Perioperative NCAS reference guide · Aims to deliver dignified and respectful care to patients...

PERIOPERATIVE NCAS REFERENCE GUIDE

To assist clinical facilitators when completing NCAS tool for students undertaking Perioperative clinical placement. Evidence of Competency as referenced against the NMBA RN Standards

University of South Australia

Uni SA Perioperative NCAS Reference Guide.docx Updated 2018 1

Contents Information ................................................................................................................... …………..1

NMBA Standard 1: Thinks critically and analyses nursing practice………………………………………. 3

NMBA Standard 2: Engages in therapeutic and professional relationships………………………….. 4

NMBA Standard 3: Maintains the capability for practice…………………………………………………….. 5

NMBA Standard 4: Comprehensively conducts assessments………………………………………………..6

NMBA Standard 5: Develops a plan for nursing practice………………………………………………………7

NMBA Standard 6: Provides safe, appropriate and responsive quality nursing practice…………8

NMBA Standard 7: Evaluates outcomes to inform nursing practice…………………………………….. 9

Information

**Refer to Completing the NCAS tool in the Perioperative Environment.docx


Reference guide to assist with completing NCAS tool: Perioperative suggestions for providing Evidence of Competency as referenced against the NMBA RN Standards


NMBA Standard 1: Thinks critically and analyses nursing practice

Wears Scrubs, hats, appropriate footwear, balaclavas and masks in perioperative environment Performs skin assessment prior to induction of patient to identify any areas of breakdown Provides warming during procedure to maintain body temperature adequately in cold Operating theatre environment Identifies risk factors for patients with history of DVT, e.g. Applying antiembolic stockings for bed bound patients &/or sequential compression devices as applicable Performs Cricoid pressure during intubation to assist Anaesthetist to provide occlusion of the oesophagus to prevent aspiration of stomach contents Remains with intubated patient in recovery Remain for extubation of patient (if occurs in Operating theatre) Wears lead apron during procedures requiring radiation or imaging to enhance procedural care Dons and doffs PPE correctly Performs a surgical scrub Assists scrubbed staff to tie a gown Positioning of patient – assessment of patient mobility & skin condition, positioning aids Participate in Nursing handover Participate in Peri-operative set-up ie equipment, sterile instruments, consumables Shares experiences with other students on placement Communicates effectively with facilitator and other staff members Utilises resources for learning during placement Accesses hospital policy webpage and best practice guidelines for aspects of care Seeks guidance from experienced staff Attends Acute Pain Service round Participates in clinical research data gathering in Recovery Notifies facilitator of any absences or requirements Participates in group debrief sessions Attends in-service programs provided by the hospital Adhering to organisations Medication Policy & Procedures for nursing students Awareness of responsibility when DDA drugs are to be administered or counted Participate as the 3rd person in administration and handling of DDA drugs & other medications Gaining or checking a patient’s consent for procedure Gaining consent or checking consent for administration of blood products Checking patient allergies Maintaining confidentiality Checking patient ID Participating as 3rd person in surgical count –according to organisational policy Identifies self as student to team members & other Peri-operative staff Accepting and providing care for clients with cultural, race, religious, gender or mental state diversity Recognises own ability to be fit for work Attends placement with a professional attitude to work Attends placement on time and in correct uniform or attire e.g. Perioperative scrubs Performs nursing handover Show consent for procedure to instrument nurse prior to induction of patient Awareness of surgical conscience, stating if sterile areas or items have been compromised Participates in Team Time Out Notifies clinical facilitator if absent from placement


NMBA Standard 2: Engages in therapeutic and professional relationships Assessment of patient pre-op, intra-op, post-op Maintains patient dignity & confidentiality Maintains a professional relationship with patients Provides a warm blanket pre or post procedure Comforts a patient during cannula insertion Reassures a patient during induction of anaesthesia Establishes a rapport with Staff Communicates effectively with staff in the perioperative environment Expresses critical incidents in appropriate settings Aims to deliver dignified and respectful care to patients when in Operating theatre e.g., exposure of patient in Operating theatre Respects conversations regarding patient care Assist a patient to make an informed decision about their health or care Responds accordingly to change in patient condition Integrates into the perioperative area by conversing with and acknowledging staff Communicates with Staff to provide quality patient care Provides logical, clear legible written communication in patient notes Participates in Team Time Out Communicates with DOSA/ward to prepare patients for Operating theatre Communicates with Recovery to gain admittance for a patient postoperatively Communicates with Transfusion to obtain blood products for the care of a patient


NMBA Standard 3: Maintains the capability for practice

Shares experiences with other students on placement Communicates effectively with facilitator and other staff members Utilises resources for learning during placement Accesses hospital policy webpage and best practice guidelines for aspects of care Seeks guidance from experienced staff Attends Acute Pain Service round Participates in clinical research data gathering in Recovery Notifies facilitator of any absences or requirements Participates in group debrief sessions Attends in-service programs provided by the hospital


NMBA Standard 4: Comprehensively conducts assessments

Completing a nursing assessment pre-op, intra-op, post-op including monitoring of patient Records nursing intervention & patient progress in clinical notes Records data for clinical research Completes a Braden Scale skin Assessment Assesses Bromage and Dermatome levels prior to discharge from Recovery Provides monitoring to patients undergoing anaesthesia Reports changes in patient condition to relevant person Adheres to discharge criteria for recovery Coordinates care of post op patient in recovery Plans and gathers equipment required for procedure ie anaesthetic, perioperative set-up


NMBA Standard 5: Develops a plan for nursing practice

Discusses care requirements for patient care with anaesthetist prior to admission to perioperative Participates in Team Time Out Participates in Nursing handover Accepts handover of a patient from perioperative from the Anaesthetist Accepts handover from the instrument nurse post operatively Plans equipment required in perioperative e.g., blood warmers, FAWD, Suction, Diathermy etc. Gathers instruments, trays, or packs from sterile store areas Documents intraoperative nursing care Work collaboratively with other members of staff Plans for discharge of patient from Recovery or Operating theatre Ascertains care requirements for patients in Operating theatre in collaboration with Dr’s, Nurses, Radiologists, etc. Contact a Dr in relation to patient care Seeks clarification from experienced staff to provide quality patient care


NMBA Standard 6: Provides safe, appropriate and responsive quality nursing practice

Provides observations for patients in Recovery to maintain safety Provides jaw support or chin lift for patient Is able to provide competent care for an unconscious patient Assists in the collection, delivery and recording of specimens from Operating theatre Assists in the positioning of a patient on an operating table Is able to position a diathermy pad on a patient to maintain skin integrity Assists in the recording of tourniquet use during a procedure Safe use of equipment within Peri-operative environment Assessment of patient and ability to identify inconsistent results and respond accordingly Recording Sedation scores in Recovery Assessing and observing respiratory rate Observing and performing Apgar scoring for Recovery patients


NMBA Standard 7: Evaluates outcomes to inform nursing practice

Participate in Team Time Out Discussing with Nurses or Anaesthetists/Doctor any changes in patient condition Initiates changes in care of a patient once identified acceptable, e.g., removal of O2 when patient breathing and saturating within normal limits Commencing or directing a tidy up on a patient in recovery prior to discharge Participate in Nursing handover Communicates knowledge to other students if required Explains procedures or interventions to patients or patient significant other Instructs patients on deep breathing or coughing exercises Instructs patient on use of PCA appliances


**Adapted from Mandy Navacchi CEC TQEH August 2008 Clinical Facilitator, version entitled ANMC competency suggestions.docm

Perioperative NCAS reference guide · Aims to deliver dignified and respectful care to patients...

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