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OSCE Medication

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The document outlines a competency-based assessment for administering and monitoring medications using an Objective Structured Clinical Examination (OSCE). Students will be evaluated on their practical skills through a series of stations.

The OSCE assessment is used to objectively measure students' clinical competency through a series of short, focused stations where students demonstrate their practical skills. They are evaluated on what they can do rather than just their theoretical knowledge.

Mrs. Ross is prescribed Flixotide 500mcg 2 puffs twice daily via metered dose inhaler and Salbutamol 200mcg 2 puffs every 6 hours. This is for her conditions of asthma, COPD and GORD.

Student

Practical Assessment - OSCE


HLTEN507C Administer and monitor medications in the work environment

Student Name: ____________ Student ID: _____

Group: ______ Date:

Assessment Coding
Assessment for this unit of competency is based on competency based grading. All assessment tasks,
except Practical Observations and Clinical Placements are weighted and graded. Overall final grades
applied to this unit of competency are:

This is a competency based assessment: results are given as: S/NS

Re-assessment
Any re-assessment is conducted as soon as practicable after you have been informed of the requirement
to be re-assessed and have been given the opportunity to be re-trained and assimilate the training. You
are re-assessed only in the areas your assessor deems that you have not met the required standard. It
is at the assessor/s discretion to re-assess the entire assessment should it be demonstrated an overall
understanding of this unit has not been achieved.
Reasonable Adjustment for this unit College Based Workplace Based

Assistance of a learning support teacher for LLN issues Choose an item. Choose an item.

Modifications to physical environment, e.g. wheelchair Choose an item. Choose an item.


access

Changes to course design, e.g. instead of written Choose an item. Choose an item.
assessment task change to verbal questioning &
assessor to write the answers

Changes in lecture schedules and arrangements, e.g. Choose an item. Choose an item.
relocating classes to an accessible venue

I acknowledge the assessment process has been explained and agree to undertake assessment.
I am aware of Careers Australias appeals process, should the need arise. I also understand that
I must be assessed as satisfactory in all parts of the assessment to gain a competent result for
this unit of competency. I declare that the work contained in this assessment is my own, except
where acknowledgement of sources is made. I understand that a person found responsible for
academic misconduct will be subject to disciplinary action (refer to student handbook).
Student Signature: ________________ Date: ______

Assessor use only

Assessor Comment/Feedback: ___________


_____
_____
_____

Assessor Name: _____________________ Assessor Signature: ____________________

Date: ______________ Result: ____% Reassessment: YES / NO Due Date: __________

Office use only:


Results Date: Skills
entered by: Centre:

4th January 2017 Page 1


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
STUDENTS ARE TO PREPARE ANSWERS FOR QUESTIONS IN THE OSCES BEFORE THEY
ATTEND THE PRACTICAL SESSION.

This is a competency based assessment: results are given as: S/NS

NURSING LABORATORY
This practical assessment will take the form of OSCEs. Objective Structured Clinical Examination
(OSCE) is a form of performance-based testing used to measure candidates clinical competence.
During an OSCE, candidates are observed and evaluated as they go through a series of stations in
which they interview, examine and treat standardized patients (SP) who present with some type of
problem.

Features of the Objective Structured Clinical Examination (OSCE)


Stations are short
Stations are numerous
Stations are highly focused , candidates are given very specific instructions
Emphasis on what candidates can do rather than what they know
5 minutes most common (5-20 minutes)
Written answer sheets or observer assessed using checklists
Mix of station types/competencies tested
http://www.oscehome.com/What_is_Objective-Structured-Clinical-Examination_OSCE.html

Student Instructions
At each skills station, provide the student with an instruction sheet and an activity to complete. The
educator may alert the student at each of the following times:
1. At the beginning of the assessment.
2. 5 mins before the assessment is finished.
3. At the end of the assessment.

The student will then move onto the next skills station. The student will be allowed to spend up 20
minutes at each station. At the end of the assessment, tick off the Practical Skill Marking checklist if
the candidate has been successful and hand it back to her/him. The candidate then moves to the
next OSCE station.
Included (embedded) in each station assessment will be the following criteria:
1. Follow legal and professional standards of practice.
2. Hand hygiene.
3. Introduction of self to client.
4. Appropriate communication skills (refer to Tollefsons) and appropriate level of language and
literacy.
5. Inform client about nursing care procedure.
6. Safe manual handling.
7. Awareness of infection control principles as per organisational policy and procedures.

4th January 2017 Page 2


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
ASSESSMENT
During this assessment there will be seven (7) clinical skills stations with each station
covering the following Skills Sets:
A: Skill Set Nursing Care: Sub cutaneous injection (4.3)
B: Skill Set Nursing Care: Intramuscular Injections (4.3) & Medical Emergency
C: Skill set Nursing Care: Monitor peripheral Intravenous therapy (7.3)
D: Skill Set Nursing Care: Enteral Medication (6.2)
E: Skill Set Nursing Care: Trans-mucosal Medication (4.1)
F: Skill Set Nursing Care: Topical Medication (4.1 & 4.2)
G: Skill Set Nursing Care: Respiratory Medication (6.3)

A. Skill Set Nursing Care: Sub cutaneous injection

During this assessment there will be 1 station covering the skills required for

1. Subcutaneous injection (4.3)

The assessment criteria is constructed from the reference list provided:


Australian nursing & Midwifery Council, 2002, National Competency standards for the enrolled
nurse, ANMC, ACT Australia
Bishop, T, Jelly, E, Tambree, K, Tollefson, J, Watson, G & 2012, Essential Clinical Skills
Enrolled/Division 2 Nurses, 2nd edn, Cengage Learning, Australia.
Hughson, J, Koutoukidis, G & Stainton, K 2013, Tabbners Nursing Care Theory and Practice, 6th
edn, Elsevier, NSW.
Tiziani, A 2013, Nursing Guide to Drugs, 9th edn, Elsevier, Australia

ASSESSMENT

All Scenarios are to allow demonstrations of EN skills required for safely doing a 15-20 minute drug
round in the healthcare setting depending on the skill and route of administration. The following list
of student assessment is embedded in each of the skills station:
7 Rights for medication administration
Right time
Right drug
Right route
Right dose
Right patient
Right documentation
Right to refuse (Tollefsons 2012, p. 107)
Safe work practice & workplace requirements
Follows correct principles of infection control
Documentation & communication requirements
Patient assessment check for allergy
Indications & contraindications of drug (and route)
Correct patient positioning

Equipment for Station A1:

Station Skill Equipment


Bed and pillow, Mannequin with injectable surface,
A1 Sub cutaneous Laminated scenario & whiteboard marker / alcohol
injection wipes
Insulin pen and needle tip OR 0.5ml single use syringe,
Vial of insulin, Kidney dish, Sharps container, MIMS and
Hand Hygiene resource/s

4th January 2017 Page 3


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

Instructions for OSCE Station A1

Subcutaneous injection

You have up to 20 minutes to complete this assessment.

Case Study
You are looking after Isla Sweet, a 14 year old with Type 1 Diabetes. Her insulin is
ordered TDS, pre-prandial and nocte, post BGL readings. The Rapid acting insulin is
prescribed on a sliding scale. On your shift you measure Islas BGL to be 10.2mmol/L
at the appropriate time it is due.

Instructions:
Using the resources as a reference, read the medication chart and provide answers to
your educators questions.
Prepare the appropriate drug for administration via sub cutaneous injection, according
to the medication chart.

Resources for practical assessment: MEDICATION CHART PRN MEDICATIONS

URN: 125456
Family name: SWEET Allergies: Nil known
Given name: Isla
Date of birth: 24.5.2001
Sex: F
DATE MEDICATION (PRINT DATE 23/2
GENERIC NAME)

22.06.15 Glucagon
ROUTE DOSE HOURLY MAX Time 1000

IM FREQUENCY DOSE/24

1mg HRS

INDICATION PHARMACY DOSE 1mg

LOC p/t hypoglycaemia ROUTE


IM
PRESCRIBER SIGNATURE - CONTACT SIGN T.T
PRINT YOUR NAME
#4589
ALEC LEOREN

4th January 2017 Page 4


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
Classification :Hyperglycaemic agent

Indications
Hypoglycemia
Beta blocker toxicity
Anaphylaxis with refractory hypotension
Calcium channel blocker toxicity refractory to IV calcium
Relief of lower esophageal foreign body (smooth muscle relaxation of
lower esophageal sphincter)

Contraindications
Hypersensitivity to the medication
Precautions
Administer with caution in patients receiving corticosteroids

NovoRapid :is used to treat adults, adolescents and children over one year
old who have diabetes. It contains the active substance insulin aspart, a
rapid-acting insulin.
Resources for practical assessment: MEDICATION CHART REGULAR MEDICATIONS

URN: 125456
Family name: SWEET Allergies: Indomethacin, Pethidine, eggs, shellfish
Given name: Isla
Date of birth: 24.5.2001
Sex: F
YEAR 2015 DATE AND 22 23 24 25 26
MONTH 06 06 06 06 06
15 15 15 15 15
DATE MEDICATION(PRINT GENERIC NAME)
0700 NP NP AB AB KW
22.06.15 Novo Rapid
BGL 3.4 4.8 2.1 4.5 3.7
Route Dose Frequency and NOW enter times
1230 NP NP AB AB KW
SC As per sliding scale, pre-prandial
TDS BGL 11.9 12.5 18.2 7.8 8.9
Indication
BGL 0 4.9mmol/L 2 units (must eat first to get
Pharmacy
1800 DF DF DF KW
BGL up to at least 4.0mmol before giving this dose) BGL 18.4 7.5 16.3 7.9
BGL 5 9.9mmol/L 4 units
BGL 10 14.9mmol/L 6units
BGL 15 19.9mmol/L 8 units
BGL > 20mmol/L 10units
PRESCRIBER SIGNATURE - PRINT CONTACT
YOUR NAME
#4589
ALEC LEOREN

URN: 125456
Family name: SWEET Allergies: Indomethacin, Pethidine, eggs, shellfish
Given name: Isla
Date of birth: 24.5.2001
Sex: F
4th January 2017 Page 5
Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
YEAR 2015 DATE AND 22 23 24 25 26
MONTH 06 06 06 06 06
DATE MEDICATION (PRINT GENERIC NAME)

22.06.15 Lantus
Route Dose Frequency and NOW enter times
2000 DF DF DF KW
SC 16 units nocte
BGL 12.9 7.2 14.3 8.4
Indication Pharmacy

Regular medication
PRESCRIBER SIGNATURE - PRINT CONTACT
YOUR NAME
#4589
ALEC LEOREN

4th January 2017 Page 6


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
Practical Assessment Checklist OSCE station A1 S or N/S
SUB CUTANEOUS INJECTION
Analytical Decision Making within the scenario
Links to the Enrolled Nurses competency standards 1.3, 1.4, 2.1, 3.1, 3.6, 4.1, 4.2, 6.1, 7.2, 8.1,
9.2, 9.3, 10.2, 10.4
Links to HTEN507C Elements 1.1, 1.7, 2.3, 2.4, 2.5, 3.4, 3.5, 4.3, required knowledge & skills
1. Complete the clients medication chart by entering Islas BGL reading of
10.2mmol/L under the correct date and time.

2. Identify which insulin is now due as well as the right dose, time, and route
of administration.
6 Unit Novorapid.SC
3. Compare and contrast the effects of the drug that is now due, to the other
type of insulin that is also charted for Isla. Include which insulin is likely to
be affecting the consistent low morning BGLs, given their action times. You
may use MIMS.
Action Onset Peak
Novo rapid Short acting 15 mins 1-3 hrs

Lantus Long acting 1-2 hrs Steady 24hr

4. From reviewing the medication chart, BGL readings since admission and
the MIMs, you conclude that Isla has a pattern of low readings before
breakfast. Explain two (2) actions that you might take in regards to
multidisciplinary care and client education.
Explain consequences of missing meal cause low BGL
Pt to recognise early symptoms of hypoglycaemia:
always having glucose tablet, hard candy , jelly or
simple food contain sugar readily available
5. Explain the requirements of storage for unopened and in use Insulin pens
and vials.
Unopen: 2-8 degree in refrigerator
In use : label and name, discard after 28 degree
Keep it to Room temperature before inject

Safe and effective administration of subcutaneous injection


Links to EN Competency standards 1 .1, 1.3, 1.4, 1.5, 2.1, 3.1, 3.2, 3.4, 4.1, 6.3, 7.1, 7.4, 8.1,
8.2
Links to HTEN507C Elements 1.1, 1.4, 1.6, 1.8, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 3.1,3.2,
3.3,4.2,4.3, 3.4, 3.5, required knowledge and skills
6. Demonstrate appropriate communication skills:
Introduce self to client, confirm clients identification, explain the procedure,
obtain consent, and ensure comfort, privacy and dignity throughout the
procedure and provide reassurance, as required.
7. Check the 7 Rights of Medication Administration, three (3) times.
1) Check accuracy against documentation (med chart / allergy )
2) Check accuracy with the client (verbal name, dob, allergy)
3) Check accuracy when handling medication/s (rights / expiry date / allergy)
Right time, Right drug, Right route, Right dose, Right patient, Right
documentation, OTHER: Rights reason, Right to refuse, Right education.

4th January 2017 Page 7


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
8. Comply with Infection control practices throughout the procedure.

9. Comply with Workplace Health & Safety practices, including


positioning clients to ensure they are able to swallow medications
safely, working with a medication trolley and crushing medications
(angle / height).
10. Gather equipment. 2nd nurse to check drug preparation dosage and
injection administration / BGL result / med chart & pen / insulin vial &
syringe or pen delivery device / alcohol wipe / tissue / hand hygiene
equipment / sharps container.

(It is assumed that the needle size and length has been directed by the
Diabetes Educator, thus appropriate for injection).
11. Prepare the medication.
Storage - take from and return to appropriate storage according to
drug scheduling, organisation policy and product requirements.
CHECK-drug name and dose against Medication Order / Expiry date on
packaging.
Calculation or Measurement:
Pen Device
-Prime the bevelled syringe with 2 units.
-ensure there is enough insulin left for the correct and full dose.
Single use insulin syringe
-Removing air bubbles to ensure accurate dose.
-Pinching technique used on the plunger, and aligned accurately with
syringe measurements.

12. Administer the medication.


Locate appropriate injection site, using anatomical landmarks.
(you may ask the client, the site they prefer for this injection however,
ensure that it is rotated from the previous injection site and not
showing signs of over use)
-upper outer aspect (middle third) of upper arm
-upper anterior thigh
-lower quadrants of the abdomen
Observe the injection site for erythema, lumps, bruises etc.
Pinch adipose tissue gently between thumb and forefinger.
Insert needle quickly and firmly at 45 or 90 degree angle.
Inject the solution. It is important to note that if 2 types of insulin
were required, they are given in alternative areas, to prevent BGL
instability related to absorption compromise.
Place an alcohol swab over the injection site and withdraw the needle.
Gently massage the injection site (unless contraindicated).
Observe for any abnormality (hardening, bruising and inflammation).
Ensure client comfort following administration.

Follow up and completion of task


Links to EN Competency standards 1.1, 1.3, 1.4, 1.5,5.1, 5.2, 6.1, 7.2, 7.3, 8.1, 9.2, 10.2
Links to HTEN507C Elements 2.8, 3.4, 4.1, required knowledge and skills

4th January 2017 Page 8


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
13. Disposal of single use equipment, sharps hazards.

14. Documentation signing the medication chart, progress notes,


treatment record, risk and quality; incident reports as required.

15. Verbally discuss a short reflective practice exercise where the


student can identify areas that went well and areas that can improve,
according learned theory and if required how to avoid potential or
repeated errors.

END OF OSCE A1

4th January 2017 Page 9


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

B. Skill Set Nursing Care: Intramuscular Injection

During this assessment there will be 1 station covering the skills required for:

1. Intramuscular injection (4.3)


2. Emergency care

The assessment criteria is constructed from the reference list provided:


Australian nursing & Midwifery Council, 2002, National Competency standards for the enrolled
nurse, ANMC, ACT Australia
Bishop, T, Jelly, E, Tambree, K, Tollefson, J, Watson, G & 2012, Essential Clinical Skills
Enrolled/Division 2 Nurses, 2nd edn, Cengage Learning, Australia.
Gorksi, L, Phillips, L 2014, Manual of IV Therapeutics Evidence-Based Practice for Infusion
Therapy, 6th edn, F.A Davis, USA
th
Gulanick M & Myers J 2011, Nursing Care Plans Diagnoses, Interventions and Outcomes, 8 edn,
Elsevier Australia, NSW.
Hughson, J, Koutoukidis, G & Stainton, K 2013, Tabbners Nursing Care Theory and Practice, 6th
edn, Elsevier, NSW.
Tiziani, A 2013, Nursing Guide to Drugs, 9th edn, Elsevier, Australia

ASSESSMENT

All Scenarios are to allow demonstrations of EN skills required for safely doing a 15-20 minute drug
round in the healthcare setting depending on the skill and route of administration. The following list
of student assessment is embedded in each of the skills station:
7 Rights for medication administration
Right time
Right drug
Right route
Right dose
Right patient
Right documentation
Right to refuse (Tollefsons 2012, p. 107)
Safe work practice & workplace requirements
Follows correct principles of infection control
Documentation & communication requirements
Patient assessment check for allergy
Indications & contraindications of drug (and route)
Correct patient positioning

Equipment for Station:

Station Skill Equipment


Bed and pillow
Mannequin with injectable surface
Laminated scenario & whiteboard marker / alcohol
wipes
Glucagon Emergency kit
B1 Intramuscular injection
PPE
Kidney dish
Sharps container
MIMS
Hand Hygiene resource/s

4th January 2017 Page 10


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
Instructions for OSCE Station B1

Intra muscular injection & emergency care

You have up to 20 minutes to complete this assessment.

Case Study
You come back after days off, and are again allocated to care for Isla Sweet; a 14
year old with Type 1 Diabetes. Isla has been reviewed by the multidisciplinary team.

During the morning handover you are told that the endocrinologist has adjusted her
Lantus and the Diabetes educator has given Isla some information to help her identify
and self-manage, fluctuating BGLs. The dietician has also been sent a referral, as Isla
has expressed interest in better understanding low GI food choices and exercise /
weight loss considerations.

During your first round, you find Isla unresponsive in bed. Observations measured
are:

BP: 118 /75 SpO2: 95% on RA


HR: 68bpm BGL: 1.3mmol/L
RR: 15 GCS: =3

The RN requests for you to prepare and administer a Glucagon Intramuscular


injection.

Resource for practical assessment: MEDICATION CHART PRN

URN: 125456
Family name: SWEET Allergies: Indomethacin, Pethidine, eggs, shellfish
Given name: Isla
Date of birth: 24.5.2001
Sex: F
DATE MEDICATION (PRINT DATE
GENERIC NAME)

22.06.15 Glucagon
ROUTE DOSE HOURLY MAX Time

IM FREQUENCY DOSE/24
HRS

INDICATION PHARMACY DOSE

LOC p/t hypoglycaemia ROUTE

PRESCRIBER SIGNATURE - CONTACT SIGN


PRINT YOUR NAME
#4589
ALEC LEOREN

4th January 2017 Page 11


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
Resource for practical assessment: MEDICATION CHART REGULAR

URN: 125456
Family name: SWEET Allergies: Indomethacin, Pethidine, eggs, shellfish
Given name: Isla
Date of birth: 24.5.2001
Sex: F
YEAR 2015 DATE AND MONTH 29 30 01 02 03
06 06 07 07 07

DATE MEDICATION(PRINT GENERIC NAME)


0700 AB AB NP NP
22.06.15 Novo Rapid
BGL 6.4 5.2 6.7 4.3
Route Dose Frequency and NOW enter times
1230 AB AB NP NP
SC As per sliding scale, pre-prandial TDS
BGL 11.8 8.9 7.2 6.5
Indication
BGL 0 4.9mmol/L 0 units
Pharmacy
1800 KW DF DF KW
BGL 5 9.9mmol/L 4 units BGL 10.2 6.4 9.8 7.2
BGL 10 14.9mmol/L 6units
BGL 15 119.9mmol/L 8 units
BGL > 20mmol/L 10units
PRESCRIBER SIGNATURE - PRINT CONTACT
YOUR NAME
#4589
ALEC LEOREN

URN: 125456
Family name: SWEET Allergies: Indomethacin, Pethidine, eggs, shellfish
Given name: Isla
Date of birth: 24.5.2001
Sex: F
YEAR 2015 DATE AND MONTH 29 30 01 02 03
06 06 07 07 07

DATE MEDICATION (PRINT GENERIC NAME)

24.06.15 Lantus
Route Dose Frequency and NOW enter times
2000 KW DF DF KW
SC 58 units nocte
BGL 8.9 7.2 15.4 6.8
Indication Pharmacy

PRESCRIBER SIGNATURE - PRINT CONTACT


YOUR NAME
#4589
ALEC LEOREN

4th January 2017 Page 12


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
Practical Assessment Checklist OSCE station B1 S or N/S
INTRAMUSCULAR INJECTION
Analytical Decision Making within the scenario
Links to the Enrolled Nurses competency standards 1.3, 1.4, 2.1, 3.1, 3.6, 4.1, 4.2, 6.1, 7.2, 8.1,
9.2, 9.3, 10.2, 10.4
Links to HTEN507C Elements 3.4, 4.4, 4.5, 4.6, required knowledge & skills
16. In reference to the scenario, explain an adverse reaction of Insulin.
Hypoglycaemia ( timing is dependent on action profile of particular
insulin, signs and symptoms include cold sweat , cool pale skin, tremor,
nervous , anxiety, tiredness ,weakness, confusion excessive hunger,
visual disturbance , headache, nausea and palpitation.
Severe hypoglycaemia can lead to unconsciousness, brain impairment
and death.
17. Explain to the educator, the livers involvement in glycogen release and
loss of consciousness and one (1) reason why IM Glucagon is used as a
treatment for hypoglycaemia.
Severe hypoglycemia cause loss of consciousness
Glycogen may be released by the liver for a number of
reasons, including low blood glucose

Glucagon is a hormone which helps to raise blood glucose


level
Glycogen is mainly stored in the liver and the muscles and
provides the body with a readily available source of energy
if blood glucose levels decrease
Glucose is the preferred energy source for the brain and
glucose also can provide energy for cells in the absence of
oxygen,
We need to perform IM Glucagon as glucagon is absorbed
into the blood stream faster and patient is loss of conscious.
18. Working within your scope of practice as an EN, identify and demonstrate,
in order, the first aid steps when responding to the above scenario.
Maintain position for airway
Check airway
Report to RN and follow instruction to administer
Glycogen Short.
Call Emergency Care
If emergency not arrive in 5 min , check BGL and give
another shot of Glycogen

19. Identify to the educator, three (3) other emergency nursing actions you
would perform, specific to this scenario, including the rationale for
continuing or decrease in frequency of monitoring after the event.
Drink Juice with Glucose or Wait about 15 minutes check BGL,
If still low then eat 15 grams of carbohydrate
Check Vital Signs and maintain air way
Monitoring of BGL levels, if not improve, call RN and
Emergency care.

Safe and effective administration of subcutaneous injection

4th January 2017 Page 13


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
Links to EN Competency standards 1.1, 1.3, 1.4, 1.5, 2.1, 3.1, 3.2, 3.4, 4.1, 6.3, 7.1, 7.4, 8.1,
8.2
Links to HTEN507C Elements 1.1, 1.4, 1.6, 1.8, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 3.1,3.2,
3.3,4.2,4.3, 3.4, 3.5 required knowledge and skills
20. Demonstrate appropriate communication skills:
In an emergency situation, it is important to give and receive clear
instructions. If you are the first qualified person on the scene, you need to
take charge, and delegate others to assist where required. Once a more
senior / qualified member of the health care team arrives, it is necessary for
them to lead the recovery, and for you to communicate clearly and follow
their instruction.
It is also useful, when caring for an unconscious client, to maintain dialogue,
and communicate as you would, if they were aware and responsive to their
environment.
21. Check the 7 Rights of Medication Administration, three (3) times.

1) Check accuracy against documentation (med chart / allergy )


2) Check accuracy with the client (verbal name, dob, allergy)
3) Check accuracy when handling medication/s (rights/ expiry date / allergy)
Right time, Right drug, Right route, Right dose, Right patient, Right
documentation, OTHER: Rights reason, Right to refuse, Right education.

22. Comply with infection control practices throughout the procedure.

23. Comply with Workplace Health & Safety practices.

24. Gather equipment. 2nd nurse to check drug preparation dosage and
injection administration / BGL result / med chart & pen / glucagon
emergency kit / alcohol wipe / tissue / hand hygiene equipment and
sharps container.
25. Prepare the medication.
Storage - take from and return to appropriate storage according to
drug scheduling, organisation policy and product requirements.
CHECK-drug name and dose against Medication Order / Expiry date on
packaging.
Calculation or Measurement:
-Inject the liquid into the vial
-Dissolve the tablet / powder
-Redraw the entire contents into the syringe
26. Administer the medication.
Locate suitable site for Intramuscular injection
-VASTUS LATERALIS middle third of the anterior lateral aspect of the
thigh
-GLUTEAL upper outer quadrant of the buttock
-DELTOID upper outer (middle third) aspect of the upper arm
Position the client appropriately, maintaining privacy and dignity
Insert needle, smoothly and quickly at a 90 degree angle
Aspirate (draw back) the syringe to confirm you are not injecting into a
vein or artery then inject solution
4th January 2017 Page 14
Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
Place an alcohol swab over the injection site and withdraw the needle
Gently massage the injection site (unless contraindicated)
Observe for any abnormality. (hardening, bruising, inflammation)
Ensure client comfort following administration

Follow up and completion of task


Links to EN Competency standards 1.1, 1.3, 1.4, 1.5,5.1, 5.2, 6.1, 7.2, 7.3, 8.1, 9.2, 10.2
Links to HTEN507C Elements 2.8, 3.4, 4.1 required knowledge and skills
27. Dispose of single use equipment, sharps hazards.

28. Identify to the educator, two (2) forms of documentation that would be
used in this scenario.
Medication Chart
Progress note

29. Continue to Monitor and Assess client status.

30. Verbally discuss a short reflective practice exercise where the


student can identify areas that went well and areas that can improve,
according learned theory and if required how to avoid potential or
repeated errors.

31. Referring to the scenario, Discuss with your educator, social,


cultural or religious factors that may be contributing Isla Sweets current
condition.

Culture food and practice, limited finance, lack of exercise, different of


medical treatments views and limited languages may effect on her Illness

END OF OSCE B1

C. Skill Set Nursing Care: Monitor peripheral intravenous therapy

During this assessment there will be 2 stations covering the skills required for:

2. Monitor peripheral intravenous therapy (7.3)


3. Removal of an intravenous cannula

The assessment criteria is constructed from the reference list provided:


Australian nursing & Midwifery Council, 2002, National Competency standards for the enrolled
nurse, ANMC, ACT Australia
Bishop, T, Jelly, E, Tambree, K, Tollefson, J, Watson, G & 2012, Essential Clinical Skills
Enrolled/Division 2 Nurses, 2nd edn, Cengage Learning, Australia.
Gorksi, L, Phillips, L 2014, Manual of IV Therapeutics Evidence-Based Practice for Infusion
Therapy, 6th edn, F.A Davis, USA
th
Gulanick M & Myers J 2011, Nursing Care Plans Diagnoses, Interventions and Outcomes, 8 edn,
Elsevier Australia, NSW.

4th January 2017 Page 15


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
Hughson, J, Koutoukidis, G & Stainton, K 2013, Tabbners Nursing Care Theory and Practice, 6th
edn, Elsevier, NSW.
Tiziani, A 2013, Nursing Guide to Drugs, 9th edn, Elsevier, Australia

ASSESSMENT

All Scenarios are to allow demonstrations of EN skills required for safely doing a 15-20 minute drug
round in the healthcare setting depending on the skill and route of administration. The following list
of student assessment is embedded in each of the skills station:
7 Rights for medication administration
Right time
Right drug
Right route
Right dose
Right patient
Right documentation
Right to refuse (Tollefsons 2012, p. 107)
Safe work practice & workplace requirements
Follows correct principles of infection control
Documentation & communication requirements
Patient assessment check for allergy
Indications & contraindications of drug (and route)
Correct patient positioning

Equipment for Station:

Station Skill Equipment


Monitor peripheral Mannequin arm with peripheral IV cannula,
C1 intravenous therapy Dressing of choice: Tegaderm, or gauze and tape,
bandage and adhesive removal (optional).

4th January 2017 Page 16


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

Instructions for OSCE Station C1

Monitor peripheral Intravenous therapy

You have up to 20 minutes to complete this assessment.

Case Study
You have been allocated Mrs Poh Tassium, a 68 year old female, for your shift. She
was admitted for medical investigations and her client data collected includes:

CURRENT MEDICATIONS: PAST MEDICAL HISTORY:


PREDNIZONE (corticosteroid) Rheumatoid Arthritis
DIATHIAZIDE (loop diuretic) Hypertension
History of Presenting OBSERVATIONS:
Complaint: BP 184/95
Fractured R) humerus HR 96
Heart palpitations RR 14
Excessive weakness Spo2 94% on RA
Thirst BGL 13.4mmol/L
Purple striae
Diarrhoea

During this admission Mrs Poh Tassium was diagnosed with Cushings syndrome
secondary to a pituitary tumour. The tumour was causing an excess production of
aldosterone (a mineral corticosteroid, which increases renal secretion of potassium.)

The tumour was excised under intraoperative conditions and Mrs Poh Tassium,
continued to receive IV therapy, on the neurosurgical ward post operatively.

Practical Assessment Checklist OSCE station C1 S or N/S


MONITOR PERIPHERAL INTRAVENOUS THERAPY
Analytical Decision Making within the scenario
Links to the Enrolled Nurses competency standards 1.1, 1.2, 1.3, 1.4, 2.1, 3.5, 6.1, 6.2, 7.1, 7.2,
7.3, 8.1, 9.1, 9.2, 10.1 10.4.
Links to HTEN507C Elements 2.4, 2.5 3.4, 3.5, 4.4, 4.6, 4.7, 5.1, 5.2, 5.4, 5.5, 5.6, 5.5, 5.7, 5.8,
6.1, 6.4 required knowledge & skills
32. From the Case Study, identify to the educator two (2) reasons why Mrs
Poh Tassium continued to be managed with Intravenous Therapy post
operatively.
Patient just had an operation. IV therapy is a fast way to absorb
medication to help faster recover for fluid and electrolyte
imbalance
Patient can not take orally after operation.
33. Identify to the educator two (2) documents that would assist you in
monitoring/providing nursing care with Mrs Tassiums electrolyte
imbalance.

Pathology level chart to detect fluid retention/Fluid balance chart


4 th
January 2017 Page 17
Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
34. Identify to the educator, two (2) holistic client-centred topics that would
also contribute to nursing care considerations for the client with any fluid
and / or electrolyte imbalance, which was not collected or represented in
the case study.

Monitor input and out put


Make sure pt have enough fluid.
35. Identify to the educator, three (3) areas to check, when performing an
IV site check, how often IV cannula sites are checked and when they
should be replaced.

Any sides of vein damage or spasm: red , swelling or inflammation of


vein
Arround the skin : bruise, phlebitis areas, inflammation, redness.
Check for infection.
if any of that symptom. The cannula should replaced
IV stite need to be check often every 15 mins
36. For the identified risks/complications listed below, identify to the
educator one (1) symptom and one (1) prevention method for each.
Inaccurate flow rate

Pain, swelling , redness, cool to touch


Prevent: Regular assess IV site
Air embolism

Shortness of breath, coughing , wheezing, hypotension,


increase heart rate
Prevent: Ensure drip chamber is one third to half filled

Circulatory overload

Oedema, crackles, discomfort, increase Blood pressure, large


positive fluid balance
Prevent: Transfusion smaller volume of blood at a slower rate
37. Identify two (2) areas of education would you give to Mrs Tassium, regarding her
Intravenous cannula while it is in place.

Bedside activity: Removing an Intravenous Cannula


Links to EN Competency standards 1, 2, 3, 4, 5, 7, 8, 9, 10
Links to HTEN507C Elements 1.1, 1.4, 1.6, 1.8, 2.1, 2.2, 2.7, 2.8, 3.1,4.2,4.3, 3.4, 3.5 required
knowledge and skills
38. Demonstrate appropriate communication skills:
Introduce self to client, confirm clients identification, explain the procedure,
obtain consent, and ensure comfort, privacy and dignity throughout the
procedure and provide reassurance, as required
39. Comply with Infection control practices throughout the procedure.

40. Comply with Workplace Health & Safety practices.

41. Gather equipment.

4th January 2017 Page 18


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
PPE, sterile dressing, tape if required, receptacle for clinical waste and
pillow to support arm.

42. If required; Cease IV therapy by checking the 7 Rights of


Medication Administration three (3) times.

1) Check accuracy against documentation (med chart / allergy )


2) Check accuracy with the client (verbal name, dob, allergy)
3) Check accuracy when handling the infusion bag to be ceased.
In some situations the IVT will cease sometime before the nurse is given
the instruction to remove the cannula. Here, the nurse maintains patency
with regular saline flushes, in the event of IV access still anticipated.

43. Fully engage the roller clamp to stop infusion flow, and side clamp
closest to the point of entry.

44. (Preparation: immediately before task)


Ensure that the limb is supported, by a pillow or stable surface. (if
the IV site is bandaged, remove this)
Expose the dressing, from its packaging keeping the pad sterile
for contact with the puncture site.
Begin to peel back the adhesive that is keeping the cannula in
place. (you may use adhesive remover, for clients with compromised
skin integrity, such as the elderly)
Leave enough adhesive around the cannula, so it is still in situ.
45. (Remove the cannula: during task)
Pick up the dressing and hold it in your non-dominant hand, just
above the inserted cannula.
With you dominant hand, gently gather excess (lifted) adhesive.
As you slowly withdraw the cannula, by bringing your dominant hand
toward you, maintain a neutral angle with the skin.
Apply the dressing directly to the exposed puncture site.
The final 2 steps must be done in the same motion, to avoid blood
flow and bruising, avoid having the puncture site exposed.
At the same time avoid applying the dressing too early, or it may
adhere to the adhesive and be not usable.
Follow up and completion of task
Links to EN Competency standards 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
Links to HTEN507C Elements 2.8, 3.1, 3.2, 3.4, 3.5, 4.1, 4.2, 4.3, required knowledge and skills
46. Dispose of single use equipment, sharps hazards, clinical waste. The
student must directly place the contaminated equipment into an
appropriate vesicle to transport this from the client area.

47. Secure dressing to the site, if appropriate, encourage the client to apply
pressure and elevate limb, or assist the client to do this.

48. Client Education: explain to the client to leave the dressing in


place for 24 hours and to avoid lifting heavy items or knocking the
area.

4th January 2017 Page 19


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
49. Identify to the educator, two (2) forms of documentation that would be
used in this scenario.

Progress note and fluid balance


50. As an enrolled nurse, you are required to monitor peripheral
intravenous lines. According to the national industry codes and
legislative standards, what aspect of caring for a client requiring
intravenous treatment are you prohibited from performing within the
scope of practice for the enrolled nurse?

IV therapy
Putting cannula in
51. Verbally discuss a short reflective practice exercise where the
student can identify areas that went well and areas that can improve,
according learned theory and if required how to avoid potential or
repeated errors.

D. Skill Set Nursing Care: Enteral Medications

During this assessment there will be 2 stations with each station covering one of the following set of
skills:
1. Oral medication administration (4.1)
2. Nasogastric tube/ PEG tube medication administration (as per Reference list)

The assessment criteria is taken from the prescribed essential skills text and the reference
list provided:

Tollefson, J, Bishop, T, Jelly, E, Watson, G & Tambree, K 2012, Essential Clinical Skills
Enrolled/Division 2 Nurses, 2nd edn, Cengage Learning, Australia.

ASSESSMENT

All Scenarios are to allow demonstrations of EN skills required for safely doing a 15-20 minute drug
round in the healthcare setting depending on the skill and route of administration. The following list
of student assessment is embedded in each of the skills station:
7 Rights for medication administration
Right time
Right drug
Right route

4th January 2017 Page 20


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
Right dose
Right patient
Right documentation
Right to refuse (Tollefsons 2012, p. 107)
Safe work practice & workplace requirements
Follows correct principles of infection control
Documentation & communication requirements
Patient assessment check for allergy
Indications & contraindications of drug (and route)
Correct patient positioning

Equipment for Station:

Station Skill Equipment


Bed, mannequin, pillow, medication chart, the patients
D1 Oral ID wrist band, medication trolley, mock medications
and a pen.
Bed, mannequin with NGT/PEG in situ, 60ml syringe, a
D2 Nasogastric tube glass, medication chart, the patients ID wrist band,
medication trolley, mock medications, mortar and
pestle, non-sterile gloves and optional: bluey, towel or
tissue papers.

Instructions for OSCE Station D1

Enteral/Oral medications administration

You have up to 20 minutes to complete this assessment.

Case Study
Mr Fedyer is a 40 year old Russian born Australian man with limited understanding
of verbal and written English. He has been admitted as an inpatient following an
arthroscopy of his left knee this morning. He suffered an injury recently and tore his
anterior cruciate ligament. He returned to the ward at 1830 and has been stable,
eating and drinking a small amount.

It is 2000hrs and you have assessed his pain using the pain score below, with his
score being 5/10. You ask him to point to the location of the pain and he points to
the incision sites of his left knee. He is grimacing and does not want to move his body
at all. He is ordered Panadeine Forte, two tablets 6 hourly PRN and Ibuprofen 400
mg 6/24 PRN. He had local anaesthetic in theatre as well as intravenous Perfalgin
(Panadol) at 1800 in recovery.
4th January 2017 Page 21
Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

Practical Assessment Checklist OSCE station D1 S or N/S


Enteral/Oral medications administration
52. Verbally explain to your Educator the most appropriate way of assessing
Mr Fedyers pain and why.

53. Refer to your medication handbook or your Mims medication resource


text, to confirm which of the prescribed PRN analgesics Mr Fedyer can
have at 2000hrs. Explain why you have made this decision.

54. Explain to your educator which of the Code of Professional conduct


statements relates to your demonstration of cultural sensitivity when
assisting Mr Fedyer.
55. Verbally explain what non-medication strategies you could implement to
help alleviate Mr Fedyers pain.

56. Verbally explain how you could monitor the effectiveness of the analgesia
and comfort measures you have provided.

57. Administer Mr Fedyers prescribed oral medication effectively and safely.

58. Document the medication you have chosen in the medication chart below
and write up your pain assessment in the progress notes provided.

PROGRESS NOTES Mr Alik Fedyer

4th January 2017 Page 22


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

MEDICATION CHART - AS REQUIRED PRN MEDICATIONS

URN: 125690
Family name: Fedyer Allergies: Nil known
Given name: Alix
Date of birth: 2.4.75 Sex: M
DATE MEDICATION(PRINT DATE
GENERIC NAME)
16/4/2015 Panadeine Forte
ROUTE DOSE HOURLY MAX Time
FREQUENCY DOSE/24
oral Two (2) tablets HRS
6/24 8 tablets
INDICATION PHARMACY DOSE
Pain ROUTE
PRESCRIBER SIGNATURE - PRINT CONTACT SIGN
YOUR NAME
#4589
ALEC LEOREN
DATE MEDICATION (PRINT DATE
GENERIC NAME)
16/4/2015 Ibuprofen 400mg
ROUTE DOSE HOURLY MAX Time
FREQUENCY DOSE/24
oral Two (2) 200mg HRS
tablets 6/24 8 tablets

INDICATION PHARMACY DOSE


Pain ROUTE
PRESCRIBER SIGNATURE - PRINT CONTACT SIGN
YOUR NAME
#4589
ALEC LEOREN
DATE MEDICATION(PRINT DATE
GENERIC NAME)
16/4/2015
ROUTE DOSE HOURLY MAX Time
FREQUENCY DOSE/24
oral HRS
INDICATION PHARMACY DOSE
Pain ROUTE
PRESCRIBER SIGNATURE - PRINT CONTACT SIGN
YOUR NAME
#4589
ALEC LEOREN

4th January 2017 Page 23


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

Instructions for OSCE Station D2

Medication administration via Nasogastric tube

You have up to 20 minutes to complete this assessment.

Case Study
Mr. Allegro is a 78 year old Italian male who is admitted to the hospital with
oesophageal burns after ingesting a cleaning product that had been stored in a soft
drink bottle. He is illiterate (cannot read or write) and understands English but is
difficult to understand because of his strong and broken English. His son is a solicitor
and interprets for his father.
Mr. Allegro remains Nil By Mouth, and has a nasogastric tube is in situ for medication
administration and nutrition. He has significant chronic pain due to osteo-arthritis in
both hips. He is prescribed Panadol osteo 665mg - 2 tablets tds, for this. He has also
been prescribed Allopurinol 300mg daily for his gout. Allopurinol may be halved
and/or crushed to aid dispersion via nasogastric tube. He has also been prescribed
oral Oxycodone 10mg PRN for pain associated with his oesophageal burns.
He has received 2 doses of the Panadol osteo earlier today as the morning nurse
crushed the tablets and gave them via the nasogastric tube.
The time is currently 1600hrs.

Practical Assessment Checklist OSCE station D2 S or N/S


Medication administration via Nasogastric tube
59. Refer to your medication handbook or your Mims to confirm if the
controlled release Panadol osteo can be crushed and administered in this
way.
Not allow to crus Panadol Osteo
Less affective and greater risk of toxicity
60. Explain to your educator what Duty of Care you have to Mr Allegro
regarding administration of Mr Allegros prescribed medications via the
nasogastric tube.

Provide the best of care


Stop administer the crush medicine and report to RN
61. What procedure would you follow if you discover that Mr Allegros Panadol
osteo cannot be crushed or altered? Who would you refer this matter to?
Stop administer and report to RN

62. You note that Mr Allegro has already received a dose of Panadol osteo via
the nasogastric tube. What quality management and risk assessment
practice should be completed in this case in order to improve Public
Safety?
Correct identify administration route

4th January 2017 Page 24


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
63. Mr Allegros son states that he wants to see his fathers medication chart
and medical notes to make sure his father is receiving appropriate care.
How would you respond to his request?

Discuss with RN
Explain about error with patient son
64. What Drugs and Poisons Schedule and classification is Oxycodone?
Explain to your Educator what the legal storage, handling and
administration requirements are for this drug.

Level 8
Classification: Opioid pain= Narcotic
Storage: Kept in a separate cupboard that secured fix in the wall
Locked cupboard often with another locked cupboard
Key kept by RN

65. Administer Mr Allegros PRN Oxycodone medication effectively and safely


including documentation.

MEDICATION CHART - AS REQUIRED PRN MEDICATIONS

URN: 457812
Family name: Allegro Allergies: Penicillin
Given name: Giovanni Reaction: Rash
Date of birth: 16.2.37
Sex: M
DATE MEDICATION (PRINT GENERIC DATE
NAME)
16/4/2015 Oxycodone
R ROUTE DOSE HOURLY MAX Time
FREQUENCY DOSE/24
Naso - 10mg 6 hourly HRS
G gastric PRN 400mg
INDICATION PHARMACY DOSE
Pain ROUTE
PRESCRIBER SIGNATURE - PRINT CONTACT SIGN
YOUR NAME
#4589
ALEC LEOREN

4th January 2017 Page 25


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

E. Skill Set Nursing Care: Trans mucosal Medications

During this assessment there will be 2 stations with each station covering one of the following set of
skills.

1. Insertion of vaginal medication (Tabbners 2013, p. 459)


2. Insertion of suppositories/Rectal (4.1 or Tabbners 2013, p. 458)

The assessment criteria is taken from the prescribed essential skills text and the reference
provided -

Tollefson, J, Bishop, T, Jelly, E, Watson, G & Tambree, K 2012, Essential Clinical Skills:
Enrolled/Division 2 Nurses, 2nd edn, Cengage, Australia.
Koutoukidis, G, Stainton, K & Hughson, J 2013, Tabbners Nursing Care Theory and Practice,
6th edn, Elsevier, NSW.

ASSESSMENT

All Scenarios are to allow demonstrations of EN skills required for safely doing a 15-20 minute drug
round in the healthcare setting depending on the skill and route of administration. The following list
of student assessment is embedded in each of the skills station:
7 Rights for medication administration
Right time
Right drug
Right route
Right dose
Right patient
Right documentation
Right to refuse (Tollefsons 2012, p. 107)
Safe work practice & workplace requirements
Follows correct principles of infection control
Documentation & communication requirements
Patient assessment check for allergy
Indications & contraindications of drug (and route)
Correct patient positioning

Equipment for Station:

Station Skill Equipment


Bed, pillow, female mannequin, a
towel/sheet/blanket, applicator, mock ointment,
E1 Vaginal
non-sterile gloves, medication chart, the patients
ID band, medication trolley and a pen.

Bed, pillow, mannequin, a towel/sheet, lubricant


sachet/tube, suppositories, non-sterile gloves,
E2 Suppositories
medication chart, the patients ID band, medication
trolley and a pen.

4th January 2017 Page 26


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

Instructions for OSCE Station E1

Insertion of vaginal medication

You have up to 20 minutes to complete this assessment.

Case Study
Mrs. Smith is an 86 year old lady who is admitted to the hospital for treatment of
community acquired pneumonia. She has been prescribed oral antibiotics and
developed vaginal thrush as a result.

She is prescribed Clotrimazole 100mg pessaries, nocte, for 3 days.

The time is currently 2000 hrs on the clock.

Practical Assessment Checklist OSCE station E1 S or N/S


Insertion of vaginal medication
66. Verbally explain to your educator which of the competency standards and
scope of practice as an Enrolled Nurse you are adhering to when you
administer Mrs Smiths medications.

67. Verbally explain to your Educator what specific Legal and Ethical
considerations you need to observe when administering Mrs Smiths
medication.

68. What actions should you take to maintain Mrs Smiths dignity in this
instance?

69. Administer Mrs Smiths prescribed vaginal medication effectively and


safely, including documentation.

4th January 2017 Page 27


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

MEDICATION CHART REGULAR MEDICATIONS

URN: 125456
Family name: Smith Allergies: Nil known
Given name: Ellen
Date of birth: 24.5.29
Sex: F
YEAR 2015 DATE AND MONTH

Doctors Must Enter Administration Times


DATE MEDICATION (PRINT GENERIC NAME)

16/4/2015 Clotrimazole
Route Dose Frequency and NOW enter times 2000

PV 100mg pess Nocte


Indication Pharmacy

Candida infection

PRESCRIBER SIGNATURE - PRINT YOUR CONTACT


NAME
#4589
ALEC LEOREN

4th January 2017 Page 28


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

Instructions for OSCE Station E2

Insertion of a suppository

You have up to 20 minutes to complete this assessment.

Case Study
Mrs Johnson is a 65 year old female who is admitted to the ward following a Total
Abdominal Hysterectomy. She has been prescribed a NSAID - Diclofenac (Voltaren)
suppositories 100mg daily to aid in postoperative pain management.
The time is currently 0800 hrs on the clock.

Practical Assessment Checklist OSCE station E2 S or N/S


Insertion of a suppository
70. Verbally explain to your Educator some of the contraindications for this
medication.

71. Verbally explain to your Educator some of the adverse effects of this
medication.

72. Verbally explain to your Educator how you will position Mrs Johnson to
administer this medication and why.

73. Verbally explain to your Educator, the important client education that you
will need to give Mrs Johnson prior to the administration of this
medication.

74. Verbally explain to your Educator how the Diclofenac suppositories should
be stored.

75. Administer Mrs Johnsons prescribed suppository effectively and safely


including documentation.

4th January 2017 Page 29


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

URN: 125456
Family name: Johnson Allergies: Nil known
Given name: Elizabeth
Date of birth: 20.7.50
Sex: F
YEAR 2015 DATE AND MONTH

Doctors Must Enter Administration Times

DATE MEDICATION (PRINT GENERIC NAME)

16/4/2015 Diclofenac
Route Dose Frequency and NOW enter times 0800

PR 100mg supp Daily

Indication Pharmacy

Pain

PRESCRIBER SIGNATURE - PRINT CONTACT


YOUR NAME
#4589
ALEC LEOREN

4th January 2017 Page 30


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

F. Skill Set Nursing Care: Topical Medications

During this assessment there will be 1 station with each station covering one of the following set of
skills.

1. Transdermal, eye & ear (4.2 or Tabbners 2013, pp. 453, 455-457)

ASSESSMENT

All Scenarios are to allow demonstrations of EN skills required for safely doing a 15-20 minute drug
round in the healthcare setting depending on the skill and route of administration. The following list
of student assessment is embedded in each of the skills station:
7 Rights for medication administration
Right time
Right drug
Right route
Right dose
Right patient
Right documentation
Right to refuse (Tollefsons 2012, p. 107)
Safe work practice & workplace requirements
Follows correct principles of infection control
Documentation & communication requirements
Patient assessment check for allergy
Indications & contraindications of drug (and route)
Correct patient positioning

The assessment criteria is taken from the prescribed essential skills text

Tollefson, J, Bishop, T, Jelly, E, Watson, G & Tambree, K 2012, Essential Clinical Skills:
Enrolled/Division 2 Nurses, 2nd edn, Cengage, Australia.
Koutoukidis, G, Stainton K & Hughson, J 2013, Tabbners Nursing Care Theory and Practice,
6th edn, Elsevier, NSW.

Equipment for Station:

Station Skill Equipment

Bed, mannequin, pillow, mock eye & ear drops,


transdermal patches such as GTN patch, the
F1 Transdermal, eye & ear
patients ID wrist band, medication chart,
medication trolley and a pen.

4th January 2017 Page 31


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

Instructions for OSCE Station F1

Administer transdermal, eye & ear medications

You have up to 20 minutes to complete this assessment.

Case Study
Mr. Jones is a 65 year old male who has been admitted to the ward following a
surgical procedure 2 days ago. He has a history of glaucoma and has been prescribed
Pilocarpine eye drops 2 drops twice a day. He has recently developed otitis externa
in his left ear and is currently on Soframycin ear drops 3 drops three times a day.

His medical history also includes angina associated with congestive heart failure and
peripheral vascular disease. His is on prophylactic Glyceryl Trinitrate 10mg daily via
a transdermal patch.

The time is currently 0750 hrs on the clock.

Practical Assessment Checklist OSCE station F1 S or N/S


Administer transdermal, eye & ear medications
76. Explain verbally to your educator what the specific indications actions are
for each of the medications that you will administer to Mr Jones.

77. Verbally explain to your Educator three important nursing considerations


regarding the correct use and administration of Gyceryl Trinitrate
transdermal patches.

78. Verbally explain to your Educator what specific infection control practices
you need to observe regarding administering Mr Jones eye and ear drops.

79. Verbally explain to your Educator, how and why you would position and
handling Mr. Jones when administering ear drops.

80. Administer Mr Jones prescribed eye, ear and transdermal patch


medication effectively and safely including documentation.

4th January 2017 Page 32


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

URN: 125223
Family name: Jones Allergies: Morphine
Given name: Robert Reaction: Rash, vomiting, pruritis
Date of birth: 20.7.50
Sex: M
YEAR 2015 DATE AND MONTH

Doctors Must Enter Administration Times


DATE MEDICATION (PRINT GENERIC NAME)

16/4/2015 Pilocarpine
Route Dose Frequency and NOW enter times 0800

Topical 10mg/mL 2 drops to both eyes bd

Indication Pharmacy

Glaucoma 2000

PRESCRIBER SIGNATURE - PRINT YOUR CONTACT


NAME
#4589
ALEC LEOREN

URN: 125223
Family name: Jones Allergies: Morphine
Given name: Robert Reaction: Rash, vomiting, pruritis
Date of birth: 20.7.50
Sex: M
YEAR 2015 DATE AND MONTH

Doctors Must Enter Administration Times


DATE MEDICATION (PRINT GENERIC NAME)

16/4/2015 Soframycin
Route Dose Frequency and NOW enter times 0800

Topical 5mg/ml 3 drops to left ear tds

Indication Pharmacy 1400

Otitis externa

2200

PRESCRIBER SIGNATURE - PRINT YOUR NAME CONTACT

ALEC LEOREN #4589

4th January 2017 Page 33


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment

URN: 125223
Family name: Jones Allergies: Morphine
Given name: Robert Reaction: Rash, vomiting, pruritis
Date of birth: 20.7.50
Sex: M
YEAR 2015 DATE AND MONTH

Doctors Must Enter Administration Times

DATE MEDICATION (PRINT GENERIC NAME)

16/4/2015 Gyceryl Trinitrate


Route Dose Frequency and NOW enter times Apply
0800
Transdermal 10mg Daily

Indication Pharmacy Remove


2000
Angina

PRESCRIBER SIGNATURE - PRINT YOUR CONTACT


NAME
#4589
ALEC LEOREN

4th January 2017 Page 34


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
G. Skill Set Nursing Care: Respiratory Medications

During this assessment there will be 2 stations with each station covering one of the following set of
skills:

1. Inhaler/MDI (Tollefsons 6.3 p. 170) and (Tabbners 2013, p. 460)


2. Nebuliser (Tollefsons 6.3 p. 170) and (Tabbners 2013, p. 460)

ASSESSMENT

All Scenarios are to allow demonstrations of EN skills required for safely doing a 15-20 minute drug
round in the healthcare setting depending on the skill and route of administration. The following list
of student assessment is embedded in each of the skills station:
7 Rights for medication administration
Right time
Right drug
Right route
Right dose
Right patient
Right documentation
Right to refuse (Tollefsons 2012, p. 107)
Safe work practice & workplace requirements
Follows correct principles of infection control
Documentation & communication requirements
Patient assessment check for allergy
Indications & contraindications of drug (and route)
Correct patient positioning

The assessment criteria is taken from the prescribed essential skills text

Tollefson, J, Bishop, T, Jelly, E, Watson, G & Tambree, K 2012, Essential Clinical Skills:
Enrolled/Division 2 Nurses, 2nd edn, Cengage, Australia.
Koutoukidis, G, Stainton, K & Hughson, J 2013, Tabbners Nursing Care Theory and Practice,
6th edn, Elsevier, NSW.

Equipment for Station:

Station Skill Equipment

Bed, mannequin, pillow, inhaler/MDI (use of


G1 Inhaler /MDI (preventer) spacer is an optional), the patients ID wrist band,
medication chart, medication trolley and a pen

Bed, mannequin, pillow, nebuliser solution,


nebuliser face mask, oxygen tubing, flow meter
G2 Nebuliser (reliever) (air) or nebuliser machine, assembles for
nebuliser, medication chart, medication trolley and
a pen

4th January 2017 Page 35


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
Instructions for OSCE Station G1

Administering inhaler medications

You have up to 20 minutes to complete this assessment.

Case Study
Mrs. Ross is a 68 year old female who has been admitted to the hospital after an
exacerbation of asthma. Her medical history includes asthma, COPD and GORD. Mrs
Ross has been prescribed Flixotide 500mcg 2 puffs twice a day via Metred dose
inhaler and Salbutamol 200mcg 2 puffs 6th hourly.

The time is currently 0800 hrs on the clock.

Practical Assessment Checklist OSCE station G1 S or N/S


Administering inhaler medications
81. Verbally explain to your Educator the indications for Flixotide and
Salbutamol.

82. Verbally explain to your Educator the education you will need to give Mrs
Ross prior to administering the medication.

83. Administer Mrs Ross prescribed medication effectively and safely


including documentation.

4th January 2017 Page 36


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
URN: 125223
Family name: Ross Allergies: Nil known
Given name: Shirley
Date of birth: 24.1.47
Sex: F
YEAR 2015 DATE AND MONTH

Doctors Must Enter Administration Times

DATE MEDICATION(PRINT GENERIC NAME)

16/4/2015 Flixotide
Route Dose Frequency and NOW enter times 0800

MDI 500mcg 2 puffs bd

Indication Pharmacy

Asthma

2000

PRESCRIBER SIGNATURE - PRINT YOUR CONTACT


NAME
#4589
ALEC LEOREN

URN: 125223
Family name: Ross Allergies: Nil known
Given name: Shirley
Date of birth: 24.1.47
Sex: F
YEAR 2015 DATE AND MONTH

Doctors Must Enter Administration Times

DATE MEDICATION 0600


(PRINT GENERIC NAME)
16/4/2015
Salbutamol
Route Dose Frequency and NOW enter times 1200

MDI 200mcg 2 puffs qid

Indication Pharmacy 1800

Asthma 2200

PRESCRIBER SIGNATURE - PRINT YOUR CONTACT


NAME
#4589
ALEC LEOREN

4th January 2017 Page 37


Student
Practical Assessment - OSCE
HLTEN507C Administer and monitor medications in the work environment
Instructions for OSCE Station G2

Administering a nebuliser

You have up to 20 minutes to complete this assessment.

Case Study
Mrs Brown is a 52 year old female who has been admitted to the hospital after an
exacerbation of asthma. She has returned to her bed from a physiotherapy session
and complains of shortness of breath. SpO2 is 92 % on room air and she has an
audible expiratory wheeze. She has been prescribed Salbutamol 5mg 4hourly via a
nebuliser.
The time is currently 1000 hrs on the clock.
Practical Assessment Checklist OSCE station G2 S or N/S
Administering a nebuliser
84. Verbally explain to your Educator what position you would place Mrs Jones
in to administer the nebulised Salbutamol and why.

85. Verbally explain to your Educator the side effects of Salbutamol that you
need to make Mrs Brown aware of prior to administration of medication.

86. Verbally explain what precautions you need to consider when


administering Salbutamol via a nebuliser.

87. Administer the prescribed respiratory medication with the nebuliser safely
and effectively, including documentation.

URN: 125557
Family name: Brown Allergies: Nil known
Given name: Angela
Date of birth: 14.7.63
Sex: F
YEAR 2015 DATE AND MONTH

Doctors Must Enter Administration Times


DATE MEDICATION(PRINT GENERIC NAME) 0200

16/4/2015 Salbutamol
Route Dose Frequency and NOW enter times 0600

NEB 5mg 4 hrly


Indication Pharmacy 1000

Asthma 1400

1800

PRESCRIBER SIGNATURE - PRINT YOUR CONTACT 2200


NAME
#4589
ALEC LEOREN

4th January 2017 Page 38

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