Annexe A & B Skills

1. Underpinning communication skills for assessing, planning, providing, and managing best practice, evidence-based nursing care

1.1 actively listen, recognise, and respond to verbal and non-verbal cues

1.2 use prompts and positive verbal and non-verbal reinforcement

1.3 use appropriate non-verbal communication including touch, eye contact and personal space

1.4 make appropriate use of open and closed questioning

1.5 use caring conversation techniques

1.6 check understanding and use clarification techniques

1.7 be aware of own unconscious bias in communication encounters

1.8 write accurate, clear, legible records and documentation

1.9 confidently and clearly present and share verbal and written reports with individuals and groups

1.10 analyse and clearly record and share digital information and data

1.11 provide clear verbal, digital or written information and instructions when delegating or handing over responsibility for care

1.12 recognise the need for, and facilitate access to, translator services and material.

2. Evidence-based, best practice approaches to communication for supporting people of all ages, their families and carers in preventing ill health and in managing their care

2.1 share information and check understanding about the causes, implications and treatment of a range of common health conditions including anxiety, depression, memory loss, diabetes, dementia, respiratory disease, cardiac disease, neurological disease, cancer, skin problems, immune deficiencies, psychosis, stroke and arthritis

2.2 use clear language and appropriate, written materials, making reasonable adjustments where appropriate in order to optimise people’s understanding of what has caused their health condition and the implications of their care and treatment

2.3 recognise and accommodate sensory impairments during all communications

2.4 support and manage the use of personal communication aids

2.5 identify the need for and manage a range of alternative communication techniques

2.6 use repetition and positive reinforcement strategies

2.8 provide information and explanation to people, families and carers and respond to questions about their treatment and care and possible ways of preventing ill health to enhance understanding

2.9 engage in difficult conversations, including breaking bad news and support people who are feeling emotionally or physically vulnerable or in distress, conveying compassion and sensitivity.

3. Evidence-based, best practice communication skills and approaches for providing therapeutic interventions

3.1 motivational interview techniques

3.2 solution focused therapies

3.3 reminiscence therapies

3.4 talking therapies

3.5 de-escalation strategies and techniques

3.6 cognitive behavioural therapy techniques

3.7 play therapy

3.8 distraction and diversion strategies

3.9 positive behaviour support approaches

4. Evidence-based, best practice communication skills and approaches for working with people in professional teams

4.1 Demonstrate effective supervision, teaching and performance appraisal through the use of:

4.1.1 clear instructions and explanations when supervising, teaching, or appraising others

4.1.2 clear instructions and check understanding when delegating care responsibilities to others

4.1.3 unambiguous, constructive feedback about strengths and weaknesses and potential for improvement

4.1.4 encouragement to colleagues that helps them to reflect on their practice

4.1.5 unambiguous records of performance

4.2 Demonstrate effective person and team management through the use of:

4.2.1 strengths-based approaches to developing teams and managing change

4.2.2 active listening when dealing with team members’ concerns and anxieties

4.2.3 a calm presence when dealing with conflict

4.2.4 appropriate and effective confrontation strategies

4.2.5 de-escalation strategies and techniques when dealing with conflict

4.2.6 effective co-ordination and navigation skills through:

4.2.6.1 appropriate negotiation strategies

4.2.6.2 appropriate escalation procedures

4.2.6.3 appropriate approaches to advocacy

1. Use evidence- based, best practice approaches to take a history, observe, recognise and accurately assess people of all ages

1.1 mental health and well-being status

1.1.1 signs of mental and emotional distress or vulnerability

1.1.2 cognitive health status and wellbeing

1.1.3 signs of cognitive distress and impairment

1.1.4 behavioural distress-based needs

1.1.5 signs of mental and emotional distress including agitation, aggression and challenging behaviour

1.1.6 signs of self-harm and/or suicidal ideation

1.2 physical health and wellbeing

1.2.1 symptoms and signs of physical ill health

1.2.2 symptoms and signs of physical distress

1.2.3 symptoms and signs of deterioration and sepsis.

2. Use evidence-based, best practice approaches to undertake the following procedures:

2.1 take, record, and interpret vital signs manually and via technological devices

2.2 undertake venepuncture and cannulation and blood sampling, interpreting normal and common abnormal blood profiles and venous blood gases

2.3 set up and manage routine electrocardiogram (ECG) investigations and interpret normal and commonly encountered abnormal traces

2.4 manage and monitor blood component transfusions

2.5 manage and interpret cardiac monitors, infusion pumps, blood glucose monitors and other monitoring devices

2.6 accurately measure weight and height, calculate body mass index, and recognise healthy ranges and clinically significant low/high readings

2.7 undertake a whole-body systems assessment including respiratory, circulatory, neurological, musculoskeletal, cardiovascular, and skin status

2.8 undertake chest auscultation and interpret findings

2.9 collect and observe sputum, urine, stool, and vomit specimens, undertaking routine analysis and interpreting findings

2.10 measure and interpret blood glucose levels

2.11 recognise and respond to signs of all forms of abuse

2.12 undertake, respond to and interpret neurological observations and assessments

2.13 identify and respond to signs of deterioration and sepsis

2.14 administer basic mental health first aid

2.15 administer basic physical first aid

2.16 recognise and manage seizures, choking and anaphylaxis, providing appropriate basic life support

2.17 recognise and respond to challenging behaviour, providing appropriate safe holding and restraint

3. Use evidence-based, best practice approaches for meeting needs for care and support with rest, sleep, comfort and the maintenance of dignity, accurately assessing the person’s capacity for independence and self-care and initiating appropriate interventions

3.1 observe and assess comfort and pain levels and rest and sleep patterns

3.2 use appropriate bed-making techniques including those required for people who are unconscious or who have limited mobility

3.3 use appropriate positioning and pressure-relieving techniques

3.4 take appropriate action to ensure privacy and dignity at all times

3.5 take appropriate action to reduce or minimise pain or discomfort

3.6 take appropriate action to reduce fatigue, minimise insomnia and support improved rest and sleep hygiene.

4. Use evidence-based, best practice approaches for meeting the needs for care and support with hygiene and the maintenance of skin integrity, accurately assessing the person’s capacity for independence and self-care and initiating appropriate interventions

4.1 observe, assess, and optimise skin and hygiene status and determine the need for support and intervention

4.2 use contemporary approaches to the assessment of skin integrity and use appropriate products to prevent or manage skin breakdown

4.3 assess needs for and provide appropriate assistance with washing, bathing, shaving, and dressing

4.4 identify and manage skin irritations and rashes

4.5 assess needs for and provide appropriate oral, dental, eye and nail care and decide when an onward referral is needed

4.6 use aseptic techniques when undertaking wound care including dressings, pressure bandaging, suture removal, and vacuum closures

4.7 use aseptic techniques when managing wound and drainage processes

4.8 assess, respond, and effectively manage pyrexia and hypothermia.

5. Use evidence-based, best practice approaches for meeting needs for care and support with nutrition and hydration, accurately assessing the person’s capacity for independence and self-care and initiating appropriate interventions

5.1 observe, assess, and optimise nutrition and hydration status and determine the need for intervention and support

5.2 use contemporary nutritional assessment tools

5.3 assist with feeding and drinking and use appropriate feeding and drinking aids

5.4 record fluid intake and output and identify, respond to, and manage dehydration or fluid retention

5.5 identify, respond to and manage nausea and vomiting

5.6 insert, manage and remove oral/nasal/gastric tubes

5.7 manage artificial nutrition and hydration using oral, enteral, and parenteral routes

5.8 manage the administration of IV fluids

5.9 manage fluid and nutritional infusion pumps and devices.

6. Use evidence-based, best practice approaches for meeting needs for care and support with bladder and bowel health, accurately assessing the person’s capacity for independence and self-care and initiating appropriate interventions

6.1 observe and assess level of urinary and bowel continence to determine the need for support and intervention assisting with toileting, maintaining dignity and privacy and managing the use of appropriate aids

6.2 select and use appropriate continence products; insert, manage, and remove catheters for all genders; and assist with self-catheterisation when required

6.3 manage bladder drainage

6.4 assess bladder and bowel patterns to identify and respond to constipation, diarrhoea and urinary and faecal retention

6.5 administer enemas and suppositories and undertake rectal examination and manual evacuation when appropriate

6.6 undertake stoma care identifying and using appropriate products and approaches.

7. Use evidence-based, best practice approaches for meeting needs for care and support with mobility and safety, accurately assessing the person’s capacity for independence and self-care and initiating appropriate interventions

7.1 observe and use evidence-based risk assessment tools to determine need for support and intervention to optimise mobility and safety, and to identify and manage risk of falls using best practice risk assessment approaches

7.2 use a range of contemporary moving and handling techniques and mobility aids

7.3 use appropriate moving and handling equipment to support people with impaired mobility

7.4 use appropriate safety techniques and devices

8. Use evidence-based, best practice approaches for meeting needs for respiratory care and support, accurately assessing the person’s capacity for independence and self-care and initiating appropriate interventions

8.1 observe and assess the need for intervention and respond to restlessness, agitation and breathlessness using appropriate interventions

8.2 manage the administration of oxygen using a range of routes and best practice approaches

8.3 take and interpret peak flow and oximetry measurements

8.4 use appropriate nasal and oral suctioning techniques

8.5 manage inhalation, humidifier, and nebuliser devices

8.6 manage airway and respiratory processes and equipment.

9. Use evidence-based, best practice approaches for meeting needs for care and support with the prevention and management of infection, accurately assessing the person’s capacity for independence and self-care and initiating appropriate interventions

9.1 observe, assess, and respond rapidly to potential infection risks using best practice guidelines

9.2 use standard precautions protocols

9.3 use effective aseptic, non-touch techniques

9.4 use appropriate personal protection equipment

9.5 implement isolation procedures

9.6 use evidence-based hand hygiene techniques

9.7 safely decontaminate equipment and environment

9.8 safely use and dispose of waste, laundry and sharps

9.9 safely assess and manage invasive medical devices and lines.

10. Use evidence-based, best practice approaches for meeting needs for care and support at the end of life, accurately assessing the person’s capacity for independence and self-care and initiating appropriate interventions

10.1 observe, and assess the need for intervention for people, families and carers, identify, assess and respond appropriately to uncontrolled symptoms and signs of distress including pain, nausea, thirst, constipation, restlessness, agitation, anxiety and depression

10.2 manage and monitor effectiveness of symptom relief medication, infusion pumps and other devices

10.3 assess and review preferences and care priorities of the dying person and their family and carers

10.4 understand and apply organ and tissue donation protocols, advanced planning decisions, living wills and health and lasting powers of attorney for health

10.5 understand and apply DNACPR (do not attempt cardiopulmonary resuscitation) decisions and verification of expected death

10.6 provide care for the deceased person and the bereaved respecting cultural requirements and protocols

11. Procedural competencies required for best practice, evidence-based medicines administration and optimisation

11.1 carry out initial and continued assessments of people receiving care and their ability to self-administer their own medications

11.2 recognise the various procedural routes under which medicines can be prescribed, supplied, dispensed, and administered; and the laws, policies, regulations and guidance that underpin them

11.3 use the principles of safe remote prescribing and directions to administer medicines

11.4 undertake accurate drug calculations for a range of medications

11.5 undertake accurate checks, including transcription and titration, of any direction to supply or administer a medicinal product

11.6 exercise professional accountability in ensuring the safe administration of medicines to those receiving care

11.7 administer injections using intramuscular, subcutaneous, intradermal, and intravenous routes and manage injection equipment

11.8 administer medications using a range of routes

11.9 administer and monitor medications using vascular access devices and enteral equipment

11.10 recognise and respond to adverse or abnormal reactions to medications

11.11 undertake safe storage, transportation, and disposal of medicinal products.