Download 2016 Midwifery Practice 5 - Edinburgh Napier Staff Intranet

School of Nursing, Midwifery and Social Care
Bachelor of Midwifery Programme
Master of Midwifery Programme
COMPETENCY ASSESSMENT BOOK
MODULE MID09116 MIDWIFERY PRACTICE 5
STUDENT MIDWIFE ……………..……………….
MODULE NUMBER & TITLE
MID09116 MIDWIFERY PRACTICE 5
[3-Year Route]
NAME OF STUDENT
MATRICULATION NUMBER
INTAKE
MODULE LEADER
PLACEMENT
FROM:
TO:
COMPETENCIES
PASS/FAIL
OVERALL
MARKS
NAME OF
SIGN-OFF MENTOR
1. Ante/Postnatal
2. Neonatal Unit
Marks to be completed by Module Leader
Signature of Module
Leader
SUM OF OVERALL PLACEMENT MARKS
FINAL MODULE MARK
SUMMARY OF RECORD OF ABSENCE/SICKNESS FROM PRACTICE
DURING PLACEMENT/S
Placement
Dates
Absent/Sick
Total number of
days absent/sick
Comment if
medical certificate submitted
etc.
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INTRODUCTION TO COMPETENCY ASSESSMENT BOOK
The Nursing and Midwifery Council (NMC) has set standards for education programmes, for
pre-registration midwifery these are set out within the Standards for Pre-Registration
Midwifery Education (NMC 2009). This document includes the competencies required to
prepare students to practise effectively and safely and is based upon the Essential Skills
Clusters (ESCs).
The four domains are divided into categories:
1. Effective midwifery practice
2. Professional and ethical practice
3. Developing the individual and others
4. Achieving quality through evaluation and research
The Midwifery ESCs are categorised in the following general headings that are fundamental
to best practice:
 Communication
 Initial consultation between the woman and the midwife
 Normal labour and birth
 Initiation and continuance of breastfeeding
 Medicine management
The above general headings reflect women’s expectations of newly registered midwives and
fulfil the NMC requirements. Students must demonstrate competence in the ESCs and will be
subject to ongoing monitoring and review.
THE PROCESS OF MARKING PRACTICE
Students must pass ALL the competencies as set out in the Competency Assessment Book
for each placement. A practice module is made up of either one, two or three placements.
The competencies assessed in each placement are grouped into four elements based on the
midwifery domains and all competencies in each individual element must be achieved. The
elements’ criteria statements match the Scottish Credit Qualification Framework (SCQF) of
levels 7, 8 and 9 and relate to the student’s stage of study in the programme.
At the end of each placement: The sign-off mentor uses the Practice Marking Tool to
assess the student’s overall performance in achieving the competencies within each element.
The mentor decides on a mark from the range of marks available (100-65, 64-40 and 39-0)
that reflects the overall performance of the student using the competency marking criteria.
The pass mark for each placement must be 40 or more. When a student fails any
competencies, this failure will be reflected as 39 marks or less in the criteria elements and
although 40 or more may be the overall score the placement outcome will be a fail.
At the end of the module: The module leader adds the marks from the placements and the
average derived is the final mark for the module. Where the practice module has more than
one placement the final module mark will be the average of the overall marks achieved in
each placement. All competencies must be passed and the module pass mark is 40 or more.
When a student fails a placement but has gained more than 40 as an average, the student
will be awarded a fail for the module. A student who has a score of 65 or above will be
awarded a MERIT for the module.
Students should be marked using the full grading range of 0 -100 as they are being
assessed on competencies expected for their level of study.
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If a student fails the practice module she/he is entitled to one re-assessment opportunity. The
Board of Examiners will decide on the duration necessary for the failed element and when
the component re-assessment is to be taken.
STUDENT MIDWIFE’S RESPONSIBILITIES
The NMC Code (2015) states the professional standards that nurses and midwives must
uphold in order to be registered to practise in the United Kingdom.
The Code contains a series of statements that taken together signify what good nursing and
midwifery practice looks like. It puts the interests of patients and service users first, promotes
safety and effectiveness and promotes trust through professionalism.
Statements:
 Prioritise people - you put the interests of people using or needing nursing or
midwifery services first. You make their care and safety your main concern and make
sure that their dignity is preserved and their needs are recognised, assessed and
responded to. You will ensure that those receiving care are treated with respect, that
their rights are upheld and that any discriminatory attitudes and behaviours towards
those receiving care are challenged.
 Practice effectively - you will assess need and deliver or advise on treatment, or give
help (including preventative or rehabilitative care) without too much delay and to the
best of your abilities, on the basis of the best evidence available and best practice.
You communicate effectively, keeping clear and accurate records and sharing skills,
knowledge and experience where appropriate. You reflect and act on any feedback
you receive to improve your practice
 Preserve safety - you make sure that patient and public safety is protected. You work
within the limits of your competence, exercising your professional ‘duty of candour’
and raising concerns immediately whenever you come across situations that put
patients or public safety at risk. You take necessary action to deal with any concerns
where appropriate.
 Promote professionalism and trust - you uphold the reputation of your profession at all
times. You should display a personal commitment to the standards of practice and
behaviour set out in the Code. You should be a model of integrity and leadership for
others to aspire to. This should lead to trust and confidence in the profession from
patients, people receiving care, other healthcare professionals and the public.
You should familiarise yourself with the NMC documents: The Code (2015), Midwives Rules
and Standards (2012) and the Standards for Medicines Management (2010).
Practice concerns
There may be times where you see practice that concerns you. If this happens, you have a
professional duty, as an aspiring midwife, to protect the women and babies you care for. You
should seek advice as soon as possible and follow the whistleblowing flow chart which is
found on the Practice 5 Moodle site.
If you are involved in a practice investigation
If you are involved in a practice event that requires either investigation, you are advised to
contact your Practice Development Tutor (PDT) or a Supervisor of Midwives (SOM) for
advice and support. If you are asked to write a factual account of your involvement in events,
then always seek an appointment with your PDT and/or SOM.
Hours of work/time keeping
In Practice 5, you are required to undertake 37.5 hours practice per week. The identified
dates for reflection are included as clinical hours.
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5
In preparation for the initial meeting with your mentor, you should have reflected on your
learning and identified goals and expectations for the current placement as per the Practice
Learning Checklist (2014). It is your responsibility to keep your practice assessment
documents safe and ensure that current documents are always readily available for your
mentor to sign-off competencies following discussions on your progress. You are expected to
reflect and self-assess your own progress during a placement and be prepared to discuss
your learning with your mentors, your PDT and link lecturer.
It is your responsibility to ensure that the mentors sign the timesheets for practice
attendances daily and any sickness/absence is recorded. You should refer to your
Programme Handbook for more details concerning reporting sickness when in practice.
ROLE AND RESPONSIBILITIES OF A SIGN-OFF MENTOR
The sign-off mentor must have completed the essential mentor preparation and be recorded
as active on the Sign-off Mentor database held by the relevant NHS provider. It is the
mentor’s responsibility to orientate the student at the start of the placement and ensure that
health and safety procedures are explained. The sign-off mentor is responsible for ensuring
that the learning experience available for the student enables them to meet the required
learning outcomes. Sign-off mentors are accountable to the NMC for ensuring that students
are fit to practice and should assess the students’ level of competence by observing their
practice and discussing the knowledge and skills required to practice safely.
The mentor should encourage the student to reflect, self-assess her /his own achievement of
the competencies, and that they are ready to discuss on-going learning experiences. The
mentor must involve the link lecturer and/or the practice education facilitator (PEF) at an early
stage when there are concerns about a student’s standard of practice or behaviour. In this
instance any action plan and follow-up review must be clearly documented in the
Competency Assessment Book.
Initial Meeting / Orientation
At the beginning of a placement (within two days), the sign-off mentor must meet with the
student to complete the orientation checklist and discuss the student’s previous learning. At
this initial meeting, the sign-off mentor will discuss learning needs and prepare a
development plan for learning opportunities to be facilitated during the placement. The outline
of the plan must be documented and signed.
Mid-point Meeting
Both mentor and student should meet at the mid-point of the placement to discuss progress.
This is a valuable time for the student and mentor to review the initial developmental plan.
Students must be given objective feedback on their progress at this point; and where
concerns have been raised that a student may not achieve the required level of competence,
an action plan must be developed. Where appropriate the link lecturer and/or PEF will be
involved at this meeting. It would be good practice to sign individual competencies throughout
the placement to monitor the students’ progress.
Final Meeting
At the end of the placement, the student and mentor must meet to discuss and complete all
the documentation in the Competency Assessment Book. The mentor enters a grade and
completes the individual competencies that are left to sign. It is the responsibility of the signoff mentor to document the rationale for the overall mark awarded. This should be
documented as a summary during the final meeting. It would be beneficial to also include
feedback from the wider team, women and their families.
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What to do IF an experience/competency is not available during the placement
When there is no opportunity for the student to demonstrate a competency, such as an
obstetric emergency, the student midwife must be able to discuss and demonstrate accurate
understanding of the situation and the implications. Simulation can be used to assess
competence.
The mentor will then verify that the competency is achieved by signing it off as “Explanation
Verified” (EV). When a student is unable to explain, the competency is recorded as ‘FAIL’.
The mentor must also document the EV or Fail in the Student’s Ongoing Record of
Attainment (ORA).
Apart from ‘EV’, the assessment outcome of each competency outcome must be written P for
pass or write FAIL in full for clarity.
On-going Record of Achievement (ORA)
The NMC Standard 16 (NMC, 2009) states that an on-going record of achievement (ORA) is
a required component of the assessment of practice.
The ORA allows information about overall student performance to be passed from one
placement mentor to the next, enabling the mentors to judge student progress. All three
years of practice learning are evidenced in this document providing mentors with an overview
that will support mentors and students to plan the learning outcome and complete the
assessment process.
LINK LECTURER AND PEF’S RESPONSIBILITIES
A midwife lecturer is identified as the link lecturer for each approved midwifery practice
placement area. They discuss changes, developments and review students’ allocations and
suitability of the placements by conducting practice placement audits and completing
placement profiles every 18 to 24 months.
The link lecturer updates the mentors of any regulatory and programme changes such as
assessment processes to ensure that the practice marking tools are used effectively. The link
lecturer (and where appropriate the midwife PEF) will be involved in supporting and guiding
both mentors and students when issues arise, for example, if the sign-off mentor is
concerned about a student’s lack of progress or unacceptable behaviour, the link lecturer will
be involved in discussions and give guidance of the marking and moderation of practice. Any
decisions or action points must be documented in the Competency Assessment Book.
PEF’s support mentors in the practice learning environment and they are responsible for a
range of placements.
MODULE LEADER’S RESPONSIBILITIES
The module leader is responsible for issuing the Competency Assessment Book to students
and prepares the students for the learning outcomes of each practice module. The module
leader must give students information about the submission date and how/where to submit
the completed documents. The module leader is responsible for ensuring fairness and equity
of the assessment process and will moderate and ensure due process has been applied. The
module leader ensures that the external examiner is able to scrutinise completed
Competency Assessment Books, discussing the marking/moderation and any issues with
them. It is also the module leader’s responsibility to present the results to the Module Board
of Examiners.
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Practice learning process
The student to make initial contact with the practice placement area 2 weeks prior
to commencement date.
↓
Initial meeting within 2 days of commencing the practice placement
 You and your sign-off mentor must compete the induction sheet.
 Review progress to date.
 Identify learning outcomes and write a plan.
 Set dates for your mid-point and final assessments and book these in the
ward diary.
Mid-point meeting
 You are expected to complete your own self-assessment prior to meeting
your mentor to highlight your learning needs.
 You and your sign-off mentor meet to review your progress. If there are no
concerns raised, then continue with the original plan. If concerns are raised
then a plan needs to be devised and documented to facilitate the
achievement of outstanding competencies. The link lecturer, module leader,
PDT or PEF should be contacted to support this process.
End of placement meeting
 You and your sign-off mentor meet to evaluate the placement, sign the
competencies, allocate a grade, demonstrate the rationale for the grade,
complete the time sheets and complete the ORA. You also need to evaluate
the placement and write a summary of your experience.
↓
Submission of assessment documentation
You must submit all your documentation together by the set date and time given
by the module leader which for Practice 5 (MID09116) is Nessa McHugh. Nonsubmission will result in a fail for the module regardless of the grade awarded by
the practice placement sign-off mentor.
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PLACEMENT: ANTENATAL / POSTNATAL
RIE
ST JOHN’S BORDERS FORTH VALLEY FIFE
Please circle the applicable
DATE OF PLACEMENT FROM
PLEASE PRINT NAME OF
MENTORS INVOLVED IN THE
ASSESSMENT
TO
SIGNATURES & INITIALS OF
MENTORS
DATE OF LAST
MENTOR UPDATE
ORIENTATION AT INITIAL MEETING
The orientation to practice area must be completed during the first shift of the placement. Please indicate if you have provided the orientation
information to the practice placement in relation to the following with a tick:
Yes
√
No
Preliminary discussion of skills previously
achieved and the learning opportunities
available
Introduction to other team members
Is aware of how to contact and who the
Supervisors of Midwives are in the area
Orientation to placement philosophy and
client group
Location of equipment and stores
Fire and safety procedures
Emergency procedures
Specific policies/ legal frameworks/
confidentiality issues
Moving and handling policies and
procedures
Others –
Date & Signature of student
Date & Signature of mentor
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ANTENATAL/POSTNATAL WARD PLACEMENT SUMMARY
PRACTICE PLACEMENT AREA:
DATES:
I have received and discussed student’s previous placement records
Sign-off mentor’s signature:
RECORD OF DEVELOPMENTAL PLAN AT INITIAL MEETING
To be completed by the student prior to initial meeting
To be completed by the mentor at the initial meeting
Student’s goals and expectations
Agreement of learning opportunities during the placement
Student’s signature:
Print Name
Date:
Sign-off mentor’s signature:
Print Name
Date:
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RECORD OF MID-POINT MEETING AND COMMENTS:
Student’s self-assessment of progress:
Sign-off mentor’s comments:
Students’ signature: ………………………………… Date:
Sign-off mentor’s signature: ………………………….. Date:
Use this section only if necessary. Sign-off mentor’s action plan for areas of concern if required.
ACTION PLAN:
REVIEW OF OUTCOMES:
Print Name
Sign and Date
Sign and Date
Student
Sign-off mentor
Link lecturer/PEF
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Edinburgh Napier University
8 Week Antenatal/ Postnatal Hub & Spoke placement: 5 weeks Ward hub and 3 spokes as applicable
Student’s self-assessment of progress:
Students’ signature: …………………………… Date:
Student’s self-assessment of progress:
Students’ signature: …………………………… Date:
Record of Maternity Spoke:
Mentor’s comments:
Mentor’s signature: ………………………….. Date:
Record of Maternity Spoke:
Mentor’s comments:
Mentor’s signature: ………………………….. Date:
All mentors are responsible for signing off competencies within the main booklet. The mentor in week 8 of the placement must ensure that they collate evidence and
complete the final assessment.
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Edinburgh Napier University
8 Week Antenatal/ Postnatal Hub & Spoke placement: 5 weeks Ward hub and 3 weeks Maternity Day Care/ Observation/ Outpatient /Triage spokes as applicable
Student’s self-assessment of progress:
Students’ signature: …………………………… Date:
Record of Maternity Spoke:
Mentor’s comments:
Mentor’s signature: ………………………….. Date:
All mentors are responsible for signing off competencies within the main booklet. The mentor in week 8 of the placement must ensure that they collate evidence and
complete the final assessment.
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Student’s evaluation of achievement:
RECORD OF FINAL MEETING AND COMMENTS:
Sign-off mentor’s rationale for mark awarded:
COMPETENCIES: PASS/FAIL
Student’s signature: ……………………………………Date:
Module Leader’s Comments:
OVERALL MARK …….
Sign-off mentor’s signature: ……………………………Date:
Signature, Print Name and Date:
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Assessment Criteria – Clinical Score-Directions for use: Level 9
The scoring system is based on the assessment of each element of practice. Each box has the same 4 criteria which identify progress according to
performance. Based on your experience and comments from other sign-off mentors you need to decide whether the student is excellent, pass or fail. Once
you have decided which box best describes your student’s performance; you should mark according to the box you have chosen. For example, if you feel
that the student is a pass this automatically means that the student will receive a mark of 40% with additional scoring increasing it to a maximum of 64%.
Overall
Domain criteria
Available Actual Overall
Judgement
Score
Score
score
Excellent
Domain 1
Excellent care and clinical skills achieved at level 9, at all times with exceptionally
0-9
Effective midwifery
(merit)
effective practice
practice
100-65%
Domain 2
Consistently critically reflects on professional practice and is fully aware of the
0-9
Professional and ethical
ethical issues within midwifery practice
practice
Domain 3
Developing the individual
midwife and others
Domain 4
Can clearly evaluate own learning requirements in practice in relation to the need
for life long teaching and learning for themselves and others: Principles and
processes relating to revalidation
Excellent ability to apply research and the evidence to practice
0-9
Good care and clinical skills achieved at level 9, with good effective practice
Regularly critically reflects on professional practice and is aware of the ethical
issues within midwifery and midwifery practice
Can evaluate some of her own learning requirements in practice in relation to the
need for life long teaching and learning for themselves and others: Principles and
processes relating to revalidation
Ability to apply research and the evidence to practice
Care and clinical skills not achieved at level 9
0-6
0-6
0-8
Achieving quality care
through evaluation and
research
Pass
64-40%
Domain 1
Domain 2
Domain 3
Fail
39-0%
Domain 4
Domain 1
Domain 2
Domain 3
Domain 4
Minimal or no critical reflection on professional practice and does not indicate
awareness of the ethical issues within midwifery
Is unable to or has limited ability to evaluate her own learning requirements in
practice in relation to the need for life long teaching and learning for themselves
and others: Principles and processes relating to revalidation
Limited or no ability to apply research and the evidence to practice
0-6
0-6
0-10
0-10
0-10
0-9
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ANTENATAL/POSTNATAL PLACEMENT
P or Fail
Student
If there is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he
has the underpinning theoretical knowledge
Communication
Domain:
Effective midwifery
practice
Professional and ethical
practice
ESC:
Communication
Initial consultation
between the woman and
the midwife
Initiation and continuance
of breastfeeding
Diagnosis
Domain:
Effective midwifery
practice
Professional and ethical
practice
ESC:
Communication
Initial consultation
between the woman and
the midwife
Medicines management
P or Fail
Mentor
Sign-off mentors
signature
Date
Demonstrates effective communication skills with women and their
families and always seeks to confirm understanding and gain
informed consent.
Is proactive and creative when encouraging women to think about
their own health, and the health of their babies and families, and how
this can be improved.
Utilises appropriate communication skills to deal with difficult and
challenging circumstances including situations where women have
physical, cognitive or sensory disabilities.
Engages in multidisciplinary communication: face to face, telephone,
in writing and electronically ensuring the woman’s needs are wishes
are clear.
Plans and provides health education during antenatal and postnatal
periods for women, families and juniors.
Initiates the holistic assessment and monitoring of women throughout
the antenatal period.
Considers the following through the assessment of cultural and
emotional wellbeing:
History taking, observation, physical examination and Including social
factors for example; substance misuse, domestic violence.
Can provide information relating to 2 specific antenatal investigations
and demonstrate an understanding of their indications:
1.
2.
Applies evidence based knowledge when sharing information and
performing assessments/tests/investigations and screening tests such
as:
 Blood glucose monitoring.
 Blood testing.
 Urine samples.
 Infection screening.
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19
ANTENATAL/POSTNATAL PLACEMENT
P or Fail
Student
If there is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he
has the underpinning theoretical knowledge
Diagnosis
(cont.…)
P or Fail
Mentor
Sign-off mentors
signature
Date
Initiates maternal observations: temperature, pulse, blood pressure,
respirations, urinalysis, fluid balance and Per Vaginum (PV) loss.
Demonstrates awareness and critical understanding of the following
signs and symptoms in both ante and postnatal women:
 Pain.
 Bradycardia, tachycardia, pyrexia, hypo/hypertension,
dyspnoea, tachypnoea.
 Headaches.
 Offensive PV loss.
 Abnormal urinary function.
 Abnormal bowel function.
Can prepare and transfer women between ward areas utilising SBAR.
Can complete pre-operative care and preparation of women for
transfer to theatre.
Initiates the holistic assessment and monitoring of women throughout
the postnatal period.
Considers the following:
History taking, observation, physical examination and biophysical
tests. Include social, cultural and emotional assessments.
Provide information relating to 2 specific postnatal investigations and
demonstrate an understanding of their indications:
1.
2.
Recognises, monitors and discusses the normal maternal postnatal
physiological adaptations and refers as appropriate when deviation
occurs.
Prepares women for discharge home including appropriate
documentation, discharge prescriptions/medications and follow up
appointments.
20
ANTENATAL/POSTNATAL PLACEMENT
P or Fail
Student
If there is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he
has the underpinning theoretical knowledge
Care planning
Domain:
Effective midwifery
practice
Professional and ethical
practice
Achieving quality through
evaluation and research
ESC:
Communication
Initiation and continuance
of breast feeding
Care provision
Domain
Effective midwifery
practice
ESC:
Communication
Initiation and continuance
of breast feeding
Medicines management
P or Fail
Mentor
Sign-off mentors
signature
Date
Can initiate appropriate care planning made in partnership with
women and other health care professionals; which is evidence based
and respecting culture, choice and individual context.
Evaluates care plans and assists midwives making and documenting
amendments to enhance care and improve outcomes.
Critically discusses the need for individualised postnatal support for
families.
Provides examples of national and local policy/guidelines that support
best practice and promotes women centred care:


Is proactive in promoting care environments that are diversity
sensitive and free from exploitation, discrimination and harassment.
Can take an accurate social, medical, surgical and obstetric history in
order to determine pathway of care including consideration for women
with disabilities.
Can provide care under supervision for women with antenatal
complications in a variety of settings, including the following:
 Ultrasounds.
 Glucose tolerance tests.
 Electronic fetal monitoring/fetal movements.
 Blood pressure profiles.
 Blood testing as appropriate.
Recognises and explores the role of the midwife in normal postnatal
care and assesses the needs of women.
Provides a critical rationale for the midwifery care offered to women
who have had an antenatal/intrapartum complication; for example:
APH, instrumental delivery or caesarean section.
21
Understands the role of the midwife and actively participate when
caring for women with complex needs such as; pregnancy loss, still
birth neonatal death.
ANTENATAL/POSTNATAL PLACEMENT
P or Fail
Student
If there is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he has
the underpinning theoretical knowledge
Care provision
(cont.…)
Referral
Domains
Effective midwifery
practice
Professional and ethical
practice
Developing the
individual midwife and
others
ESC:
Communication
P or Fail
Mentor
Sign-off
mentors
signature
Date
Understands and evaluates the processes of monitoring and supporting
women who have antenatal/postnatal or mental health issues.
Ensures the comfort needs of women are met such as: bladder care,
hydration, nutrition, hygiene, infection prevention and assessment of skin
integrity.
Supports women to become independent and self-caring, such as
providing advice on: bladder control, recuperation and contraceptive
choices.
Applies knowledge to assess, plan, care and provide support for women
and their family who have babies who are ill/preterm or have a disability.
Under supervision manages and prioritises competing demands, include
identification of who is most appropriate to provide particular
interventions.
Identifies and initiates appropriate and timely referral for women who
would benefit from the skills and knowledge of other professionals: acting
within the law when disclosing information without consent.
Discusses the reasons for referral such as: health, social and
psychological issues, maternal obesity, child protection, financial issues
and law.
Recognises and critically discusses the importance of team working to
support the best interests of individual women.
22
Emergency
procedures
Domain
Effective midwifery
practice
ESC:
Communication
Medicines management
Discusses and evaluates the role of the midwife when participating in
emergency procedures that meet the needs of women and their babies:
 Adult resuscitation.
 Antepartum haemorrhage.
 Postpartum haemorrhage.
 Severe pre-eclampsia/eclampsia.
 Acute fetal distress.
 Neonatal resuscitation.
 The use of medicinal products.
23
ANTENATAL/POSTNATAL PLACEMENT
P or Fail
Student
If there is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he
has the underpinning theoretical knowledge
Examination and
care for babies
Domain
Effective midwifery
practice
Professional and ethical
practice
Achieving quality through
evaluation and research
ESC:
Communication
Initiation and continuance
of breast feeding
Medicines management
P or Fail
Mentor
Sign-off mentors
signature
Date
Performs and completes the documentation of a full assessment/
physical examination of the baby recognising normal growth and
development.
Provides a rationale when assessing the following signs and
symptoms in the baby:
 Colour/skin perfusion.
 Behaviour/alertness.
 Cry.
 Muscle tone/movements.
 Feeding patterns.
 Elimination patterns.
 Weight loss.
 Signs of infection.
 Tachycardia, bradycardia, pyrexia and dyspnoea.
Provides advice and support for parents on hygiene, safety,
protection, security and child development.
As appropriate assists women to administer medicines to their babies.
Discusses and justifies referral pathways for babies with child
protection issues.
Initiates and justifies the care and referral as necessary for babies
with specific health needs such a low birth weight.
Under supervision, evaluates the care required for babies with
pathological conditions, such as babies affected by maternal
substance misuse.
Prepares a baby for discharge home including appropriate
documentation, follow-up and discharge medication.
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ANTENATAL/POSTNATAL PLACEMENT
P or Fail
Student
If there is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he
has the underpinning theoretical knowledge
Infant nutrition
Domain:
Effective midwifery
practice
Professional and ethical
practice
Achieving quality through
evaluation and research
ESC:
Communication
Initiation and continuance
of breast feeding
P or Fail
Mentor
Sign-off mentors
signature
Date
Supports and advises women as they start to feed and care for their
baby, recognising the woman’s existing attitude, knowledge and skills.
Communicates sensitively the importance of breast feeding and
consequences of not breast feeding in terms of health outcomes.
Applies knowledge and skills when advising women over the
telephone, when contacted for advice on breast feeding issues.
Encourages and supports mothers to keep their baby close so that
they can tune into each other and learn early feeding cues (skin to
skin and baby holding) avoiding unnecessary separation.
Facilitates and encourages the development of the parent(s)/baby
relationship.
Critically discusses the principles underpinning responsive feeding,
bed sharing and the use of dummies with an awareness of your own
thoughts and feelings about infant feeding. Ensures that information
shared is ethical and non-judgemental.
Advises women on effective positioning, attachment using the ‘see’
‘hear’ ‘feel’ principles.
Supports women to hand express breast milk and feed their baby
using a cup or syringe as appropriate.
Under supervision provides support when early feeding challenges
occur; such as the baby who is slow to initiate and maintain feeding or
the baby with specific health needs.
Critically discusses the importance of exclusive breast feeding and
the consequences of offering artificial milk to breastfed babies.
Critically appraises and evaluates the strength of research evidence
in relation to breast feeding practices, promotion and support
interventions.
Recognises and discusses pathways for referral to appropriate health
care professionals such as the infant feeding advisor.
25
ANTENATAL/POSTNATAL PLACEMENT
P or Fail
Student
If there is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he
has the underpinning theoretical knowledge
Partnership
Domain:
Effective midwifery
practice
Professional and ethical
practice
Developing the individual
midwife and others
ESC:
Communication
Medicine
administration
Student must also
complete with their
sign-off mentor the
managing
medicines in
practice
assessment p33
Domain:
Effective midwifery
practice & Professional
and ethical practice
Esc:
Communication
Initiation and continuance
of breast feeding
Medicines management
(ENU Guidance for
Student Midwives and
Medicine Administration
p35)
P or Fail
Mentor
Sign-off mentors
signature
Date
Initiates partnership working with women that facilitates the provision
of seamless care. Discussions should include women centred care,
promotion of health and management of health needs.
Provides culturally sensitive support for women regarding future
reproductive choices; for example: contraception and family planning.
Takes a medicine history and accesses evidence based sources of
information relating to the safe and effective management of
medicinal products utilising the British National Formulary.
Identifies how medicines are absorbed, distributed, metabolised and
eliminated (the principles of pharmaco-kinetics); and how medicine
doses are determined by dynamics/systems in the body.
Can correctly calculate and discuss 3 common medicines and
dosages used in antenatal midwifery practice at the first attempt
(100% accuracy).
1.
2.
3.
Ensures an individual women centred focus when sharing
information, alleviating fear and anxiety of the women in relation to
medicine administration. Where appropriate utilises medicine
information leaflets.
Safely administers oral, intramuscular and subcutaneous medication
under direct supervision and disposes of all equipment needed during
preparation and administration.
Demonstrates an understanding of and participates in the
administration and management of blood and blood products.
Observes the siting of intravenous cannulae and participate in the
subsequent care of the intravenous site.
26
ANTENATAL/POSTNATAL PLACEMENT
P or Fail
Student
If there is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he
has the underpinning theoretical knowledge
Medicine
administration
(cont.…)
Record keeping
Domain:
Effective midwifery
practice
Professional and ethical
practice
ESC:
Communication
Public health
Domain:
Professional and ethical
practice
Achieving quality through
evaluation and research
ESC:
Communication
Initiation and continuance
of breast feeding
Medicines management
Normal labour and birth
P or Fail
Mentor
Sign-off mentors
signature
Date
Participates in involving women in administration and/or selfadministration of medicines over the counter or prescribed.
Interprets and maintains prescription charts accurately as per The
Code (NMC, 2015), national/local policies for the administration of
medicines with an understanding of professional responsibilities such
as midwives exemption lists (MEL).
Demonstrates knowledge of how to report contraindications, side
effects and adverse reactions.
Initiates with support, referral to the appropriate practitioner for
medicine review such as pain relief.
Demonstrates the ability to maintain the stock control/storage of
medicinal products including: ward stock and take-home medications.
Demonstrates awareness of the role and function of bodies that
regulate and ensure the safety and effectiveness of medicinal
products; for example: the Standards for Medicines Management
(NMC, 2007) & the Medicines and Healthcare Products Regulatory
Agency (UK Government).
Completes accurate, legible and continuous records which include the
rationale behind actions taken.
Demonstrates the correct use of appropriate information technology
systems available.
Adheres to the data protection laws around women’s records.
Critically discusses public health policies which influence maternity
care provision; for example: infant hearing screening and Anti-D
programmes.
Discusses and justifies health promotion strategies which target
specific groups with particular health needs; for example: smoking
cessation, obesity and infant nutrition.
Demonstrates application of evidence based practice in relation to the
reduction of maternal and perinatal morbidity and mortality.
27
ANTENATAL/POSTNATAL PLACEMENT
P or Fail
Student
If there is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he
has the underpinning theoretical knowledge
Respecting the
individual
Domain:
Professional and ethical
practice
ESC:
Communication
Professional
practice
Domain:
Professional and ethical
practice
Developing the individual
midwife and others
Achieving quality through
evaluation and research
ESC:
Communication
Initiation and continuance
of breast feeding
Medicines management
P or Fail
Mentor
Sign-off mentors
signature
Date
Recognises and discusses the different roles and relationships in
families; reflecting religious and cultural beliefs, preferences and
experiences, particularly around family planning advice.
Challenges situations/others where the dignity of women may be
compromised.
Respects women’s autonomy and rights when making a decision
even where choice may result in harm to themselves or their unborn
baby, unless a court of law orders the contrary.
Practices in accordance with The Code (NMC, 2015) and within the
limitations of the individuals’ own competence, knowledge and sphere
of professional practice.
Demonstrates knowledge and application of legislation relating to
human rights, equal opportunities and equality and diversity; for
example: informed choice.
Acts professionally to ensure that personal judgements, prejudices
values and beliefs do not compromise the care provided.
Maintains confidentiality and security of written and verbal information
acquired in a professional capacity.
Critically reflects upon the need to disclose information about
individuals and organisations only to those who have a right and need
to know.
Through reflection and evaluation demonstrates commitment to
personal and professional development.
Acts as an effective role model in decision making, taking action and
supporting more junior staff.
Maintains midwifery standards by adhering to local uniform policies,
practising good time keeping, conducting yourself in a professional
manner and adhering to infection control policies.
Undertakes universal precautions when handling blood and body
fluids.
Applies safe moving and handling principles to practice.
28
29
ANTENATAL/POSTNATAL PLACEMENT
P or Fail
Student
If there is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he
has the underpinning theoretical knowledge
Collaborative
working
Domain:
Effective midwifery
practice
Professional and ethical
practice
Developing the individual
midwife and others
ESC:
Communication
Initiation and continuance
of breast feeding
P or Fail
Mentor
Sign-off mentors
signature
Date
Actively participates in collaborative working with the wider health
care team and sharing skills with other agencies, such as: social
policy, nursery nurses and paediatricians.
30
31
NEONATAL WARD PLACEMENT
RIE
ST JOHN’S
BORDERS FORTH VALLEY FIFE
Please circle the applicable
DATE OF PLACEMENT FROM
PLEASE PRINT NAME OF
MENTORS INVOLVED IN THE
ASSESSMENT
TO
SIGNATURES & INITIALS OF
MENTORS
DATE OF LAST
MENTOR UPDATE
32
ORIENTATION AT INITIAL MEETING
The orientation to practice area must be completed during the first shift of the placement. Please indicate if you have provided the orientation
information to the practice placement in relation to the following with a tick:
Yes
√
No
Preliminary discussion of skills previously
achieved and the learning opportunities
available
Introduction to other team members
Orientation to placement philosophy and
client group
Location of equipment and stores
Fire and safety procedures
Emergency procedures
Specific policies/ legal frameworks/
confidentiality issues
Moving and handling policies and
procedures
Others –
Date & Signature of student
Date & Signature of mentor
33
NEONATAL WARD PLACEMENT SUMMARY
PRACTICE PLACEMENT AREA:
DATES:
RECORD OF DEVELOPMENTAL PLAN AT INITIAL MEETING
Throughout this short practice placement students will work seven 12.5 hour shifts or 37.5 hours per week and will have to achieve
all of the competencies as set out in this section of the Competency Assessment Book. This placement will not be graded but each
competency will be assessed on a Pass or Fail basis. At the end of this placement the student must have passed all competencies.
If there is no opportunity for the student to demonstrate a competency during this placement, the student must be able to discuss and
demonstrate accurate understanding of the competency and the implications for practice.
The mentor will then verify that the competency is achieved, apart from ‘EV’, the assessment outcome of each competency must be
written P for pass or write FAIL in full for clarity.
To be completed by the student prior to initial meeting
To be completed by the mentor at the initial meeting
Student’s goals and expectations
Agreement of learning opportunities during the placement
Student’s signature:……………………………Date:
Print Name
Mentor’s signature:……………………………………….Date:
Print Name
34
Student’s comments:
RECORD OF FINAL MEETING AND COMMENTS:
Mentor’s comments:
COMPETENCIES: PASS/FAIL
Student’s signature: …………………………Date:
Module Leader’s Comments:
Mentor’s signature: ……………………………Date:
Signature, Print Name and Date:
35
NEONATAL PLACEMENT
P or Fail
Student
If there is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he
has the underpinning theoretical knowledge
P or Fail
Mentor
Mentors
signature
Date
Demonstrates an awareness of common conditions and complications during childbirth
which may result in admission to the neonatal unit.


Communicates effectively using appropriate strategies with parents and their families
ensuring the meaning is always clear and informed consent is gained.
Participates in the admission process and care planning for babies receiving care in the
neonatal unit, including welcoming parents to the neonatal environment.
Observes the multidisciplinary team approach to care provision; for example: doctors
round, Advanced Neonatal Nurse Practitioner (ANNP), feeding advisor and pharmacy
input.
Observes neonatal medicine administration and can discuss commonly used prescribed
medication in neonates, their doses, therapeutic effects and side effects:



Supports and advises parents as they start to feed and care for their baby, recognising
their existing attitudes, knowledge and skills.
Facilitates and encourages the development of the parent(s)/baby relationship.
Participates in the assessment and documentation of a baby’s vital signs and well-being
including:
 Temperature, heart rate and respirations.
 Arterial oxygen saturation.
 Weight.
 Blood glucose.
 Signs of infection.
 Signs of jaundice.
Demonstrate knowledge and understanding of the causes of neonatal jaundice and
subsequent treatment options including phototherapy.
36
NEONATAL PLACEMENT
P or Fail
Student
If there is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he
has the underpinning theoretical knowledge
P or Fail
Mentor
Mentors
signature
Date
Recognises and responds to the following acute events if they arise:
 Cyanosis.
 Bradycardia.
 Apnoea.
 Choking.
 Convulsions.
Respiratory Support:
 Administer oxygen according to guidelines via nasal route or incubator.
 Use of the humidifier.
 Uses mechanical suction appropriately.
 Aware of resuscitation techniques.
Cardiovascular:
 Aware of the rationale for neonatal blood transfusion.
 Observes the administration of blood transfusion including the continuous
monitoring of the baby if available.
Personal hygiene:
 Participates in providing individualised care as required/ tolerated.
 Carries out basic care including clothes, bed linen and nappy changing.
 Performs eye and mouth care according to guidelines.
Fluid and nutrition:
 Participates in calculating the daily fluid requirements.
 Participates in the passing and care of a naso/orogastric tube.
 Supports the mother to express and store expressed breastmilk (EBM).
 Supports the mother to bottle feed (EBM or artificial formula).
 Assists in giving enteral nutrition via naso/orogastric tubes.
Elimination:
 Participates in fluid balance measurement.
 Performs urinalysis.
 Observes and records bowel movements.
37
38
NEONATAL PLACEMENT
P or Fail
Student
If there is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he
has the underpinning theoretical knowledge
P or Fail
Mentor
Mentors
signature
Date
Thermoregulation:
 Minimises the potential for heat loss.
 Discusses and justifies heat conservation.
Developmental care:
 Recognises and discusses the influence of baby’s gestational age, condition and
needs upon positioning and care.
Care provision:
 Ensures the care environment minimises negative stimuli such as light and noise.
 Aware of factors which may cause the baby to experience pain and interventions to
reduce impact.
Recognises and can discuss common neonatal screening tests such as: hearing
screening, detection of retinopathy of prematurity and newborn blood spot screening.
Participates in discharge processes and care planning, including follow-up arrangements
such as developmental assessments, clinic appointments and immunisation
requirements.
Practices safely in accordance within contemporary legal frameworks, The Code (NMC,
2015) and within the limitations of the individuals own competence, knowledge and
sphere of professional practice.
Maintains midwifery standards by adhering to local uniform policies, practising good time
keeping, conducting yourself in a professional manner and adhering to infection control
policies.
Applies safe moving and handling principles to practice.
39
Medicines Management Assessment
Guidance for students:
During this placement you are required to undertake a Medicines Management Assessment. You will
have lots of opportunities to practice this skill during your placement. Towards the end of the
placement identify with your sign-off mentor a morning/afternoon where you will take the lead in
managing the medicine needs of the women in the bay(s)/rooms that you are responsible for. Your
sign-off mentor will supervise your practice throughout and will complete the tick list below.
Guidance for mentors:
While your student is allocated to your ward, you are required to ensure that she/he has the
opportunity to learn the skills and knowledge required for safe medicines management. Your student
must undertake a ‘Medicines Management Assessment’ towards the end of the allocation. It would
be very helpful if they have lots of opportunities to practice this skill before completing the
assessment. On the day of the assessment your student will be required to take the lead in managing
the medicine needs of the women in the bay(s)/rooms that you are responsible for. The student will
remain under your supervision at all times.
No.
Competency
1.
Has negotiated a suitable date and
time for this assessment?
Can identify an effective plan to meet
the individual needs of the women in
the allocated bay(s)/rooms?
Can safely administer a medicine:
 Identifies the correct woman
 Identifies the correct medicine
 Checks expiry dates on the
medication
 Identifies the correct dose
 Identifies the correct route
 Measures the correct amount
 Ensures the medication is
taken
Can effectively read a prescription
chart and can document correctly on
the chart & in the woman’s notes as
required?
Demonstrates effective
communication with the woman and
the team?
Can discuss the use, dose, modes of
action and possible side-effects of the
medicines administered?
Knows the procedures to be followed
if a mistake is made? Can discuss
how to manage and document an
adverse drug reaction including
anaphylaxis?
Can identify the roles, responsibilities
and scope of a midwife’s practice in
regard to medicines management?
Can identify the legal and ethical
framework of local and national
guidance and regulations relating to
medicines management?
2.
3.
4.
5.
6.
7.
8.
9.
Achieved
Yes (√)
No (√)
Comments
33
41
Mentor’s comments:
Student’s comments:
I can confirm that…………………………………. (Student’s name) has achieved a safe
standard of medicines management.
Signed:
(Sign-off mentor)
Name:
(Please PRINT)
Date:
42
ENU Guidance for Student Midwives and Medicine Administration
Please note that within individual NHS Trusts there is variation in practice
therefore local unit policies must be consulted to determine the specific roles
and responsibilities for students and medicine administration.
Medication which has been prescribed and is not being administered via the intravenous (IV)
route may be checked and administered by student midwives under the direct supervision of
a registered midwife. All student signatures must be clearly countersigned when supervision
of medicine administration has occurred.
Midwives exemption list (MEL) and Patient Group Directions (PGD)
Patient Group Directions (PGDs) should only be used once a registered midwife has been
assessed as competent and their name is identified and recorded within documentation
retained at ward level. The administration of drugs via a PGD may not be delegated.
Students cannot supply or administer under a PGD but would be expected to understand
the principles and be involved in the process. Where medication is already subject to
exemption order legislation there is no requirement for a PGD.
As per guidance from the Nursing and Midwifery Council (NMC) (2011) student midwives
may administer, under direct supervision of a sign-off mentor, the medicines found on the
MEL except controlled drugs.
For example if Cyclizine Lactate was required this may be administered as a MEL. The
student must be under direct supervision during all stages of the administration process. The
drug should be checked by the student and the sign-off mentor, the medication is prepared
for administration and then the midwife and sign-off mentor must go to the bedside and
complete the patient identification checks following which the student may administer the
medication and complete the required documentation. For the administration of
Phytomenadione (Konakion) found on the MEL, this must be checked by two registered
midwives (as it is a paediatric medicine two registered staff are needed) then checked by the
student midwife – the student midwife may administer the medicine under direct supervision
of that sign-off mentor. When documenting check local policies and guidelines but if required
‘(MEL)’ should be written next to the medicine and all practitioners involved in checking and
administration must sign the drug prescription / administration record or Scottish Women
Handheld Maternity Record (SWHMR) if used.
“Standard 18: Nursing and midwifery students
1. Students must never administer or supply medicinal products without direct
supervision.
Guidance
In order to achieve the outcomes and standards required for registration, students must be
given opportunities to participate in the administration of medication but this must always be
under direct supervision. Where this is done, both the student and registrant must sign the
patient or woman’s medication chart or document in the notes. The registrant is responsible
for delegating to a student, and where it is considered the student is not yet ready to
undertake administration in whatever form, this should be delayed until such time that the
student is ready. Equally a student may decline to undertake a task if they do not feel
confident enough to do so. The relationship between the registrant and the student is a
partnership and the registrant should support the student in gaining competence in order to
prepare for registration. As a student progresses through their training, their supervision may
become increasingly indirect to reflect their competence level.”
(NMC, 2010)
43
Controlled Drugs
Student Midwives may not administer controlled drugs when they are provided as a
MEL or if the controlled drug is to be administered IV. If however the controlled drug is
prescribed by medical staff and is not being administered IV then a student midwife may
check the medication with a registered midwife and administer the drug under direct
supervision.
“When controlled drugs are prescribed the second signatory should be another registered
health care professional (for example doctor, pharmacist, and dentist) or student nurse or
midwife, in the interest of patient care, where this is not possible a second suitable person
who has been assessed as competent may sign. It is good practice that the second signatory
witnesses the whole administration process. For guidance, go to www.dh.gov.uk and search
for Safer Management of Controlled Drugs: Guidance on Standard Operating Procedures.”
(NMC, 2010)
Please note that within NHS Lothian the second signatory cannot be a student
midwife or nurse - two registered health care professionals must check and
witness the administration of a controlled drug. A student midwife may carry
out the administration if they have been involved in the whole process of
collection and checking of the drug in addition to the two registered midwives.
Within NHS Forth Valley from second year onwards a student midwife may be
the second signatory.
Within NHS Fife the second signa tory may be a student midwife with no
restriction upon the year of study.
Controlled Drug Stock Checks
Two registered nurses or midwives should perform this check. A student midwife may be the
second checker provided they have the necessary knowledge to carry this out.
IV Fluids and Medication
Student midwives may check and administer under direct supervision prescribed IV fluids
with no additives such as Sodium Chloride 0.9% and Plasmalyte or equivalent as per the
MEL.
Student midwives cannot prepare or administer any IV drug therapy which includes
antibiotics, Syntocinon infusions or boluses. However they must observe and understand the
process involved.
When electronic /medical devices are utilised e.g. infusion pumps or syringe drivers student
midwives may only observe.
44
References and Resources
Knight M, Tuffnell D, Kenyon S, Shakespeare J, Gray R, Kurinczuk JJ (Eds.) (2015) on
behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care - Surveillance of maternal
deaths in the UK 2011-13 and lessons learned to inform maternity care from the UK and
Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-13.Oxford: National
Perinatal Epidemiology Unit, University of Oxford. Accessed 14th March 2016 from:
https://www.npeu.ox.ac.uk/downloads/files/mbrrace-uk/reports/MBRRACEUK%20Maternal%20Report%202015.pdf
National Health Service (NHS) Education for Scotland (NES). (2012) Midwives and
Medicines 3rd Edition Interactive Version. Scotland: NES. Accessed 6th February 2015 from:
http://www.nes.scot.nhs.uk/media/14194/Midwives_and_Medicines_Third_Edition_Nov2012.
pdf
National Institute for Health and Care Excellence (NICE) (2014). Intrapartum care for healthy
women and babies (CG190). Accessed 18th March 2016 from:
https://www.nice.org.uk/guidance/cg190
Nursing and Midwifery Council (2009). Standards for Pre-registration Midwifery Education.
London; NMC. Accessed 14th March 2016 from:
https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-forpreregistration-midwifery-education.pdf
Nursing and Midwifery Council. (2010) Standards for Medicine Management. London: NMC.
Accessed 14th March 2016 from:
https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-for-medicinesmanagement.pdf
Nursing and Midwifery Council. (2011). NMC Circular – Changes to Midwives Exemptions.
Accessed 5th December 2014 from: http://www.nmcuk.org/documents/circulars/2011circulars/nmccircular07-2011-midwives-exemptions.pdf
Nursing and Midwifery Council (2012). Midwives Rules and Standards. London: NMC.
Accessed 14th March 2016 from:
https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-midwives-rules-andstandards.pdf
Nursing and Midwifery Council (2015). The Code. London: NMC. Accessed 14th March 2016
from: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf
45
Edinburgh Napier University
School of Nursing, Midwifery and Social Care
Midwifery Practice Placement Record of Hours
Name
Matriculation number
Intake
Trimester
Placement area/s include all 1.
Date Placement
commenced
1.
2.
Mentor’s Name
Date placement
was completed
Total Hours
worked
Total hours
sickness/absent
Occasions
Absent
Mentor
Signature/s all
areas (if required)
NMC requirements
Number of births
Number of Assisted
Deliveries
Total number of births at the
beginning of the trimester
Total number of births at the
end of the trimester
On completion of each trimester this form must be submitted for checking to: THE
PRACTICE MODULE LEADER along with your Competency Assessment Book,
Ongoing Record of Achievement (ORA) and your Student audit forms. Remember, it is
your responsibility to:
1. Accurately record the hours worked each week on placement.
2. You complete an average of 30.0 hours per week in years one and two of the programme and 37.5
hours per week in year three of the programme (excluding the practice elective) in practice including
study/reflection days of hours = shifts missed. In the gynaecological placement you will work three
12.5 hour shifts or four 8 hour shifts.
3. To calculate hours worked per day, from the total hours per shift on a long day deduct 60 minutes for
meal breaks e.g., (12.5 hours – 1, record 11.5 hours worked) and 30 minutes from short shifts e.g.,
(8 hours – 30 minutes, record 7.5 hours).
4. Ensure your mentor signs the practice placement record of hours work card daily and at the end of
each week after the hours are completed. Mentor must sign off any changes to this document.
5. Sick leave is noted as ‘S/L’. Sick leave is to be signed off by your mentor and academic staff will sign
off UNI time.
6. Submit Practice Placement Record of Hours card along with your Competency Assessment Book and
placement audit forms to the designated person/sign-in box on the date/time indicated by the Practice
Module Leader. Do not separate any of the documents.
7. Never falsify Practice Placement records or assessments in any way. This would be considered nonacademic misconduct and will affect your fitness to practise (see regulations).
25
46
Week 1 Commencing: ……………………
Mon
Tues
Wed
Thu
Fri
Sat
Sun
Start
Finish
Hours
worked
Daily
signature
Total
Mentor’s signature ____________________________________________________
Week 2 Commencing: ……………………
Mon
Tues
Wed
Thu
Fri
Sat
Sun
Start
Finish
Hours
worked
Daily
signature
Total
Mentor’s signature ____________________________________________________
Week 3 Commencing: ……………………
Mon
Tues
Wed
Thu
Fri
Sat
Sun
Start
Finish
Hours
worked
Daily
signature
Total
Mentor’s signature ____________________________________________________
Week 4 Commencing: ……………………
Mon
Tues
Wed
Thu
Fri
Sat
Sun
Start
Finish
Hours
worked
Daily
signature
Total
Mentor’s signature ____________________________________________________
Week 5 Commencing: ……………………
Mon
Tues
Wed
Thu
Fri
Sat
Sun
Start
Finish
Hours
worked
Daily
signature
Mentor’s signature ____________________________________________________
Total
Week 6 Commencing: ……………………
Mon
Tues
Wed
Thu
Fri
Sat
Sun
Start
Finish
Hours
worked
Daily
signature
Mentor’s signature ____________________________________________________
Total
47
Week 7 Commencing: ……………………
Mon
Tues
Wed
Thu
Fri
Sat
Sun
Start
Finish
Hours
worked
Daily
signature
Total
Mentor’s signature ____________________________________________________
Week 8 Commencing: ……………………
Mon
Tues
Wed
Thu
Fri
Sat
Sun
Start
Finish
Hours
worked
Daily
signature
Total
Mentor’s signature ____________________________________________________
Week 9 Commencing: ……………………
Mon
Tues
Wed
Thu
Fri
Sat
Sun
Start
Finish
Hours
worked
Daily
signature
Total
Mentor’s signature ____________________________________________________
Week 10 Commencing: ……………………
Mon
Tues
Wed
Thu
Fri
Sat
Sun
Start
Finish
Hours
worked
Daily
signature
Total
Mentor’s signature ____________________________________________________
Week 11 Commencing: ……………………
Mon
Tues
Wed
Thu
Fri
Sat
Sun
Start
Finish
Hours
worked
Daily
signature
Total
Mentor’s signature ____________________________________________________
48
Week 12 Commencing: ……………………
Mon
Tues
Wed
Thu
Fri
Sat
Sun
Start
Finish
Hours
worked
Daily
signature
Total
Mentor’s signature ____________________________________________________
49