Competency Tool
Caesarean Section Competency Tool – December 2013 1
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The Victorian Department of Health is making this document freely available on the internet for health services to use and adapt to meet the National Safety and Quality Health Service Standards of the Australian Commission on Safety and Quality in Health Care. Each health service is responsible for all decisions on how to use this document at its health service and for any changes to the document. Health services need to review this document with respect to the local regulatory framework, processes and training requirements.
Caesarean Section Competency Tool – December 2013 1
Key: I – Independent S – Supervised A – Assisted M – Marginal D – Dependent
(Refer‘Bondy’ Rating Scale p.4)
ASSESSMENT CRITERIA / ELEMENTS / Participant Performance / Standard1 – Safety and Quality /
- Elective Caesareans –babies are expected to go to PACU with mother for feeding
- Emergency Caesareans – Babies are expected to be transferred to the ward/SCN
2 – Partnering with Consumers /
- Discuss procedure with, and obtain consent from, the patient or nominated representativeand give a brief over view of what to expect if appropriate
3 – Healthcare Associated Infection /
- Ensure all equipment required is cleaned and in working order both before and after use. (This includes making sure that gas cylinders are at least half full regardless of connection to mains gas)
- Insert IDC if not already in situ
4 – Medication Safety /
- Ensure you have the required routine drugs and signed consent forms for these for this patient (this may not apply to emergency situations)
5 - Patient Identification and Procedure Matching /
- Ensure ID labels are checked and attached to the baby before it leaves theatre in accordance with legislative requirements
6 - Clinical Handover /
- Transfer care and handover to appropriate personnel using ISOBAR
7 - Blood and Blood Products /
- Check Placenta and membranes
- Take cord lactate
- Collect cord blood if indicated for grouping
- Package and label any cord blood collected for storage
- Take blood from the baby for BSL if indicated in PACU
8 - Preventing and Managing Pressure Injuries /
- Document any invasive device or acquired skin breach for the baby if appropriate e.g. IV cannula, laceration or forceps damage
9 - Recognising and Responding to Clinical Deterioration in Acute Health Care /
- Monitor foetal well being if appropriate during preparation (emergency caesareans)
- Assist paediatrician to receive the baby
- Assist with resuscitation as indicated
- Escalate to emergency response team if indicated
- Ensure infant’s observations are attended hourly or more often if indicated in PACU
ASSESSMENT CRITERIA / ELEMENTS / Participant Performance / Standard
10 - Preventing Falls and Harm From Falls /
- Ensure equipment/cords are located appropriately for access and do not cause hazards to the team
11 –
Service Delivery /
- Ensure all consent requirements are met according to the standard
12 - Provision of Care /
- Decide where this baby should be cared for e.g. Transfer to SCN or to PACU with mother
- In PACU the midwife’s responsibility is to care for the baby and assist with initiating feeding. PACU staff are responsible for care of the mother
13 - Workforce Planning /
- If an elective list , ring the ward to ask for midwife to attend PACU to allow transfer of care if appropriate
14 - Information Management /
- Complete all required documentation including the back of the partograph as this is important information that will accompany patient until BOS is completed.
- Complete BOS for each patient when you return to the ward
15 - Corporate Systems and Safety /
- Ensure any faulty equipment is reported and replaced
- Ensure sharps containers are accessible and usable
I ______have reviewed all current associated policies and procedures pertaining to this tool
(Name)
Supernumerary /orientation shift completionDate: ______
Midwife signature and name:______
Midwife in charge of orientation signature and name:______
Annual self assessment:
I ______have reviewed all current associated policies and procedures relevant to this tool
I am current with the supporting skills and education required to fulfil the role and responsibilities of the Midwife in relation to this procedure.
Date:______
Signature and name: ______
Caesarean Section Competency Tool – December 2013 1
Action Plan
Please document the agreed education plan and completion timelines for staff assessed as not yet competent:
Staff Member Name______
Staff Member Signature______
Staff Member Ward______
Educator Name______
Educator Signature______
Proposed Completion Date______
Caesarean Section Competency Tool – December 2013 1
‘Bondy’ Rating Scale
Scale label / Score / Standard of procedure / Quality of performance / Level of assistance requiredIndependent / 5 / Safe
Accurate
Achieved intended outcome
Behaviour is appropriate to context / Proficient
Confident
Expedient / No supporting cues required
Supervised / 4 / Safe
Accurate
Achieved intended outcome
Behaviour is appropriate to context / Proficient
Confident
Reasonably expedient / Requires occasional supportive cues
Assisted / 3 / Safe
Accurate
Achieved most objectives for intended outcome
Behaviour generally appropriate to context / Proficient throughout most of performance when assisted / Requires frequent verbal and occasional physical directives in addition to supportive cues
Marginal / 2 / Safe only with guidance
Not completely accurate
Incomplete achievement of intended outcome / Unskilled
Inefficient / Requires continuous verbal and frequent physical directive cues
Dependent / 1 / Unsafe
Unable to demonstrate behaviour
Lack of insight into behaviour appropriate to context / Unskilled
Unable to demonstrate behaviour/procedure / Requires continuous verbal and continuous physical directive cues
Bondy, 1983
References
ACORN. (2012-2013). Standards for perioperative nursing including nursing roles, guidelines and position statements. Adelaide: ACORN.
Bondy, K.N. (1984) Clinical Evaluation of student performance: the effects of criteria on accuracy and reliability. Research in Nursing and Health, 7(1), 25-33.
Bondy, K.N. (1983) Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation. Journal of Nursing Education, 22(9), 376-382
Rowley, S., & Clare, S. (2011). Aseptic Non Touch Technique (ANTT): Reducing Healthcare Associated Infections (HCAI) by Standardising Aseptic Technique with ANTT across Large Clinical Workforces. American Journal of Infection Control, 39(5), 90.
Standards Australia, (2003), Australian/New Zealand Standard: Cleaning, disinfecting & sterilising reusable medical & surgical instruments & equipment, & maintenance of associated environments in health care facilities. Sydney: Standards Australia.
Caesarean Section Competency Tool – December 2013 1