Competency Tool
December 2013
Wound Dressing Competency Tool1
The Victorian Department of Health is making this document freely available on the internet for health services to use and adapt to meet the National Safety and Quality Health Service Standards of the Australian Commission on Safety and Quality in Health Care. Each health service is responsible for all decisions on how to use this document at its health service and for any changes to the document. Health services need to review this document with respect to the local regulatory framework, processes and training requirements
The author disclaims any warranties, whether expressed or implied, including any warranty as to the quality, accuracy, or suitability of this information for any particular purpose. The author and reviewers cannot be held responsible for the continued currency of the information, for any errors or omissions, and for any consequences arising there from.
Published by Sector Performance, Quality and Rural Health, Victorian Government, Department of Health
February 2014
Wound Dressing Competency Tool1
Key: I – Independent S – Supervised A – Assisted M – Marginal D – Dependent(Refer‘Bondy’ Rating Scale p.5)
Note:Shaded area indicates minimum criteria to meet clinical competency
* The following workflow has been used as an example only. If the health care worker follows the principles of aseptic technique but performs tasks differently they should be deemed competent providing individual technique does not breech the aseptic field.
ASSESSMENT CRITERIA / ELEMENTS / Participant Performance / StandardClean Preparation Zone /
- Performs hand hygiene
ACORN
S – 2, 11
- Wipes down trolley with a disinfectant wipe
- Gathers required equipment and supplies
- Place dressing pack on the top shelf and all items on the bottom shelf. If the trolley has a draw – (do not go into the draw without removing gloves and performing hand hygiene.
- Dons protective eyewear and surgical mask as necessary
Patient Zone /
- Discusses procedure with patient and obtains verbal consent if patient conscious/able to provide consent
ACORN
S – 2, 11, 12
- Maintains patient dignity and exposes patient only as much as necessary
- Performs hand hygiene
- Entering patient room, open dressing pack and add items required ensuring items remain sterile. Prepare the patient.
- Don a pair of Non sterile gloves and loosen old dressing so it can be removed with a pair of forceps. Remove gloves.
- Performs hand hygiene.
- Option 1 - Using non sterile gloves remove the old dressing without touching the wound and discard with gloves.
- Option 2 - Using non sterile gloves and a forcep remove old dressing and discard with dressing items and forcep.
- Option 3 - Using no gloves and a forcep remove old dressing and discard dressing items and forcep
- Option 4 - If required to touch the wound – use sterile gloves and a forcep and discard as per option 3.
- If extra items are required for use, remove gloves if being worn and perform hand hygiene prior to getting items out of a draw in the trolley or before leaving the room to obtain further items.
- Open items, perform hand hygiene and put on gloves before continuing with dressing.
ASSESSMENT CRITERIA / ELEMENTS / Participant Performance
Standard / Standard
Patient Zone
(cont) /
- Performs hand hygiene.
ACORN
S – 2, 11, 12
- Using sterile forceps cleanse area as required without contaminating the forceps and the other items on the trolley / clean field.
- Complete dressing and remove gloves if applicable
- Performs hand hygiene.
Dirty Utility Zone /
- Assists patient to a comfortable position
ACORN
S - 2, 3, 7, 11, 12, 18
- Covers patient
- Wipes down trolley with a disinfectant wipe
- Performs hand hygiene
Documentation /
- Document procedure in patients’ medical record.
ACORN
S - , 3, 7, PS4
Staff member being assessed:______
Assessor:______Signed (Assessor): ______
(Please print name)
Date of Assessment: ______
Standard Achieved: (please circle one)Competent (C)Not Yet Competent(NYC)
Comments (if required):
Wound Dressing Competency Tool1
Action Plan
Please document the agreed education plan and completion timelines for staff assessed as not yet competent:
Staff Member Name______
Staff Member Signature______
Staff Member Ward______
Educator Name______
Educator Signature______
Proposed Completion Date______
Wound Dressing Competency Tool1
‘Bondy’ Rating Scale
Scale label / Score / Standard of procedure / Quality of performance / Level of assistance requiredIndependent / 5 / Safe
Accurate
Achieved intended outcome
Behaviour is appropriate to context / Proficient
Confident
Expedient / No supporting cues required
Supervised / 4 / Safe
Accurate
Achieved intended outcome
Behaviour is appropriate to context / Proficient
Confident
Reasonably expedient / Requires occasional supportive cues
Assisted / 3 / Safe
Accurate
Achieved most objectives for intended outcome
Behaviour generally appropriate to context / Proficient throughout most of performance when assisted / Requires frequent verbal and occasional physical directives in addition to supportive cues
Marginal / 2 / Safe only with guidance
Not completely accurate
Incomplete achievement of intended outcome / Unskilled
Inefficient / Requires continuous verbal and frequent physical directive cues
Dependent / 1 / Unsafe
Unable to demonstrate behaviour
Lack of insight into behaviour appropriate to context / Unskilled
Unable to demonstrate behaviour/procedure / Requires continuous verbal and continuous physical directive cues
Bondy, 1983
References
ACORN. (2012-2013). Standards for perioperative nursing including nursing roles, guidelines and position statements. Adelaide: ACORN.
Bondy, K.N. (1984) Clinical Evaluation of student performance: the effects of criteria on accuracy and reliability. Research in Nursing and Health, 7(1), 25-33.
Bondy, K.N. (1983) Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation. Journal of Nursing Education, 22(9), 376-382
Cabrini Health Policy and Procedures Manual & Cabrini Nursing Clinical Protocol Manual
Rowley, S., & Clare, S. (2011). Aseptic Non Touch Technique (ANTT): Reducing Healthcare Associated Infections (HCAI) by Standardising Aseptic Technique with ANTT across Large Clinical Workforces. American Journal of Infection Control, 39(5), 90.
Standards Australia, (2003), Australian/New Zealand Standard: Cleaning, disinfecting & sterilising reusable medical & surgical instruments & equipment, & maintenance of associated environments in health care facilities. Sydney: Standards Australia.
Wound Dressing Competency Tool1