RECORD OF MID-POINT MEETING AND COMMENTS: Student’s self-assessment of progress: Students’ signature: ………………………………… Date: Sign-off mentor’s comments: 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 RECORD OF FINAL MEETING AND COMMENTS: Student’s evaluation of achievement: Student’s signature: ……………………………………Date: Sign-off mentor’s rationale for mark awarded: COMPETENCIES: PASS/FAIL OVERALL MARK ……. Sign-off mentor’s signature: ……………………………Date:
Domain 4 Demonstrates some awareness of the research that informs practice 0-6 Fail 39-0% Domain 1 Care and clinical skills not achieved at level 7 0-10 Domain 2 Displays minimal understanding of professional practice and does not indicate awareness of the ethical issues within midwifery 0-10 Domain 3 Has shown no awareness of the importance of identifying 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 0-10 Domain 4 Does not demonstrate awareness of the research that informs practice 0-9 COMMUNITY PLACEMENT P or Fail 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 Sign-off mentors signature Date Student Mentor Communication Domain: Effective midwifery practice Esc: Communication Initial consultation between the woman and the midwife Has developed effective communication skills with women throughout their pregnancy and postnatal period, developing supportive relationships with women and their families. Actively listens to women and their families enabling them to make informed choices about their health and health care, and gain informed consent. Can identify health promotion strategies available in the community which are women and family focused. Has develop skills for multidisciplinary communication. Diagnosis Domain: Effective midwifery practice Esc: Communication Initial consultation between the woman and the midwife Demonstrates knowledge of how women can access midwives as the first point of contact in their pregnancies. Participates with the holistic assessment and monitoring of women throughout the preconception, antenatal and postnatal period. Considers the following: History taking, observation, physical examination and biophysical tests. Include social, cultural and emotional assessments. Participates in the monitoring of fetal wellbeing which includes assessment of the fetal heart rate through auscultation using a pinard stethoscope and noting fetal movements.
Care planning Domain: Effective midwifery practice Esc: Communication Initial consultation between the woman and the midwife Normal labour and birth Initiation and continuance of breast feeding Medicine management Can identify appropriate care planning made in partnership with women and other health care professionals which is evidence based and respects her culture, choice and individual context. Demonstrates an awareness of plans for birth, infant nutrition, preparation for parenthood and postnatal support. Participates in parent education or group sessions to share information. Evaluates care plans and observe midwives making and documenting amendments to improve outcomes. COMMUNITY PLACEMENT P or Fail 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 Sign-off mentors signature Date Student Mentor Care provision Domain: Effective midwifery practice Esc: Communication Initial consultation between the woman and the midwife Medicines management Supports and maintains an environment which promotes health, safety and security where care is provided. Provides women centred, evidence based care in partnership with women and other care providers to promote continuing health and well-being. Participates in taking an accurate social, medical, surgical and obstetric history in order to determine the woman’s pathway of care. Supports choice and gives the woman an opportunity to ask questions. Recognises the role of the midwife in normal pregnancy. Begins to identify risk and the needs of women by assessing maternal and fetal wellbeing relevant to their stage of pregnancy. Observes the role of the midwife when caring for women with complex needs for example; pregnancy loss, stillbirth, neonatal death, previous operative or assisted deliveries. Referral Domain: Effective midwifery practice Esc: Communication Identifies appropriate and timely referral for women who would benefit from the skills and knowledge of other professionals. Consider reasons for referral such as: women’s choice, health, social and psychological issues, child protection, financial issues and law.
Initial consultation between the woman and the midwife Normal labour and birth Initiation and continuance of breast feeding Recognises the importance of team working to support the best interests of individual women. Community, care in labour and birth (if home birth available) Domain: Effective midwifery practice Esc: Communication Normal labour and birth Medicine management Can discuss the care of women labouring at home including how midwives monitor and support the well-being of the mother and fetus. COMMUNITY PLACEMENT P or Fail 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 Sign-off mentors signature Date Student Mentor Emergency procedures Domain: Effective midwifery practice Esc: Communication Normal labour and birth Medicines management Can discuss the role of the midwife when participating in emergency procedures that meet the needs of women and their babies such as sudden collapse requiring resuscitation. Examination and care for babies Domain: Effective midwifery practice Esc: Communication Normal labour and birth Medicines management Participates in a full daily physical examination of the baby using communication, observation and assessment of wellbeing. Can discuss referral pathways for babies with child protection issues. Participates in referral as necessary for babies with specific health needs. Infant nutrition Domain: Effective midwifery practice Professional and ethical practice Esc: Communication Supports and advises women as they start to feed and care for their baby; recognising the woman’s existing knowledge and skills. Participates in communicating sensitively the importance of breast feeding and consequences of not breast feeding in terms of health outcomes.
Initial consultation between the woman and the midwife Normal labour and birth Initiation and continuance of breast feeding Medicines management Maintains confidentiality and security of written and verbal information acquired in a professional capacity. Is aware of the need to disclose information about individuals and organisations only to those who have a right and need to know this information. Can discuss the process of NMC revalidation for midwives in relation to reflection, continuous professional development and practice standards. 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. Continues to complete cleanliness champions’ modules 1-6. Applies safe moving and handling principles to practice. COMMUNITY PLACEMENT P or Fail 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 Sign-off mentors signature Date Student Mentor Collaborative working Domain: Professional and ethical practice Esc: Communication Initial consultation between the woman and the midwife Normal labour and birth Initiation and continuance of breast feeding Observes collaborative working with other health care professionals, the wider health care team and other agencies, such as: social security, benefits and housing. PLACEMENT: LABOUR WARD RIE ST JOHN’S BORDERS FORTH VALLEY FIFE
The orientation to the practice area must be completed during the first shift of the placement. Please indicate if you have provided the following orientation information to the practice placement in relation to the following with a tick: √ Yes No Preliminary discussion of skills previously achieved and 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 LABOUR WARD PLACEMENT SUMMARY PRACTICE PLACEMENT AREA: DATES:
I have received and discussed student’s previous placement records Sign-Off ’s Signature: RECORD OF DEVELOPMENTAL PLAN AT INITIAL MEETING To be completed by the student prior to initial meeting Student’s goals and expectations Student’s signature:…………………………………….. Date: Print Name To be completed by the mentor at the initial meeting Agreement of learning opportunities during the placement Sign-off mentor’s signature: Date: Print Name RECORD OF MID-POINT MEETING AND COMMENTS: Student’s self-assessment of progress: Sign-off mentor’s comments:
RECORD OF FINAL MEETING AND COMMENTS: Student’s evaluation of achievement: Student’s signature: ……………………………………Date: Sign-off mentor’s rationale for mark awarded: COMPETENCIES: PASS/FAIL OVERALL MARK ……. Sign-off mentor’s signature: ……………………………Date: Module Leader’s Comments:
Domain 3 Has shown no awareness of the importance of identifying 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 0-10 Domain 4 Does not demonstrate awareness of the research that informs practice 0-9 LABOUR PLACEMENT P or Fail 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 Sign-off mentors signature Date Student Mentor Communication Domain: Effective midwifery practice Developing the individual midwife and others Esc: Communication Initial consultation between the woman and the midwife Normal labour and birth Has developed effective communication skills with women throughout their labour and birth, ensuring the meaning is always clear and informed consent is gained. Is able to initiate a conversation and actively listens to women and their families enabling them to make informed choices about their care. Recognises when silence is appropriate. Has developed skills for multidisciplinary communication, such as using SBAR. Diagnosis Domain: Effective midwifery practice Esc: Communication Initial consultation between the woman and the midwife Normal labour and birth Participates with the holistic assessment and monitoring of women and the fetus during the intrapartum period including social, cultural and emotional assessments. Participates in the initial and ongoing observation of the onset and progress of labour: History taking on admission. Abdominal examination. Maternal behaviour. Vaginal examination where appropriate. Measurement and documentation of maternal vital signs such as temperature, pulse, respirations and blood pressure.
Has developed the skills to assess progress and care for women during the 1st 2nd and 3rd stages of labour in relation to the latent and active phases of birth. Assists in supporting women to use a variety of birthing aids such as birthing balls and encouraging mobility which promotes spontaneous normal birth. Assists in preparing the environment and necessary equipment for birth. LABOUR PLACEMENT P or Fail 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 Sign-off mentors signature Date Student Mentor Referral Domain: Effective midwifery practice Esc: Communication Initial consultation between the woman and the midwife Normal labour and birth Initiation and continuance of breast feeding Identifies appropriate and timely referral for women who would benefit from the skills and knowledge of other professionals. Consider reasons for referral such as: deviations from normal on examination which are outwith the scope of midwifery practice. Recognises the importance of team working to support the best interests of individual women and their families. Emergency procedures Domain: Effective midwifery practice Esc: Communication Normal labour and birth Medicines management Can discuss role of the midwife when participating in emergency procedures that meet the needs of women and their babies such as fetal distress or maternal sudden collapse requiring resuscitation. Can initiate basic emergency call procedures for example 2222. Examination and care for babies Domain: Effective midwifery practice Professional and ethical practice Esc: Communication Normal labour and birth Medicines management Participates in the initial midwifery examination of the baby identifying when birth defects or congenital disorders are present. Can discuss pathways for identifying babies with child protection issues. Participates in referral as necessary for babies with specific health needs. Observes the assessment and documentation of the baby’s Apgar score.
RECORD OF MID-POINT MEETING AND COMMENTS: Student’s self-assessment of progress: Students’ signature: ………………………………… Date: Sign-off mentor’s comments: 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
Achieving quality care through evaluation and research Esc: Communication Initial consultation between the woman and the midwife Initiation and continuance of breast feeding Medicine management Evaluates care plans and observe midwives making and documenting amendments to improve outcomes. Identifies the need for individualised postnatal support for families. POSTNATAL PLACEMENT P or Fail 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 Sign-off mentors signature Date Student Mentor Care provision Domain: Effective midwifery practice Professional and ethical practice Esc: Communication Initial consultation between the woman and the midwife Medicines management Supports and maintains an environment which promotes health, safety, infection control and security where care is provided. Provides women centred, evidence based care in partnership with women and other care providers which promotes continuing health and well-being. Participates in taking an accurate social, medical, surgical and obstetric history on order to determine pathway of care including consideration for women with disabilities. Recognises the role of the midwife in normal postnatal care and begins to identify risk and the needs of women. Participates in caring for women who have had antenatal/intrapartum complications, for example APH or emergency caesarean section. Observe the role of the midwife when caring for women with complex needs such as: pregnancy loss, stillbirth neonatal death. Aware of the processes to monitor and support women who have postnatal or mental health issues. Participates in ensuring the comfort needs of women are met such as: bladder care, hydration, nutrition, hygiene, infection prevention and assessment of skin integrity.
Can discuss referral to appropriate practitioner for medicine review such as pain relief. Record keeping Domain: Effective midwifery practice Achieving quality care through evaluation and research Esc: Communication Medicines management Participates in completing accurate, legible and continuous records which include the reasoning behind actions taken. Utilises the appropriate information technology systems available. Adheres to the data protection laws around women’s records. POSTNATAL PLACEMENT P or Fail 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 Sign-off mentors signature Date Student Mentor Public health Domain: Effective midwifery practice Achieving quality care through evaluation and research Esc: Communication Initial consultation between the woman and the midwife Initiation and continuance of breast feeding Awareness of the public health policies which influence maternity care provision; for example: infant hearing screening and baby blood spot sampling. Discusses health strategies which target specific groups with particular health needs; for example: smoking cessation, SIDs. Is aware of evidence based practice in relation to the reduction of maternal and perinatal morbidity and mortality. Respecting the individual Domain: Professional and ethical practice Esc: Communication Initial consultation between the woman and the midwife Initiation and continuance of breast feeding Medicines management Is aware of the different roles and relationships in families, reflecting religious and cultural beliefs, preferences and experiences particularly around family planning advice and respect the right to decline services or treatment.
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