Name

Competency Statement: Postoperative Free Flap Monitoring in Adult Patients

Competency Indicators Achieved Competency Indicators Achieved Competency Indicators Achieved Competency Indicators Achieved
st Assessor Assessor Assessor Assessor
1 Level signature 2nd Level signature 3rd level signature 4th level signature

a) Define a free flap All of level 1 plus: All of levels 1 & 2 plus: All of levels 1,2 & 3 plus:
b) Describe the basic a) Describe the most a) Monitor & escalate a) Act as an expert
anatomy & physiology critical periods for the need for resource to the team
related to a free flap free flaps adjustments to the IV in the care of post
c) Demonstrate b) Describe the optimal fluid regimen with operative free flap
awareness of the parameters for: the medical team patients
other factors required (i) Urine b) Describe the b) Promote systems
to support free flap output intervention required within the
survival: (ii) Temper at the first sign of a department to
(i) Blood ature failing flap ensure nurses caring
pressure (iii) Flap c) Support a learner in for free flaps are
(ii) Fluid colour undertaking free flap competent & up to
balance (iv) Flap observations date
(iii) Positionin turgidity c) Monitor performance
g (v) Flap & any adverse
(iv) Temperat temperat events in order to
ure ure improve practice
(v) Movemen (vi) Capillary
t refill
d) Discuss the rationale c) Describe the optimal
for undertaking free position of the
flap observations patient
e) Describe the clinical d) Describe the role of
observations required analgesia in the
during the early survival of the free
postoperative phase flap
f) Describe the optimal e) Describe the role of
timings for free flap anti-emetics in the
observations survival of the free
g) Demonstrate an flap
awareness of the f) Describe the risks to
signs of a failing flap the flap associated
h) Demonstrate effective with suctioning
documentation in g) Describe the risk to
relation to free flap the flap associated

1st Aug 2014 proforma Competency template- v 2 /DJK Form AC2

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observations with securing the

i) Demonstrate effective tracheostomy tube
communication skills h) Describe how
in passing on mouth-care is
information regarding undertaken in this
the flap group of patients
j) Describe the possible i) Describe how the
complications related nutritional needs will
to lack of rest due to be met during the
frequency of initial post-operative
observations. period

Education resources to support your development

Refer to references
Author: Gill Haynes, Mandy Houghton Department: H&NU Review Date: Aug 2016

Record of Achievement.
To verify competence please ensure that you have the appropriate level signed as a record of your achievement in the boxes below either by the educator/ trainer if
attendance on study session and or the workplace assessor when performed in practice.
Level 1 Level 2 Level 3 Level 4
Date: Date: Date: Date:
Signature of Educator/ Trainer Signature of Educator/ Trainer Signature of Educator/ Trainer

Signature of Educator/ Trainer

Date Date Date Date

Signature of Workplace Assessor Signature of Workplace Assessor Signature of Workplace Assessor Signature of Workplace Assessor

References to Support Competency

Hutchinson. CR & Williams KD (2000) Postoperative free flap monitoring: clinical guidelines, Bahnon
SRH (1995) Protocol for the ITU management of patients having microvascular free flap grafts to the head & neck

1st Aug 2014 proforma Competency template- v 2 /DJK Form AC2

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Coull A & Wyllie K (1990) Regular monitoring: The way to ensure flap healing: nursing priorities following flap repair & reconstructive
surgery, Professional nurse October p18-21
Carapet D (2007) Algorythm for IV fluid ajustment

1st Aug 2014 proforma Competency template- v 2 /DJK Form AC2