f { Sew OCU LEE LC a > > vw wv Su = Ol Ue Placement 3 Placement Provider: UNIVEESITy COCCEGE CONDOS HosoxT AL (e.g. TrusOrganisation) Name of Placement Area: Haectwlogyy Type of Experience: Ward (e.g. Community/Ward based) Placement Telephone Number: ©2O ays6s lz Placement Contact Em seh, eMson » Jalang @uhs net .. No. of Hours... -1,£.3.. End Date. Start Date. Nominated person to support student and address concerns ay arse: Name: SeJpersor Shan Designatio Contact email address: Se/}erson. galong@nbs.ner Practice Assessor Details: Name: Mobei olding Designation: StajJ Murse Contact email address: Mabel .claina @ nhs.net. Academic Assessor Details (for part): Sune Bliss Name: Satie Blisg Designation: Contact email address: Julie Shiss @ Leh ac-uleSoowvvetwtvouetvebseowovoovoeeoeoeeeesesed oe List of Practice Supervisors {A sample signature must be obtained for al entries within this document een Job Title Signature initia Placement Marra anasrasy | Orare nuese | foawatrn (PA Weed + vech Neko GE SUinke | SF uct ite eo iG jhed + Neche pratnce Aceasor ol eae CIM Pre nes | Nv teat Dr : 4 ae Sac GRAN to Meyicay. “Len Moudonal Staff Nurye Llp : LM | Gwh2N. Feta Pieduo| Sep Done [AoQeg [FP | aeony noe re dH Mo | We 2N Se pen. sonag PE | Lulaaued bara tf y Ln __| Gog Lo0N Riya peTEe® | SN _ er GaN Yernse Big Cos ZB WA Hg TALIA RUS STA, TAA TR HED tlutaste Moder | Gf rs tabs | nn | nee WA agora] HEM | Ho mx | st | OH Woon Oral fat walye | AR oy Mol, vr HO lore ¢ wed ro Toe How CHa Law | Hare ANRC cum | he Hy PLPAD 2.0 Master Part 3 (Version 41) PLPLG 2021Placement 3: Orientation Placement Area 1 lacement Area 2 (if app.) ‘Name of Placement A\ Nan of Staff Member: | c 7 Stat atin | InilalDate | IniiaDate | InialDate | —TniiayDate “This shoutd be undertaken by @ mem gatas | aioe” | iaDale 7” InielDs the Placement Area Pe «cit within the first day in placement ‘The Following eriteria need to be m —a jai poe rartaion tothe heath and sociatcare | HN) oy oneral orientati i acme [iy | | —— ae procedures have been explained rs) Terie. rea oa 5 wet & 4 aihas been shown The Sten esr aleS HY o | + fre exits i we 1 fre extinguishers eS lu Sition policy and procedures have been f peer ea AT iat ue el rug Resuscitation equipment has been ‘shown and “ue et ae wey wh Tre Gudert mows how to summon help inthe event | yy yr ofan emergency Nye \4 “The student is aware of where to find local policies © health and safety © incident reporting procedures He + infection control i | ‘+ handling of messages and enquiries Wig Wt * _ other policies | The student has been made aware of information r 1 a Lug & Wh | ‘The shi times, meal times and reporing sick policies have been explained uP ie (ola | ‘The student is aware of his/her professional role in practice Hed ihe ‘ Policy regarding safeguarding has been explained if — ly s é | Te Suet aware oe poo ad posses of He phi working pol wl fe a ‘one working poli as bsen explained (f applicable) * 4 Pee) UA: | Risk assessmenis/reasonable adj jusiments relating to _ | disabiliylleainglpregnancy needs have been Q discussed (where disclosed ye [Teton cto ied Beat pRarISURE oot | _| The student has been shown and given a - | demonstration of th adnbep ent aad and handling equipment | HA The student fas [igen shown and given tt Blacement area "eee devices used in the Ho Wy 8g o @& Hed POAHH MDMAA H RAH HHH HHHH HAG [RE Aa | | ss sy sel | OY VW eg a | ee ye | ao hieeec“ Placement 3: Initial Interview pleted by a Practice Supervisor or Practice Assessor. . ithe PS they must discuss and agree with the PA) ike place within the first week of the placement (This can be cor If completed by ‘This meeting should tab J wo’ NY Vy jp v wv eUees lacement Area N ™ sar guk mine Placement Area sat needs (with guidance from the Prac Student to identify = BLod Comp eaihors SD MLiCine - Garey “ \ | ~y come L patient Jo underrend the osasene then | [2 ea | ming and developmer ities Into consideration, the student and Practice Supervisor/Practice \ [Taking available learning opportuni | Assestor to negotiate and agree a learning plan. [[outine oFTearning plan How will this be achieved? 1 ] | : : % % Slain, our @ potent SD beams Mare obser dart + “s Ps cor | = Corners > encour. | > | i . | 3 Jy on wt peo aa 4 > dear See enol dosh) 54 2 ap unser wading eh 2D | | = Crmeanar Aeehi odIOrd gy | . | | f | Learning plan for placement agreed by Practice Assessor (where applicable) YESINO 9 | Student's Name: Hotwaly Nawa2, Signature: \ej— Date: } 2/4) 23 =] 3 _| Practice Supervisor/Assessor’s Name: M 0.0 U OUing: 2 Ee Signature: oy Date: (2/4/23 53Profe: nal Values in Practice (Part 3) ‘Students are required to demonstrate high standards of professional conduct. placements. Students should work within ethical and legal frameworks, and be abl ‘underpinning values of The Code (NMC, 2018), Professional Values reflect a num statements and are captured under the 4 sections of The Code, “The Practice Assessor has responsibilty for assessing Professional Values t at all times during their e to articulate the ber of proficiency though the Mid-Point review Can boconpsud bya cic Spermor bon wth iho Praca ASH cue) Meeemcoed = hn Pri eh Final Dé Yes/No. (Fine Ac The siden maintains confidentially in accordance with MO MO ‘ant code and ocopises tts to content or ee publ imerest and protection tom harm, 40S | ccna | “eS inesns | D The student is non judgemental, respectful and Mo No Ramnecos aa ne when reractng wth Peventtoroe wer ad al coleegues Yes |oisn2| Yed fis 23 5. The sion meine the prsor's privacy and gn, a ‘seeks consent prior to care, challenges discriminatory M6 M behevur end aavocaes of et Dehal yes |ysna} “5 | wise Tie sca arg. corpo and eertive We uO teneacs chat dornsiaingpotveroemoceina. | yes |Mna| eS | wisi2 5. The student understands their professional MO Senden ahaa pee ne Mo forthe wel-being of themselves and others. Yes Joga] YeS | masied '. The student consistently delivers safe, person-centred 10. The student demonstrates openness (candour), and evidence based care ensuring patienis/serv NO ue eee eerie scree 4eS |ocng] “eS J amises 7. The sues abe to work conidanily and as an qual partner within the inter-discipinary team and can build MO MO ‘fective professional relationship. Ye |gisng} Yes | aera & The student makes consistent effort to engage in and e ‘eon te arin, canting evn eo" | mo Mo professional evelopment and supporting te earring and Sevelopment of others cae memes gs | 4e5 | ees 3 The slodent demonstrates leadership skis ands able o work autonomously, seeks support where Mo Mo ‘propriate and responds positively to feedback. NO | sons} 4S |yiens ee ee] trustworthiness end integrity. ie 4 < Mes] snd] Yes | ess eae ‘student reports any concems to a member of staff her apropia and esas a equ aspera M6 Ne professional quidance) .g, safeguarding 4eS | sisns | Yes wor 12: The sen danas hw appropri 5 ss Sek areton wher apropsnd ary NOT ue y Yes | siS>} Yes — | yais23 {3-The aes bl to ocpniae and inutredominnie stcrtmcasea™ | yes | Mo is Sure arta at heya pre sis? | Yes |rais/s PLPAD 2.0 Mastor Part 3 (Version 41) PLPLG 2021 £ HOHRhEADFAraageaaaanaOaAaaRagea & @ € @ € vi u UWF.Torin fontation and dress code Is peer Menthe students personal pres 14, erdance withthe local poicy sropriate professional - oo communi 1573 | yes Ta ind communicates placement NO asim % MO Yes Mo Mes ISLS attitude regarding punctuality Spproprately if unable to attend | a-Tne Sndont demonstrates that they use critical self- | RAE || MO ‘Gresten and supervision 0 gan insight iniothek own | 9 His | values, taking i Wderation the possible impact on Mase faking into consideration the possible imp Me mre the caring relationship an 2 > > > > [76. The student maintains ar J > > 1d the decision making process. 77-The student acts as a role model in promoting @ yore io | ) professional image and acts as an ambassador for the 4s Yes | IMO est ISIE | profession, in | Signature: Date: | [mid-point assessment | Practice Supervisor Nam | | Roviewed and agreed by Practice Assessor 3 | Practice Assessor Name:\\q Joking Signature: oy pate: /S(2> | End point: Student reflection on meeting Professional Values. Choose one example from your practice on this placement to demonstrate how you practice within the NMC Code of Conduct (ensure confidentiality is ‘maintained). For each placement, please select a different ‘section of Cc mcionet re Cte OID loaner bare eon oe Mane So eaemeey aomoumcusay £9 abeitey 1 NE ant PS Sade | Barend x Seth Ro Pe aa tangeh uss ieee te oS us | o fone fm pay, ey Fred peanovded 6 j aaa eee Ses Gaede As My Insr chat hs Jaina, Abe BO of curse SOAS cays, ar ecante, Nea Dine Norn aekiin! Vaan gre: ouensciae a Date: /2 /OS/%3 Final assessment - please add comments on Final Interview Page Practice Assessor Name: nh ck SWUNG ——Signatu of Date: [S-2 If there are any issues/areas for concern, these must be recorded. ‘Not Achieved’ must trigger an Action Plan. This must involve the Practice Supervisor and the Practice Assessor (as appropriate) in liaison with the Academic Assessor.Placement 3: Mid-Point Interview This discussion must take place half way through the placement ‘Student's self-assessment/reflection on progress roficiencies. Identify your strengths and document areas for development. _ Knowledge: UAE POSER Significantitg 47 Verne | cy He anh Ay AAAS Ten ee Aaa Sebee, SPUN pues coats Gude a Lat ddr SYR cottons arent 2 Sheth Late oud eae ten SO SPN ae Rotlect on your overall progression referring to Your personal learning needs, professional values and eiAUROA bint ond. putes lh toe Darede on tS Rie rig rope ere neh ie [ee ea Be c : : ae | Seay Teak Fe Taormina SES Weaie, Corpo Canali tins 2 eaten Re ena ese ute = : pe eohees of oy | TS contisheritny “yor nee Serves | Shes - alaates BA tm, epee \ : y | oo nah, Tress Ad ® wridenee bared ametemes IM. IS prosic, Hany tot ME Gorersl 23 Practice Assessor's comments recuse with the student their self-assessment and comment on their progression using the criteria for ‘Assessment in Practice Descriptors, detailing evidence used to come to your decision. Yatumasn hoy a good wroker of common machicah os Ca Ses use on rat ted) Site Rou dea on anh wads ¢ foun pe A OES sigs. fev blood ro, c cut © + 4 (oo 1 INO To ei udder Fra Wood! Vane) We ‘Skills: 7 Whe Sh WU mo tye dud a S Mane ete la abun Ko ee ee aeeat hon hae aone | care winch O So am putand 1m ary pla He dinucas JEWS (e'g PICL Lunt foot). Sag ee aeasings Hanah ibs ifrengtnde rel wor OW an Attitudes and values: Me tna ward fe not abe td wdera placnat MH MMM Of SV f+ If Very yofesyionak and nies feodha kext te hod from other of Situ - Have Hod exterdiye QUO abr Ae mport on esr! sa WOT 14) MmanbadLd wwe Getigk @ ——— ee ee ee Placement 3: Mid-Point Review ‘Ongoing learning and development needs To be agreed between Practice Assessor and ign and date all entries below Folfowing the Mid-Point interview the student is to id sarning and development needs for the remainder of the placement and neg: :ssor how these will be achieved. ‘Learning and development needs - How will these be achieved? *CoPVUre fr lente Knouredye We Wh do Q Ms 4e5t On Tre Of Common Medicare oiug roundS Natt wee = WU - aah-wrancs - gernids. To Woole a patent anol Hola to, its GEARS dunuuss an eptiacle of cove Gracy wth a fon gomgont eth & Roanadr gr cal «TG doutlop COnfidone On ward sien ord making pho cou. Getting more UNduledl MOT Meee al ek and Communicating WA Othe red oHlonserin mouber of mer kading team | @ palresrmn Cortreuslicodn o18 fomour naweuina uacocohceids - hypensone uit, 1A @ rrednisolne Se eee acyl este A ATO inne bSordesy \otrancicahi ny [oo dose om anfsen o nny unbewed woods D pronposr come Student’s Name: \Latimalh men2az Signature: Jeo Date: S¢sver Practice Assessor's Name: 0,0 Sain Signature: «| Date: ¢/S/22 Any outstanding learning and development needs are to be discussed and documented at the final interview.« Placement 3: Final Interview ‘Tis should take place towards he ond othe placement « Student's sol'assesamanteflecion on progress i = Sarees our overal progression refering to our persone! laring needs, professionel valves 3 “ prflscisldarly your swenghs and decunn areas for dovtopmen = Cen ee er cogent aren Fe oot Ss BR utee osama, neremencier Std Lagsiba Heath Be ef tant een auras cae é Fe oe, undwerensing Sieh tei a or a Ro reek casa pins, secret tad Gua aera CASAS « oF a (OOTRL hoe 2 EP bond cabty) Heirs tL eh @ Hrs. Rr Arientes 4 Pare ee ae quite ea cho nr fe © serene, gnc, ME Ouenchts cen bet _ulan nares « € tana NepC tee Corton oUNi cad re Skis: EAS Je gue crete, enpownensthtst RS a © asonencs ) BET Brsoareys p eesered Core ory “ptuupech Cancun oak beldre- Pena yO ag Aigo fanin 205 € | ee BOS Cl naan Hearst + \ commnsoinn, neh NS, te anus Fso, Ok Coa EG. |. © Bg, Rueveny comer nominates eotrey t eet U ‘Ss eel See Cad be eset TES et cee € Pmretiary Hoe eS he pores Seed DO ee Rs Tastes Tynin, 8 = PA na excel SO Sastre € aly et sot Be Filan oh nen eek | : Practice Assessor's comments ; ; = ‘Discuss with the student their self-assessment and comment on their progression using the criteria for a ReeSnntin Practice Deseripors, dealing evidence used fo come to your decison. | « Knowledge: Wed. She i$ Mow able | plAAGS trouledge on MEdLcaklans pee ne APIO! o. fue about common ee about a a ide oe i Her kenourad 96, OF A Of hom ED aes 4 eat Hatin AOS OWN 6 | (gee esove rostishe n toed er qguunustrthon ond Hho 6 Iyeo! sa tore adnanted cbenical Gaul, fer esp mse Feng AU PAN fos8, ACC abrestings NV medica | preperaim ) Sub wut Wye! onal Re Ca Be a P Holumah’S Char a very open proa cradle COMMUM Style ord has connuanscahin EUS ave Nbwtloped OOy weLl | ‘ eee and oan Hak [hone boon reody amrpressed Mth the pro eSSion of Hadanals profesono/ vores She hoy been ver prof cfs onat ac ANU KO on tue Cah “F : (aia 405, gtd fe EOL patient Where Sho herpes he Fei potent ath on tea podlnanc Mannor homonlhy Sree to Aor profelsional VaLsres Please record any further comments on the next pageLearning and Development Needs To be agreed Practice Assessor to identify specif a : 1. ProfessiOnal Values- 1? let placaniont Know f not able fo come an for ser ft, Via phone cM (a) pry povicy) \ 2, BUALDUNG cORfidlantR an OPPOAGUAG ofhrar Manhess Of MAOT: \ 2 Conse 10 chevelop CACO SEUAS Arndt OF) UME ORIS ELEY Was an Action Plan required to support the student? Yes (NO) | If Yes, was the Academic Assessor informed? YES INO | Checklist for assessed documents Tick | Pracice | Student | initian | teat | “The professional value statements have been signed at both Mid-Point andFinal | 7 | 14 Q | | interview pals | The relevant proficioncies/skils that the student has achieved in this area (where 1 applicable) have been signed Y| Mo | The practice placement hours have been checked and signed Were | 1 | \ 7rilthe interview records and development plans have been completed and signed y as appropriate ecto | The Praciice Supervisors and Practice Assessor have printed and signed their name on the appropriate list at the beginning of the document. uv MO | | The Praclice Assessor has completed the Ongoing Achievement Record (OAR) VI Mo | | ‘Student's Name: Signature: Ao Date: Hatmah mova Practice Assessor's Name: 9/00! (NG signature: ty Date: |4/5 23 Additional Signature (If Applicable, e.g. Academic Assessor): Name: SignaturPart 3 Assessment of Performance: The individual completing the assessment should draw on a range of observed experiences in which the student demonstrates the required knowledge, skills, attitudes and values in co-ordinating high quality person/famil centred care, ensuring all care is underpinned by effective communication skills. Those marked with an * may have been met in Part 2. Record achievement of Part 3 proficiencies marked * in OAR as well. Confidently assesses needs and plans person-centredcare SEAR EM Oks oF ED eal fo NO = Not Achieved ASSesemer Tssessment2 ‘Assessment Fasesoment YesiNo | —_Sign/Date Signato_[ YesINo| SigniDate | YesINo | Sign/Date Utilises a range of strategiesiresources (including | yp relevant diagnostic equipment) to undertake @ comprehensive whole body assessment to plan and prioritise evidence-based person-centred care 2. Assesses a persons’ capacity to make best interest deci about their own care and applies processes for making reasonable adjustments when a person does not have capacity. 3 Actively participates in the safe referral of people to other professionals or services such as cognitive behavioural therapy or king therapies across health and social care as appropriate. If any proficiency has not been assessed or is not applicable to the Practice area, please leave blank. PLPAD 2.0 Master Part 3 (Version 41) PLPLG 2021 tnenfidently delivers and evaluates person-centred care aa eS ed YES = Achieved, NO = Not Aci Rssessment1 Fssessment 2 _ “Assessment ‘Sign/Date Yes/No SigniDate YesiNo | Sign/Date Yes/No Sign/Date_ ¥, Recognises signs of deterioration (mental distress/emotional vulnerabilty/physical symptoms) and takes prompt and appropriate action to prevent or reduce risk of harm to the person and others using for example positive behavioural support or distraction and diversion strategies. %. Accurately and legibly records care, with the use of available digital technologies where appropriate, in a timely manner. 6. Works in partnership with people, families and carers using therapeutic use of self to support shared decision making in managing their own care. 7. Manages a range of commonly encountered symptoms of increasing complexity including pain, distress, anxiety and confusion. 8, Uses skills of active listening, questioning, paraphrasing and reflection to support therapeutic interventions using a range of communication techniques as required. if any proficiency has not been assessed or is not applicable to the Practice area, please leave blank. PLPAD 2.0 Master Part 3 (Version 41) PLPLG 2021YES = Achieved, HO = Hot Achieved! ae Temasaron say delvers and evaluates person-conired care ee TeseeenonrT pesos ome YeuNo | SignDate Re | Sabie — | Year| oaroms No | SignDaia (ee | arte abie t support people | eo I ring voices or jarcd | carrercin seoerg tongs | UE | aA svaatng ears a | enfieny manages the prods in assessing, prov ing and eneceesoneret | pesenaltpgie, rome | Independence and makes YA | appropriate referrals to other [Steptoe [noses fa cont opr, | audiologist), | 77. Manages the care of people | with specific nutrition and Je hydration nests domonoveting | YES ong eee | contributions of the | muttidisciplinary team, [712 Manegs tho car af pope | who are redeving Iv fide ara ° | accurately records fluid intake » & ard outa domonataing Understanding of polo comlcatons |*13. Manages the care of people rocovng fu and i‘ nuttin via infason pumps and i deve ncig the acimristaion of medicines [whee requred la Hf any proficiency has not been assessed or is not applicable to the Practice area, please leave blank. |[Gonfidently manages the procedures in assessing, aa ate ela —_] YesiNo ys +44, Manage and monitor the effectiveness of symptom relief medication, with the use of infusion pumps and other devices. roviding and evaluating Aesessment 2 ‘Assessmer | ny a confidently when working with ! these members. If any proficiency has not been assessed or is not applicable to the Practice area, please leave blank. SA) oO Kite cake A 1 eeeae 79: Effectively manages and needs of a prioritises the care group of people demonstrating appropriate leadership st responsi the team as required. to delegate for care to others in Tesessment 1 shieved, NO = Not Achieved “Assessment 3 [__Sign’Date ind working in tea YE ‘Assessment 2 YesiNo SigniDate Rasessment 4 YesINo_| _ SigniDate ~ Sign/Date ‘20. Monitors and evaluates ‘the quality of care delivery by all members of the team to promote improvements in practice and understand the process for performance management of staff (if required). 21. Actively participates in ‘audit activity and demonstrates understanding of appropriate quality improvement strategies. 22. Undertakes acourate risk assessments and understanding of relevant frameworks, legislation and regulations for managing and reporting risks. demonstrates an | \/ ES 73, Parlicipates in appropriate decision making regarding safe staffing levels, appropriate skill mix and understands process for a — leave blank. escalating concerns. Ifany proficiency has not be enti A) PLPLO alee een assessed or iS not applicable to the Practice area, pleasese lle eee eS |e PS oe bbe = acta = : = y of person-centred care Se confidently contributes to improving safety and quality of per YES = Achieved, NO = Not Achieved Z Resessment 2 Assessment 3 Resossment@ ‘YesNo | SigniDate YesINo | SignDate ‘YesiNo SigniDate | 2a Demonstrates understanding of | processes involved in managing hear misses, ciical incidents or major incidents | Confidentiy ‘coordinates person-centred care | 25. Co-ordinates the care for | people with complex co-morbidities and understands the principles of | partnership collaboration and | interagency working in managing | muttiple care needs. { | 26. Evaluates the quality of | peoples’ experience of complex | care, maintains optimal | independence and avoids | unnecessary interventions and | disruptions to their lifestyle. 27. Engages in difficult Conversations including breaking bad news with compassion and sensitivity. 28. Facilitates the safe discharge and transition of people with Complex care needs advocating on their behalf when required. 29. Assess and reviews the vidual care needs and references of people and their families and carers at the end of ;pecting cultural fequirements and preferences, Yes If any profici ie Proficiency has not been assessed or is not applicable to the Practice area, please leave blank. | PLPAD 2.0 Master Part 3 (Version 41) PLPLG 2024ye achieved in Part 2 he student record in the OAR to confirm if the proficiencies have been achieved or not in Part lowing proficiencies can b* in Part 3, record achievement below and in the OAR should check t! ieving these proficienci The Practice Assessor 2, Ifthe student is achi YES = Achieved, NO = Not Achieved Assessment 1 ~_ Assessment 2 [aaron ————TYesiNo|_Sign/Date | “YesiNo | Sign/Date Part 2, No.3 Recognise people at risk of self- harm and/or suicidal ideation and demonstrates the knowledge and skills required to support person | centred evidence-based practice using appropriate risk assessment tools as needed. Part 2, No. 4 Demonstrates an understanding of the needs of people and families for care at the end of life and contributes to the decision-making relating to treatment and care preferences. Part 2, No. 10 Utilises aseptic techniques when undertaking wound care and in managing wound and drainage processes (including management of sutures and vacuum removal where appropriate). Part 2, No.12 Demonstrates understanding of artificial nutrition and hydration and is le to insert, manage and remove oralnasal gastric tubes where appropriate. “PAD 2.0 Master Part 3 (Version 41) PLPLG 2021 nA OAD ® 2.A Ase eee ee eee‘Assessment 1 YES = Achieved, NO = Not Achieved ‘Assessment 3 ‘Assessment 2 YesiNo Sign/Date YesiNo | Sign/Date YasiNNo Part 2, No. 14 Insert, manage and remove urinary catheters for all genders and assist with clean, intermittent self- catheterisation where appropriate. Manages bladder drainage where | SigniDate appropriate. Part 2, No. 15 Undertakes, responds to and interprets neurological observations and assessments and can recognise and manage seizures (where appropriate) Part 2, No. 19 Undertakes a comprehensive respiratory assessment including chest auscultation e.g. peak flow and pulse oximetry (where appropriate) and manages the administration of oxygen using a range of routes. Part 2, No. 20 Uses best practice approaches to undertake nasal and oral suctioning techniques. Part 2, No. 24 Undertakes an effective cardiac assessment and demonstrates the to undertake an ECG and interpret findings. Part 2 No, 25 : Demonstrates knowledge and skills related to safe and effective venepuncture and can interpret normal and abnormal blood profiles. PLPAD 2.0 Master Part 3 (Version 41) PLPLG 2021[ ns =e —[Yesitvo | Sign/Date_ Part 2 No, 26 tes knowledge and skills effective cannulation in line with local policy. —Tssessment 4 “YesNo | __ SigniDate ae Part 2 No, 27 Manage and monitor blood component transfusions in line with local policy and evidence based practice. Part 2No, 28 Can identify signs and symptoms of deterioration and sepsis and initiate appropriate interventions as required. PLPAD 2.0 Master Part 3 (Version 41) PLPLG 2021 74% ST OF” 7 a en en ens ens eee en DRA PDAnNADTONHDDVNN HH Sal & eee ¢ ceed cl co oongs ors ———PRACTICE HOURS Please start a new page per placement To be completed as per your local University Requirements Please ensure all details are printed CLEARLY and sic ified. All hours completed, alterations and totals should be initialed by a member of staff yy . 9 a a a Mon = Tue 3 Gob en Hoer |G | MO | UD | wea . 7 en Ob 16 tw |gios| Po TE s FTG IAW AN TCGT iw s = Weokty Total = 2 = LD. ~ [ives stein! cin oeud js | ZAM us Tu lt hens| PEt 2s 7 2 fa GweIN [is | mo [td oa ‘Sun MO wD. Wiookty Tota = Mon QUIN Hew (WS [FP ILD | men = Tw Wed Wed tu frp foe] Pct Vs Thu is Fi a [ea Sat T 5 [= sin . as Brae EE [Total hours of completed practice on this page Figures |6-Sh#Words One hundred and Tworty fre tier Total hours of Sickness/Absence on this page Figures S4'ShSWords Fifty four Pout pvehowd ‘Staff member: | have checked the hours of experience recorded by the student, oe Lag cli pgs he Precoment wee: COG DN __ oat: Declaration by Student: | confirm thatthe hours recorded on this sheet are a true and accurate account of the shits | have worked. swdenn) dato: 4 (OS / 2.3 __ It is expected that the student will work a range of shifts to meet NMC Requirements Shift Codes D = Day Shift, N= Night Shift, S= Sickness, A = Absent woe a Signed: PLPAD 2.0 Master Part 3 (Version 41) PLPLG 2021