ࡱ> &5(L / 00DTimes New Romanll00DArial Narrowanll00" DArialNarrowanll000DWingdingsowanll00 C0.  @n?" dd@  @@`` ||`5         HG '() *,-./3475>? @ABCDFGHIJKLMNPQUVWX 0AAPf3f3@80 1  7? ʚ;1_8ʚ;g4rdrdb 0dppp@ <4!d!d8A10l0<4dddd8A10l0<4BdBd8A10l0g49d9dd 0>p& p^0___PPT10 ppf___PPT9H@(?  O =H) CLINICAL COMPETENCESBy Shelina Sunni Clinical Specialist Cardiac Radiographer Guy s & St Thomas NHS Foundation``% IntroductionDefinition of Competence Definition of Competency Why have competences? How did we start? How do we assess them? How often do we assess? Who Assesses? Record Keeping Potential BarriersD   # >Definition of word  Competence Z 100s of definitions for Competence e.g.  Competences are descriptors of the performance criteria, knowledge and understanding that are required to undertake work activities (Ref: Skills for Health) www.skillsforhealth.org.uk/ A competence describes the skill/knowledge needed to perform a task)%$"%D$: kDG>Definition of word  Competency   VA  Competency assesses the ability of a specific person to perform the task (s) Minimum standard for measuring performance which is acceptable for fulfilling a role ` ! !7Our Definition Our comprehensive Clinical Competences are the framework by which Radiographers understanding of the Radiographic role and their ability to successfully carry it out, are assessed and recorded"!&Why have them?Code of Practice/Statement of Professional Conduct  requirement for registration CNST- reduces risk to trust Standardisation of knowledge Opportunity for self development F$,%!,8How and when did we start?`KSF  6 CORE dimensions CNST  Medical devices 8  1Assessment of CompetencesJ Comprehensive Clinical Competences  assesses the knowledge, skill and capabilities of the Radiographic role Knowledge - Radiation Protection and Compliance with Local Policies Skill - Specific Equipment Assessments Capabilities  knowledge + skill Based on locally agreed standards |o$*%4! ;" ? Competency CategoriesnCommunication Personal Development Service Development Health & safety Imaging and Equipment The Clinical roleo o  CommunicationAccept constructive feedback Skills required to relate to staff and patients Can articulate boundaries and limitations of own role  asks for assistance when needed Sensitive to patients needs  how to overcome physical/cultural differences > ZZZZ Personal DevelopmenthContinuous Professional Development Understands Diversity and Equality policy Advocacy Own Limitations ,g i Service Development & QualityRecognises role and contribution of other members of the team Participates in advancing quality and maintains high standards Understands purpose of audit Familiar with Quality Assurance programmes  %Health & Safety/ Radiation ProtectionPolicies Infection Control Health & Safety Policy Manual Handling Data Protection Radiation Protection Policies and compliance  $ZvnZnZZZZZ x Imaging & Equipment Imaging Anatomy and Physiology knowledge relating to cardiovascular system Standard views  know these and interpret images and provide advice on most appropriate views QCA Post Processing Archiving 4$$  Individual Equipment assessment USwitching on & off Safe operation of equipment (aware of environment) TroubleshootingV V  Clinical Role(Correct Record keeping  register and equipment Compliance with policy for referral for x-ray exposure Radiation Safe environment Dispose of waste Assist in safe transfer of patient Maintain cleanliness of Cath Labs between patients Stocking Aseptic technique On Call protocol Z3* Evaluation & Statement of CompetencyEvaluation includes: Feedback Evaluation of assessment Statement of Competency: Signature of trainer who has observed whole demonstration of role Agreement of Compliance "$%Z$%#\ Additional RoleskQuality Assurance Tests (QA) Training Documentation Maintenance of lead protection Role extension - CCLP  k l'How often do we assess?Annually  statement of Professional Conduct states that clinical practice should be subjected to regular audit i.e. regular assessment.  ) Who Assesses?Anyone who demonstrates they have the background knowledge  policies/protocols Have understanding of the competences and the role itself have answers to questions Patience to provide training Have people skills  get information across ZAWho else do we assess?JNew Staff Agency staff Cardiologists Cardiac Catheter Lab Practitioners4 !2 K6Record KeepingJDepartmental databases Trust Requirements Individual Documents for CPD v$%$%$,B Any Problems?jStaff understanding of importance of competences Releasing staff to go through it Training Cardiologists41 !9 k/ Summaryb Clinical Competences: A necessary tool for learning, evaluating, motivating and improving bc.Any Questions? 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A competency assesses the ability of a specific person to perform the same task (i.e. do They are minimum standards for measuring performance which is acceptable for fulfilling a role. Competence is the knowledge and skills needed to do a task while competency is the ability to assess the ability. Competences are based on locally agreed standards. I will talk about that in a bit.H L 09gĖ ? ̙3380___PPT10.v80 TH(  T^ T S <Kp   U T c $CU< ;z  U >*My name is Shelina Sunni and I m Clinical Specialist at St Thomas Hospital. I m also one of the committee members of CRAG and hope you enjoy our Study day. I ve been asked to speak on Clinical Competences and how we at STH use them to assess our radiographers capabilities.H T 09gĖ ? ̙3380___PPT10.he 0   X* (  X^ X S <Kp     X c $g< ;z    Hence we got our comprehensive clinical competences, which are used to assess the knowledge, skills and capabilities of the radiographer to perform the role. Knowledge  In Radiation Protection and compliance with local policies e.g. IRMER policy for checking justification and authorisation of a procedure, terms practitioner, operator, referrer, dose ref levels for procedures, signing of pregnancy form. Knowledge in policies that apply to the role. They must have extensive knowledge of cardiac anatomy and physiology. This is needed to advise on choice of projections to image certain coronary arteries. Skills- We have separate protocols called  Standards of Clinical Competences , which are written instructions for performing procedures using our x ray equipment, the way we want it to be used E.g. how to use GE or Siemens Labs used to do the procedures, what protocols to chose for a procedure. They both have different functions to do the same job!! To measure skills, within our ccs, we have specific equipment assessments which assesses skills required to use the equipment the way we would like it to be used Capability  is knowledge and skills put together to perform a role. Competences are based on locally agreed standards.& 3 H X 09gĖ ? ̙3380___PPT10.a< 0   0\L (  \^ \ S <Kp    \ c $X< ;z   B Statement 6 in Statement of Professional Conduct states  Rads will undertake lifelong learning and keep record of their record of their on going development activities. This is a requirement for registration. Equality & Diversity  Understands the terms and how they apply to them in their role and others. Are they being treated fairly, given equal opportunity to do what they would like to do eg additional roles, courses. Understanding and awareness of whole multidisciplinary team and how each member works, recognising and valuing differences. Has empathy towards patients and understanding their feelings/needs. To be the patient s advocate. In our labs we talk to our patients while the sheaths are being put in. This way, we can act on their behalf e.g. if they are in pain we could suggest using more local anaesthetic. PD is about knowing their own limitations and all about developing oneself to see one s limits. Limitations before seeking assistance and knowing when to hand over to a more senior member of staffyH \ 09gĖ ? ̙3380___PPT10.苪.0 @`>(  `^ ` S <Kp    ` c $l< ;z   4 Specially when being assessed. They accept shortfalls and willing to change practice. We work in multidisciplinary environment. We do a lot of multitasking and lots of communication goes into this. COORDINATING When there is a problem, doesn t hesitate to ask for help, but also tries to troubleshoot and not call for help every time. Communicating with patients who may have communicating barriers. H ` 09gĖ ? ̙3380___PPT10.%70 `lG(  l^ l S <Kp    l c $@< ;z   =)Imaging includes knowing ( AS PER SLIDE)H l 09gĖ ? ̙3380___PPT10.pVH> 0 ppN(  p^ p S <Kp    p c $P$< ;z   D0The individual equipment assessment assesses skills to use the equipment including how it is is switched on and off. Use the equipment with safety of patient, other members of staff and yourself into consideration. Troubleshooting  know what to do in case of equipment breakdown.H p 09gĖ ? ̙3380___PPT10.4 0  x(  x^ x S <Kp    x c $<< ;z   \In this competency, the knowledge and skills to do the role is assessed. This takes into account all the policies, e.g. infection control  maintains cleanliness of lab in between patients, dispose of waste, MH  safe transfer of patients, checking justification, authorisation, correct record keeping.eH x 09gĖ ? ̙3380___PPT10.=E0 @8|(  |^ | S <Kp   2 | c $< ;z   This competency ensures the radiographer gets all the background knowledge for the role. By knowing the policies and how they are applied to the role.H | 09gĖ ? ̙3380___PPT10.p|ɢp 0 (  ^  S <Kp   U  c $U< ;z  U v6There is a lot of confusion in understanding words Competence, Competency and Competences. I was confused, though it doesn t take much to confuse me. I found 100s of definitions for Competence. What I have is just 1 examples. Skills for Health says  Competence are descriptors& &  A Measure of learning achievement . In simple English, Competence describes the knowledge and skills necessary to do a task by anyone. i.e. the task does not have to be radiographer specific. Competence is not person specific. You could say competence is talking the talk (just describing) (Skills for Health is the Sector Skills Council (SSC) for the UK health sector. They help the whole sector develop solutions that deliver a skilled and flexible UK workforce in order to improve health and healthcare.)$BH  09gĖ ? ̙3380___PPT10.-Z 0 j(  ^  S <Kp     c $x$< ;z   `LSo why have competencies? There are various reasons for having Competences. Here we have some of the important ones: Firstly, it s a requirement for registration. The health professional council statement 5 states  Rads must not undertake any procedure unless adequately educated & trained. How do we know Radiographers are correctly and adequately trained? By assessing their Clinical Competences. Secondly, Clinical Negligence Scheme for Trusts (CNST in short) requires that hospitals reduce risks associated with the use of medical devices, which include X-ray equipment, by implementing competence based training Third - Standardisation of knowledge & technique By using these competences, everyone has the same background knowledge and skills needed for their role. Fourth CCs provide individuals with opportunity to identify their capability and further need for development in order to aid their personal and career growth.H  09gĖ ? ̙3380___PPT10.5pqcl0 |(  ^  S <Kp     c $(< ;z   r^Individual Trusts will have different criteria for trainers/assessors. They may need to do certain courses like Training trainers, Mentorship courses. We take the following points in consideration for who assesses: & & & & & & & & & & . There is no point in assessing if you don t know the answers to the questions or don t understand the Competencies. You must have patience to teach and have people skills to able to get your views acrossH  09gĖ ? ̙3380___PPT10.@@0 NF(  ^  S <Kp   @  c $< ;z   Our Clinical Competences are divided in the following categories. (AS PER SLIDE) The following slides with these categories briefly summarise key points within the category we have to assessH  09gĖ ? ̙3380___PPT10.e 0   0  (   ^   S <Kp       c $[< ;z     Once the assessment is completed, there is evaluation and signing of documents i.e.  Statement of Competency. To evaluate, we need feedback. We have feedback forms given to our trainees. This allows us to highlight any problems in the process making changes and improvement. Feedback is given to trainee as well, on how they performed or do they need to brush up on anything. They may be given a piece of work to write on e.g. IRMER policy or explain cardiac anatomy and physiology. At STH, we ve just finished evaluating our training programme and made changes to our CCs. CCs should be changed to meet service requirements e.g. we had 4 Siemens labs but now have 4 different pieces of kit. If you are trained and competent on one piece of equipment, it doesn t mean you are competent on the others. So we have got feedback, homework is handed in then comes Statement of Competency. This is signed by the assessor, who has observed whole demonstration of the role during a procedure. Finally, an agreement of Compliance is signed by the trainee to agree not only can they do the role but agree to perform the role as they ve been taught to do it.H   09gĖ ? ̙3380___PPT10._0`j, 0 @$<(  $^ $ S <Kp    $ c $y< ;z   2CCs have been set up to provide Rads to provide evidence for their PDRs Additional roles are evidence for PDRs. Our Rads can do any of the additional roles on the slide. Documentation is helping with rotas or audits.>C#aH $ 09gĖ ? ̙3380___PPT10.Bp30 <C(  <^ < S <Kp   U < c $U< ;z  U 9%The talk is made up of the following:H < 09gĖ ? ̙3380___PPT10.wkul0 @|(  @^ @ S <Kp   U @ c $< ;z  U r^We have seen general definitions of Competencies. But how do we define Competencies? Comprehensive Clinical Competencies are the framework by which a radiographer s understanding of the radiographic role and their ability to successfully carry it out, are assessed and recorded. Why comprehensive? Our CCs include having the knowledge in Trust policies e.g. MH, Infection control, Health & Safety, Radiation Protection, and compliance Our radiographers are dedicated cardiac radiographers and do not rotate through other department. We expect a very high level of expertise and excellent understanding of not only their role but also everyone else s role within a multidisciplinary teamH @ 09gĖ ? ̙3380___PPT10.y"%[w0 D(  D^ D S <Kp    D c $HD< ;z   }iIn the old days, (in my time which was ages ago) I remember being taught the clinical role by see one, do one, and teach one module, ALMOST. Did anyone else do that module? There was no comprehensive training with the background knowledge which we pay so much emphasis on now. Now we have numerous files of information for staff to read and get their knowledge from, all within the department So how did we start writing our competences? In 2004, we started our competences linked to NHS Knowledge & Skills Framework (KSF). We were then able to use CCs as evidence for several dimensions within KSF for each member of staff for their PDRs (personal development reviews) In 2005, CNST came in and we made a few changes. The original competences were based on the 6 CORE dimensions of KSF. CNST is more to do with medical devices and need for strict framework for assessment.H D 09gĖ ? ̙3380___PPT10.P$V0 vnH(  H^ H S <Kp   h H c $h< ;z   We try to assess annually. You ll understand why I say try in a bit. Obviously we assess straight away after a new piece of equipment or a new technique. We assess new staff as soon as training is completed and they are independent in the Labs.H H 09gĖ ? ̙3380___PPT10.\N0 L^(  L^ L S <Kp    L c $< ;z   T@I think the most important part of the whole process is documenting it. You can assess and pass someone but if this is not documented and something goes wrong, you would not have a leg to stand on. Once the competencies are signed, we record on our departmental databases. These are updated annually or as assessment is done. Trust documents: The trust requires we keep documentation and send documents on all training including equipment and statutory and mandatory training e.g. MH, infection control, fire training. We have CNST databases sent to our T&D to show training.H L 09gĖ ? ̙3380___PPT10.cr0 1)T(  T^ T S <Kp   # T c $< ;z   CCs are necessary tool for learning, evaluating, motivating and improving. By means of CCs, individuals identify their capability and further need for development.H T 09gĖ ? ̙3380___PPT10.[Y[0 Xk(  X^ X S <Kp    X c $(Ш< ;z   aMUnderstanding importance of each member of staff and participating in advancing quality. We are in the process of implementing On Call staff being trained to set up equipment for other staff members. This saves time and improves door to needle time . Actively participating in promoting CCLP course for staff shortages. We currently have a radiographer who is seconded to nurses. Participates in shift pattern to accommodate service changes e.g. 11-7 shift to accommodate late arrival of transfers Audit help to improve service based on evidence. We have turnaround time audits, discharge audits QA tests for dose optimisation, early equipment faults and malfunctions and not working to its capacity. By having assessment, high standards are maintained. Evidence based practice by participating in audits to improve service. Reason for having Quality Assurance programmesH X 09gĖ ? ̙3380___PPT10. O0  `t(  td t c $<Kp     t s *< ;z   dDO we encounter problems? Is Pope catholic? It s very difficult for staff to understand why they need assessing when they ve been doing the role for x number of years and it s almost the same process every year. Because we assess academic knowledge as well, we need a whole day to assess and this may be a problem for releasing staff to go through it. Therefore, we TRY to assess yearly but sometimes this isn t practical Cardiologists are a world of their own. They have ward rounds, clinics etc and may turn up to do a acase without being trained and assessed. %H t 09gĖ ? ̙3380___PPT10.0 z|(  |d | c $<Kp   n | s *< ;z   New staff assessed once training completed. Our agency staff go through the assessment on the equipment they would use and certain background knowledge. Our trust insists on a mini Orientation for agency staff where they have to have knowledge in some of the Trust policies. Every October, we have a turnaround of cardiologists. They are trained and assessed in use of x ray equipment, i.e. use of x-ray pedal, radiation protection equipment, IR(M)ER policy. 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Shelina Sunni.-@Arial-. C2 ? (Clinical Specialist Cardiac Radiographer.-@Arial-.  2 F#Guy.-@Arial-.  2 F-.-@Arial-. 2 F. s & St Thomas.-@Arial-.  2 FQ.-@Arial-. 2 FSNHS Foundation.-՜.+,0X    On-screen ShowJ Times New Roman Arial NarrowArial WingdingsGeneric CLINICAL COMPETENCES Introduction Definition of word Competence Definition of word CompetencyOur DefinitionWhy have them?How and when did we start?Assessment of Competences Competency CategoriesCommunicationPersonal DevelopmentService Development & Quality&Health & Safety/ Radiation ProtectionImaging & Equipment !Individual Equipment assessment Clinical Role+ Evaluation & Statement of CompetencyAdditional RolesHow often do we assess?Who Assesses?Who else do we assess?Record KeepingAny Problems? SummaryAny Questions?  Fonts UsedDesign Template Slide Titles#_& Mark BowersMark Bowers  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~Root EntrydO)Current UserSummaryInformation(GPowerPoint Document(JDocumentSummaryInformation8