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INTRODUCTION TO REVALIDATION JANUARY 2016
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Agenda BupaPrivate and Confidential 1An introduction to revalidation 2What is revalidation? 3The Code 4Revalidation requirements 5Creating and developing your portfolio 6Writing Reflective Accounts 7 Reflective Discussion 8 CPD 9Practice Related Feedback 10Confirmation 11Making your application 12What should all nurses do now?
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BupaPrivate and Confidential An introduction to revalidation The purpose of this session is to provide an introduction to revalidation and what is required in order to revalidate. By the end of this session you should understand; What revalidation is and its requirements The benefits of revalidation How revalidation links to the Code The importance of keeping a portfolio
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BupaPrivate and Confidential What is revalidation? Every three years, at the point of their renewal of registration, nurses and midwives will need to show that, as a professional, they are living by the Code’s standards of practice and behaviours. The process is called revalidation and it builds on the current Prep requirements Participation is on an on-going basis rather than a point in time assessment Nurses and midwives will need to meet a range of requirements designed to show that they are keeping up to date and practice safely and effectively Revalidation is about promoting good practice across the whole population of nurses and midwives. It is not an assessment of a nurse or midwife’s fitness to practice.
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BupaPrivate and Confidential What is revalidation? Revalidation builds on existing renewal processes by introducing new requirements that focus on; Up to date practice and professional development Reflection on the professional standards of practice and behaviour set out in the Code, and Engagement in professional discussions with other registered nurses and midwives
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BupaPrivate and Confidential The Anticipated Benefits of Revalidation For the public: - Provide confidence that nurses and midwives are up to date in terms of their skills and professional development - Provide assurance that nurses and midwives are being reviewed regularly For the nurses and midwives: - Raise awareness of the Code and standards that are expected of nurses and midwives - Encourage a culture of sharing, reflection and continuous improvement - Encourage nurses to stay up to date in their professional practice For employers: - Increase confidence that their staff practice safely and effectively - Encourage more consistent participation in appraisal and professional development - Help clarify the nature and scope of investment required in CPD For the NMC: - Help strengthen regulation of nurses and midwives - Help to raise standards of practice - Provide more insight in to how nursing and midwifery professions are practising
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BupaPrivate and Confidential When do I need to revalidate? The revalidation application date is the first day of the month in which the registration expires. This is different to the renewal date. Nurses must submit their revalidation application by the revalidation application date so that the NMC has time to process this. The renewal date is the last day of the month in which the registration expires. Nurses will be able to submit their application 60 days before the revalidation application date. Nurses will also need to pay their fee as part of the revalidation application.
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BupaPrivate and Confidential Let’s Recap on The Code
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BupaPrivate and Confidential What is the Code? The NMC has updated the Code of Professional Standards The revised Code became effective on 31 March 2015 and all registered nurses and midwives are required to uphold the standards of practice and behaviours The Code is centred around four themes with public protection at the core and builds on the existing function of good nursing and midwifery practice
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BupaPrivate and Confidential Activity: The Code Four themes brought together in one Code Together they signify good nursing and midwifery practice
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BupaPrivate and Confidential Activity 1 What do these 4 themes mean to you personally?
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BupaPrivate and Confidential The Code Remember The Code should be used as a ‘living’ guide at the heart of everyday nursing and midwifery practice and revalidation is designed to encourage reflection on the Code
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REVALIDATION REQUIREMENTS
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BupaPrivate and Confidential Practice Hours You must have practiced a minimum number of hours over the three years since your registration was last renewed or you joined the register
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BupaPrivate and Confidential Practice Hours – Common Questions
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BupaPrivate and Confidential Continuing Professional Development You must have undertaken continuing professional development (CPD), relevant to your scope of practice as a nurse or midwife, over the three years since your registration was last renewed or you joined the register.
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BupaPrivate and Confidential Practice-related feedback You must have obtained practice-related feedback over the three years since your registration was last renewed or you joined the register.
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BupaPrivate and Confidential Written reflective accounts You must have prepared 5 written reflective accounts on your CPD, practice-related feedback, and/or an event or experience in your practice You should explain how this relates to the Code You should prepare these over the three years since your registration was last renewed or you joined the register
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BupaPrivate and Confidential Reflective Discussion You must have had a reflective discussion with another NMC registered nurse or midwife, covering your five written reflective accounts and how they relate to the Code
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BupaPrivate and Confidential Health and Character You must provide a health and character declaration, including any cautions or convictions or any determinations from another regulatory body
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BupaPrivate and Confidential Professional Indemnity Arrangement You must declare when you are completing your online application that you have, or will have when practising, appropriate cover under an indemnity arrangement.
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BupaPrivate and Confidential Confirmation You will need to demonstrate to an appropriate person (e.g. your line manager) that you have met some of the revalidation requirements. A confirmer is being asked to assess whether you have demonstrated that you have met the requirements for revalidation, not whether you are fit to practice. A confirmer will not need to check the health and character or professional indemnity arrangement requirements – you will make this declaration as part of your application to the NMC.
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BupaPrivate and Confidential Verification In order to ensure the process of revalidation is working effectively, each year the NMC will request to see further evidence from a small sample (5%) of nurses and midwives that they meet the requirements of the revalidation process. If you are selected this does not mean that the NMC has any concerns about your application and you can continue to practice as normal. If you are selected you will be notified immediately after submitting your application and you will be asked to provide further details. The NMC will also contact your confirmer to request further information. Please ensure that your confirmer is aware that if they do not respond it may put your registration at risk. You should keep a record of all your evidence in case it is required by the NMC. Your registration will not lapse whilst verification is ongoing but it will not be renewed until the verification process is complete.
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CREATING AND DEVELOPING YOUR PORTFOLIO
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BupaPrivate and Confidential Creating and developing a portfolio Definition: A portfolio is a compilation of materials that exemplifies your beliefs, skills, qualifications, education, training and experiences. It provides insight in to your personality and work ethic. All in all, it is a representation of your professionalism. Clark University
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BupaPrivate and Confidential Helpful tips on keeping a portfolio If you already have a professional portfolio there is no need to maintain a separate one. Creating a portfolio is the simplest way of keeping everything together. It will: Help you know what you still need to complete Bring clarity to your discussions with your Confirmer Help you be prepared if the NMC needs to see your supporting evidence as part of the verification process Your portfolio should: Contain evidence on how you meet the requirements of revalidation Be a live document developed over the three years before you are required to revalidate. A portfolio does not have to be electronic.
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BupaPrivate and Confidential Revalidation check list Your portfolio should include the following elements; Practice hours – a record of practice hours Continuing Professional Development (CPD) – accurate and verifiable records of your CPD activities Practice-related feedback – notes on the content of the feedback and how you used it to improve your practice. Reflective accounts – five reflective accounts that explain what you have learnt from the CPD activity, feedback and/or event of experience from your practice. You must use the NMC’s form for this. Reflective discussion – A completed NMC form used to record your reflective discussion Confirmation – a completed NMC confirmation form It can also contain anything else you feel is relevant. It is your portfolio.
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BupaPrivate and Confidential Confidentiality The Code – Prioritise people Respect people’s right to privacy and confidentiality In no circumstances should any information be recorded in your portfolio, that can identify any individual, whether they are alive or deceased.
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WRITTEN REFLECTIVE ACCOUNTS
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Agenda BupaPrivate and Confidential 1 The requirement 2 The purpose of this requirement 3 The Code 4 Meeting the requirement 5 Reflection in practice
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BupaPrivate and Confidential The Requirement You need to prepare five written reflective accounts on your CPD and/or practice-related feedback, and/or an event or experience in your practice, and explain how this relates to the Code These should be prepared over the three years since your registration was last renewed or you joined the register You must use the mandatory form provided by the NMC to record your reflective accounts
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BupaPrivate and Confidential The Purpose of this requirement To encourage nurses and midwives to reflect on their professional development and identify any changes or improvements they can make to their practice based on what they have learnt To raise awareness of the Code and encourage nurses and midwives to consider the role of the Code in their practice and professional development
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BupaPrivate and Confidential Four themes brought together in one Code
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BupaPrivate and Confidential How to meet the requirement Gather and reflect on feedback from a variety of sources, using it to improve your practice and performance. 1. You must have prepared five written reflective accounts in total, in the three year period since your registration was last renewed or you joined the register 2. They should be based on CPD/feedback/event or experience in your practice (or a combination of each) and how they relate to the code 3. Written reflective account: What did you learn from the CPD activity, feedback or experience? How have you changed or improved your practice as a result? How is it relevant to the Code? You must use the NMC form provided for each reflective account
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BupaPrivate and Confidential How to reflect on your practice “Reflection is part of learning and thinking. We reflect in order to learn something, or we learn as a result of reflecting, and the term ‘reflective learning’ emphasises the intention to learn from current or prior experience.” (Moon, 2004) Reflection is about ‘reviewing an experience of practice in order to describe, analyse and so inform learning about practice’ (Reid, 1993) Many of you would agree that ‘we are doing it already!’ but others find in busy clinical practice it is hard to produce written reflections.
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REFLECTIVE DISCUSSION
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Agenda BupaPrivate and Confidential 1 Reflective discussion 2 Purpose 3 What is reflective discussion 4 About reflective discussion 5 Reflective discussion partner / responsibilities 6 Listening 7 Leading and taking part 8 The Code 9 Recording 10 Evidencing 11 Understanding
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BupaPrivate and Confidential Reflective Discussion You must have had a reflective discussion with another NMC-registered nurse or midwife, covering your five written reflective accounts and how they relate to the Code.
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BupaPrivate and Confidential Purpose of the requirement Encourage a culture of sharing, reflection and improvement amongst nurses and midwives by: Requiring nurses and midwives to discuss their professional development and improvement Ensuring that nurses and midwives do not work in professional isolation by ensuring discussion with another NMC registered nurse or midwife To enable nurses and midwives to learn and enhance the quality of professional work by discussing changes and improvements, having reflected on their practice To ensure that nurses and midwives understand and apply the Code to their practice
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BupaPrivate and Confidential Activity 2 What is reflective discussion?
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BupaPrivate and Confidential About the reflective discussion It should be face to face in an appropriate environment If this is not possible you may use video conferencing It can take place as part of your appraisal, as long as it is with another NMC registered nurse or midwife You should share your reflective accounts with your reflective discussion partner ahead of the discussion.
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BupaPrivate and Confidential Reflective discussion partner Must be an NMC registered nurse or midwife with an effective registration - they cannot be subject to suspension, removal or striking-off order at the time of the discussion It could be someone you work with frequently or someone from a professional network They do not need to be on the same part of the register as you If you work in a setting with few or no nurses or midwives, you should reach out to your NMC registered peers via professional or specialist networks It is for you to decide the most appropriate person including whether they are at the same level, senior or junior.
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BupaPrivate and Confidential If you are a reflective discussion partner You will need: Knowledge - to understand the purpose of the reflective discussion and to ensure that the reflections discussed are aligned with the four themes of the NMC code Communication skills – to facilitate an effective reflective discussion The reflective discussion partner may not have specialist knowledge of the registrant’s role, but can add real value by listening and then asking open and challenging questions.
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BupaPrivate and Confidential Good listeners... Hear the words and the meaning behind the words Seek first to understand and then evaluate Listen to the narrative before diving in with questions. They don’t: Filter what they hear Pre-judge what they hear Let their own agendas colour what they hear.
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BupaPrivate and Confidential When listening... Do... Use non verbal signals Ask questions Summarise back what you heard Use open and closed questions appropriately Don’t... Jump in and interrupt! Forget the power of pause Reflective Questions Reflecting back a word or thought often encourages more disclosure.
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BupaPrivate and Confidential Leading and taking part in a reflective discussion Reflective discussion partner ------------------------------------------------- o Prepare in advance (read reflective accounts and make notes) o Discussion is focussed on reflective accounts o Discussion linked to the Code o Ensure conversation is two way Nurse or midwife sharing reflective accounts ----------------------------------------------- o Prepare written reflective accounts in advance and consider sharing with discussion partner in advance o Discussion focussed on learning o Discussion linked to the Code o Directed to future action o Explanation of reflections
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BupaPrivate and Confidential Activity 3 In pairs, one person acts as the nurse or midwife who is revalidating and the other as the reflective discussion partner Discuss on written reflective account from previous module Ensure discussion links back to the code Swap roles
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BupaPrivate and Confidential Linking the Code to the discussion
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BupaPrivate and Confidential How to record your reflective discussion You must use the form provided by the NMC to record your discussion This will also need to be signed by the nurse or midwife with whom you have your reflective discussions They will also need to record their name NMC Pin, email and the date of the discussion You should keep a paper copy of the form only
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BupaPrivate and Confidential Reflective Discussion Form
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BupaPrivate and Confidential What will the confirmer need to see? The Confirmer will need to see your completed NMC reflective discussion form In your online application to the NMC you will need to tick a box to declare that you have met the reflective discussion requirement You will also need to enter the name, NMC Pin and email of the nurse or midwife with who you had the discussion, as well as the date of the discussion
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BupaPrivate and Confidential Activity 4 Give examples of what you think individually, and then in partcipatory CPD might be.
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BupaPrivate and Confidential You should now understand How to hold a reflective discussion and link this to the Code Who your reflective discussion partner can be How to record your reflective discussion
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CONTINUING PROFESSIONAL DEVELOPMENT
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Agenda BupaPrivate and Confidential 1 The requirement 2 The purpose of this requirement 3 How to meet the requirement 4 What counts as CPD 5 How to evidence your CPD 6 What the confirmer needs to see
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BupaPrivate and Confidential The Requirement You must have undertaken continuing professional development (CPD), relevant to your scope of practice as a nurse or midwife, in the three year period since your registration was last renewed or you joined the register. You must also keep a record of this.
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BupaPrivate and Confidential The Purpose of this requirement To keep nurses and midwives’ professional skills and knowledge up to date To help nurses and midwives maintain safe and effective practice To help nurses and midwives develop new skills and respond to changes and advances in nursing and midwifery To challenge professional isolation by requiring learning through engagement and communication with others
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BupaPrivate and Confidential How to meet the requirement The NMC does not specify any particular type of CPD which you should follow You are best placed to decide what is most suitable and beneficial for you Any CPD must be relevant to your scope of practice CPD does not have to be in a classroom environment 20 hours of CPD must include participatory learning
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BupaPrivate and Confidential What counts as CPD Structured learning Workshops and conferences Accredited higher education Reading and reviewing publications Mandatory training relevant to scope of practice Coaching and mentoring Research Participatory learning includes any activity where you personally interact with other people. This can be face to face or in a virtual environment.
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BupaPrivate and Confidential How to evidence your CPD You should keep a record of all CPD you undertake including: The method A description of the topic and how it relates to your practice Dates undertaken Number of hours (including participatory) Which part of the Code is most relevant to the activity Evidence that you undertook the activity, which may include: Certificates of completed courses Notes Learning outcomes Notes and practice outcomes You must not record any information that may identify any individual, whether that individual is alive or deceased.
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BupaPrivate and Confidential
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BupaPrivate and Confidential What the Confirmer needs to see Evidence that 35 hours CPD (including 20 hours participatory learning) has taken place In your online application to the NMC you need to tick a box to declare that you have met the CPD requirement You do not need to upload evidence of CPD to the NMC
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BupaPrivate and Confidential You should now understand The requirement for CPD The requirement for participatory CPD How to evidence your CPD
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PRACTICE RELATED – FEEDBACK
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Agenda BupaPrivate and Confidential 1 Practice related feedback 2 The requirement 3 The purpose 4 Meeting requirements 5 Feedback 6 The Code 7 Evidence 8 Understanding
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BupaPrivate and Confidential The Requirement You must have obtained five pieces of practice-related feedback in the three year period since your registration was last renewed, or you joined the register.
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BupaPrivate and Confidential Purpose of this requirement It encouraged nurses and midwives to be more responsive to the needs of patients and service users, and those who care for them, by seeking feedback from those they work with and care for. This feedback can be used to make improvements to nurses’ and midwives’ practice.
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BupaPrivate and Confidential How to meet the requirement Try to obtain feedback from variety of sources. This may include: Feedback from patients, service users, carers or students as part of your day to day work Feedback from colleagues such as nurses, midwives and healthcare professionals Feedback from colleagues in management, on reception, in assistant positions, as well as from fellow teachers, researchers, academics to policy colleagues Complaints Team performance reports Serious event reviews Feedback received through your annual appraisal.
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BupaPrivate and Confidential Types of feedback Feedback can either be about your individual practice or about your team, ward, unit or organisation’s practice. It can be: Formal or Informal Written or verbal Positive or constructive
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BupaPrivate and Confidential How to record your feedback We recommend that you keep a note of the content of any feedback you obtain. This will be helpful when demonstrating to your confirmer that you have met the requirements and for you to use when preparing your reflective accounts. You must not record any information that might identify an individual, whether that individual is alive or deceased.
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BupaPrivate and Confidential Activity 5 In pairs, think about feedback you have received about your practice and discuss a piece of positive or constructive feedback you have received. Relate this back to the Code.
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BupaPrivate and Confidential Four themes brought together in one Code
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BupaPrivate and Confidential What the confirmer needs to see Evidence that satisfies the confirmer that you have obtained five pieces of practice–related feedback In your online application to the NMC you need to tick a box to declare that you have met the requirement You do not need to provide evidence of feedback to the NMC
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BupaPrivate and Confidential You should now understand The requirement for practice-related feedback Different types of feedback and where it can come from How to record your feedback
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CONFIRMATION
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Agenda BupaPrivate and Confidential 1 Confirmation 2 Purpose 3 In practice 4 The role of the confirmer 5 The Code 6 Practice hours 7 CPD 8 Feedback 9 Written accounts 10 Discussions 11 The Confirmer 12 Evidencing 13 Understanding 76
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BupaPrivate and Confidential The Requirement You must demonstrate to an appropriate confirmer that you have not met the relevant requirements of revalidation You do not need to demonstrate that you have met the health and character or professional indemnity insurance requirements. You make this declaration as part of your online application to the NMC. 77
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BupaPrivate and Confidential Purpose of this requirement Encourages line managers to regularly consider and discuss how their staff are maintaining and developing their competence and improving their practice Increases professionalism by making nurses and midwives more accountable for their practice Provided additional assurance that the registrant has met the revalidation requirements Encourages a culture of sharing, reflection and improvement Helps to reduce nurses and midwives working in professional isolation. 78
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BupaPrivate and Confidential Confirmation in practice You will need to meet with your Confirmer and have a face-to-face discussion about your revalidation As part of the discussion, you will need to demonstrate to the confirmer that you have met the revalidation requirements This can form part of the annual appraisal process If your line manager is an NMC registered nurse or midwife, you might want to have your reflective discussion at the sale time as your confirmation discussion, although this is not a requirement. 79
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BupaPrivate and Confidential The Confirmer’s role The Confirmer is being asked to confirm that they have seen evidence that you have met the requirements of revalidation The Confirmer is not required to verify any evidence provided to them. For example, the Confirmer does not need to contact CPD providers to check whether you attended a course but they must check that CPD is related to scope of practice The Confirmer is not making an assessment of nurse or midwife’s Fitness to Practice. Existing Fitness to Practice processes already exist at the NMC to deal with this There is specific information for Confirmers to support them through the process Revalidation is not an assessment against the requirements your current/former employment 80
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BupaPrivate and Confidential 81
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BupaPrivate and Confidential Practice Hours The Confirmer will need to see written evidence that the nurse or midwife has practiced for the minimum number or hours Evidence may include a contract of employment, timesheets, job spec and role profiles Only hours relating to nursing and midwifery registration count, but this can include non-clinical roles such as management, education and policy both paid and voluntary Only hours undertaken whilst registered as a nurse or midwife count If a nurse or midwife has not practiced for the required number of hours, the Confirmer must be satisfied that they have successfully taken an NMC approved return to practice course 82
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BupaPrivate and Confidential Continuing professional development The Confirmer will need to see evidence that the nurse or midwife has undertaken at least 35 hours of CPD, including evidence of 20 hours of participatory learning All CPD must be relevant to the nurse or midwife’s scope of practice A Confirmer is not being asked to assess the quality of the CPD undertaken A Confirmer should see accurate records of: The CPD method A description of the topic and how it relates to their practice Dates of the activity Number of hours Which part of the code the CPD relates to. 83
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BupaPrivate and Confidential Practice-related feedback The Confirmer will need to be satisfied that the nurse or midwife has obtained five pieces of practice-related feedback Feedback can come from a variety of sources including patients, service users, colleagues, carers and students The NMC recommends that nurses and midwives make a note of feedback, but this isn’t compulsory. The nurse or midwife should be able to provide an account of the feedback where there is no written note. 84
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BupaPrivate and Confidential Written reflective accounts The confirmer should see the five written reflective accounts that the nurse or midwife has prepared on their CPD, practice related feedback or event/experience in their practice and how this relates to the Code The accounts should include what the nurse or midwife has learnt and how they changed or improved their work as a result and how it relates to the Code Nurses and midwives must record their reflective accounts on the NMC form. 85
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BupaPrivate and Confidential Reflective discussion 86 The Confirmer will need to see a completed and signed NMC form showing that the nurse or midwife has discussed their reflective accounts with another NMC-registered nurse or midwife The Confirmer can be the reflective discussion partner as long as they are an NMC registered nurse or midwife The Confirmer is not making a judgement as to the quality of the reflective discussion that this has taken place This completed form must be signed by both the nurse or midwife going through revalidation and the reflective discussion partner.
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BupaPrivate and Confidential Who can act as your Confirmer The Nurses line manager is an appropriate Confirmer and the NMC strongly recommends that you use your line manager for confirmation where possible The line manager does not have to be a registered nurse or midwife If you do not have a line manager, the NMC recommends that the confirmer, wherever possible, is an NMC registered nurse or midwife If you do not have access to either of the above the NMC recommends you use another healthcare professional registered in the UK. For example a doctor or dentist It is for you to decide who is the most appropriate confirmer The NMC has developed an online tool to help you identify a suitable Confirmer. Visit www.nmc.org.uk/standards/revalidation/confirm-nurse- midwife/www.nmc.org.uk/standards/revalidation/confirm-nurse- midwife/ 87
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BupaPrivate and Confidential Joint responsibilities Both the nurse or midwife and the Confirmer need’s to: Be mindful about any personal or commercial relationship Exercise judgement where there is any conflict of interest or perception of bias to ensure that the confirmation process retains credibility and remains objective Consider whether a different person should be used as the Confirmer. 88
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BupaPrivate and Confidential Confirmation and reflective discussion Remember, if your confirmer is not a registered nurse or midwife Your reflective discussion must be with another registered nurse or midwife Your reflective discussion partner must have completed and signed the reflective discussion form This must happen prior to meeting with your Confirmer If your Confirmer is a registered nurse or midwife then they can complete both the reflective discussion and confirmation roles. 89
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BupaPrivate and Confidential Confirmer Forms The Confirmer will need to complete the NMC’s confirmer form The Confirmer will need to provide their name, NMC Pin, or other professional registration number (where relevant), email and professional address The Confirmer is being asked to confirm based on the evidence they have seen. They will not be held responsible if they inadvertently provide incorrect information 90
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BupaPrivate and Confidential If a nurse or midwife does not meet the requirements The Confirmer will need to explain to the nurse or midwife why they have not met the revalidation requirements The nurse or midwife can then be given the opportunity to fully complete the requirements and go back to the Confirmer before their revalidation application is due The confirmation discussion should take place well in advance of the revalidation application date to allow plenty of time for nurses and midwives to fully comply.
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BupaPrivate and Confidential. 92
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BupaPrivate and Confidential
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BupaPrivate and Confidential [DD Month YYYY]94
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BupaPrivate and Confidential You should now understand... 95 The role of the Confirmer Who can be your Confirmer What the Confirmer needs to see.
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MAKING YOUR APPLICATION
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BupaPrivate and Confidential Making your application You need to make your application via NMC online You will need to complete the online form and declare that you have met the revalidation requirements You will not need to upload your evidence from your portfolio to the NMC. Your confirmer will confirm that they have seen this evidence. You can print a summary of your application to keep in your portfolio 97
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BupaPrivate and Confidential The Revalidation Journey 98
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BupaPrivate and Confidential What should all nurses do now? 1. Go online and set up an NMC online account if you haven’t already at www.nmc.org.uk/nmc-onlinewww.nmc.org.uk/nmc-online 2. The first nurses and midwives are due to revalidate in April 2016 3. Make sure you know your renewal date 4.Read the revalidation guidance and get up to date at www.nmc.org.uk/revalidation www.nmc.org.uk/revalidation 99
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WHAT SHOULD NURSES DO NOW?
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BupaPrivate and Confidential What should nurses do now... Visit the Revalidation pages on www.nmc.co.ukwww.nmc.co.uk Visit the Revalidation page at www.OurBupa.co.ukwww.OurBupa.co.uk Any question to the Bupa Revalidation Team nursing@bupa.com 101
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BupaPrivate and Confidential And finally... Q & A for whole process On a ‘post it’ and collect at the end of each module 102
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INTRODUCTION TO REVALIDATION
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