›Clinical Skills and Experience Logbook 2012 Name:_______________________________________
© WFA Clinical Education Team
›Contents
Introduction
3
Frequently asked questions about the logbook
4
Clinical Experience Case Logs Filling Out a Case Log Sample Clinical Experience Case Log 8 Clinical Experience Case Logs Drug Administration Log Filling Out the Drug Administration Log Drug Administration Log
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Skills Log
Case Log
Filling Out the Skills Log Skills Log
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Filling Out the Case Log Case Log
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Year Summaries
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›Introduction
to the Clinical Skills and Experience Logbook
It has often been said that “experience counts for a lot” within the ambulance industry. The reality is that our experience comes directly out of the jobs we attend and the subsequent opportunity we get to apply our skills and knowledge. This logbook is an attempt to record and quantify the experience paramedics accumulate through the jobs attended. There is increasing acknowledgement of the importance of critical thinking/ reflection as a learning tool. The logbook is an important document because it forms a life long record of your experience in pre-hospital emergency care and in a sense, becomes your paramedic “curriculum vitae”. Students and Delegated Skills/Medications Students who are enrolled on an approved training course (i.e. NDAP, ILS, or ALS) may carry out interventions, or administer medications for which they have received classroom training and educator sign off. Students must be directly supervised by a staff member who holds an ATP for the medication/intervention. Direct supervision is defined as being in the same ambulance. The supervising staff member holds clinical responsibility for care provided by students, and must co-sign patient report forms. Students providing delegated cares must discuss planned skills/medications with supervising staff members before providing patient care. Logbook Purpose Other registered health professionals (e.g. nNurses) need to keep a professional portfolio as part of registration requirements. This skills log will be an important part of any future professional portfolio The three main purposes for keeping the logbook are: 1.
To be a record of your experience gained while working on the road
2.
To be a learning tool for you to use to reflect on cases you attend
© WFA Clinical Education Team
3.
To be an assessment tool for an assessor to use as a means of gathering evidence from your accumulated experience when doing a revalidation or any other type of on job assessment.
We trust that you will enjoy using this logbook and find it a useful tool to supplement and enhance your paramedic practice. Please do not hesitate to contact us if you have any feedback regarding the logbook and in particular any suggestions for improvements. Adam Pilmore, Sarah Parnell Clinical Educators
© WFA Clinical Education Team
›Frequently
Asked Questions Regarding the Clinical Skills and Experience Logbook
Why keep a clinical skills and experience logbook? •
To form a record of the experience you are gaining from skills performed, drugs administered and cases attended. It is your paramedic ”curriculum vitae”.
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To assist you in reflecting on and learning from cases you have attended
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To assist you in monitoring your accumulated experience with specific skills, drugs administered and cases you have attended
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To be a tool for an on job assessor or in-service training clinical educator to use when gathering evidence on your practice as part of a revalidation, right to practice, pre entry, on job qualification or pre employment assessment
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To be a tool for a trainer, mentor or team manager to use in assisting you with your on going training and development.
Who will look at my clinical skills and experience logbook? •
The logbook is your document and as such you control what you enter in it and who looks at it. Please keep it in a safe place
•
The following people may ask to look at it as part of assisting you with training or when doing an assessment: On Job Assessor Clinical Educators Team Manager Operations Mentor
© WFA Clinical Education Team
Is my logbook kept on file or retained by the service? • .
No the logbook is kept and retained by you and is only ever looked at by assessors or trainers when gathering evidence for an assessment or when assisting you in training. It will always be given back to you and no copies of any page will be taken other than what may be required for evidence for an assessment.
Do I have to fill the Clinical Skills and Experience Logbook out if I am already filling out a logbook for a PTE course (e.g. National Diploma in Ambulance Practice,ILS2 , ICP etc)? •
No, your course logbook takes priority over the Clinical Skills and Experience Logbook. However as soon as you have finished with your course logbook you should start using the Clinical Skills and Experience Logbook again. Whitireia undergraduate students should likewise give Whitireia logbooks priority over Clinical Skills and Experience Logbook
© WFA Clinical Education Team
›Filling Out a Case Experience Log •
You choose which cases you wish to record. As a suggestion record all Stat 1 or 2 patients you attend and any significant MCI incidents.
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You may also like to record any other case that you attend that was interesting, unusual or caused you to reflect a little more than usual.
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Enter as much information under each section as you deem necessary. Generally the more concise and brief the information is, the better.
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Other things you may wish to record in the log are:
Anything new you learnt through doing a particular job Rationales for why treatments or assessments were done Anything you would do differently next time Any significant thoughts, emotions or feelings you had while doing the job.
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Remember that this is designed to be a learning tool. You learn from reflecting on cases you attend.
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Remember that it is also an assessment tool that your revalidation assessor or on job assessor will use when doing an assessment. They will use it as a catalyst for discussing cases, gathering assessment evidence as well as getting an idea of your experience base.
© WFA Clinical Education Team
Date 26/7/04
Job# 26
Clinical Experience Case Log Location (Not street address) PRO QA Determinant Category Wellington City Industrial accident at engineers workshop
Gender Male
Age 42
History Details
Patient Management Plan
Patient was standing under a small crane moving a large metal plate Metal plate fell of the crane hook and struck patient on right arm The right arm was pinned under the metal plate for 5 minutes while work colleagues arranged for it to be lifted off
High concentration O2 therapy X2 16g IV cannulation Fluid therapy Wrapped arm in large bulk dressings and splinted with a vacuum splint Transported to WPH ED
Assessment Details Partial amputation of the right arm at the mid shaft humerus area Blood loss 750 – 1000 mls Nil distal pulse or sensation or cap refill LOC GCS of 15 through out Reflection/Critical Thinking
Follow up details
Forgot to do limb baselines until after limb was splinted Should have consulted with WPH ED about whether to go to WPH or HED for early access to plastic surgeons
Successful surgery at HH. Limb was saved and patient regained full use of arm.
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Filling Out the Drug Administration Log 1.
Each time you administer a drug enter the date in the drug administration log.
2.
Enter a drug administration route code as flows:
3.
If the drug was administered to a paediatric patient enter a P.
4.
At the end of the year total up the entries.
Maxolon
© WFA Clinical Education Team
7/4 ET
8/9 IV
7/9 IVP
6/4 IV
7/4 IV
17/4 IV
23/4 IV
24/4 IV
IV IM IO ET
3. Paediatric code
2. Drug route code
1. Date
Adrenaline (cardiac arrest) Atropine (cardiac arrest) Morphine
Intravenous Intramuscular Intraosseous Endotracheal
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2 8/4 IV
9/4 IV
9 /4 IV
14/4 IM
14/4 IV
14/4 IV
16/4 IV
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›Drug Administration Log Adrenaline
Aspirin
Amiodarone Ceftriaxone Clopidogrel
© WFA Clinical Education Team
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Total Dextrose (10%)
Entonox
Fentanyl
Glucagon
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GTN Spray
Hydrocortisone
Total Heparin
Ipratropium
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Ketamine
Lignocaine
Loratadine Midazolam
Morphine
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Naloxone
Ondansetron
Paracetamol Salbutamol Tenecetplase
Paralytic Medications Vecuronium Suxamethonium
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© WFA Clinical Education Team
›Filling Out the Skills Log 1.
Each time you perform a skill, enter the date in the skills log.
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If appropriate, enter the size of cannula or airway etc
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If the skill was administered to a paediatric patient enter a P.
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At the end of the year total up the entries
2. Size of cannula or airway etc route code
1. Date
IV Cannulation
6/4 16g
IM Injection IO Cannulation
8/4
© WFA Clinical Education Team
6/4 18g
6/4 18g
7/418gP 7/4 18g
3. Paediatric code
7/4 20g
9/4 20g
4. Total
7
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›Skills Log Total IV Cannulation
© WFA Clinical Education Team
Total IV Fluids
IO Cannulation/EZ IO IM Injection
Total OPA
Intubation
Nasopharyngeal Airway LMA
Cricothyroid Puncture Chest Decompression Blood culture collection IPPV
© WFA Clinical Education Team
Total 12 Lead ECG Tracing
Intranasal Medication Defibrillation CPR TCP Cardioversion
T Piece for delivery of Asthma Medication
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Total CPAP
Capnography
Total Cervical Collar
Spine Board
Scoop Stretcher
KED Application Sagar Splint Application
© WFA Clinical Education Team
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›Filling Out the Case Log 1.
Each time you attend a case that warrants an entry, enter the date in the case log.
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If the case was a paediatric patient enter a P.
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Enter case description in “other” table if it doesn’t fit in any other category
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At the end of the year enter the total in the total column
1. Date
2. Paediatric code
Cardiac Arrest
6/7
12/8
19/8 P
Asthma
6/7 15/8
8/7 16/8
10/7
Other
Diving 8/7
Gunshot 11/9
© WFA Clinical Education Team
4. Total
3. Case description
3 12/7 P
12/7
26/7
28/7
2/8
6/8
10/8
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Case Log
Year ________ Total
Cardiac Chest Pain
Heart Failure
Cardiac Arrest Other Cardiac
Total
© WFA Clinical Education Team
Asthma
CORD
Other Respiratory
Total
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Anaphylaxis
Stroke
Hypoglycaemia
Hyperglycaemia
Total Overdose
Seizures
Total
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Multi trauma Head Injury Spinal Injury Chest Trauma Limb Trauma
Penetrating Trauma Tension Pnemothorax Burns
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Total Obstetric Gynecological Emergency Paediatric Presentations SIDS Croup Febrile Convulsion
Total
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Other
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Annual Summary
© WFA Clinical Education Team
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Yearly Summaries Skills Totals
Case Totals Total Cardiac Chest Pain Heart Failure Cardiac Arrest Other Cardiac Asthma CORD Other Respiratory Anaphylaxis Stroke Hypoglycaemia Hyperglycaemia Overdose Seizures Multi trauma Head Injury Spinal Injury Chest Trauma Limb Trauma Penetrating Trauma Tension Pnemothorax Burns Obstetric SIDS Croup Febrile Convulsion Other
© WFA Clinical Education Team
Total Aspirin Adrenaline Amiodarone Atropine Ceftriaxone Clopidogrel Dextrose Entonox Fentanyl Glucagon GTN Hydrocortisone Heparin Ipratropium Ketamine Lignocaine Magnesium Sulphate Loratadine Midazolam Morphine Naloxone Ondansetron Paracetamol Salbutamol Tenecteplase Vecuronium Suxamethonium
Total
Drug Administration Totals
© WFA Clinical Education Team
IV Cannulation IM Injection IO/EZ IO Cannulation IV Fluids OPA’s Intubation Nasopharyngeal Airway LMA Cricothyroid Puncture Chest Decompression IPPV 12 Lead ECG Defibrillation TCP Cardioversion Capnography CPAP CPR Cervical Collar Spine Board Scoop Stretcher KED Application Sagar Splint Application