NVQ evidence

PC

1

The correct necessary documents and records for the clinical activity are ready for use.

This is important because this facilitates the easy flow of any procedure as well as presents a professional approach to activities. Documentation must pertain to the specific client as if they do not, inappropriate care, if not fatal care could be given to a client.

2

Before the activity starts, the essential resources for the clinical activity are prepared ready for use.

COVERED

3

Before any actions are taken, the client’s consent to the activity is confirmed.

COVERED

4

Where the client and advocate do not give consent to the activity, advice is sought from an appropriate member of the care team without delay.

If a client or client's advocate say no to a procedure then it is the role of the worker to report this. Any activity carried out when there is not validly consented constitutes assault. It is very important that an accountable practitioner is involved as soon as possible to answer any questions that are outside the role of the worker.

5

The client is offered appropriate support and information in preparation for the activity in a manner appropriate to them.

COVERED

6

Client behaviour and condition is observed and monitored throughout contact and any unexpected change or aspect which gives cause for concern is reported to an appropriate member of the care team without delay.

It is very important that the worker understands what the effects of any given treatment as this can give indications for what is normal in the given instance. If there are deviations from the norm with a procedure, it is very important that Accountable Partitioners are contacted as they can then act accordingly.

7

Any questions from the client and advocate are answered correctly and in a manner, and at a level and pace, appropriate to them.

COVERED

8

Where the client and advocate raise questions which are beyond the worker’s responsibility, further appropriate advice or assistance is sought before undertaking the activity.

It is not the role of the worker to answer questions that are outside their role. Even if the worker knows the answer, this is still the case. Support workers are not Accountable for their practice. They are responsible. If any incorrect information is given by the worker, then the Practitioner is vicariously accountable for this. If there is any doubt then the Practitioner should be informed as soon as possible.

9

The reasons for any particular forms of dress and protection are explained in a manner appropriate to the client.

It is very important to explain the specific types of dress that are required for certain clinical procedures for a number of reasons. An individual may feel threatened by the wearing of gloves and apron for example. It may be that they feel that they have an infection that the medical fraternity are not telling them about. It must be explained that the wearing of protective clothing is merely precautionary and universal. It is also important that their protective qualities are emphasised as being two way.

10

Where there are contra-indications before starting the activity, the preparation is halted and advice sought from the appropriate member of the care team with minimum delay.

It is very important that contra-indications are noted before any procedure is commenced as beginning without prior consultation may cause harm to the individual. Also, there are accountability issues that may arise if nothing is done. The practitioner must be informed as there may be steps that she/he may need to take before the procedure may begin. The procedure may even have to be forgone altogether. Also, the worker may not be the best person to undertake the task

11

The client is offered the opportunity to use toilet facilities prior to the activity when this is appropriate.

This is important as it increase the likelihood of a smooth procedure without causing the client discomfort. There is also a clinical reason for this. Some procedures require asepsis. If the procedure needs to be temporality, then all sterile areas including wounds need to be covered and all sterile fields covered. It may be necessary for new procedure packs to be opened. This is expensive so prior toileting helps to reduce this.

12

The client is assisted to reach as comfortable a position as possible given the constraints of the activity.

COVERED

Range

1

Clinical activities:

a) care of lesions and applications of dressings

b) elimination

COVERED

c) extended personal care

d) tube feeding

e) obtaining specimens

COVERED

f) undertaking physical measurements and monitoring

COVERED

2

Essential resources:

a) for the activity to be undertaken

COVERED

b) necessary protective clothing

COVERED

PC

1

Hands are cleansed effectively before and after the activity.

COVERED

2

The client is informed of the activities being undertaken during the procedure, treatment or dressing in a manner which is sensitive to their needs and concerns and is at an appropriate level and pace.

COVERED

3

The procedure, treatment and dressing is carried out using the correct technique and at an appropriate time according to the plan of care.

COVERED

4

The client is given appropriate support throughout.

COVERED

5

Client behaviour and condition is observed and monitored throughout contact and any unexpected change or aspect which gives cause for concern is reported to an appropriate member of the care team without delay.

Prior knowledge of the client is very helpful as this facilitates noticing any changes in behaviour that may be relevant. Also quick reporting of changes is very important as, if there is any action that is required that is outsider the role of the worker, then this can be actioned more quickly. Any adverse reaction must be recorded in the client’s care plan

6

Particular observation and monitoring of the client is carried out at the time intervals specified in the plan of care.

Certain procedures require monitoring after they have been undertaken. These will be requested by the registered practitioner who has undertaken or requested the procedure.

7

Any condition or behaviour which may signify adverse reactions to the activity is reported without delay and action appropriate to the client’s condition is taken.

See above

8

Following the activity, the client is assisted to reach as comfortable a position as possible given their current state of health.

COVERED

9

The outcomes of the activity are recorded correctly using the required format and reported to the appropriate member of the care team.

It is important that this occurs because the accountable practitioner needs s to know what is happening with clients. Any action that has been undertaken that can have an effect on the client’s health status must be reported and recorded for this reason.

10

Waste materials or equipment are disposed of in an appropriate safe manner and place.

All clinical waste must be disposed in yellow clinical waste bags. These must then be tied, when three quarters full, using black plastic bag ties and placed in the clinical waste bin.

Non-clinical waste is placed in a black plastic non-clinical waste bag and placed in the non-clinical waste bin when three quarters full.

All sharps should be placed in a sharps bin. When this is three quarters full. This must be sealed and this fact must be signed for and dated on the bin. On it’s assembly, the bin should have been signed and dated by the assembler as well as having the setting where the bin is to be used. When it has been shut, it must be placed in the clinical waste bin.

11

Records completed by the worker are accurate, legible and complete.

COVERED

Range

1

Procedures, treatments and dressings:

a) care of lesions and the applications of dressings

b) elimination

COVERED

c) extended personal care

d) tube feeding

2

Adverse reactions related to:

a) the client’s condition

b) the procedure being undertaken

COVERED

PC

1

Hands are cleansed effectively before and after the activity.

COVERED

2

The client is informed of the activities related to obtaining specimens in a manner which is sensitive to their needs and concerns and is at an appropriate level and pace.

COVERED

3

Any questions from the client are answered correctly or referred to the appropriate member of the care team.

COVERED

4

The specimen is collected using the correct technique and at an appropriate time according to the plan of care.

COVERED

5

The client is given appropriate support throughout.

COVERED

6

Client behaviour and condition is observed and monitored throughout contact and any unexpected change or aspect which gives cause for concern is reported to an appropriate member of the care team without delay.

Prior knowledge of the client is very helpful as this facilitates noticing any changes in behaviour that may be relevant. Also quick reporting of changes is very important as, if there is any action that is required that is outsider the role of the worker, then this can be actioned more quickly. Any adverse reaction must be recorded in the client’s care plan

7

Particular observation and monitoring of the client is carried out at the time intervals specified in the plan of care.

See above

8

Any condition or behaviour which may signify adverse reactions to the procedure is reported without delay and action appropriate to the client’s condition is taken.

This is very important because that reaction could be dangerous to the client and result in serious injury or death if nothing is done about it. It is very important to have the client and the advance we actions that can occur that with me specific procedure. It is important to involve an account the practitioner at because they have they hire knowledge base and that of the worker as well as being accountable for any procedure that is under taken. All adverse reactions must be recorded in the client’s care plan as well as being the report did to be accountable practitioner.

9

Where the worker is unable to obtain the specimen, this is correctly recorded and the appropriate member of the care team informed without delay.

It is very important to report with failure To collect a specimen that is a requested. If it is not, there could keep an assumption that it has already been taken. There may have been a problem with the collection of the specimen. If this is the case, then the appropriate accountable practitioner may have other ideas and solutions to opt taming the specimen.

10

Specimens are labelled correctly for the individual, the relevant documentation attached and they are put in the correct place for storage, collection or transportation.

Specimens should have the following information on them:-

• Date
• Time of collection
• Type of specimen
• Client name
• Client Date of birth
• Hospital number
• Hospital
• Location

The form should have all the above plus:-

• Examination requested
• Any other relevant required such as results of any urine analysis or any underlying conditions that the individual has.

Once they are collected, labled and packaged correctly, they must be placed in the correct designated place for collection. If they are urgent, then special messures, such as arranging for them to be fast tracked to be processed.

11

Specimens are tested correctly, the results accurately recorded in the required fromat and reported to the appropriate member of the care team.

Some speciemens are not suitable to be tested at ward level. They need special testing under laboratory contitions.

Urine may be tested at ward level for such things as pH, blood, protein, ketones, nitrites, leukocytes etc.

This is explained further in

12

Following the activity, the client is assisted to reach as comfortable a position as possible given their current state of health.

It is very important that clients are returned as comfortable position as possible. Some tests, such as lumber puncture require the client to remain lying flat for 4 hours post procedure. In this case, then the individual need to be made as comfortable as possible but within these constraints

13

After use, equipment and materials are cleaned and returned to the correct location for storage, sterilisation and transportation, and waste is disposed of in an appropriate safe manner and place.

All disposable materials must be done appropriately. If these have been in contact with body product, then they need to be placed in a yellow clinical waste bag. If they have not been in contact with body products, then they can be disposed of in a black non-clinical waste bag.

Any sharp must be disposed of in a sharps bin, irrespective of them having come into contact with body products or not;

Anything that requires Autoclaving need to be put in the CCSD bag (blue).

Range

1

2

3

Tests:

a) urinalysis

b) blood sugar analysis

COVERED

Specimens:

a) urine

b) faeces

c) sputum

d) exudates

e) blood

COVERED

Adverse reactions related to:

a) the client’s condition

b) the specimen being taken

COVERED

PC

1

The client is informed of the nature of the measurement and what is involved, in a manner which is sensitive to their needs and concerns and is at an appropriate level and pace.

Not telling the client the nature of the measurement constitutes assault, so it is very important that they are fully informed of what the test is for before it is commenced. It is also very important to pitch the delivery of the information at a level that the client understand that is not patronising to them.

2

Any questions from the client are answered correctly or referred to the appropriate member of the care team.

COVERED

3

Measurements are taken using the correct technique and at the appropriate time according to the plan of care.

It is important that all tests are take using a standardised method as then extraneous variable are kept to a minimum. Also it increases accuracy of results. It is very important that results are as accurate as possible as vital decisions are made on the basis of tests.

4

The client is given appropriate support throughout.

COVERED

5

Client behaviour and condition is observed and monitored throughout contact and any unexpected change or aspect which gives cause for concern is reported to an appropriate member of the care team without delay.

See above

6

Particular observation and monitoring of the client is carried out at the time intervals specified in the plan of care.

See above

7

Measurements are accurately interpreted, correctly recorded using the required format and reported to the appropriate member of the care team.

See above.

Reporting results is very important as well as recording them correctly as they the Accountable Practitioner is then informed of the progress of the client.

8

Where any change or unexpected occurrence is observed from taking the measurement or the measurement is difficult to take or to interpret the results, advice is sought without delay.

The quick notification of changes in condition is very important as this can result in necessary action may be taken as quickly as possible.

9

Any condition or behaviour which may signify adverse reactions to the measurement is reported without delay and action appropriate to the client’s condition taken.

Knowledge of the client and the significance of changes in behaviour/condition are very important here as then action can be taken quickly. Some changes can be indicative of life threatening results

10

Following the activity, the client is assisted to reach as comfortable a position as possible given their current state of health.

COVERED

11

Records completed by the worker are accurate, legible and complete.

COVERED

Range

1

Measurement and monitoring of:

a) temperature, pulse, respiration

COVERED

b) blood pressure

COVERED

c) height, weight, girth

d) peak flow

e) fluid balance

COVERED

2

Adverse reactions related to:

a) the client’s condition

b) the physical measurement being taken

COVERED