date issued planned review pgn no: jul 2018 july 2021 pp -pgn …… · registered nurse and...

Multi-Professional Preceptorship Policy, Practice Guidance Note

1st level Registered Nurse and Nursing Associate Preceptorship Guidance – V02

Date Issued Planned Review PGN No:

Issue 1 –Jul 2018

Issue 2 – Feb 19

Issue 3 – Oct 19

July 2021 PP-PGN-01 – part of

CNTW(C)22-Preceptorship Policy

Author/Designation Lindsay Spencer, Community Matron

Responsible Officer / Designation

Executive Director of Nursing and Chief Operating Officer

Contents

Section Description Page No

1 Introduction 2

2 Preceptorship 2

3 Responsibilities of the Preceptee, Preceptor, Managers, Clinical Manager/ Community Modern Matron

3

4 Competency Assessment Forms 7

5 Assessment of Competency including Medicine Management 8

6 Support in Practice 9

7 Monitoring Process 9

8 Revalidation 10

Appendix 11

Cumbria Northumberland, Tyne and Wear NHS Foundation Trust PP-PGN-01 In-Patient Registered Nurse (PCF) – V02-Iss3-Oct 19 Part of CNTW(C)22 – Multi-Professional Preceptorship Policy

Registered Nurse and Nursing Associate

Preceptorship Guidance Document

CNTW (C) 22 Multi Professional Preceptorship Policy

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2 Cumbria Northumberland Tyne and Wear NHS Foundation Trust PPT-PGN-01 – Registered Nurse Preceptorship Guidance V02- Iss 3-Oct 19 Part of CNTW(C)22 – Multi-Professional Preceptorship

1 Introduction

1.1 Cumbria Northumberland, Tyne and Wear NHS Foundation Trust (the Trust/CNTW)

is committed to the development of all staff in order to ensure individuals have the necessary skills required to deliver a high quality service to patients/service users in its care. The Trust has developed this Guidance Document as per of the Preceptorship Policy CNTW(C)22, in order to support and guide the newly qualified nurse/Nursing Associate during the first six months in practice and to begin the process of professional development and life-long learning.

1.2 The Policy and Guidance applies to nurses and Nursing Associates recruited from the university cohorts and will be adapted for Registered Nurses/ Nursing Associates new to CNTW and those completing following ‘Return to Nursing’ courses. In such cases the length of the programme will be negotiated taking into account the individual needs of the nurse/ Nursing Associate.

1.3 Any local induction and specific training required for the clinical speciality will be additional to this process.

2 Preceptorship

2.1 From the moment of registration, practitioners are autonomous and accountable. The

Nursing and Midwifery Council (NMC) defines preceptorship as:

‘A period of time to guide and support all newly qualified practitioners to make the transition from student to develop their practice further’

Taken from a number of definitions, preceptorship is summarised in the Department of Health Preceptorship Framework 2010 as:

‘ A period of structured transition for the newly registered practitioner during which he or she will be supported by a preceptor to develop their confidence as an autonomous professional, refine skills, values and behaviours to continue on their journey of life–long learning’

2.2 Preceptorship will normally be undertaken in a clinical area consistent with the registrant’s pre- registration education (Mental Health, Learning Disabilities or Adult Nursing) in order to consolidate skills.

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3. Responsibilities 3.1 Preceptee

Practice in accordance with your Professional Code

Practice in accordance with your job description and operating procedures and protocols

Adhere to all Trust policies and procedures

Meet with your preceptor as soon as possible after you have taken up post

Ensure that you understand the CNTW Competency Document

Work collaboratively with your preceptor to identify, plan and achieve your learning needs

Prepare for your tripartite meetings

Prepare for clinical supervision sessions

Attend any training deemed appropriate

Provide evidence to demonstrate your competence

Be open and willing to discuss any limitations or problems you may have; accept constructive criticism and where required work with your preceptor to develop further action plans

Attend peer support / reflective practice days

You will

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3.2 Preceptor

-

Be an experienced Registered Nurse and qualified mentor

Meet with you on a regular basis to evaluate your progress towards fulfilling the objectives set and attend tripartite meetings

Ensure you have access to clinical supervision

Provide positive feedback on those aspects of your performance that are being undertaken well

Commit time and provide constructive feedback

Where there is a requirement for further development or cause for concern is identified, they will assist you to develop a plan of action to remedy these.

Encourage your participation in peer support days

Your Preceptor will

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3.3 Managers

Identify an appropriate Preceptor

Implement local induction

Ensure you have an appraisal in line with CNTW (HR) 09 Staff Appraisal Policy

Ensure the clinical area provides a high quality learning environment

Ensure you are provided with clinical supervision

Have an awareness of any issues and seek to problem solve.

Support your attendance at peer support days

3.4 Clinical Manager / Community Modern Matron

Your Manager will

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Your Clinical Manager or Community Modern Matron will

Ensure the clinical area provides a high quality-learning environment

Be an active participant within all tripartite meetings

Monitor your progress towards competencies

Ensure action plans are developed and implemented with the appropriate level of support

Address issues as they arise from both the preceptee and preceptor

Maintain an up to date account of all preceptees within the service.

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4 The Competency Document and Evidence Portfolio

4.1 It is important that as you progress through preceptorship, you collect evidence that demonstrates practice and professional development in line with the defined competencies.

4.2 The Competency Document is intended to guide you to identify and your competence development. It reflects core practice areas in line with the Nursing Strategy, NMC Code, and your job description. In collaboration with your preceptor you should initially establish your current level of functioning and plan how you will achieve the remaining competencies

4.3 The Evidence Portfolio provides assurance that you can deliver on a practical level as well as understand the theoretical rationale for the delivery of care.

You will build up your evidence collection as you achieve your competencies.

You must ensure that you clearly link the evidence to the appropriate indicator

Examples of and criteria for evidence are listed in the appendix of this document.

Where evidence relates to 6cs, NMC Code, CNTW Nursing Strategy or Trust Values (see appendix), this should be identified on the relevant piece of evidence.

Please note in developing evidence confidentiality must be maintained.

5. Assessment of Competence

5.1 Your preceptor is required to assess your competence against the core practice areas and the indicators in the competency framework. This is not a “one off” assessment, rather as you progress, your mentor will work with you to monitor your progress and identify any areas in which you need to develop. They will assess your ability against the indicators to;

consistently apply knowledge and skills in practice

consistently display appropriate behaviours and judgements in practice

practice in a safe and confident manner

Further guidance on competence is contained in the appendix of this document Through discussion with your preceptor, your will review your progress when it is agreed that you can evidence competency (see below), the indicator can be dated as completed. Your preceptor will sign the summary sheet when you have achieved the competencies for each Practice Area

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5.2 Medicine Management Competency

Preceptees are required to completed Medicine Management competencies during their period of preceptorship (and three yearly thereafter). The Medicine Management competencies are located on the trust intranet under Policies>Medicine Management (CNTW C 17) > Medicine Management Competency documentation They comprise as follows

MMComp1 Management and Administration of Medication

MMComp2 Safe and Secure Medicines Handling and Supply

MMComp3 Management and Administration of Depot and Injectable Medication

MMComp4 Management and Administration of Anti-Coagulation Medication

MMComp5 Administration of oxygen

MMComp6 Management and Administration of medication and Enteral Feeds via PEG Tubes

Associated Document MMCompGuide Assessors Guidance for the Management and Administration of Medication Medicines Management Competencies 1-3 are relevant to all Registered Nurses

and Nursing Associates working in a clinical setting. Medicines Management Competencies 4-6 are relevant to all Registered Nurses

and Nursing Associates working in a clinical setting where these procedures are used Successful completion of the Medication Competencies demonstrates that preceptees have the necessary skills and knowledge to practise. Assessment is through a combination of verbal discussion and/or observation

6. Support in Practice 6.1 During your six month preceptorship period you will be supported by your preceptor

and manager in the Tripartite Reviews (see below). Your preceptor will provide, or ensure you have access to, clinical supervision. You will have an appraisal in the first three months.

You will be invited to attend peer support/reflective practice days on a bi-monthly basis. These sessions offer you an opportunity to share your experience and reflect on your practice in a safe environment supported by experienced senior nurses.

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7. Monitoring Process 7.1 Tripartite meetings

Tripartite Meetings should involve the preceptee, the preceptor or Ward / Team Manager and the Clinical Nurse Manager/Community Matron. In usual circumstances as a minimum, these meetings should be held at the outset of the preceptorship and then every two months. However, additional tripartite meetings may be convened at the request of either party.

7.2 Initial Tripartite Meeting At the initial meeting the preceptee should be in receipt of

Preceptorship Guidance

Competency Framework

Reflective Account form

Action Plan

Participants should;

Establish current level of functioning and prior learning

Talk through the competency document

Agree how the evidence file will be compiled

Agree how medication competencies will be achieved (for Nursing Associates, this will include agreeing how the competencies relate to the specific clinical area)

Agree support needed

Address any concerns

Identify training requirements

Complete the “Record of Discussion”

Following the meeting, in clinical practice, the preceptor and preceptee will utilise the Competency Document to identify learning and development objectives and record competency achievement.

7.3 Two Month Review

In accordance with the Trust’s policy, CNTW (HR) 09 – Staff Appraisal Policy, all new staff will receive a Development Review meeting with their manager within first month of their arrival. Preceptees will have an additional review at two months. The purpose of the 2 month review is to ensure that the preceptee is successfully working toward achieving their competencies, in order that they will satisfy achievement at the 6 month point. Participants should;

Highlight competency achievement including medication competencies

Agree support needed

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Commence an action plan if required



Following the meeting, in clinical practice, the preceptor and preceptee will continue to utilise the Competency Document to identify learning and development objectives and record competency achievement.

7.4 Four Month Review

The purpose of the 4 month review is to ensure that the preceptee is on target to achieve all required competencies. Participants should;

Highlight competency achievement including medication competencies


Review the action plan and add further actions if required


Consider implementation of the Performance Policy (CNTW (HR) 13 In the event of significant underachievement.


Following the meeting, in clinical practice, the preceptor and preceptee will continue to utilise the Competency Document to identify learning and development objectives and record competency achievement.

7.5 Six Month Review

This is the final Tripartite Meeting when it is expected that all competencies should be achieved and evidenced. Participants should;

Review and sign off competency achievement. Preceptors will give feedback on the preceptees performance ( NMC Feedback Form)

Hold a review in line with the Trust Performance Policy in the event that the preceptee has not provided sufficient evidence and cannot demonstrate that they have met the competency level. There may be extenuating circumstances, which would be considered on an individual basis.

Complete the “Record of Discussion” 8. Revalidation

Revalidation will require every nurse and midwife and Nursing Associate to confirm 3 yearly that they:

Continue to remain fit to practise by meeting the principles of the revised Code

Have completed the required hours of practice and learning activity through continuing professional development (CPD)

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Have used feedback to review and improve the way they work

Have received confirmation from someone well placed to comment on their continuing fitness to practise

NMC 2014

Appendix

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Five Rules of Evidence The requirements

1. Valid/Relevant – does it meet the requirements of the Competency Document? Relevant to any training and development needs that have been jointly identified.

2. Sufficient – there must be enough evidence to match work against the competency

statements. Generally speaking, one piece of evidence is required for each statement, although the same piece of evidence can be used for more than one indicator.

3. Current – is it up-to-date? Evidence must be provided that knowledge and skills are

being currently and consistently demonstrated and used. 4. Reliable – is it appropriate and reflect the standards. Evidence must relate to the

competency statements.

5. Authentic - can the evidence be attributed to the individual?

EXAMPLES OF EVIDENCE

Research article

Reflective diary

Statement by others

Record of training

Example of reports, care plans developed by the nurse

Policy

Ward guidelines

Risk assessments

Record of attendance at meetings

COMPETENCE AND COMPETENCY

Competence is made up of four inter linked components;

Knowledge: you must first acquire the knowledge to know how to do your work and why you do it

Skills : you must learn the skills required for your role

Behaviour : you must demonstrate the behaviour that is required to effectively manage every situation you will encounter

Judgement : you must finally develop and use your judgement to appropriately address situations

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Competency can be defined as the application and demonstration of appropriate knowledge, skill, behaviour and judgement in a practice setting. It can’t be attained simply by attending a course and you can’t measure it simply by passing a test; it can only be confirmed when Knowledge and skills are consistently applied in practice

Nursing Strategy

Strategic Aim 1 Call to Action: Helping people to stay independent, maximising well-being and improving health outcomes

Strategic Aim 2 Call To Action: Working with people to provide a positive experience of care

Strategic Aim 3 Call to Action : Delivering high quality care and measuring the impact of care

Develop your skills as a health promoting practitioner making every contact count

Recognise rights and aspirations of patients; service users; carers and their families

Use measures of care to help you learn improve and highlight the positive impact on the people you care for

Ensure you use clear principles of recovery /living well in all interventions; working within broad agreed care pathways

Embed the 6C’s in your daily practice and use these to evaluate the standards of care and support received

Develop knowledge and skills to interpret data and research findings

Build meaningful relationships increasing time spent with patients and service users by utilising appropriate technology

Listen to; seek out and act on patient , carer feedback ensuring the patient and carer voice is heard

Commit to supporting the development of a culture of continuous improvement

Reduce the impact of health inequalities for people with a learning disability

Promote the NMC Code; Standards of Conduct , Performance and Ethics for Nurses in all aspects of your practice

Ensure you and your team use evidence and information available to continually improve the standard of care delivered every day

Maximise your contribution to the dementia challenge

Strategic Aim 4 Call to Action : Building and strengthening Leadership

Strategic Aim 5 Call to Action: Ensuring we have the right staff, with the right values and skills, in the right place

Strategic Aim 6 Call to Action : Supporting positive staff experience

Put yourself in patients shoes and ensure your actions are always in their best interest

Ensure each patient is allocated and introduced to a named key nurse responsible for coordinating care

Engage fully in the appraisal system taking joint responsibility for a positive personal development plan

Include examples of how you have delivered the 6C’s in appraisals with your line manager

Incorporate values and behaviours of Compassion in Practice into recruitment and appraisals

Engage in clinical supervision and where appropriate skills based supervision

Act as a role model at all times setting and maintaining high standards of care and treatment

Provide ongoing evidence of fitness to practice for periodic revalidation with the NMC

Personally be responsible for applying the 6 C’s every day in your work in line with statutory duty of candour

Utilise available staff effectively within the team to maximise delivery of 6 C’s

Deploy staff effectively and efficiently identify the impact this has on quality of care and experience of people in our care

Acknowledge your own lived experience of using health care services : creating a culture where your experience is valued

Raise concerns and challenge practice if it is not contributing to wards delivery of compassionate care

Collect, share and further review evidence based good practice

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Trust Values

Caring and Compassionate Respectful Honest and Transparent

Put yourself in other peoples shoes

Listen and offer hope

Focus on recovery

Be approachable

Be sensitive and considerate

Be helpful

Go the extra mile

Value the skill and contribution of others

Give respect to all people

Respect and embrace difference

Encourage innovation and be open to new ideas

Work together and value our partners

Have no secrets

Be open and truthful

Accept what is wrong and strive to put it right

Share information

Be accountable for our actions

Embedding the 6 Cs

6 Cs

CARE

COMPASSION

COMPETENCE

Delivering high quality care is what we do. People receiving care expect it to be right for them consistently throughout every stage of their life.

Compassion is how care is given, through relationships based on empathy, kindness, respect and dignity.

Competence means we have the knowledge and skills to do the job and the capability to deliver the highest standards of care based on research and evidence.

COMMUNICATION

COURAGE

COMMITMENT

Good communication involves better listening and shared decision making – ‘no decision about without me’

Courage enables us to do the right thing for the people we care for, be bold when we have good ideas, and to speak up when things are wrong.

Commitment will make our vision for the person receiving care, our professions and our teams happen. We commit to take action to achieve this.

7th C – CANDOUR

Staff and employers to speak out when mistakes are made and which could have a negative effect on patients.

date issued planned review pgn no: jul 2018 july 2021 pp -pgn …… · registered nurse and...

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