reflective accounts form - wirral university teaching...

Revalidation pack

This is a pack of templates to support the revalidation process, including:

Practice hours record log 2 - 3

Template Continuing Professional Development (CPD) record log 4 - 7

Template: Reflective accounts record log 8 - 14

Professional development discussion (PDD) form 15 - 16

Confirmation from a third party form 17 - 19

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1

Practice hours record log

DatesName and address of

organisationType of

organisationScope of practice

Number of hours Registration Brief description of work

1st April 2015 –

31st March 2016

Wirral University Teaching Hospital

Arrowe Park HospitalWirral

CH495PE

Hospital

Management Education Direct Patient

Care

1650 Nurse

Working within general medical ward duties include:Medicine administration including IVCannulation, venepuncture, urinary catheter insertion and care, care to support activities of daily living, care assessments (various), referral and support to multidisciplinary team both internal and outside agencies, safeguarding, emergency care, advocacy, support of nursing and medical students, Instructor for ALS and support clinical training on the ward.

1st April 2014 –

31st March 2015

Wirral University Teaching Hospital

Clatterbridge HospitalWirral

CH63 4JY

Hospital


Contact

1650 Nurse

Working within general medical ward duties include:Medicine administration including IVCannulation, venepuncture, urinary catheter insertion and care, care to support activities of daily living, care assessments (various), referral and support to multidisciplinary team both internal and outside agencies, safeguarding, emergency care, advocacy, support of nursing and medical students, Instructor for ALS and support clinical training on the ward.


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1st April 2013 –

31st March 2014

Wirral University Teaching

Hospital Arrowe Park Hospital

WirralCH495PE

Hospital


Contact

1650 Nurse

Working within general medical ward duties include:Medicine administration including IVCannulation, venepuncture, urinary catheter insertion and care, care to support activities of daily living, care assessments (various), referral and support to multidisciplinary team both internal and outside agencies, safeguarding, emergency care, advocacy, support of nursing and medical students, Instructor for ALS and support clinical training on the ward

Guide to completing practice hours log:

To record you hours of practice as a registered nurse and/or midwife, please enter you most recent practice first and then any other practice until you reach 450 hours. You do not necessarily need to record individual practice hours. You can describe your practice hours in team of standard working days or weeks. For example if you work full time, please just make one entry of hours. If you have worked in a range of setting please set these out individually. You may need to print additional pages to add more periods of practice.. if you are both a nurse and midwife you will need to provide information to cover 450 hours of practice of these registrations

Work settings (select appropriate setting: Your scope of practice: Registration:

Ambulance service Care home sector Care inspectorate Cosmetic/aesthetic sector District nursing Education Governing body or leadership role GP practice or other primary care Health Visiting Hospital or other secondary care Insurance/legal Military Occupational health

Other community services Overseas Policy Prison Private domestic setting Private health care Public health Research School Specialist (tertiary) care Telephone or e0health advice Trade union or professional body Voluntary sector Other

Commissioning Consultancy Education Management Policy Direct patient care Quality assurance or inspection

Nurse Midwife Nurse/SCPHN Midwife/SCPHN


3

Continuing Professional Development (CPD) record logPlease provide the following information for each learning activity, until you reach 35 hours of CPD (of which 20 hours must be participatory). For examples of the types of CPD activities you could undertake, and the types of evidence you could retain, please refer to Guidance sheet 3 in ‘How to revalidate with the NMC’.

Dates

MethodPlease describe the

methods you used for the activity.

Topic(s) Link to Code Number of hours

Number of participatory

hours

12th December 2013 Course attendance

Clinical Champions Course – theory and practical Infection control MRSA Bacteraemia Blood Cultures (post course assessment

within ward) Venepuncture Cannulation Urinary Catheter Insertion and care PICC line care

Practise effectivelyPreserve safety 6 ½ hours 6 hours

4th January 2014 Course attendance

Mandatory Basic Life Support Adult & Paediatric BLS Adult & Paediatric Choking Unified Do Not Attempt Cardiopulmonary

Resuscitation Policy overview Emergency Equipment Familiarisation Modified Early Warning Score overview and

audit feedback Sepsis

Practise effectivelyPreserve safetyPromote professionalism and trust

1 ½ hours 1 ½ hours

Dates Method Topic(s) Link to Code Number Number of participatory


4

of hours hours

June 2014 Online Learning

Dementia Awareness Tier 1 Training Awareness & understanding symptoms,

recognising signs, challenging behaviour Knowledge of the condition – types of

dementia, differences between dementia, delirium, depression etc.

Communications, listening skills and supporting people with dementia;

Person centred care – sign posting to advice and guidance, medication, ethics, impact on families

Prioritise peoplePractise effectivelyPreserve safetyPromote professional ism and trust

20 minutes 0

November 2014

Independent Learning

Pressure Sore Management Prevention Grading & assessment Pain management Pressure area management treatments and

devices Nutrition

Prioritise peoplePractise effectivelyPreserve safetyPromote professionalism and trust

4 hours 0

February 2015 Course Attendance

Safer Use of Medicines Theory & Practice of Safer Use of Medicine

Administration Anticoagulants Insulin Injectable medications Calculation

Practise effectivelyPreserve safetyPromote professional ism and trust

7 hours 7 hours

Dates Method Topic(s) Link to Code Number of hours

Number of participatory

hours


5

June 2015 Course attendance

Mandatory Basic Life Support Adult & Paediatric BLS Adult & Paediatric Choking Unified Do Not Attempt Cardiopulmonary

Resuscitation Policy overview Emergency Equipment Familiarisation Modified Early Warning Score overview and

audit feedback Sepsis

Practise effectivelyPreserve safetyPromote professional ism and trust

1 ½ hours 1 ½ hours

November 2015 Online Learning

SN@P Education Training Package – linked to Safer Use of Medicines

Drug calculation practice

Practise effectivelyPreserve safety

2 hours 0

January 2016Course attendance &

Independent Learning

BSc Module – Infection Control .. .. .. .. .. .. .. ..

Prioritise peoplePractise effectivelyPreserve safetyPromote professional ism and trust

150 15

Total: Total:175 hours20 minutes

34 hours

Guide to completing CPD record logExamples of learning method What was the topic? Link to Code


6

Online learning Course attendance Independent learning

Give a brief outline of the key points of the learning activity

How it is linked to your scope of practice What you learnt How you have applied what you learnt to

your practice

Please identify the part or parts of the Code relevant to the CPD Prioritise people Practice effectively Preserve safety Promote professionalism and trust


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Reflective Accounts FormYou must use this form to record five written reflective accounts on you CPD and/or practice related feedback and/or an event or experience in you practice and how this relates to the Code. Please fill in a page for each of you reflective accounts, making sure you do not include any information that might identify a specific patient, service user or colleague. Please refer to the NMC guidance on preserving anonymity in Guidance sheet 1 in ‘How to revalidate with the NMC’.

Reflective account:What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in you practice?

I received a letter that was sent to my ward Sister thanking me for the care I had given to their relative during the End stages of life.

What did you learn from the CPD activity and/or feedback and/or event or experience in you practice?

Several years ago I undertook an end of life training course and this has impacted upon my practice ever since. Is it nice to know that this course and consequently the skills & knowledge I have gained from it have made a difference to both patient and their relatives experiences during the end stages of the patient’s life and their death.

How did you change or improve your work as a result?

I am thinking that I may try and access a more advanced end of life course to enhance and develop my skills further which will directly affect patient and their relatives care. Even though I have had positive feedback there is always room for improvement and I strive for this as end of life care is of upmost importance. This will enable me to teach and support others dealing with clients’ needs.

How is this relevant to the Code?Select one or more themes: Prioritise people - Practice effectively - Preserve safety - Promote professionalism and trust

Prioritise peoplePractice effectivelyPreserve safetyPromote professionalism and trust


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I attended Cardiopulmonary resuscitation training in January 2014 where the implementation of the North England North West Unified Do Not Attempt Cardiopulmonary Resuscitation policy was introduced. During the session they explained how the policy practically worked within clinical practice and the new documentation (Lilac form), the Mental Capacity documentation and the patient information leaflet.

What did you learn from the CPD activity and/or feedback?

That the policy is now Northwest Regional and not just Trust based. The documentation (Lilac form) is given to the patient / relative / caregiver on discharge. What to do in relation to the Mental Capacity assessments and documentation (in relation to UDNACPR)The use of patient / relative information leafletsOther key documentation that may influence uDNACPR decisions such as Advanced Directive to Refuse Medical Treatment (ADRT) and Power of Attorney Health and Welfare.


I know feel that I understand the process of uDNACPR and have a more comprehensive understanding of the policy which I can utilise in clinical practice which directly affects patient care.I also went away from the training session and accessed the policy and read it in full which has explained things further. I also feel that I can now manage affectively patient / relative / caregivers questions and those of colleagues.




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I received practice feedback in the form of a thank you letter (see attached)


The feedback thanked me for supporting a junior doctor during their clinical skills induction and assessing their clinical competence within the classroom setting.


This has made me feel more confident about my role as a teacher and I feel better equipped to support new staff in developing their clinical skills.


Practice effectivelyPreserve safetyPromote professionalism and trust


10



I attended clinical champions’ course in December 2013 which is a one-day course focused on how clinical skill can influence patient safety in relation to infection control.


I learned about the risks of catheter associated urinary tract infections and how to correctly perform this procedure.


I had never catheterised a male patient before so following the course (where I had practiced both female and male catheterisation) I undertook supervised practice (with patient consent) in this skill (see attached competency.




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I attended Cardiopulmonary resuscitation training in January 2014 where we were instructed and practiced Adult and Paediatric Basic Life Support


Within the training session I refreshed my knowledge of the current national resuscitation guidance and the instructor linked this with practice and the clinical environment. I also gained refreshed knowledge and information regarding audit finding on local issues and policies. These included MEWS and Sepsis.


Emergency situations are generally quite daunting however require immediate action which involves having the knowledge and confidence to sure safe and best practice. Through regular refresher training this allows me to practice the skills and ask questions in a safe environment to ensure that the care I deliver in such moments remains based on current guidance and best practice. The training reassures that the care I deliver is accurate and appropriate and I feel better equipped to deal.




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Reflective Accounts FormYou are required to record a minimum of five written reflections on the Code, your CPD and practice-related feedback, as outlined in ‘How to revalidate with the NMC’. Please fill in a page for each of your reflections, ensuring you do not include any information that might identify a specific patient or service user. You must also discuss these reflections as part of a professional development discussion (PDD) with another NMC registrant and may be required to upload a signed PDD form.


I completed 2 modules, Clinical Examination skills & Diagnostic Health Assessment over a 4 month period.


I completed 2 modules, Clinical Examination skills & Diagnostic Health Assessment over a 4 month period.


I learnt how to obtain a comprehensive history from the patient. Also, how to examine different systems and provide a differential diagnosis. I was also able to write several assignments & written examination at Level 7. It provided me with the underpinning knowledge to interpret physiological and clinical data to determine a differential diagnosis and management plan.

How is this relevant to the Code?Select one or more themes: Prioritise people - Practice effectively - Preserve safety - Promote professionalism and trust:

Prioritise peoplePractice effectivelyPromote professionalism and trust


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Reflective Accounts FormYou are required to record a minimum of five written reflections on the Code, your CPD and practice-related feedback, as outlined in ‘How to revalidate with the NMC’. Please fill in a page for each of your reflections, ensuring you do not include any information that might identify a specific patient or service user. You must also discuss these reflections as part of a professional development discussion (PDD) with another NMC registrant and may be required to upload a signed PDD form.


The patient was newly diagnosed with end stage renal failure and had been finding it hard to come to terms with the constraints on his lifestyle. I made time to sit and chat to the patient, to go through his concerns and to check that he fully understood about the diet and fluid restrictions. But, to also explain that the situation will get better and he may well be able to return to work and go on holiday again. I explained that the staff are here to help and there is a patient support network. The patient came to time the next week to say that he really appreciated the time that I had spent with him. He felt much better about everything. He also had a better understanding of his diet and fluid restrictions which were making him feel better. He had also been chatting to a couple of the other patients, some of whom were able to hold down a job, and the other had been on a cruise.What did you learn from the CPD activity and/or feedback?

It made me feel really pleased that I was able to make difference to the patient. It is so nice to have positive feedback from a patient making my role worthwhile. Although, at times the pace on the ward can be really fast it is important to make time to chat to the patients allowing them time to voice their concerns and give them guidance to improve their quality of life. It is important that patients are able to trust the healthcare professionals.How did you change or improve your work as a result?

Although it is a busy period of time when the patient is being ‘hooked up’ to the machine I will try and discuss any concerns they have, but I will always ensure that I spend some time with them later on in the dialysis session. Also, as a result of the patients having many common concerns and questions I have decided to start up a patient newsletter with the help of my colleagues. Patients will also be encouraged to contribute to the newsletter to provide hints, tips and personal experiences. We could also look at recipe ideas, and contact details for advice.How is this relevant to the Code?Select one or more themes: Prioritise people - Practice effectively - Preserve safety - Promote professionalism and trust:

Prioritise people , Practice effectively, Promote professionalism and trust


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Reflective Discussion FormYou must use this form to record your reflective discussion with another NMC-registered nurse or midwife about your five written reflective accounts. During your discussion you should not discuss patients, service users or colleagues in a way that could identify them unless they expressly agree, and in the discussion summary section below make sure you do not include any information that might identify a specific patient or service user. Please refer to Guidance sheet 1 in ‘How to revalidate with the NMC’ for further information. This form should be completed, stored and shared in manual paper form, as opposed to electronically. This is important because creating, storing or sharing these data electronically may trigger an obligation to register with the Information Commissioner.

To be completed by the nurse or midwife:Name: Ernie JonesNMC Pin number: 99I123456E

To be completed by the nurse or midwife with whom you had the discussionName: George FormbyNMC Pin number: 99I56789EEmail address: [email protected] of discussion: 31st March 2014Number of reflections discussed: 2

Short summary of discussion:

We discussed the reflection regarding the thank you card and CPR training. We discussed the need for individualised care and to keep current with all guidance and continuation of training and development to improve patient care and safety.

I have discussed the number ofreflective accounts listed abovewith the named nurse or midwifeas part of a reflective discussion.I agree to be contacted by the NMC to provide further information if necessary for verification purposes.

Goerge Fornby

31st March 2014


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Reflective Discussion FormYou must use this form to record your reflective discussion with another NMC-registered nurse or midwife about your five written reflective accounts. During your discussion you should not discuss patients, service users or colleagues in a way that could identify them unless they expressly agree, and in the discussion summary section below make sure you do not include any information that might identify a specific patient or service user. Please refer to Guidance sheet 1 in ‘How to revalidate with the NMC’ for further information. This form should be completed, stored and shared in manual paper form, as opposed to electronically. This is important because creating, storing or sharing these data electronically may trigger an obligation to register with the Information Commissioner.

To be completed by the nurse or midwife:Name: Ernie JonesNMC Pin number: 99I123456E

To be completed by the nurse or midwife with whom you had the discussionName: George Formby

NMC Pin number: 99I78910EEmail address: [email protected] of discussion: 31st January 2015Number of reflections discussed: 3

Short summary of discussion:

We discussed clinical champions training, support to training for junior doctors and the dialysis patient. We have discussed the importance of training and passing on our experience and knowledge to others whether patients or colleagues as this improves patients care directly.

I have discussed the number of reflective accounts listed above with the named nurse or midwife as part of a reflective discussion.I agree to be contacted by the NMC to provide further information if necessary for verification purposes.

Rebecca Smith

31st January 2015


16

Confirmation FormYou must use this form to record your confirmation. This form should be completed, stored and shared in manual paper form, as opposed to electronically. This is important because creating, storing or sharing these data electronically may trigger an obligation to register with the Information Commissioner. Please refer to Guidance sheet 1 in How to revalidate with the NMC for further information.

To be completed by the nurse or midwife:Name: Ernie JonesNMC pin number: 99I123456EDate of last renewal of registration or joined the register: 2nd April 2013

I have received confirmation from (select applicable): A line manager who is also an NMC registered nurse or midwife

A line manager who is not an NMC registered nurse or midwife

Another NMC registered nurse or midwife

A regulated health care professional

An overseas regulated health care professional

Other professional in accordance with the NMC’s online confirmation tool

To be filled in by your confirmer:Name: Eric TwingeJob Title: Ward Charge Nurse (manager)Email address: [email protected]

Professional address including postcode:

Wirral University Teaching HospitalArrowe Park Hospital,

CH495PEDate of confirmation discussion: 31st March 2016


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mailto:[email protected]

If you are an NMC registered nurse or midwife please provide:NMC Pin Number: 99E12345E

If you are a regulated health care professional please provide:Profession:

ID of membership for regulatory body:

If you are an overseas regulated health care professional please provide: Country: ID of membership for regulatory

body: Profession:

If you are another professional please provide: Profession: Registration number for regulatory

body:

Confirmation checklist of revalidation requirementsPractice hours

You have seen written evidence that satisfies you that the nurse or midwife has practised the minimum number of hours required for their registration.

Continuing professional development

You have seen written evidence that satisfies you that the nurse or midwife has undertaken 35 hours of CPD relevant to their practice as a nurse or midwife.

You have seen evidence that at least 20 of the 35 hours include participatory learning relevant to their practice as a nurse or midwife.

You have seen accurate records of the CPD undertaken.

Practice-related feedback

You are satisfied that the nurse or midwife has obtained five pieces of practice-related feedback.

Written reflective accounts

You have seen five written reflective accounts on the nurse or midwife’s CPD and/or practice-related feedback and/or an event or experience in their practice and how this relates to the Code, recorded on the NMC form.


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Reflective discussion

You have seen a completed and signed form showing that the nurse or midwife has discussed their reflective accounts with another NMC-registered nurse or midwife (or you are an NMC-registered nurse or midwife who has discussed these with the nurse or midwife yourself).

I confirm that I have read ‘Information for confirmers’, and that the above named NMC-registered nurse or midwife has demonstrated to me that they have complied with all of the NMC revalidation requirements listed above the three years since their registration was last renewed or they joined the registered as set out in ‘Information for confirmers’.I agree to be contracted by the NMC to provide further information if necessary for verification purposes. I am aware that if I do not respond to a request for verification information I may put the nurse or midwife’s revalidation application at risk.

Signature: Rebecca SmithDate: 31ST March 2016


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reflective accounts form - wirral university teaching...

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