in the trust policy Signed: ...... Name & Title: ...... Section 5 - 8 Whipps Cross Hospital FINAL ASSESSMENT Nurse to be assessed by Practice Development Nurse for final sign off, this can be either venepuncture or cannulation. Date: ...... I certify that the above named has competed 2 cannulations & 2 venepunctures under supervision as signed for above. I have witnessed the final cannulation or venepuncture which has been done in line with the criteria specified in the trust policy. Signed: ...... Practice Development Nurse SELF DECLARATION I can conform I have achieved this competency and am willing to perform cannulation in line with Trust Policy. I am aware of my professional and legal responsibilities and understand that I must perform at least three peripheral intravenous cannulations or venepunctures per month. Should my level of proficiency or competency fall, I shall seek retraining. Signature: ...... Date: ...... Section 5 - 9 Whipps Cross Hospital Specific Competencies BLOOD CULTURE SAMPLING COMPETENCY Equipment and patient preparation Met Not met Articulates correctly all the equipment necessary to take blood culture sample Articulates knowledge why each piece of equipment is required and rationale for use Provides explanation to the patient why the test is required and is able to prepare the patient for the procedure Hand Hygiene & Personal Protective Equipment Met Not met Selects appropriate method of hand decontamination for this procedure Selects and utilises appropriate items of personal protective equipment Blood Collection Procedure Met Not met Articulates the procedure and product used to identify a suitable vein Demonstrates cleaning of skin with appropriate product and shows awareness regarding actions that can contaminate skin after cleaning Articulates what amount of blood is required for each bottle and provides rationale why this should be done aseptically Articulates how to decontaminate blood culture bottle tops prior to inoculation and shows awareness of correct product required for this process Articulates and understands rationale for the order that culture bottles should be inoculated Demonstrates compliance in ensuring the correct disposal of clinical waste, sharps and protective equipment after use Section 5 - 10 Whipps Cross Hospital Sample Processing, storage and Documentation Met Not met Demonstrates awareness how to generate relevant diagnostic test request via CRS Articulates how to request appropriate diagnostic test if there is a system failure Shows awareness regarding placement of test label so not to obscure or remove barcode on sample bottle Complies with trust documentation policy by recording in patient’s healthcare records the time the sample has been sent Assessor Signature: ...... Print Name: ...... Designation: ...... Date: ...... Section 5 - 11 Whipps Cross Hospital Specific Competencies PLASTER OF PARIS COMPETENCY Below Elbow Above Elbow Below Knee Above Knee Scaphoid Correct patient/ Correct limb Explained procedure Correct limb position Correct application of stocking Correct application of padding Cut and applies plaster slab correctly 6/8 layers Check correct limb position is maintained Applies wet and dry bandage correctly Secures bandage correctly # clinic appointment given Written and verbal instructions given Check if patient needs OT/Physio follow up Documented on CRS Complete plaster book Clean plaster room/trolley Assessor signature/date Section 5 - 12 Whipps Cross Hospital I can confirm that ...... has completed the Whipps Cross Emergency Department Plaster of Paris course and competencies and has been signed off for the above backslabs and a copy has been placed in the individuals file. Practice Development Nurse signature: ...... Print Name: ...... Date: ...... SELF DECLARATION I can conform I have achieved this competency and am willing tom perform the application of plaster casts in line with Trust Policy. I am aware of my professional and legal responsibilities and understand that I must perform plaster of Paris application regularly . Should my level of proficiency or competency fall, I shall seek retraining. Signature: ...... Date: ...... Section 5 - 13 Whipps Cross Hospital Specific Competencies CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) COMPETENCY COMPETENCY STATEMENT Provides safe and effective care for a patient requiring Continuous Airway Pressure (CPAP) Met Not met Demonstrates an understanding of the principles of CPAP therapy Identify the clinical indications for CPAP therapy Identifies the absolute and relative clinical contraindications to CPAP therapy Identifies pre-conditions which must be fulfilled prior to commencement of CPAP Identifies indications for discontinuation of CPAP Discuss potential complications of CPAP therapy Identifies clinical interventions to prevent and treat the above Describes the equipment required for the implementation of CPAP Able to set up the equipment Demonstrates the ability to initiate CPAP therapy and secure face mask Identifies observations and checks that need to be carried out when patient on CPAP Discusses procedure of administration of nebulised drug therapy to a patient undergoing CPAP Describes procedure for administration of oral fluids and nutrition whilst patient receiving CPAP Demonstrates ability to troubleshoot for patients receiving CPAP Document all relevant information in patients record Assessor Signature: ...... Print Name: ...... Designation: ...... Date: ...... Section 5 - 14 Whipps Cross Hospital BILEVEL NON-INVASIVE VENTILATION COMPETENCY COMPETENCY STATEMENT Provides safe and effective care for a patient requiring Bilevel Non-Invasive Ventilation Met Not met Demonstrates an understanding of the principles of Bilevel therapy Identify the clinical indications for Bilevel therapy Identifies the absolute and relative clinical contraindications to Bilevel therapy Identifies pre-conditions which must be fulfilled prior to commencement of Bilevel therapy Identifies indications for discontinuation of Bilevel therapy Discuss potential complications of Bilevel therapy Identifies clinical interventions to prevent and treat the above Describes the equipment required for the implementation of Bilevel therapy Able to set up the equipment Demonstrates the ability to initiate Bilevel therapy and secure face mask Identifies observations and checks that need to be carried out when patient on Bilevel therapy Discusses procedure of administration of nebulised drug therapy to a patient undergoing Bilevel therapy Describes procedure for administration of oral fluids and nutrition whilst patient receiving Bilevel therapy Demonstrates ability to troubleshoot for patients receiving Bilevel therapy Document all relevant information in patients record Assessor Signature: ...... Print Name: ...... Designation: ...... Date: ...... Section 5 - 15 Whipps Cross Hospital Specific Competencies NASO-GASTRIC TUBE (NGT) COMPETENCY Competency Achieved Assessor Learner Comments Yes/No Sign & date Sign & date Demonstrates an understanding of a NGT Identifies conditions that require insertion of NGT Describes the anatomical position of NGT Demonstrates how to access the NGT policy and can discuss relevant NPSA guidelines Articulates contra-indications for NGT Describes the different NGT available in the Trust. Discusses advantages of tubes and identifies when they are required to be changed Demonstrates safe nursing care of a NGT Identifies when subsequent testing (ie, after initial insertion) of a NGT is required Articulates correct documentation for subsequent pH and length of NGT to nostril Articulates actions to be taken if pH is 5.5 or above Articulates actions to be taken if nil aspirate available on subsequent testing of NGT Identifies actions to be taken if a child with a NGT: zz Demonstrates increased work of breathing zz Has increased oxygen requirement zz Vomits zz Coughs Section 5 - 16 Whipps Cross Hospital Competency Achieved Assessor Learner Comments Yes/No Sign & date Sign & date Demonstrates the safe passing of a NGT Identifies which staff member can pass a NGT and when it is not advisable to pass a NGT Articulates the risks involved with passing a NGT Prepares all equipment for passing of a NGT Demonstrates correct and safe insertion of a NGT following Trust guidelines Identifies the position of a NGT if it has been miss-placed and presenting signs Articulates the correct pH to confirm NGT is correctly placed and demonstrates the correct procedure for checking the pH of a NGT Articulates correct documentation on initial insertion of a NGT Articulates actions to be taken if unable to gain an aspirate on initial insertion Date: ...... Name of Assessor: ...... Designation of Assessor: ...... Signature: ...... Section 5 - 17 Whipps Cross Hospital Specific Competencies BLOOD COMPONENTS COLLECTION TRAINING AND COMPETENCY ASSESSMENT This framework is for assessing the candidate’s ability in collecting blood components for transfusion. Candidates should be assessed after they have received training in this skill. Training is provided by means of a local workbook and assessment (porters) and e-learning or face to face training for all other staff. This workforce competence is linked to the Knowledge and Skills Framework dimensions developed by Skills for Health and based on the recommendations from the National Patient Safety Agency (NPSA) and National Blood Transfusion Committee (NBTC). The competency assessment is designed as a one-off practical assessment. The practical assessment need not be repeated if there is on-going satisfactory performance but should be repeated if there is a period of greater than one year out of a workplace where regular blood collection is taking place or the member of staff is involved in an incident regarding Blood collection. HOW TO USE THIS COMPETENCY ASSESSMENT zz This assessment should be completed whilst observing the candidate collecting blood components for transfusion in a simulated environment. zz The assessor should allow the candidate time to read through the assessment criteria prior to the assessment zz All assessment criteria must be completed zz The assessment should be undertaken within one working day zz For Porters: The candidate is to complete the competency assessment after completion of the assessment documentation at the end of the local workbook provided (the assessment is required on a 2-yearly basis) zz For all other staff: The candidate is to complete the competency assessment after completion of Blood Transfusion statutory and mandatory training. zz It is the assessor’s responsibility to ensure that the competency and training assessment are completed, and copies are returned to the Transfusion Practitioners and Ward Managers/ Practice Development Nurses as proof of assessment. zz The ID badges to access the blood fridge will only be activated for the staff members who have successfully completed their training and collection competency. A scanned copy of the completed collection competency with the barcode number MUST be sent to the transfusion practitioner at NUH (Nidhi Sharma) & WXH (Josephine McCullagh) for the ID badge to be activated. Please note completion of this assessment document is subject to periodic quality control checks. Section 5 - 18 Whipps Cross Hospital BLOOD COMPONENTS COLLECTION TRAINING AND COMPETENCY ASSESSMENT Name of Collector: ...... Job title: ...... Contact details: ...... Date of assessment: ...... ID Barcode number: ...... Name of Assessor: ...... Job title: ...... Core competency Achieved Notes for initial and date assessors 1. Blood transfusion collection document Did the member of staff understand the data that should be written on the blood transfusion collection document by describing that it should contain: a) The patient’s full name? b) Date of birth? c) Hospital or other identification number? 4. Using BloodTrack System Did the member of staff: a) Understand the purpose of BloodTrack system b) Understand how BloodTrack monitors blood movement and maintains cold chain 3) BloodTrack Enquiry Was the member of staff: a) Able to access BloodTrack Enquiry software b) Able to print a pickup slip 4. Taking crossmatched units out of blood fridge Did the member of staff: a) Identify themselves using ID badge (Barcode Scanner, holographic sticker) b) Use Pickup Slip or add patients details on the kiosk from the collection form c) Scan crossmatched unit (if collecting from kiosk) or collect unit form the lab staff (if collecting from lab) d) Understand error messages in the kiosk Section 5 - 19 Whipps Cross Hospital Specific Competencies Core competency Achieved Notes for initial and date assessors 5. Matching the information on the blood component to the minimum data set information on the blood collection slip (ie, patient documentation, pick up slip) Did the member of staff correctly check: a) The patient’s full name? a) Date of birth? a) Hospital number? 6. Documentation Did the member of staff correctly document the removal of blood from the fridge by: a) Recording the date and time blood is removed from the fridge? a) Writing their signature and contact information? a) Where an electronic tracking system is in place, demonstrating that they know how to maintain a secure ID throughout and showing this by scanning in and out correctly 7. Returning unit to the fridge Did the member of staff: a) Identify themselves using ID badge (Barcode) a) Scan unit of blood a) Place blood in correct compartment in blood fridge a) Understand error messages a) Aware of cold chain rule a) Documenting in the blood register if returning to the blood bank 8. Removing emergency units/flying squad blood Did the member of staff: a) Understand the minimum requirement to access emergency units (MRN/Emergency number) a) Know when it is appropriate to remove more than one unit for the same patient (Major Haemorrhage) a) Know what is required for filling-in and returning emergency unit traceability tags a) Documentation required Section 5 - 20 Whipps Cross Hospital Core competency Achieved Notes for initial and date assessors 9. Transportation and handover of blood products Did the member of staff: a) Transport the blood product immediately to the clinical area? a) Transport the blood product in the appropriate bag? a) Not leave the blood unattended at any point? a) Hand the blood product over to an appropriate member of staff immediately? a) Ensure that receipt of the blood was recorded? All of the above must be achieved to pass the assessment TRAINING & COMPETENCY Date: ...... Date: ...... PASS o REFERRAL o Reason for referral: ...... Barcode number provided: ...... Section 5 - 21 Whipps Cross Hospital Specific Competencies PATIENT GROUP DIRECTION COMPETENCY Attended 1 hour PGD teaching lecture? Date of lecture: (compulsory) Have you completed the PGD Test Paper? Date: (compulsory) PGD’s that you have been signed off as competent to use: Drug Date Assessor (Print & sign) Competent (Y/N) Section 5 - 22 Whipps Cross Hospital MALE CATHETERISATION COMPETENCY URINARY CATHETER MANAGEMENT IN ED STEP 1 Perform a bladder scan to ascertain urinary retention or incomplete bladder emptying before urinary catheterisation. Indications for urinary catheterisation (HOUDINI) zz Haematuria (gross) zz Obstruction zz Urological surgery zz Damaged skin - sacral/perineal wound zz Intake and Output (hourly monitoring) zz Neurogenic bladder - patients with spinal cord injury/lesion zz Immobilisation - unstable fracture NB:If none of the above indication is met, please do not catheterise the patient Ideal catheter size Adult: Male – 12 to 14. (Suprapubic – 16 to 18 for both sexes) STEP 2 zz Use aseptic technique during the procedure zz Insert catheter stickers into healthcare record zz Document the indication and residual volume obtained - these are very important for after care on the ward/clinic/community zz Secure catheter with catheter securement device zz Date urine drainage bag STEP 3 zz Refer patient to community nursing team and/or TWOC clinic, should they be discharged from ED It is not just a catheter, unnecessary catheters cause harm. HELP US SAY GOODBYE TO SEPSIS CAUSED BY E. COLI Section 5 - 23 Whipps Cross Hospital Specific Competencies MALE CATHETERISATION COMPETENCY Skill: Male Catheterisation Aim: To demonstrate Safe and Efficient Practice in Passing a Urethral Catheter using Aseptic Technique Standard Yes/ Comment No Provides appropriate rationale for the catheterisation being undertaken Demonstrates appropriate knowledge of the normal male lower urinary tract anatomy and physiology Explains the procedure to the patient, obtains consent and offers chaperone Ensures privacy and maintains dignity of the patient Performs hand hygiene and puts on disposable apron Positions patient and ensures patient can maintain the position Understands the importance of correct catheter selection (including non-latex catheters for those with sensitivity/allergy) Checks and selects appropriate equipment: zz Disposable plastic apron zz Sterile gloves x 2 pairs (including non-latex gloves for patients or staff with sensitivity/allergy) zz Alcohol based hand rub zz Sterile catheterisation pack zz Appropriate catheter with pre-filled syringe zz Sterile anaesthetic lubricating gel/lignociane gel 2% (instillagel 11 ml) Sachet 0.9% sodium chloride zz Drainage bag zz Clinical waste disposal bag Performs hand hygiene and puts on disposable apron Opens the Catheter Pack and supplementary Packs Using Aseptic Technique Decontaminates hand, puts on sterile gloves, cleans the urethral meatus with normal saline and drapes the patient with sterile towel. Instil the instillagel slowly into the urethra (wait 3–5 min). Warn the patient slight stinging may be experienced. Change gloves using alcohol gel in between. Position the receiver to catch the urine. Inserts the tip of the catheter into urethral orifice, without contaminating it up to its bifurcation point. Section 5 - 24 Whipps Cross Hospital Standard Yes/ Comment No Steady the catheter in place and inflate the balloon with 10 ml of sterile water Attaches the catheter to the drainage bag Ensures that the foreskin is replaced back over the glans, the patient is comfortable and dry post procedure and observe for any complications Disposes of all equipment used according to infection control policy. Dipsticks the urine and washes hands post procedure. Sends a CSU for MC&S if indicated. Documents and observes for the following: zz Consent zz Volume drained/colour/ odour zz Reason for catheterisation zz Date and Time of Catheterisation zz Date of change zz Any complications NB: Use the Invasive and Removal Device Form Put the sticker in the medical notes Overall Comment: Date: ...... Name of Assessor: ...... Designation of Assessor: ...... Signature: ...... Section 5 - 25 Whipps Cross Hospital Specific Competencies LAERDAL SUCTION UNIT (LSU) COMPETENCY Performance Criteria Attained Date Preparation 1. State the cautions and warnings to be aware of when using the unit 2. Describe the intended use of the Laerdal suction unit 3. Explain the purpose of the buttons and indicators on the user interface 4. Explain the Automatic Power-save Function (see user manual) 5. Describe the different parts of the unit 6. Explain what needs to be checked before use 7. Explain why it is important to operate and transport the unit in an upright position Operation 1. Describe how to operate the unit 2. Describe how to empty the canister - when should this be done? 3. Describe how to assemble the Serres bag suction system 4. Describe what needs to be done after using the unit Maintenance 1. Explain how to clean the cabinet and parts 2. Explain how to disinfect reusable parts 3. Describe how to charge the battery and how often 4. Describe how to check the battery quality 5. Explain how to run and evaluate the device test 6. Explain what to do if there is a fault with the unit Section 5 - 26 Whipps Cross Hospital Competency verified Yes More training required Signature of Assessor: …………...... ………………………………………… Name: ……………………………….…...... ……….………… Date: ……………………………….…...... ………..………… Signature of Participant: ………...... …………………………………………. Name: …………………...... …………….………….………… Date: ...... Section 5 - 27 Whipps Cross Hospital Specific Competencies RANGER 245 BLOOD/FLUID WARMER COMPETENCY Performance Criteria Attained Date Signature of Assessor Correctly prepare the patient and equipment 1. Explain the procedure to the patient 2. Clamp Ranger to IV pole - must be at or below patient height Powering up the Ranger unit 1. Switch power on 2. Explain the purpose of the self test 3. Describe the function of the temperature read out Insert/prime/remove cassette 1. Insert cassette the correct way 2. Demonstrate ability to prime the cassette correctly 3. Demonstrate how to remove cassette showing how to clamp off flow Cleaning 1. Describe how to clean the unit safely 2. Demonstrate rear of unit showing how to use cleaning tool 5. Alarms 1. Explain the safety alarms and features of the unit Section 5 - 28 Whipps Cross Hospital Competency verified Yes More training required Signature of Assessor: …………...... ………………………………………… Name: ……………………………….…...... ……….………… Date: ……………………………….…...... ………..………… Signature of Participant: ………...... …………………………………………. Name: …………………...... …………….………….………… Date: ...... Section 5 - 29 Whipps Cross Hospital Specific Competencies BAXTER COLLEAGUE INFUSION PUMP COMPETENCY Performance Criteria Attained Date Setting up 1. State the clinical application for the Baxter Colleague infusion pump 2. Identify the correct giving set for the Baxter Colleague 3. Describe the safety features on the giving set 4. Identify the following features on the rear of the pump and their use: hh Volume and contrast control hh USB stick hh Panel lock out button 5. Show how to attach the pole clamp to a drip stand 6. Demonstrate how to remove pole clamp for cleaning 7. Identify the following features on the front of the pump: hh Display screen hh Hard keys hh Soft keys hh Numeric keypad hh Pump Head Module Operation 1. Start the infusion & identify two features that show the pump is infusing 2. Show how to stop the infusion 3. Demonstrate how to change the rate Alarms/Alerts - identify the following alarms/alerts and state the corrective action 1. Upstream occlusion 2. Downstream occlusion 3. Air in line 4. Temperature Too Low or Too High 5. Tube misloaded 6. KVO mode 7. Battery (including why screen may turn yellow or red) Section 5 - 30 Whipps Cross Hospital Performance Criteria Attained Date Infusion Complete and Manual Tube Release 1. Describe what to do when infusion is complete 2. Explain why you should always close the roller clamp before removing the giving set 3. Show how to operate the manual tube release and explain when you would use this Maintenance 1. Explain what you need to clean the pump with 2. Explain why it is important to keep the pump charged 3. Explain what to do if a failure code shows on the screen Competency verified Yes More training required Signature of Assessor: …………...... ………………………………………… Name: ……………………………….…...... ……….………… Date: ……………………………….…...... ………..………… Signature of Participant: ………...... …………………………………………. Name: …………………...... …………….………….………… Date: ...... Section 5 - 31 Whipps Cross Hospital Specific Competencies FK INJECTOMAT/SP INFUSION PUMP COMPETENCY Performance Criteria Attained Date Safety checks 1. State the clinical application for the Injectomat/SP pump 2. Explain the safety checks and precautions to be taken prior to use 3. Identify appropriate equipment needed for use with the pump Controls and indicators/set-up and operation 1. State the functions of all the soft keys and indicators on the front display panel 2. Assemble two pumps and lock them together 3. Install the pump on a pole or rail 4. Load the pump into a docking station (if required) 5. Demonstrate the correct insertion and positioning of the syringe 6. Initiate and commence a prescribed infusion 7. Select chosen drug name from the Vigilant Drug Library option 8. Set a specified volume to be infused 9. Set a volume to be infused over time 10. Explain information on front display panel whilst infusing 11. Explain what the orange and green indicators are for 12. Demonstrate how to clear volume infused 13. Demonstrate how to check the pressure level and the use of the DPS option 14. Demonstrate how to alter the flow rate during the infusion 15. Access the event log and show recent events 16. Demonstrate the use of the keyboard lock and night mode 17. Show the value of the volume infused and how to clear it 18. Explain KVO and state the standard KVO rate 19. Demonstrate how to programme a pause in the infusion 20. Demonstrate the bolus function 21. Show how to check the battery life in the menu 22. Stop the infusion, turn the pump off and discuss the correct cleaning and storage procedures Section 5 - 32 Whipps Cross Hospital Performance Criteria Attained Date Alarms - identify the following alarms and state the corrective action: 1. Syringe holder alarm 2. Syringe plunger alarm 3. Occlusion alarm 4. Low battery 5. End of infusion pre-alarm SP Infusion Pump - key differences 1. Understand the reason the pump asks ‘Same Infusion?’ when switched on 2. Know the differences on the front screen 3. Know the difference in the alarms 4. Understand the differences in the Pause function 5. Understand the differences in the Bolus function Competency verified Yes More training required Signature of Assessor: …………...... ………………………………………… Name: ……………………………….…...... ……….………… Date: ……………………………….…...... ………..………… Signature of Participant: ………...... …………………………………………. Name: …………………...... …………….………….………… Date: ...... Section 5 - 33 Whipps Cross Hospital Specific Competencies FK VOLUMAT/VP INFUSION PUMP COMPETENCY Performance Criteria Attained Date Safety checks 1. State the clinical application for the Volumat/VP infusion pump 2. Explain the safety checks and precautions to be taken prior to use 3. Identify appropriate equipment needed for use with the pump Controls and indicators/set-up and operation 1. State the functions of all the soft keys and indicators on the front display panel 2. Assemble two pumps and lock them together 3. Load the pump into a docking station (if required) 4. Install the pump on a pole or rail 5. Demonstrate the installation of a dedicated giving set 6. Explain the safety features on the giving set 7. Initiate and commence a prescribed infusion 8. Select chosen drug name from the Vigilant Drug Library option 9. Explain how to select a drug not included in the Vigilant Drug Library 10. Set a specified volume to be infused 11. Set a volume to be infused over time 12. Explain information on front display panel whilst infusing 13. Explain what the orange and green indicators are for 14. Demonstrate how to clear volume infused 15. Demonstrate how to check the pressure level and the use of the DPS option 16. Demonstrate how to alter the flow rate during the infusion 17. Access the event log and show recent events 18. Demonstrate the use of the keyboard lock and night mode 19. Explain KVO and state the standard KVO rate 20. Demonstrate how to programme a pause in the infusion 21. Demonstrate the bolus function 22. Show how to check the battery life in the menu Section 5 - 34 Whipps Cross Hospital Performance Criteria Attained Date 23. Explain the ramp up/down and sequential features (if required) 24. Stop the infusion, turn the pump off and discuss the correct cleaning and storage procedures Alarms - identify the following alarms and state the corrective action 1. Install set 2. Door open 3. Air alarm and ‘see Air Bubble’ 4. OCS failed (Occlusivity check) 5. End of infusion pre alarm and end of infusion alarm 6. Pressure increase DPS 7. Occlusion pre alarm 8. Downstream and upstream occlusions 9. Battery pre alarm and empty battery 10. Technical error and action to be taken VP Infusion Pump - key differences 1. Understand the reason the pump asks ‘Same Infusion?’ when switched on 2. Know the differences on the front screen 3. Know the difference in the alarms 4. Understand the differences in the Pause function 5. Understand the differences in the Bolus function 6. Understand the ‘Change Drug?’ option in the menu Competency verified Yes More training required Signature of Assessor: …………...... ………………………………………… Name: ……………………………….…...... ……….………… Date: ……………………………….…...... ………..………… Signature of Participant: ………...... …………………………………………. Name: …………………...... …………….………….………… Date: ...... Section 5 - 35 Whipps Cross Hospital Specific Competencies LIFEPAK 20 DEFIBRILLATOR COMPETENCY Performance Criteria Attained Date 1. Demonstrates ability to power on equipment and awareness of buttons for operation 2. Aware of use of therapy cable and monitoring leads, and select appropriate lead for monitoring on equipment 3. Able to describe how to select energy level and safety administer shock 4. Able to demonstrate method of daily check 5. Demonstrates an understanding of use of pacing mode and synchronised energy deliver 6. Able to identify risks associated with therapy 7. Able to identify alarm indicators, potential causes, and actions to be taken to correct problems 8. Aware of procedure for management of faulty equipment Competency verified Yes More training required Signature of Assessor: …………...... ………………………………………… Name: ……………………………….…...... ……….………… Date: ……………………………….…...... ………..………… Signature of Participant: ………...... …………………………………………. Name: …………………...... …………….………….………… Date: ...... Section 5 - 36 Whipps Cross Hospital LUCAS COMPETENCY Performance Criteria Attained Date 1. Demonstrates yellow board to go under patient 2. Demonstrates understanding of why to attach to wall oxygen supply 3. Demonstrates ability to attach clips to yellow board 4. Demonstrates ability to adjust cardio pump to patient’s chest height 5. Demonstrates ability to “lock in” position 6. Demonstrates ability to turn on 7. Demonstrates how to safety dissemble Competency verified Yes More training required Signature of Assessor: …………...... ………………………………………… Name: ……………………………….…...... ……….………… Date: ……………………………….…...... ………..………… Signature of Participant: ………...... …………………………………………. Name: …………………...... …………….………….………… Date: ...... Section 5 - 37 Whipps Cross Hospital Specific Competencies MORTARA ECG COMPETENCY Performance Criteria Attained Date Correctly prepare the equipment 1. Demonstrates ability to request ECG on CRS Preparing the patient 1. Explain the procedure to the patient and gain verbal consent 2. Demonstrate ability to correctly attach the ECG leads to the patient Powering up the Mortara ECG 1. Switch power on including WAM 2. Able to locate correct patient on the machine 3. Demonstrates ability to submit the ECG to CRS 4. Able to locate the ECG on CRS 5. Ensure Registrar or above signs off ECG as being seen (either electronically or physically) Cleaning 1. Describe how to clean the unit safely after each patient Section 5 - 38 Whipps Cross Hospital Competency verified Yes More training required Signature of Assessor: …………...... ………………………………………… Name: ……………………………….…...... ……….………… Date: ……………………………….…...... ………..………… Signature of Participant: ………...... …………………………………………. Name: …………………...... …………….………….………… Date: ...... Section 5 - 39 Whipps Cross Hospital Specific Competencies BAIR HUGGER 775 COMPETENCY Performance Criteria Attained Date Correctly set up the equipment 1. Explain available mounting options and safely position the warming unit, using one of these options Bair Hugger 775 features 1. Describe the features of the warming unit hose and explain how to correctly connect it to a Bair Hugger Blanket or Bair Paws Gown, ensuring a snug fit 2. Describe the function and use of the following warming unit controls: temperature settings, fan speeds, standby mode, temperature mode timer and the total hours of use indicator 3. Describe what the three indicator lights represent and explain the Temp in Range indicator Fault conditions 1. Explain what happens to the warming unit in an over temperature condition and what action should be taken 2. Describe what happens to the warming unit in a fault condition and what action should be taken Set up and operation 1. Demonstrate how to set up and operate the warming unit, with a Bair Hugger blanket 2. Describe how to use a Bair Hugger blanket and why 3. Describe how to safely position the warming unit hose, when in use 4. How frequently should the patient’s temperature be monitored? 5. How should you not use a Bair Hugger warming unit and why? 6. Describe what to do on completion of therapy, how to store and clean unit and dispose of consumables Section 5 - 40 Whipps Cross Hospital Competency verified Yes More training required Signature of Assessor: …………...... ………………………………………… Name: ……………………………….…...... ……….………… Date: ……………………………….…...... ………..………… Signature of Participant: ………...... …………………………………………. Name: …………………...... …………….………….………… Date: ...... Section 5 - 41 Whipps Cross Hospital Specific Competencies LEVEL 1 RAPID INFUSER Competency Statement: On completion of this assessment the participant will be able to demonstrate competence and both clinical and theoretical knowledge regarding the safety aspects and practical use of the Belmont rapid infuser. Performance Criteria Attained Date Signature of Assessor Has watched Level 1 training video: Q drive/A&E/A&E Nurse/Teaching &Education/Device Training 1. Setting up a) Check the water level inside the level 1 is full b) Check all giving set luer connectors are tight and line clamps are closed. Then spike fluid bags c) Demonstrate loading the number coded giving set, whilst the machine is switched off d) Locate the on/off switch, turn machine on e) Ensure 2 x green lights are on to ensure machine is ready f) Open all connectors and clamps, prime the line with fluids g) After prime is completed, clamp the lowest connector h) Inspect patient line for air i) Demonstrates how to hang fluid bags in pressure chambers and turn pressure on, (+) position j) Can articulate which fluids are suitable to use with the Level 1 k) Connect to patient if ready to infuse 2. Infusing a) Demonstrate how to increase and decrease volume (with roller clamp) b) Demonstrate how to stop infusion c) Can articulate the need for wide bore cannulas d) Understands that only one bag to be open at a time Section 5 - 42 Whipps Cross Hospital Performance Criteria Attained Date Signature of Assessor 3. Troubleshooting list actions to solve the follow problems a) Air detected b) Check fluid bag is not caught in the door chamber c) Awareness of having to monitor fluid flow d) Demonstrate how to fill water in the Level 1 e) What to do if pump is faulty 4. Cleaning Method a) Turn off machine and appropriately removes emptied IV bag from chambers. Appropriately removes the giving set b) Disconnect power cable and clean following Trust Infection Control Policy Competency verified Yes More training required Signature of Assessor: …………...... ………………………………………… Name: ……………………………….…...... ……….………… Date: ……………………………….…...... ………..………… Signature of Participant: ………...... …………………………………………. Name: …………………...... …………….………….………… Date: ...... Section 5 - 43 Whipps Cross Hospital Specific Competencies WELCH ALLYN 1500 PATIENT MONITOR COMPETENCY Performance Criteria Attained Date 1. Able to turn on monitor and knows how to put on standby mode 2. Able to input patient details 3. Knows how to print off observations 4. Able to demonstrate how to print ECG 5. Can demonstrate how to set alarm parameters 6. Can state what P1 & P2 are used for 7. Able to activate P1, P2 & ETCO2 8. Able to deactivate P1, P2 & ETCO2 9. Can set up NIBP for 15 minute intervals Competency verified Yes More training required Signature of Assessor: …………...... ………………………………………… Name: ……………………………….…...... ……….………… Date: ……………………………….…...... ………..………… Signature of Participant: ………...... …………………………………………. Name: …………………...... …………….………….………… Date: ...... Section 5 - 44