specialist community public health nursing portfolio · king’s college london florence...

Florence Nightingale School of Nursing & Midwifery King’s College London

Specialist Community

Public Health Nursing

Portfolio

2013

Contents

Section 1 Handbook

Section 2 The Learning Contract

Section 3

Self and joint assessment document: Standards of Proficiency for Specialist Community Public Health Nurses

Section 4 Practice Accounts

Section 5 Observation and Assessment Schedule

Section 6 Practice Teacher: Interim and Final Reports

Section 7 Verification of Practice Attendance

Section 8 Verification of experience not central to defined area of practice

Section 9 Learning Outcomes for Prescribing from the Nurse Prescribers Formulary for Community Practitioners (for those undertaking the prescribing module only)

Section 10 Troubled Placement Algorithm

Section 11 Standards of Proficiency for Specialist Community Public Health Nurses

Appendix 1 Self and joint assessment

Section 1

Handbook

(See separate document)

Section 2

The Learning Contract

The Contracting Process Steps in Contracting

Activities Involved

Exploring learning needs Consider your future role and past experience, identify your strengths and areas of development. Discuss with your practice teacher. Use the contract outline to help raise questions and formulate ideas.

Establish goals and targets Be SMART (specific, measurable, achievable, relevant, timed). Consider goals and targets for both college work and practice. Take account of course requirements and standards of proficiency for specialist community public health nursing. Your practice may be a more useful starting point than college work.

Identify resources and/or mentor

Seek out available resources and talk to your practice teacher and/or mentor, lecturers, fellow students, other professionals and agencies. Look at the literature, media and internet. Be imaginative.

Develop and agree a contract Agree goals, identify resources, determine time span and identify evaluation strategies. Discuss with your practice teacher. Use the contract outline to articulate your identified needs and goals.

Make a written plan Make good use of resources. Remember that targets may change as your knowledge and experience develops. The targets you set should not act as a constraint for your learning and practice.

Carry out the contract Discuss with your practice teacher and college lecturers and complete your contracting record. Remember that targets may not be achieved for various reasons. You should celebrate your successes and identify reasons why you have not been able to achieve all of your targets.

Evaluate achievements and the contracting process

Re-negotiate your contract with your practice teacher. You should amend your contract and review the process.

On-going process As well as evaluating progress for each learning need identified, new needs should be identified throughout the placement.

Name

Learning Contract Outline Learning needs identified Resources available

Agreed Targets (with dates identified for review or achievement)

Joint evaluation with Practice Teacher (PT) (PT should sign and date the evaluation)

Section 3

Self and joint assessment document: Standards of Proficiency for Specialist Community Public Health Nursing

Self and joint assessment document:

Standards of proficiency for Specialist Community Public Health Nurses

The self and joint assessment document is to support you in identifying your learning needs in order to achieve the standards of proficiency necessary to be admitted to the register as a specialist community public health nurse. It may be used as point of discussion with the programme leaders and your practice teacher when drawing up your learning contract and facilitating your learning needs in practice. This self and joint assessment is not summativley assessed, however you may wish to use it as evidence of your own professional development in discussion with your practice teacher and managers. The self and joint assessment document supports and works in conjunction with the interim reporting system. The standards of proficiency underpin the ten key principles of public health practice in the context of specialist community public health nursing and are grouped into four domains:

• Search for health needs • Stimulation of awareness of health needs • Influence on polices affecting health • Facilitation of health enhancing activities

It is anticipated that you will undertake the self assessment three times throughout the duration of the programme. In order to help you identify your learning needs it is suggested that the first assessment is undertaken early in the first term, again in the second and third terms and, finally, towards the end of your consolidation period if you are undertaking the one year programme. If you are undertaking the part time pathway you will need to discuss the appropriate assessment intervals with one of the programme lecturers. The first assessment should be completed by yourself with or without discussion with your practice teacher. However you will need to discuss your identified learning needs with your practice teacher. The second assessment should be undertaken jointly in consultation with your practice teacher to help monitor your progress. The final assessment must be carried out jointly with your practice teacher. The self and joint assessment document will enable you and your practice teacher to assess skill levels for each of the proficiencies. Each proficiency should be assessed using the following key:

0- Do not do at all 1- Require teaching/training in this area 2- Utilise skills as part of a team 3- Able to work alone but with advice from a supervisor 4- Skills and ability to practise safely and effectively without the need for direct supervision (Fitness for Practice, NMC, 1999)

It is anticipated that the level of skill attained at the end of training will be level 4 for those proficiencies required by the NMC. The self and joint assessment document identifies those proficiencies required for entry to the register. Additional proficiencies have been identified which the programme leaders consider necessary in order to practice within the context of public health nursing. These additional proficiencies are based upon the self audit tool of the Faculty of Public Health Medicine (FPHM) and are identified in this document as such (fphm).

This Self & Joint Assessment Document should be completed and submitted as part of your professional or advanced practice portfolio. The numbers on the table do not need initialling unless there is no agreement between student and practice teacher. In the case of disagreement, please record as follows: e.g. student is PB, practice teacher is VW. In the cell put:

4 PB 3VW

See Appendix 1 for further guidance on possible discussions informing assessment decisions.

Domain: Search for Health Needs

Principle of Public Health: Surveillance and assessment of the population’s health and wellbeing Standards of proficiency for entry to the Register

Discussion and agreement of level between Practice Teacher and student Date: end October 2013

Joint assessment of progress and agreement of level between Practice Teacher and Student Date: 01.02.14

Joint assessment of progress and agreement of level between Practice Teacher and Student Date : 14.6.14

Final joint assessment of progress and agreement of level between Practice Teacher and Student Date: 23.8.14

Collection and structure data on population health needs

Analyse, interpret and communicate data and information on health needs of a defined population

Undertake a needs assessment for a target group or service (fphm)

Develop and sustain relationships with groups and individuals to improve health and social well-being

Identify individuals, families and groups who are at risk and in need of further support

Undertake screening of individuals and populations and respond to findings

Domain: Stimulation of awareness of health needs Principal of public health: Collaborative working for health and well being Standards of proficiency for entry to the Register





Raise awareness about health and social wellbeing and related factors, services and resources.

Develop, sustain and evaluate collaborative work

Recognise and value the potential contribution to improving health made by different agencies; health and other, in public, private and voluntary sectors (fphm)

Understand and value the different roles of public health practitioners in different settings (fphm)

Understand and value the work of local authorities and the non statutory sector and their role in improving public health (fphm)

Domain: Stimulation of awareness of health needs Principal of public health: Working with and for communities to improve health and wellbeing Standards of proficiency for entry to the Register





Communicate with individuals, groups and communities about promoting their health and wellbeing

Raise awareness about the actions that groups and individuals can take to improve their health and social wellbeing

Develop capacity and confidence of individuals and groups, including families and communities, to influence and use available services, information and skills, acting as an advocate where appropriate.

Work with others to protect the public’s health and well being from specific risks

Understand the importance of addressing the wider determinants of health within communities e.g. housing, employment and education (fphm)

Domain: Influence on polices affecting health Principal of Public Health: Developing health programmes and services and reducing inequalities Standards of proficiency for entry to the Register





Work with others to plan and implement and evaluate programmes and projects to improve health and well being

Ensure that the development of programmes and projects are informed by consideration of health inequalities (fphm)

Identify and evaluate service provision and support networks for individuals and groups in local area or setting

Use health needs of a population to inform decisions about health and preventive measures, demonstrating an ability to make realistic changes to meet identified needs taking into account local circumstances (fphm)

Domain: Influence on polices affecting health Principal of Public Health: Policy and strategy development and implementation to improve health and wellbeing Standards of proficiency for entry to the Register





Appraise policies and recommend changes to improve health and wellbeing

Interpret and apply health and safety legislation and approved codes of practice with regard for the environment, wellbeing and protection of those who work with the wider community

Contribute to policy development

Influence polices affecting health

Domain: Influence on polices affecting health Principal of Public Health: Research and development to improve health and wellbeing Standards of proficiency for entry to the Register





Develop, implement, evaluate and improve practice on the basis of research evidence and evaluation.

Conduct a literature review to look for primary and secondary research, using electronic databases, able to define a search strategy and summarise results of it. (fphm)

Domain: Facilitation of health enhancing activities

Principal of Public Health: Promoting and protecting the population’s health and well being

Standards of Proficiency for entry to the Register





Work in partnership with others to prevent the occurrence of needs and risks related to health and wellbeing

Work in partnership with others to protect the public’s health and wellbeing from specific risks

Recognise inequity, discrimination and its impact on health (fphm)

Understand the theoretical models of behaviour change and their relevance in the context of health promotion (fphm)

Identify clear aims and objectives for different health promotion interventions (fphm)

Understand the principles involved in childhood immunisation programmes (fphm)


Principal of Public Health: Developing quality and risk management within an evaluative culture

Standards of proficiency for entry to the Register





Prevent, identify and minimize risk of interpersonal abuse or violence, safeguarding children and other vulnerable people, initiating the management of cases involving actual or potential abuse or violence where needed.

Critically appraise the quality of primary research. Be familiar with the hierarchy of evidence and understand strengths and limitations of different approaches. (fphm)

Critically appraise the quality of a review (secondary research) in a relevant policy context (fphm)

Examine evidence of effectiveness for specific interventions and different health promotion programmes. (fphm) Contd..

Standards of proficiency for entry to the Register





Understand the principles of evaluation, audit, research and development of standard setting to improve quality (fphm)

Demonstrate the use of evaluation/audit as a tool to introduce change (fphm)

Demonstrate an understanding of the way in which data collected at a local level may be used to evaluate the effectiveness or outcomes of an intervention or service (fphm)

Demonstrate an understanding of the way in which information on effectiveness and outcomes may be used to change a service or impact on the uptake of a new intervention (fphm)

Identify the steps for the implementation of recommendations based on research where appropriate and possible. (fphm)


Principal of Public Health: Strategic leadership for health and well-being Standards of proficiency for entry to the Register





Apply leadership skills and manage projects to improve health and well being

Plan, deliver and evaluate programmes to improve the health and wellbeing of individuals and groups.

Prepare and give appropriate written and verbal presentations. (fphm)

Understand NHS funding arrangements and resource allocation (fphm)

Demonstrate the ability to teach and educate a wide range of audiences on public health issues (fphm)

Domain: Facilitation of health enhancing activities Principal of Public Health: Ethically managing self, people and resources to improve health and well being Standards of proficiency for entry to the Register





Manage teams, individuals and resources ethically and effectively

Demonstrate insight and the ability to learn from experience, identify personal learning needs and take action to meet them using appropriate continuing professional development. (fphm)

Mentor and support others to maximise and realize their potential and identify others learning needs and take appropriate action to meet these. (fphm)

Section 4

Practice Accounts (See information in the module handbook, additional information will be provided on KEATs)

Section 5 Observation and Assessment Schedule Electronic Resource (See information in handbook, additional information will be provided on KEATs) E-learning link

Section 6

Practice Teachers: Interim Reports Final Report

Guidance for Practice Teachers and Mentors regarding the 1st and 2nd interim progress reports The following criteria are stated for the reports: 1st interim report hand-in Friday 7.2.14

• Able to undertake visits/interviews on their own to known* clients in a variety of settings

*Known clients, are clients known to the student or the service. For example they could include follow-up visits to clients who the student has met during a supervised new birth visit or a clinic consultation, or a new birth visit to a client the practice teacher/mentor has previously visited. 2nd Interim report hand-in Friday 20.6.14

• Able to undertake visits/interviews on their own to new clients in a variety of settings

Please note that these are MINIMUM requirements, it is not expected that students wait to undertake these activities until the above dates. It is recognised that students will be ready to visit/interview clients alone at different points of the year depending on a range of factors, primarily their developing competence. It should be the aim for the majority of students to be undertaking follow-up and new birth visits to clients on their own from late in Term 1 to the middle of Term 2. If the student is not able to undertake new birth visits alone by Easter the Practice Teacher should make contact with the visiting lecturer to discuss this further, so an action plan can be developed which will support the student being ready to progress to consolidated practice in June.

Practice Teacher Assessment First Interim Progress Report Name of student: Based on knowledge gained from supervised visits, the practice teacher verifies that the student is able to undertake visits/interviews on their own to known clients in a variety of settings.

Yes � No � Please include comments on the following when commenting on student’s progress to date

• Assessment skills • Interpersonal skills • Maintenance of accurate, contemporaneous records

Print Name (Practice Teacher/mentor) Signature (Practice Teacher/mentor)

Date AND/OR Print Name (Sign-off Practice Teacher) Signature (Sign-off Practice Teacher)

Date

First Interim Progress Report

Student comments I agree with the practice teacher report

Yes � No � Please comment on your progress and learning experience to date. If you do not agree with this report please provide evidence for your review. Print name (student) Signature

Date

I understand that I must notify the Programme Leader if there is any change to my circumstances regarding good health and good character at any point during the programme. Signed (student) Date

Practice Teacher Assessment Second Interim Progress Report Name of student: Based on knowledge gained from supervised visits, the practice teacher verifies that the student is able to undertake visits/interviews on their own to new clients in a variety of settings. The student is ready to undertake the period of consolidated practice.

Yes � No � Please include comments on the following when commenting on student’s progress to date

• Assessment skills • Interpersonal skills • Maintenance of accurate, contemporaneous records • Planning and service delivery

Print Name (Practice Teacher/mentor) Signature (Practice Teacher/mentor)


Date Second Interim Progress Report


Yes � No � Please comment on your progress and learning experience to date. If you do not agree with this report please provide evidence for your review. Print name (student) Signature Date Practice Teacher Assessment

Summative Report Name of student: Based on knowledge gained from student supervision, the practice teacher is able to recommend that the student is able to assess, plan, provide and evaluate health interventions to meet health need and health related needs of individuals, families, groups and communities, as appropriate to the specialism.

Yes � No � Print Name (Practice Teacher/mentor*) Signature (Practice Teacher/mentor)


Date *NB The summative assessment must be signed/counter-signed by a Sign-off Practice Teacher.

Summative Report


Yes � No � Please comment on your progress and learning experience to date. If you do not agree with this report please provide evidence for your review. Print name (student) Signature (student)

Date

Section 7

Verification of Practice Attendance

Verification of Practice Attendance Name of student:

……………………………….. …………………………………… ……………………………………… ……………………………………… Print name PT Signature PT Print Name student Signature student Date Date

date

sign

date

sign

date

sign

date

sign

date

sign

date

sign

Agreed as a correct record

Section 8

Verification of experience not central to defined area of practice

Name of student Date(s) of experience Number of days Step 1 Identifying the setting and client group

• Why is this setting/client group considered important or a potential area of responsibility?

• How did you identify this setting/client group? • How will this experience contribute to your professional development as a

specialist community public health nurse?

Step 2 What are your intended learning outcomes from this experience? Step 3 What will be the impact of this experience on: You and your specialist nursing practice? Users of your service? Colleagues/peers?

Step 4 Description of the setting and client group Step 5 Evaluation of experience

• What have you learnt from this experience • How can you apply this learning to your specialist practice • Have you met your intended learning outcomes

Section 9

Learning Outcomes for Prescribing from the Nurse Prescribers Formulary for Community Practitioners (for those undertaking the prescribing module only)

Outcome 1 • Assess and consult with patients/clients, parents and carers.

Student Assessment

Please provide examples from practice that demonstrate your knowledge, skills and understanding in relation to the above outcome.

Outcome 2 • Undertake a thorough history, including medication history and current

medication (including over-the-counter, alterative and complementary health therapies) to inform diagnosis.

Student Assessment

Please provide examples from practice that demonstrate your knowledge, skills and understanding in relation to the above outcome (maximum 200 words).

Outcome 3 • Understand and apply the relevant legislation to the practice of nurse/midwife

prescribing.

Student Assessment


Outcome 4 • Critically appraise, use sources of information/advice and decision support

systems in prescribing practice.

Student Assessment


Outcome 5 • Understand the influences that can affect prescribing practice, and demonstrate

your understanding by managing your prescribed practice in an ethical way.

Student Assessment


Outcome 6 • Understand and apply knowledge of drug actions in prescribing practice.

Student Assessment


Outcome 7 • Demonstrate an understanding of the roles and relationships others involved in

prescribing, supplying and administering medicines.

Student Assessment


Outcome 8 • Prescribe safely, appropriately and cost-effectively.

Student Assessment


Outcome 9 • Practice within a framework of professional accountability and responsibility.

Student Assessment


Outcome 10 • Discuss legislative requirements involving prescribing.

Student Assessment


Outcome 11 • Take an appropriate history, undertake a clinical assessment and make an

appropriate diagnosis, having considered the legal, cognitive, emotional and physical differences between children and adults.

Student Assessment


Section 10

Troubled Placement Algorithm

Troubled Placement Algorithm Student identifies discuss PT identifies problem problem

no resolution Joint meeting between link lecturer, student,

SPT and manager* no resolution

NB * The purpose of the troubled placement algorithm is to identify difficulties at an early stage so that appropriate support can be provided to resolve the difficulties. Although the algorithm shows the Trust Manager involved at the third stage it is permissible and it may be necessary to contact the Trust Manager and/or Education Lead at each level within the Troubled Placement algorithm. For many difficulties the opportunity to air the issues tends to lead to their resolution without any need for escalation. However it is recognised that speed is important in resolving many issues so they do not adversely affect the student’s progress, consequently involvement of Trust Managers at an early stage is supportive and enables the manager, who has an overview of the Trust’s situation, to act early if this is needed.

Resolution monitor Resolution

monitor

Discuss with link lecturer (Students who raise concerns regarding their practice placement will be asked to put these concerns in writing so they can be addressed effectively)

Resolution monitor

Consider change of placement

Section 12

Standards of Proficiency for Specialist Community Public Health Nurses http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Standards-of-proficiency-for-specialist-communicty-public-health-nurses.pdf

http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Standards-of-proficiency-for-specialist-communicty-public-health-nurses.pdf



APPENDIX 1

Self and joint assessment document The entries below are examples of the types of discussion which might inform the self and joint assessment process and of how the numerical data or ‘score’ might be entered as a result of the discussion. There is no need for the type of dialogue described here to be entered within the actual document; the score alone is sufficient. If either the Practice Teacher or the student wishes to record a rationale for the decision made that is also permissible. These are examples only The numbers on the table do not need initialling unless there is no agreement between student and practice teacher. In the case of disagreement, please record as follows: e.g. student is PB, practice teacher is VW. In the cell put:

4 PB 3VW

Domain: Search for Health Needs Principle of Public Health: Surveillance and assessment of the population’s health and wellbeing Standards of proficiency for entry to the Register





Collection and structure data on population health needs

Discussion about student’s current knowledge of the sources of population level data is acquired from: e.g. Public Health Reports, Office of Population Census and Surveys returns. Consideration of the students’ ability to articulate how these data might be used within SCPHN practice based on early practice experience and the Leadership in Public Health Nursing Module. 2 S Student 1 PT Practice Teacher

The student is able to identify numerous sources and types of public health data and to identify how these inform the work of their Practice Teacher and the health promotion targets of the organisation. The student can identify and describe the roles of different workers (e.g. breastfeeding co-ordinators and immunisation co-ordinators) in responding to identified public health need. The student can contribute to team working by sharing data acquired through individual endeavour or for the Leadership in Public Health Nursing module. 2

The student can use data retrieved from numerous sources, including data used for the Leadership in Public Health Nursing Module, to inform their decision making in practice but needs guidance from the Practice Teacher about how best to meet local needs. For example the PT may advise the student that although data indicate breast feeding is an important issue it is best addressed with individual families rather than through group work as groups tend to have a poor uptake in the locality. 3

The student can now identify and access relevant data sources and use these to inform individual and population level health promoting practice based on local conditions and health needs. 4

Domain: Stimulation of awareness of health needs

Principal of public health: Collaborative working for health and well being Standards of proficiency for entry to the Register





Raise awareness about health and social wellbeing and related factors, services and resources

Discussion about student’s current knowledge of health promotion theory and ecological models of health. Identification of information sources on services available to promote health and social wellbeing and the discussion of the mechanism which enables these to work. 1

The student is able to describe the ecological model of health and to illustrate in conversation how this informs practice in terms of work with individual families and with groups within the population. The student can identify the contribution of different team members to promoting health and wellbeing and describe the particular role and function of the SCPHN. 1 S Student 2 PT Practice Teacher

The student uses the ecological model of health and the Assessment Framework to inform SCPHN work with individual families and to contribute, with support, to multi-disciplinary approaches to health promotion. 3

The student works with increasing independence in complex situations to promote health and social wellbeing for individuals and for population groups. 4

Domain: Influence on policies affecting health

Principal of public health: Developing health programmes and services and reducing inequalities Standards of proficiency for entry to the Register





Ensure that the development of programmes and projects are informed by consideration of health inequalities

Discussion about student’s current knowledge of marginalised and disenfranchised groups and identification of their understanding of the ways in which marginalisation affects health and wellbeing.. 1

The student is able to identify and describe the ways in which SCPHNS work to include vulnerable others within healthcare provision. 2.

The student uses inclusion strategies within their own supported practice and develops a critique of their effectiveness in discussion with the Practice Teacher. 3

The student works with increasingly challenging families and population groups to identify ways in which they can have greater access to services. The student is able to discuss with greater sophistication the health implications of exclusion and how these can be overcome. 4