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SWSLHD Mental Health Services

Inst
ruct
ions
Thi
s
doc
um
ent
mu
st
be
co
mp
let
ed
at
the
end
of
eac
h
clin
ical placement. The Registered Nurse will complete the ‘Employee’ rating and comments
section for each Performance Indicator. Each rating must be accompanied by a couple of
examples providing evidence of how the rating is justified (bullet points are fine).
The Preceptor or Manager then initials the ‘Preceptor or Manager’ section to confirm the
rating. If the Preceptor does not agree with the RNs self-rating they must right their
rating in the ‘Preceptor or Managers’ section and initial to indicate that the amended
rating has been discussed with the RN.
At the completion of the document the RN then arranges time with the NUM or Team
Leader to go through the form and summarise their progress. At this time the NUM or
Team Leader would then complete the checklist at the bottom of the last page. Finally
the document must be scanned and an email a copy of the document to the Nurse
Manager – Workforce / Delegate for filing.

Rating
The purpose of the Interim Performance Assessment is to ascertain whether or not the
Employee is on track to meet the relevant performance indicator by the end of their
transition year, as will be evidenced by a full Registered Nurse Performance
Management Review at the end of the third placement. The Registered nurse is
required to rate themselves against each performance indicator and provide an
example. The manager will also need to rate the Registered Nurse against the
performance indicators and provide feedback.
Rating Scale
1 – Considerable improvement required

2 – Some improvement required

3 – On track to achieve by completion of TPMHN year


4 – Outstanding progress

Rating ‘3 or 4’
No further action is required. Complete the document, sign it and forward a scanned
copy to the Nurse Manager, Workforce.

Rating ‘1 or 2’
The Participant’s Learning Development Plan must be updated to evidence that the
Employee has a SMART Goal to improve the rating in the next placement.

The Process
Performance
Manager reviews Participant

Professional
Knowledge Skills
Development

Workbook and the HETI

Completion Report.

Interim

Performance Manager reviews the Summary of

Assessment Clinical Skills Assessment

completed at

the end of the

placement CEWD advice non-attendance

LDP for any Indicators Learning

scored 1 or 2. Development

Plan Reviewed

Feedback provided

by NUM/Manager Progress

Review
Transition to Professional Practice Program-Mental Health (TPPPMH) Interim Performance Review

Name of Participant:

Employee Number:

Name of Manager:

Date of Assessment:

Location of Placement:

Rotation Number: 1 or 2 (please circle)

Performance Indicator Employee Rating and Comments Pr

1 – Considerable Improvement Required /M

2 – Some Improvement Required

3 – On track to achieve by end of the year

4 – Outstanding Progress

1. Work Conduct Self- Examples Manager/

The Nurse advocates the values of the Rating Preceptor


organisation
Rating
through ethical behaviour, professionalism
and cultural

sensitivities. They Display a positive


attitude, are

genuinely interested, curious and


authentic in their

conduct and model reliability and


accountability.

2. Teamwork/Collaboration
The Nurse demonstrates an
understanding of how

collaboration has an impact on the safe and


effective

provision of comprehensive care.


They support the

integrity of team practice by collaborating in


decision

making, following team processes and


sharing team

responsibilities. They contribute discipline


specific skills

to multidisciplinary team practice.

3. Decision-making and safe


practice

The Nurse is able to analyse problems and


use critical

thinking to solve problems within own scope


of practice.

They Integrate organisational policies and


guidelines with

professional standards and this is


demonstrated by safe

working practices. They intervene, act and


report where

appropriate.

4. Work Practice

The Nurse demonstrates a thorough


knowledge and
understanding of the clinical and Technical
/skills aspects

within their practice. The Nurse


displays a sound

judgement in the Practical application of


these principles

in daily work practices.

5. Problem-Solving

The Nurse identifies problems/issues,


consults and

implements creative, innovative and


Workable solutions.

Identifies relevant priorities and meets


deadlines.

Assesses effectiveness of
interventions and acts

accordingly. Applies information


appropriately and

effectively to achieve desired


outcomes

6. Communication-Verbal

The Nurse expresses their position clearly, in


a concise

and confident manner. They interact


respectfully and

professionally with colleagues, consumers


and carers.

They communicate with relevant


health care
professionals and service providers to
facilitate continuity

of care, and deliver accurate and relevant


information

e.g. clinical handovers, health care


team reviews.

SWSLHD Mental Health


Services

TPPP MH Interim Performance Review – Mar


2017

Page 2 of 4

Performance Indicator Employee Rating and Comments

1 – Considerable Improvement Required

2 – Some Improvement Required

3 – On track to achieve by end of the year

4 – Outstanding Progress

7. Communication-Written Rating Examples Please

The Nurse presents facts clearly, concisely and initial


logically in

documentation and reports. Incidents are


accurately

documented in a timely fashion in accordance


with the

minimum standard for documentation.


8. Adaptability

The Nurse demonstrates ability to support


change and

apply knowledge/skill to accommodate service


needs at

the organisation level.

9. Personal and Professional Development

The Nurse actively seeks opportunities for


learning and

self-improvement; requests feedback and


welcomes

advice when offered. Supports personal and


professional

development for self and others.

10. Continuous Improvement

The Nurse seeks to improve their own practice


and

actively contributes to the improvement of


services and

efficiencies on the ward through ongoing


reflective

practice, attendance and input at staff and


clinical

meetings and involvement in project work.

11. Complies and Contributes to Infection

Control and WH&S; Commitment to


EEO/Anti discrimination

The Nurse complies with Infection Control,


WH&S and

EEO/Anti discrimination legislation and


policies.

12. Customer Service

The Nurse is professional and respectful


attitude toward

clients and carers while providing care and


service

delivery. Interactions are courteous and foster a

partnership with consumers and carers.

Items for Addition to Learning Development Plan (if applicable)


Signatures

Employee Manager D

Office Use Only

Yes/No/N/A Previous Learning Development Plan goals met (Check previous Performance Review

Yes/No/N/A Learning Development Plan amended to include any new goals (if applicable).

Yes/No MHPOD up-to-date (As per report)

Yes/No Clinical Skills Assessments up-to-date (should be two per placement)

Yes/No Attendance at Block Training during placement (CEWD report non attendance)

SWSLHD Mental Health Services

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