Programme requirements of clinical experience · Nursing Care Plan (NCP) The ability to develop a...

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Programme requirements of clinical experience

The main reason for placing students in clinical placements is for them to experience what

nursing is all about in a real life setting. Students need to experience what it is like to be part

of a team, to deal with unplanned and unexpected events, to work under pressure, and to

accept responsibility for providing delegated nursing interventions. However, apart from the

hands-on experience, students are required to complete a limited number of ‘written

requirements’ that are all focused on reflecting and learning in and from clinical practice.

This document contains information in regard to the most commonly expected written

requirements. It is important to realise that much of this shouldn’t be done during the actual

time in clinical. On the contrary, while the students may need to collect clinical data while in

the practice setting, the expectation of the School is that actual processing of data and

fulfilling any other written requirements occur outside of clinical, thus after the clinical shift

has finished.

The information provided here is for agency staff. It is intended to ensure that preceptors are

informed and fully aware of the requirements and expectations placed on students. Such

knowledge is vital when preceptoring students. Effective support and guidance can only be

provided when preceptors understand the goals of clinical experience in general, and the

learning objectives of the students in particular. However, clinical agency staff is not

required to ‘deal with the paperwork’, this is the responsibility of the CTAs.


Orientation Check List

Whenever BN students enter a new practice area, they are required to orientate to this new

environment. Proper orientation ensures that students ‘settle in’ quicker; get to know the lay-

out, and know where to find things. This will directly contribute to health and safety in the

workplace, which is a legal requirement, but it also will reduce the student’s level of anxiety,

which in turn will increase readiness for learning. Please ensure that the orientation check list

is completed on the first day of the placement (see: Orientation Check List Form, page 10). If

the agency has its own orientation programme/check list, the student is expected to complete

that instead.


Individualised Learning Objectives

All students are required to develop Individualised Learning Objectives (ILOs) for each

clinical placement block. ILOSs require students to reflect on the knowledge they have

gained in classroom and from their own independent study, on their experiences in previous

placement(s), and the feedback they received. ILOs are the tool to help student think about,

and put in writing what it is that they would like to learn/master in their current clinical

setting.

As a registered nurse supporting students, you may ask yourself the question: What is it that

you would like the student to learn while they are in your clinical area? Are there unique

nursing interventions (skills) that students can only develop in your practice area? If so,

suggest these objectives to the students and help them focus on these areas. ILOs should not

have a purely ‘academic’ component but should always involve a client and nursing skill

development. ILOs are intended to ‘stretch’ the student in terms of their learning. ILOs need

to be clear, concise, unambiguous, and ‘measurable’ and accompanied by criteria that

describe in consecutive steps how the student will achieve the objective. Evidence-based

practice requires students to engage in a literature search to support their learning/findings.

Students have been provided with the following guidelines:

Write what it is that you would like to learn (this is the learning objective). This

should be concise and focused on knowledge as well as skill development. Clinical

learning objectives always include a client.

I will competently care for a patient who suffers from osteoarthritis.

I will demonstrate competent care for a patient who requires rectal

administration of medication.

I will demonstrate competent assessment skills (when physical focused you

may specify the body system) and document my findings using the agency's

forms.

An example of an inappropriate ILO would be one where the client is missing: 'To

learn how Vit B12 works in the body and in what cases it is used', or: 'Safe handling

using hoist'. The former learning objective can be done in a library or at home using

the internet, while the latter focuses on a piece of equipment instead of the client.


Once the student has formulated their learning objective, they need to develop performance

'criteria', which outline the steps to be taken to achieve the objective. Performance criteria

include such things as:

A literature review on the topic/skill/procedure.

Review/study related clinical protocols/procedures used by the agency and link this

to the literature review;

Discuss with the CTA/preceptor the protocols/procedures involved to demonstrate

knowledge/understanding;

Prepare and inform client and seek their consent prior to performing the

intervention;

Demonstrate competence in the procedure while ensuring appropriate supervision;

Demonstrate knowledge of correct documentation/reporting requirements.

We encourage agency staff to become involved in, and support students with individualised

learning objectives. What can be learned depends very much on the specific setting and you

as the preceptor are the expert in the field. Your input, guidance, and support will be truly

appreciated by students and CTAs alike.

(See: ILO Exemplar, page 11)


Nursing Care Plan (NCP)

The ability to develop a NCP requires in-depth knowledge of the patient, the reason for

admission, the main health complaints/concerns, the goals to be aimed for, the selection of

appropriate nursing interventions, and strategies to evaluate the effectiveness of the

interventions. Even if NCPs are no longer used as frequently as in the past, for

educational/learning purposes they are still a very useful tool. For this reason, Massey

University requires students to complete NCPs during a variety of clinical placements. NCPs

will be adapted to the level the student is at and even the name and format might change

slightly i.e. Patient Health Plan. While students are expected to complete the bulk of the

writing outside of clinical practice, there is a need to interview patients as well as have access

to the patients’ file in order to obtain the required data. NCP are checked by CTAs but your

support and feedback will at all times be truly appreciated.

Guidelines for the assessment of clinical nursing care plans

Patient assessment

Except during the very first clinical experience (168.121), when students have not been

taught interview- and health assessment skills (paper 168.123), all NCP submitted for

competence assessment, require a comprehensive patient assessment on which the diagnosis,

goal setting, interventions, and evaluation will be based. Preferably, students utilise the

health/nursing/patient assessment documentation that it routinely used in the clinical agency.

An extra page can be used to document additional assessment data obtained through

interview, through systematic objective assessment using inspection, palpation, percussion

and auscultation, or for information obtained from secondary sources such as family,

significant others, health team members, and health records. A combination of functional

health patterns and body system review can provide the assessment framework for collecting

and organising data which in turn forms the foundation for a personalised nursing care plan.

CTA assessment considerations:

Has the student used the documentation appropriately?

Does the quality of data collected suggest good interview skills?

Does the data suggest a comprehensive assessment using subjective and objective

data as well as secondary sources?

Is the assessment data consistent, accurate and concise, using a set framework to

organise the findings?

If relevant, have safety concerns been identified and prioritised?


Nursing diagnosis

The analysis of client data clusters will lead to the identification of:

actual nursing diagnoses: patient response to current health condition(s)

risk diagnoses (sometime also called ‘potential problem’: risk factors that contribute

to increased vulnerability

wellness diagnoses: opportunities for enhancement of a healthy state

Furthermore, nursing diagnoses need to be prioritised, and coping patterns/patient strengths

to prevent or resolve the health challenge need to be identified.


Has the right data been clustered, resulting in a well-defined nursing diagnosis?

Does the nursing diagnosis encapsulate the health concern/risk identified?

Are the nursing diagnoses listed in priority order?

Do you as CTA ‘recognise’ the patient in this NCP?

Do the identified nursing diagnoses go beyond the medical diagnosis?

Do the identified nursing diagnoses go beyond the patient’s physical health (is it

holistic)?

Nursing outcomes

The formulation of outcomes includes measurable, realistic, goals that provide the basis for

implementing nursing interventions to prevent, reduce, or eliminate the identified nursing

diagnosis/problem. The focus is on health promotion, health maintenance, and health

restoration.

Nursing outcomes:

Provides a basis for individualised care

Promotes patient participation

Allows for involvement of support people

Outcomes are realistic and measurable


Do the nursing outcomes contain measurable goals that are realistic/achievable within

the time frame given?

Do the outcomes relate to the nursing diagnoses?

Is the focus on health promotion, health maintenance, and health restoration ?

Do the nursing outcomes focus on the individual and does it promote patient

participation?

Are the outcomes realistic and measurable?

Nursing interventions

Nursing interventions are all the activities carried out by the nurse to achieve the nursing

outcomes. Interventions relate directly to the identified nursing problem and outcome.


Do the nursing interventions relate to the goals aimed for?

Do you consider the interventions listed to be appropriate and likely to be effective?

Is the full range of nursing interventions prescribed?


Do the nursing interventions reflect a level professional knowledge expected of the

student concerned?

Nursing evaluation

Nursing evaluation is systematic and ongoing, and measures how well the patient has

achieved the goals/outcomes specified in the care plan. The evaluation identifies factors that

have positively or negatively influenced goal achievement and may lead to changes in

nursing interventions.


Is there written evidence of (ongoing) evaluation?

Is evaluation of nursing interventions based on patient’s responses?

Does the evaluation reflect a thorough systematic review of each intervention?

Does the evaluation determine whether the nursing outcomes have been achieved?


Clinically-based Written Assignments

Depending on the Year Level and the specific paper, students will be required to base some

of their academic requirements on data obtained from the clinical setting. The assignment

task may for example be a:

Case study of a patient actually cared for in the clinical setting;

Critical review of a clinical protocol/policy;

Proposal for a clinical teaching session with a fully prepared plan including resources;

The above list is only a small sample of potential tasks and is certainly not all inclusive.

Students are also required to develop a Professional Portfolio which contains a number of

different tasks to be completed. While there will be written requirements that change from

year to year, there is one rule that will remain applicable to all students and all situations:

Students can use clinical time to gather the information they require for the task at hand, but

they are not allowed to complete the written requirements during clinical time. The actual

writing of the assignment needs to be done after the work day has finished.

Competency-based Assessment

The assessment of the students’ clinical competence is the responsibility of the CTA,

although it is acknowledged that preceptors play a key role in this activity. Working

alongside the students for 8 hours a day, the preceptor is in a privileged position to really get

to know the student’s capabilities and competence. It is vital that the preceptor provides

feedback to the CTA, or raises the alarm if there are concerns. It is the CTA’s responsibility

to deal with any concerns and ensure that measures are taken to maintain a safe learning

environment. It is also the CTA’s responsibility to complete the written Competency-based

Assessment Form. This assessment process will be completed in two stages but relies heavily

on preceptors providing ongoing feedback over the period of the clinical experience.

Stage 1:

This is the formative assessment undertaken halfway through the clinical experience (or

earlier if there are concerns). Formative assessment is feedback, intended to highlight

strength and to address any concerns. It occurs largely verbally with the CTA although we

encourage preceptors to be present and where possible contribute to the discussion.

Stage 2:

This is the summative written assessment which is completed at the end of the clinical

experience by the CTA with input from the preceptor. Competency-based assessments do


not result in a grade; rather the outcome is expressed in either Pass (being competent), NF

(not finalised = not yet competent), or Fail (not competent).

All competence-based assessments are based on some or all of the following:

observed clinical practice including written client reports;

knowledge displayed in face-to-face discussions;

student’s participation in tutorials;

feedback from agency staff (mostly Preceptors);

feedback from clients;

written documentation such as nursing care plans, case studies etc.

The documentation related to summative competence-based assessments are:

Competency-based Assessment 100 Level (Year One) – page 13

Competency-based Assessment 200 Level (Year Two) – page 19

Competency-based Assessment 300 Level (Year Three) – page 26

Final Pre-Graduate Competency-based Assessment – page 33


Orientation Check List Form

Name of the Agency/Ward:

_____________________________________________

_____________________________________________

Date of orientation and sign-off

Responsibilities of Student in the event of:

Cardiac arrest-phone no., equipment

Fire-phone no., exits, extinguishers

Civil emergency-phone no.

Aggression or violence

___________________________

___________________________

___________________________

___________________________

Location of Emergency Equipment including:

Oxygen – wall outlet, portable

Suction – wall outlet, portable

Resuscitation Trolley – bag-valve-mask device

___________________________

___________________________

___________________________

Physical layout of agency/ward/unit including:

Staff toilet

Sluice room, preparation room

Linen cupboard

Emergency Exits

Relevant Protocols/Policies

Health and Safety requirements

___________________________

___________________________

___________________________

___________________________

___________________________

___________________________

Location of additional equipment:

IV pole and fluids

Dressing packs and trolleys

Charts/Forms: incident forms, FBC, TPR etc

Mobility equipment and instruction for safe use

___________________________

___________________________

___________________________

___________________________

Relevant Phone Numbers including:

CTA/Practicum lecturer

Clinical agency contact number

___________________________

___________________________


Exemplar of Individualised Learning Outcome (Yr Two BN)

Student Name: ____________________________ Date: ______________________

Agency’s Name: __________________________ CTA: ______________________

ILO: I will competently administer medication via IM/SC injection

Criteria: (this is what I have to achieve/demonstrate)

I will:

Study one evidence-based article related to administration of

medication via IM/SC injection;

Discuss the difference in technique between IM and SC

injections, as well as nursing considerations;

Demonstrate knowledge of agency’s protocols related to the

administration of IM/SC medications.

Demonstrate skills in the preparation of the medication;

Explain the procedure to the client and ask for consent to

proceed;

Prepare client for nursing intervention;

Safely administer medication via IM/SC route under direct

supervision;

Dispose of used equipment appropriately;

Complete all documentation according to protocol;

Monitor effects of medication on patient.

Self evaluation: _________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

CTA’s comment: ________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

ILO met: YES / NO

CTA’s Signature: __________________________ Date: ___________________________

13

Competency-based Assessment 100 Level

Assessment criteria for students at 100 Level of the Bachelor of Nursing programme

Student’s name: ________________________ Paper No: 168.1____ CTA/Preceptor’s name: _____________________

Clinical placement: _________________________ Placement period from _______________ till _______________

Professional responsibility This domain contains competencies that relate to professional, legal and ethical responsibilities and cultural safety. These include being able

to demonstrate knowledge and judgement and being accountable for own actions and decisions, while promoting an environment that

maximises clients' safety, independence, quality of life and health. Criteria: Indicators at 100 Level: CTA/Preceptor’s assessment: Met Not

met

Accepts responsibility for

ensuring that his/her

nursing practice and

conduct meet the standards

as set out in this document.

Practises nursing in accordance to the guidelines and

protocols as set out by Massey University BN

programme.

Upholds client rights by seeking informed consent prior

to any nursing interventions.

Accepts responsibility for own actions within scope of

practice.

Accesses agency’s policies and procedural guidelines and

acts in accordance with established protocols.

At a beginning level, is able to discuss with agency

staff/CTA specific aspects of policies and procedures that

relate to the clinical experience i.e. fire and evacuation

procedures, infection control, safe patient handling.

Displays behaviour that demonstrates respect for clients,

peers/colleagues, agency staff and CTA.

Is punctual and reliable; follows through on promises

made.

Complies with all standards of dress code.

Comments:

This is a summative assessment.

Students need to meet all criteria (left-

hand column) as well as any other

predetermined requirements in order to

pass this paper successfully.

14

Professional responsibility (cont.) Criteria: Indicators at 100 Level: CTA/Preceptor’s assessment: Met Not

met

Demonstrates the ability to

apply the principles of the

Treaty of Waitangi/Te Tiriti

0 Waitangi to nursing

practice.

Is aware of the Treaty of Waitangi/Te Tiriti 0 Waitangi

and its relevance to the health of Maori in Aotearoa/New

Zealand.

Is aware of differing health and socioeconomic status of

Maori and non-Maori.

Avoids imposing prejudice onto others

Comments:

Demonstrates

accountability for nursing

care provided.

Understands personal accountability as it relates to own

nursing actions.

Seeks advice from appropriate agency staff when unsure

about own role or the nursing skill to be carried out.

Arranges for supervision for any skill carried out for the

first time in clinical practice.

Comments:

Promotes an environment

that enables client safety,

independence, quality of

life, and health.

Informs agency staff and/or CTA of any mishap or

perceived safety concern.

Is aware of the location of emergency equipment and

where supplies are stored.

At a beginning level maintains infection control

principles.

Informs agency staff or CTA when the client requests

additional support or has limited ability to make decisions.

Assists with the provision of care that best meets the

needs and interests of the clients.

Comments

Practises nursing in a

manner that the client

determines as being

culturally safe.

Begins to recognise own beliefs, values and prejudices.

Acknowledges each person as a unique individual.

Respects the client’s right to hold personal beliefs, values

and goals.

Is aware of the culture of nursing and its potential

influence on individual clients.

Seeks support and advice from agency staff/CTA when

unsure about providing culturally safe care.

At a beginning level, reflects on own beliefs and values in

relation to the client's age, ethnicity, culture, beliefs,

gender, sexual orientation and/or disability, and the

impact these have on the provision of nursing care.

Comments:

15

Management of nursing care This domain contains competencies related to client assessment and managing client care, which is responsive to clients' needs, and which is

supported by nursing knowledge and evidence based research.

Criteria: Indicators at 100 Level: CTA/Preceptor’s assessment: Met Not

met

Provides planned nursing

care to achieve identified

outcomes.

At a beginning level, provides delegated care safely and

within own scope of practice.

Demonstrates a beginning understanding of the processes

and environments that support recovery.

With supervision/guidance, undertakes fundamental

practice procedures and skills in a competent and safe

manner.

Comments:

Ensures the client has

adequate explanation of the

intended nursing care.

Explains to clients the intended nursing care and obtains

informed consent prior to commencement of care.

With guidance, is able to make appropriate decisions

regarding the extent to which the client is capable of

participating in his/her care.

At a beginning level, is aware of the ethical issues related

to nursing practice, (for example: informed consent,

privacy, refusal of treatment).

Is aware of, and respects the client's right to choose

amongst alternatives.

Seeks guidance from agency staff/CTA regarding the

individual's request to change and/or refuse care.

Takes the client's preferences into consideration when

providing care.

Comments:

Undertakes an accurate

nursing assessment of

clients.

At a beginning level, uses an appropriate framework to

assess clients.

Is able to conduct a limited subjective health assessment.

Uses a limited range of assessment tools/equipment

appropriately, and is able to discuss normal findings.

With guidance, begins to make judgements on the client’s

health status.

Seeks guidance when assessment findings are outside the

normal range.

Comments:

16

Management of nursing care (cont.) Criteria: Indicators at 100 Level: CTA/Preceptor’s assessment: Met Not

met

Ensures documentation is

accurate and maintains

confidentiality of information.

With guidance is able to document accurately

assessment findings (i.e. TPR, BP) in client records.

Is able to write a DRAFT client progress report,

demonstrating literacy and the use of a framework

(i.e. SOAPIE).

Comments:

Evaluates client's progress toward

expected outcomes in partnership

with clients.

With guidance from agency staff/CTA, evaluates the

effectiveness of own interactions and interventions in

regard to the client’s identified needs.

Reflects on client’s feedback concerning the cares

provided

Comments:

Reflects upon, and evaluates with

agency staff/CTA the effectiveness

of nursing care provided.

Is aware of own level of competence and seeks

guidance and direction as necessary.

Actively seeks feedback on own performance from

agency staff/CTA and responds appropriately to

feedback.

Comments:

Maintains professional

development.

Begins to take responsibility for own professional

development and for sharing knowledge with

peers/CTA.

With assistance, sets appropriate learning objectives.

Takes part in formal and informal educational

sessions.

Makes use of learning opportunities as provided by

the agency staff.

Attends and contributes to tutorials/clinical sessions

as provided by the CTA.

Attends discussions/team meetings concerning client

needs/cares to increase understanding/knowledge.

Takes initiative when realising that deficit in

knowledge or skills is hindering professional

progress.

Comments:

17

Interpersonal relationships This domain contains competencies related to interpersonal and therapeutic communication with clients, other nursing staff and

interprofessional communication and documentation.


met

Establishes, maintains and

concludes therapeutic inter-

personal relationships with client.

Demonstrates respect, empathy and interest in clients.

Establishes rapport and trust with clients.

At a beginning level, utilises effective interpersonal

skills in interactions with clients.

Demonstrates verbal and non-verbal skills of

clarification.

Responds appropriately to the client’s questions and

requests.

Comments:

Practises nursing in a negotiated

partnership with the client where

and when possible.

Implements delegated nursing care in partnership

with the clients.

Implements delegated nursing care in a safe and

respectful manner.

Begins to recognise, and supports the personal

resourcefulness of people with physical illness.

Is aware of the importance of family/whanau

perspectives and supports their participation in

nursing care.

Comments:

Communicates effectively with

clients and members of the health

care team.

At a beginning level, uses a variety of communication

techniques.

Uses language that is appropriate to the client and

context.

With assistance establishes alternative

communication methods when clients are unable to

verbalise.

Is aware of the boundaries of a professional

relationship and acts accordingly.

Raises questions in the appropriate forum.

Comments:

18

Interprofessional health care & quality improvement This domain contains competencies to demonstrate that, as a member of the health care team, the nurse evaluates the effectiveness of care and

promotes a nursing perspective within the interprofessional activities of the team.


met

Collaborates with agency staff

and CTA to facilitate client

care.

Demonstrates an awareness of the importance of

collaboration between the client and other members

of health team.

Appreciates the importance of a team approach to

health care.

Demonstrates the ability to work effectively as a team

member.

Comments:

Recognises and values the roles

and skills of all members of the

health care team in the

delivery of care.

Is able to verbalise the role of the Registered Nurse as

the primary provider of care.

Demonstrates an appreciation for the input that other

members of the health care team have in order to

maximise health outcomes for clients.

Collaborates with all other health professionals for

the benefit of the client.

Is aware of some of the community services and

resources that are available to support clients.

Comments:

This assessment has been discussed with the student: YES / NO

Student comments (optional): _________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

Student’s signature: ___________________ CTA/Preceptor’s name: _________________________

Date: _______________________________ CTA/Preceptor’s signature: _________________________

19








met





of the professional, ethical

and relevant legislated

requirements.

Practises nursing in accord with the guidelines and protocols

as set out by Massey University BN programme.

Begins to relate own nursing practice to relevant

legislation/codes/policies and upholds clients’ rights derived

from that legislation.

Accepts responsibility for own actions, and in partnership

with agency staff/CTA makes decision within scope of

practice.

Identifies perceived breaches of law that may occur in practice

and discusses these with appropriate agency staff/CTA.

Accesses and, at a beginning level, demonstrates knowledge

of policies and procedural guidelines that have implications

for practice.

Uses the professional standards of practice as set out in this

document.

Comments:



Treaty of Waitangi/Te

Tiriti 0 Waitangi to nursing

practice.

At a beginning level, understands the Treaty of Waitangi/Te

Tiriti 0 Waitangi and its relevance to the health of Maori in

Aotearoa/New Zealand.

Is able to discuss the discrepancies of health and socio-

economic status between Maori and non-Maori.

Begins to apply the Treaty of Waitangi/Te Tiriti 0 Waitangi to

nursing practice.

Comments:






20


met

Demonstrates

accountability for nursing

care provided.

Demonstrates accountability for delivering and evaluating

nursing care.

Seeks advice and clarification from agency staff/CTA

regarding any aspect of nursing care if unsure.

Arranges for supervision for any skill carried out for the first

time in clinical practice.

Makes appropriate and efficient use of resources available.

Informs agency staff when delegated nursing task exceeds

personal ability or scope of nursing practice.

Comments:




life, and health.

Begins to identify situations that affect client or staff

members' health or safety and reports these appropriately.

Knows the location of emergency equipment and supplies and

at a beginning level is able to use these.

Maintains infection control principles.

Recognises potential physical, social and psychological risks

for clients in a health care setting and provides care that best

meets the needs and interests of clients and the public.

Comments:



determines as being

culturally safe.

Begins to apply the principles of cultural safety in own

nursing practice.

Is aware of the culture of nursing and its impact on client care

and endeavours to protect the client's wellbeing within this

culture.

Respects each client's identity and right to hold personal

beliefs, values and goals.

Informs agency staff/CTA of the need to assist the client to

gain appropriate support and representation from those who

understand the client's culture, needs and preferences.

Reflects on his/her own practice and values that impact on

nursing care in relation to the client's age, ethnicity, culture,

beliefs, gender, sexual orientation and/or disability.

Avoids imposing prejudice on others and is able to discuss

advocacy strategies when prejudice is apparent.

Comments:

21




met



outcomes.

Works in close collaboration with clients and agency

staff/CTA when planning care, and demonstrates an

understanding of the client’s right to make informed decisions.

At a beginning level, demonstrates understanding of the

processes and environments that support recovery and healing.

Nursing care is based on situational and current knowledge

and supported by clear rationale.

Undertakes appropriately delegated practice procedures and

skills in a competent and safe way.

Administers medications in accordance to agency policies and

under direct supervision of agency staff/CTA.

Comments:



effects, consequences of the

proposed nursing care

options.

Provides clients with appropriate information concerning

intended nursing care to protect their rights and to allow

informed decision-making.

Begins to take into account the readiness of the client to

participate in health education.

With guidance, makes appropriate professional judgement

regarding the extent to which the client is capable of

participating in decisions related to his/her care.

At a beginning level, discusses ethical issues related to health

care/nursing practice, (for example: informed consent,

privacy, refusal of treatment and rights of formal and informal

clients).

Assists in the facilitation of the client's access to appropriate

therapies or interventions.

Respects the client's right to choose amongst alternatives.

Seeks clarification from relevant members of the health care

team regarding the individual's request to change and/or refuse

care.


providing care.

Comments:

22


met

Undertakes a comprehen-

sive and accurate nursing

assessment of clients in a

variety of settings.

Assists with, and uses an appropriate framework to assess

and determine client health status.

Is able to conduct a subjective health assessment

Uses suitable assessment tools/equipment to assist the

collection of objective data.

Reports and seeks guidance when assessment findings are

outside the normal range.

Begins to apply relevant research data to underpin nursing

assessment.

Comments:



confidentiality of

information.

With guidance, maintains clear, concise, accurate client

records.

Begins to understand the legal and ethical aspects that

applies to documentation.

With minimal guidance is able to complete a wide range of

forms that are part of nursing documentation (i.e. FBC,

diabetic record, PF record).

Comments:

Acts appropriately to

protect oneself and others

when faced with unexpected

client responses, confronta-

tion, personal threat or

other crisis situations.

Is aware of the agency’s emergency procedures and lines of

communication in a crisis situation.

Informs immediately agency staff of any situation that

compromise client safety and wellbeing.

Is aware of own limitations and seeks assistance as

necessary.

Comments:

Evaluates client's progress

toward expected outcomes

in partnership with clients.

At a beginning level, identifies criteria for evaluation of

expected outcomes of care.

With guidance from agency staff/CTA and in collaboration

with the client, evaluates the effectiveness of the client's

response to prescribed treatments, interventions and health

education.

Reflects on client feedback on the evaluation of nursing care

and health service delivery.

Comments:

23


met

Provides health education

appropriate to the needs of

the client within a nursing

framework.

Checks clients' level of understanding of health care when

answering their questions and providing information.

At a beginning level, uses informal and formal methods of

teaching that are appropriate to the client's abilities.

Begins to participates in health education, and ensures client

understands relevant information related to their health care.

Comments:

Reflects upon, and

evaluates with agency

staff/CTA the effectiveness

of nursing care provided.

Identifies own level of competence and seeks assistance and

guidance as necessary.

Accesses advice/support and acts accordingly.

Recognises need for debriefing and takes steps to obtain this

as necessary.

Comments:


development.

Takes responsibility for one's own professional development

and for sharing knowledge with others.

Takes actively part in formal and informal educational

sessions.

Sets personal learning objectives that are appropriate for the

setting and achievable in the time available.

Pursues learning opportunities that extend own professional

knowledge/skills base.

Identifies knowledge/skills deficits and takes appropriate

initiatives to resolve these.

Responds to feedback by setting new objectives that address

the areas that require improvement.

Comments:

24




met


concludes therapeutic

interpersonal relationships

with client.

At a beginning level, initiates, maintains and concludes

interpersonal interactions with clients.

Begins to incorporate therapeutic use of self as the basis for

nursing care.

Utilises effective interviewing skills in interactions with

clients.

Demonstrates respect, empathy and interest in client.

Establishes rapport and trust with the client.

Comments:


negotiated partnership with

the client where and when

possible.

Ensures that clients receive and understand information

concerning their health care in order to make an informed

choice.

Implements nursing care in a manner that facilitates the

independence, self-esteem and safety of the client and an

understanding of therapeutic and partnership principles.

Recognises and supports the personal resourcefulness of

people with mental and/or physical illness.

Acknowledges family/whanau perspectives and supports

their participation in nursing care.

Comments:

Communicates effectively

with clients and members of

the health care team.

Utilises a variety of effective communication techniques.

Demonstrates verbal and non-verbal skills of clarification.

Employs appropriate language to context.

Provides adequate time for discussion.

Endeavours to establish alternative communication methods

when clients are unable to verbalise.

Communicates in a manner that respects the boundaries of a

professional relationship.

Communicates clearly and concisely in writing to ensure

continuity of care and recovery.

Discussions concerning clients are restricted to settings,

learning situations and relevant members of the health care

team including CTA.

Comments:

25




met

Collaborates and partici-

pates with colleagues and

members of the health care

team to facilitate and

coordinate care.

Collaborates with the client and agency staff in order to

develop and implement a plan of care.

Assists in the development of a discharge plan and follow

up care in consultation with the client and agency staff.

Demonstrates knowledge of the formal referral system to

other health care team members for clients who require

consultation.

Demonstrates the ability to work effectively as a team

member.

Comments:

Recognises and values the

roles and skills of all

members of the health care

team in the delivery of care.

Is knowledgeable about the roles and responsibilities of the

Registered Nurse within the clinical setting.

Demonstrates a beginning understanding of the roles,

responsibilities, and skills of other members of the health

team.

Assists with the co-ordination of care to maximise health

outcomes for the client.

Collaborates with, and provides accurate information to, the

client and other health professionals about the prescribed


Demonstrates knowledge of community services and

resources and encourages clients to use them when

appropriate.

Comments:

Participates in quality

improvement activities to

monitor and improve

standards of nursing.

Begins to identify researchable practice issues and discusses

these during clinical tutorials and/or with CTA.

Engages in literature searches to find evidence-based


Raises in an appropriate forum, valid questions about

current nursing practices and protocols.

Comments:



_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________



26








met





of the professional, ethical

and relevant legislated

requirements.

Practises nursing in accord with relevant

legislation/codes/policies and upholds client rights

derived from that legislation.

Accepts responsibility for own actions and decision

making within scope of practice.

Identifies breaches of law that occur in practice and

reports them to the appropriate agency staff/CTA.

Demonstrates knowledge of, and accesses, policies

and procedural guidelines that have implications for

practice.

Uses professional standards of practice.

Comments:



Treaty of Waitangi/Te

Tiriti 0 Waitangi to nursing

practice.

Understands the Treaty of Waitangi/Te Tiriti 0

Waitangi and its relevance to the health of Maori in

Aotearoa/New Zealand.

Demonstrates knowledge of differing health and

socioeconomic status of Maori and non-Maori.

Applies the Treaty of Waitangi/Te Tiriti 0 Waitangi

to nursing practice.

Comments:






27


met

Demonstrates accountability for

directing, monitoring and

evaluating nursing care that is

provided by nurse assistants,

enrolled nurses and others.

Understands the various aspects for directing,

monitoring and evaluating nursing care that is

provided by nurse assistants, enrolled nurses and

others.

Is able to discuss accountability issues related to

directing, monitoring and evaluating nursing care.

Seeks advice from a senior registered nurse if unsure

about the role and competence of nurse assistants,

enrolled nurses and others when delegating work.

Comments:

Promotes an environment that

enables client safety, indepen-

dence, quality of life, and health.

Identifies and reports situations that affect client or

staff members' health or safety.

Accesses, maintains and uses emergency equipment

and supplies.


Recognises and manages risks to provide care that

best meets the needs and interests of clients and the

public.

Comments:

Practises nursing in a manner

that the client determines as

being culturally safe.

Applies the principles of cultural safety in own

nursing practice.

Recognises the impact of the culture of nursing on

client care and endeavours to protect the client's

wellbeing within this culture.

Practises in a way that respects each client's identity

and right to hold personal beliefs, values and goals.

Assists the client to gain appropriate support and

representation from those who understand the client's

culture, needs and preferences.

With guidance of agency staff, consults with

members of cultural and other groups as requested

and approved by the client.

Reflects on his/her own practice and values that

impact on nursing care in relation to the client's age, ethnicity, culture, beliefs, gender, sexual orientation

and/or disability.

Avoids imposing prejudice onto others and provides

advocacy when prejudice is apparent.

Comments:

28




met

Provides planned nursing care to

achieve identified outcomes.

Contributes to care planning, involving clients and

demonstrates an understanding of clients' rights, to

make informed decisions.

Demonstrates understanding of the processes and

environments that support recovery.

Identifies examples of the use of evidence in planned

nursing care.

Undertakes practice procedures and skills in a

competent and safe manner.

Administers interventions, treatments and

medications, within legislation, codes and scope of

practice; and according to authorised prescription,

established policy and guidelines.

Comments:

Ensures the client has adequate

explanation of the effects,

consequences and alternatives of

proposed treatment options.

Provides appropriate information to clients to protect

their rights and to allow informed decisions.

Assesses the readiness of the client to participate in

health education.

With minimal guidance, makes appropriate

professional judgement regarding the extent to which

the client is capable of participating in decisions

related to his/her care.

Discusses ethical issues related to health care/nursing

practice, (for example: informed consent, privacy,

refusal of treatment and rights of formal and informal

clients).

With guidance, facilitates the client's access to

appropriate therapies or interventions and respects the

client's right to choose amongst alternatives.

Seeks clarification from relevant members of the

health care team regarding the individual's request to

change and/or refuse care.


providing care.

Comments:

29


met

Undertakes a comprehensive and

accurate nursing assessment of

clients in a variety of settings.

Undertakes assessment in an organised and

systematic way.

Uses suitable assessment tools and methods to assist

the collection of data.

Applies relevant research data to underpin nursing

assessment.

Comments:




Maintains clear, concise, timely, accurate and current

client records within a legal and ethical framework.

Demonstrates literacy and computer skills necessary

to record, enter, store, retrieve and organise data

essential for care delivery.

Comments:

Acts appropriately to protect

oneself and others when faced

with unexpected client responses,

confrontation, personal threat or

other crisis situations.

Understand emergency procedures and plans, and

lines of communication, to manage crisis situations.

Takes action in situations that compromise client

safety and wellbeing.

Implements nursing responses, procedures and

protocols for managing threats to safety within the

practice environment.

Comments:

Evaluates client's progress toward

expected outcomes in partnership

with clients.

Identifies criteria for evaluation of expected

outcomes of care.

In collaboration with client, agency staff/CTA,

evaluates the effectiveness of the client's response to

prescribed treatments, interventions and health

education.

Reflects on client feedback for evaluation of nursing

care and health service delivery.

Comments:


appropriate to the needs of the

client within a nursing

framework.

Checks clients' level of understanding of health care

when answering their questions and providing

information.

Uses informal and formal methods of teaching that

are appropriate to the client's or group's abilities.

Participates in health education, and ensures that the

client understands relevant information related to

their health care.

Educates client to maintain and promote health.

Comments:

30


met

Reflects upon, and evaluates with

agency staff/CTA, the effective-

ness of nursing care.

Identifies one's own level of competence and seeks

assistance and knowledge as necessary.

Determines the level of care required by individual

clients.

Accesses advice, assistance, debriefing and direction

as necessary.

Comments:

Maintains professional develop-

ment.

Takes responsibility for own professional

development.

Takes actively part in formal and informal

educational sessions.

Sets personal learning objectives that are appropriate

for the setting and achievable in the time available.

Pursues learning opportunities that extend own

professional knowledge/skills base.

Identifies knowledge/skills deficits and takes

appropriate initiatives to resolve these.

Responds to feedback by setting new objectives.

Begins to contribute to the support, direction and

teaching of peers and junior staff to enhance

professional development.

Updates knowledge related to administration of

interventions, treatments, medications and best

practice guidelines within area of practice.

Comments:

31




met


concludes therapeutic inter-

personal relationships with client.

Initiates, maintains and concludes interpersonal

interactions with clients.

Incorporates therapeutic use of self and

psychotherapeutic communication skills as the basis

for nursing care for clients with mental health needs.

Utilises effective interviewing and counselling skills

in interactions with clients.



Comments:

Practises nursing in a negotiated

partnership with the client where

and when possible.

Undertakes nursing care that ensures clients receive

and understand relevant and current information

concerning their health care that contributes to

informed choice.

Implements nursing care in a manner that facilitates

the independence, self-esteem and safety of the client

and an understanding of therapeutic and partnership

principles.

Recognises and supports the personal resourcefulness

of people with mental and/or physical illness.

Acknowledges family/whanau perspectives and

supports their participation in services.

Comments:

Communicates effectively with

clients and members of the health

care team.

Uses a variety of effective communication

techniques.



Endeavours to establish alternative communication

methods when clients are unable to verbalise.

Accesses an interpreter when appropriate.


learning situations and or relevant members of the

health care team.

Comments:

32



Criteria: Indicators at 300 Level: CTA/Preceptor’s assessment: Met Not met

Collaborates and participates

with colleagues and members

of the health care team to

facilitate and coordinate care.

Promotes a nursing perspective and contribution within

the interprofessional activities of the health care team.

Collaborates with the client and agency staff to develop a

plan of care.

Maintains and documents information necessary for


Develops a discharge plan and follow up care in

consultation with the client and agency staff members.

With guidance, makes appropriate formal referrals to

other health care team members and other health related

sectors for clients who require consultation.

Comments:

Recognises and values the

roles and skills of all members

of the health care team in the

delivery of care.

Contributes to the co-ordination of care to maximise

health outcomes for the client.

Collaborates, consults with, and provides accurate

information to the client and other health professionals

about the prescribed interventions or treatments.

Demonstrates a comprehensive knowledge of community

services and resources and actively supports service users

to use them.

Comments:


improvement activities to

monitor and improve

standards of nursing.

Raises in an appropriate forum valid questions about

current nursing practices and protocols.

Contributes to discussions concerning current policies,

processes, procedures using relevant published research

data.

Recognises and identifies researchable practice issues and

discusses these with appropriate people,

Shares with agency staff/CTA/peers published research

findings that indicate changes to practice.

Comments:



_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________



33

Final Pre-Graduate Competency-based Assessment

Assessment criteria for students completing the final clinical experience in the Bachelor of Nursing programme

Student’s name: ________________________ Paper No: 168.343 Preceptor’s name: _____________________




maximises clients' safety, independence, quality of life and health. Criteria: Indicators at 300 Level: Preceptor’s assessment: Met Not

met




conduct meet the

standards of the

professional, ethical and

relevant legislated

requirements.

Practises nursing in accord with relevant

legislation/codes/policies and upholds client rights derived

from that legislation.

Accepts responsibility for actions and decision making

within scope of practice.

Identifies breaches of law that occur in practice and reports

them to the appropriate person(s).

Demonstrates knowledge of, and accesses, policies and

procedural guidelines that have implications for practice.

Uses professional standards of practice.

Comments:

Demonstrates the ability

to apply the principles of

the Treaty of

Waitangi/Te Tiriti 0

Waitangi to nursing

practice.

Understands the Treaty of Waitangi/Te Tiriti 0 Waitangi and

its relevance to the health of Maori in Aotearoa/New

Zealand.

Demonstrates knowledge of differing health and socio-

economic status of Maori and non-Maori.

Applies the Treaty of Waitangi/Te Tiriti 0 Waitangi to

nursing practice.

Comments:

34

Professional responsibility (cont.) Criteria: Indicators at 300 Level: Preceptor’s assessment: Met Not

met

Demonstrates

accountability for

directing, monitoring and

evaluating nursing care

that is provided by nurse

assistants, enrolled nurses

and others.

Understands accountability for directing, monitoring and

evaluating nursing care provided by nurse assistants,

enrolled nurses and others.

Seeks advice from a senior registered nurse if unsure about

the role and competence of nurse assistants, enrolled nurses

and others when delegating work.

Takes into consideration the role and competence of staff

when delegating work.

Makes appropriate decisions when assigning care,

delegating activities and providing direction for enrolled

nurses, nurse assistants and others.

Comments:




life, and health.

Identifies and reports situations that affect client or staff

members' health or safety.

Accesses, maintains and uses emergency equipment and

supplies.


Recognises and manages risks to provide care that best

meets the needs and interests of clients and the public.

Comments:



determines as being

culturally safe.

Applies the principles of cultural safety in own nursing

practice.

Recognises the impact of the culture of nursing on client

care and endeavours to protect the client's wellbeing within

this culture.

Practises in a way that respects each client's identity and

right to hold personal beliefs, values and goals.

Assists the client to gain appropriate support and

representation from those who understand the client's

culture, needs and preferences.

Consults with members of cultural and other groups as

requested and approved by the client.

Reflects on his/her own practice and values that impact on

nursing care in relation to the client's age, ethnicity, culture,

beliefs, gender, sexual orientation and/or disability.

Avoids imposing prejudice on others and provides advocacy

when prejudice is apparent.

Comments:

35


supported by nursing knowledge and evidence-based research.

Criteria: Indicators at 300 Level: Preceptor’s assessment: Met Not

met



outcomes.

Contributes to care planning, involving clients and

demonstrating an understanding of clients' rights, to make

informed decisions.

Demonstrates understanding of the processes and

environments that support recovery.

Identifies examples of the use of evidence in planned

nursing care.

Undertakes practice procedures and skills in a competent

and safe way.

Administers interventions, treatments and medications,

(for example: intravenous therapy, calming and restraint),

within legislation, codes and scope of practice; and

according to authorised prescription, established policy

and guidelines.

Comments:



effects, consequences and

alternatives of proposed

treatment options.

Provides appropriate information to clients to protect their

rights and to allow informed decisions.

Assesses the readiness of the client to participate in health

education.

Makes appropriate professional judgement regarding the

extent to which the client is capable of participating in

decisions related to his/her care.

Discusses ethical issues related to health care/nursing

practice, (for example: informed consent, privacy, refusal

of treatment and rights of formal and informal clients).

Facilitates the client's access to appropriate therapies or

interventions and respects the client's right to choose

amongst alternatives.

Seeks clarification from relevant members of the health

care team regarding the individual's request to change

and/or refuse care.


providing care.

Comments:

36

Management of nursing care (cont.)


met

Undertakes a comprehensive

and accurate nursing

assessment of clients in a

variety of settings.

Undertakes assessment in an organised and systematic

way.

Uses suitable assessment tools and methods to assist the

collection of data.

Applies relevant research to underpin nursing assessment.

Comments:




Maintains clear, concise, timely, accurate and current

client records within a legal and ethical framework.

Demonstrates literacy and computer skills necessary to

record, enter, store, retrieve and organise data essential for

care delivery.

Comments:

Acts appropriately to protect

oneself and others when faced

with unexpected client

responses, confrontation,

personal threat or other crisis

situations.

Understands emergency procedures and plans and lines of

communication to maximise effectiveness in a crisis

situation.

Takes action in situations that compromise client safety

and wellbeing.

Implements nursing responses, procedures and protocols

for managing threats to safety within the practice

environment.

Comments:

Evaluates client's progress

toward expected outcomes in

partnership with clients.

Identifies criteria for evaluation of expected outcomes of

care.

In collaboration with preceptor/mentor, evaluates the

effectiveness of the client's response to prescribed

treatments, interventions and health education in

collaboration with the client and other health care team

members.

Reflects on client feedback on the evaluation of nursing

care and health service delivery.

Comments:


appropriate to the needs of

the client within a nursing

framework.

Checks clients' level of understanding of health care when

answering their questions and providing information.

Uses informal and formal methods of teaching that are

appropriate to the client's or group's abilities.

Participates in health education, and ensures that the client

understands relevant information related to their health

care.

Educates client to maintain and promote health.

Comments:

37

Management of nursing care (cont.)


met

Reflects upon, and evaluates

the effectiveness of nursing

care with peers and

experienced nurses.

Identifies one's own level of competence and seeks

assistance and knowledge as necessary.

Determines the level of care required by individual clients.

Accesses advice, assistance, debriefing and direction as

necessary.

Comments:


development.

Contributes to the support, direction and teaching of

colleagues to enhance professional development.

Updates knowledge related to administration of

interventions, treatments, medications and best practice

guidelines within area of practice.

Takes responsibility for own professional development and

for sharing knowledge with others.

Comments:

38




met


concludes therapeutic

interpersonal relationships

with client.

Initiates, maintains and concludes interpersonal


Incorporates therapeutic use of self and psychotherapeutic

communication skills as the basis for nursing care for

clients with mental health needs.

Utilises effective interviewing and counselling skills in




Comments:


negotiated partnership with

the client where and when

possible.

Undertakes nursing care that ensures clients receive and

understand relevant and current information concerning

their health care that contributes to informed choice.

Implements nursing care in a manner that facilitates the

independence, self-esteem and safety of the client and an

understanding of therapeutic and partnership principles.

Recognises and supports the personal resourcefulness of

people with mental and/or physical illness.

Acknowledges family/whanau perspectives and supports

their participation in services.

Comments:

Communicates effectively

with clients and members of

the health care team.

Uses a variety of effective communication techniques.



Endeavours to establish alternative communication methods

when clients are unable to verbalise.

Accesses an interpreter when appropriate.


learning situations and or relevant members of the health

care team.

Comments:

39


promotes a nursing perspective within the interprofessional activities of the team. Criteria: Indicators at 300 Level: Preceptor’s assessment: Met Not

met

Collaborates and participates

with colleagues and members of

the health care team to facilitate

and coordinate care.

Promotes a nursing perspective and contribution

within the interprofessional activities of the health

care team.

Provides guidance and support to fellow students,

beginning practitioners and those who are

transferring into a new clinical area when

appropriate.

Collaborates with the client and other health team

members to develop and plan of care.

Maintains and documents information necessary for


Develops a discharge plan and follow up care in

consultation with the client and other members of the

health care team.

Makes appropriate formal referrals to other health

care team members and other health related sectors

for clients who require consultation.

Comments:

Recognises and values the roles

and skills of all members of the

health care team in the delivery of

care.

Contributes to the co-ordination of care to maximise

health outcomes for the client.

Collaborates, consults with and provides accurate

information to the client and other health

professionals about the prescribed interventions or

treatments.

Demonstrates a comprehensive knowledge of

community services and resources and actively

supports service users to use them.

Comments:


improvement activities to monitor

and improve standards of

nursing.

Reviews policies, processes, procedures based on

relevant research.

Recognises and identifies researchable practice issues

and refers to appropriate people,

Distributes research findings that indicate changes to

practice to colleagues,

Comments:

40


Additional Preceptor’s comments (optional): _____________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

Preceptor’s name: ______________________ Preceptor’s signature: _______________________ Date: ____________________


_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

Student’s signature: ___________________ Date: ________________________

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