Clinical Learning Portfolio 2017

Hospital Authority
醫院管理局
Higher Diploma in Nursing
Clinical Learning Portfolio
(2017)
Name of student : ________________________
Student number: ________________________
Class : _________________________________
Table of Contents Page
1 Introduction 1
2 General Purposes of Field Studies 1
3 Evaluation of Clinical Competency 1
3.1 Self-evaluation 1
3.2 Field Evaluation Report 2
3.3 Unsatisfactory Performance 3
4 Application for Leave 3
5 Reporting Sick Leave 3
6 Report on Incident 4
7 Clinical Assessment 4
8 Clinical Teaching 4
9 Field Study Requirements 4
10 Learning Objectives, Clinical Venues and Contents of Field Studies 6
11 Records of Clinical Learning Experience 18
11.1 Clinical Learning Experience Record I 18
11.1.1 Foundations of Nursing Therapeutics 18
11.2 Clinical Learning Experience Record II 27
11.2.1 Medical and surgical nursing skills for illness prevention and health restoration of clients with alteration in various
body system functions 27
i) Alimentary Nursing 27
ii) Cardiovascular and Lymphatic Nursing 30
iii) Haematological Nursing 34
iv) Respiratory Nursing 35
v) Endocrine Nursing 37
vi) Reproductive Nursing 39
vii) Genito-urinary Nursing 41
viii) Dermatological Nursing 43
ix) Musculoskeletal Nursing 45
x) Neurological Nursing 48
xi) Ophthalmic Nursing 50
xii) Oto-rhino-laryngological Nursing 52
11.2.2 Specialty Nursing 54
i) Primary Health Care Nursing (GOPC) 54
ii) Paediatric Nursing 56
iii) Obstetric Nursing 59
iv) Mental Health Nursing 61
v) Community Health Nursing 62
vi) Gerontological Nursing 63
vii) Accident and Emergency Nursing 64
viii) Operating Theatre (OT) and Recovery Room Nursing 66
11.2.3 Nursing Management 67
12 Records of Clinical Practicum 68
13 Records of Specialty Practicum 70
14 Field Studies Attendance Record 71
15 Record of Absence from Field Studies and Clinical Make-up Day(s) 83
16 Records of Clinical Assessments
i) Aseptic Technique 84
ii) Administration of Medications 84
iii) Professional Nursing Competencies in Total Patient Care 84
17 Mandatory Record for Field Studies 85
18 Record of Educational Visit 85
19 Record of Clinical Experience Checking 86
20. Record of Demonstration and Guided Practice 87
Appendix I : Field Study Evaluation Form ............................................................................................................................91
Appendix II : Clinical Appraisal Form ....................................................................................................................................96
Appendix III : Clinical Assessment on Professional Nursing Competencies in Aseptic Technique ........................................99
Appendix IV : Clinical Assessment on Professional Nursing Competencies in Administration of Oral Medications ...........102
Appendix V : Clinical Assessment on Professional Nursing Competencies in Administration of Parenteral Medications ..105
Appendix VI : Clinical Assessment on Professional Nursing Competencies in Total Patient Care .......................................108
Appendix VII : Total Patient Care Supplementary Data in Addition to Client Initial Assessment Record .............................111
Appendix VIII : Total Patient Care Plan ...................................................................................................................................112
Appendix IX : Reflective Journal ...........................................................................................................................................115
Appendix X : Incident Reporting Form .................................................................................................................................116
Appendix XI : Supervision of Nurse Learners in Clinical Practice ........................................................................................117

1 Introduction
The clinical learning portfolio serves as a guide and a record for student nurses throughout
their 3-year clinical practicum in various clinical areas. However, it should be read in
conjunction with the corresponding student handbook of the programme. Foundations of
nursing therapeutics, medical and surgical nursing skills for illness prevention and health
restoration of clients with alteration in various body system functions, specialty nursing
and nursing management are included in the Record of Clinical Learning Experience.
Students are expected to be self-initiative in seeking learning opportunities and keep

complete records on areas of clinical allocation, period of attachment, number of night
duties and the items observed and practised. For any difficulties encountered, students
should approach the school teachers/school mentors/clinical mentors/clinical coordinators
for assistance and advice.
Students are required to submit reflective journal(s) on each field study which enhances
the consolidation of their clinical learning experience and provide reference for field
evaluation.
2 General Purposes of Field Studies

In general, through clinical practicum, the student will be able to:
- apply knowledge learnt in clinical situations;
- practise related skills to meet the required standard;
- fulfil the requirement of the Nursing Council of Hong Kong for registration as
Registered Nurse by accomplishing competency in specified assessment items.
3 Evaluation of Clinical Competency

The clinical performance of students will be evaluated on a continuous pattern according
to their professional behaviours. Self-evaluation and field evaluation reports are adopted
to assess students’ knowledge, skills and attitudes throughout their field studies.
3.1 Self-evaluation
Self-evaluation is an important component in the learning process. It provides
opportunities for students in analysing and reflecting on their clinical performance
so as to strengthen their competencies and enhancing their abilities in critical
thinking. Students are encouraged to keep journals on particular events that occur
throughout their course of field studies. The self-evaluation process can facilitate
students to have in-depth understanding in the relationship between knowledge and
practice. At the same time, it stimulates them to reflect on the interactions between
client, environment, health and nursing. As a result, the students’ values, ethics and
professional attitudes towards nursing can thus be consolidated throughout the
training. However, this self-evaluation will not be counted in the assessment result.
1|P age
3.2 Field Evaluation Report
In order to facilitate the teaching and learning process, the clinical performance of
students will be assessed by the assigned clinical mentors/school mentors/school
teachers on a continuous basis throughout the programme. In fact, continuous and
prompt feedback on students’ performance is important for quality improvement
during their field studies.
3.2.1 Field Study Evaluation Form

The criterion-referenced “Field Study Evaluation Form” (Appendix I) has been
designed to highlights the developmental nature of students’ performance and
enable the clinical mentors/school mentors/school teachers to readily identify
the difficulties that students may encounter and formulate corresponding
remedial action. Two specific strategies are employed to assess knowledge
and skills learnt and attributes developed.
(i) Formative Evaluation

Formative Evaluation is conducted when the duration of a sub-unit of field
study is less than 4 weeks or in the midway when the field study is of 4
weeks or longer duration. It provides an opportunity for students to reflect
and evaluate on their field performance with their clinical mentors/school
mentors/school teachers. Any specific areas of difficulty that students
have encountered can thus be identified promptly and rectified with
required remedial and supportive actions.
(ii) Summative Evaluation

The summative evaluation is conducted by clinical mentors/school
mentors/school teachers at the end of a sub-unit of field study of 4 weeks
or longer duration. In order to have a more comprehensive and objective
evaluation on students’ daily clinical performance, consultation with other
clinical staff for comments may be required.
To obtain a satisfactory grade of field studies, students must score not less
than 3 for all the objectives assessed as specified in the Field Study Evaluation
Form.
3.2.2 Clinical Appraisal Form

Clinical appraisal (Appendix II) is conducted in nursing specialty or when the
duration of a sub-unit of field study is 2 weeks or less for the purpose of
providing feedback to students.
2|P age
3.3 Unsatisfactory Performance
3.3.1 Summative Evaluation

When a student fails in summative evaluation of a field study, he/she is
required to extend his/her field study period by participating in supplementary
field study before having the 2nd summative evaluation for the field study. In
order to strengthen student’s clinical competency up to the required standard,
intensive coaching which includes clinical teaching, counselling and other
remedial work such as supplementary laboratory practice will be arranged by
school mentor/clinical mentor/school teacher. Upon completion of the
supplementary field study, evaluation (2nd evaluation) will be conducted again
based on the student’s clinical performance.
In case the student has passed the 2nd evaluation of the field study, he/she may
resume his/her normal academic progression. However, if the student has
passed the 2nd evaluation after the commencement of his/her scheduled study
term, he/she will be required to join the next class from that particular study
term onwards to continue the study.
If the student fails the 2nd evaluation of the field study, he/she may be granted
the 3rd evaluation (3rd summative evaluation) for the field study or de-
registered from the programme according to the recommendation by the Board
of Examiners (BOE). However, if the student fails the 3rd evaluation, this will
be regarded as a ground for de-registration.
3.3.2 Clinical Appraisal

If a student fails in the appraisal of specialty placement, a remedial work on
the corresponding clinical specialty would be required.
4 Application for Leave

Students should be aware that absence from field study is not encouraged. A written
application with supporting document for the absence should be submitted to the School
for prior approval. For urgent leave, a student should notify the clinical mentor or ward
in-charge and school as soon as possible. Any absence from field study is required to be
made up within the field study period or supplementary field study.
5 Reporting Sick Leave

Students are required to inform ward in-charge and school before the duty is commenced.
Students who take sick leave must obtain a sick leave certificate from a registered medical
practitioner or registered/listed Chinese medicine practitioner. Students must also
complete the reporting form for sick leave from field study. The completed reporting form
and sick leave certificate should be submitted on resumption of field study as specified in
3|P age
the sick leave reporting form. Any absence from field study is required to be made up
within the field study period or supplementary field study.
6 Report on Incident
Student should inform the ward in-charge of any incident during field study immediately
and notify school within 24 hours. He/she needs to submit an “Incident Reporting Form”
(Appendix X) to the school within 72 hours. If the incident involves injury of the student,
he/she should seek medical advice at the nearest Accident and Emergency Department
(AED) if necessary.
7 Clinical Assessment
In compliance with the requirement of the Nursing Council of Hong Kong, all students are
required to demonstrate competency in:
(i) Aseptic Technique (AT)

(ii) Administration of Medications (AOM)
(iii) Professional Nursing Competencies in Total Patient Care (TPC)
Assessments of AT and AOM would normally be completed in the second year and TPC in
the third year of study. Each student is entitled to have three attempts on each of the
clinical assessments. For student who has failed in any of the captioned assessments for
three attempts, this will be regarded as a ground for de-registration.
8 Clinical Teaching
Clinical teaching will be provided by clinical staff, clinical mentors, school mentors and
school teachers. They facilitate students’ learning by identifying learning opportunities in
clinical situations as well as providing mentoring and supervision to them. As a result, the
learning environment can thus be optimized and safeguarded as it is crucial for the
development of clinical and professional competencies in students.
9 Field Study Requirements

Field study provides students opportunities to acquire and develop clinical skills under
guidance in various clinical healthcare settings throughout the 3-year training. Students
have to fulfil the programme requirement of 1480 clinical practice hours including at least
4 night shifts before graduation.
Clinical Areas Minimum Practice

Requirement (Hours)
1 Medical Nursing 440
For example: General Medicine, Dermatology, Infectious

Diseases, Oncology Nursing and Palliative Care,
Rehabilitation, Out-patient Department (OPD)
4|P age
2 Surgical Nursing 330
For example: General Surgery, Day Surgery, Operating

Theatre and Recovery Room, Cardiothoracic Surgery, Neuro-
surgery, Gynaecology, Ear, Nose and Throat (ENT) Care,
Ophthalmology, Orthopaedics and Traumatology,
Rehabilitation, OPD
3 Primary Health Care 60
4 Obstetric Nursing 60
5 Paediatric and Adolescent Nursing 60
6 Mental Health Nursing 60
7 Accident and Emergency Department 60
8 Community Nursing 60
9 Gerontological Nursing 60
10 Any clinical area(s) among item 1 to 9 290
Total 1480
5|P age
10 Learning Objectives, Clinical Venues and Contents of Field Studies
Subject Title : Field Study I

Level : Year 1
Pre-requisite : Fundamental Concepts of Health and Nursing
Health Assessment and the Nursing Process
Primary Health Care and Health Promotion
Foundations of Nursing Therapeutics
Clinical Venues : Sub-acute Units; Primary Health Care settings; Medical/Surgical
Units
Students are required to pass the objective structured clinical assessment (OSCA) before Field
Study IB. The contents for assessment include subjects of Foundations of Nursing
Therapeutics and Health Assessment & the Nursing Process.
Intended Learning Outcomes

Through observations and practice in the clinical areas, students will be able to:
1. Describe the organizational structure and functions of various departments in different
clinical settings;
2. Describe the roles and responsibilities of health care providers in various clinical
settings;
3. Perform health assessment on clients;
4. Apply nursing process in providing care related to:
4.1 Maintenance of a safe environment;
4.2 Control of body temperature;
4.3 Breathing;
4.4 Elimination;
4.5 Personal hygiene;
4.6 Mobilization;
4.7 Promotion of comforts and sleep;
4.8 Maintenance of nutrition and hydration;
4.9 Maintenance of skin integrity;
4.10 Promotion of wound healing;
4.11 Handling of emotions; and
4.12 Administration of medications;
5. Apply nursing process in managing clients with health problems in:
5.1 Respiratory system; and
6|P age
5.2 Metabolic and endocrine system;
6. Provide peri-operative care to clients requiring surgery and anaesthesia;
7. Assist in the control of infection in the ward and practice medical and surgical asepsis;
8. Demonstrate effective communication with clients, families and health care team
members;
9. Provide rehabilitative care and discharge plans for clients;
10. Document client records accurately and clearly;
11. Recognize the importance of evidence-based nursing practice; and
12. Reflect own nursing practice for professional and personal development.
Intended Learning Outcomes for Primary Health Care

1. Identify available primary health care services in local community;
2. Identify various approaches for providing primary health care service;
3. Identify factors contributing to or impeding the health of individuals of different age
groups; and
4. Provide health promotion and health education to clients.
Assessment
Students are able to:
1. Demonstrate basic understanding in using the nursing process approach in caring of
clients in their activities of daily living;
2. Demonstrate proficiency and competency in aseptic technique; and
3. Achieve satisfactory results in the field study evaluation reports as graded by clinical
mentors / school mentors / school teachers.
7|P age
Subject Title : Field Study II
Level : Year 2
Pre-requisite : Field Study I
Clinical Venues : Medical/Surgical Units; Primary Health Care settings; Obstetric
Units; Paediatric and Adolescent Units; Mental Health Care
Units; Community Nursing Service Centres; Operating Theatre
and Recovery Room; Accident and Emergency Department

clinical settings;
2. Describe the roles and responsibilities of health care providers in various clinical
settings;
3. Identify factors impeding or contributing to the health of individuals of different age
groups;
4. Perform health assessment on clients;
5. Apply nursing process in managing clients with health problems in:
5.1 Cardiovascular system;
5.2 Respiratory system;
5.3 Digestive system;
5.4 Genitourinary system (urinary, renal, and male and female reproductive systems);
5.6 Haematologic system
5.7 Integumentary system;
5.8 Immune system;
5.9 Lymphatic system;
5.10 Musculoskeletal system;
5.11 Nervous system; and
5.12 Special senses (eye, ear, nose and throat);
6. Provide peri-operative care to clients requiring surgery and anaesthesia;
7. Assist in the control of infection and practice medical and surgical asepsis;
8. Demonstrate effective communication with clients, families and health care team
members;
9. Provide health promotion and health education to clients;
10. Provide rehabilitative care and discharge plans for clients;
8|P age
12. Use problem-solving approach in performing the dependent, interdependent and
independent functions of nursing;
13. Collaborate and cooperate with the multi-disciplinary health care team;
14. Integrate knowledge from nursing science and evidence-based practice to make
decisions in regard to the health needs of the persons, families or community in given
situations; and

groups; and
Intended Learning Outcomes for Maternal and Infant Nursing

1. Demonstrate basic understanding in the care given to pregnant women and their families
in normal pregnancy, labour and puerperium;
2. Assist in the provision of antenatal care by taking the history of the pregnant women on
their first visits, and conducting assessments of the pregnant women under guidance on
subsequent visits and parent craft teaching;
3. Provide supportive nursing care to the women in labour and during the puerperium;
4. Observe care given to the neonates with common health problems and congenital
defects;
5. Adopt the nursing process approach in providing care to meet the infant and maternal
needs;
6. Participate in health education on breast-feeding and family planning; and
7. Appraise different types of available health care and social services in the community for
child-bearing family, infant and maternal care.
9|P age
Intended Learning Outcomes for Child, Adolescent and Family Health Nursing
1. Conduct physical and developmental assessment on infants, children and adolescents;
2. Conduct family assessment;
3. Identify factors contributing to wellness and illness of children;
4. Provide appropriate care to assist children and families to cope with illness; and
5. Evaluate the adequacy of resources in the community for meeting the needs of the
children and families to restore optimum family functioning.
Intended Learning Outcomes for Mental Health Nursing

1. Assess the bio-psycho-social needs of the clients;
2. Plan, implement and evaluate care for clients with mental disorders;
3. Interact with clients and their relatives to establish therapeutic relationship in the unit;
4. Function effectively as a member of the multi-disciplinary team;
5. Participate in group activities and therapies;
6. Participate in behavioural modification programme;
7. Demonstrate an understanding of the nursing care in relation to the following
psychiatric treatments:
7.1 Electro-convulsive therapy; and
7.2 Pharmacotherapy.
8. Gain an insight into the following methods of psychological treatments:
8.1 Listening;
8.2 Counselling;
8.3 Reassurance;
8.4 Suggestion;
8.5 Persuasion;
8.6 Behavioural therapy; and
8.7 Group therapy.
9. Participate in the rehabilitation of clients;
10. Participate in recreational activities, such as indoor games and excursions;
11. Participate in social activities, such as dances and entertainment activities which are
organized for the mental clients; and
12. Participate in educational activities, such as discussions and lectures.
10 | P a g e
Intended Learning Outcomes for Community Health Nursing
Through observations and practice in the community nursing services, students will be able to:
1. Adopt primary health care approaches in promoting individual and family health;
2. Conduct health assessments to clients, families and community;
3. Provide appropriate care to clients in family setting;
4. Educate clients and their family members to participate in the care of their own health and
well-being;
5. Provide anticipated care and education to prevent deterioration of illness and promote
recovery;
6. Recognize intersectoral support for care provision and health promotion;
7. Develop knowledge to mobilize community resources to meet the needs of clients and
families; and
8. Evaluate the availability and adequacy of community resources.
Intended Learning Outcomes for Accident and Emergency (AED) Nursing

1. Describe the functions and become familiarize with the AED settings, e.g. triage,
resuscitation room, cubicles, minor theatre;
2. Demonstrate understanding of the principles of emergency care;
3. Recognize the roles & responsibilities of the triage nurse;
4. Demonstrate understanding of prioritization of emergency care and different clients that
are admitted to the triage, cubicles, resuscitation room, recovery and minor theatre in the
AED;
5. Assist in admission of clients in AED;
6. Describe the primary, secondary & focused nursing assessments; and
7. Assist to provide emergency care to clients.
Intended Learning Outcomes for Operating Theatre and Recovery Room Nursing
Through observations and practice in the Operating Theatre, students will be able to:
1. Describe the functions and become familiarize with the operation room settings e.g.
clean zone, sterile zone and dirty zone;
2. Apply principles of asepsis and infection control in providing care for the clients in the
operating theatre;
3. Describe roles and responsibilities of the peri-operative nurse, e.g. circulating nurses,
scrub nurses;
4. Recognize various types of anaesthesia, the principles of application and possible
complications;
11 | P a g e
5. Describe nursing responsibilities in anaesthetic procedures, e.g. induction, maintenance
and recovery phases;
6. Describe the action, uses, side effects, dosage and nursing implications of anaesthetic
drugs commonly used in the operating theatre;
7. Observe and assist in the preparation of operating theatre before surgery, e.g. diathermy
machine;
8. Describe the admission procedure of clients in the operating theatre;
9. Familiarize with different positions of clients for various surgeries and the use of
appropriate aids;
10. Differentiate the common suture materials used in the operating theatre;
11. Familiarize with different surgical instruments and equipment;
12. Assist in providing care to client undergone surgeries and anaesthesia and describe the
immediate post-anaesthesia complications;
13. Participate in the peri-operative education and care; and
14. Adopt the nursing process in the care of clients in the operating theatre.
Assessment
1. Demonstrate proficiency and competency in:
1.1 Aseptic technique; and
1.2 Administration of medications.
2. Demonstrate proficiency and competency in delivery of ‘total patient care’ (TPC) to a
client in relation to his / her acuity level; and
mentors / school mentors / school teachers.
12 | P a g e
Subject Title : Field Study III
Level : Year 3
Pre-requisite : Field Study I & II
Clinical Venues : Medical and Surgical Units; Obstetric Units; Paediatric and
Adolescent Units; Community Nursing Service Centre; Primary
Health Care settings; Operating Theatre and Recovery Room;
Accident and Emergency Department; Gerontological Units

clinical settings and appraise contemporary approaches to organizational management
within health care services;
2. Describe and appraise the roles and responsibilities of health care providers in various
clinical settings;
3. Discuss various approaches of the primary health care in the local community;
4. Analyse factors impeding or contributing to the health of individuals of different age
groups;
5. Utilize holistic approach to perform health assessment on clients;
6. Perform the role as care managers and apply the nursing process in caring of clients with
health problems in:
6.1 Cardiovascular system;
6.2 Respiratory system;
6.3 Digestive system;
6.4 Genitourinary system (urinary, renal, male and female reproductive systems);
6.6 Haematologic system;
6.7 Integumentary system;
6.8 Immune system;
6.9 Lymphatic system;
6.10 Musculoskeletal system;
6.11 Nervous system;
6.12 Special senses (eye, ear, nose and throat).
7. Discuss and provide peri-operative care to clients requiring surgeries and anaesthesia;
8. Analyse the effectiveness of infection control measures to promote medical and surgical
asepsis;
13 | P a g e
9. Develop strategies for effective communication to create a therapeutic environment for
clients, families and health care team members;
10. Develop individualized health education and health promotion programmes to clients;
11. Develop discharge plans, strategies and rehabilitative care for clients to promote and
facilitate optimum functioning;
13. Use problem-solving approach in performing the nursing cares;
14. Identify different roles of nurse within multi-disciplinary teams and provide safe nursing
practices in health care settings;
15. Integrate knowledge from nursing science and evidence-based practice to make
decisions in regard to the health needs of the persons, families or community in given
situations; and

groups; and
Intended Learning Outcomes for Maternal and Infant Nursing

1. Demonstrate basic understanding in the care given to pregnant women and their families
in normal pregnancy, labour and puerperium;
2. Assist in the provision of antenatal care by taking the history of the pregnant women on
their first visits, and conducting assessments of the pregnant women under guidance on
subsequent visits and parent craft teaching;
3. Provide supportive nursing care to the women in labour and during the puerperium;
4. Observe care given to the neonates with common health problems and congenital
defects;
5. Adopt the nursing process approach in providing care to meet the infant and maternal
needs;
6. Participate in health education on breast-feeding and family planning; and
7. Appraise different types of available health care and social services in the community
for child-bearing family, infant and maternal care.
14 | P a g e
Intended Learning Outcomes for Child, Adolescent and Family Health Nursing
1. Conduct physical and developmental assessment on infants, children and adolescents;
2. Conduct family assessment;
3. Identify factors contributing to wellness and illness of children;
4. Provide appropriate care to assist children and families to cope with illness; and
5. Evaluate the adequacy of resources in the community for meeting the needs of the
children and families to restore optimum family functioning.
Intended Learning Outcomes for Community Health Nursing

Through observations and practice in the community nursing services, students will be able to:
1. Adopt primary health care approaches in promoting individual and family health;
2. Conduct health assessments to clients, families and community;
3. Provide appropriate care to clients in family setting;
4. Educate clients and their family members to participate in the care of their own health
and well-being;
5. Provide anticipated care and education to prevent deterioration of illness and promote
recovery;
6. Recognize intersectoral support for care provision and health promotion;
7. Develop knowledge to mobilize community resources to meet the needs of clients and
families; and
8. Evaluate the availability and adequacy of community resources.
Intended Learning Outcomes for Accident and Emergency (AED) Nursing

1. Describe the functions and become familiarize with the AED settings e.g. triage,
resuscitation room, cubicles, minor theatre;
2. Demonstrate understanding of the principles of emergency care;
3. Recognize the roles & responsibilities of the triage nurse;
4. Demonstrate understanding of prioritization of emergency care and different clients that
are admitted to the triage, cubicles, resuscitation room, recovery and minor theatre in the
AED;
5. Assist in admission of clients in AED;
6. Describe the primary, secondary & focused nursing assessments; and
7. Assist to provide emergency care to clients.
15 | P a g e
Intended Learning Outcomes for Operating Theatre and Recovery Room Nursing
Through observations and practice in the Operating Theatre, students will be able to:
1. Describe the functions and become familiarize with the operation room settings, e.g.
clean zone, sterile zone and dirty zone;
2. Apply principles of asepsis and infection control in providing care for the clients in the
operating theatre;
3. Describe roles and responsibilities of the peri-operative nurses, e.g. circulating nurses,
scrub nurses;
4. Recognize various types of anaesthesia, the principles of application and possible
complications;
5. Describe nursing responsibilities in anaesthetic procedures, e.g. induction, maintenance
and recovery phases;
6. Describe the action, uses, side effects, dosage and nursing implications of anaesthetic
drugs commonly used in the operating theatre;
7. Observe and assist in the preparation of operating theatre before surgery, e.g. diathermy
machine;
8. Describe the admission procedure of clients in the operating theatre;
9. Familiarize with different positions of clients for various surgeries and the use of
appropriate aids;
10. Differentiate the common suture materials used in the operating theatre;
11. Familiarize with different surgical instruments and equipment;
12. Assist in providing care to client undergone surgeries and anaesthesia and describe the
immediate post-anaesthesia complications;
13. Participate in the peri-operative education and care; and
14. Adopt the nursing process in the care of clients in the operating theatre.
Intended Learning Outcomes for Gerontological Nursing

1. Demonstrate understanding of the aging process related to biological, psychological,
and sociological perspectives of aging;
2. Identify the health care needs of the older persons in the community and in diverse care
settings, and be cognizant of the resources available for meeting those needs;
3. Discuss the roles and responsibilities in gerontological nursing;
4. Develop knowledge and skills and adopt problem-solving approach in caring for the
well and sick older persons including assessing the individual needs for nursing care,
formulating care plan, implementing, and evaluating the care provided;
5. Perform nursing care in different levels of prevention and care;
16 | P a g e
6. Provide care to the older persons experiencing alterations in health status such as
continence problems, impaired cognition, or difficulty in mobility, and/or common
acute and chronic condition;
7. Provide care to the older persons who are terminally ill or facing death of their
significant others;
8. Familiar with the clinical settings and provide collaborative care within the resources
and constraints of the agency;
9. Mobilise resources to meet the health care needs of the older persons; and
10. Develop the ability and insight in analysing contemporary issues related to the health
and aging through practice.
Assessment
1. Demonstrate proficiency and competency in:
1.1 Aseptic technique; and
1.2 Administration of medications.
2. Demonstrate proficiency and competency in delivery of ‘total patient care’ (TPC) to a
client in relation to his/her acuity level; and
mentors/school mentors/school teachers.
17 | P a g e
11 Records of Clinical Learning Experience
11.1 Clinical Learning Experience Record I
11.1.1 Foundations of Nursing Therapeutics
Date practised
Date
Item Mentor under Mentor
Observed
supervision
1. Ensuring a safe and comfortable
environment for care
1.1 Fire precautions and emergency measures

1.2 Ward Unit
 Ventilation
 Temperature
 Lighting
 Noise
 Tidiness
 Others
1.3 Bed /Cot Unit

 Bed linen & accessories
 Bed making
 Special types of beds
 Others
1.4 Measures to prevent accidents and injuries

Understand hospital policy
 Body mechanics and prevention of back
injuries
 Use of bedside rails
 Use of safety vest /jacket
 Use of limb holders
 Suicidal precautions
 Others
1.5 Measures to prevent cross infection

 Hand hygiene
 Use of gown
 Use of gloves
 Use of mask
18 | P a g e
Date practised
Date
Observed
supervision
 Disinfection and /or disposal of infected
material:
- body fluids
- urine /faeces /sputum /drainage
/discharges/aspirate/vomitus
 Bedding & clothing
 Equipment
 Isolation precautions
 Others
2. Admission of client to hospital
2.1 Clinical (Elective)

 Child
 Adult
 Others
2.2 Emergency
 Child
 Adult
 Others
2.3 Care of client’s belongings

 Clothing
 Valuables
 Others
2.4 Meeting psychosocial needs

 Client and relatives
 Others
2.5 Taking nursing history

2.6 Nursing assessment
 Level of consciousness
 Anxiety
 Skin
 Colour
19 | P a g e
Date practised
Date
Observed
supervision
 Pain and discomfort
 Temperature
 Pulse rate
 Apical rate
 Respiration rate
 Blood oxygenation (SpO2)
 Blood pressure
 Height and weight
 Fluid intake and output
 Others
2.7 Nursing diagnosis and implementation

 Formulation of nursing diagnosis
 Implement routinized and individualized
care
 Others
2.8 Evaluation and documentation

3. Mobility and immobility
3.1 Positions used in nursing care

 Supine
 Prone
 Lateral
 Fowler’s
 Others
3.2 Moving and lifting client

 In bed
 Between bed and stretcher
 Between bed and chair
 Between bed and wheelchair
 Use of ambulatory devices
 Others
20 | P a g e
Date practised
Date
Observed
supervision
3.3 Preventing pressure sore
 Assessment
 Positioning
 Regular turning
 Use of devices for relieving pressure
- Heel protectors
- Sitting Cushion
- Triangular pillow
- Unicore mattress
- Low airflow mattress
 Passive and active limb exercise
 Others
4. Promoting hygiene
 Bed bath
 Bath in bathroom
 Change of napkin
 Mouth care
 Care of hair
 Vulval toilet
 Perineal toilet
 Others
5. Attending elimination needs
5.1 Assisting client in using devices for

elimination
 Giving and removing bedpan
 Giving and removing urinal
 Use of commode / sani-chair
 Use of lavatory
 Others
5.2 Care of client with constipation, impaction

and flatulence
 Administration of
- Rectal suppositories
21 | P a g e
Date practised
Date
Observed
supervision
- Enema
- Others
5.3 Care of incontinent clients

5.4 Catheterization
 Female
 Male
 Others
5.5 Care of client with indwelling catheter

5.6 Care of client with bladder irrigation
6. Providing care to various types of clients
 Ambulant client
 Ill client
 Client confined to bed
 Incontinent client
 Unconscious client
 Paralyzed client
 Elderly client
 Restless client
 Suicidal tendency client
 Client requiring isolation
 Others
7. Meeting fluid and nutritional needs
7.1 Serving meals

7.2 Feeding
 Helpless client
 Infant
 Physically handicapped client
 Elderly client
 Others
22 | P a g e
Date practised
Date
Observed
supervision
7.3 Artificial feeding
 By naso-gastric tube
 By gastrostomy
 Others
7.4 Care of client with

 vomiting
 Gastric aspiration
 Gastric washout
 Others
8. Observation and collection of specimens
8.1 Urine
 For ward test
 For laboratory test
 Others
8.2 Faeces
8.3 Sputum
8.4 Drainage
 Discharge from wound
 Aspirate from, e.g. pleural cavity,
abdomen
 Others
8.5 Vomitus
8.6 Blood
8.7 Aspirates
8.8 Discharges
9. Meeting respiration needs
9.1 Assisting the client during breathing and

coughing exercise
9.2 Assisting the client during postural drainage
9.3 Administration of oxygen
23 | P a g e
Date practised
Date
Observed
supervision
9.4 Perform suction
 Naso-/oropharyngeal suction
 Tracheal suction
 Others
10. Administration of medicine
 Storage
 Checking
 Recording
 Ordering
 Others
10.1 Routes of administration of drugs

 By mouth
 By injection
- Intra-Dermal
- Subcutaneous (Hypodermic)
- Intramuscular
- Intravenous
 By Inhalation
 By Topical Application
 Others
10.2 5 rights principle

11. Providing care for clients undergoing
surgery
11.1 Preparation of client for surgery

 Psychological
 Physical
 Others
11.2 Post-operative care

 Psychological
 Physical
24 | P a g e
Date practised
Date
Observed
supervision
 Others
11.3 Aseptic technique

 Care of simple wound
 Care of wound with sutures
 Care of wound with drains
 Care of wound with staples
 Other sterile procedures
 Others

12. Care of client receiving intravenous
infusion of
 Whole blood
 Blood components, e.g. platelets
 Other fluids
13. Care of hyperthermia and hypothermia
 Application of cold
 Application of heat
 Others
14. Care of clients for tests and investigations
 Physical examination
 X-ray examination
 Endoscopies, e.g. bronchoscopy,
gastroscopy,
 Proctoscopy
 Blood tests
 Ultrasonogram
 CT scan
 MRI
 Others
25 | P a g e
Date practised
Date
Observed
supervision
15. Promoting health and rehabilitation
15.1 Transfer of client

 From ward to ward
 From ward to operation theatre
 To other hospital
 Others
15.2 Discharge of client

 Discharge of planning
 Health education and health promotion
 Services and personnel contributing to
the promotion of health
 Others
16. Emergency resuscitation
 Artificial respiration
 Cardiopulmonary resuscitation
- Adult
- Child
- infant
 Others
17. Care of the dying
 Helping client to cope with loss, grief

and dying
 Last offices
 Care of relatives
 Others
18. First aid
 Use of different types of bandage and

splints
 Others
26 | P a g e
11.2 Clinical Learning Experience Record II
11.2.1 Medical and surgical nursing skills for illness prevention and health restoration of
clients with alteration in various body system functions
i) Alimentary Nursing
Date practised
Date
Observed
supervision
1. Care of clients undergoing special
investigation
1.1 Radiology and imaging studies

 Plain X-ray examinations of abdomen
 Ultrasonography
 Scanning, e.g. computed tomography
(CT)
 Others
1.2 Endoscopic examinations

 Oesophagogastroduodenoscopy
 Colonoscopy
 Sigmoidoscopy, proctoscopy
 Endoscopic retrograde cholangio-
pancreatography
 Others
1.3 Blood tests

 Liver function tests (LFT)
 Electrolytes
 Complete blood count (CBC)
 Others
1.4 Biopsy
 Liver biopsy
 Others
1.5 Other laboratory studies

 Gastric analysis
 Others
27 | P a g e
Date practised
Date
Observed
supervision
2. Care of clients undergoing therapeutic
measures
 Enteral feeding
 Total parenteral nutrition
 Abdominal tapping
 Sengstaken tube intubation
 Sitz bath
 Others
3. Care of clients with the following

common disorders
3.1 Oral cavity

 Cleft lips and cleft palate
 Neoplasm of the tongue
 Dental problems
 Common oral infections
 Others
3.2 Oesophagus
 Foreign body
 Oesophageal varices
 Gastroesophageal reflux disease
(GERD)
 Neoplasms
 Others
3.3 Stomach and duodenum

 Gastritis
 Pyloric stenosis
 Peptic ulcer disease
 Gastroesophageal reflux disease
(GERD)
 Neoplasms
 Others
28 | P a g e
Date practised
Date
Observed
supervision
3.4 Intestines
 Intestinal obstruction
 Appendicitis
 Hernia
 Haemorrhoid
 Abscess and fistula
 Diverticulitis & diverticular disease
 Crohn’s disease
 Ulcerative colitis
 Neoplasms
 Others
3.5 Accessory organs

 Cholangitis
 Gallstones
 Jaundice
 Hepatitis
 Cirrhosis of liver
 Carcinoma of liver
 Hepatic failure
 Pancreatitis
 Neoplasms
 Others
3.6 Others
 Peritonitis
 Food poisoning
 Mal-absorption syndrome
 Hiatus hernia
 Worm infestation
 Enteric infections
- Typhoid
- Cholera
- Dysentery
29 | P a g e
Date practised
Date
Observed
supervision
 Gastrointestinal bleeding (Upper or
Lower)
 Others
4. Nursing implications for clients with the

following therapeutic agents
 Antacids
 Histamine H2 receptor blocker
 Proton-pump inhibitor (PPIs)
 Anti-ulcerants
 Anti-cholinergic agents
 Anti-emetics
 Laxatives
 Anti-diarrhoeal agents
 Anti-helmintics
 Topical rectal medications
 Others
ii) Cardiovascular and Lymphatic Nursing
Date practised
Date
Observed
supervision
investigation
1.1 Imaging procedures

 Plain X-ray chest
 X-ray examination using contrast
medium
 Angiogram
 Doppler ultrasound
 Cardiac computed tomograhpy (CT)
 Magnetic resonance imaging (MRI)
 Thallium scan
 Cardiac catheterisation
30 | P a g e
Date practised
Date
Observed
supervision
 Echocardiogram
 Others
1.2 Electrographic diagnostic procedures

 Electrocardiogram
 Exercise stress test / treadmill
 Others
1.3 Blood tests

 Arterial blood gas (ABG)
 Cardiac enzymes
 Serum electrolytes
 Serum lipids
 Serum cholesterol
 Coagulation test
 Blood glucose
 Others
1.4 Biopsy
 Lymph node biopsy
 Lymphangiography
 Others
1.5 Others

measures
 Cardiac pacing
 Pericardiocentesis
 Percutaneous Transluminal Coronary
Angioplasty (PTCA)
 Coronary Artery Bypass Graft
(CABG)
 Advanced cardiac life support
 Others
31 | P a g e
Date practised
Date
Observed
supervision
common disorders
3.1 Cardiac conditions

 Congenital heart diseases
 Cardiac arrhythmia
 Heart block
 Coronary heart disease
 Valvular heart disease
 Carditis
 Cardiac tamponade
 Rheumatic fever and rheumatic heart
disease
 Subacute bacterial endocarditis (SBE)
 Heart failure
 Cardiac arrest
 Others
3.2 Vascular conditions

 Hypertension
 Chronic arterial occlusive disease/
peripheral vascular disease (PVD)
 Aneurysm
 Deep venous thrombosis
 Varicose veins
 Arterial/venous/mixed ulcer
 Others
3.3  Phlebotomy
 Others
3.4 Lymphatic disorders

 Lymphadenitis
 Lymphomas
 Others
32 | P a g e
Date practised
Date
Observed
supervision
4. Nursing implication for clients with the
 Cardiac glycosides
 Cardiac stimulants
 Nitrates
 Antiarrhythmic drugs
 Angiotensin-converting enzyme
inhibitors (ACEI)
 Beta-blockers
 Calcium channel blockers(CCB)
 Vasodilators
 Thrombolytic drugs
 Diuretics
 Others
33 | P a g e
iii) Haematological Nursing
Date practised
Date
Observed
supervision
investigation
1.1 Blood tests

 Total differential count
 Coagulation studies
 Peripheral blood smear
 Others
1.2 Biopsy
 Bone marrow biopsy and aspiration
 Others

measures
2.1 Blood product transfusion

 Whole blood / red cell
 Platelets / plasma / albumin
 Others
2.2 Marrow transplant

 Others

common disorders
 Anaemias
 Leukaemias
 Haemorrhagic conditions
 Autoimmune diseases
 Human immunodeficiency virus
(HIV) infection
 Malaria
 Others
34 | P a g e
Date practised
Date
Observed
supervision
4. Nursing implications for clients with
the following therapeutic agents
 Iron preparations
 Haematinic
 Anticoagulants
 Clotting agents & haemostatic
 Fibrinolytic agents
 Others
iv) Respiratory Nursing
Date practised
Date
Observed
supervision
investigation
1.1 Imaging examination

 Plain X-ray chest
 Scanning
 Bronchoscopy
1.3 Electrographic study:
 Sleep study
1.4 Pleural / lung biopsy
1.5 Laboratory tests
 Blood tests
1.6 Thoracentesis
1.7 Pleurodesis
1.8 Others
 Pulmonary function test
 Peak expiratory flow rate test
 Allergy tests
 Others
measures
2.1 Oxygen therapy
35 | P a g e
Date practised
Date
Observed
supervision
2.2 Aerosol drug therapy
2.3 Nebulization
2.4 Under-water seal chest drainage
2.5 Mechanical ventilation
 Invasive mechanical ventilation
 Non-invasive mechanical ventilation
2.6 Others

common disorders
3.1 Inflammatory and infective conditions

 Pulmonary tuberculosis
 Pneumonia
 Upper respiratory tract infection
3.2 Chronic obstructive pulmonary diseases
(COPD)
3.3 Asthma
3.4 Pleural disease
 Pneumothorax
 Pleural effusion
3.5 Trauma and injury
3.6 Lung cancer
3.7 Occupational lung diseases
3.8 Respiratory failure
3.9 Others
4. Nursing implication for clients with

 Cough suppressants
 Expectorants
 Mucolytics
 Decongestants
 Anti-infective agents
 Anti-allergic agents
 Bronchodilators
36 | P a g e
Date practised
Date
Observed
supervision
 Corticosteroids
 Others
v) Endocrine Nursing
Date practised
Date
Observed
supervision
investigation

 Computerized Tomography (CT)
 Magnetic Resonance Imaging (MRI)
Blood test
 Thyroid function test
 Adrenal function test
 Pituitary function test
 Others
1.2 Biopsy
 Fine needle aspiration and biopsy
 Others

measures
 Diabetic diet
 Radioactive iodine therapy
 Others

common disorders
3.1 Pituitary gland

 Gigantism /acromegaly
 Dwarfism
 Diabetes insipidus
 Neoplasm
37 | P a g e
Date practised
Date
Observed
supervision
 Syndrome of inappropriate anti-
diuretic hormone (SIADH)
 Others
3.2 Thyroid gland

 Congenital abnormalities
 Hyperthyroidism
 Hypothyroidism
 Neoplasm
 Others
3.3 Parathyroid gland

 Hyperparathyroidism
 Hypoparathyroidism
 Others
3.4 Pancreas
 Diabetes mellitus
 Others
3.5 Adrenal gland

 Cushing’s syndrome
 Addison’s disease
 Phaeochromocytoma
 Others
3.6 Neoplasms
 Systemic corticosteroids
 Anabolic steroids
 Insulin preparations
 Insulin antagonist
 Oral antidiabetics agents
 Thyroid hormones
38 | P a g e
Date practised
Date
Observed
supervision
 Anti-thyroid drugs
 Androgens
 Oestrogens
 Progesterone
 Pituitary hormones
 Others
vi) Reproductive Nursing
Date practised
Date
Observed
supervision
investigation

 Plain X-ray
 Mammography
 Ultrasonography
1.3 Laboratory tests
 Blood tests
1.4 Biopsy and smears
1.5 Others

measures
 Vaginal douching
 Vaginal packing and removal
 Vaginal pessaries
 Others
39 | P a g e
Date practised
Date
Observed
supervision
common disorders
3.1 Congenital conditions
 Others
3.2 Physiological disorders

 Menstrual disorders
 Displacement of uterus and vagina
 Infertility and subfertility
 Endometriosis
 Others
3.3 Inflammatory and infective conditions

 Vulvitis
 Vaginitis
 Pelvic infection
 Mastitis
3.4 Abnormal pregnancy
 Abortion
 Ectopic pregnancy
 Molar pregnancy
3.5 Neoplasm
 Vulva
 Cervix
 Uterus
 Ovary
 Breasts
 Others

 Anti-inflammatory agents
40 | P a g e
Date practised
Date
Observed
supervision
 Hormonal agents
 Others
vii) Genito-urinary Nursing
Date practised
Date
Observed
supervision
investigation

 X-ray Kidney, Ureter & Bladder
(KUB)
 Intravenous urography (IVU)
 Ultrasonography
 Computerized Tomography (CT)
 Others

 Cystoscopy
 Ureteroscopy
 Nephroscopy
 Others
1.3 Blood test

 Chemistry
 Haematology
 Others
1.4 Urine tests

 Routine urinalysis
 Bacteriological studies
 Cytological studies
 Clearance studies
41 | P a g e
Date practised
Date
Observed
supervision
 Others
1.5 Urodynamic studies

1.6 Renal biopsy
1.7 Prostatic biopsy
1.8 Renal Angiography
1.9 Others

measures
2.1 Bladder irrigations

2.2 Renal replacement therapy
 Peritoneal dialysis
2.3  Haemodialysis
2.4  Renal transplant
2.5 Lithrotripsy
2.6 Others

common disorders
3.1 Kidney and bladder

 Acute nephritic syndrome
 Nephrotic syndrome
 Acute kidney injury
 Chronic kidney disease
 Traumatic conditions
 Pyelonephritis
 Urinary tract infection
 Cystitis
 Urinary tract calculi
 Neoplasm
 Others
3.2 Prostate
 Benign prostatic hyperplasia (BPH)
42 | P a g e
Date practised
Date
Observed
supervision
 Neoplasm
 Others
3.3 External genitalia

 Hydrocele and varicocele
 Phimosis
 Hypospadias
 Paraphimosis
 Others
3.4 Sexually transmitted diseases

4. Nursing implications for clients with the
 Diuretics
 Urinary alkalinizing agents
 Parasympathominetics
 Anti-spasmodic agents
 Phosphate binding agents
 Ion-exchange resin
 Urinary tract analgesics
 Urinary antiseptics
viii) Dermatological Nursing
Date practised
Date
Observed
supervision
investigation
 Skin biopsy
 Skin scrapping
 Sensitivity test

measures
 Local applications
 Cauterization
43 | P a g e
Date practised
Date
Observed
supervision
 Skin grafting
common disorders
3.1 Eczema
 Contact dermatitis
 Atopic eczema
 Others
3.2 Bacterial infection

 Impetigo
 Folliculitis
 Hansen’s disease
 Others
3.3 Fungal infections

 Tinea infections
 Candidiasis
 Others
3.4 Viral infections

 Herpes
 Warts
 Others
3.5 Parasitic infestations

 Scabies
 Pediculosis
 Others
3.6 Psoriasis
3.7 Skin cancers
3.8 Burns and scalds
3.9 Others
44 | P a g e
Date practised
Date
Observed
supervision
 Topical & protective agents

 Anti-bacterials
 Anti-fungals
 Anti-parasitics
 Corticosteroids
 Anti-histamines
 Others
ix) Musculoskeletal Nursing
Date practised
Date
Observed
supervision
investigation

 Plain x-ray
 CT & MRI (contrast / plain cut)
 Bone scan
 Angiogram
 USG/Doppler USG
 Diabetic foot assessment
 Others

 Electromyography
 Others
1.3 Blood tests

1.4 Endoscopic examination
 Arthroscopy
 Others
1.5 Joint aspiration
45 | P a g e
Date practised
Date
Observed
supervision
1.6 Muscle & synovial biopsy
measures
2.1 Manipulation
2.2 Tractions (skin / skeletal)
2.3 Splintage
2.4 Cast
2.5 Cryotherapy
2.6 Continuous passive motion
2.7 Physiotherapy
2.8 Occupational therapy
2.9 Prosthetic & Orthotic
2.10 Others

common disorders
3.1 Infection
 Osteomyelitis
 Pyogenic arthritis
 Tuberculosis spondylitis
 Gangrene
 Others
3.2 Chronic non-infective conditions

 Osteoarthritis
 Rheumatoid arthritis
 Gouty arthritis
 Ankylosing spondylitis
 Others
3.3 Trauma
 Fractures
 Dislocations
 Strains & sprains
46 | P a g e
Date practised
Date
Observed
supervision
 Others
3.4 Metabolic diseases

 Osteoporosis
 Osteomalacia
 Others
3.5 Neoplasms
3.6 Congenital & developmental disorders
 Analgesics
 Non-steroidal anti-inflammatory
agents (NSAID)
 Muscle relaxants
 Anti-gout agents
 Anti-rheumatic agents
 Others
5. Highlights in musculoskeletal nursing
5.1 Mobilization
 Uses of different walking aids
 Active and passive exercise
 FWB, PWB, NWB
 Touch down walking
 Heel walking
5.2 Bandaging technique
 Simple bandaging: figure of 8, spiral
 Stump bandage
 Tube gauze for finger
 Boxing glove
47 | P a g e
x) Neurological Nursing
Date practised
Date
Observed
supervision
investigation

 Plain x-ray skull
 X-ray examination using contrast
medium
 Computerised Tomography (CT)
Scanning
 Ultrasonography
 Others
 Electroencephalography (EEG)
 Electromyography (EMG)
1.3 Blood tests
1.4 Neurological assessments
1.5 Others

measures
2.1 Speech therapy

2.2 Physiotherapy
2.3 Occupational therapy
2.4 Others

common disorders
3.1 Infection
 Meningitis
 Encephalitis
 Brain abscess
 Rabies
 Tetanus
 Poliomyelitis
48 | P a g e
Date practised
Date
Observed
supervision
 Others
3.2 Trauma
 Head injuries
 Spinal cord and spinal nerve injuries
 Others
3.3 Toxic conditions

 Alcoholism
 Drug intoxication
3.4 Cerebral vascular conditions
 Cerebral vascular accidents
 Transient ischaemic attacks
 Cerebral aneurysm and arterio-venous
malformations
3.5 Congenital & developmental disorders
 Hydrocephalus
 Spina bifida
 Others
3.6 Degenerative conditions

 Parkinson’s Disease
 Alzheimer’s Disease
 Multiple Sclerosis
 Myasthenia Gravis
3.7 Neoplasm
3.8 Seizure disorders
 Others
3.9 Disturbance of speech and consciousness

 Paralysis
 Sleep disorders
 Migraine
 Cranial nerve disorders
49 | P a g e
Date practised
Date
Observed
supervision
 Others

 Anaesthetics
- General
- Local
 Analgesics
 Sedatives & hypnotics
 Tranquilizers
 Antidepressants
 Anticonvulsants
 Stimulants
 Adrenergic agents
 Parasympathomimetics
 Anticholinergics
 Agents for Parkinson’s disease
 Neuromuscular blocking agents and
other muscle relaxants
 Others
xi) Ophthalmic Nursing
Date practised
Date
Observed
supervision
investigation

 Radiological studies
 Electro-retinography
1.3  Blood tests
1.4 Ophthalmic examination
 External
 Internal
50 | P a g e
Date practised
Date
Observed
supervision
1.5 Vision tests
 Visual acuity
 Visual field
 Colour vision
1.6  Laboratory tests
1.7  Others

measures
 Hot / cold compress application

 Eye swabbing and irrigation
 Instillation of eye drops
 Application of eye ointment
 Cutting of eye lashes
 Application of eye pad / eye shield
 Eye bandaging
 Others

common disorders
 Inflammatory and infective conditions

 Refractive errors
 Retinal detachment
 Cataract
 Glaucoma
 Squint
 Eye injuries
 Enucleation
 Others

 Miotic drops
 Mydriatric drops
 Cycloplegic drops
51 | P a g e
Date practised
Date
Observed
supervision
 Local anaesthetics
 Topical anti-infective agents
 Topical inflammatory agents
 Topical corticosteroids
 Others
xii) Oto-rhino-laryngological Nursing
Date practised
Date
Observed
supervision
investigation

 Plain X-ray
 Scanning
1.2 Hearing tests
e.g. pure tone audiometry
 Weber test
 Rinne test
1.3 Balance tests
1.4 Examination of the ear / nose / throat
measures
 Irrigation of ear / nose

 Instillation of ear / nose drops
 Antral puncture and washout
 Nasal packing
 Spraying of throat
 Tracheostomy
 Others

common disorders
3.1 Ear disorders

 Inflammatory and infective disorders
52 | P a g e
Date practised
Date
Observed
supervision
 Foreign bodies
 Injuries
 Neoplasms
 Hearing impairment (conductive or
sensorineural)
 Meniere’s disease
 Benign paroxysmal positional vertigo
(BPPV)
 Others
3.2 Nasal disorder

 Inflammatory and infective disorders
 Foreign bodies
 Injuries
 Neoplasms
 Epistaxis
 Sinusitis
3.3 Throat conditions
 Foreign bodies
 Inflammation
 Neoplasms
 Others

 Analgesics and anaesthetic agents

 Anti-inflammatory agents
 Corticosteroids
 Wax softeners
 Nasal decongestants
 Others
53 | P a g e
11.2.2 Specialty Nursing
i) Primary Health Care Nursing (GOPC)
Date practised
Date
Observed
supervision
1. Approaches to clients and members of
the public
 Demonstrate courtesy and concern to

clients
 Provide prompt attention
2. Assessment and management of clients
with the following conditions
 Hypertension
 Chronic obstructive pulmonary
diseases
 Wound
 Urinary Tract Infection
 Gastro-enteritis
 Others
3. Nursing practice in GOPC
 Vital sign monitoring

 Body mass index (BMI) measurement
 Blood glucose monitoring
 Intramuscular / hypodermic injections
 Wound dressing
 Removal of stitches
 Performing electrocardiogram (ECG)
 Performing visual acuity
 Health education
 Instruction for specimen collection
 Instruction for AED or SOPD
 Handling of Client-held record
 Others
54 | P a g e
Date practised
Date
Observed
supervision
4 Other services in GOPCs
4.1 Chronic care management

 Nurse-led clinics
- Diabetes mellitus
- Hypertension
- Warfarin clinic
- Chronic wound
- Osteoporosis clinic
- Chronic obstructive pulmonary
disease
 Allied Health Clinic
4.2 Risk Assessment and Management
Programme (RAMP)
 Hypertension
4.3 Smoking Cessation & Counselling Service
4.4 Integrate Mental Health Programme
(IMHP)
4.5 Patient Empowerment Programme (PEP)
4.6 Enhancement of Public Primary Care
Service (EPPS)
4.7 Triage clinic
4.8 Family medicine specialist clinic
4.9 Others
55 | P a g e
ii) Paediatric Nursing
Date practised
Date
Observed
supervision
1. Care of the neonates with the following
conditions
 Pre-term baby
 Low birth weight baby
 Neonatal jaundice
 Phototherapy
 Exchange blood transfusion
 Feeding problem
 Failure to thrive
 Down’s syndrome
 Glucose-6-Phosphate Dehydrogenase
deficiency (G6PD)
 Others
2. Care of the paediatric client with the

following medical disorders
2.1 Respiratory disorder

 Upper respiratory tract infection
 Bronchitis
 Pneumonia
 Asthma
 Others
2.2 Gastro-intestinal disorder

 Gastro enteritis
 Vomiting
 Others
2.3 Cardio-vascular disorder

 Congenital heart disease
 Rheumatic heart disease
 Kawasaki disease
 Others
56 | P a g e
Date practised
Date
Observed
supervision
2.4 Haematological disorder
 Anaemias
 Leukaemias
 Clotting disorders
 Others
2.5 Genitourinary disorder

 Urinary tract infection
 Glomerulonephritis
 Nephrotic syndrome
 Others
2.6 Endocrine/Metabolic disorder

 Juvenile diabetes
 Others
2.7 Neurological disorder

 Cerebral palsy
 Meningitis
 Encephalitis
 Febrile convulsion
 Epilepsy
 Others
2.8 Musculoskeletal disorder

 Muscular dystrophies
 Others
2.9 ENT & Eye disorder

 Otitis media
 Conjunctivitis
 Tonsillitis
 Others
2.10 Dermatological skin disorder
57 | P a g e
Date practised
Date
Observed
supervision
 Eczema
 Scabies
 Burns & Scalds
 Others
2.11 Immunological disorder

 Systematic Lupus Erythematosus
(SLE)
 Others
2.12 Communicable disorder

 Measles
 Chicken pox
 Rubella (German measles)
 Mumps
 Others
3. Pre and post- operative care of

paediatric client with the following
surgical conditions
 Cleft lip
 Cleft palate
 Oesophageal atresia
 Pyloric stenosis
 Hiatus hernia
 Umbilical hernia
 Imperforated anus
 Intussusception
 Tetralogy of Fallot (TOF)
 Septal defects
 Patent ductus arteriosus
 Hypospadias
 Phimosis
 Undescended testes
 Wilm’s tumour
58 | P a g e
Date practised
Date
Observed
supervision
 Polycystic kidney
 Tonsillitis
 Club foot
 Congenital dislocation of hip
 Spina bifida
 Hydrocephalus
 Others
4. Care of the child with the following

conditions
 Abuse
 Eating disorders
 Others
iii) Obstetric Nursing
Date practised
Date
Observed
supervision
1. Care of the pregnant mother in
relation with the following
1.1 Antenatal care

 History taking
 Examination
 Taking of fetal heart sound
 Others
2. Observation of labour
2.1  Normal labour

 First stage
 Second stage
 Third stage
2.2 Abnormal labour
3. Postnatal care
3.1 Observation of :
59 | P a g e
Date practised
Date
Observed
supervision
 Vital signs
 Lochia
 Involution of uterus
 Urinary output
3.2 Care of the breasts
 Lactation
3.3 Vulval toilet
3.4 Health education
3.5 Others
4. Care of the neonates
4.1  Immediate care at birth

4.2 Observation of
 Vital signs
 Elimination (urine + meconium)
 Others
4.3 Maintenance of personal hygiene

4.4 Feeding
4.5 Others
60 | P a g e
iv) Mental Health Nursing
Date practised
Date
Observed
supervision
1. Care of clients in relation with the
following
1.1 Admission and discharge procedures

1.2 Meeting client’s physical and psycho-
social needs
1.3 Communication and observation
1.4 Building interpersonal relationship
1.5 Organizing and participating in client’s
activities
1.6 Preparation for investigation and treatment
 E.E.G.
 E.C.T.
 Others
2. Management of psychiatric conditions
 Anxiety
 Dementia
 Neurosis
 Psychosis
 Depression
 Others
3. Management of psychiatric emergencies
 Aggressive and violent

 Suicidal tendency
 Manic
 Epileptic
4. Common psychotropic drugs in current
use
5. Educational activities
6. Re-socialization and rehabilitation
7. Visit to psychiatric community nursing

centre /service
61 | P a g e
v) Community Health Nursing
Date practised
Date
Observed
supervision
1. Care of clients during home visit
 Assessment of client’s needs

 Planning of care with client and
relatives
 Implementing care
 Evaluation of care given
 Education of client and relatives
regarding self-care
 Record and report
 Discharge of client
2. Care and management of client with
the following conditions
 Wound
 Continence
 Diabetes
 Renal
 Cardiac
 Respiratory
 Stroke
 Hip fracture
 Dementia
 Postpartum
 Others
3. Care and management provided

during home visits
 Wound care
 Foley care
 Blood glucose monitoring
 CAPD care
 Rehabilitative exercise
 Naso-gastric tube care
 PEG care
62 | P a g e
Date practised
Date
Observed
supervision
 Drug supervision
 Others
4. Nursing management in Community

Nursing
 Pre-discharge intake
 Preparation for home visit
 Case Conference
5. Others Community Support Care
 Transitional Care
 Chronic Disease Care Management
 Others
6. Visit to Social Service Centre
vi) Gerontological Nursing
Date practised
Date
Observed
supervision
1. Care and management of the elderly
client with the following conditions
 Hypertension
 Cerebrovascular accident
 Diabetes
 Arthritis
 Chronic heart diseases
 Chronic lung disease
 Dementia
 Parkinson’s disease
 Fractured femur
 Acute confusion state
 Depression
 Others
63 | P a g e
Date practised
Date
Observed
supervision
2. Nursing care of the elderly client
regarding the following issues
 Senility
 Incontinence
 Malnutrition
 Hypothermia
 Fall injury
 Skin integrity
 Administration of drugs
 Discharge Planning
3. Rehabilitation
 Physiotherapy
 Occupational therapy
 Speech therapy
 Habit training
4. Visit to geriatric day hospital / centre
5. Home visit
6. Case conference
vii) Accident and Emergency Nursing

Assessments and setting priorities of care are important in A&E nursing since clients may suffer life-
threatening illnesses / injuries. As the A&E Department is also the ‘frontier’ of the hospital, learners
should learn the appropriate attitudes towards the public.
Date practised
Date
Observed
supervision
1. Approaches to clients and members of
the public
1.1 Demonstrate courtesy and concern to

clients
1.2 Provide prompt attention
2. Assessments and management of
clients in the following situations
2.1 Haemorrhage
 Epistaxis
64 | P a g e
Date practised
Date
Observed
supervision
 Gastrointestinal bleeding
 Bleeding wounds
2.2 Clients with wound
 Open wound
 Wounds with foreign body
 Special wounds e.g. dog bites, snake
bites etc.
 Burns and scalds
2.3 Poisoning
 Food poisoning
 Gas poisoning
 Chemical poisoning
 Drug poisoning
2.4 Clients with
 Severe dyspnoea
 Convulsion
 Unconsciousness
 Heart attack
 Drowning
 Alcohol intoxication
 Mental cases
 Infectious diseases e.g. AIDS, rabies,
meningitis
 Trauma, e.g. spinal injuries
 Others
2.5 Preparation and procedure of special

treatment in A&E department
 Admission procedure
 Triage
 Assistance to doctor in the procedure
of:
-
-
 Assist in life-saving techniques
 Assist in other procedure
-
-
65 | P a g e
viii) Operating Theatre (OT) and Recovery Room Nursing
Date practised
Date
Observed
supervision
1. Preparation and use of the Operating
Theatres and Recovery rooms
2. Reception of client
 Checking
 Reassurance
 Transportation
3. Preparation, sterilization, use and
care of instruments and equipment in
OT
 Endoscopes
 Special apparatus/trolleys
 Use of operating table
4. Care of clients during anaesthesia
5. Role as an OT
 “circulating nurse”
 “scrub nurse”
6. Care of client in recovery room
7. Transfer of client after surgery
66 | P a g e
11.2.3 Nursing Management
Date practised
Date
Observed
supervision
1. Responsibility of team leader/
cubicle in-charge during a span of
duty
2. Assessment and planning of care
3. Organization of nursing care for a

group of clients
4. Evaluation and documentation of

nursing care
5. Supervision and teaching of junior

nurses / student nurses / health
care assistants
6. Demonstrate effective
communication skill with client
and relatives
7. Demonstrate an awareness of
nursing legal responsibility
References:
Queen Elizabeth Hospital, Hospital Authority. (1993). Clinical learning workbooks: Medical, Surgical,
Central Sterile Supply Department, Accident & Emergency Department, Paediatric, Obstetrics and
Gynaecology, Mixed Specialty Department. Hong Kong: Author.
The Nursing Board of Hong Kong. (1988). Record of practical instruction and experience for the
examination for the Certificate of Registered General Nurse. Hong Kong: Author.
The Nursing Council of Hong Kong. (2014). A reference guide to the syllabus of subjects & requirements
for the preparation of registered nurse (General) in the Hong Kong Special Administrative Region.
Retrieved from
http://www.nchk.org.hk/en/core_competencies_and_reference_guides/registered_nurses_general/ind
ex.html.
67 | P a g e
12 Records of Clinical Practicum
Name and Name and
Total No.
Ward/ No. of Signature of Ward/ No. of Signature of
Unit Period Period of weeks /
Hosp. weeks Clinical Hosp. weeks Clinical
days
Supervisor Supervisor
Medical
(wks)
Date of Night Duty Date of Night Duty

(days)
Medical
(wks)

(days)
Medical
(wks)

(days)
Medical
(wks)

(days)
Medical
(wks)

(days)
Surgical
(wks)

(days)
Surgical
(wks)

(days)
Surgical
(wks)

(days)
Ortho-
paedics & (wks)
Trauma-
tology Date of Night Duty Date of Night Duty
(days)
68 | P a g e
Name and Name and
Total No.
Ward/ No. of Signature of Ward/ No. of Signature of
Unit Period Period of weeks /
Hosp. weeks Clinical Hosp. weeks Clinical
days
Supervisor Supervisor
Obstetrics
& (wks)
Gynaeco-
logy
(days)
Eye
Ear, Nose (wks)
& Throat
(days)
Neuro
Surgical (wks)

(days)
Cardio-
thoracic (wks)
Surgical
(days)
Operating
Theatre (wks)

(days)
Others
(wks)

(days)
69 | P a g e
13 Records of Specialty Practicum
Name & Signature

Specialties Ward / Hosp. No. of Weeks Period of Clinical
Supervisor
Accident and Emergency Nursing
Community Health Nursing
Gerontological Nursing
Mental Health Nursing
Obstetric Nursing
Paediatric and Adolescent Nursing
Primary Health Care
70 | P a g e
14 Field Studies Attendance Record
Name: Class: Student no.:
Field Study: IA Period:
Week 1 Mon Tue Wed Thur Fri Sat Sun

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty
*Write down your duty into the record first. In case of any duty change, absence, i.e. sick leave,
casual leave, use red pen to update.
71 | P a g e
Supplementary Field Study

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty
72 | P a g e
Field Study: IB Period:

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty
73 | P a g e

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty
74 | P a g e
Field Study: IIA Period:

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty
75 | P a g e

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty
76 | P a g e
Field Study: IIB Period:

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty
77 | P a g e
Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty
78 | P a g e

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty
79 | P a g e
Field Study: III Period:

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty
80 | P a g e
Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty
81 | P a g e

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty

Dept Date
Ward / Hosp. Duty
82 | P a g e
15 Record of Absence from Field Studies and Clinical Make-up Day(s)
Field Study IA Total no. of sick leave: _______(days)

Date of Absence
Ward / Hosp.
Date of make-up
Hosp / Ward
Field Study IB Total no. of sick leave: _______(days)

Date of Absence
Ward / Hosp.
Date of make-up
Ward / Hosp.
Field Study IIA Total no. of sick leave: _______(days)

Date of Absence
Ward / Hosp.
Date of make-up
Ward / Hosp.
Field Study IIB Total no. of sick leave: _______(days)

Date of Absence
Ward / Hosp.
Date of make-up
Ward / Hosp.
Field Study III Total no. of sick leave: _______(days)

Date of Absence
Ward / Hosp.
Date of make-up
Ward / Hosp.
83 | P a g e
16 Records of Clinical Assessments
i) Aseptic Technique
Name and Signature Ward /

Attempt Date Result Remarks
of Assessor Hosp.
First Pass / Fail
Second Pass / Fail
Third Pass / Fail
ii) Administration of Medications

of Assessor Hosp.
First Pass / Fail
Second Pass / Fail
Third Pass / Fail
iii) Professional Nursing Competencies in Total Patient Care

of Assessor Hosp.
First Pass / Fail
Second Pass / Fail
Third Pass / Fail
Note: Each student is entitled to have 3 attempts. If a student fails in the 1st attempt, he/she is
entitled to schedule for a re-assessment (2nd attempt) at 1 week later. A final re-assessment (3rd
attempt) can be arranged at least 2 weeks after the failure of 2 nd attempt. The 3rd attempt should
normally be completed within the scheduled field study.
For the 3rd attempt, 2 assessors would be appointed in order to enhance the objectivity of assessment.
Student must be aware that if he/she fails in the 3rd attempt, he/she would be de-registered form the
programme.
84 | P a g e
17 Mandatory Record for Field Studies
Date
Items Date (Refresher if
applicable)
Basic Infection Control Training
Information Security and Privacy Training
Point-of-care testing (POCT): Blood Glucometer Analysis

Training/ Blood glucose monitoring
Fire Safety Training
N95 Mask Fit Test
Confidential Agreement
Immunity Vaccinated
Immunization Record
Yes / No Yes / No
Chickenpox
Hepatitis B
Measles, Mumps & Rubella (MMR)
18 Record of Educational Visit
Name of Educational Visit Date Duration
From __/__/__to __/__/__

From __/__/__to __/__/__
From __/__/__to __/__/__
85 | P a g e
19 Record of Clinical Experience Checking
Year Term Field Study Clinical Venues Checked by

Nursing School Teacher
(Name/Signature/Date)
1 I IA  Sub-acute Units
 Medical / Surgical
Units
 Primary Health Care
II IB
Settings
2 I IIA  Medical / Surgical Units

 Specialty nursing settings:
- Primary Health Care
Settings
- Obstetric Units
- Paediatric & Adolescent
Units
- Mental Health Care Unit
II IIB - Community Nursing
Service Centre
- Operating Theatre and
Recovery Room
- Accident and
Emergency Department
3 III  Medical / Surgical Units

 Specialty nursing settings:
- Primary Health Care
Settings
- Obstetric Units
- Paediatric & Adolescent
Units
- Community Nursing
Service Centre
- Operating Theatre and
Recovery Room
- Accident and
Emergency Department
- Gerontological Unit
86 | P a g e
20 Record of Demonstration and Guided Practice
To enhance communication with clinical learning settings and let them have a better understanding on the
background of students during field studies, the record below shows the nursing skills / procedures which
have been demonstrated to with / without return guided practice by students in nursing laboratory of
School of General Nursing, for clinical reference.
Students should complete the entries after each demonstration and/ or guided practice session. Each entry
should have the signature of teaching staff.
Date of
Date of Teacher’s Teacher’s
Year/Term Nursing Skills / Procedures guided
Observation Signature signature
Practice
Infection Control Practice
Bed Making
Vital Signs Monitoring
Hygiene Care
Baby Bathing
Manual Handling and Transfer
Application of Physical Restraints
Administration of Oxygen Therapy
Suctioning
Insertion of Artificial Airway
Insertion of nasogastric tube (NGT)
NGT Feeding
Y1T1 Baby Feeding

Record of Intake and Output
Urinary Catheterization
Simple Wound Dressing
Care of Drain / Removal of Stitches and
Staples
Blood glucose monitoring
Elimination Care
Others:
Perioperative Care
Administration of Parenteral Medication
Administration of Oral Medication
Administration of IV Infusion
CPR (Adult)
CPR (Paediatric)
Use of Automated External Defibrillators
(AED)
Y1T2
Last offices
87 | P a g e
Date of
Practice
Glasgow Coma Scale
Others:
Respiratory Nursing
Inhalation Therapy
Assisting in Thoracentesis
Chest Drainage Care
Measurement of Peak Flow Rate
Others:
Y1T2
Endocrine Nursing
Insulin therapy
Others:
Haematological Nursing
Assisting in Bone Marrow Aspiration
Blood Transfusion
Others:
Y2T1
Cardiovascular Nursing
Basic ECG Interpretation
Introduction to External Defibrillation and
Cardioversion
88 | P a g e
Date of
Practice
Central Venous Pressure Monitoring
Others:
Gastrointestinal Nursing
Assist in Liver Biopsy
Assist in Abdominal Paracentesis
Stoma Care
Gastrostomy care
Sitz Bath
Total Parenteral Nutrition Care
Others:
Y2T1
Genitourinary Nursing
Continuous ambulatory peritoneal dialysis
(CAPD)
Bladder Irrigation
Bladder scanning
Others:
Maternal and Infant Nursing
Others:
89 | P a g e
Date of
Practice
Orthopaedic nursing
Stump Bandaging
Care of cast
Traction
Use of Mechanical Aids for Walking
Others:
Neurological Nursing
Assisting in Lumbar Puncture
Others:
Ophthalmic Nursing
Y2T2
Eye Swabbing
Instillation of Eye Drops
Irrigation of Eyes
Others:
ENT Nursing
Irrigation of Ears
Ear Drop Instillation
Nasal Douching
Nasal Drops Instillation
Tracheostomy Care
Others:
90 | P a g e
Appendix I
HIGHER DIPLOMA IN NURSING
Field Study Evaluation Form
Student Name: Student Number:
Class: Year: 1 / 2 / 3 *
Field Study/Practicum Period: Hospital/Unit/Ward:
Formative (F) Evaluation (Date): Name of Clinical Mentor / Teacher:
Summative (S) Evaluation (Date): Name of Clinical Mentor / Teacher:
Date(s) of Absence: Total no. of absence: (days)
Overall Result for Summative (S) Evaluation:
Result (Please “”): □ Satisfactory □ Unsatisfactory
Clinical Mentor / Teacher’s Signature: Student’s Signature:
Notes on Field Study Evaluation
1. Student who fails (unsatisfactory performance) in the summative evaluation is required to

participate supplementary field study for the 2nd attempt field study evaluation. In order to
strengthen student’s clinical competency up to the required standard, intensive coaching which
includes clinical teaching, counselling and other remedial work such as supplementary laboratory
practice will be arranged. (Upon completion of the supplementary field study, field evaluation
will be conducted again by clinical mentor / school teachers in accordance with student’s clinical
performance.)
2. If the student fails in the 2nd attempt field study evaluation, he / she may be granted the 3rd attempt
field study evaluation or de-registered from the programme according to the recommendation by
the Board of Examiners (BOE). However, if the student fails in the 3rd attempt evaluation, this will
be regarded as a ground for de-registration.
*Deleted as appropriate
91 | P a g e
Rating Scale in Clinical Evaluation
Score Standard Procedure Quality of Performance Assistance

5 Safe } - Proficient; Coordinated; - Without
Accurate } Each time Confident supporting cues
Effect } - Occasional expenditure of excess
Affect } energy
- Within an expedient time period
4 Safe } - Efficient; Coordinated; Confident - Occasional
Accurate } Each time - Some expenditure of excess supportive cues
Effect } energy
Affect } - Within a reasonable time period
3 Safe } - Skilful in parts of behaviour - Frequent verbal
Accurate } Most of the - Coordinated and occasional
Effect } time - Expends excess energy physical
Affect } - Within a delayed time period directive cues in
addition to
supportive cues
2 Safe but not alone - Unskilled; Inefficient - Continuous
Performs at risk - Considerable expenditure of verbal and
Accurate - Not always excess energy frequent physical
Effect } Occasionally - Prolonged time period cues
Affect }
1 Unsafe - Unable to demonstrate - Continuous
Unable to demonstrate behaviour procedure/behaviour verbal and
- Lacks confidence, coordination, physical cues
and efficiency
X Not Applicable / Not Observed
(Modified from Bondy, K.N. (1983). Criterion-Referenced Definitions, Journal of Nursing Education, 22(9), 376-
381.)
Note: Student must score 3 or above for all objectives in order to obtain a satisfactory grade.
Effect refers to the attainment of intended purpose after the behaviour is performed.
Affect refers to the student's manner or attitudes in which the behaviour is performed.
Students' clinical performance will be evaluated according to the above rating scale. The criteria provided are the
guidelines to evaluate the student's level of competency.
92 | P a g e
Please rate the ‘F’ (Formative) & ‘S’ (Summative) respectively
SCORE
OBJECTIVES Comments
F S
1. Assessment
1.1 Collect and interpret relevant health
data
1.2 Identifies health needs of the clients
and /or families
1.3 Identify health risk of clients and /
or families
2. Planning
2.1 Involve clients and or families in
care planning
2.2 Identify and develop goals within a
specific time frame
2.3 Develop appropriate nursing
interventions for client’s and / or
family’s health problems
2.4 Demonstrate skills in organizing
nursing care
3. Implementation
3.1 Implement health care plan based on
identified needs
3.2 Demonstrate safety and competence
in performing nursing
e.g. Vital signs measurement
 __________________________
 __________________________
 __________________________
 __________________________
 __________________________
 __________________________
3.3 Show understanding of the
rationales, risks and benefits of the
clinical procedure
93 | P a g e
Please rate the ‘F’ (Formative) & ‘S’ (Summative) respectively
SCORE
OBJECTIVES Comments
F S
4. Evaluation
4.1 Evaluate outcomes of care
4.2 Recognize the needs for

modification of care
4.3 Maintain an accurate documentation
4.4 Report on time
5. Professional Behaviours
5.1 Demonstrate initiation and self-
direction in learning
5.2 Demonstrate caring, empathetic and
support attitude to clients and / or
their families
5.3 Communicate effectively with
clients and / or families and health
care team
5.4 Recognizes self-awareness on
personal strengths and limitations by
reflection
5.5 Demonstrates responsibilities for
own practice
5.6 Seeks guidance as appropriate
5.7 Demonstrates abilities to evaluate

own work for continuous
improvement
5.8 Demonstrates punctuality, personal
integrity, honesty and self-discipline
5.9 Maintains a professional appearance
94 | P a g e
Comments for Evaluation:
Clinical Mentor / Teacher:
Student:
95 | P a g e
Appendix II
Appendix I

Clinical Appraisal Form
Class: Year: 1 / 2 / 3 *
Field Study / Practicum Period: Hospital /Unit / Ward:
Date(s) of Absence: Total no. of absence: (days)
Date of Appraisal: Name of Clinical Mentor:
Overall Result for clinical appraisal:
Result (Please “”): □ Satisfactory □ Unsatisfactory
Clinical Mentor’s Signature: Student’s Signature:
Notes on Clinical Appraisal
If a student fails (unsatisfactory performance) in the clinical appraisal of the specialty placement, a
remedial work on corresponding clinical specialty would be required.
96 | P a g e
Rating Scale in Clinical Appraisal
Any item(s) below 3 will be considered as
OBJECTIVES unsatisfactory
Poor Excellent
1. Knowledge & skills
1.1 Shows understanding of the rationales,
risks and benefits of clinical procedures 1 2 3 4 5
1.2 Demonstrates safety and competence in

performing nursing care 1 2 3 4 5
(refer clinical learning objectives)
2. Professional Behaviours
2.1 Demonstrate initiation and self-direction in
learning 1 2 3 4 5
2.2 Demonstrates caring, empathetic and

supportive attitude to clients and / or their 1 2 3 4 5
families
2.3 Communicate effectively with clients and /
or families and health care team 1 2 3 4 5
2.4 Recognizes self-awareness on personal

strengths and limitations by reflection 1 2 3 4 5
2.5 Demonstrates responsibilities for own

practice 1 2 3 4 5
2.6 Seeks guidance as appropriate

1 2 3 4 5
2.7 Demonstrates abilities to evaluate own

work for continuous improvement 1 2 3 4 5
2.8 Demonstrates punctuality, personal

integrity, honesty and self-discipline 1 2 3 4 5
2.9 Maintains a professional appearance

1 2 3 4 5
97 | P a g e
Comments for Appraisal:
Clinical Mentor / Teacher:
Student:
98 | P a g e
Appendix III
Appendix II

Clinical Assessment on Professional Nursing Competencies
Aseptic Technique
Class: Attempt: 1 / 2 / 3 *
Procedure:
□ Removal of stitches / clips □ Wound dressing / irrigation / packing
□ Shortening / removal of drains □ Others ________________________
□ Urinary catheterization
Assessment Result:
Hospital Name: Clinical Practice Unit:
Name of Assessor: Date and Time:
Result (Please “”): □ Pass □ Fail
Assessor’s Signature: Student’s Signature:
Notes on Aseptic Technique (AT) assessment
1. Each student is entitled to have 3 attempts. If a student fails in the 1st attempt, he / she is entitled to
schedule for a re-assessment (2nd attempt) at least 1 week later. A final re-assessment (3rd attempt)
should be arranged at least 2 weeks after the failure of 2nd attempt.
2. For the 3rd attempt, 2 assessors will be appointed in order to enhance the objectivity of assessment.
Failure in the 3rd attempt is regarded as the ground for de-registration from the programme.
3. Students may be required to duplicate and submit the original copy of the assessment form to the
General Office within 3 working days after the assessment.
99 | P a g e
Please tick either ‘C’ (competent) or ‘NC’ (not competent)
Assessment items Comments
C NC
(Please comment on all ‘NC’ items)
1. Assessment
Standard: able to collect relevant health data and correct interpretation of data
1.1 Identify right clients*
1.2 Check medical / nursing order*
1.3 Assess client’s needs
2. Planning
Standard: able to develop a plan for Aseptic Technique
2.1 Client*
2.2 Environment
2.3 Equipment
2.4 Nurse*
3. Implementation
Standard: able to deliver care in a safe, efficient and caring manner
3.1 Perform hand hygiene when necessary*
3.2 Perform aseptic technique*
3.3 Effective cleansing*

- one swab once, from clean to dirty, no
dripping from swab
3.4 Observe client’s condition*
- maintain client’s safety
3.5 Aftercare of client / environment / equipment
4. Evaluation
Standard: able to evaluate outcomes of care
4.1 Evaluate effectiveness of procedure and
wound status*
4.2 Recognize the need for modification of care
4.3 Document and report*
100 | P a g e
C NC
5. Professional attitude and behaviour
5.1 Respect clients’ right and dignity
5.2 Demonstrate effective communication
5.3 Demonstrate caring attitude
*=Critical item
Pass: Passed all critical items and at least 50% of non-critical items
Fail: Failed in any one critical item OR more than 50% of non-critical items
Comments:
Assessor:
101 | P a g e
Appendix IV
Appendix III

Administration of Oral Medications
(A group of 6-8 clients)
Assessment Result:
Notes on Administration of Oral Medications (AOM) assessment
Failure in the 3rd attempt is regarded as ground for de-registration from the Programme.
3. Student may be required to keep a duplicate and submit the original copy of the assessment form to
the General Office within 3 working days after the assessment.
* Deleted as appropriate.
102 | P a g e
Please tick either ‘C’ (competent) or ‘NC’ (not competent).
C NC
1. Assessment
1.2 Check valid prescription*
1.3 Check clients’ allergy history*
1.4 Assess clients’ general conditions
2. Planning
Standard: able to develop an individualized plan for administration of medications
2.1 Prepare medication trolley and necessary
items
2.2 Clients
2.3 Nurse
3. Implementation
3.1 Perform hand hygiene when necessary
3.2 Perform 3 checks of the drugs*
3.3 Check 5 rights in drug administration*

- Client
- Drug
- Route
- Date and time
- Dosage
3.4 Observe and take precaution of specific

drug*
3.5 Maintain drug security at all times*
3.6 Explain to / educate clients about the drugs

being administered
3.7 Provide care or assistance to clients as
needed
3.8 Ensure clients have taken all medications*
3.9 Observe clients' conditions: maintain

clients’ safety*
103 | P a g e
C NC
3.11 After care of clients / environment /
equipment
4. Evaluation
4.1 Evaluate effects/side effects of medications
given
6. Drug knowledge
6.1 Knowledge of drugs *
*=Critical item
Comments:
Assessor:
104 | P a g e
Appendix V
Appendix IV

Administration of Parenteral Medications
(1-2 clients)
Procedure: □ Intradermal □ Intramuscular

□ Subcutaneous □ Intravenous
Assessment Result:
Notes on Administration of Parenteral Medications assessment
Failure in the 3rd attempt is regarded as ground for de-registration from the Programme.
3. Student may be required to keep a duplicate and submit the original copy of the assessment form to
the General Office within 3 working days after the assessment.
* Deleted as appropriate
105 | P a g e
C NC
1. Assessment
1.2 Check valid prescription*
1.3 Check clients’ allergy history*
1.4 Assess clients’ general conditions
2. Planning
Standard: able to develop an individualized plan for administration of medications
2.1 Prepare medication trolley and necessary
items
2.2 Clients
2.3 Nurse
3. Implementation
3.1 Perform hand hygiene when necessary
3.2 Perform 3 checks of the drugs*
3.3 Check 5 rights in drug administration:*

- Client
- Drug
- Route
- Date and time
- Dosage
3.4 Ensure sterility of the drug and injection

items throughout the procedure*
3.5 Administer the drug to appropriate injection
site with correct technique*
3.6 Maintain drug security at all times*
3.7 Observe and take precaution of specific

drug*
3.8 Explain to /educate clients about the drugs
being administered
3.9 Provide care of assistance to clients as
needed
3.10 Observe clients' conditions: maintain
clients’ safety*
106 | P a g e
C NC
3.12 After care of clients / environment /

equipment
4. Evaluation
4.1 Evaluate effects/side effects of medications
given
6. Drug knowledge
6.1 Knowledge of drugs *
*=Critical item
Comments
Assessor:
107 | P a g e
Appendix VI
Appendix V

Total Patient Care
Client’s diagnosis: ____________________________
Assessment Result:
Notes on Total Patient Care (TPC) assessment
1. Each student is entitled to have 3 attempts. If a student fails in the 1st attempt, he/she is entitled to
Failure in the 3rd attempt is regarded as the ground for de-registration from the Programme.
3. Students may be required to duplicate and submit the original copy of the assessment form to the
General Office within 3 working days after the assessment.
108 | P a g e
C NC
1. Assessment
1.1 Identify right client*
1.2 Present accurate client’s profile*
1.3 Perform appropriate nursing assessment*

- history taking
- physical examinations
1.4 Identify relevant client’s problems / needs*
2. Planning
Standard: able to develop a plan of care for client based on assessment data
2.1 Formulate nursing diagnoses and care plan*
- Set priorities of care
- Develop goals with specific time frame
- Organize nursing interventions with

rationales
3. Implementation
3.1 Incorporate knowledge and evidence-based
practice into care and health advice
3.2 Implement interventions in a safe, efficient
and caring manner*
 ___________________________
 ___________________________
 ___________________________
 ___________________________
 ___________________________
3.3 Respond and react appropriately to client’s

needs
3.4 Document all relevant information properly
and promptly*
4. Evaluation
4.1 Evaluate attainment of goals
4.2 Recognize the need for modification of care

plan and able to develop alternative
interventions*
4.3 Report client’s progress
109 | P a g e
C NC
5. Professional Attitude & Behaviour
5.1 Respect client’s right and dignity
*=Critical item
Comments:
Assessor:
110 | P a g e
Appendix VII
Total Patient Care Appendix VI
Mentor / Teacher :
Student No. & Name :
Client’s Gender /Age :
Current Diagnosis :
Supplementary Data in Addition to Client Initial Assessment Record
Past Medical History:
Chief Complaint(s):
Current Treatment(s):
Other relevant information:
111 | P a g e
Appendix VIII
Appendix VII
Total Patient Care Plan
Prioritized Client’s Problems
Problem 1 :
Problem 2 :
Problem 3 :
Problem 4 :
Problem 5 :
Problem 6 :
Problem 7 :
Problem 8 :
112 | P a g e
Nursing Diagnosis :
Related to :
As evidenced by :
Goal :
Nursing Interventions & Rationales
113 | P a g e
Nursing Interventions & Rationales
Evaluation
114 | P a g e
Appendix IX
Appendix VIII
Reflective Journal
Write at least 300 words reflective account on your field work experience. Try not to just describe
what you did but instead what challenges you faced and how you overcame them. Focus on what you
worked well and what could be improved next time.
Students should submit 2 reflective journals if the field study period is > 8 weeks, the assignment
should be sent to the General Office on the first day of the subsequent study block.
Student No. & Name : ______________________________________________
Year and Term of Study / Field Study : ______________________________________________
Named Mentor / Tutor : ______________________________________________
Date of Submission : ______________________________________________
( words)
115 | P a g e
Appendix X
Appendix IX

CONFIDENTIAL
Incident Reporting Form
Section A(To be completed by Student)
Student No : Student Name :
Hospital : Ward : Unit / Specialty :
Incident Date : Time : Reporting Date :
Brief description of the incident (what, where, when, how, and who-without mentioning names)
Incident has been reported to  Ward manager  Ward In-Charge (Rank / Name)
Accident & Emergency  Yes  No
Department attended
Section B (To be completed by School General Office Staff)

Date received: Name in block letters: Signature:
Section C (To be completed by Teaching staff)

Follow up action
Name in block letters: Signature: Date:
116 | P a g e
Appendix XI
Appendix X
COC-G(N) Approved Paper 27/2016
Clinical Supervision of Nurse Learners in Hospital Authority Hospitals
Purpose
This paper aims to provide a guide for Hospital Authority (HA) nurses serving as clinical
mentors in providing clinical supervision to nurse learners in HA hospitals.
Background
2. In HA, there are various types of nurse learners undergoing training in HA hospitals including
nurse learners undertaking (i) pre-enrolment or pre-registration programs conducted by HA nursing
schools or tertiary institutions, (ii) Registered Nurse (RN) conversion programs for Enrolled Nurse (EN)
conducted by tertiary institutions, and (iii) nursing programs organized / coordinated by the Institute of
Advanced Nursing Studies (IANS) or tertiary institutions. During their clinical practice, nurse learners
would encounter situations where they do not possess the necessary knowledge or skills to enable them
to perform nursing care or procedures safely and competently.
3. Clinical supervision is a process of overseeing and / or coaching and support to nurse learners
provided by qualified nurses during the delivery of patient care. It aims to assure the quality of patient
care and facilitate nurse learners’ learning.
Objectives of Clinical Supervision
4. The objectives of clinical supervision are to:

(a) Ensure safe clinical practice of nurse learners;
(b) Assure the standard of patient care delivered by nurse learners; and
(c) Enhance the learning of the nurse learners.
117 | P a g e
Overall Accountability
5. In clinical settings, nurse learners are often assigned to perform some of the nursing care /
procedures during the course of patient care delivery. In all cases, the qualified nurses serving as
clinical mentors are accountable for the overall nursing care of the patients and for designing nursing
care plans. The nurse learners would perform nursing care under the instruction and supervision of the
qualified nurses. It is equally important that nurse learners have the opportunity to acquire the
necessary knowledge, attitude and skills to become competent nurses.
General Guidelines for HA Nurses on Clinical Supervision of Nurse Learners
6. As general guidelines on clinical supervision of nurse learners, the clinical mentors are
required to:
(a) Assess the competency of the nurse learners before assigning nursing care or procedure;
(b) Determine if the nurse learners have the competence and give support to the nurse
learners as appropriate to perform the assigned nursing care / procedure properly;
(c) Assign nursing care or procedure to the nurse learners appropriate to their level of
competencies and in accordance with the hospital guidelines concerned;
(d) Provide demonstration to nurse learners and assure their competencies when they are
expected to operate clinical equipment, and the relevant operational manual must be
available for reference;
(e) Supervision must be provided especially when the nurse learners are performing high risk
nursing care / procedures as set by respective hospital / department / unit, and performing
the nursing care / procedure for the first time;
(f) Monitor the performance of the nurse learners, facilitate their learning and give guidance
and coaching whenever necessary;
(g) Meet regularly and whenever necessary with nurse learners to evaluate and provide
feedback on their performance;
(h) Document the learning progress / outcome as required;
(i) Refer those nurse learners with learning problems to the respective school / institution as
appropriate for remedial actions if necessary;
(j) Make certain the availability and accessibility of clinical practice guidelines and
protocols concerned to nurse learners to ensure safe clinical practice.
118 | P a g e
General Guidelines for Nurse Learners during Clinical Practicum
7. As general guidelines for nurse learners during clinical practicum, all nurse learners are
required to:
(a) Take the initiative to enhance their competencies on the nursing care / procedures that
have been taught before their clinical practicum;
(b) Ensure the safety of the patients in all circumstances;
(c) Exercise vigilance and care in the delivery of patient service and performance of nursing
care / procedures;
(d) Observe and comply with the clinical guidelines and protocols of the hospital /
department / unit;
(e) Do not perform nursing care, procedures or operate equipment that is beyond one’s
knowledge and skill;
(f) Inform the clinical mentor or nurse concerned about the inadequacy of skills and
knowledge in carrying out the assigned nurse care / procedure;
(g) Ask for help and advice from nurses whenever necessary or when attempting a skill /
procedure for the first time, and seek for clarification whenever in doubt;
(h) Perform high risk nursing care / procedures under supervision of clinical mentor or nurse
concerned according to the list of high risk nursing care / procedures set by respective
hospital / department / unit;
(i) Observe for and report and changes in the patient’s condition;
(j) Provide learning objectives to facilitate clinical mentors to assess and monitor the
progress of learning throughout the clinical practicum;
(k) Take the initiative to discuss with the clinical mentor or nurse concerned for the learning
progress; and
(l) Maintain proper documentation of clinical learning record as required by the respective
school / institution.
High Risk Nursing Care / Procedures
8. There are certain nursing care / procedures that carry potential risks to patient’s safety. As the
nature of hospitals and clinical settings varies, nursing care / procedures with potential high risk to the
patients also very among different hospitals / departments / units. Individual hospital / department /
unit must develop a list of high risk nursing care / procedures according to its scope of service. Clinical
119 | P a g e
supervision and support must be provided to nurse learners when they are assigned to perform the high
risk nursing care / procedures.
Monitoring of Clinical Supervision of Nurse Learners
9. Individual hospital should have a monitoring system to enhance the clinical supervision of
nurse learners. The nurse of nursing guidelines, practice protocols, orientation programs, competency
assessment, regular communication platform among parties concerned are common mechanisms
employed in clinical supervision of nurse learners. The hospital and ward management, and clinical
mentors should have the responsibility to assure the standard of patient care delivered by nurse learners.
Approval Sought
10. Members are invited to comment and endorse this guide for HA nurses serving as clinical
mentors in providing clinical supervision to nurse learners in HA hospitals as set out in paragraphs
5 - 9.
Hospital Authority
September 2016
120 | P a g e

Clinical Learning Portfolio 2017

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Clinical Learning Portfolio 2017

Uploaded by

Copyright:

Available Formats

Hospital Authority

Higher Diploma in Nursing

Clinical Learning Portfolio

Name of student : ________________________

Student number: ________________________

Appendix I : Field Study Evaluation Form ............................................................................................................................91

Appendix II : Clinical Appraisal Form ....................................................................................................................................96

Appendix VIII : Total Patient Care Plan ...................................................................................................................................112

Appendix IX : Reflective Journal ...........................................................................................................................................115

Appendix X : Incident Reporting Form .................................................................................................................................116

Appendix XI : Supervision of Nurse Learners in Clinical Practice ........................................................................................117

Students are expected to be self-initiative in seeking learning opportunities and keep

2 General Purposes of Field Studies

3 Evaluation of Clinical Competency

3.2.1 Field Study Evaluation Form

(i) Formative Evaluation

(ii) Summative Evaluation

3.2.2 Clinical Appraisal Form

3.3.1 Summative Evaluation

3.3.2 Clinical Appraisal

4 Application for Leave

5 Reporting Sick Leave

(i) Aseptic Technique (AT)

9 Field Study Requirements

Clinical Areas Minimum Practice

For example: General Medicine, Dermatology, Infectious

For example: General Surgery, Day Surgery, Operating

Subject Title : Field Study I

Intended Learning Outcomes

Intended Learning Outcomes for Primary Health Care

Intended Learning Outcomes

Intended Learning Outcomes for Primary Health Care

Intended Learning Outcomes for Maternal and Infant Nursing

Intended Learning Outcomes for Mental Health Nursing

Intended Learning Outcomes for Accident and Emergency (AED) Nursing

Intended Learning Outcomes

Intended Learning Outcomes for Primary Health Care

Intended Learning Outcomes for Maternal and Infant Nursing

Intended Learning Outcomes for Community Health Nursing

Intended Learning Outcomes for Accident and Emergency (AED) Nursing

Intended Learning Outcomes for Gerontological Nursing

11.1 Clinical Learning Experience Record I

11.1.1 Foundations of Nursing Therapeutics

1.1 Fire precautions and emergency measures

1.3 Bed /Cot Unit

1.4 Measures to prevent accidents and injuries

1.5 Measures to prevent cross infection

2. Admission of client to hospital

2.1 Clinical (Elective)

2.3 Care of client’s belongings

2.4 Meeting psychosocial needs

2.5 Taking nursing history

2.7 Nursing diagnosis and implementation

2.8 Evaluation and documentation

3.1 Positions used in nursing care

3.2 Moving and lifting client

5. Attending elimination needs

5.1 Assisting client in using devices for

5.2 Care of client with constipation, impaction

5.3 Care of incontinent clients

5.5 Care of client with indwelling catheter

7. Meeting fluid and nutritional needs

7.1 Serving meals

7.4 Care of client with