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Grampians Region Nurse Preceptor Information 2012 The following information is provided as a guide to nurse preceptors of Australian Catholic University and University of Ballarat students who are undertaking professional experience placements in a Health Service within the Grampians Region. The guide is a companion document to the Clinical Competency Assessment Tool (ACU) and the Clinical Placement Appraisal Tool (UB) that nursing students will bring to each placement. The guide provides a summary of the skills that students are expected to apply during each of their semester placements over the three years of training. Preceptors will be able to review the skill sections for their student’s previous semester’s placements as well as note the skills to be applied in the current placement. Please note that there are separate sections for each university. If there are any queries or problems whilst students are on placement please refer to the contact details for each university’s clinical staff at the rear of each section. Preceptor information 2012 The Bachelor of Nursing course aims to develop a caring professional nurse, who is proactive and adaptable, a competent, safe and ethical clinical, a creative and critical thinker, an informed consumer of practice evidence, and an independent lifelong learner. Graduates will be eligible to apply for registration as a nurse. The course is designed with an Inquiry Based Learning (IBL) teaching/learning strategy and incorporates inter professional learning, nursing theory as well as clinical practice. The clinical units are where students begin the clinical experience and where they will be initiated into health care environment. Please refer to the last page of the ACU notes for a list of the clinical units. FIRST YEAR Skills that students can practice whilst on clinical placement Basic Life Support Standard and additional precautions Mobility Basic Handover Mini Mental Exam Manual handling Admission history taking Basic physical examination and health assessment Vital signs Pre-operative preparation Basic documentation Oral medications under direct supervision Patient admission Mouth/toilet hygiene NG insertion and care PEG feeds Wound assessment Principles of asepsis Eye toilet/hygiene Topical medications under direct supervision Please Note: First year students cannot practice Subcutaneous injections Intramuscular injections Enteral medication administration Intravenous fluid administration Intravenous mediation administration 2 Australian Catholic University SECOND YEAR Skills that students can practice whilst on clinical placement Health values and spiritual beliefs Self-perception-self-concept Tissue Perfusion Oxygen therapy Nebuliser therapy Suctioning CPR revision Wound care – Suture and staple removal, drainage tube management IV therapy Patient-controlled analgesia Airway clearance Circulation 12 lead ECG recording Documentation / discharge planning Please Note: Any medications administered by a second year student must be under the direct supervision of their RN preceptor. It is important to note that individual agencies may have policies and procedures related to the administration of medications and student nurses – please refer to your health care facility guidelines. THIRD YEAR Skills that students can practice whilst on clinical placement Skills acquisition in the context of holistic framework - testing of all skills that have been undertaken across the course. Advanced CPR Complex wound dressings Management of intercostals and pleural drains Complex wound dressings Revision of advanced CPR Respiratory/cardiac arrest procedures Medication administration via all routes, across the life span Basic management of CVAD Tracheotomy care Revision of catheterisation, naso-gastric tube insertion, management of drains, tubes and IV therapy Patient/family education Advanced skills to meet speciality needs 3 Australian Catholic University STUDENTS ‘AT RISK’ OF FAILING UNIT It is not uncommon for some students to experience difficulties in meeting the requirements of a clinical placement. There are many reasons students may be identified as ‘at risk’ of not successfully completing the clinical placement that broadly include either unsafe or unprofessional practice. Please refer to ACU’s Handbook for further advice on how to manage a student “at risk”. In all instances please contact: Jenny D’Antonio, Clinical Lecturer in Charge Aquinas Campus Ballarat Australian Catholic University Email: [email protected] Phone: 03 5366 5365 or 0487 498 765 4 Australian Catholic University Appendix 1: ACU 2012 Bachelor of Nursing Clinical Unit Outline 2012 Bachelor of Nursing Clinical Unit Outline SEMESTER UNIT CODE & NAME DETAILS COMPETENCY ASSESSMENT Semester 1 HLSC110: Beginning Professional Practice 4 hour Hospital Observation al Visit NIL Semester 2 NRSG137: Introduction to Nursing Practice 3 Weeks MedicalSurgical Competency Assessment* Interviewing & Health History Documentation of Care Semester 3 Semester 4 NRSG262: Clinical Integration: Mental Health NRSG261: Clinical Integration: Acute Care 3 Weeks Competency Assessment* Mental Health Mental Status Exam 3 Weeks Competency Assessment* Episodes of Care Episodes of Care (inc.) Aseptic Procedure Pain Management IV Therapy Semester 5 NRSG354: Clinical Integration: Complex Care Semester 6 NRSG3XX: Clinical Elective 2 weeks Competency Assessment* Community/ 1. Complex Wound Management 2 weeks (complete ONE only): Medicalsurgical a. Drain, Clip, Staple Removal b. Wound Irrigation 4 weeks c. Packing a Wound Medicalsurgical 2. Ongoing patient assessment 3 weeks Clinical elective Competency Assessment* TBA 5 Semester 6 NRSG355: Clinical Integration: Towards professional practice 5 weeks Preceptored Competency Assessment* Assessment of groups of patients Preceptor Information The Bachelor of Nursing offers student a broad range of clinical experiences over a three year period. The aims of the clinical component of the Bachelor of Nursing are to graduate students at a safe beginning level registered nurse. Clinical education forms an integral part of the Bachelor of Nursing program with students undertaking clinical practice in laboratory settings and in health care agencies throughout Victoria, specifically the Grampians region. Common skills among all years Integration of the Australian Nursing and Midwifery Council standards and competencies into professional practice Demonstrate an understanding of the scope of nursing practice Demonstrate an understanding of Occupational Health and Safety issues in professional practice Be able to undertake reflective practice, understand the need for professional growth and development and social responsibility Competently undertake and document vital signs and observations Use appropriate interviewing and interpersonal skills that are culturally sensitive for health assessment Demonstrate and use standard precautions Develop core nursing skills including oral and written communication Acquire and apply knowledge in relation to fundamentals of nursing care Describe various nursing activities undertaken in clinical practice, self –evaluate these experiences and examine their individual learning needs Demonstrate a satisfactory performance in practice Develop a therapeutic relationships and empathy with patients/clients/family Be able to plan care in conjunction with patient/client/family FIRST YEAR Skills that students can practice whilst on clinical placement Demonstrate beginning level competence in drug calculations Hand washing and basic infection control principles Responding to patients and families emotional, spiritual and cultural needs Maintaining a safe working environment Changing and making beds Assist with activities of daily living including hygiene. Beginning level systems assessment Positioning and pressure area care for patients (including a basic skin assessment) 6 Assisting with mobility of patients Oral feeding of patient Monitoring and recording vital signs and basic interpretation of them Basic principles of manual handling Basic dressings and aseptic technique Correct documentation, handover and beginning time management skills University of Ballarat Please Note: First year students cannot practice Subcutaneous injections Intramuscular injections Enteral medication administration Intravenous fluid administration Intravenous mediation administration SECOND YEAR Skills that students can practice whilst on clinical placement First Semester Second year students are able to perform any clinical skills outlined above. At a second year level of practice we would expect to see further development and connection between theory and practice. Students at this level should be able to perform first year skills without direct supervision. By the end of first semester of the second year we would expect students to be to complete the following range of skills: Incorporate knowledge around pathophysiology of disease and injury into appropriate nursing care Beginner understanding and application of the use of medications and the management of medications Developing a sense of professional responsibility and accountability Basic Life support Basic ECG skills – including placement of leads and basic interpretation including assessment of cardiac pain Medication administration – subcutaneous, IM, and oral medications only Oxygen therapy and care for the patient with oxygen therapy UWSD and tracheostomy care Specimen collection – sputum, MSU, venepuncture Introduction to blood transfusions IVT – calculating drip rates, priming lines and imeds Supra pubic catheter care and female only catheterisation Admission and discharge of a patient including appropriate documentation Clinical handover Clinical Handover Detailed Fluid Balance charts Assessment of wound and basic wound care Use standard and additional precautions Appropriate documentation for medication administration Basic pain assessment and documentation 7 University of Ballarat Second Semester By the end of second semester of their second year we would expect students to be to complete the following range of skills: IM injections and intradermal injections Inhalation and nebulised medication administration Topical medication administration Enteral medication administration IV bolus injection Removal of a cannula Administration of medication via a burette or flask Advanced aseptic technique – including surgical scrub, sterile gloving and gowning Pre and Post-Operative assessment and management Blood Glucose Monitoring and assessment of the diabetic patient NGT insertion and management PEG care Jejunostomy tube care Enteral feeding Colostomy care – stoma care and application of appliances Rectal tube care and PR medication administration Chest auscultation Mental Status Examination Signs and symptoms of major mental health problems and potential treatment options. Please Note: Any medications administered by a second year student must be under the direct supervision of their RN preceptor. It is important to note that individual agencies may have policies and procedures related to the administration of medications and student nurses – please refer to your health care facility guidelines. THIRD YEAR Skills that students can practice whilst on clinical placement Third year nursing students will complete a 4 week block placement in semester 1 and an 8 week block placement in semester 2. Those students who are undertaking the flexi-model of delivery will be undertaking 2 shifts per week over the whole semester. Third year students will be expected to perform any of the clinical skills in the lists above. The focus in third year is: Consolidation Problem solving Planning 8 Implementation Negotiation Prioritisation Extension and evaluation of nursing care. University of Ballarat Students are expected to undertake all skills relevant to the specific clinical area both under direct and indirect supervision by the preceptor. This will be limited in relation to legal issues around medication administration and agency policies and procedures. Students are expected at all times to have with them the UB Clinical Placement Guidelines and UB Clinical Placement Appraisal Tool. STUDENTS ‘AT RISK’ OF FAILING UNIT It is not uncommon for some students to experience difficulties in meeting the requirements of a clinical placement. There are many reasons students may be identified as ‘at risk’ of not successfully completing the clinical placement that broadly include either unsafe or unprofessional practice. Please refer to UB’s Clinical Placement Guidelines for further advice on how to manage a student “at risk”. In all instances please contact: The Clinical Administration Officer Mt Helen Campus University of Ballarat (Monday to Friday 0900-1700) Phone: 03 5327 9635. 9 The idea for this guide was taken from a similar document developed by the University of Tasmania www.utas.edu.au/data/assets/pdf_file/0004/99031/Information-For-Preceptors.pdf 10