Appendix 3

Doppler (Ankle Brachial Pressure Index–ABPI) Assessment clinical competency

Name: / Role: BAND 3 / 4
Base: / Date initial training completed:

Competency Statement:

The participant demonstrates clinical knowledge and skill in Doppler assessment without assistance and/or direct supervision (level 3 - see level descriptors). Completion of the leg ulcer assessment in practice must be by a Registered Nurse who can demonstrate competence at level 3 or above. Band 3 Health Care Support Workers may be deemed as competent to undertake ABPI assessment in a clinic setting only under direct supervision of a competent (Level 4) and confident Registered Nurse. Band 4 Health Care support workers may be deemed as competent to undertake ABPI assessment in a clinic and the home environment having been assessed as competent by a competent and confident level 4 registered nurse

Performance Criteria

/ Assessment Method / Level achieved
/ Date / Assessor/self assessed
The Participant will be able to:
1.Demonstrate the knowledge and skills to perform Doppler (APBI) assessment
a) The participant is able to demonstrate an understanding of the need for a leg ulcer assessment to take place / Questioning
b) The participant is able to explain their accountability / Questioning
c) The participant has undertaken the Trusts leg ulcer course. / Questioning
d) The participant has read the Trust guidelines and policy on leg ulcer management / Questioning
e) Describe the contra-indications/precautions for undertaking ABPI / Questioning
f) Explain to the patient the reasons for having an ABPI completed and distinguish between arterial and venous blood flow / Questioning
g) Explain and identify the difference between mono-phasic, biphasic and tri-phasic sounds / Questioning
h) Locate/name the 4 pedal pulses / Questioning / observation
i) The participant can demonstrate undertaking an ABPI assessment / Observation & Questioning
j) Calculate the ABPI / Questioning
k) Discuss the reason for resting and positioning the patient prior to undertaking ABPI / Questioning
l) Discuss when to use a 5 MHz or an 8MHz probe? What is the difference / Questioning
m) The participant demonstrates what equipment is required for undertaking ABPI and infection control procedures / Observation
n) The participant demonstrates the need to gain consent and maintain privacy and dignity throughout the procedure / Observation
o) The participant demonstrates and understands the position, rest time and management of the patient and their leg ulcer prior to the procedure. / Observation
p) The participant is able to explain why the ABPI is only part of the leg ulcer assessment. / Questioning
q) The participant demonstrates competency in documenting a formal ABPI assessment / Observation
r) The participant is able discuss the ABPI results and the relevance of this with a Registered Nurse prior to the Registered Nurse making a decision regarding the ongoing care / Observation
s) The participant is able to discuss the ongoing management of the patient and correct compression therapy treatment with a Registered Nurse prior to the Registered Nurse completing the appropriate initial care plan / Observation
t) The participant is aware that they must attend yearly updates to maintain their competencies / Questioning
u) Demonstrate ability to document a review and appropriate update of initial care plans which have been completed by Registered Nurse following initial assessment / Observation

Source: Tissue Viability Team: Leg Ulcer Guidelines

Date all elements of Competency Tool completed to level 3______

Name ______Signature ______Status______Date ______

I confirm that I have assessed the above named individual and can verify that he/she demonstrates competency in Doppler assessment

Assessor ______Signature ______Status______Date ______

Review Dates: / Competent
Yes / No / Registered Nurse Signature / Verifier signature / Comments

Doppler (Ankle Brachial Pressure Index–ABPI) Assessment clinical competency

Name: / Role: Band 5/6/7
Base: / Date initial training completed:

Competency Statement:

The participant demonstrates clinical knowledge and skill inDoppler assessment without assistance and/or direct supervision (level 3 - see level descriptors). Assessment in practice must be by a Registered Nurse who can demonstrate competence at level 3 or above.

Performance Criteria

/ Assessment Method / Level achieved
/ Date / Assessor/self assessed
The Participant will be able to:
1.Demonstrate the knowledge and skills to perform Doppler (APBI) assessment
a) Describe the Trust guidelines and policy for ABPI assessment / Questioning
b) Discuss the Registered Nurses responsibility and NMC accountability when delegating to junior and non registered staff / Questioning
c) The participant has undertaken the trust leg ulcer course. / Questioning
d) Describe the indications for undertaking ABPI and the anticipated outcomes
e) Describe the contra-indications/precautions for undertaking ABPI / Questioning
f) Describe what equipment is required for undertaking ABPI, and which gel should be used / Questioning
g) Explain to the patient the reasons for having an ABPI completed and distinguish between arterial and venous blood flow / Questioning
h) Explain and identify the difference between mono-phasic, biphasic and tri-phasic sounds / Questioning
i) Locate/name the 4 pedal pulses / Questioning / observation
j) Understand the need to gain consent and maintain privacy and
dignity throughout the procedure / Questioning
k) Calculate the ABPI / Questioning
l) Discuss the reason for resting and positioning the patient prior to undertaking ABPI / Questioning
m) Discuss when to use a 5 MHz or an 8MHz probe? What is the difference / Questioning
n) Discuss how to interpret the results and understand the significance / Questioning
o) Discuss the appropriate referral pathways depending on the ABPI / Questioning
p) Explain why the ABPI is only part of the leg ulcer assessment. / Questioning
2. Demonstrate the practical skills necessary to perform Doppler (APBI) assessment
a) The participant can demonstrate undertaking an ABPI assessment and in conjunction with the leg ulcer assessment form identify leg ulcer treatment options. / Observation
b) The participant demonstrates what equipment is required for undertaking ABPI, which gel should be used and infection control procedures / Observation
c) The participant demonstrates the need to gain consent and maintain privacy and dignity throughout the procedure / Observation
d) The participant demonstrates and understands the position, rest time and management of the patient and their leg ulcer prior to the procedure. / Observation
e) The participant demonstrates competency in documenting a formal ABPI assessment / Observation
f) The participant can complete a patient centered care plan based on the leg ulcer assessment form information. / Observation
g) The participant can complete a patient centered wellbeing care plan based on the leg ulcer assessment information. / Observation

Source: Tissue Viability Team

Date all elements of Competency Tool completed to level 3______

Registered Nurse ______Signature ______Status______Date ______

I confirm that I have assessed the above named individual and can verify that he/she demonstrates competency in Doppler assessment

Assessor ______Signature ______Status______Date ______

Review Dates: / Competent
Yes / No / Registered Nurse Signature / Verifier signature / Comments