2016 Clinical Practice Handbook by Whitireia New Zealand

Table of Contents Introduction ....................................................................................................................... 1 Clinical Practice Portfolio ............................................................................................... 1 Clinical Practice Protocol ................................................................................................ 2 Agreement for Clinical Placement ............................................................................................................. 2 Attendance ................................................................................................................................................ 2 Confidentiality ........................................................................................................................................... 2 Health Screening ....................................................................................................................................... 2 Incident Reports ........................................................................................................................................ 3 Intravenous Therapy ................................................................................................................................. 3 Medication Policy ...................................................................................................................................... 3 Uniform ..................................................................................................................................................... 4

Raising and Responding to Concerns within Clinical Learning Environments ...... 5 Clinical Portfolio Evidence / Forms ............................................................................... 6 Types of Evidence ...................................................................................................................................... 7 Attendance Record for Clinical Placements .............................................................................................. 9 Clinical Practice Make-Up Hours ............................................................................................................. 10 Orientation Checklist ............................................................................................................................... 11 Student Objectives for Clinical Placement .............................................................................................. 12

Drug Calculation Formulae ............................................................................................ 13 Appendix 1: Agreement for Clinical Placement Responsibilities .......................... 14 Appendix 2: Domains of Competence for the Registered Nurse Scope of Practice.............................................................................................................................. 16 Appendix 3: Formative Preceptor Feedback ............................................................ 21 Bachelor of Nursing Clinical Judgement Rubric....................................................................................... 22 Preceptor Feedback Form ....................................................................................................................... 24

Introduction As part of an undergraduate nursing programme, the New Zealand Nursing Council requires that the student nurse undertake a minimum of 1100 clinical practice hours. Practice experiences are designed to focus on the learning needs of the student nurse and enable them to undertake nursing care with people in any context:    

At all stages of the life cycle In all dimensions of health care Experiencing usual life events Experiencing the impact of a physiological, psychosocial, and/or developmental problem in relation to their health status

Practice experiences are planned to facilitate the development of competence in a supportive environment, and must have well formulated learning outcomes objectives and be health consumer focused (Nursing Council of New Zealand, 2010). It is important that a student nurse can apply a variety of skills and concepts to any clinical practice setting. A student nurse will have a range of learning opportunities both in community and hospital settings as they progress through the curriculum. However, it is not necessary for a student nurse to visit every type of clinical practice setting in order to be prepared to deliver comprehensive nursing care.

Clinical Practice Portfolio The purpose of the clinical practice portfolio is to:   

Promote student nurse responsibility for their own experience and learning Record the competency skill level achieved by the student nurse Record the student nurse's clinical practice experience over three years

Each student nurse will have their own clinical practice portfolio folder to keep throughout their programme. This folder will contain relevant assessment and objective forms for each of the Praxis courses. It must be brought each day to clinical practice, and be available when requested to be sighted by the Clinical Tutor. It is important not to lose the folder as it may contain both personal and confidential information. NB. This portfolio will be an invaluable tool when applying for nursing positions after graduation.

Faculty of Health: Nursing Clinical Handbook ©Whitireia Community Polytechnic 2016

Clinical Practice Protocol Agreement for Clinical Placement An Agreement for Clinical Placement (Appendix 1) is signed between Whitireia and the clinical placement and outlines all parties’ responsibilities, including students.

Attendance Student nurses are expected to complete all of the clinical practice hours offered in the programme. Therefore students may be required to make up any clinical days missed during the year. All students will be required to have attendance records completed on a daily basis. The Nursing Council of New Zealand requires a minimum 1100 hours of practice for registration. All student nurses are entitled to a maximum of 1500 hours of practice to demonstrate competence. Students who do not demonstrate competencies in Year Two or Year Three practice courses may be offered additional practice hours at the end of each semester, prior to having their summative assessment completed. If a student nurse is going to be late or absent from a clinical placement they must telephone the ward/agency before the starting time, and notify their clinical tutor on their mobile phone. During clinical placements, clinical tutors can be contacted on their cell phones (numbers available on Moodle). Student nurses can either send text messages or, if the tutor is unable to answer the call, leave a message on the voicemail. A medical certificate is required if a student nurse is absent three days or more. Clinical makeup will only be organised for unexpected absences, for example illness, or bereavement. Clinical makeup and additional clinical hours will be arranged at the discretion of the Year team. Arrangements for clinical makeup and additional clinical hours will be made through the Clinical Co-ordinator. Make-up time is to be documented on the form ‘Clinical Practice Make-up Hours’ and given to the clinical tutor when completed.

Confidentiality All student nurses will be required to sign a declaration regarding non-disclosure of information at the beginning of the nursing programme. The law protects information about a health consumer that is gathered by examination, observation, conversation or treatment. Student nurses must keep confidential any information noted in health consumer's records, or heard about a health consumer from other staff members. All student nurses must maintain health consumer anonymity when discussing their health consumer as per the Privacy Act (1994). A legal suit can be brought against a student nurse who discloses information about a health consumer without their consent. Student nurses must ensure that they do not talk about health consumers in any public places including social media. The student nurse should know the location of the health consumer's records at all times, and protect them from unauthorised readers. Only staff members directly involved in a health consumer's care have legitimate access to that health consumer's record.

Health Screening It is the student’s responsibility to complete all required health screening. Please note that students will be excluded from all clinical learning (this includes onsite clinical lab sessions and external clinical placements) until this evidence is provided and you are cleared. Once you are cleared, your results will be returned to you and should be kept in your clinical folder.

Faculty of Health: Nursing Clinical Handbook ©Whitireia Community Polytechnic 2016

Incident Reports When any incident occurs involving a health consumer and/or student nurse, a report should be prepared with supervision from the clinical tutor and registered nurse/clinical placement staff. The Clinical Coordinator will be notified of any incidents. A form should be available for this purpose in the placement either electronically or hard copy. Types of incidents requiring an incident report would include:       

Medication errors slips, trips or falls Needle stick injuries Assault Abuse Fire Disaster etc

If the clinical tutor is not immediately available to assist in completing the incident report, it is imperative that they are contacted and consulted prior to your signing any form. If student nurses injure themselves while working in a clinical placement (including needlestick injury), they must do the following:   

Contact Occupational Health Nurse as per clinical placement protocol. Visit a Doctor or the Occupational Health Department of the agency who will complete an Accident Compensation form. Notify Whitireia Community Polytechnic Health Nurse about the injury and hand in a copy of the Accident Compensation form to her.

Needle stick injuries It is IMPORTANT to note that needle stick injuries are unfortunately common amongst health care workers. Each agency has specific protocol to follow. Please adhere strictly to these, as there is a high risk of infection. Action after exposure: FIRST AID a) Immediately rinse the affected area under running warm water for at least ten minutes. b) If there is a puncture wound, squeeze it gently. c) Paint puncture wound with povidone-iodine or isopropyl alcohol. d) Cover with dry, occlusive dressing.

Intravenous Therapy Only registered nurses who have completed IV certification can manage intravenous therapy. Student nurses are responsible for observing intravenous or related therapy of health consumers they are caring for, and reporting and documenting to their preceptor any changes that may occur in the health consumer’s condition. If student nurses believe the infusion and/or its rate is injurious to the health consumer’s health status they should report it immediately to the clinical placement staff. All cares associated with the infusion, including the putting up of bags of fluids, setting the rate of the infusions, checking the medications and removing of cannulae are the responsibility of the IV certified staff. This management may be performed by the student nurse under direct supervision of the registered nurse who has IV certification, dependent upon local placement protocols.

Medication Policy All student nurses in clinical placements give medications under the direct supervision of a registered nurse. Both the student nurse and the supervising registered nurse should sign for all medications given, following administration. Student nurses must be aware of correct dosage action and side effects of drugs they are administering.

Faculty of Health: Nursing Clinical Handbook ©Whitireia Community Polytechnic 2016

Uniform Full uniform is worn in the Simulation Learning Environment at all times and in the hospitals and some community clinical placements. Female Student Nurses  Whitireia programme specific uniform tunic  Whitireia uniform black trousers or black skirt  Black/natural pantyhose  Flat black rubber soled shoes will full polishable uppers  Whitireia name badge Male Student Nurses  Whitireia programme specific uniform tunic  Whitireia uniform black trousers  Flat black rubber soled shoes with full polishable uppers  Black socks  Whitireia name badge Required equipment Stethoscope BP kit (dual sphygmomanometer with cuff) Scissors Watch with second hand Black/blue Red pen Name badge for identification must be worn to all clinical practice settings as health consumers have a legal right to know the identity of the health care professionals working with them. Mufti is acceptable in some clinical placements. However, the student nurse's clothing should be appropriate for the area they is working in, and should reflect a professional attitude. A student nurse may be sent home at the discretion of the clinical tutor/preceptor for inappropriate mufti or incorrect uniform. For safety reasons, jewellery must not be worn when student nurses are in uniform or providing one-onone nursing care. Plain metal band rings and simple studs for any pierced facial areas may be worn. Nails should be kept short and clean and no nail polish is to be worn. Hair should be tidy. If hair is long, it should be tied back to prevent it falling forward when attending to health consumers. Plain black cardigans, sleeveless jackets, or light polar fleece (without hoods) may be worn to and from placements only. They are not to be worn during the clinical duty or during direct patient contact. Any garments worn under the uniform must not be visible. Students with religious beliefs that require their arms and heads to be covered, may wear a plain white ¾ length sleeved top under their uniform tunic and a plain head scarf (white or black) that can be tucked into the tunic if required. Smoking while in uniform is not permitted. At all times the student nurse must portray a professional image.

Faculty of Health: Nursing Clinical Handbook ©Whitireia Community Polytechnic 2016

Raising and Responding to Concerns within Clinical Learning Environments Concerns about clinical learning experiences are relatively infrequent. In most case students have good learning opportunities in clinical areas facilitated by dedicated nurses, preceptors and the wider health community. There are occasional exceptions to this. All staff and students within the Faculty of Health have a clear responsibility to raise and respond to any concerns that they have relating to clinical learning environments. If you have any concerns it is important that you alert the relevant staff immediately so that issues can be dealt with in an expedient manner. All issues raised will be dealt with in partnership between Whitireia New Zealand and industry partners. Throughout all investigations there will be a clear, transparent and confidential tracking process in place from initial concern to formal resolution. There are a number of instances where concerns relating to clinical learning experiences which may arise and some examples of these are listed below. However, if you have concerns and are unsure of whether they fit within these categories then please seek clarification from the Academic Leader (Clinical) or the Clinical Coordinator.    

Alleged abuse of a vulnerable adult or child. Unsafe or poor practice/patient care delivery and professional training issues. Quality of placement experience, for example students not assigned to a preceptor, or preceptor unsupportive. Quality issues, for example arising from audits in the clinical environment.

I am a student, what should I do if I have a concern? All students of the Faculty of Health have a professional responsibility to report any concerns relating to patient care and safety, clinical practice or learning support to their tutor. All concerns that relate to patient care or safety must be reported immediately to the Clinical Manager in the area. If the Manager is not available, concerns must be reported to the senior RN. You should also make sure that you inform your clinical tutor of your concerns. They are there to support you in this process. 1.

Concerns Relating to Patient Care and Safety or Clinical Practice In the first instance you should attempt to raise your concerns within your placement area, if appropriate, through your preceptor or a member of staff in the area. If you feel unable to do this then you must contact either your tutor who will inform the Academic Leader (Clinical) or the Clinical Coordinator.

Concerns Relating to Learning Support Preceptors are a crucial aspect of clinical learning. If this relationship is compromised it can seriously affect your clinical learning experience in terms of learning opportunities and support. In the first instance, and if you feel able to do so, you should attempt to raise your concerns with your preceptor or the educator. You should let your clinical tutor know. They will be able to support you to resolve the issue at a local level.

In All Instances It is important to document your concerns, including dates and times of any events, the names of witnesses and how you have attempted to resolve the issues. Try and do this as close to the incident(s) as possible. Ensure this document has a date and is signed by you. It is important that you raise concerns while you are in practice so that any issues can be dealt with effectively for you and future students. Please keep your tutor and programme advised of any issues which arise.

There are a number of individuals within Whitireia who are able to support you. Your tutor is the first point of contact but there are other forms of student support such as the 24 hour counselling service Vitae (0508 664 981) and Student Health Services. Faculty of Health: Nursing Clinical Handbook ©Whitireia Community Polytechnic 2016

Whitireia Clinical Tutors / Staff responsibilities where there are concerns There are a number of ways in which concerns about a clinical learning experience are identified and raised, for example observing an issue during routine student visits. Students may also report their own concerns relating to their clinical learning experience. This policy offers a guide to managing concerns, but advice from senior staff should always be sought. Dealing with concerns outside of your area of speciality / expertise can be challenging. It can be a good idea to get advice from other staff in the faculty who can provide support in this process. In all instances we would expect that the Academic Leader (Clinical) and the Clinical Coordinator be informed of all concerns raised, even where the concerns are resolved. This allows identification of any clusters or concerns raised about an area or particular experience. 1.

Concerns Relating to Patient Care, Safety or Clinical Practice in an Area In the first instance you should attempt to raise your concerns within the clinical area, for example through the preceptor, educator or clinical manager. Where the issue isnâ&#x20AC;&#x2122;t resolved at this level or where there is an immediate risk to patient safety then you should contact the Academic Leader (Clinical) and your programme manager. It may be necessary to remove the student from the area.

Concerns Relating to Learning Support If you have concerns relating to the quality of the learning environment for students then you should raise your concerns with the clinical area to identify a clear action plan towards resolution of the issue(s). Concerns can often be resolved locally at this stage. If you feel that the placement team do not adequately address the concerns, the actions required are outside of the remit of the manager, they seriously compromise the learning experience, or require removal of students from practice then you need to alert the Academic Leader (Clinical) and the Clinical Coordinator.

Student Assignments All areas of concern relating to clinical practice, patient safety or quality of clinical learning experiences reported within a student assignment or other theoretical experience should be approached with the student in the first instance by the tutor. Prior discussion may need to take place with the programme team. If the concerns raised are not resolved then the tutor should escalate the concerns via the Academic Leader (Clinical).

Faculty Responsibility The Faculty of Health works hard to provide valuable clinical learning for student nurses in all of the programmes. By monitoring and acting where there are concerns, this supports the development of quality clinical learning experiences. The faculty has 2 key roles in managing any concerns raised:1.

To ensure any concerns raised have been appropriately reviewed and any actions agreed have been completed Options available to the faculty to review concerns could include meeting with the placement provider and agreeing an action plan to address issues, asking for a member of the faculty to review clinical learning experience in a clinical area or carrying out an evaluation of that area.

To log any issues raised so that there is a clear, transparent and auditable trail available Having a clear record of the status of the concern make it possible to track the issue. By maintaining a clear record it enables clear reporting on these issues and being able to look at trends etc. of these types of concerns as a faculty. The information might also be useful as part of the bi-annual evaluation report. An electronic record of all complaints raised, will be maintained making it possible for the faculty to report on concerns around clinical learning experiences.

Clinical Portfolio Evidence / Forms Faculty of Health: Nursing Clinical Handbook ÂŠWhitireia Community Polytechnic 2016

You are required to provide a portfolio of evidence that demonstrates achievement of the summative clinical competencies in each semester. The competencies are based on the Nursing Council competencies (Appendix 2). As you collect the information, it will assist you to see links between theory and practice and the progress you are making with clinical skills. These together, create a body of evidence, a picture of your journey through the course. There is an expectation that as a first year nursing student you will begin to think like a nurse and begin to enter into professional nursing relationships. As a second year nursing student you are ‘in action’ towards becoming a professional nurse. By third year the student is able to move from ‘being in action toward being a nurse’ to ‘being a nurse’.

Model for Assessment Student Nurse

Clinical Staff

 Personal Objectives  Clinical Skills List  Self assessment against competencies



Preferably named preceptor or clinical nurse educator Feedback on four domains with evidence examples and using clinical rubric

Clinical Tutor 



Formative feedback using clinical rubric and evidence from clinical staff and student Summative Competencies assessment developed from

above and own judgement

Types of Evidence Clinical Skills The clinical skills list is an ongoing record of the student nurse's practice of identified nursing clinical practice skills. The student nurse is responsible for the recording of these skills by getting a registered nurse (clinical tutor or preceptor), to initial and date in the appropriate space. There are two separate skills lists: a) b)

Clinical Nursing Skills List - Year One Clinical Nursing Skills List - Years Two and Three

Formative Preceptor Feedback The student nurse will work with a Preceptor/s during your clinical practice. They will guide practice and complete the Formative Preceptor Feedback form (Appendix 3). The student nurse must let the preceptor know as early as possible that feedback is required. This feedback is considered as part of all the evidence in your portfolio.

Clinical Self-Assessment The student nurse must provide examples and evidence to demonstrate how they meet each of the competencies. Students may be required to provide this evidence for both formative and summative assessments.

Faculty of Health: Nursing Clinical Handbook ©Whitireia Community Polytechnic 2016

Learning Objectives Each student nurse is required to identify their learning needs for each clinical placement. These objectives are to be written in a professional manner on the form Student nurse Objectives for Clinical Practice. Objectives will be provided for some placements. However, the student nurse will be expected to add appropriate personal learning objectives. Student nurse learning objectives need to be discussed with agency staff/charge nurse during the first two days of the placement. At least once per week, most student nurses will meet with the clinical tutor to reflect upon the student nurses' performance to date, and to suggest strategies for their ongoing progress and learning.

Orientation Check List An orientation checklist must be completed within the first two days of placement. If the placement does not have its own student nurse orientation checklist, then the student nurse is to complete the check list included in this portfolio.

Presentation of Case Study In some clinical placements, the student nurse will be asked to present a health consumer case study during a clinical tutorial. This provides the student with the opportunity to demonstrate their ability to link theory to practice. Confidentiality is important so the case content in the portfolio needs to use pseudonyms and be fictionalised

Reflection Reflection is both a learning tool and a way of learning through practice. Reflection allows the student nurse to examine, question and learn from their experience as opposed to providing care uncritically. Reflective education is not only about reflecting on the process, but involves reflection on the process of learning. This supports a responsibility for the student nurseâ&#x20AC;&#x2122;s own learning as it enables student nurses to identify their own learning needs. The process is about teaching student nurses how to think not what to think. The purpose is to provide the student nurse with the skills to develop their own practice. Students will be expected to share their reflections with their clinical tutor as part of their evidence in their portfolio.

Drug Knowledge In some clinical placements, the student will be expected to demonstrate their drug knowledge in relation to the area of practice. The student nurse will be expected demonstrate this knowledge to the clinical tutor, preceptor and to a small group of their peers at a clinical tutorial.

Attendance at Simulation Learning and Skills Acquisition sessions Sessions will be scheduled during theory weeks to give you an opportunity to learn new skills and develop your nursing practice. 100% attendance is expected at these sessions. Students who are absent from any of these sessions may be required to provide evidence of meeting the learning outcomes covered in the session(s) missed.

Summative Assessment of Nursing Council Competencies The summative assessment will be completed by the clinical tutor in the final practice placement for that clinical course using the clinical portfolio of evidence. The student nurse must provide examples and evidence in relation to each competency. Feedback from preceptors will also be utilised to complete this assessment. Student nurses must demonstrate consistently safe practice â&#x20AC;&#x201C; previous achieved competencies may be rescinded if safe practice is not demonstrated and maintained.

Faculty of Health: Nursing Clinical Handbook ÂŠWhitireia Community Polytechnic 2016

Attendance Record for Clinical Placements Student Name: ........................................................................................................................

Clinical Placement: ...................................................................................................................

Date Mon

Tue

Wed

Thurs

Fri

Start

Finish

e.g. 0700, 1530

e.g. 1530, 2300

Comments e.g. left early for peer supervision, late start due to appt

Preceptor Signature

Week Total Hours

Start

Date

e.g. 0700, 1530

Mon

Tue

Wed

Thurs

Fri

Finish

Comments

e.g. 1530, 2300

e.g. Left early for peer supervision, late start due to appt

Preceptor Signature

Week Total Hours

Date Mon

Tue

Wed

Thurs

Fri

Start

Finish

e.g. 0700, 1530

e.g. 1530, 2300

Comments e.g. Left early for peer supervision, late start due to appt

Preceptor Signature

Week Total Hours

Faculty of Health: Nursing Clinical Handbook

ÂŠWhitireia Community Polytechnic 2015

Clinical Practice Make-Up Hours This form MUST be handed in following clinical makeup STUDENT NURSE'S NAME: ......................................………...............………………………….......................... CLINICAL PLACEMENT: ……………….............................................................................................................. DATES ATTENDED: ............................................................. TO: ...................................................................... TOTAL NUMBER OF HOURS: ........................................................................................................................... COMMENTS IF NECESSARY: ........................................................................................................................... ............................................................................................................................................................................. ............................................................................................................................................................................. SUPERVISOR'S SIGNATURE: ..........................................................................................................................

STUDENT NURSE'S NAME: ......................................………...............………………………….......................... CLINICAL PLACEMENT: ……………….............................................................................................................. DATES ATTENDED: ............................................................. TO: ...................................................................... TOTAL NUMBER OF HOURS: ........................................................................................................................... COMMENTS IF NECESSARY: ........................................................................................................................... ............................................................................................................................................................................. ............................................................................................................................................................................. SUPERVISOR'S SIGNATURE: ..........................................................................................................................

Faculty of Health: Nursing Clinical Handbook

©Whitireia Community Polytechnic 2015

Orientation Checklist Student Name: .......................................................................... Placement 1

Placement 2

Placement 3

Placement 4

1. I know my responsibilities in the event of: a) b) c) d)

Fire Cardiac Arrest/Respiratory Arrest Emergencies Security Related Emergencies

2. I have identified the following equipment: a) b) c) d) e)

Oxygen Suction Resuscitation Trolley Emergency Alarms Fire Extinguisher and Hoses

3. I have identified the following equipment: a) b) c) d) e) f) g) h)

Staff Toilet Sluice Room Clean Utility Room Linen Cupboard Patient Showers, Bathrooms and Toilets Lifts, Stairs Cafeteria Medicines area

4. I know where to find relevant phone numbers and the correct protocol for answering the phone.

5. I know where I can find information on the specific nursing responsibilities/protocols for this agency/area.

6. I have discussed my identified learning objectives for this placement with the unit/agency staff.

7. I have discussed my tutorial attendance requirements with the unit/agency staff.

8. Where required, I have given the evaluation form to the unit/agency staff and discussed my need for both ongoing feedback, and feedback at the end of my clinical placement.

Faculty of Health: Nursing Clinical Handbook ÂŠWhitireia Community Polytechnic 2015

Student Objectives for Clinical Placement Student:................................................................... Placement: .................................................................

Dates: ..........................................................

Learning Objectives (what you want to achieve)

Outcome Objective (how you want to achieve it)

Time Frame (when you will achieve it)

Outcome measurement (how will you know you have achieved it)

Result and Date

Faculty of Health: Nursing Clinical Handbook ÂŠWhitireia Community Polytechnic 2015

Drug Calculation Formulae Summary of drug calculations: 1.

To find the number of tablets that need to be given, to give a specified dose:

Desired amount Available amount in tablet

Number of tablets

Liquid Medication: Dose required (weight) Dose available (weight)

Volume available

Volume required

Paediatric Medication: Amount to give per kg of body weight Number of time periods per day

dose per time period

e.g. 1mg/kg q6h

Then use correct formula to find number of tablets or volume to be given

IV fluids administration Volume to infuse Time in hours x 60

Faculty of Health: Nursing Clinical Handbook ÂŠWhitireia Community Polytechnic 2015

Drop factor

Drops/minute

Appendix 1: Agreement for Clinical Placement Responsibilities 1.

Definitions of Key Terms

Whitireia Clinical Coordinator: The contact at Whitireia Community Polytechnic who coordinates clinical placements. Clinical Tutor: A registered nurse, with current practicing certificate, employed by Whitireia Community Polytechnic as a tutor who oversees and/or supervises nominated students on clinical placement. Preceptor: A registered nurse employed by the provider, who supports the student while on clinical placement and is involved in assessing the student’s level of competency and providing feedback to the clinical tutor. Provider: Named health service that employs registered nurses to deliver health care

Expectations and Responsibilities

The clinical learning experience is a partnership between Whitireia Community Polytechnic, the clinical tutor, the provider and the student. Each of these partners has responsibilities and expectations, which are summarised as follows: a.

Whitireia Community Polytechnic will i.

Send out details of forthcoming clinical placements to providers on a term by term basis, usually within six weeks of the placement start date.

ii.

Ensure that all providers are provided with the contact details of the Faculty of Health during business hours.

iii.

Ensure that all students and clinical tutors have an appropriate health clearance. The specifics of the health screening will be guided by best practice guidelines. If a provider requires any specific health screening, this will be discussed with the Whitireia Clinical Coordinator.

iv.

Provide an online survey for students to complete around their clinical learning experience (the CLES+T tool). Providers can request to see evaluations related to their service, in order to develop clinical learning experiences.

Respond to any concerns raised, including any around student performance, in a timely manner.1

The Clinical Tutor will i.

Ensure the preceptor has appropriate information around the student’s learning needs in that placement and work with the preceptor to facilitate clinical learning experiences for the student.

ii.

Visit the student at regular intervals throughout their placement (this will be determined by the capability of the student, their level of study and feedback from the preceptor).

iii.

Respond to concerns around the student in the clinical placement in a timely manner.2

A copy of the Whitireia Community Polytechnic “Dealing with Concerns” Policy is available on request.

Faculty of Health: Nursing Clinical Handbook ©Whitireia Community Polytechnic 2015

iv.

Work with the preceptor to support them in providing clinical learning experiences to the student including, but not limited to, providing them with information about the programme requirements or feeding back specific issues relating to individual students.

Wear appropriate uniform or follow acceptable dress code standards when visiting clinical areas.

vi.

Hold their own professional indemnity insurance.

The Provider will i.

ii.

iii. iv. v.

vi. vii.

Provide a quality clinical learning experience for each student. Ensure that Whitireia Community Polytechnic is provided with up to date contact details for the provider when requested. Assign a Registered Nurse preceptor to students before the start of the clinical learning experience. The preceptor should be appropriately qualified in the area of practice and have no conditions on their Nursing Council New Zealand Annual Practicing Certificate. 3 Ensure that an orientation package is in place for the students to access and that students receive an appropriate orientation to the clinical area on their first day (or before). 4 Ensure that service users consent to the involvement of student nurses. Work to provide opportunities so that students can meet their learning objectives by allocating students an appropriate workload that will enable them to demonstrate their clinical learning competencies. Provide quality feedback to the student and their clinical tutor around their clinical learning objectives and competencies, in line with New Zealand Nursing Council competencies Raise any concerns around the clinical learning experience, support or student performance as soon as possible to enable timely resolution (please note that Whitireia Community Polytechnic is the sole arbiter in relation to matters regarding student assessment and achievement and will refer to its local Concerns / Complaints Policy).

The Student will: i. ii. iii.

iv. v. vi. vii. viii. ix. x.

Call the clinical placement prior to the start of their placement and check roster, working hours and other practical arrangements. Wear appropriate uniform or dress code for that clinical area. Undertake some preliminary research around the clinical area before they start (including, but not limited to, searching on the internet around the service, orientation booklets, looking at the major health concerns likely to be seen in that area). Develop appropriate Learning Objectives prior to the first day of placement and share these with their preceptor. Behave in a professional manner at all times (including but not limited to observing confidentiality and privacy, being punctual, calling in if absent etc.). Raise any concerns that arise around the clinical learning experiences with the preceptor in the first instance, or in their absence the clinical manager and or / their clinical tutor. Complete all necessary documentation in a timely manner, in order to demonstrate they have met the required competencies laid out in the programme outlines. Complete the online survey (CLES+T) at the end of their clinical learning experience. Report to the clinical provider and the Clinical Tutor any concerns they have about their health which might impact on their clinical learning, the patients or colleagues. Hold their own professional indemnity insurance.

Nursing Council standards require that CAP students have a registered nurse in the preceptor role with three yearsâ&#x20AC;&#x2122; experience.

An orientation template is available on request

Faculty of Health: Nursing Clinical Handbook ÂŠWhitireia Community Polytechnic 2015

Appendix 2: Domains of Competence for the Registered Nurse Scope of Practice There are four domains of competence for the registered nurse scope of practice. Evidence of safety to practise as a registered nurse is demonstrated when the applicant meets the competencies within the following domains: Domain one:

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 health consumersâ&#x20AC;&#x2122; safety, independence, quality of life and health. Domain two:

Management of nursing care

This domain contains competencies related to assessment and managing health consumer care, which is responsive to the consumersâ&#x20AC;&#x2122; needs, and which is supported by nursing knowledge and evidence based research. Domain three:

Interpersonal relationships

This domain contains competencies related to interpersonal and therapeutic communication with health consumers, other nursing staff and interprofessional communication and documentation. Domain four:

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.

Competencies and indicators The competencies in each domain have a number of key generic examples of competence performance called indicators. These are neither comprehensive nor exhaustive; rather they provide examples of evidence of competence. The indicators are designed to assist the assessor when using his/her professional judgement in assessing the attainment of the competencies. The indicators further assist curriculum development for bachelorsâ&#x20AC;&#x2122; degrees in nursing or first year of practice programmes. Registered nurses are required to demonstrate competence. They are accountable for their actions and take responsibility for the direction of nurse assistants, enrolled nurses and others. The competencies have been designed to be applied to registered nurse practice in a variety of clinical contexts. They take into account the contemporary role of the registered nurse, who utilises nursing knowledge and complex nursing judgement to assess health needs, provide care, and advise and support people to manage their health. The registered nurse practises independently and in collaboration with other health professionals. The registered nurse performs general nursing functions, and delegates to, and directs enrolled nurses and others. The registered nurse also provides comprehensive nursing assessments to develop, implement, and evaluate an integrated plan of health care, and provides nursing interventions that require substantial scientific and professional knowledge and skills. This occurs in a range of settings in partnership with individuals, families, whanau and communities. The nursing student is expected to be supervised in practice by a registered nurse when the competencies relate directly to an undergraduate nursing student. Nursing students are assessed against all competencies on an ongoing basis, and will be assessed for entry to the registered nurse scope of practice at the completion of their programme.

Copied and adapted from Nursing Council Competencies 2012

Domain One:

Professional Responsibility

Competency 1.1

Accepts responsibility for ensuring that his/her nursing practice and conduct meet the standards of the professional, ethical and relevant legislated requirements.

Indicator:

Practises nursing in accord with relevant legislation/codes/policies and upholds health consumer 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.

Indicator: Indicator: Indicator: Indicator: Competency 1.2

Demonstrates the ability to apply the principles of the Treaty of Waitangi/Te Tiriti o Waitangi to nursing practice.

Indicator:

Understands the Treaty of Waitangi/Te Tiriti o 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 nonMaori. Applies the Treaty of Waitangi/Te Tiriti o Waitangi to nursing practice.

Indicator: Indicator: Competency 1.3

Demonstrates accountability for directing, monitoring and evaluating nursing care that is provided by nurse assistants, enrolled nurses and others.

Indicator:

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.

Indicator: Indicator: Indicator:

Competency 1.4

Promotes an environment that enables health consumer safety, independence, quality of life, and health.

Indicator: Indicator: Indicator: Indicator:

Identifies and reports situations that affect health consumer or staff members’ health or safety. Accesses, maintains and uses emergency equipment and supplies. Maintains infection control principles. Recognises and manages risks to provide care that best meets the needs and interests of health consumers and the public.

Competency 1.5

Practises nursing in a manner that the health consumer determines as being culturally safe.

Indicator: Indicator:

Applies the principles of cultural safety in own nursing practice. Recognises the impact of the culture of nursing on health consumer care and endeavours to protect the health consumer’s wellbeing within this culture. Practises in a way that respects each health consumer’s identity and right to hold personal beliefs, values and goals. Assists the health consumer to gain appropriate support and representation from those who understand the health consumer’s culture, needs and preferences. Consults with members of cultural and other groups as requested and approved by the health consumer. Reflects on his/her own practice and values that impact on nursing care in relation to the health consumer’s age, ethnicity, culture, beliefs, gender, sexual orientation and/or disability. Avoids imposing prejudice on others and provides advocacy when prejudice is apparent.

Indicator: Indicator: Indicator: Indicator: Indicator:

Copied and adapted from Nursing Council Competencies 2012

Domain Two:

Management of Nursing Care

Competency 2.1

Provides planned nursing care to achieve identified outcomes.

Indicator:

Contributes to care planning, involving health consumers and demonstrating an understanding of health consumers’ 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.

Indicator: Indicator: Indicator: Indicator:

Competency 2.2

Undertakes a comprehensive and accurate nursing assessment of health consumers in a variety of settings.

Indicator: Indicator: Indicator:

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.

Competency 2.3

Ensures documentation is accurate and maintains confidentiality of information.

Indicator:

Maintains clear, concise, timely, accurate and current health consumer 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.

Indicator:

Competency 2.4

Ensures the health consumer has adequate explanation of the effects, consequences and alternatives of proposed treatment options.

Indicator:

Provides appropriate information to health consumers to protect their rights and to allow informed decisions. Assesses the readiness of the health consumer to participate in health education. Makes appropriate professional judgement regarding the extent to which the health consumer 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 health consumers). Facilitates the health consumer’s access to appropriate therapies or interventions and respects the health consumer’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. Takes the health consumer’s preferences into consideration when providing care.

Indicator: Indicator: Indicator: Indicator: Indicator: Indicator: Competency 2.5

Acts appropriately to protect oneself and others when faced with unexpected health consumer responses, confrontation, personal threat or other crisis situations.

Indicator:

Understands emergency procedures and plans and lines of communication to maximise effectiveness in a crisis situation. Takes action in situations that compromise health consumer safety and wellbeing. Implements nursing responses, procedures and protocols for managing threats to safety within the practice environment.

Indicator: Indicator:

Competency 2.6

Evaluates health consumer’s progress toward expected outcomes in partnership with health consumer.

Indicator: Indicator:

Identifies criteria for evaluation of expected outcomes of care. Evaluates the effectiveness of the health consumer’s response to prescribed treatments, interventions and health education in collaboration with the health consumer and other health care team members. (Beginning registered nurses would seek guidance and advice from experienced registered nurses). Reflects on health consumer feedback on the evaluation of nursing care and health service delivery.

Indicator:

Copied and adapted from Nursing Council Competencies 2012

Competency 2.7

Provides health education appropriate to the needs of the health consumer within a nursing framework.

Indicator:

Checks health consumers’ 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 health consumer’s or group’s abilities. Participates in health education, and ensures that the health consumer understands relevant information related to their health care. Educates health consumer to maintain and promote health.

Indicator: Indicator: Indicator: Competency 2.8

Reflects upon, and evaluates with peers and experienced nurses, the effectiveness of nursing care.

Indicator: Indicator: Indicator:

Identifies one’s own level of competence and seeks assistance and knowledge as necessary. Determines the level of care required by individual health consumer. Accesses advice, assistance, debriefing and direction as necessary.

Competency 2.9

Maintains professional development.

Indicator:

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 one’s own professional development and for sharing knowledge with others.

Indicator: Indicator:

Domain Three:

Interpersonal Relationships

Competency 3.1

Establishes, maintains and concludes therapeutic interpersonal relationships with health consumer.

Indicator: Indicator:

Initiates, maintains and concludes therapeutic interpersonal interactions with health consumer. Incorporates therapeutic use of self and psychotherapeutic communication skills as the basis for nursing care for health consumers with mental health needs. Utilises effective interviewing and counselling skills in interactions with health consumers. Demonstrates respect, empathy and interest in health consumer. Establishes rapport and trust with the health consumer.

Indicator: Indicator: Indicator: Competency 3.2

Practises nursing in a negotiated partnership with the health consumer where and when possible.

Indicator:

Undertakes nursing care that ensures health consumers 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 health consumer 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.

Competency 3.3

Communicates effectively with health consumers and members of the health care team.

Indicator: Indicator: Indicator: Indicator:

Uses a variety of effective communication techniques. Employs appropriate language to context. Provides adequate time for discussion. Endeavours to establish alternative communication methods when health consumers are unable to verbalise. Accesses an interpreter when appropriate. Discussions concerning health consumers are restricted to settings, learning situations and or relevant members of the health care team.

Indicator: Indicator:

Copied and adapted from Nursing Council Competencies 2012

Domain Four:

Interprofessional Health Care & Quality Improvement

Competency 4.1

Collaborates and participates with colleagues and members of the health care team to facilitate and coordinate care.

Indicator:

Promotes a nursing perspective and contribution within the interprofessional activities of the health care team. Provides guidance and support to those entering as students, beginning practitioners and those who are transferring into a new clinical area. Collaborates with the health consumer and other health team members to develop and plan of care. Maintains and documents information necessary for continuity of care and recovery. Develops a discharge plan and follow up care in consultation with the health consumer and other members of the health care team. Makes appropriate formal referrals to other health care team members and other health related sectors for health consumers who require consultation.

Indicator: Indicator: Indicator: Indicator: Indicator:

Competency 4.2

Recognises and values the roles and skills of all members of the health care team in the delivery of care.

Indicator: Indicator:

Contributes to the co-ordination of care to maximise health outcomes for the health consumer. Collaborates, consults with and provides accurate information to the health consumer 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.

Indicator:

Competency 4.3

Participates in quality improvement activities to monitor and improve standards of nursing.

Indicator: Indicator: Indicator:

Reviews policies, processes, procedures based on relevant research. Recognises and identifies researchable practice issues and refers them to appropriate people. Distributes research findings that indicate changes to practice to colleagues.

Copied and adapted from Nursing Council Competencies 2012

Appendix 3: Formative Preceptor Feedback How to use the Formative Preceptor Feedback Form 

This form is an assessment tool based on Nursing Council Competencies, the same competencies that you as a staff nurse are expected to meet each year for your practising certificate.



Nursing Council has developed four domains of competence, each with examples of evidence of competence or indicators.



This assessment is based on the level of achievement you value the student’s performance at, in relation to each competency and indicator. The Clinical judgement rubric (adapted from Lasater, 2005) should be used to aid your assessment of competency and your description of the student nurse’s learning.



Whitireia has a philosophy that focuses on the progress of nursing students learning and development in praxis:

Year One nursing students are learning to ‘think like a nurse’ and are dependent learners Year Two nursing students are learning to ‘act like a nurse’ and are semi-independent learners Year Three nursing students are learning to ‘be a nurse’ and are independent learners



Supporting Evidence – it is imperative that when assessing the student, you provide a clear example of the student’s behaviour to suggest they meet the indicator. The student is also required to provide an example.



This tool will be utilised as evidence for formative or summative assessment. The formative assessment relies on clear feedback from you so the student is able to identify which areas need to be addressed. The summative assessment is an appraisal undertaken by the clinical tutor that requires competencies to be met. The preceptor is not responsible for passing or failing the student nurse in relation to the competencies. This is the clinical tutor’s role, done in conjunction with the clinical placement.



If you identify any issues or concerns with the student you are working with, it is imperative that you address the issue with the student, and/or talk directly with the clinical tutor or with your manager.

Bachelor of Nursing Clinical Judgement Rubric Discovery Effective assessment involves: Dimension Exemplary Focused observation Focuses observation appropriately; regularly observes and monitors a wide variety of objective and subjective information to discover any useful information

Accomplished Regularly observes and monitors a variety of information, including both subjective and objective; most useful information is noticed; may miss very subtle signs

Developing Attempts to monitor a variety of subjective and objective information but is overwhelmed by the array of information; focuses on the most obvious information, missing some important information

Beginning Confused by the clinical situation and the amount and kind of information; observation is not organized and important information are missed, and/or assessment errors are made

Recognizing deviations from expected patterns

Recognizes subtle patterns and deviations from expected patterns in information and uses these to guide the assessment

Recognizes most obvious patterns and deviations in information and uses these to continually assess

Identifies obvious patterns and deviations, missing some important information; unsure how to continue the assessment

Focuses on one thing at a time and misses most patterns and deviations from expectations; misses opportunities to refine the assessment

Information seeking

Assertively seeks information to plan intervention: carefully collects useful subjective information from observing and interacting with the health consumer, family and members of the health care team

Actively seeks subjective information about the health consumer’s situation from the health consumer and family to support planning interventions; occasionally does not pursue important leads

Makes limited efforts to seek additional information from the health consumer and family; often seems not to know what information to seek and/or pursues unrelated information

Is ineffective in seeking information; relies mostly on objective information; has difficulty interacting with the health consumer and family and fails to collect important subjective information

Accomplished Generally focuses on the most important information and seeks further relevant information but also may try to attend to less pertinent information In simple, common, or familiar situations, is able to interpret the health consumer’s information patterns and compare with known patterns to develop an intervention plan and accompanying rationale; can seek the guidance of a specialist or a more experienced nurse

Developing Makes an effort to prioritize information and focus on the most important, but also attends to less relevant or useful information

Beginning Has difficulty focusing and appears not to know which information are most important to the diagnosis; attempts to attend to all available information Even in simple, common, or familiar situations, has difficulty interpreting or making sense of information; has trouble distinguishing among competing explanations and appropriate interventions, requiring assistance both in diagnosing the problem and developing an intervention

Interpretation Effective interpreting involves: Dimension Exemplary Prioritizing information Focuses on the most relevant and important information useful for explaining the health consumer’s condition Making sense of information

In most situations, interprets the health consumer’s information patterns and is able to (a) note and make sense of patterns in the health consumer’s information, (b) compare these with known patterns (from the nursing knowledge base, research, personal experience, and intuition), and (c) develop plans for interventions that can be justified in terms of their potential of success

In simple, common, or familiar situations, is able to compare the health consumer’s information patterns with those known and to develop or explain intervention plans; requires advice or assistance

Bachelor of Nursing Clinical Judgement Rubric (cont’d) Facilitation Effective interpreting involves: Dimension Exemplary Calm, professional Assesses health consumers and manner reassures them and their families; assumes professional responsibility

Clear interpersonal communication

Communicates effectively; explains interventions; calms and reassures health consumers and families; checks for understanding

Generally communicates well; explains carefully to health consumer and within team; could be more effective in establishing rapport

Shows some communication ability; communication with health consumers, families, and team members is only partly successful; displays caring but not competence

Well-planned intervention/flexibility

Interventions are tailored for the individual health consumer; monitors health consumer progress closely and is able to adjust treatment as indicated by health consumer response Shows mastery of necessary nursing skills

Develops interventions on the basis of relevant health consumer information; monitors progress regularly but does not expect to have to change treatments

Develops interventions on the basis of the most obvious information; monitors progress but is unable to make adjustments as indicated by the health consumer’s response

Beginning Except in simple and routine situations, is stressed and disorganized, lacks self-awareness, makes health consumers and families anxious or less able to cooperate Has difficulty communicating; explanations are confusing; directions are unclear or contradictory; health consumers and families are made confused or anxious and are not reassured Focuses on developing a single intervention, addressing a likely solution, but it may be vague, confusing, and/or incomplete; some monitoring may occur

Displays proficiency in the use of most nursing skills; could improve speed or accuracy

Is hesitant or ineffective in using nursing skills

Is unable to select and/or perform nursing skills

Accomplished Evaluates and analyzes personal clinical performance with minimal prompting, primarily about major events or decisions; key decision points are identified, and alternatives are considered

Developing Even when prompted, briefly verbalizes the most obvious evaluations; has difficulty imagining alternative choices; is self-protective in evaluating personal choices

Beginning Even prompted evaluations are brief, cursory, and not used to improve performance; justifies personal decisions and choices without evaluating them

Demonstrates a desire to improve nursing performance; reflects on and evaluates experiences; identifies strengths and weaknesses; could be more systematic in evaluating weaknesses

Demonstrates awareness of the need for ongoing improvement and makes some effort to learn from experience and improve performance but tends to state the obvious and needs external evaluation

Appears uninterested in improving performance or is unable to do so; rarely reflects; is uncritical of himself or herself or overly critical (given level of development); is unable to see flaws or need for improvement

Being skilful

Evaluation Effective reflecting involves: Dimension Exemplary Evaluation/self-analysis Independently evaluates and analyzes personal clinical performance, noting decision points, elaborating alternatives, and accurately evaluating choices against alternatives; practices in a culturally safe manner Commitment to Demonstrates commitment to improvement ongoing improvement; reflects on and critically evaluates nursing experiences; accurately identifies strengths and weaknesses and develops specific plans to eliminate weaknesses

Accomplished Generally displays confidence in most situations; may show stress in particularly difficult or complex situations

Developing Reassures health consumers and families in routine and relatively simple situations, but becomes stressed and disorganized easily

Developed from Lasater’s (2005) Clinical Judgement Rubric Faculty of Health: Nursing Clinical Handbook ©Whitireia Community Polytechnic 2015

Preceptor Feedback Form Student Name: Paper: Clinical Placement: Formative / Summative (for BN Pacific students only) Domain One: Professional Responsibility Competency 1.1 Competency 1.2 Competency 1.3 Competency 1.4 Competency 1.5

Accepts responsibility for ensuring that his/her nursing practice and conduct meet the standards of the professional, ethical and relevant legislated requirements. Demonstrates the ability to apply the principles of the Treaty of Waitangi/te Tiriti o Waitangi to nursing practice. Demonstrates accountability for directing, monitoring and evaluating nursing care that is provided by enrolled nurses and others. Promotes an environment that enables health consumer safety, independence, quality of life, and health. Practices nursing in a manner that the health consumer determines as being culturally safe.

Supporting evidence/examples in meeting Domain 1:

Preceptor Name:

Signature:

Date:

Domain Two: Management of Nursing Care Competency 2.1

Provides planned nursing care to achieve identified outcomes.

Competency 2.2

Undertakes a comprehensive and accurate nursing assessment of health consumers in a variety of settings.

Competency 2.3

Ensures documentation is accurate and maintains confidentiality of information.

Competency 2.4 Competency 2.5 Competency 2.6 Competency 2.7 Competency 2.8 Competency 2.9

Ensures the health consumer has adequate explanation of the effects, consequences and alternatives of proposed treatment options Acts appropriately to protect oneself and others when faced with unexpected health consumer responses, confrontation, personal threat or other crisis situations. Evaluates health consumerâ&#x20AC;&#x2122;s progress toward expected outcomes in partnership with clients. Provides health education appropriate to the needs of the health consumer within a nursing framework. Reflects upon, and evaluates with peers and experienced nurses, the effectiveness of nursing care. Maintains professional development.

Supporting evidence/examples in meeting Domain 2:

Preceptor Name: Faculty of Health: Nursing Clinical Handbook ÂŠWhitireia Community Polytechnic 2015

Signature:

Date:

Domain Three: Interpersonal Relationships Competency 3.1

Establishes, maintains and concludes therapeutic interpersonal relationships with health consumer.

Competency 3.2

Practices nursing in a negotiated partnership with the health consumer where and when possible.

Competency 3.3

Communicates effectively with health consumers and members of the health care team.

Supporting evidence/examples in meeting Domain 3:

Preceptor Name:

Signature:

Date:

Domain Four: Interprofessional Health Care & Quality Improvement Competency 4.1

Collaborates and participates with colleagues and members of the health care team to facilitate and coordinate care.

Competency 4.2

Recognises and values the roles and skills of all members of the health care team in the delivery of care.

Competency 4.3

Participates in quality improvement activities to monitor and improve standards of nursing.

Supporting evidence/examples in meeting Domain 4:

Preceptor Name:

Faculty of Health: Nursing Clinical Handbook ÂŠWhitireia Community Polytechnic 2015

Signature:

Date: