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Hong KongCollege of Surgical Nursing

Surgical Nursing Training: Part B Specialty – Breast Care Nursing

Clinical Log Book

Name of Mentee :

TABLE OF CONTENTS

No. Content Page 1. Particulars of Mentor and Mentee Training Period 3

2. Selection of Elective Specialty 4

3. Introduction 5

4. Aims 5

5. Learning Objectives 5

6. Advanced Practice Level in Breast Care Nursing 8

7. Practice Environment (Training Site) – Breast Ward and Clinic

8

8. Eligibility of Candidate to Enter Training in Breast Care Nursing as Mentee

8

9. Guideline for Clinical Assessment 8

9.1 Domain & Skill-based Competence 9

9.2 Key Domains of Competency Framework for Advanced Practice Nurse

10

9.3 Clinical Logbook 10

9.4 Mentors 10

10. Level of Competence Assessment 11

11. Generic Core Log 13

12. Mandatory Specialty Log 15

13. Elective Specialty Log 26

14. Advanced Specialty Case Log 46

15. Personal Contribution Record 47

16. Assessment 48

17. Final Verification 48

18. Evaluation 49

19. Appendix 1: Advanced Specialty Case Log Sheet 51

Appendix 2: Summary of Competence Practice 52

Appendix 3: Assessment Form for Surgical Nursing Training 53

2

1. PARTICULARS OF MENTOR AND MENTEE TRAINING PERIOD

Name of Mentee:

Rank: __________ HKCSN Associate Membership No.:

No. Training Site Period of Training

1 Clinical Department: General / Specialty: ________ Ward: Hospital: _______________

From: To:

Name of Mentor: __________________________

Fellowship No.: ____________________________

2 Clinical Department: General / Specialty: Ward: Hospital: _______________

From: To:

Name of Mentor: ____________________________

Fellowship No.: _____________________________

3 Clinical Department: General / Specialty: Ward: Hospital: _______________

From: To:

Name of Mentor: ____________________________

Fellowship No.: _____________________________

4 Clinical Department: General / Specialty: Ward: Hospital: ______________

From: To:

Name of Mentor: ____________________________

Fellowship No.: _____________________________

5 Clinical Department: General / Specialty: Ward: Hospital: ______________

From: To:

Name of Mentor: ____________________________

Fellowship No.: _____________________________

2. SELECTION OF ELECTIVE SPECIALTYMentees are required to attain the Advanced Surgical Practice in the Generic Core. Mentees should select Breast Care Nursing as the mandatory specialty and TWO other specialties from the Elective Specialty as stated below.

* Generic Core Mandatory SpecialtyElective Specialty

Select any of 2^ out of 12- Advanced Health

Assessment- Advanced Clinical

Intervention & Case Management

- Advanced physiology, psychology, sociology and pathophysiology,

- Evidence-based Practice

- Advanced Pharmacology & Therapeutics Drugs management

- Clinical Leadership- Team Collaboration &

Communication

- Breast Care - Burn & Plastic Care- Cardiothoracic Care- Ear Nose & Throat Care / Head & Neck Care- Gastrointestinal Care /

Colorectal Care- Gynaecological Care- Hepatobiliary and

Pancreatic Care- Neurosurgical Care- Ophthalmological Care- Organ Donation- Stoma and Wound Care

/ Enterostomal Therapy Care

- Urological Care- Vascular Care

*Generic Core is mandatory to be signed by Mentor.

Please select Breast Care Nursing as the mandatory specialty and TWO other specialties from the following Elective Specialty for your Log by indicating with a tick () in the boxes provided.

Elective Specialty Burn & Plastic Care Cardiothoracic Care Ear Nose & Throat

Care / Head & Neck Care

Gastrointestinal Care / Colorectal Care

Gynaecological Care Hepatobiliary and Pancreatic Care

Neurosurgical Care Ophthalmological Care Organ Donation

Stoma and Wound Care / Enterostomal TherapyCare

Urological Care Vascular Care

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3. INTRODUCTIONThis is a Surgical Nursing Training: Part B Mentee Log Book providing opportunities for Breast Care Nurses. Nurses at the advanced practice level qualified as an Ordinary Member of the Hong Kong College of Surgical Nursing (HKCSN), he/she should be able to demonstrate clinical expertise, to equip and benchmark the clinical updated knowledge, analytical skills and critical thinking in providing holistic quality client care. He/she should adopt in-depth knowledge and build on research evidence to make clinical judgment and autonomous decision making. The practice development is mainly through observation and guided practice in caring patient with breast problems which enhance the competency of nurses working in Breast Units and maintain a high standard of care in breast care nursing.

4. AIMS4.1 To fulfill the requirement of College in attaining the qualification of Ordinary

Membership in HKCSN.4.2 To develop the competence of registered nurses in breast care nursing in order

to ensure a high standard of specialized care for breast clients4.3 To provide interactive learning experience that will encourage nurses to develop

the skills of analysis and critical awareness in order to stimulate an inquiry approach to both the theory and practice of breast care nursing

4.4 To develop the nurses’ awareness of relevant evidence-based findings and facilitate integration of these findings into breast care nursing practice

5. LEARNING OBJECTIVESAfter completion of the training, the breast care nurse should be able to:

5.1 Knowledge and application 5.1.1 Obtain and apply the contemporary knowledge and advanced practice

in Breast Care Nursing with complex, acute, critical problem and chronic breast health conditions in different care settings

5.1.2 Perform comprehensive breast assessment, physical assessment and health history taking

5.1.3 Facilitate the choice of operation or treatment to patients

5.1.4 Able to understand the new trend of treatment modality, operation technique and most update on knowledge of diseases

5.1.5 Knowledge on adjuvant treatment related to breast cancer

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5.2 Therapeutic n ursing intervention

5.2.1 Able to implement individualized care and evaluate the therapeutic nursing intervention

5.2.2 Able to perform pre, peri and post-operative care to patient

5.2.3 Able to identify post-operative complications and apply immediate care accordingly

5.2.4 Able to perform post-operative nursing management with holistic care, to maintain physical and psychological, social and spiritual wellness

5.2.5 Able to understand the current used medication for breast cancer patients and can recognized the pharmacodynamics, pharmacokinetic processes and possible complications of the medication used for individualized patient

5.2.6 Manage altered body image and sexuality concern

5.2.7 Able to manage the complications related to adjuvant treatment

5.2.8 Pain management to post op wound and palliative pain

5.2.9 Skill on wound management: benign breast wound, post-op wound, wound complication and malignant fungating wound

5.3 Diagnosis and investigation

5.3.1 Understand the rationale on breast problem diagnosis and investigation

5.4 Therapeutic relationship 5.4.1 Enhance therapeutic nurse-client relationship when patient is newly

diagnosed with breast problem

5.4.2 Analyze the family or social relationship to identify factors that influence the psychological health of patient in relation with his / her disease

5.5 Care Management

5.5.1 Able to interpret the radiology and pathology results and the rationale of related treatment modality

5.5.2 Able to perform breast patient advocacy to illustrate patients’ need to the professional health team

5.5.3 Participate in ethical decision making and practice

5.5.4 Utilizes appropriate educational strategies, approaches and materials to enable the patient and family to make informed decisions on treatment, investigation and follow up care

5.5.5 Able to respond to the rapidly changing clinical conditions, including the recognition and management of emerging crises

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5.5.6 Able to manage the complex health condition of breast cancer patients at different complex health condition and able to apply critical thinking to the clinical situation and apply skill with onsite professional judgment and discuss with patient for the planned care

5.5.7 Able to follow the department protocol to the treatment of disease and communicate the follow up with patient

5.5.8 Collaborate with patient and relatives or significant others in treatment planning and decision making

5.5.9 Able to apply critical thinking and work independently to face different breast conditions

5.6 Multi-disciplinary Teamwork

5.6.1 Collaborate with other members of the health care team

5.6.2 Able to negotiate with the multi-disciplinary team for service development

5.6.3 Consult with or refer to other members of the health care team

5.7 Patient education , health promotion, survivorship and community contribution

5.7.1 Gain knowledge on breast screening and able to give education on breast awareness

5.7.2 Educate patient and relatives or significant others concerning the demands of treatment of disease, treatment modalities, the possible psycho-social impact of disease onto patient and the responsibility for self-care

5.7.3 Participate in the survivorship service, including support group and community talk

5.8 Ethical / evidence - based practice

5.8.1 Incorporate evidence-based practice and research into treatment modalities

5.8.2 Initiate and lead quality improvement strategies and measures, research and evidence-based practice

5.9 People and service development

5.9.1 Provide anticipatory guidance and health promotion in the professional and community context

5.9.2 Develop standards, pathways and protocols

5.9.3 Contribute to the development of nursing care delivery system in advance

5.9.4 Serve as a role model and preceptor / mentor to colleagues and juniors

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6. ADVANCED PRACTICE LEVEL IN BREAST CARE NURSINGBreast care nurse at the advanced practice level is qualified as an Ordinary Member of HKCSN who has achieved education of master level and he/she should be able to demonstrate clinical expertise in relation to assessment, diagnosis, management and evaluation in the care of breast patients and their families. Breast care nurse should possess the competencies reflecting his/her ability to adopt comprehensive, specialized, factual and theoretical in-depth knowledge build on research evidence to make clinical judgment with autonomous decision making. He/she should attain high level of analytical skills and critical thinking in providing holistic care to the breast patients and their families and involve in decision making process with multidisciplinary health care team.

7. PRACTICE ENVIRONMENT (TRAINING SITE) – BREAST WARD AND CLINICThe Advanced Practice Nurse in Breast Care Nursing works with the families and carers to care the patient in accordance with their individual health care needs. For the purpose of the training, acute and sub-acute care setting in the hospital should be accredited by the HKCSN and being recognized as training site for Breast Care Nursing. Mentor(s) in such setting should also be verified by the HKCSN.

8. ELIGIBILITY OF CANDIDATE TO ENTER TRAINING IN BREAST CARE NURSING AS MENTEEThe nurse should have completed the Surgical Nursing Training. Before enrolment to be the mentee, he/she needs to obtain approval for the entry to the training from the HKCSN.

9. GUIDELINE FOR CLINICAL ASSESSMENTMentees should have a minimum of 500 hours of direct bedside care of surgical nursing in accredited training site(s) within a 4 years’ time span. The clinical experience can be 50% under supervision and with some (at most 50%) in work placement. i.e. 50-100% supervised practice, 0%-50% work placement.

The definition of supervised practice refers to the experience in which there is an on-site designated appointed mentor who is an Academy Fellow in current practice.

Supervised practice guided by log-book includes:

- Experiential learning with mentor guidance on-site

- Practicum at work/ non-work place with mentor on-site under university programme

- Practicum at work/non-work place with mentor on-site under specialty training programme conducted by recognized institution

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If the practicum at workplace in which there is no on-site designated appointed mentor, the experience is recognized as a learning component with explicit learning objectives and evidence of learning assessed by a recognized supervisor / mentor.

The theory component of the Surgical Nursing Training: Part B – There are Generic Core, Mandatory Specialty and 12 Surgical Nursing Specialties. Mentees are required to attain the Generic Core, Mandatory Specialty and TWO Elective Specialties.

*Generic CoreMandatorySpecialty

Elective SpecialtiesSelect 2 out of 12

- Advanced Health Assessment

- Advanced Clinical Intervention & Case Management

- Advanced physiology, psychology, sociology and pathophysiology,

- Evidence-based Practice

- Advanced Pharmacology & Therapeutics Drugs management

- Clinical Leadership- Team Collaboration &

Communication

- Breast Care - Burn & Plastic Care- Cardiothoracic Care- Ear Nose & Throat

Care / Head & Neck Care

- Gastrointestinal Care / Colorectal Care

- Gynaecological Care- Hepatobilliary

and Pancreatic Care

- Neurosurgical Care- Ophthalmological Care- Organ Donation- Stoma and Wound

Care / Enterostomal Therapy Care

*Generic Core is mandatory to be signed by Mentor.

9.1 Domain and Skill Based CompetenceMentee should demonstrate competencies at Advanced Practice Level in breast care nursing according to the 7 Domains. Scenario reflecting the corresponding competencies of the domains should be well documented. Ongoing assessment and feedback from mentor(s) to mentee are expected to help the mentee identifying his/her strengths and weaknesses, and achieve the expected professional competencies throughout the period of supervised practice. As summative assessment, the assessment will serve as documented evidence certifying that the mentee has achieved the required competence levels.

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9.2 Key Domains of Competency Framework for Advanced Practice NurseDomain 1 Managing clients with complex health conditions

Domain 2 Enhancing therapeutic nurse-client relationship

Domain 3 Demonstrating effective leadership and team work

Domain 4 Enhancing quality assurance and improvementDomain 5 Managing and negotiating innovative and effective approaches to care

deliveryDomain 6 Enhancing professional attributes of general and advanced practice Domain 7 Enhancing personal attribute

9.3 Clinical LogbookLogbook is a record to facilitate the mentor to assess the competence of the mentee and to provide support and guidance to accomplish the training at the advanced practice level as required. Such practice must be supervised by designated on-site mentor(s). There should be an on-going assessment during the training period. The mentor should provide mentee with feedback of his / her performance, record his / her training, experience and achievements in details, and provide extra training in areas of deficiency. It is recommended that mentor and/or mentee should discuss with clinical supervisor to allow rotation within the department and cluster hospitals to meet the mandatory learning items in the logbook. Entries into the logbook should be made from the beginning of the mentee’s supervised practice in a recognized training site. There are mandatory items “*” which indicate the “must know” knowledge in the specialty. 100% mandatory items are expected to complete. While at least 50% of the non-mandatory items are expected to complete.

9.4 Mentor(s)Mentor(s) must be Fellow(s) of the Hong Kong College of Surgical Nursing and is/are in current practice in Surgical Nursing. Mentee must be assigned to a designated mentor at the training site. One mentor should supervise no more than 2 mentees at one time.

For a hospital / institution where there is no fellow of the specialty / subspecialty on-site:

- A specialist doctor who is in charge of the service can be invited as the mentor of the mentee approved for training

- A nurse supervisor, who meets the criteria set out by the College, can be invited as the mentor

These mentors are to be appointed by the College prior to the start of training. The

College is responsible to appoint a Visiting Mentor to meet with the specialist doctor / nurse supervisor regularly to discuss the progress of the mentee.

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Responsibilities of Mentor:- Provide learning opportunities to the mentee in practicing advanced breast care

- Facilitate the mentee to integrate and apply the knowledge and skills in providing care to patients and families with benign and malignant breast conditions

- Facilitate and guide the mentee to reflect the advanced practice skills in patient care

- Provide on-going feedback on the mentee’s clinical performance and advice on areas for improvement

- Facilitate the mentee to exercise professional autonomy during clinical case management

- Facilitate and guide the mentee to prepare for Ordinary Membership Examination

10. LEVEL OF COMPETENCE ASSESSMENTTo guide the mentees in achieving their competencies, a FOUR-level Model of Competence is adopted. The level of competence ranges from Excellent (Level 4) to Deficient (Level 1). The Mandatory items (*) should be achieved 100% and the achievable items should be reached at Level of Competence (2) Satisfactory or above. Non-mandatory items should be achieved 50% and the achievable items should be reached at Level of Competency (2) Satisfactory or above. Mentees are required to log 3 Practice Records and the last practice should achieve the rating at least Satisfactory or above.

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Rating Scale KeyRating Description

4 Excellent Staff at this level consistently demonstrates highly specialized knowledge, skills and behavior in a manner which reflects a superior level of competence. He/she has the forefront of knowledge in the field of work and is leader with ability to research and analyze complex processes. He/she is responsible for service improvement or development, service delivery, and has a leading education or commissioning role. Performance is independent, accurate and complete.

3 Good Staff at this level consistently demonstrates knowledge, skills and behavior in a manner which reflects an above average level of competence. He/she has a critical awareness of knowledge and is innovative with responsibility for developing and changing practice and/or services in a complex and unpredictable environment. Staff performance requires minimal assistance from mentor.

2 Satisfactory Staff at this level consistently demonstrates knowledge, skills and behavior in a manner which reflects an average level of competence He/she requires a critical understanding of detailed theoretical and practical knowledge, and has management and leadership responsibilities. Performance requires moderate assistance from mentor; it is acceptable but needs strengthening.

1 Deficient Staff at this level demonstrates inadequate amount of knowledge, skills and behavior in a manner which reflects an insufficient level of competence. Performance requires moderate assistance from mentor; it is acceptable but needs further strengthening.

NA Not applicable

11. GENERIC CORE LOG

No Competency AreaPractice Record

Rating of Competence

RemarksDate and Mentor’s Signature Rate (1-4)

Mentor’s Signature1st

Practice 2nd Practice 3rd

Practice

GENERIC CORE CLINICAL SKILLS IN BREAST CARE NURSING

1. Manage clients with complex health conditions

*1.1

Demonstrate knowledge to interpret the report data with various imaging and investigation and procedures and apply the data in clinical care including:- Ultrasonography

- Mammography

- Computed Tomography Scan

- Magnetic Resonance Imaging

- Fine Needle Aspiration

- Core Biopsy

- Excision

*1.2

Demonstrate knowledge and skills in managing patients with benign breast disease and its management including:- Breast Pain (Mastalgia)

- Breast abscess

- Fibroadenoma

- Mastitis

*1.3

Demonstrate knowledge and skills in managing patients with malignant breast condition and its operative management, specific care on pre-operative, post-operative, and rehabilitative care to patients undergo:- Lumpectomy

- Mastectomy

- Axillary node dissection

Notes: * Mandatory items should be achieved 100%. Non mandatory items should be achieved 50%. Rating 1= Deficient; 2=Satisfactory; 3= Good, 4=Excellent.In order to pass the competency assessment at ordinary membership level, all items should be achieved at least level 2 or above

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RemarksDate and Mentor’s Signature Rate (1-4)



Practice

GENERIC CORE CLINICAL SKILLS IN BREAST CARE NURSING

2. Therapeutic nurse-client relationship

*2.1 Demonstrate effective counseling and communication skills to enhance nurse-client relationship with patients and families

3. Effective leadership and team work

*3.1 Coordinate multi-disciplines to meet the individual needs of patient during the course of treatment to optimize patient outcome

4 Quality assurance and improvement

*4.1

Demonstrate patient safety due to breast diseases and during treatment

- Mastectomy

- Axillary node dissection

5 Innovative and effective approaches to care delivery

*5.1Integrate and apply advanced theoretical knowledge, clinical investigation and assessment data to design, implement, and evaluate nursing care plan

6 Professional attributes of general and advanced practice

*6.1Demonstrate expertise in breast care nursing and act as resource agent for referrals and advice


12. MANDATORY SPECIALTY LOG



RemarksDate and Mentor’s Signature Rating (1-4)



Practice

BREAST CARE1. Manage complex health conditions

*1.1Demonstrate knowledge and skills in performing history taking

- Past breast history

- Past medical history

- Family history of breast cancer / ovarian cancer

- Menstruation history

- Obstetric history

- Hormonal therapy history

- Presentation of breast symptom:

Asymptomatic

Mass

Mastalgia

Bloody nipple discharge

Axillary lymph node enlargement

1.2Demonstrate knowledge and skills in assisting and preparing patient for triple assessment

*Clinical breast examination

Imaging

- *Ultrasonography (USG)

- *Mammography (MMG)

- Magnetic Resonance Imaging (MRI)

*Cytohistology

- Fine needle aspiration (FNAC)

- Core biopsy







Practice

BREAST CARE

1.3 Demonstrate knowledge and skills in explanation of various radiological and cytohistological examination to patients- *Ultrasonography (USG)



- *Fine needle aspiration (FNAC)

- *Core biopsy

- Stereotactic biopsy

- Minimal invasive surgery

1.4 Demonstrate knowledge to interpret various radiological and cytohistological report

- *Ultrasonography (USG)



- *Fine needle aspiration (FNAC)

- *Biopsy

1.5 Integrate and apply knowledge and skills in caring patient

1.5.1

After investigation procedure

*FNAC

*Core biopsy

Stereotactic biopsy

Minimal invasive surgery

1.5.2

With benign breast disease

*Mastalgia

*Cyst

*Fibroadenoma

Mastitis

Breast abscess

Nipple discharge

Phyllodes tumour

Atypical ductal hyperplasia




RemarksDate and Mentor’s Signature Rating(1-4)



Practice

BREAST CARE1.5.3 With

malignant breast disease

*Ductal carcinoma in-situ

Lobular carcinoma in-situ

*Invasive ductal carcinoma

Invasive lobular carcinoma

Paget’s disease

Inflammatory breast cancer

Malignant phyllodes tumour*Axillary lymph node metastasis*Visceral metastasis

*Non-visceral metastasis

1.6 Integrate and apply knowledge and skills in psychosocial support

1.6.1 Provide psychological support when

- *breaking bad news

- *post-operative pathology disclosure

- *discussion of adjuvant treatment plan

- disease recurrence

- metastatic disease

1.6.2 *Introduce patient support groups in hospital and community

1.7 Demonstrate knowledge and skills in explanation of various breast surgery

For breast *Incision and drainage

*Excision

*Breast conservation surgery

Occult lesion localizaton

- By isotope

- By wire guide

*Mastectomy

*For axilla Sentinel Lymph Node Biopsy

Axillary Dissection


17






Practice

BREAST CAREBreast reconstruction

*Autologus tissue

- TRAM flap

- LD flap

Implant

Tissue expander

Fat graft

Nipple reconstruction

1.8 Integrate and apply knowledge and skills in facilitating patient to make informed decision- *Incision and drainage

- *Excision

- *Breast conservation surgery

- Occult lesion localizaton

By isotope

By wire guide

- *Mastectomy

- *Sentinel Lymph Node Biopsy

- *Axillary Dissection

- *Immediate reconstruction

- Delay reconstruction

- *Neo-adjuvant chemotherapy

- *Use of fact sheet

1.9 Demonstrate knowledge and skills in explanation and interpretation of systematic work up

- Chest X-Ray

- Bone scan

- *Computed Tomography Scan (CT scan)

- *Positron Emission Tomography Scan (PET scan)







Practice

BREAST CARE

*1.10

Integrate and apply knowledge and skills in preparing patient for treatment

- Psychological care when breaking bad news

- Counseling

- Effective communication and caring with respectful behavior for discussion of various breast cancer treatment options to facilitate patient to make informed decision Breast conservation surgery Occult lesion localization (by

isotope / wire guide) Mastectomy Sentinel Lymph Node Biopsy Axillary Dissection Immediate / delay breast

reconstruction Autologus tissue Implant Tissue expander Fat graft Nipple reconstruction

- Ability to explain neo-adjuvant chemotherapy for patient concern

1.11Integrate and apply knowledge and skills in caring patient after surgery

1.11.1

Early post-operative care during hospitalization

*Vital sign observation

*Wound management

*Drain management

*Pain assessment

Post reconstruction care

- Flap

- Donor site

- Reconstructed nipple Potential complications observation:- *Wound infection

- *Seroma collection

- *Wound gapping

- *Wound necrosis

- *Haematoma

- Fat necrosis


19






Practice

BREAST CARE*1.11.2 Discharge

education (self care at home)

Wound care

Drain care

Clothing

Bathing

Personal hygiene

Diet recommendation

Follow up plan

1.11.3 Post-operative rehabilitation

Normal wound management:

- *Breast wound

- *Axilla wound

- Neo-breast

- Donor site

- Reconstructed nipple

*Wound complication management:

- Infection

- Seroma

- Gapping

- Necrosis

- Haematoma

*Understand the choice of dressing products

*Low vacuum drain management:

- Patient education - Daily output

documentation- Removal of drain

*Shoulder range of movement assessment

*Progressive mobilization exercise education

*Scar management

*Referral mechanism for complications


20






Practice

BREAST CARE1.11.4 Body image

care *Assist to look own body

*Assist to look at wound

*Assist to touch own body

*Assist to touch the wound

Bra fitting

Prosthesis fitting

Education on care of bra and prosthesis

*Clothing

Wig fitting

*1.12 Demonstrate knowledge and skills to interpret the pathological report

- T staging

- N staging

- Hormonal status

- C-erb status

- Whole pathology intrepretation

*1.13 Demonstrate knowledge in explanation of various adjuvant therapy

- Chemotherapy

- Hormonal therapy

- Radiotherapy

- Targeted therapy

1.14 Demonstrate knowledge and skills in caring patients on adjuvant Chemotherapy treatment care

- *Patient education

- *Choice of regime

- *Observation of potential complications

- Management of complications

Nausea

Hair loss

Neutropenia

Neutropenic fever


21






Practice

BREAST CARE1.14 *Radiotherapy:

- Patient education

- Post treatment skin care

Hormonal therapy:

- *Patient education

- *Choice of hormonal therapy drugs

- *Observation of potential complications

- Management of complications

PV bleeding

Deep vein thrombosis

Bone pain

Osteoporosis

*Targeted therapy:

- Patient education

- Observation of potential complications

*Educate to locate the resource

1.15Integrate and apply knowledge and skills in specialized care

1.15.1

Advanced care

Complicated wound management:- Complicated breast

abscess- Fungating wound

Pain control

Odour control

Bleeding control

Nipple areolar 3-D tattoo

Breaking bad news

Pathology disclosure

Genetic counseling

Lymphoedema management:

- *Patient education- *Identification of

lymphoedema- *Lymphoedema

assessment- Lymphoedema

management


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Mentor’sSignatur

e1st

Practice 2nd

Practice 3rd

Practice

BREAST CARE1.15.1

Advanced care

Survivor health surveillance:- Clinical breast

examination- Detection of local

recurrence- Detection of distant

metastasisKeloid scar management by injectionInjection of tissue expander

1.15.2Complex breast cancer patient

Complicated medical illness

Pregnant woman

Younger woman

Psychiatric illness

1.15.3 Family and care givers

*Psychosocial support*Introduce support service in community Refer specialist if needed

1.15.4 Miscellaneous *Diet and nutrition

Traditional Chinese Medicine

Breast screening

Sexuality and fertility issues

Local recurrence

Metastatic diseasePalliative care, spirituality, loss and grief, dying and bereavement*Infection control

2 Therapeutic nurse-client relationship

*2.1

Demonstrate effective counseling and communication skills to enhance nurse-client relationship with patients and families


23




Mentor’sSignatur

e1st

Practice 2nd

Practice 3rd

Practice

BREAST CARE3 Effective leadership and team work

*3.1Coordinate multi-disciplines to meet the individual needs of patient during the course of treatment to optimize patient outcome

3.2 Participate in multi-disciplinary team meeting:

- Diagnostic meeting

- *Combined breast clinic

- Clinico-Pathological Conference

- *Workflow / clinical service meeting

*4 Quality assurance and improvement

4.1 Demonstrate patient safety due to breast disease and during treatment

4.2 Participate in regular service review

4.3 Monitor existing practice and resources for quality & risk management

4.4 Demonstrate knowledge and skills to ensure the protection of individual client and the community as well as accountability for the public

5. Innovative and effective approaches to care delivery

*5.1 Integrate and apply advanced theoretical knowledge, clinical investigation and assessment data to design, implement, and evaluate nursing care plan

*5.2 Integrate and apply knowledge and skills to optimize the availability of resources to facilitate the operations and the provision of an accessible, effective and efficient service6. Professional attributes of general and advanced practice

*6.1Demonstrate expertise on Breast Care and be a resource person for referrals and advice

*6.2Participate in specialty specific professional activities

*6.3Nourish a caring and supportive culture within the team

*6.4 Facilitate team collaboration

*6.5 Liaise community resources

6.6 Provide support to peer support groups


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Mentor’sSignatur

e1st

Practice 2nd

Practice 3rd

Practice

BREAST CARE7. Enhancing personal attribute

*7.1Demonstrate the quality and characteristics of a reliable and responsible person required in fulfilling the nursing duties

*7.2Share clinical experience and knowledge with colleagues

*7.3Evaluate own practice and enhance own nursing knowledge and skills

*7.4Demonstrate the commitment to strive for excellence in providing holistic care services, and safeguarding good practice

*7.5Empower colleagues / staff to assume responsibilities for client care with delegation, support and supervision


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13. ELECTIVE SPECIALTY LOG

No Competency AreaPractice Record Rating of

CompetenceRemarksDate and Mentor’s Signature Rating

(1-4)Mentor’s Signature1st

Practice 2nd

Practice3rd

Practice

A BURN & PLASTIC CARE 1. Manage complex health conditions

*1.1Demonstrate knowledge and skills in performing assessment of Burn Injury

*1.2Demonstrate knowledge and skills in management of burn injury and prevention of complications during acute burn phase

*1.3

Demonstrate knowledge and skills in provision of pre and post-operative nursing are to burn injury patients, including prevention and management of associating complications on:- skin graft

- surgical debridement

*1.4Demonstrate knowledge and skills in wound care management and dressing technique of patients with burn injuries


*2.1

Demonstrate skills of counseling and rendering psycho-social support to patients with burn injuries and their families throughout span of burn healing


*3.1

Demonstrate effort in coordinating and liaising multi-disciplines to meet the individual needs of burns patient during the course of treatment to optimize patient’s healing outcome

4. Quality assurance and improvement

*4.1Demonstrate patient safety due to burn and during treatment


*5.1Integrate and apply clinical knowledge and skills in pain management in burn patients

5.2 Integrate and apply knowledge on Nutritional support in acute burn patients

*5.3

Integrate and apply knowledge and skills in maintaining appropriate infection control measures and practice for different burn patients

6. Professional attributes of general and advanced practice

6.1

Integrate and apply knowledge and skills in supporting and educating burns patients and their families during rehabilitation of burn recovery.

Notes: * Mandatory items should be achieved 100%. Non mandatory items should be achieved 50%.Rating 1= Deficient; 2=Satisfactory; 3= Good, 4=Excellent.

In order to pass the competency assessment at ordinary membership level, all items should be achieved at least level 2 or above

26




Practice 2nd

Practice3rd

Practice

B CARDIOTHORACIC CARE 1. Manage complex health conditions

*1.1

Demonstrate clinical knowledge and skills in caring patients with cardiovascular disorders and the after care of related surgical interventions including:- Heart failure and cardiogenic shock- Dissecting aneurysm and aneurysm of

aorta

*1.2

Demonstrate clinical knowledge and skills in specific care of patients undergo various investigations including: - Cardiac Catheterization

- Coronary Angiography

- Lung function test

- Bronchoscopy

- Lung tissue biopsy

- Fine needle aspiration

*1.3

Demonstrate clinical knowledge and skills in caring patient with:- Carcinoma of Lung

- Pneumothorax

*1.4Demonstrate knowledge and skills in caring patients receiving thoracic bronchoscopy


*2.1Demonstrate skills of counseling and provide psycho-social support to patients with cardiothoracic diseases




*4.1Demonstrate patient safety due to cardiothoracic diseases and during treatment


*5.1

Integrate and apply advanced theoretical knowledge, clinical investigation and assessment data to design, implement, and evaluate nursing care plan


6.1Demonstrate expertise on cardiothoracic care and be a resource person for referrals and advice

Notes: * Mandatory items should be achieved 100%. Non mandatory items should be achieved 50%.Rating 1= Deficient; 2=Satisfactory; 3= Good, 4=Excellent.

In order to pass the competency assessment at ordinary membership level, all items should be achieved at least level 2 or above

27




Practice 2nd

Practice3rd

Practice

C EAR, NOSE & THROAT CARE / HEAD & NECK CARE1. Manage complex health conditions

*1.1Demonstrate knowledge and skills in performing hearing assessment and audiology test

1.2

Demonstrate knowledge and skills in specific pre-operative and post–operative care on patients receiving ear surgeries including:- Preauricular sinus excision

- Myringotomy

*1.3

Demonstrate knowledge and skills in performing ear procedures including:- Ear syringing

- Removal of wax / foreign body

- Administration of aural medication

*1.4

Demonstrate knowledge and skills in caring patient performing common nasal procedures including:- Epiglottitis

- Croup

- Vocal Cord Polyps

- Stridor

- Hoarseness

*1.5

Demonstrate nursing knowledge and skills in specific pre-operative and post-operative care for patients performing interventional strategies for larynx including: - Tonsillectomy

- Tracheostomy

*1.6

Demonstrate knowledge and skills in caring various common benign and malignant head & neck condition and specific care after reconstruction including:- Cutaneous infection

- Neck Masses

- Naso-pharyngeal Carcinoma (NPC)

- Benign & malignant skin lesion

- Thyroid disease & cancer

- Parathyroid cancer

Notes: * Mandatory items should be achieved 100%. Non mandatory items should be achieved 50%.Rating 1= Deficient; 2=Satisfactory; 3= Good, 4=Excellent. In order to pass the competency assessment at ordinary membership level, all items should be achieved at least level 2 or above

28




Practice 2nd

Practice3rd

Practice

C EAR, NOSE & THROAT CARE / HEAD & NECK CARE1. Manage complex health conditions

1.7

Demonstrate knowledge and skills in caring patients with head & neck diseases and the pre-operative, post-operative, and rehabilitative care to patients undergo: - Head & Neck surgery

- Reconstruction surgery

*1.8

Integrate and apply advanced clinical knowledge and skills in specific nursing management on:- Wound management

- Nutritional support

- Tracheostomy care (Temporary / Permanent)

- Transitional and home care


*2.1

Demonstrate knowledge and skills in effective communication and psychosocial support in establishing therapeutic and caring relationship with patients and families on ear, nose & throat diseases / head & neck diseases


*3.1 Coordinate multi-disciplines to meet the individual needs of patient during the course of treatment to optimize patient outcome ear, nose & throat care / head & neck care


*4.1Demonstrate patient safety due to ear, nose & throat diseases / head & neck diseases and during treatment


*5.1

Integrate and apply advanced theoretical knowledge, clinical investigation and assessment data to design, implement, and evaluate nursing care plan in ear, nose & throat care / head & neck care


6.1Demonstrate expertise roles on areas of ear, nose & throat care / head & neck care and be a resource person for referral and advice

Notes: * Mandatory items should be achieved 100%. Non mandatory items should be achieved 50%.Rating 1= Deficient; 2=Satisfactory; 3= Good, 4=Excellent. In order to pass the competency assessment at ordinary membership level, all items should be achieved at least level 2 or

above

29




Practice 2nd

Practice3rd

Practice

D GASTROINTESTINAL CARE / COLORECTAL CARE 1. Manage complex health conditions

1.1

Demonstrate knowledge and skills on the preparation and care after various gastrointestinal investigations and Endoscopic procedures including:- *OGD

- *Colonoscopy

- *Sigmoidoscopy

- *Proctoscopy

- Capsule endoscopy

*1.2

Demonstrate knowledge and skills on the preparation and care after various gastrointestinal investigations and Radiological procedures including:- Barium meal

- Barium enema

- CT Colonography

1.3

Demonstrate knowledge and skills on the pre-operative, post-operative, and rehabilitative care to patients undergo oesophagectomy

*1.4

Demonstrate knowledge and skills in caring patients with stomach, duodenum diseases and specific care after surgical interventions including:- Inflammation and ulceration- Peptic/duodenal/perforated ulcer with

bleeding

- Gastric tumors

- Gastroesophageal reflux disease (GERD)

*1.5

Demonstrate knowledge and skills on the pre-operative, post-operative and rehabilitative care to patients undergo gastrectomy

1.6 Demonstrate knowledge and skills in caring patients with colorectal tumour and the pre-operative, post-operative & rehabilitative care after surgical interventions including: - Colectomy (e.g. Right Hemicolectomy,

Extended Right Hemicolectomy, Lett Hemicolectomy)

- Rectal Surgery (e.g. Anterior Resection , Lower Anterior Resection, Total Mesorectal Excision)


30




Practice 2nd

Practice3rd

Practice

1.7

Demonstrate knowledge and skills in caring patients with colorectal disease and pre-operative, post-operative & rehabilitative care after surgical interventions including :- Crohn’s disease

- Ulcerative Colitis

- Diverticular Disease


*2.1

Demonstrate effective communication skills in establishing therapeutic nurse-patient relationship to patients receiving Gastrointestinal / Colorectal surgery




*4.1Demonstrate patient safety due to Gastrointestinal / Colorectal diseases and during treatment


5.1



6.1Demonstrate expertise on Gastrointestinal / Colorectal Care and be a resource person for referrals and advice


31




Practice 2nd

Practice3rd

Practice

E GYNAECOLOGICAL CARE 1. Manage complex health conditions

*1.1

Demonstrate advanced knowledge and skills in caring patients with gynecological disorders and the pre and post operative care to patients undergo operations related to reproductive organs including:- ovaries

- fallopian tubes

- uterus, cervix

- vagina

- vulva

*1.2

Demonstrate advanced knowledge and skills in caring patients with Menstrual dysfunction including:- Amenorrhea (absent menstrual periods)- Dysmenorrhea (painful menstrual

periods)

- Menorrhagia

- Menopause

*1.3

Demonstrate advanced knowledge and skills in caring patients with Pelvic Inflammatory Diseases including :- Sexually transmitted infections

- Infections of the vagina (vaginitis)

- cervix and uterus (including fungal, bacterial, viral, and protozoal)

*1.4

Demonstrate advanced knowledge and skills in caring patients receiving gynaecological assessment including:- Pap smear

- HPV screening

- Colposcopy

- Cervical Pathology


32




Practice 2nd

Practice3rd

Practice

1.5

Demonstrate advanced knowledge and specific care on the pre-operative, post-operative & rehabilitative care to patients undergo gynaecological operations including: - Dilation and curettage

- Hysterectomy

- Oophorectomy

- Tubal ligation

- Hysteroscopy

- Diagnostic laparoscopy

- Exploratory laparotomy


*2.1

Demonstrate knowledge and skills in effective communication and psychosocial support in establishing therapeutic and caring relationship with patients and families




*4.1Demonstrate patient safety due gynecological diseases and during treatment


*5.1



6.1Demonstrate expertise on Gynaecological Care and be a resource person for referrals and advice


33




Practice 2nd

Practice3rd

Practice

F HEPATOBILIARY AND PANCREATIC CARE 1. Manage complex health conditions

1.1

Demonstrate knowledge and skills on the preparation and care after various investigations and procedures including:- Endoscopic Retrograde Cholangio -

Pancreatogram (ERCP)

- Endoscopic Ultrasound (EUS)

- Metallic stenting insertion

- Percutaneous Trans-hepatic Biliary Drainage (PTBD)

- Abdominal tapping

- Liver biopsy

*1.2

Integrate and apply knowledge and skills in specific care of patients with liver diseases and its surgical interventions including: - Liver cyst

- Liver abscess

- Liver tumour

1.3

Demonstrate knowledge and skills on the pre-operative, post-operative, and rehabilitative care to patients undergo Hepatic resection

*1.4

Integrate and apply knowledge and skills in caring patient with biliary disorders and its surgical interventions including :- Gall stone

- Common Bile Duct stone

- Recurrent pyrogenic cholangitis

- Cholangio Carcinoma

- Choledochal cyst

1.5

Integrate and apply knowledge and skills in pancreatic disorders and its surgical interventions including: - Pancreatitis

- Pancreatic tumors

*1.6

Demonstrate knowledge and skills on the pre-operative, post-operative, and rehabilitative care to patients undergo pancreatic surgery


34




Practice 2nd

Practice3rd

Practice


*2.1

Demonstrate knowledge and skills in establishing rapport, provide counseling, Psycho –social and informational support to clients and their families on Hepatobiliary and Pancreatic diseases




*4.1Demonstrate patient safety due to hepatobiliary and pancreatic diseases and during treatment

*4.1Integrate and apply clinical practice according to standard, guideline, and protocols


5.1



6.1Demonstrate expertise on hepatobiliary and pancreatic Care and be a resource person for referrals and advice


35




Practice 2nd

Practice3rd

Practice

G NEUROSURGICAL CARE 1. Manage complex health conditions

*1.1Demonstrate knowledge and skills in caring patients with neurology and spinal cord disorder

1.2

Demonstrate knowledge in identifying and interpreting the report of specific types of neurological investigation and laboratory test and apply in clinical management

*1.3Demonstrate knowledge and skills in performing head injury assessment

*1.4Demonstrate knowledge and skills in caring patient with head injury

*1.5Integrate and apply advanced clinical knowledge in caring patients with neurovascular disease

*1.6Integrate and apply advanced clinical knowledge and skills in managing patients with epilepsy

1.7

Integrate and apply advanced clinical knowledge in managing patients with degenerative neurological disease including: - Parkinson’s Disease

- Alzheimer Disease

- Dementia

- Cerebral Atrophy

*1.8

Demonstrate knowledge and specific pre-operative, post-operative, and rehabilitative care to patients undergo neurosurgical operations including: - Craniotomy

- Burr Hole Drainage

- Spinal Surgery

1.9Integrate and apply advanced clinical knowledge and skills in performing post neurosurgery rehabilitation program


*2.1



*3.1 Coordinate multi-disciplines to meet the individual needs of patient during the course of treatment to optimize patient outcome


36




Practice 2nd

Practice3rd

Practice


*4.1Demonstrate patient safety due to neurological diseases and during treatment


5.1



6.1 Demonstrate expertise in Neurosurgery and act as resource agent for referrals and advice


37




Practice 2nd

Practice3rd

Practice

H OPHTHALMOLOGICAL CARE 1. Manage complex health conditions

*1.1

Demonstrate advanced knowledge and skills in caring patients with eye disorders including:- Disorders of eyelid, lacrimal system and

orbit

- Disorders of conjunctiva

- Disorders of sclera, cornea, iris and ciliary body

- Disorders of lens

- Disorders of choroid and retina

- Visual disturbances & blindness

*1.2

Demonstrate advanced knowledge and skills in caring patients with :- Red eye

- Eye infection

- Eye trauma / injury

1.4Integrate and apply advanced knowledge and skills in performing optometric and orthoptic assessment

*1.5

Demonstrate knowledge and specific pre-operative, post-operative, and rehabilitative care to patients receiving eye operations including :- Cataract surgery

- Glaucoma surgery

*1.6Demonstrate knowledge and skills in caring patients with visual impairment

*1.7Demonstrate knowledge and skills in caring patients with ophthalmic emergency


*2.1


3 Effective leadership and team work


4 Quality assurance and improvement

*4.1Demonstrate patient safety due to ophthalmological diseases and during treatment


38




Practice 2nd

Practice3rd

Practice


*5.1



6.1Demonstrate expertise in ophthalmology nursing and act as resource agent for referrals and advice


39




Practice 2nd

Practice3rd

Practice

I ORGAN DONATION 1. Manage complex health conditions

*1.1Integrate and apply knowledge and skills on the management of immediate brain death patient

*1.2Integrate and apply advanced knowledge and skills on management of potential organ donor during Organ Donation process

*1.3Demonstrate knowledge and skills in Certification of Brain Death

*1.4Integrate and apply advanced clinical knowledge in the physiological support of potential organ donor


*2.1Integrate and apply advanced clinical knowledge and skills in managing grief and bereavement in organ donation


*3.1

Demonstrate effective coordination between Organ Donation Coordinator, Transplant Teams, and other disciplinary teams including: - Identified potential donor - Donor evaluation, maintenance and

screening- Logistics and coordination work in organ

procurement process- Donor's families follow up and

management

- Extraction, distribution and organ sharing


*4.1Demonstrate safe transplant in whole donation process


5.1Demonstrate knowledge and skills with strategies in internal promotion of organ donation


6.1 Demonstrate expertise in organ donation and act as resource agent for referrals and advice


40


CompetenceRemarksDate and Mentor’s Signature Rate


Practice 2nd

Practice3rd

Practice

J STOMA & WOUND CARE / ENTEROSTOMAL THERAPY CARE 1. Manage complex health conditions

*1.1Demonstrate knowledge and skills in identification of various wound care products and applicable to different wound condition

1.2

Integrate and apply clinical knowledge and skills in management of stoma care - Colostomy

- Ileostomy

*1.3Demonstrate knowledge and skills on the pre-operative and post-operative care to patients undergo surgery with stoma

1.4 Demonstrate knowledge and skills in performing Colostomy irrigation

*1.5Demonstrate knowledge and skills in managing fistula and drainage wounds


*2.1

Demonstrate knowledge and skills in establishing rapport, provide counseling, psycho –social and informational support to clients and their families for wound / stoma care




*4.1Demonstrate patient safety during stoma and wound management


5.1Demonstrate knowledge and skills in managing stomal and peristomal complications


6.1Demonstrate expertise on Stoma and Wound care and be a resource person for referrals and advice


41




Practice 2nd

Practice3rd

Practice

K UROLOGICAL CARE 1. Manage complex health conditions

*1.1

Demonstrate knowledge and skills in performing advanced urological investigations / procedures: - Uroflowmetry

- Bladder scan

*1.2Demonstrate knowledge to interpret radiological investigations and laboratory tests

*1.3Integrate and apply knowledge and skills in caring patients with Trans-urethral resection of prostate gland

1.4

Integrate and apply knowledge and skills in caring patients with urological carcinoma and its surgical interventions including :- Prostate cancer

- Bladder cancer

*1.5

Demonstrate advanced clinical knowledge in caring patients after urological surgeries including :- Bladder irrigation

- Ileal conduit

- Stoma care

1.6

Demonstrate knowledge and skills in catheter care including :- *Urethral catheter

- Suprapubic catheter

- Percutaneous nephrostomy catheter

1.7Demonstrate knowledge and skills in managing patients with urinary　 incontinence


42




Practice 2nd

Practice3rd

Practice


*2.1Demonstrate effective counseling and communication skills to enhance nurse-client relationship with patients and families




*4.1 Demonstrate patient safety due to urology disease and during treatment


5.1



6.1Demonstrate expertise on Urological Care and be a resource person for referrals and advice


43




Practice 2nd

Practice3rd

Practice

L VASCULAR CARE1. Manage complex health conditions

*1.1Demonstrate knowledge and skills in a systematic approach for assessing the peripheral vascular system

1.2

Demonstrate knowledge and skills in performing Ankle Brachial Index; correlate the findings from these examinations with appropriate nursing interventions

*1.3

Demonstrate knowledge and skills in clinical indications for invasive vascular diagnostic examinations and can interpreting the report and plan nursing interventions accordingly the findings

1.4

Demonstrate knowledge and skills in caring patients with Aortic Aneurysm/ aneurysmal diseases and identify the specific nursing implications relevant to the disease.

1.5

Demonstrate knowledge and skills in caring patients with peripheral arterial occlusive disease. The specific nursing interventions related to pre-operative care, post-operative care, health promotion, disease prevention and home care.

*1.6

Demonstrate knowledge and skills in caring patients with chronic venous insufficiency disease. The specific nursing interventions related to pre-operative care, post-operative care, and long term self care.

*1.7Demonstrate knowledge and skills in caring patients with lower limb Vascular ulcer and ulcer prevention measures.


*2.1





*4.1Demonstrate patient safety due vascular diseases and during treatment


44




Practice 2nd

Practice3rd

Practice


5.1



*6.1 Demonstrate expertise on Vascular Care and be a resource person for referrals and advice


45

14. ADVANCED SPECIALTY CASE LOG

This Advanced Specialty Case Log aims to build up in-depth skill based competencies of mentees in areas of nursing practice specific to Breast Care Nursing after the Specialty Log. Mentees should apply critical thinking and evidence based knowledge and skills to each areas of nursing practice that meet the 7 domains of competency as stipulated in the Log Book.

Mentees are required to log at least 5 scenario records in each of the following Specified Areas of Competency Practice and 7 domains of competency should be demonstrated within the 5 scenario records. Mentors should provide supervision to mentees throughout the care process and it is expected that the competency skills of the mentee improves with the increased experience gained.

Specified Areas of Competence Practice1 Health assessment, history taking, interpretation of common screening and

diagnostic laboratory, pathology results with related possible treatment2 Investigation Procedures, Observation and Management

ManagementofBenignDiseases3 Management of Benign Diseases4 Management of Malignant Diseases5 Patient Education and Counseling6 Pre-operative Preparation of Patients in Various Operations7 Immediate Post-Operative Care Observation/Monitoring8 Different Surgical Wound Condition, Drain or Tube and their management9 Management of Surgical Complications

10 Management on Complex Clinical Condition

14.1 Advanced Specialty Case Log Sheet

An Advanced Specialty Case Log Sheet (Appendix 1) is designed and prepared to facilitate mentor-mentee discussion on scenario log.

14.2 Summary of Competence PracticeTo ensure Mentee has attained all the specified areas of competency practice during scenario case logs, Mentee has to fill in a Summary of Competence Practice (Appendix 2) indicating the coverage of competence practice from each scenario with the verification from the Mentor.

46

15. PERSONAL CONTRIBUTION RECORD To demonstrate personal attributes, mentees are recommended to record their

outstanding and remarkable experience contribution to the significant outcomes during

the discharge of nursing practice.

Date Significant Contribution Remarks

_______________________ ________________________Mentee’s Signature Mentor’s Signature

_______________________ ________________________Date Date

47

16. ASSESSMENT Mentee should be assessed periodically at half yearly during the 4 years’ of clinical

practice with the Assessment Form for Surgical Nursing Training (Appendix 3).

17. FINAL VERIFICATION

This is to verify that _________________________ (Name of Mentee) of HKCSN

Associate Membership Number _____________________ has completed the period of

supervised practice from ___________ (dd/mm/yy) to ____________ (dd/mm/yy)

in the training post as approved by the HKCSN.

___________________________ _______________________

Mentor’s Name and Signature Date (dd/mm/yy)

48

18. EVALUATION

Evaluation is to be completed by the Mentor for recommending the Mentee to attend

Certification Examination leading to the award of HKAN Ordinary Membership

Please tick (√) in the boxes provided as appropriately

Evaluation

Competence Areas

Grading Demonstrated Competency Practice in

Specific Areas (1-10, please

specify)

Demonstrated Competency

Domain(1-7, please

specify)

RemarksPass Fail

1. Generic and Special Log

1.1 Mandatory

achieved 100% with

competency level 2 or

above

NA NA

1.2 Non-mandatory

achieved 50% with

competency level 2 or

above

NA NA

2 Advanced Specialty Case Log

2.1 Scenario 1

2.2 Scenario 2

2.3 Scenario 3

2.4 Scenario 4

2.5 Scenario 5

Overall Grading

49

Recommendation: □ Recommended to attend membership certification examination leading to the award of HKAN

Ordinary Membership□ NOT Recommended to attend membership certification examination leading to the award of

HKAN Ordinary Membership

Overall Comments (use addition sheet if necessary) :

Name and Signature of Mentee Name (Block Letter) :______________________

Signature : _______________________________Membership Number: _____________________

Date:

Name and Signature of Mentor Name (Block Letter) :______________________

Signature : _______________________________Fellowship Number: _______________________

Date:

Endorsement Chairman of Examination & Accreditation Committee

□ Endorsed □ Not endorsed

Name (Block Letter) : ______________________

Signature : _______________________________

Date:

50

19. APPENDIX 1

Advanced Specialty Case Log Sheet

This Log Sheet is used for Scenario Case Log. Mentee could supplement with additional

sheet if required.

Date

Patient Information Initial / Episode No. _______________

Sex / Age : _______________________ Ward : _________________

Diagnosis : __________________________________________________

Clinical Background : _________________________________________

Psychosocial Background : ____________________________________

Intervention/ Management/ Education provided

Reflection / Learning

______________________ ________________________Mentee’s Name & Signature Mentor’s Name & Signature

_______________________ ________________________Date Date

51

19. APPENDIX 2

Summary of Competence Practice Please put ‘’ in the boxes provided as appropriately

Demonstration of CompetenceScenario Case Log Remarks

Case

1

Case

2

Case

3

Cas

e 4

Case

5

1 Health assessment, history taking, interpretation of common screening and diagnostic laboratory, pathology results with related possible treatment

2 Management of Benign Diseases

3 Management of Malignant Diseases

4 Pre-operative Preparation of Patients in Various Operations

5 Immediate Post-Operative Care Observation / Monitoring

6 Different Surgical Wound Condition, Drain or Tube and their Management

7 Management of Surgical Complications

8 Patient Education and Counseling

9 Management on Complex Clinical Condition

10 Endoscopic Examination Procedures, Observation and Management

Domains of Competency1 Managing clients with complex health

conditions

2 Enhancing therapeutic nurse-client relationship

3 Demonstrating effective leadership and team work

4 Enhancing quality assurance and improvement

5 Managing and negotiating innovative and effective approaches to care delivery

6 Enhancing professional attributes of general and advanced practice

7 Enhancing personal attribute

Date & Signature of Mentee

Date & Signature of Mentor

52

19. APPENDIX 3

HONG KONG COLLEGE OF SURGICAL NURSING ASSESSMENT FORM FOR SURGICAL NURSING TRAINING (6 MONTHLY)

Name of Mentee: Training Period From: To:

Date of commencement of Surgical Nursing Training:

Hospital: Specialty in Training:

No. of Days absent Reason for absence (e.g. holiday / study leave / others)

Guidelines for Mentor : Please enter your number (scored 1-4) in the column provided, which best reflects your assessment using the prompts as a guide. Each column must contain a number. Please note that explanatory comments would be required for a score of 1 and 4 in “Overall Rating” of the performance.

UNSATISFACTORY = 1 SATISFACTORY = 2 ABOVE AVERAGE = 3 EXCELLENT =4

RATING UNSATISFACTORY SATISFACTORY EXCELLENT

(A) CLINICAL SKILLSAssessmentHistory / Examinations

Incomplete or inaccurate Poorly recorded Poor basic skills

Usually complete, orderly and systematic

Precise, thoroughand perceptive

Oral Presentation Jumbled / disorganized Usually satisfactory Well organized Systematic / focused

Use of Investigations Inappropriate, poor ability to Interpret and apply data in

clinical management

Can utilize X-rays / understand results

Almost always best utilization of tests.

Excellent at interpretation.

Judgment Fails to grasp significance of findings or respond accordingly. Under or

overreacts to emergencies.

Reliable, Competent under pressure. Asks for

advice appropriately.

Outstanding clinicians, who is

aware of his / her limits.

Post-operative Care Disinterested. Fails to notice complications and

act appropriately

Conscientious. Good awareness of

complications. Reliable follow-up

Excellent care. Notices problems early.

Outstanding in follow-up.

(B) TECHNICAL SKILLS Bed-side care Too hasty or too slow.

Slow learner. Poor hand / eye coordination.

Good hand / eye coordination. Sound skills

for level of training

Excellent and unusual ability

at bed-side care

Independent procedures

Rough, “Near enough is good enough”. Hesitant

Mastered basic skills Well ordered approach,

careful

Outstanding technician

As procedure assistant Fails to follow the operation Follows the operation with guidance from the

operator

Anticipates the needs of the operator

53

(C) ACADEMIC PERFORMANCE Knowledge of Subject Poor knowledge base.

Significant deficiencies or poor perspective

Adequate fund of knowledge

and relates it satisfactory to patient care.

Outstanding knowledge of the subject. Knows

common areas in depth. Aware of the unusual.

Case presentations Wordy or inaccurate on history, signs or diagnosis.

Poor discussion.

Competent, concise and correct on clinical details.

Good deductions.

Accurate and succinct case presentation, good

perspective in case discussions.

Learning Little evidence of reading texts or journals. Needs

direction to study.

Reads appropriately, asks for information and follow-

up.

Always keen to discover new knowledge, Takes

extra courses.

Teaching Avoids if possible. Poorly prepared, poorly delivered.

Competent and well prepared in teaching

others.

Enthusiastic teacher. Logical and clear.

Can inspire.

(D) ATTITUDES Communication with patients

Bad listener and communicator. Disliked by patients. Increases patient

anxieties.

Listens well, explains well.Trusted by the patient.

Excellent rapport. Inspires confidence.

Patients delighted to be looked after by him / her.

Cooperation with staff Refuses to help out. Poor relationship with peers

and may undermine.

Good rapport with colleagues and medical

staff. Willing to help.

Always willing to help even if personally

inconvenient. Diffuses any problems in the

team.Self motivation Organization

Idle, lacking in any work enthusiasm. Behind with

letters or summaries.

Hard-working, keen to learn, self-organizes

waiting list.

Full of energy. Performances go

far beyond the “call of duty”.

ReliabilityPunctuality

Poor time management. Forgets to do things.

Unreliable

Dependable. Efficient in use of his / her time

Highly conscientious. Always completes tasks

and anticipates well.

Stress Response Copes poorly. “Disappears” when problems arise

Responds appropriate, seeks help when needed,

copes well.

Thinks ahead, still efficient “when the going

gets tough”. Seems to thrive on

pressure.

Acceptance of criticism Responds poorly to criticism. Angry. “Turn off”.

Adequate response. Works to correct the

problem area.

Prompt response, marked improvement and positive change.

RESEARCH ACTIVITIES DURING CURRENT TERM: Continuing Research 1. No current research project(Circle appropriate number) 2. Research project in progress

3. Active researcher, demonstrated flair for research, original ideasResearch Requirement satisfied: YES / NO / not applicablePublications 1. No current project(Circle appropriate number) 2. Project in process of being prepared for submission for publication

How? Meeting: Date: (Please specify) Title of Presentation

Publication(s) Reference (including date)

54

COMPETENCY ASSESSMENT: Mentees are required to submit this half-yearly assessment form. Mentees are also required to KEEP a duplicated copy in their logbook during the entire higher training. The respective training rotation will not

be recognized if the mentees fail to submit the outstanding documentation by the deadline.

OVERALL RATING (place appropriate number in boxes provided)

UNSATISFACTORY = 1 SATISFACTORY = 2 ABOVE AVERAGE = 3 EXCELLENT =4

Overall Rating Log Book Statistics

SUMMARY REPORT ON TRAINING PROGRAMME

Assessment Period 1st / 2nd / 3rd / 4th / 5th / 6th / 7th / 8th (6 monthly) (circle or write appropriate number)

ADDITIONAL / EXPLANATORY COMMENTS (If insufficient space attach separate document)

Feedback to mentee in area with score less than 2 & suggestion for improvement

55

RECOMMENDATIONS REGARDING FUTURE TRAINING Date :

(Circle appropriate number)

1. Mentee should continue in Training Position.

2. Continued position in training programme in doubt due to identified deficiencies.

3. Mentee should be removed from training programme because of deficiencies that have not

been rectified.

Signature of Supervisor / Mentor Print Name

Mentee’s Signature I have sighted this assessment YES / NO

Important Note: Mentees should ensure that this Mentee Assessment form together with a copy of the logbook summary and logbook summary report are distributed as follows:

1. Original assessments, logbook summary forms and report, and competency assessment forms

should be submitted to the Accreditation Committee through your supervisor / mentor. The

Secretariat of the Hong Kong College of Surgical Nursing at LG1, School of Nursing, Princess

Margaret Hospital, 232 Lai King Hill Road, Lai Chi Kok, Kowloon, Hong Kong.

2. Copies of the above should be made and retained by the mentee for his / her personal record of

curriculum.

3. A score less than 2 in any category will be discussed by the Accreditation Committee, Hong

Kong College of Surgical Nursing.

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