Nursing associate – NMC 2018

Reference Number: ST0827

Details of standard

Occupation summary

This is a new occupation, introduced into the health and care workforce to bridge the gap between health and care assistants and registered nurses. Nursing associate is a stand-alone role that will also provide a progression route into graduate level nursing. It’s intended that the role will enable registered nurses to focus on more complex clinical duties. Nursing associates work in the public, independent and voluntary sectors and it is a statutorily regulated profession. The standards for proficiency are set by the Nursing and Midwifery Council (NMC). Successful completion of this apprenticeship will meet the education requirements for registration with the NMC. This standard covers the NMC Standards for Proficiency and Annexes A & B for nursing associates (October 2018).

The broad purpose of the occupation is to provide care for people of all ages and from different backgrounds, cultures and beliefs. Nursing associates may provide care for people who have mental, physical, cognitive and behavioural care needs. They may provide care for people in their own home, in the community or hospital or in any health care settings where their needs are supported and managed. Nursing associates work in the context of continual change, challenging environments, different models of care delivery, shifting demographics, innovation and rapidly evolving technologies. Increasing integration of health and social care services will require nursing associates to play an active role in multidisciplinary teams.

Nursing associates contribute to the promotion of health, health protection and the prevention of ill health. They do this by empowering people and communities to exercise choice, take control of their own health decisions and behaviours and by supporting people to manage their own care where possible. In their daily work, an employee in this occupation interacts with a variety of service users, families and carers, and with an extensive range of health and care professionals and other agencies including social services, police, probation, prisons, housing, education, language interpreters and third sector agencies. They might be working in a health, social care or public health provider and may work various shift patterns which enable care to be provided 24 hours per day, seven days per week, 365 days of the year. This is a new role and it is expected that nursing associates will become a key part of the team to meet the integrated health and care needs of patients and service users.

An employee in this occupation will be responsible for providing care for people of all ages and from different backgrounds, cultures and beliefs. They must be able to care for people in their own home, in the community or hospital or in any care settings where their needs are supported and managed. All nursing associates will work as part of a team but on a day to day basis they may be working alone when seeing people in their own homes or in the community. They work in the context of continual change, challenging environments, different models of care delivery, an older and more diverse population, innovation and rapidly evolving technologies. Increasing integration of health and social care services will require nursing associates to negotiate boundaries and play an important role in multidisciplinary teams. The confidence to apply knowledge and skills and provide evidence based, direct nursing care therefore lies at the centre of all nursing associate practice.

Nursing associates must be emotionally intelligent and resilient individuals, able to manage their own personal health and well-being, recognise boundaries of their practice and know when and how to access support.

Typical job titles

Typical job titles include nursing associate. Nursing associate is a protected title and may only be used by someone on the Nursing and Midwifery Council register.

Entry requirements

The Nursing and Midwifery Council stipulate selection, admission and progression requirements for entry to approved nursing associate programmes. The requirements can be seen in https://www.nmc.org.uk/globalassets/sitedocuments/education-standards/nursing-associates-programme-standards.pdf

Occupation duties

KSBs

Knowledge

K1: Understand the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and how to fulfill all registration requirements

K2: Understand the demands of professional practice and demonstrate how to recognise signs of vulnerability in themselves or their colleagues and the action required to minimise risks to health

K3: Understand the professional responsibility to adopt a healthy lifestyle to maintain the level of personal fitness and well-being required to meet people’s needs for mental and physical care

K4: Understand the principles of research and how research findings are used to inform evidence-based practice

K5: Understand the meaning of resilience and emotional intelligence, and their influence on an individual’s ability to provide care

K6: Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice

K7: Understand the importance of courage and transparency and apply the Duty of Candour

K8: Understand how discriminatory behaviour is exhibited

K9: Understand the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people

K10: Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes

K11: Understand the factors that may lead to inequalities in health outcomes

K12: Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being

K13: Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes

K14: Understand the importance of health screening

K15: Understand human development from conception to death, to enable delivery of person-centred safe and effective care

K16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care

K17: Understand commonly encountered mental, physical, behavioural and cognitive health conditions as applied to delivery of care

K18: Understand and apply the principles and processes for making reasonable adjustments

K19: Know how and when to escalate to the appropriate professional for expert help and advice

K20: Know how people’s needs for safety, dignity, privacy, comfort and sleep can be met

K21: Understand co-morbidities and the demands of meeting people’s holistic needs when prioritising care

K22: Know how to meet people’s needs related to nutrition, hydration and bladder and bowel health

K23: Know how to meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity

K24: Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain

K25: Know how to deliver sensitive and compassionate end of life care to support people to plan for their end of life

K26: Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld

K27: Understand the principles of safe and effective administration and optimisation of medicines in accordance with local and national policies

K28: Understand the effects of medicines, allergies, drug sensitivity, side effects, contraindications and adverse reactions

K29: Understand the different ways by which medicines can be prescribed

K30: Understand the principles of health and safety legislation and regulations and maintain safe work and care environments

K31: Understand how inadequate staffing levels impact on the ability to provide safe care and escalate concerns appropriately

K32: Understand what constitutes a near miss, a serious adverse event, a critical incident and a major incident

K33: Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes

K34: Know and understand strategies to develop resilience in self and know how to seek support to help deal with uncertain situations

K35: Understand own role and the roles of all other staff at different levels of experience and seniority in the event of a major incident

K36: Understand the roles of the different providers of health and care

K37: Understand the challenges of providing safe nursing care for people with complex co-morbidities and complex care needs

K38: Understand the complexities of providing mental, cognitive, behavioural and physical care needs across a wide range of integrated care settings

K39: Understand the principles and processes involved in supporting people and families with a range of care needs to maintain optimal independence and avoid unnecessary interventions and disruptions to their lives

K40: Understand own role and contribution when involved in the care of a person who is undergoing discharge or a transition of care between professionals, settings or services

K41: Know the roles, responsibilities and scope of practice of different members of the nursing and interdisciplinary team, and own role within it

K42: Understand and apply the principles of human factors and environmental factors when working in teams

K43: Understand the influence of policy and political drivers that impact health and care provision

Skills

S1 Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and fulfil all registration requirements

S2 Keep complete, clear, accurate and timely records

S3 Recognise and report any factors that may adversely impact safe and effective care provision

S4 Take responsibility for continuous self-reflection, seeking and responding to support and feedback to develop professional knowledge and skills

S5 Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018)

S6 Act as an ambassador for their profession and promote public confidence in health and care services

S7 Communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive and behavioural health challenges

S8 Recognise signs of vulnerability in self or colleagues and the action required to minimise risks to health

S9 Develop, manage and maintain appropriate relationships with people, their families, carers and colleagues

S10 Provide, promote, and where appropriate advocate for, non-discriminatory, person-centred and sensitive care at all times, reflecting on people’s values and beliefs, diverse backgrounds, cultural characteristics, language requirements, needs and preferences, taking account of any need for adjustments

S11 Report any situations, behaviours or errors that could result in poor care outcomes

S12 Challenge or report discriminatory behaviour

S13 Apply the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people

S14 Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and wellbeing

S15 Identify people who are eligible for health screening

S16 Promote health and prevent ill health by understanding the evidence base for immunisation, vaccination and herd immunity

S17 Protect health through understanding and applying the principles of infection prevention and control, including communicable disease surveillance and antimicrobial stewardship and resistance

S18 Apply knowledge, communication and relationship management skills required to provide people, families and carers with accurate information that meets their needs before, during and after a range of interventions

S19 Recognise when capacity has changed recognise and how a person’s capacity affects their ability to make decisions about their own care and to give or withhold consent

S20 Recognise people at risk of abuse, self-harm and/or suicidal ideation and the situations that may put them and others at risk

S21 Monitor the effectiveness of care in partnership with people, families and carers, documenting progress and reporting outcomes

S22 Take personal responsibility to ensure that relevant information is shared according to local policy and appropriate immediate action is taken to provide adequate safeguarding and that concerns are escalated

S23 Work in partnership with people, to encourage shared decision making, in order to support individuals, their families and carers to manage their own care when appropriate

S24 Perform a range of nursing procedures and manage devices, to meet people’s need for safe, effective and person-centred care

S25 Meet people’s needs for safety, dignity, privacy, comfort and sleep

S26 Meet people’s needs related to nutrition, hydration and bladder and bowel health

S27 Meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity

S28 Support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain

S29 Give information and support to people who are dying, their families and the bereaved and provide care to the deceased

S30 Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed

S31 Act in line with any end of life decisions and orders, organ and tissue donation protocols, infection protocols, advanced planning decisions, living wills and lasting powers of attorney for health

S32 Work collaboratively and in partnership with professionals from different agencies in interdisciplinary teams

S33 Maintain safe work and care environments

S34 Act in line with local and national organisational frameworks, legislation and regulations to report risks, and implement actions as instructed, following up and escalating as required

S35 Accurately undertake risk assessments, using contemporary assessment tools

S36 Respond to and escalate potential hazards that may affect the safety of people

S37 Participate in data collection to support audit activity, and contribute to the implementation of quality improvement strategies

S38 Prioritise and manage own workload, and recognise where elements of care can safely be delegated to other colleagues, carers and family members

S39 Recognise when people need help to facilitate equitable access to care, support and escalate concerns appropriately

S40 Support and motivate other members of the care team and interact confidently with them

S41 Monitor and review the quality of care delivered, providing challenge and constructive feedback when an aspect of care has been delegated to others

S42 Support, supervise and act as a role model to nursing associate students, health care support workers and those new to care roles, review the quality of the care they provide, promoting reflection and providing constructive feedback

S43 Contribute to team reflection activities to promote improvements in practice and services

S44 Access, input, and apply information and data using a range of methods including digital technologies, and share appropriately within interdisciplinary teams

Behaviour

B1: Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences

B2: Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice

B3: Be adaptable, reliable and consistent, show discretion, resilience and self-awareness

Qualifications

 English and Maths qualifications

Apprentices without level 2 English and maths will need to achieve this level prior to taking the End-Point Assessment.  For those with an education, health and care plan or a legacy statement, the apprenticeship’s English and maths minimum requirement is Entry Level 3. A British Sign Language (BSL) qualification is an alternative to the English qualification for those whose primary language is BSL. 

Other qualifications

Mandatory qualification 1: Foundation Degree approved by the Nursing and Midwifery Council

Professional recognition

Nursing and Midwifery Council

Additional details

Occupational Level: 5

Duration (months): 24

Review

This standard will be reviewed after three years.

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