The School Of
Nursing
And
Midwifery.
Pre-registration Post Graduate Diploma in Nursing (Adult)
CLINICAL SKILLS PASSPORT
STUDENT / COHORTPERSONAL TUTOR / CAMPUS
Guidelines on the use of this document
This document is designed to help you direct your learning in relation to your clinical skills development and assist you in keeping a record of your progress. It is the compulsory formative part of the summative assessment of practice documentation and should be used to provide additional evidence at your progress reviews.
It lists the core skills expected to be achieved by all students during the programme. The list of skills is not exhaustive, in recognition of this fact; spaces are included for you to add any skills unique to your personal learning experiences.
You should initial and date the first column when you have been instructed in or studied the theoretical underpinnings of the skill. Initial and date the other Columns when:
Level 1 - You have observed the procedure in the practice setting
Level 2 - You have participated in the skill under direct supervision
Level 3 - You have performed the skill on a number of occasions and required minimal supervision
Level 4 - You can perform the skill safely and competently, giving the rationale for your actions
Level 5 - You have taught the skill to others
PLEASE BEAR IN MIND THE REQUIRED LEVELS OF SUPPORT REQUIRED FROM A FIRST LEVEL REGISTERED NURSE FOR EACH UNIT WHEN USING THIS DOCUMENT.
UNIT 1: DIRECT OBSERVATION
UNIT 2: GUIDANCE
UNIT 3: SUPERVISION
UNIT 4: MINIMAL SUPERVISION
It is expected that, when performing each skill, you exhibit not only the skill element but also demonstrate that you have a sound knowledge base and understand the underlying principles, making reference to national and local policies as appropriate e.g. Essence of Care, NSF’s.
SKILLS RELATED TO THE ACTIVITY OF BREATHING
Assess individuals’ ability to breath normally
Monitor and record respiratory rate
Monitor and record peak flow
Maintain airway of :
Infant
Child
Adult
Position clients experiencing difficulty breathing
Monitor and record expectorant
Disposal of sputum secretions
Obtain sputum specimen
Maintain safe administration of oxygen as prescribed via:
Mask
Nasal cannulae
Humidifier
Tracheostomy
Assist with the insertion of an endotracheal tube
Care of clients with a Tracheostomy
Care of clients requiring mechanical ventilation
Care of clients requiring insertion and maintenance of a chest drain
Assess, plan, implement and evaluate care for a range of clients who are breathless
SKILLS RELATED TO THE ACTIVITY OF BREATHING (continued)
Provide psychological support to the breathless client
Perform artificial respiration:
Infant
Child
Adult
Use an ambu bag
Use of airway adjuncts:
Guerdal
Laryngeal mask
Perform oro/pharyngeal suctioning
Assist clients receiving nebuliser therapy
Recognise and report changes in clients’ condition
Refer clients to physiotherapist
Assist clients in performing exercises to improve respiration
SKILLS RELATED TO THE ACTIVITY OF MOBILITY
Care of Self
Assess task, load and environment
Move inanimate objects
Moving and Handling of a range of clients into the following positions:
Upright
Recumbent
Semi-recumbent
Lateral
Semi-prone
Prone
Side to side
Positioning/moving clients who are:
Unconscious
Hemiplegic
Paraplegic
Spinally injured
Positioning/moving clients who have had a joint replacement
Move a range of clients from:
Chair to chair
Bed to chair
Chair to bed
Up the bed
Up in the chair
Cot
Use moving & handling aids:
Please list:
1
2
3
4
5
6
7
8
9
SKILLS RELATED TO THE ACTIVITY OF MOBILITY (continued)
Assess risk of pressure sore development
Use of pressure relieving devices:
Mattresses
Air loss/water bed
Bed cradle/other
Prevent deformity in clients with compromised mobility
Provide continuity of care for clients receiving physiotherapy
Care for an individual who is falling
Care for the individual who has fallen
Report untoward occurrences
Report faulty/damaged equipment
Refer clients to physiotherapist
Assess the skin integrity of a range of clients using acknowledged assessment tools
Select appropriate dressings for clients with disordered skin integrity
Apply appropriate dressings to pressure sores/leg ulcers
Apply anti-embolic stockings
Apply pressure bandages/tubigrip
Apply slings/triangular bandages
Care for clients who have a splint/plaster cast
Assess, plan, implement and evaluate care for a range of clients with compromised mobility
SKILLS RELATED TO THE ACTIVITY OF PERSONAL CLEANSING & DRESSING
Make a bed/cot which is:
Unoccupied
Occupied
Changing a sheet underneath a patient:
Top to bottom
Side to side
Dispose of linen which is:
Uncontaminated
Contaminated
Assist individuals requiring a:
Shower
General bath
Bed bath/towel bath
Wash
Assist individuals to maintain their oral hygiene:
Cleansing of teeth/dentures
Use of mouthwashes
Use of dental floss
Use of interdental sticks
Administer eye care
Facial shaving:
With a safety razor
With an electric shaver
Care of hair:
Washing in bed
Dealing with infestation
Assist individuals to select appropriate clothing:
Infant
Child
Adult
Assist a variety of individuals to dress:
Infant
Child
Adult
Provide psychological support to the client requiring assistance with cleansing and dressing
SKILLS RELATED TO THE ACTIVITY OF PERSONAL CLEANSING AND DRESSING (continued)
Develop a health education programme for clients experiencing difficulty maintaining their personal cleansing and dressing
Assess, plan, implement and evaluate care for a range of clients who are unable to cleanse or dress independently
SKILLS RELATED TO THE ACTIVITY OF MAINTAINING A SAFE ENVIRONMENT
Prevent cross infection by effective:
Hand washing
Use of gloves
Use of plastic aprons
Safe disposal of equipment
Adheres to Health and Safety at Work Act in relation to:
Disinfection policies
Disposal of infected materials
Isolation/barrier nursing procedures
Dealing with mercury spillage
Dealing with blood and body fluids
Assessing and swabbing clients for MRSA
Radiation
Monitor pulse:
Radial
Carotid
Apex
Femoral
Use of cot sides
Monitor and record Blood Pressure using:
A sphygmomanometer
An electronic device
Perform a simple dressing using aseptic technique
Obtain a wound swab
Perform complex dressings using aseptic technique
Removal of sutures/clips
Care for and change (if appropriate) wound drains
Removal of drains:
Wound
Other
SKILLS RELATED TO THE ACTIVITY OF MAINTAINING A SAFE ENVIRONMENT (continued)
*Administration of Medicines (under direct supervision only during CFP):
Ordering and storage of medicines
Drug calculations
Reading prescriptions
Checking drugs prior to administration
Identify contra-indications/side-effects
Administer medications as prescribed:
By mouth
By intramuscular injection
By subcutaneous injection
Other
Record administration
Report untoward occurrences
Administration, ordering, disposal and storage of medicines:
Tablets/liquids
Suppositories/pessaries
Eye drops
Nasal drops
Ear drops
Topical preparations
Nebulisers
Controlled drugs
Other
Recognise the significance of laboratory results and respond accordingly
Care of individuals’ clothing and personal belongings
Safe discharge of clients from institutional settings
Provide Health Education and Promotion to a variety of individuals in a range of settings
SKILLS RELATED TO THE ACTIVITY OF MAINTAINING A SAFE ENVIRONMENT (continued)
Respond in the event of an actual or suspected fire
Respond in the event of a cardiac arrest
Respond in the event of other emergency (state type):
Provide psychological support to the client requiring assistance with maintaining a safe environment
Care of clients requiring the infusion of blood/blood products:
Venepuncture/cannulation (as Trust policy permits)
Obtaining and storing blood/blood products
Administering blood/blood products
Use of blood filters
Use of warming coils
Cardiac Monitoring
Monitor, record and recognise the significance of neurological observations:
TPR and B/P
General orientation
Pupil reaction
Motor activity
Level of consciousness
Glasgow coma score
Contribute to the monitoring and recognition of Patients at Risk (PAR Scoring)
SKILLS RELATED TO THE ACTIVITY OF MAINTAINING A SAFE ENVIRONMENT (continued)
Care for individuals who are experiencing:
Tonic/clonic seizures (grand mal fit)
Petit mal fit
Preparation and care of clients requiring:
General anaesthesia
Local anaesthesia
Regional anaesthesia
Safely care for a variety of clients:
Intra-operatively
Post-operatively
Safely care for a variety of clients undergoing investigations/procedures:
Lumbar puncture
Bronchoscopy
Gastroscopy
Liquid nitrogen
Minor operative procedures
Intra-uterine device insertion
Other
Respond appropriately to emergency situations
Liaise with the Critical Outreach Team(s) as appropriate
Assess, plan, implement and evaluate care for a range of clients who are unable to safely maintain their environment
SKILLS RELATED TO THE ACTIVITY OF EATING and DRINKING
Assess individuals’ nutritional status
Maintain adequate hydration for a range of clients
Assist clients in selecting appropriate meals/fluids
Monitor and record nutritional intake
Maintain adequate nutrition for a range of clients
Monitor and record fluid balance
Assist clients with feeding
Assist clients with drinking
Feed dependant clients
Feed clients with difficulty swallowing
Monitor and record blood glucose level in accordance with local policy
Recognise and report changes in clients’ condition
Provide first aid to a client who is choking
Refer clients to dietician/nutritionalist
Provide psychological support to the client requiring assistance with eating and drinking
Ordering of special dietary needs for clients including supplements
Providing dietary/nutritional guidance including:
Obesity management
Alcohol cessation
Care of clients requiring insertion and maintenance of a nasogastric tube
Care and maintenance of clients requiring an intravenous infusion
SKILLS RELATED TO THE ACTIVITY OF EATING and DRINKING (continued)
Care of maintenance of clients requiring a subcutaneous infusion
Maintenance of therapy for individuals with a:
Syringe driver
Intravenous pump
Central venous line
Care of clients requiring parenteral feeding
Feeding by and care of enteral tube:
Jejunostomy
Percutaneous Endoscopic Tube (PET)
Assess, plan, implement and evaluate care for a range of clients who are unable to maintain adequate nutrition
Assess, plan, implement and evaluate care for a range of clients who are unable to maintain adequate hydration
SKILLS RELATED TO THE ACTIVITY OF COMMUNICATING
Communicate by telephone appropriately and effectively
Assess the communication needs of clients
Interview:
Clients
Relatives
Significant others
Communicate sensitively and effectively with clients who have a:
Hearing difficulty
Speaking difficulty
Language difficulty
Comprehension difficulty
Refer clients to speech therapist
Recognise and report changes in clients’ condition
Give and receive reports of clients’ condition:
Orally
Through documentation
Respond appropriately to requests for information from:
Clients
Relatives
Significant others
Other members of the multi-disciplinary and multi-agency team
External agencies
Communicate effectively with the client and other members of the multi-disciplinary and multi-agency teams
Engage interpreters/other modes of communication as appropriate
SKILLS RELATED TO THE ACTIVITY OF COMMUNICATING (continued)
Maintain client care records in keeping with legislation
Maintain client confidentiality
Deal with distressed clients
Deal with distressed relatives/others
Manage the care of a group of patients
Assess, plan, implement and evaluate care for a range of clients who are unable to communicate effectively
SKILLS RELATED TO THE ACTIVITY OF DYING
When and where appropriate:
Communicate sensitively with dying patients
Communicate sensitively with relatives of dying patients
Communicate sensitively with the bereaved
Assess, plan, implement and evaluate care for a range of clients who are dying, recognising and respecting their individual beliefs and values
Provide psychological support for clients whom you know to be dying and their significant others
Provide psychological support to the recently bereaved
Liaise effectively with other support agencies:
MacMillan nurse
Hospice team
Voluntary sector
Clinical nurse specialists
Perform last offices
Refer patients to support agencies
Refer relatives to support agencies
SKILLS RELATED TO THE ACTIVITY OF ELIMINATING
Assess individuals’ ability to eliminate effectively
Assist clients to use:
Bedpan
Urinal
Toilet
Commode
Apply/change a napkin
Perform routine urinalysis
Empty a catheter bag
Care for an indwelling catheter
Change a catheter bag
Monitor and record urinary output
Monitor and record bowel actions
Monitor and record vomit/gastric aspirate
Obtain specimen of urine/faeces/vomit for laboratory examination
Identify and report changes in clients’ condition
Refer clients to Continence Nurse Specialist
Administer an enema:
Per rectum
Stoma
Rectal washout
Bowel preparation for surgery or investigation
Care for a client with a stoma:
Changing bag
Care of skin
Care of a client with an indwelling catheter
Catheterisation (as Trust policy permits):
Male
Female
Utilise a range of aids and appliances to promote continence
Assess, plan, implement and evaluate care for a range of clients who have difficulty with elimination
SKILLS RELATED TO THE ACTIVITY OF MAINTAINING BODY TEMPERATURE
Assist individuals to select suitable attire to maintain a normal body temperature
Monitor and Record the temperature of:
Infant
Child
Adult
Orally
Axilliary
Aurally/tympanic
Rectally
Using fever strips
Care for individuals with:
Pyrexia
Hypothermia
Recognise environmental influences on maintaining body temperature
Utilise a range of strategies designed to reduce a client’s body temperature
Utilise a range of strategies designed to increase a client’s body temperature
Assess, plan, implement and evaluate care for a range of clients who have difficulty maintaining normal body temperature
SKILLS RELATED TO THE ACTIVITY OF EXPRESSING SEXUALITY
Maintain clients’ privacy, dignity and modesty
Assess individuals’ ability to express their sexuality through the life span:
Child
Adult
Assist individuals to express their sexuality:
Child
Adult
Provide psychological support to the client experiencing difficulty in expressing their sexuality
Provide information to clients regarding appropriate levels of activity following their discharge
Refer to specialist agencies as appropriate
Assess, plan, implement and evaluate care for a range of clients who have difficulty expressing their sexuality
In keeping with local Trust policy, participate in the care of clients requiring:
Vaginal swabbing
Cervical screening
Breast screening
Testicular self-examination
Prostrate screening
Sexual health/planning/screening/ guidance
Recognise and protect vulnerable individuals across the life span
SKILLS RELATED TO THE ACTIVITY OF WORKING and PLAYING