KYN107
Faculty of Health & Social Care
Introducing Professional Practice and Knowledge
Guidelines for Completing the Common
Foundation Programme Portfolio
SUP 01592 5
*SUP015925*
Copyright ª 2009 The Open University
Pre-Registration Nursing Programme
l
1.1
Common Foundation Programme
Contents
1 Introduction to the Portfolio
5
1.1 Portfolio structure and assessment
6
1.2 How your practice is assessed
7
1.3 Programme curricular hours
9
1.4 Practice learning requirements
10
2 The Portfolio forms explained
13
2.1 Essential information
13
2.2 Self-assessment records
18
2.3 Evidence
19
3 How to complete your Portfolio
20
3.1 Types of evidence
20
3.2 Developing an evidence base
22
3.3 Guidelines on confidentiality
24
3.4 The three discussion meetings
25
3.5 Portfolio compilation and submission
29
References
32
Appendix 1 NMC outcomes
33
Appendix 2 Example of evidence written by a student
based on a unit activity (UA)
41
Appendix 3 Example of testimony written by a
practice supervisor (T)
43
Appendix 4 Peer testimony of student practice
learning
44
Appendix 5 Example of a summary account written
by a student (SA)
45
1
Introduction to the Portfolio
5
1 Introduction to the Portfolio
Welcome to your Common Foundation Programme Portfolio. This is a
record of your practice-based learning, underpinned by the theory
you have learned during KYN100 or KYN101 and KYN107.
You are responsible for the safekeeping of your Portfolio. You must
at all times maintain the confidentiality of patients, clients and
colleagues, and comply with current Data Protection legislation.
(The government’s Data Protection website can be accessed from
the Open University Library’s website.)
You must ensure that your complete Portfolio is made available to
each of your mentor/practice supervisors for all of your practice
learning experiences. The material within your Portfolio, once
submitted to the University, will be shared with relevant personnel
associated with quality assurance, examination board processes and
professional regulation. This information will be kept for the period of
time prescribed by the Open University for assessment purposes. You
must sign the declaration on the Ongoing Achievement Record in the
Essential Information section of your Portfolio, indicating that you
agree to share this information.
Your Portfolio will contain the evidence that demonstrates that you
meet the practice-based requirements of the Common Foundation
Programme (CFP). It will contain records of your practice assessment
as you work towards achieving the Nursing and Midwifery Council
(NMC) outcomes necessary for you to progress to the branch
programme of your choice. You will have an opportunity to discuss
the Portfolio requirements with your programme tutor and your
mentor in your practice setting. It is your responsibility to complete
the Portfolio but your programme tutor and your mentor will work
closely with you. You will also discuss the Portfolio with your
programme tutor and your student colleagues during some tutorials.
Your mentor is responsible for assessing your practice, and your
programme tutor will verify whether your completed Portfolio meets
the necessary criteria.
This guide explains how to complete your Portfolio successfully.
The forms for the Portfolio are provided as a separate item. You can
photocopy and add extra sheets to any section of the Portfolio if you
need to. When you submit the Portfolio do not include these
guidelines; just submit the Portfolio forms indicated later in this guide.
To demonstrate that you have met each NMC outcome, you need to
provide supporting evidence in your Portfolio. You will collect this
evidence in your Portfolio as the course progresses. You are not required
to submit the supporting evidence on completion of the course, but this
evidence will form the basis of each discussion meeting in which your
mentor will assess your progress in achieving the required standard for
completion of the CFP. At these discussion meetings, your programme
tutor will sign to confirm that this discussion of your supporting
6
Guidelines for Completing the Common Foundation Programme Portfolio
evidence has taken place. You should use the activities you complete in
the course materials as evidence in your Portfolio. Each activity meets
at least one NMC outcome and you can select which activities to include
as evidence in your Portfolio. The activities also provide the foundations
for your tutor-marked assignments (TMAs) and the examinable
component, which you must submit at the end of the course. However,
you can also provide other sorts of evidence in your Portfolio. For
example, you may include sections of your journal. There is more
information later in this guide about other types of evidence that can
be included in your Portfolio. Each piece of evidence should have a
sufficiently descriptive title so that the nature of the evidence is
obvious. You should remember to give each piece of evidence a code
and number (see Section 3.1) so that it can easily be located in your
Portfolio by you, your mentor and your programme tutor.
Note that you will also be required to produce and maintain further
Portfolios during the branch programme. This will enable you to
develop the necessary skills to maintain a professional Portfolio,
which is a requirement of a registered nurse.
1.1 Portfolio structure and assessment
The NMC divides practice into four domains within which you must
achieve outcomes to enter the branch programme and standards of
proficiency to complete the branch and register as a nurse. Your
practice is assessed across these four domains, which are:
1
Professional and ethical practice
2
Care delivery
3
Care management
4
Personal and professional development.
Your mentor will assess your performance in practice and the
evidence in your Portfolio to demonstrate that you meet the NMC
outcomes (Appendix 1). The assessment draws on two main sources:
your coursework and your practice.
Your coursework provides underpinning knowledge and
understanding to inform your practice. It encourages you to become a
reflective practitioner – to think about your practice in an insightful
way and to learn from your reflection. You need to demonstrate your
understanding of the coursework by relating it to your practice and
vice versa. A good way of demonstrating this understanding is to
include completed activities from the course in your Portfolio.
Your Portfolio will record your assessment in practice supported by
your Portfolio evidence for each NMC outcome and the summary of
evidence of your practice experience and practice hours. All of this
evidence, together with your successful completion of KYN100/101
and KYN107, will enable you to progress to the branch programme.
Your mentor will observe your performance directly and assess it
against the NMC outcomes to prove that you are developing your
practice. Your mentor will also consider evidence about your
performance from other sources. There is more information about this
in Section 3. Each NMC outcome/standard of proficiency is sub­
divided into a number of ‘exemplars’ which illustrate how the
1
Introduction to the Portfolio
7
outcome/standard of proficiency can be met. However, please note
that the NMC outcomes and standards of proficiency should only be
assessed at outcome/standard of proficiency level.
You must complete the Portfolio satisfactorily to pass KYN107.
1.2 How your practice is assessed
Building on your previous experience, you will develop your skills,
knowledge, understanding and judgement within your nursing
practice. Your mentor will assess your ability to integrate theory
with practice, so you must show them that relevant knowledge and
theory underpin your performance in practice. This will enable you to
demonstrate an understanding of the issues around your practice and
your ability to contribute to holistic care.
Your mentor will assess your progress towards achieving the NMC
outcomes to complete the CFP, and the standards of proficiency to enter
the NMC register (NMC, 2004), according to four levels of practice. These
levels are based on research by Kathleen Bondy (1983). She studied the
stages that students go through when developing competence. They are:
Level 1 Constant supervision
Level 2 Assistance
Level 3 Minimal supervision
Level 4 Independent practice.
Table 1 (overleaf) gives the details of the knowledge and
understanding, practice performance and professional development
and awareness expected for each level of practice.
By the end of the CFP, you must attain Level 2 in all of the NMC
outcomes and provide evidence to support these achievements. You
may be capable of Level 3 in some outcomes at this point. However,
for the purposes of assessment, Level 2 is the requirement. Starting to
work towards Level 3 in some outcomes will help you move towards
this level in the branch. At the end of the branch, you must achieve
Level 4 in all the standards of proficiency to enter the NMC register.
Read the criteria for the four levels in Table 1 now and spend some
time looking at the words which describe Level 1 more fully –
‘limited’, ‘basic’, ‘rudimentary’, ‘needs support’, etc. Check through
the four levels (even though two of them refer to the branch). You
will see that there is a definite sense of progress through them. At
first the emphasis is on basic supported practice – ‘rudimentary’ and
‘lacks insight’. However, as you progress through the levels, there is
more emphasis on insight, understanding and independence. Take
some time to familiarise yourself with the levels and the demands
each level will make on you. Use the levels and the description of the
outcomes as a basis for discussion with your mentor, your
programme tutor and your student colleagues: think about how you
would distinguish between Level 1 and Level 2. Your mentor and
your programme tutor can help you to identify what these differences
are in practice and how you can progress from one level to another.
8
Guidelines for Completing the Common Foundation Programme Portfolio
Table 1 Levels of practice
Knowledge and understanding
Practice performance
Professional development and
awareness
Level 1 Needs constant supervision to deliver routine care
Has limited knowledge but can
identify where to locate further
information
Is not confident and lacks accuracy Does not adapt care to meet
clients’ needs and current
situation
Has limited awareness of
alternatives
Needs constant supervision and
guidance
Provides basic explanation for
rationale of choice selected
Able to give rudimentary rationale
for choice selected
Needs support in organising work
Does not prioritise care
Lacks insight and awareness of
professional self and professional
behaviour
Level 2 Needs assistance and can deliver routine care with some supervision
Knowledge is usually accurate
Performance is accurate but not
always efficient and lacks
confidence
Adapts care to meet clients’
needs and current situation
Begins to identify alternatives
Needs frequent supervision and
guidance
Unable to deal with non-routine
situations
Can give rationale for actions
Can prioritise care but often needs Gives standard explanations or
does not qualify these or
prompting
explore other possibilities
Level 3 Minimal supervision. Will need occasional supervision and support
Applies accurate knowledge to
practice
Safe, accurate, and fairly efficient
and confident
Professional intervention or
behaviour is generally appropriate
for the care situation
Has a limited range of alternatives
Needs occasional support,
supervision and guidance
Rationale given for care is
coherent and appropriate
Begins to make judgements based
on available evidence
Beginning to initiate appropriate
interventions
Identifies need for assistance
Prioritises care with minimal
prompting
Level 4 Able to work independently
Applies evidence-based knowledge
Safe, efficient and confident
practitioner
Shows awareness of alternatives
Needs minimal advice and support Interventions and behaviour are
suitable to the client and
circumstances
Sound judgement underpins
actions
Prioritises care
Gives coherent, accurate and
necessary information
Decisions are based on current
evidence
Adapts to the current situation
Identifies and makes appropriate
referrals within multidisciplinary
team
(Based on Bondy, 1983)
Careful, deliberate planning of
care
1
Introduction to the Portfolio
9
1.3 Programme curricular hours
The NMC requires pre-registration nursing programmes to comprise
4600 curricular hours equally distributed between theory and practicebased learning. Within the programme there are two categories of
programme days or hours:
l
study days or hours
l
periods of supernumerary practice days or hours.
Across the programme, each category is allocated a predetermined
number of days or hours. Table 2 gives details of where these days
or hours are located.
Table 2 Allocation of curricular hours to learning activities
Part of programme
Study (days/hours)
Supernumerary practice
(days/hours)
KYN100/101
80/600
0
KYN107
40/300
100/750
Total
120/900
100/750
Grand total
220 days/1650 hours
CFP
Course
The two categories of programme days or hours are used as follows.
Study days or hours
The 40 days or 300 hours in KYN107 are used for attending tutorials,
reading course materials and text, working on the DVDs, writing
assignments and personal study. This work may be completed in
your home, or a library, or wherever you find it best to study. Some
of the learning activities guide you through a series of readings which
will help you to understand issues important to practice situations
and skills, and relevant theories. Other activities will stimulate
questions and highlight issues that you will want to raise for
discussion during your tutorials.
Supernumerary practice days or hours
The 100 days or 750 hours in KYN107 are used for sustained learning
in practice as part of a care team, delivering care to clients, following
client care pathways, and following through with care. This
experience may be called ‘placement’ in your organisation, although
the OU’s Pre-Registration Nursing Programme team prefers the term
‘practice learning’. During this time, there will be formative and
summative assessment of your achievement of the NMC outcomes in
practice. Your achievement of the NMC outcomes will be recorded in
your Portfolio. The term ‘supernumerary’ means that you will not be
counted as part of the workforce, although you will be rostered as
part of the staff. This facilitates you being involved in continuity of
10
Guidelines for Completing the Common Foundation Programme Portfolio
care for patients or clients and developing teamwork skills. Your
supernumerary status also enables you to negotiate with your mentor
opportunities to experience practice learning in other practice areas
other than your work base. For example, you may want to attend
home visits with clients or patients you are caring for. During practice
learning time, you should be working with your mentor for the
equivalent of 40 per cent of your working week. The 100 days or
750 hours of your practice learning time must be recorded in the
Record of Practice Hours and Experience in your Portfolio.
The course materials and learning activities will direct some of your
supernumerary practice time. Their purpose is to allow you to
arrange practice learning experiences which relate to what you are
learning in the course. You should use supernumerary practice time
to undertake the activities in the course materials. When you write up
the activity, you can use this as evidence in your Portfolio. Each
activity is linked to one or more of the NMC outcomes. In addition,
some of the activities will provide the basis for TMAs or the
examinable component at the end of the course. During
supernumerary practice time, you should be supervised by your
mentor or a practice supervisor.
1.4 Practice learning requirements
This section gives an overview of practice learning requirements.
Please note: it is important that you refer to Section 4 of your
Programme Guide for detailed guidance on how to meet practice
learning requirements.
Common Foundation Programme (all students)
To ensure that the practice learning opportunities you have in
KYN107 meet the statutory body requirements of the NMC, you must
have access to the following practice learning opportunities, which
represent the four disciplines or branches of nursing:
l
Adult
l
Mental Health
l
Learning Disabilities
l
Child.
In addition, you should:
l
spend one complementary and/or contrasting practice learning
period outside your programme practice learning base
l
include exposure to community-based care
l
include exposure to acute patient care.
l
include exposure to continuing care/rehabilitation
You should also experience the delivery of care across the 24 hours
and seven days a week cycle. This will give you an appreciation of
the diverse patient and client issues and the valuable learning
opportunities that night-time presents. It is important to do night
duty on a minimum of two occasions across the programme and for
each occasion to consist of at least three shifts.
1
Introduction to the Portfolio
11
Adult Branch students
By the end of your branch programme, you must provide evidence
to your mentor and your programme tutor that your programmebased practice learning meets the European Union requirements
(EU, 1977) about:
l
general and specialist medicine
l
general and specialist surgery
l
l
l
the needs of children – a requirement during the CFP (termed
‘child care and paediatrics’ by the EU)
the needs of people with mental health issues – a requirement
during the CFP (termed ‘mental health and psychiatry’ by the EU)
care of older people (termed ‘care of the old and geriatrics’ by
the EU)
l
community nursing (termed ‘home nursing’ by the EU)
l
maternity care.
In addition, you must provide evidence of practice experience in:
l
acute care
l
low, medium and high levels of dependency (this will be specific
to the patient or client group and to the context of care)
l
interprofessional working.
More details and guidance are given later in this guide.
Mental Health Branch students
By the end of your branch programme, you must provide evidence to
your mentor and your programme tutor that you have done
programme-based practice learning in relation to:
l
care of older people
l
acute care
l
care of people with severe and enduring mental health problems
l
community care
l
care of children or adolescents (care of children is a requirement
during the CFP)
l
care of adults (a requirement during the CFP).
In addition, you must provide evidence of practice experience in:
l
acute care
l
low, medium and high levels of dependency (this will be specific
to the patient or client group and to the context of care)
l
interprofessional working.
You will need a copy of the Summary of Practice Hours and
Experience form in your CFP Portfolio for your first branch Portfolio.
This will provide an ongoing record of the areas and client groups
you have experienced or gained insights into so far in the
programme. At the end of the CFP, transfer a copy of the Summary
12
Guidelines for Completing the Common Foundation Programme Portfolio
of Practice Hours and Experience form in your KYN107 Portfolio and
insert it into your Branch Portfolio.
You will find further guidance on how to complete your Portfolio
in Section 3, and your programme tutor will also support you in
doing this.
The next section explores the Portfolio forms and provides details and
discussion of the practice experiences described above.
2
The Portfolio forms explained
13
2 The Portfolio forms explained
Your Portfolio consists of three sections:
l
Essential information
l
Self-assessment records
l
Evidence index.
Each section contains a series of forms, each of which has a vital
function in documenting your experience, progress and achievements
during the CFP. As you read the following description of the
components, you may want to have the relevant forms beside you.
Section 3 of this guide explains in detail how to use the forms.
2.1 Essential information
Student Personal Details
The Portfolio starts with a form for your personal details. Fill this in
straight away.
Mentor/Practice Supervisor Details
You should ask your mentor or practice supervisor to complete one
of these forms at the earliest opportunity. They must complete and
sign this form in their own handwriting, as this is required for the
verification process. Remember that you must have one identified
mentor, who has received mentor preparation and assesses the NMC
outcomes and completes your Record of Progress at the end of your
practice experience.
A mentor is required to:
l
be a registered nurse
l
be registered in the same branch of nursing as the students are
studying
l
fulfil the NMC’s requirements for mentors and mentorship.
Mentors also accept responsibility for:
l
supporting students’ access to learning opportunities
l
facilitating practice learning
l
supervising students when they are doing programme-based
practice in the practice area
l
liaising with colleagues and practice supervisors
l
assessing students’ performance and learning in practice.
In the CFP you are required to undertake a minimum of one period
of practice learning that complements or contrasts with your normal
place of practice learning. This will broaden your learning and give
you experience of different ways of delivering and managing care.
During this period your practice learning will be supported by a
practice supervisor. This is a nurse or other professional who fulfils
the same role as your mentor but is more familiar with the
14
Guidelines for Completing the Common Foundation Programme Portfolio
complementary or contrasting area than your mentor. When you
arrive in your complementary or contrasting area, you should ask
your practice supervisor to complete one of the forms.
Record of Progress
Your progress in practice is monitored through three discussion
meetings with your mentor and your programme tutor. These are
spread throughout the course: one near the beginning of your practice
experience, one around the middle, and one towards the end. The dates
for these meetings are marked on your Study Calendar. On the Record
of Progress form you, your mentor and your programme tutor
document your progress as you achieve the NMC outcomes. All three
of you should write your signature and the date in the spaces provided.
The NMC outcomes and the supporting evidence should be signed
off preferably in Discussion 3, but definitely by the submission date.
If you have not reached Bondy Level 2 in all NMC outcomes by
Discussion 3, you will need to achieve them, provide evidence in
support of this achievement, and have the forms signed off before
you submit your Portfolio. Levels achieved after Discussion 3 should
be signed off in the column headed ‘Final Bondy level’. You may not
have the opportunity to meet your programme tutor between
Discussion 3 and the submission date. In this case, ask your mentor
to sign off the forms and send photocopies of them and supporting
evidence to your programme tutor to enable them to verify your
work, and return it to you, before you submit. If you fail to do this,
you will not meet the requirements of the course.
Essential Skills Clusters Record
The NMC introduced essential skills clusters (ESCs) to the nuring
curriculum from September 2008 (NMC, 2007). These essential skills
clusters are reproduced in the Profile of Practice Skills: a formative
resource. A small number of the essential skills are summatively
assessed during the CFP and these are recorded on the Essential
Skills Clusters Record. The Essential Skills Clusters Record should
be completed at each discussion meeting with your mentor and
programme tutor. The Profile of Practice Skills – a formative resource
will inform your mentor’s decision regarding your achievement of
each skill. You must demonstrate achievement of skills 9, 25, 27, 28,
29, 33 and 42 at Bondy level 2 by the end of the CFP.
Record of Practice Hours and Experience
By the end of the CFP, as well as achieving Level 2 in all the NMC
outcomes as described in Section 1.2, you must have had exposure to
all four disciplines of nursing:
l
Adult
l
Mental Health
l
Learning Disabilities
l
Child.
2
The Portfolio forms explained
15
Each practice period must be for a minimum of 30 days. (A day
consists of 7.5 hours so, if you work longer or shorter shifts each day,
you need to adjust the number of days to achieve at least 225 hours.)
Across the programme you are required to learn in practice as part of
the interprofessional team and experience the delivery of care for
24 hours and seven days a week, and across a range of services
which provide health care and across dependency levels. So, during
this period, it is important that you gain experience of services which
relate to your learning practice area. For example, if you are based
on, or allocated to, a surgical ward, you may follow a care pathway
or patient’s journey through:
l
diagnostic and investigative services
l
out-patient departments
l
operating theatres
l
services provided by specialist nurses
l
multi-professional team members
l
community-based services.
During the nursing programme, you must experience working in
interprofessional teams. It is also important to get an insight into the
patient’s or client’s entire experience of health care, and other services,
so that you can empathise with their experiences, changing responses
and support needs. To enable you to appreciate the diversity of issues
or opportunities for patients or clients at night-time, you should do
night duty, with the support of your mentor, at least two times
during the programme. You need to gain insights into night-time for
a patient or client so, preferably, you should follow them for a period
of night duty (for example, three shifts on each occasion).
On completing each practice period, you should fill in the Record of
Practice Hours and Experience and carefully document the hours,
workplace details, type of experience, core practice or client group
and dependency levels. In your Portfolio, you are asked to record
your practice experience and where this practice learning takes place
for each period of practice learning.
When recording this information in your Portfolio it is extremely
important that the specific location of this experience is recorded
accurately.
In order to do this, you must provide a specific reference to the
location in terms of the clinical areas and the hospital or community
trust in which this clinical area is located. It is not sufficient to record
for example ‘Elm Ward’ with no further means of identifying the
location of this clinical area. This information should be recorded as:
‘Elm Ward, Anytown Hospital, Anytown Trust.’
Please ensure that before submission of your Portfolio forms you have
provided this information in full for each practice area in which you
have had experience.
Failure to do so will result in your practice details being incomplete
and may delay your registration at the end of your study of the
programme.
You must also experience the full range of 24-hour care and the
seven-day cycle of care during the programme to ensure that your
16
Guidelines for Completing the Common Foundation Programme Portfolio
experience includes the full shift pattern, with different day shifts and
nights. There is an example form in the Portfolio to help you
complete this record.
Ask your mentor or practice supervisor to complete the summary of
your performance on page 2 of the Record of Practice Hours and
Experience form. This form must be signed by your mentor or
practice supervisor, your programme tutor and you.
You may experience all four branches of nursing in a variety of ways,
such as learning through life experience (experiential learning),
opportunistic learning through clients from other disciplines accessing
your workplace and, where possible, learning through access to
discipline-specific designated services. It is not a requirement for you
to access discipline-specific designated services but take the
opportunity if it arises, provided client care is not compromised. As
mentioned in Section 1.4, exposure to maternity care is a requirement
if you are studying the Adult Branch Programme. This experience
may be gained in a range of ways, including ‘experiential’ learning,
as follows.
l
You could produce an account of your experience of maternity care.
l
You could produce an account of a family member’s or friend’s
experience of maternity.
l
Your mentor or programme tutor may be able to negotiate time
with a community midwife or local community hospital which
offers maternity care for ‘low or no risk’ pregnancies.
l
Rarely, you may be able to access maternity services within acute
hospitals.
l
You could seek an opportunity to visit private or voluntary
support groups such as NCT and La Leche.
If you gain experience of maternity care during the CFP, you should
record this on the Record of Practice Hours and Experience form and
the Summary of Practice Hours and Experience form.
The requirement for exposure to child care and paediatrics could be
met in the following ways.
l
You could produce an account of a family member’s or friend’s
experience of children’s services.
l
You could seek an opportunity to visit private or voluntary
groups and/or contact organisations which provide services to
children, for example:
local playgroups, opportunity groups to gain insights into the
normal development of children
child health clinics, child assessment centres to gain insights
into childhood health issues and health promotion activities for
children’s organisations such as ‘Contact a Family’ to gain insights
into the issues faced by children with lifelong or life-limiting
health issues
a local Red Cross group to gain insights into how to manage first
aid emergencies in childhood
local schools to listen to a service provider’s or children’s accounts
of their experience of services provided to children – even young
children can be extremely eloquent about their experience of
health care services.
2
The Portfolio forms explained
17
l
Your mentor or programme tutor may be able to negotiate time
with a practitioner who works with children in a hospital or
community setting.
l
Rarely, you may be able to access designated children’s services.
To meet the requirements of the CFP, you must provide evidence of
750 hours of supernumerary experience on your Record of Practice
Hours and Experience form. You must log the number of hours of
practice learning in each practice setting. You must provide evidence
of experiencing the 24-hour cycle of care. Your record must be signed
by your mentor or another supervising professional.
Use the Summary of Practice Hours and Experience form to help you
plan your periods of practice learning. Please ensure that you record
the name of the practice learning area and the type of care provided
in this setting.
Summary of Practice Hours and Experience
This form summarises the information from the Record of Practice
Hours and Experience forms which you completed at the end of each
practice period. You should fill in the forms and ask your mentor and
your programme tutor to complete the comments boxes on page 2 of
each form. There is an example form in the Portfolio to help you
complete this record.
Before you submit your Portfolio, please check that you have added
up your total hours correctly. If you have not completed the required
practice hours, you must still submit your Portfolio by the cut-off
date. You must then talk to your programme tutor and your mentor
to arrange how to make up the deficit in hours.
It is important to transfer a copy of this summary to your Portfolio
when you move on to the branch programme on successfully
completing the CFP.
Ongoing Achievement Record
The Ongoing Achievement Record (OAR) summarises your progress
in practice throughout the programme. You should meet with your
mentor within five days of commencing each practice period to
identify your practice learning needs. You should identify your
strengths, areas for development and how you will achieve them to
enable judgements to be made on your progress. They should be
recorded on the first page of the record. You and your mentor should
sign the form for each practice period. Through completion of the
OAR your concerns are shared and ways forward can be agreed to
ensure they are addressed.
At the end of each practice learning period you should discuss your
progress during the practice learning period with your mentor and
record this on the second page of the record. You and your mentor
should sign this page of the record for each practice period, as before.
Your programme tutor will sign the form at the end of the course.
At the end of CFP, you must transfer a copy of the completed
Ongoing Achievement Record into your Branch Portfolio. It is
important that you keep a copy of your OAR to provide to your
18
Guidelines for Completing the Common Foundation Programme Portfolio
‘sign-off’ mentor to confirm your achievements at the end of your
programme.
Student Self Declaration of Good Health and Character
The Nursing and Midwifery Council (NMC) requires that your health
and character are sufficiently good to enable you to practise safely
and effectively (NMC, June 2008). If at any time during your study
with The Open University (both during and between courses) you
become aware and/or are alerted that your health and/or character
may not be sufficiently good to enable you to practise safely and
effectively you must inform your programme tutor immediately. To
inform your programme tutor complete and submit a ‘Student self
declaration of good health and character’ form which is available on
the ‘More resources’ page of your course website.
In addition the NMC requires students to declare that they continue
to be of good health and good character annually to the University.
To support your compliance with this NMC requirement, we have
included a student self declaration of good health and character form
in the ‘Essential information’ section of the portfolio. This declaration
must be completed and submitted as part of your portfolio at the end
of each practice course.
All information received will be treated in the strictest confidence. If it
is believed to be in the interests of public safety, information may
need to be shared with others. You will be advised who the
information will be shared with and what information will be shared.
Any sharing of information is strictly on a ‘need to know basis’. If
you declare any concerns, your declaration will be reviewed by
members of a ‘fitness to practise panel’.
Failure to comply with the above requirements may place your
progress through the nursing programme in jeopardy.
2.2 Self-assessment records
To support your achievement and progression in the CFP, you will
participate in a minimum of three practice-based discussion meetings
with your mentor and your programme tutor. These three meetings
are obligatory. There is further information about these meetings in
Section 3.
After each discussion meeting, you should complete the relevant
Discussion Self-Assessment Record, which summarises the discussion
between you and your mentor and your programme tutor in
Discussion 1, 2 or 3 across all NMC domains. This record should
highlight your strengths and learning needs and show your action
plan, detailing how you plan to achieve these learning needs. You
should also complete the ‘Agreed summary of discussion between
student, mentor and programme tutor’ box on page 2 of the form.
Once all of these statements have been agreed by you, your mentor
and your programme tutor, the form should be signed by all three of
you. Your programme tutor should keep copies of these forms to help
them verify your Portfolio, parts of which are submitted at the end of
each practice course.
2
The Portfolio forms explained
19
2.3 Evidence
On this form you should list the evidence you have collected to
support your achievement of the NMC outcomes at Bondy Level 2.
You should clearly identify each piece of evidence and label it and
indicate which outcome(s) it supports. File each piece of evidence
behind the Evidence Index form in the order in which it is listed.
This will help you to locate the relevant supporting evidence you
have selected to demonstrate to your mentor and programme tutor
your progress in achieving the NMC outcomes at each discussion
meeting.
20
Guidelines for Completing the Common Foundation Programme Portfolio
3 How to complete your
Portfolio
The central feature of your Portfolio work is practice but you need to
have evidence of it. So your Portfolio work consists of:
l
recording details of your practice on the ‘Essential Information’
forms
l
collecting supporting evidence of this practice (for example,
verification by a practice supervisor, documentation, summary
accounts)
l
three discussions in which you, your mentor and your programme
tutor monitor and document your progress.
The three discussions should be thoughtful and reflective, and lay the
foundations for the sort of discussion about your professional practice
that you should take part in throughout your career.
You have already looked at the forms in the Portfolio. In this section
you will look at the groundwork needed for your Portfolio. This
section outlines the sequence of events for completing your Portfolio
work and, in particular, explains exactly what sort of supporting
evidence you can collect for your Portfolio, and the process to follow
in the three discussions when your progress is reviewed. Don’t worry
if it seems rather complex now; your programme tutor will talk you
through it in an early tutorial.
You need to be sure that you fill in your Record of Practice Hours
and Experience form for each practice period and your Summary of
Practice Hours and Experience form.
3.1 Types of evidence
As you have seen, in each of the three discussions you, your
programme tutor and your mentor must complete and sign the
Record of Progress form to record your performance. Your mentor’s
assessment of your achievement for each outcome will be based on
three sorts of evidence:
l
observation of your practice (which they will verify)
l
discussion with you (which they will verify)
l
examination of a variety of other supporting evidence you present.
Although you should present a wide range of evidence, you are
encouraged to demonstrate how one particular piece of evidence can
support more than one outcome. However, you must ensure that the
quality and the depth of your evidence effectively support the
particular NMC outcome that you are claiming to have achieved.
Once your mentor and your programme tutor have agreed that a piece
of evidence demonstrates your achievement of a particular outcome,
you should use the following key to identify the type of evidence.
Give each piece of evidence a code and number and record this on
both the evidence itself and the Evidence Index form, so that it can be
readily located by you, your mentor and your programme tutor.
3
How to complete your Portfolio
21
UA Unit activity: this includes the work you have already completed
on the unit activities. When used as supporting evidence in your
Portfolio, the activities provide potentially strong evidence and
can reduce your workload because this is work you have already
done. The unit activities often relate to practical skills
development and, in many instances, this includes learning the
theory underpinning the skill and then using the skill in practice.
Appendix 2 shows an example of a student’s notes written about
a unit activity. You could also include a summary of your
learning from your coursework relating to NMC outcomes as
Portfolio evidence. You may also consider using TMA contents as
the basis of Portfolio evidence. If you decide to do this, write a
short account indicating how the TMA supports achievement of
NMC outcomes and highlight the relevant text within the TMA.
C
Certificated workshop or employer-led training, supported by a
summary account of what you learned from the workshop or
training. A certificate alone does not constitute evidence; it should
be supported by an account of what you have learned. The
certificate should be placed behind the evidence that refers to it.
If you refer to it in more than one piece of evidence, you should
cross-reference it.
T
Testimony of other people (written materials, letters, feedback
from clients): this can include verification of your performance in
practice written by your mentor or other suitably qualified
practitioners. The testimony can come from your practice setting
or from your complementary practice experience. It can also
include verified evidence of a discussion between you and your
mentor or another professional. Appendix 3 shows an example
of testimony written by a practitioner. Appendix 4 gives details
about the circumstances in which it may be acceptable for another
Pre-Registration Nursing Programme student to provide
testimony for you.
SA Summary accounts: these may be after attendance at tutorials,
about some practice you have observed or participated in, your
understanding of a journal article, or your reading of the
companion course KYN100 or KYN101. Appendix 5 shows an
example of a summary account written by a student.
CD/ Evidence of having worked on a DVD or an audio: this work
DVD is a good source of evidence to demonstrate numeracy,
information literacy and computer skills. Again, you need to
show how these skills will inform your practice.
P Presentation of ideas in a public forum: this might be where you
have presented information in your practice setting, during a
tutorial or at a seminar or a meeting. You should collect verified
evidence of your contribution.
PW Project work: you may decide that you want to follow up aspects
of the course, perhaps through website and evidence searches. If
you do something concrete and relevant like this, try to make
time to discuss this work and its relevance with a qualified
practitioner, and ask them to verify it.
RC Resource collection: this should include some summary accounts
about what you have learned from these resources. Sources
should be referenced accurately.
22
Guidelines for Completing the Common Foundation Programme Portfolio
PS Profile of Practice Skills: this can provide supporting evidence of
your achievement of the NMC’s Essential Skills clusters and also
outcome 2.8. You may use this record in discussion with your
mentor and your programme tutor to demonstrate the
achievement of these skills.
3.2 Developing an evidence base
Section 3.1 lists some types of evidence you may collect to support
your achievement of NMC outcomes. All the supporting evidence you
select should clearly support your clinical experience. This can be
done by explicit reference to the evidence, such as policy documents
and journal articles within your practice accounts. Alternatively, you
can write a short summary of a document and indicate how it has
informed your practice. Similarly, certificates for the successful
completion of courses that you have attended (such as moving and
handling or infection control) can also be included. However, they
must be accompanied by a short summary of your learning from the
course and an indication of how you are using this learning to
support your practice.
One of the most important pieces of evidence you will acquire is
verified evidence. This section looks in more detail at how to
collect verified evidence of practice and discussion. You should collect
evidence as you go along – don’t leave it until the three prearranged
discussion meetings! Collecting relevant evidence in a timely fashion
to support your practice is the key to a good Portfolio. You are not
just finding qualified practitioners to ‘sign off’ the Portfolio. Instead,
aim to create a picture of your developing practice and look on it as
an album of your achievements. You should make sure that your
Portfolio does you justice!
Client consent
Any evidence collected in a practice situation involving working with
a client must be done with the client’s consent. This is not a case of
‘maybe’, ‘possibly’ or ‘if I’ve got time’: you must do it. It is the basis
of your ethical approach to clients as a professional practitioner and
must happen in your work with patients and clients on a daily basis.
It must also be reflected meticulously in your Portfolio and TMAs.
Your mentor and your programme tutor will certainly want to discuss
this with you and can offer you support and advice. The following
protocol will help you build up this aspect of your work. Patients and
clients have a fundamental legal and ethical right to determine what
happens to their own bodies. Therefore, valid consent to treatment is
absolutely essential in all forms of health care. The Department of
Health has issued a range of guidance documents on consent for
examination or treatment, which can be accessed on its website.
Open University student nurses are required to observe the following
protocol to ensure that patients agree to have care delivered by a
student nurse under supervision. Patients may withdraw their consent
at any time. If a patient indicates that they do not want a student
nurse to be involved in delivering their care, you must respect their
views and inform your practice supervisor.
3
How to complete your Portfolio
23
Protocol for gaining clients’ consent
As a student nurse, you must always ensure that patients and their
carers have agreed to receive your care and, in addition, know who
is responsible for supervising your practice. You must follow this
protocol when you first meet a patient or their carer.
1
Introduce yourself as a student nurse and state who is
supervising your practice.
2 Ask the patient or carer whether they agree to receive care
from you as a student under supervision.
3 If the patient or carer asks questions, or seeks more information
about the care you want to offer, explain this care and discuss it
with them.
4 Ask the patient or carer whether they would like to speak to
your supervisor about the care that you want to offer. If they
would like to discuss any aspect of this care with your
supervisor, tell them you will ask your supervisor to speak to
them before you offer any care.
5 If the patient or carer does not offer complete agreement and
seems confused or worried about your role, refer this to your
supervisor before taking any further action.
6 If the patient or carer offers complete agreement, you may
progress to offering the care agreed.
Use this protocol whenever you approach a patient or carer with
whom you have not previously worked. Also use the protocol if you
are working with the patient or carer as a student nurse for the
first time, even if you know them from a previous role you have
held in that care environment.
Verified evidence of practice
The activities in the course materials form a framework for your
practice experiences. They enable you to link your practice with the
theory that underpins it. Each activity is linked to at least one of the
NMC outcomes that you must achieve by the end of KYN107. Some
course activities suggest that you do a piece of work under your
mentor’s supervision. Others may direct you to observe or reflect on
practice. When you submit course activity notes, use the key UA (unit
activity) and add the block number, unit number and activity number
it relates to, for example: B2/U16/A10 means Block 2, Unit 16,
Activity 10.
If you arrange for your mentor or another practice supervisor to
watch you carry out a piece of practice, you can write a summary
account about this and ask them to verify, sign and date it. Use the
key SA when listing it on your Evidence Index and on the evidence
itself. Alternatively, your practice supervisor could write an account
or a testimony of what they saw you do in practice, then sign and
date it. Use the key T (testimony) when referring to this form of
evidence. The NMC outcomes beginning with ‘Demonstrate’ are all
likely to require that your mentor verifies actual practice.
24
Guidelines for Completing the Common Foundation Programme Portfolio
Verified evidence of discussion
You should note that some of the NMC outcomes require you to be
able to ‘discuss’ certain practice issues. It is a good idea to check the
exact word that begins each outcome so that you are clear about the
type of evidence you need to produce. Again, verification by your
mentor that a discussion has taken place is central evidence. This
should be listed on both the evidence and the Evidence Index as
T (testimony) if it has been written and signed by your practice
supervisor. If written by you, it should be listed as SA (summary
account) and must be countersigned by the practice supervisor you
had the discussion with.
Verified evidence of courses and workshops
During the programme you are expected to attend various courses or
workshops organised by your employer (such as moving and
handling or basic life support), in order to update your skills.
Certificates from these workshops are essential pieces of evidence.
Keep them and put them in your Portfolio and relate them to a
relevant NMC outcome. Use the key C (certificate) on the Evidence
Index. The certificate must be current and up to date and must be
accompanied by a summary of what you have learned and how that
relates to your practice.
Issues of unsafe practice
When writing about the care you have delivered, you must
demonstrate an awareness of what constitutes safe and unsafe practices
in care delivery. This does not mean you cannot write about unsafe
practice you might have seen. For example, you may witness
unsafe practice and write about it, indicating the issues arising and
what changes may be required to avoid such practice in future. If
you write about unsafe practice but do not identify it as unsafe
practice, you will be penalised and the matter referred to the
Examinations and Assessment Board.
3.3 Guidelines on confidentiality
Your Portfolio evidence can draw on both your personal and your
work experiences. This may mean including information about, and
occasionally passing judgement on, the organisation you work for and
your colleagues, patients or clients. When using such material in your
Portfolio evidence, you should make sure that all information is made
anonymous, for example by changing or removing the names of
people or places. If you refer to a patient by name then you should
change their name and explicitly acknowledge that you have changed
it. It is good practice to cite the requirements of The Code: Standards
of Conduct, Performance and Ethics for Nurses and Midwives
(NMC, 2008). For example, ‘I greeted Mrs Green (name changed to
ensure confidentiality) on admission and showed her around the
ward.’ You should also check that you have the permission of the
3
How to complete your Portfolio
25
person(s) concerned to use any material. Make sure you read through
your supporting evidence and remove every mention of the clinical
setting and patient or client details.
If you want to use your employer’s or your trust’s headed paper for
any items of supporting evidence, you must ensure that their policy
on the use of headed paper is observed. You must get permission
from the trust or employer before using headed paper in your
evidence. Using such paper in your evidence does not in itself
compromise client confidentiality, provided that the anonymity of the
patient and clinical area is preserved.
It is important that you ensure your Portfolio is kept secure at all
times, whether at home, at work, in tutorials, or in any other place.
You must observe the standard of confidentiality set out in The Code.
Therefore, your Portfolio should not be shared with anyone who is
not connected with the Pre-Registration Nursing Programme.
Your assignments are normally confidential documents and will be
treated as such by University staff. Only members of staff who need
to see them will have access to them, for example your course
tutor. However, because of the nature of the subjects covered by
courses from the Faculty of Health and Social Care, there may be
exceptional cases where the confidentiality rule may need to be
reconsidered. Note that if your written evidence in your Portfolio
refers to dangerous practice or the abuse of patients or clients, the
course team cannot maintain confidentiality, and follow-up action will
be necessary.
Here is the explanation of the steps a tutor will follow in such a
situation.
l
The tutor will contact the local Staff Tutor to discuss the matter.
l
The tutor is free to discuss the matter with the student if they
feel competent to do so.
l
Any proposed action should be discussed by the Staff Tutor and
the Course Team Chair and Director of the Pre-Registration
Nursing Programme, who will refer it to an Associate Dean of
the Faculty if required.
l
No action will be taken without the formal approval of the Dean.
l
No action will be taken without full consultation with the student
concerned and without serious consideration of the likely
consequences.
3.4 The three discussion meetings
During the course you will participate in a minimum of three
practice-based discussion meetings with your mentor and your
programme tutor. These three discussion meetings support your
achievement and progression and are obligatory. At each meeting the
supporting evidence you are collecting is reviewed and used as a
basis to identify which Bondy level you have achieved for each
outcome.
26
Guidelines for Completing the Common Foundation Programme Portfolio
It is your responsibility to negotiate the timing of these meetings and
to liaise with your mentor and your programme tutor to agree the
date of the first discussion meeting. This should be as early as
possible in the course, as indicated on the Study Calendar, and before
you do any practice learning. The first meeting should identify your
level of practice at the beginning of the course. It is important that
your discussion is open and honest, and identifies your strengths and
any learning needs for each outcome.
Discussion 1
As discussed above, within the first few weeks of the course you,
your programme tutor and your mentor should meet to discuss each
NMC outcome in relation to your level of practice. The Discussion
Self-Assessment Record forms the basis of the discussion and you
should complete page 1 of it before your meeting. At the meeting
you, your programme tutor and your mentor should plan how any
learning needs you have identified will be addressed. These should be
recorded on the Self-Assessment Record and summarised on page 2
of it.
An important function of Discussion 1 is checking your Ongoing
Achievement Record.
You will probably find it simplest to go through the Portfolio
together with your mentor and your programme tutor. For every
outcome you should discuss which level you are performing at,
based on the supporting evidence you provide. Look back at Table 1
for an explanation of Bondy Levels 1 and 2. Your mentor will assess
your performance against each NMC outcome and then record the
Bondy level you are currently practising at on the Record of
Progress form. You might have already achieved some NMC
outcomes at Level 2, but you must provide evidence to support this.
You will need to record the type of evidence you provide using the
key in Section 3.1.
After working through the NMC outcomes, you need to reflect on
your overall progress. Remember that you, your mentor and your
programme tutor must complete and sign the Record of Progress, the
Ongoing Achievement Record and the Discussion 1 Self-Assessment
Record (page 2), stating when learning needs must be addressed and
the date for Discussion 2.
Checklist for the discussion meeting
At the discussion meeting you should all agree:
l
where you are in relation to achieving the required level in each
NMC outcome
l
where you are in relation to achieving the required level in the
essential skills
l
Ongoing Achievement Record.
l
which NMC experience requirements need to be accessed outside
your normal place of work (refer to the Summary of Practice
Hours and Experience form)
3
How to complete your Portfolio
27
l
who will arrange access to opportunities or experiences outside
your normal place of work, when will they occur and the
arrangements for induction to those opportunities or experiences
l
the date, time and place of the second and third discussion
meetings. You should refer to the Study Calendar to establish the
recommended timing of these meetings.
Practice work
During the first few months of your practice work, you will be
developing the areas identified in Discussion 1. Remember to collect
and save your supporting evidence as you go along and to file each
piece of evidence behind the Evidence divider in your Portfolio. Also
record each piece of evidence on the Evidence Index. Remember also
to use course activities as much as possible to help you collect and
structure your evidence. Do all the learning activities suggested and,
where possible, ask your mentor or another professional to witness
and sign what you do.
Discussion 2
The second discussion meeting is a formative activity. It should take
place about half way through your practice experience, as indicated
on the Study Calendar. It provides an important opportunity to
explore:
l
what you have learned
l
what you still need to learn
l
the quality of the supporting evidence you have collected to
support achievement of the NMC outcomes
l
which practice level you have achieved in each NMC outcome
and what you still need to do to achieve the required level for
the course
l
which learning activities or evidence gathering you still need to
do to demonstrate achievement of the NMC outcomes at the
required practice level
l
which practice level you have achieved for each essential skill
and what you still need to do to achieve the required level for
the pcourse.
This meeting is, therefore, a ‘looking back’ and ‘looking forward’
activity and is very important if you are to reach the required Bondy
Level 2 in practice by the end of the course. You, your mentor and
your programme tutor should review your progress, focusing
particularly on your learning needs identified in the Discussion 1
Self-Assessment Record. The level of achievement gained is noted on
the Record of Progress. Again, you should complete page 1 of the
Discussion 2 Self-Assessment Record before the meeting. In the
meeting, page 2 of the Discussion 2 Self-Assessment Record should be
completed, which summarises the discussion between you and your
mentor and your programme tutor. It should highlight your strengths
and learning needs and show your action plan, detailing how you
plan to achieve these learning needs. You should also complete the
‘Agreed summary of discussion’ comments box. Once all of these
28
Guidelines for Completing the Common Foundation Programme Portfolio
statements have been agreed by you, your mentor and your
programme tutor, the form should be signed by all three of you. The
Ongoing Achievement Record also needs to be reviewed and
amended as necessary. Your programme tutor should keep copies of
these forms.
Check how many outcomes you still need to work on. If you, your
mentor and your programme tutor decide that you are having
problems with any of the outcomes, you will need to arrange another
review before Discussion 3. Document this on the Discussion 2 SelfAssessment Record for the appropriate NMC domain.
Practice work
You now continue with your practice work, again finding every
opportunity to build up your supporting evidence. By now, you will
probably be clear about the outcomes you still need to work on. This
may partly be a matter of not having had enough opportunity to
achieve a particular outcome, but you should also be alert to
outcomes that you find more difficult and seek opportunities to focus
on these.
Discussion 3
The third, and normally final, discussion meeting should take place a
few weeks before the end of the course, as indicated on the Study
Calendar. This is the summative assessment activity, which involves
your mentor judging whether you have achieved the NMC outcomes
and essential skills at Bondy Level 2 for KYN107. This is a
requirement for completing the CFP. Your mentor’s judgement will be
informed by:
l
direct observation of your practice
l
review of the supporting evidence provided by you
l
feedback provided by colleagues such as practice supervisors.
Your programme tutor supports this decision making.
This meeting is, therefore, primarily a ‘looking back’ activity. The level
of achievement gained is noted on the Record of Progress. Again, you
should complete page 1 of the Discussion 3 Self-Assessment Record
before the meeting, and page 2, which summarises the discussion
between you, your mentor and your programme tutor, at the meeting.
This should highlight your level of achievement, and particularly
detail your plan to achieve any outstanding NMC outcomes or
essential skills. You should also complete the ‘Agreed summary of
discussion’ comments box. Once all of these statements have been
agreed by you, your mentor and your programme tutor, the form
should be signed by all three of you. The Ongoing Achievement
Record should again be reviewed and amended as necessary. Your
programme tutor should keep copies of these forms.
If you have achieved all of the NMC outcomes to Bondy level 2 by
this stage, you should have all your Record of Progress forms signed
and dated by both you and your mentor, with the ‘Final Bondy level’
section of the form completed and verified by your programme tutor.
If there are any outcomes you have not yet achieved at Bondy Level 2,
3
How to complete your Portfolio
29
it is very important that you, your mentor and your programme tutor
are clear about which ones they are and plan how to achieve them
before the end of the course.
If you have achieved the required CFP essential skills to Bondy
Level 2, you should have the Essential Skills Clusters Record signed
by both you and your mentor and verified by your programme tutor.
If there are any essential skills you have not yet achieved at Bondy
Level 2, it is very important that you, your mentor and your
programme tutor are clear about which ones they are and plan how
to achieve them before the end of the course.
In the last few weeks, you need to work on any outcomes not
achieved at Level 2, collecting supporting evidence as you go. Ask
your mentor to review your evidence and sign that you have
achieved Level 2 in the ‘Final Bondy level’ section on the Record of
Progress form. You need all your forms signed, ready to submit to
the University, by the end of this period.
Remember, at the end of CFP, you must transfer a copy of the
completed Ongoing Achievement Record into your Branch Portfolio.
Non-achievement of NMC outcomes and essential skills
at Level 2
If you do not achieve all the outcomes or the required essential skills
at Level 2 by the end of the course, discuss the issue with your
programme tutor, who will advise you about any further practice you
are required to do. Ensure that you identify what action you will take
to achieve these outstanding outcomes or essential skills as part of
your action plan on the Discussion Self-Assessment Record forms.
You should also ensure this is recorded on the Ongoing Achievement
Record.
3.5 Portfolio compilation and submission
Your Portfolio must show that you have completed the required
study and practice elements of the course: for example,
practice hours, practice experience and achievement of NMC
outcomes and essential skills. If any of this information is missing,
your course result will be delayed until you have supplied it.
At the end of the course you must submit two copies of the Essential
Information section only of your Portfolio. This includes the forms:
l
Student Personal Details
l
Mentor/Practice Supervisor Details
l
Record of Progress
l
Essential Skills Clusters Record
l
Record of Practice Hours and Experience
l
Summary of Practice Hours and Experience
l
Ongoing Achievement Record
l
Student Self-Declaration of Good Health and Character.
30
Guidelines for Completing the Common Foundation Programme Portfolio
Please make sure that you photocopy the first section of your
Portfolio and send it, plus the original section, to the University by
the date specified in the Assessment Guide. You must submit two
copies of all the forms labelled ‘Essential Information’. This will
ensure that your progression to the branch programme is not delayed
by an incomplete record. It will also avoid the unnecessary anxiety
caused by you having to supply additional information.
You are not required to submit the supporting evidence, but you
should keep this evidence in the original ring binder, as you may
want to develop some of this evidence when you move into branch,
to demonstrate your progression through the Programme. The
Portfolio forms must be attached together so they do not become
separated. We recommend that you purchase two Report Files from a
stationer and insert a set of forms into each one. These are very
inexpensive and lightweight; postage costs will therefore be lower
than if you submit your Portfolio ring binder.
Your original Essential Information section will be returned to you.
The University will keep the copy so that it can update your student
record. At the end of the programme the University will use this
information to confirm to the NMC that you are eligible to enter the
register of nurses.
In the past, there have been instances where the two copies submitted
from the Portfolio were not identical. In such cases, further
information has to be sought from the student before their record can
be completed and they become eligible for progression.
Portfolio submission checklist
The following checklist will help you ensure that the Essential
Information section of your Portfolio is complete before submission.
It is important that each form is carefully reviewed to make certain
that all details are correct. You must note that if your Portfolio is
incomplete by the submission date given in the Assessment Guide,
you must still submit it. Non-submission of your Portfolio will
result in a fail being awarded for the course and could affect your
progression through the programme.
l
Submit only the Essential Information section of your Portfolio.
l
Have you completed the Student Personal Details form?
l
Have you asked your mentor and all of your supervising
practitioners to fill out and sign a Mentor/Practice Supervisor
Details form?
l
Record of Progress
Have you achieved Level 2 in all 20 NMC outcomes? If you
had some outcomes outstanding in Discussion 3, check that
your mentor and your programme tutor have signed off the
remaining ones.
Have you checked that you, your mentor and your programme
tutor have signed and dated the Record of Progress?
3
How to complete your Portfolio
l
31
Essential Skills Clusters Record
Have you achieved Level 2 in all essential skills? If you had some
skills outstanding in Discussion 3, check that your mentor and
your programme tutor have signed off the remaining ones.
Have you checked that you, your mentor and your programme
tutor have signed and dated the Essential Skills Clusters
Record?
l
Record of Practice Hours and Experience
Have you completed a Record of Practice Hours and Experience
form for all of your practice periods?
Have you ticked all types of experience covered during this
period?
Have you ensured that the forms have been signed by you, your
mentor or practice supervisor and your programme tutor?
Has your mentor or practice supervisor completed the Summary
of Performance comment box on page 2 of the form?
Have you checked that the practice hours you have recorded add
up to the total number of 750 practice hours required by the
course?
l
Summary of Practice Hours and Experience
Have you ensured that you have recorded all types of experience
you have gained?
Does the information recorded match what you have recorded on
the Records of Practice Hours and Experience?
Has your mentor and your programme tutor completed their
comment boxes on page 2?
Have you ensured that you, your mentor and your programme
tutor have signed the form?
Have you taken a photocopy to transfer to your Branch Portfolio?
l
Ongoing Achievement Record
Have you completed the Ongoing Achievement Record for all
practice learning periods?
Have you checked that you, your mentor and your programme
tutor have signed and dated the Ongoing Achievement Record
Have you taken a copy of the Ongoing Achievement Record to
transfer to your branch Portfolio?
l
Student Self-Declaration of Good Health and Character
Have you completed and signed the Student Self-Declaration of
Good Health and Character form and included it with your
‘Essential Information’ forms?
l
Submission of Portfolio
Have you purchased ‘Report Files’ in order to submit your two
copies of the Essential Information forms securely?
If you fail to follow these points, your Portfolio will be returned to
you for completion, which could delay your progression through the
programme.
32
Guidelines for Completing the Common Foundation Programme Portfolio
References
Bondy, K.N. (1983) ‘Criterion-referenced definitions for rating scales
in clinical evaluation’, Journal of Nursing Education, vol. 22, no. 9,
pp. 376–82.
EU (1977) Clinical Instruction, 77/453/EEC, 27 June 1977, Brussels,
Office of the Official Publications of the European Community.
NMC (2004) Standards of Proficiency for Pre-Registration Nursing
Education, London, Nursing and Midwifery Council.
NMC (2007) Circular 07/2007 Introduction of Essential Skills Clusters for
Pre-Registration Nursing Programmes, London, Nursing and Midwifery
Council.
NMC (2008) The Code Standards of Conduct, Performance and Ethics for
Nurses and Midwives, London, Nursing and Midwifery Council.
Appendix 1 NMC outcomes
33
Appendix 1 NMC outcomes
The Nursing and Midwifery Council (NMC) is the statutory body
which regulates nursing, midwifery and health visiting in the four
countries of the UK. It has identified four areas of practice referred to
as domains. Within each domain, outcomes and standards of
proficiency have been identified, together with exemplars.
The outcomes must be achieved for completion of the Common
Foundation Programme and entry to the branch programme of your
choice. The standards of proficiency must be achieved by the end of
the branch programme for entry to the professional register.
Domain
Outcomes for entry to chosen
branch
Standards of proficiency for entry to
the register
1 Professional and ethical O1.1 Discuss in an informed manner P1.1 Manage oneself, one’s practice,
practice
the implications of professional
and that of others, in accordance
regulation for nursing practice
with The Code Standards of conduct,
performance and ethics for nurses and
O1.1.1 demonstrate a basic
midwives, recognising one’s own
knowledge of professional regulation
abilities and limitations
and self-regulation
P1.1.1 practise in accordance with The
O1.1.2 recognise and acknowledge
Code Standards of conduct, performance
the limitations of one’s own abilities
and ethics for nurses and midwives
O1.1.3 recognise situations that
require referral to a registered
practitioner
O1.2 Demonstrate an awareness of
The Code Standards of conduct,
performance and ethics for nurses and
midwives
O1.2.1 commit to the principle that
the primary purpose of the registered
nurse is to protect and serve society
O1.2.2 accept responsibility for one’s
own actions and decisions
O1.3 Demonstrate an awareness of,
and apply ethical principles to,
nursing practice
P1.1.2 use professional standards of
practice to self-assess performance
P1.1.3 consult with a registered nurse
when nursing care requires expertise
beyond one’s own current scope of
competence
P1.1.4 consult other health care
professionals when individual or group
needs fall outside the scope of nursing
practice
P1.1.5 identify unsafe practice and
respond appropriately to ensure a safe
outcome
P1.1.6 manage the delivery of care
services within the sphere of one’s
own accountability
O1.3.1 demonstrate respect for
patient and client confidentiality
(continued)
34
Guidelines for Completing the Common Foundation Programme Portfolio
Domain
Outcomes for entry to chosen
branch
Standards of proficiency for entry to
the register
1 (continued)
O1.3.2 identify ethical issues in
day-to-day practice
P1.2 Practise in accordance with
an ethical and legal framework
which ensures the primacy of
patient and client interest and
wellbeing and respects confidentiality
O1.4 Demonstrate an awareness
of legislation relevant to nursing
practice
O1.4.1 identify key issues in
relevant legislation relating to mental
health, children, data protection,
manual handling, and health and
safety, etc.
O1.5 Demonstrate the importance
of promoting equity in patient and
client care by contributing to
nursing care in a fair and antidiscriminatory way
O1.5.1 demonstrate fairness and
sensitivity when responding to
patients, clients and groups from
diverse circumstances
P1.2.1 demonstrate knowledge of
legislation and health and social policy
relevant to nursing practice
P1.2.2 ensure the confidentiality and
security of written and verbal
information acquired in a professional
capacity
P1.2.3 demonstrate knowledge of
contemporary ethical issues and
their impact on nursing and
health care
P1.2.4 manage the complexities arising
from ethical and legal dilemmas
P1.2.5 act appropriately when seeking
access to caring for patients and
clients in their own homes
O1.5.2 recognise the needs of
patients and clients whose lives are
affected by disability, however manifest P1.3 Practise in a fair and antidiscriminatory way, acknowledging
the differences in beliefs and cultural
practices of individuals or groups
P1.3.1 maintain, support and
acknowledge the rights of individuals
or groups in the health care setting
P1.3.2 act to ensure that the rights
of individuals and groups are not
compromised
P1.3.3 respect the values, customs
and beliefs of individuals and groups
P1.3.4 provide care which
demonstrates sensitivity to
the diversity of patients and clients
Appendix 1 NMC outcomes
35
Domain
Outcomes for entry to chosen
branch
Standards of proficiency for entry to
the register
2 Care delivery
O2.1 Discuss methods of, barriers
to and the boundaries of effective
communication and interpersonal
relationships
P2.1 Engage in, develop and
disengage from therapeutic
relationships through the use of
appropriate communication and
interpersonal skills
O2.1.1 recognise the effect of one’s
own values on interactions with
patients and clients and their carers,
families and friends
P2.1.1 utilise a range of effective and
appropriate communication and
engagement skills
O2.1.3 acknowledge the boundaries
of a professional caring relationship
P2.1.2 maintain and, where
appropriate, disengage from
professional caring relationships which
focus on meeting the patient’s or
client’s needs within professional
therapeutic boundaries
O2.2 Demonstrate sensitivity when
interacting with and providing
information to patients and clients
P2.2 Create and utilise opportunities
to promote the health and wellbeing
of patients, clients and groups
O2.3 Contribute to enhancing the
health and social wellbeing of
patients and clients by understanding
how, under the supervision of a
registered practitioner, to:
P2.2.1 consult with patients, clients
and groups to identify their need
and desire for health promotion
advice
O2.1.2 utilise appropriate
communication skills with patients
and clients
O2.3.1 contribute to the assessment
of health needs
O2.3.2 identify opportunities for
health promotion
O2.3.3 identify networks of health
and social care services
O2.4 Contribute to the
development and documentation
of nursing assessments by
participating in comprehensive
and systematic nursing assessment
of the physical, psychological, social
and spiritual needs of patients and
clients
O2.4.1 be aware of assessment
strategies to guide the collection of
data for assessing patients and clients
and use assessment tools under
guidance
P2.2.2 provide relevant and current
health information to patients, clients
and groups in a form which
facilitates their understanding and
acknowledges choice or individual
preference
P2.2.3 provide support and education
in the development and/or
maintenance of independent living
skills
P2.2.4 seek specialist or expert advice
as appropriate
P2.3 Undertake and document a
comprehensive, systematic and
accurate nursing assessment of the
physical, psychological, social and
spiritual needs of patients, clients
and communities
P2.3.1 select valid and reliable
assessment tools for the required
purpose
O2.4.2 discuss the prioritisation of
care needs
(continued)
36
Guidelines for Completing the Common Foundation Programme Portfolio
Domain
Outcomes for entry to chosen
branch
Standards of proficiency for entry to
the register
2 (continued)
O2.4.3 be aware of the need to
reassess patients and clients as to
their needs for nursing care
P2.3.2 systematically collect data
regarding the health and functional
status of individuals, clients and
communities through appropriate
interaction, observation and
measurement
O2.5 Contribute to the planning
of nursing care, involving patients
and clients and, where possible,
their carers, demonstrating an
understanding of helping patients
and clients to make informed
decisions
O2.5.1 identify care needs based
on the assessment of a patient or
client
O2.5.2 participate in the negotiation
and agreement of the care plan with
the patient or client and with their
carer
O2.5.3 inform patients and clients
about intended nursing actions,
respecting their right to participate
in decisions about their care
O2.6 Contribute to the
implementation of a programme
of nursing care, designed and
supervised by registered
practitioners
O2.6.1 undertake activities which
are consistent with the care plan
and within the limits of one’s own
abilities
O2.7 Demonstrate evidence of a
developing knowledge base which
underpins safe and effective nursing
practice
O2.7.1 access and discuss research
and other evidence in nursing and
related disciplines
O2.7.2 identify examples of the use
of evidence in planned nursing
interventions
P2.3.3 analyse and interpret data
accurately to inform nursing care and
take appropriate action
P2.4 Formulate and document a plan
of nursing care, where possible in
partnership with patients, clients,
their carers and family and friends,
within a framework of informed
consent
P2.4.1 establish priorities for care
based on individual or group needs
P2.4.2 develop and document a care
plan to achieve optimal health
P2.4.3 identify expected outcomes,
including a time frame for
achievement and/or review in
consultation with patients, clients,
their carers and family and friends
and with members of the health
and social care team
P2.5 Based on the best available
evidence, apply knowledge and an
appropriate repertoire of skills
indicative of safe nursing practice
P2.5.1 ensure that current research
findings and other evidence are
incorporated in practice
P2.5.2 identify relevant changes in
practice or new information and
disseminate it to colleagues
P2.5.3 contribute to the interventions
which support and optimise the
health and wellbeing of patients and
clients
Appendix 1 NMC outcomes
37
Domain
Outcomes for entry to chosen
branch
Standards of proficiency for entry to
the register
2 (continued)
O2.8 Demonstrate a range of
essential nursing skills, under the
supervision of a registered nurse,
to meet individuals’ needs, which
include:
P2.5.4 demonstrate the safe
application of the skills required to
meet the needs of patients and clients
within the current sphere of practice
maintaining dignity, privacy and
confidentiality; effective
communication and observational
skills, including listening and taking
physiological measurements; safety and
health, including moving and handling
and infection control; essential first
aid and emergency procedures;
administration of medicines;
emotional, physical and personal care,
including meeting the need for
comfort, nutrition and personal
hygiene
P2.5.5 identify and respond to
patients’ and clients’ continuing
learning and care needs
P2.5.6 engage with, and evaluate, the
evidence base that underpins safe
nursing practice
P2.6 Provide a rationale for the
nursing care delivered which takes
account of social, cultural, spiritual,
legal, political and economic
influences
P2.6.1 identify, collect and evaluate
information to justify the effective
O2.9 Contribute to the evaluation of utilisation of resources to achieve
the appropriateness of nursing care
planned outcomes of nursing care
delivered
P2.7 Evaluate and document the
O2.9.1 demonstrate an awareness of outcomes of nursing and other
the need to assess regularly a patient’s interventions
or client’s response to nursing
P2.7.1 collaborate with patients and
interventions
clients and, when appropriate,
additional carers to review and
O2.9.2 provide for a supervising
monitor the progress of individuals
registered practitioner,
or groups towards planned
evaluative commentary and
outcomes
information on nursing care based
on personal observations and
P2.7.2 analyse and revise expected
actions
outcomes, nursing interventions
and priorities in accordance with
O2.9.3 Contribute to the
changes in the individual’s condition,
documentation of the outcomes of
needs or circumstances
nursing interventions
O2.10 Recognise situations in which
agreed plans of nursing care no
longer appear appropriate and refer
these to an appropriate accountable
practitioner
P2.8 Demonstrate sound clinical
judgement across a range of differing
professional and care delivery
contexts
O2.10.1 demonstrate the ability to
discuss and accept care decisions
P2.8.1 use evidence-based knowledge
from nursing and related disciplines to
select and individualise nursing
interventions
O2.10.2 accurately record
observations made and communicate
these to the relevant members of the
health and social care team
P2.8.2 demonstrate the ability to
transfer skills and knowledge to a
variety of circumstances and settings
(continued)
38
Domain
Guidelines for Completing the Common Foundation Programme Portfolio
Outcomes for entry to chosen
branch
2 (continued)
Standards of proficiency for entry to
the register
P2.8.3 recognise the need for
adaptation and adapt nursing practice
to meet varying and unpredictable
circumstances
P2.8.4 ensure that practice does not
compromise the nurse’s duty of care
to individuals or the safety of the
public
3 Care management
O3.1 Contribute to the identification
of actual and potential risks to
patients, clients and their carers, to
oneself and to others and participate
in measures to promote and ensure
health and safety
O3.1.1 understand and implement
health and safety principles and
policies
P3.1 Contribute to public protection
by creating and maintaining a safe
environment of care through the use
of quality assurance and risk
management strategies
P3.1.1 apply relevant principles to
ensure the safe administration of
therapeutic substances
P3.1.2 use appropriate risk assessment
O3.1.2 recognise and report situations tools to identify actual and potential
risks
which are potentially unsafe for
patients, clients, oneself and others
P3.1.3 identify environmental hazards
and
eliminate and/or prevent where
O3.2 Demonstrate an understanding
possible
of the role of others by participating
in interprofessional working practice
P3.1.4 communicate safety concerns
O3.2.1 identify the roles of the
members of the health and social
care team
O3.2.2 work within the health and
social care team to maintain and
enhance integrated care
O3.3 Demonstrate literacy,
numeracy and computer skills
needed to record, enter, store,
retrieve and organise data essential
for care delivery
to a relevant authority
P3.1.5 manage risk to provide care
which best meets the needs and
interests of patients, clients and the
public
P3.2 Demonstrate knowledge of
effective interprofessional
working practices which respect
and utilise the contributions of
members of the health and social
care team
P3.2.1 establish and maintain
collaborative working relationships
with members of the health and social
care team and others
P3.2.2 participate with members of
the health and social care team in
decision making concerning patients
and clients
P3.2.3 review and evaluate care with
members of the health and social care
team and others
Appendix 1 NMC outcomes
Domain
39
Outcomes for entry to chosen
branch
3 (continued)
Standards of proficiency for entry to
the register
P3.3 Delegate duties to others, as
appropriate, ensuring that they are
supervised and monitored
P3.3.1 take into account the role and
competence of staff when delegating
work
P3.3.2 maintain one’s own
accountability and responsibility when
delegating aspects of care to others
P3.3.3 demonstrate the ability to
coordinate the delivery of nursing and
health care
P3.4 Demonstrate key skills
P3.4.1 literacy – interpret and present
information in a comprehensible
manner
P3.4.2 numeracy – accurately interpret
numerical data and their significance
for the safe delivery of care
P3.4.3 information technology
and management – interpret and
utilise data and technology, taking
account of legal, ethical and safety
considerations, in the delivery and
enhancement of care
P3.4.4 problem solving – demonstrate
sound clinical decision making which
can be justified even when made on
the basis of limited information
4 Personal and
professional
development
O4.1 Demonstrate responsibility for
one’s own learning through the
development of a portfolio of
practice and recognise when further
learning is required
O4.1.1 identify specific learning needs
and objectives
O4.1.2 begin to engage with, and
interpret, the evidence base which
underpins nursing practice
O4.2 Acknowledge the importance
of seeking supervision to develop
safe nursing practice
P4.1 Demonstrate a commitment to
the need for continuing professional
development and personal
supervision activities in order to
enhance knowledge, skills, values and
attitudes needed for safe and
effective nursing practice
P4.1.1 identify one’s own professional
development needs by engaging in
activities such as reflection in, and on,
practice and lifelong learning
P4.1.2 develop a personal
development plan which takes into
account personal, professional and
organisational needs
(continued)
40
Domain
4 (continued)
Guidelines for Completing the Common Foundation Programme Portfolio
Outcomes for entry to chosen
branch
Standards of proficiency for entry to
the register
P4.1.3 share experiences with
colleagues and patients and clients in
order to identify the additional
knowledge and skills needed to
manage unfamiliar or professionally
challenging situations
P4.1.4 take action to meet any
identified knowledge and skills deficit
likely to affect the delivery of care
within the current sphere of practice
P4.2 Enhance the professional
development and safe practice of
others through peer support,
leadership, supervision and
teaching
P4.2.1 contribute to creating a climate
conducive to learning
P4.2.2 contribute to the learning
experiences and development of
others by facilitating the mutual
sharing of knowledge and experience
P4.2.3 demonstrate effective
leadership in the establishment and
maintenance of safe nursing practice
(NMC, 2004, pp. 26–34)
Appendix 2 Example of evidence written by a student based on a unit activity (UA)
41
Appendix 2 Example of
evidence written by a student
based on a unit activity (UA)
The unit activity asked students to find out about their local manual
handling policy and how it is put into practice in their workplace.
Here is an example of the completed activity that a student
submitted in her Portfolio as evidence for NMC O.2.4, O.2.5, O.2.7
and O3.1, followed by some comments.
To find out about the local policy I contacted the back care
adviser in the Trust, who confirmed that the Trust has a minimal
handling policy. However, she stressed the importance of wards
having the correct equipment and knowing when and how to use it
properly. She said that carrying out assessments using the Trust’s
moving and handling documentation is really essential, and this is an
area a lot of wards need to improve on as a good assessment
should lead on to the correct techniques and equipment being
used for patients, and good communication between the team
members.
Thinking about the ward I am working on, I have noticed that
moving and handling assessment documentation is not filled in for
all patients. We have a moving and handling link nurse on my
ward and I talked to her about this. She said that she has been
talking to other members of the team about how we can improve
our moving and handling assessment documentation. She is going to
bring it up at the next ward meeting. She said that the assessment
documentation forms have been in place for about a year now.
We looked at one of the forms together and completed it for a
patient who was admitted last night and had not yet had a moving
and handling assessment carried out. I feel the form is quite
straightforward to follow and it did not take too long to complete,
especially as I had been looking after her this morning so I knew
her capabilities. We documented that a slide should be used to help
her move up the bed. She is able to transfer from bed to chair or
chair to bed with one person assisting. In the ward, as well as
slides, we have an electronic hoist and all staff seem confident with
using it. I have met a few patients who are scared of the hoist but
we always start off by finding out if they’ve been in the hoist
before and talking to them about it, and reassuring them about its
safety. If their families are around we always explain about using the
hoist to them too.
42
Guidelines for Completing the Common Foundation Programme Portfolio
Comments
The above account would be strengthened by attaching an
anonymous copy of the completed moving and handling assessment
form and by asking the moving and handling link nurse to verify the
assessment form and this account by signing and dating it. The
account would be strengthened further by making links to the
relevant evidence base on moving and handling practice.
Appendix 3 Example of testimony written by a practice supervisor (T)
43
Appendix 3 Example of
testimony written by a practice
supervisor (T)
Observation record
On Friday 9th September 2005 I observed student nurse O’Brien
provide one-to-one care (special) for a client who was at risk of self
harm. Nurse O’Brien was under my direct supervision for the
duration of the shift.
During this time Nurse O’Brien communicated appropriately with the
client. She addressed the client by her preferred name at all times.
She demonstrated skills of listening when the client was telling her of
her frustration at ‘being followed’ (one-to-one care). Nurse O’Brien
explained clearly the reason for this care, and when the client started
shouting she remained calm, and in an assertive but non-threatening
tone asked the client to stop. She allowed the client to vent her
frustration, recognising the importance of silence and the limitations
of trying to engage the client in a conversation at this time. She
refused to be drawn into the client’s tirade of abuse against ‘all the
staff’. Once the client had finished expressing her frustration she
encouraged her to sit down and watch television, explaining that she,
as her ‘special’, could then sit with the client less obtrusively,
concurring with the preference the client had stated. Once the client
was settled she engaged her in a conversation about the television
programme.
Nurse O’Brien discussed the incident with me at the end of the shift,
showing insight into the client’s perception of one-to-one care, but
also recognising that her paramount duty of care was to maintain her
client’s safety, even though this might be in opposition to the client’s
wishes. She used evidence from the KYN107 course materials on
communication strategies to underpin her practice, and undertook a
web search using the phrases ‘communication skills’, ‘de-escalation’
and ‘anger management’.
NAME: JANE BROWN
POSITION: STAFF NURSE
SIGNATURE:
J. Brown
DATE: 9/9/05
Comments
This evidence would be strengthened by providing evidence of the
web search results in the Portfolio.
This evidence could be used to support NMC O1.2, O2.1, O2.2 and
O3.1.
44
Guidelines for Completing the Common Foundation Programme Portfolio
Appendix 4 Peer testimony of
student practice learning
The Pre-Registration Nursing Programme is a work-based learning
programme offered in partnership with health care providers.
Students are employees of our partners and have differing degrees of
experience within these settings. This diversity of workplace settings
and experience enriches the programme and enhances the
opportunities for shared learning. Students can and do take
advantage of these opportunities in order to broaden their experience.
In order to ensure that students who are experienced practitioners in
their own practice area do not have this expertise devalued, and to
maintain probity for the programme, the following guidance is
provided.
It is acceptable for experienced practitioners, who may also be
students on the Pre-Registration Nursing Programme, when working
within their own practice area to provide witness statements for
students who may be participating in complementary or contrasting
practice experience within this practice setting. Such statements from
peers are acceptable as forms of testimony and can contribute to the
student’s evidence base of practice-based learning. Experienced
practitioners who are fellow students on the programme cannot act as
assessors.
The verification of practice hours/experience/achievement of
outcomes/standards of proficiency should be undertaken only by
qualified practitioners who have been assigned as mentor or associate
mentor for the student. Fellow students, however experienced within
their own practice setting, cannot be assigned as mentor or associate
mentor to other students on the programme.
At no time during practice learning is it appropriate for members of a
student’s own family or someone who is known personally to them
to act as their mentor or associate mentor. If such circumstances
should arise, the advice and guidance of the programme tutor should
be sought.
Appendix 5 Example of a summary account written by a student (SA)
45
Appendix 5 Example of a
summary account written by a
student (SA)
Assisting a patient to eat
During my spell of duty on 23/8/05 I was caring for a patient who
had senile dementia and who was no longer eating enough. Staff
nurse asked me to supervise and assist Mrs X to eat her dinner,
ensuring she maintained an adequate food and fluid intake.
Mrs X was often agitated and frequently left her meals only half
eaten when left to eat alone. I sat with her, encouraging her to eat her
meal by reminding her that her meal was on the table in front of her.
I asked her about things from her past, where she liked to eat and
what her favourite foods were. When she seemed confused about
how to eat I helped and encouraged her. It was clear that when able
to talk of what seemed familiar in terms of events and foods she ate
more readily and seemed to be less agitated.
Her conversations mentioned food she had enjoyed in her youth such
as fresh fruit. I was able to record these foods in her care plan so that
when her future menus were completed she could have food she
liked for her meals.
I was able to encourage her to drink fluids with her meal and found out
that she disliked milk of any sort. This may account for her reluctance
to drink fluids. This information was also added to her care plan.
This experience highlighted that just asking Mrs X what foods she
liked or disliked on admission was not sufficient to give us the
information. The context of eating and drinking made her talk about
these things, and she was able to give more personal and relevant
information. Asking her the questions out of context had not elicited
the same responses.
This also highlighted to me the importance of talking to people and
listening to what they say. I was able to make appropriate changes to
her care plan.
Staff nurse suggested that the dietician should be contacted to visit
Mrs X so that a diet relevant to Mrs X’s needs and likes could be
incorporated into her care package. I undertook responsibility for this.
Comments
This item of evidence would be further strengthened by asking the
practice supervisor to read, verify and date the account or even write
a short testimony or add comments to it. The outcome of the
dietician’s involvement could be included as a later piece of evidence,
and evidence identifying the importance of healthy diet in people
with long-term conditions would further enhance this example.
This evidence could be used to support NMC O2.3, O2.4, O2.5, O2.6,
O2.10 and O4.1.
Printed in the United Kingdom