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Improving the quality of nursing appraisal to meet revalidation

Dr Carolyn Middleton Project Manager at Aneurin Bevan University Health Board spoke at today’s Nursing Appraisal and Revalidation conference on:  

• how do you quality assure the nursing appraisal process?  
• how can you monitor nursing development through appraisal
• should there be a performance element of nursing appraisal or should performance management be a separate process?  
• ensuring all nurses are engaged in effective appraisal
• top tips for nurse managers in delivering appraisal  
• looking forward to revalidation: developing as a pilot site

In her presentation Dr Middleton made the following suggestions to support the appraisal and revalidation process; 

Important to work with trade unions. They have a role to play so that all of our registrants are getting the right help and support

Have the right tools, the NMC have a lot of tools on their website, we have developed a lot of tools locally which the NMC are interested in seeing. We have developed a DVD, which registrants may find useful

CPD hours have been moved back from 40 hours to 35 hours within a 3 year period

The NMC code is important to every aspect of Revalidation

There are 850,000 nurses and midwives so possibly 850,000 different reflections. you have to use the NMC template for recording them

Bring up reflection and CPD as part of annual review so then prepared for Revalidation 

Dr Middleton’s PowerPoint presentation is available for download at the end of this page. 

Abstract of Dr Middleton’s presentation 

Revalidation, Demonstrating Compliance with the Code
Welsh Pilot Site Experience

Background: The purpose of revalidation is to improve public and patient protection and this is to be achieved by ensuring that registrants continue to update and therefore remain fit to practise throughout their entire career. 

ABUHB experience as a pilot site: ABUHB was the only Welsh pilot site and the largest UK pilot participant employing over 4000 registrants, 1000 who were eligible for the pilot. 888 registrants enrolled and 813 completed the entire revalidation process accounting for >38% of the entire UK pilot.  There were registrants from all areas including general adult medical and surgical areas, paediatrics (hospital and community), midwives, registrants from learning disabilities and mental health and practice nurses. 

Quality is subjective and can be difficult to measure. However it can be defined through the development of reliable and realistic expectations.  It can be measured through performance against expected standards and can be improved through problem solving and process redesign. Quality can be assured through organisational structure, clear roles and responsibilities and organisational processes. It can also be assured through standards, rules and guidelines being in place, with tested methods, techniques and tools. Quality assurance is a key part of the appraisal process, which includes all aspects of the revalidation process, specifically the continued professional development, reflection on practice and reflection and also the professional development discussion, and confirmation processes.

Professional development discussion (PDD) is the most significant part of the process, it is a means of assessing knowledge and understanding of the learning undertaken, the impact the learning has had on the registrants practice a on the delivery of care and finally how it relates to the code. The PDD helps to bridge the theory – practice gap.

Aligning revalidation and appraisal: annual appraisal can measure progress against the triennial review, helping plan updating activities on an annual basis working toward the triennial revalidation date. 

Top tips for managers in delivering appraisal: Keep it simple / person focused / remember that organisational culture is important, the way we think, act and interact. 

Key learning
Improving the quality of nursing appraisal to meet revalidation

1.    Quality assurance requires defining quality / measuring quality and therefore improving quality. 

2.    Quality is determined by organisational structure / roles and responsibilities / organisational processes / standards / rules / guidelines / methods / techniques and tools.

3.    Monitoring nursing development can be achieved through aligning revalidation and annual review. 

4.    The professional development discussion is a means of assessing knowledge / the impact learning has had on practice and how the learning relates to the code. It helps bridge the theory practice gap.

5.    It is important to engage all staff to make appraisal effective.

6.    The top tips for nurse managers in delivering appraisal are: Keep it simple / keep it person focused / ensure the organisational culture is important, the way we think, act and interact.

Further information: 
    Middleton, C., Ryley, N., Llewellyn, D. (2015) Revalidation: A University Health Board’s learning from pilot partner engagement. Nursing Management. 26: 22 (5) 24-30. 
    Middleton, C., Ryley, N., Llewellyn, D. (2015) Revalidation: Implications for Senior Nurses. Nursing Management. Accepted for publication.

Dr. Carolyn (Lyn) Middleton joined the Corporate Nursing Team at ABUHB to lead on the revalidation pilot project with 813 registrants successfully completing the process, accounting for over 38% of the entire UK revalidation pilot cohort.  Dr. Middleton has published the UHBs experiences of revalidation and has been invited to speak about her experiences at a number of UK conferences. 

Lyn is an active member of the working party implementing the Advanced Practice Framework  within the UHB and has co-authored a poster on the implementation of the framework, accepted for the 43rd International Biennial Sigma Theta Tau conference to be held in the USA in November 2015.

Lyn has 36 years of surgical nursing experience and continues to work clinically as a non-medical prescriber, leading the ABUHB pain management nursing team. Lyn chairs the ABUHB non-medical prescribing group, sits on the all Wales Medicines Administration working party, is an a HB representative on the Royal College of Anaesthetists pain sub-group and is an officer in the Welsh Pain Society. 

Lyn sits on the UHB’s research risk committee. Her Doctoral studies focused on recognizing opioid tolerance in chronic pain patients and she was awarded the RCN Wales Research in Nursing award 2013 and the British Journal of Nursing Innovation award in 2011 for her research work. She has published widely including the Journal of Advanced Nursing and the Journal of Nursing Management and also co-authored and edited a pain management textbook published by John Wiley.

Future related events:

Masterclass: Nursing Revalidation
Tuesday 24 November 
Hallam Conference Centre, London

Nursing Revalidation for Specialist Practice and Advanced Roles
Wednesday 2 December 
ICO Conference Centre, London

Nursing Appraisal and Revalidation & implementing the New NMC Code of Practice
Wednesday 20 January 
ICO Conference Centre, London

Nursing Revalidation Preparing for Going Live
Tuesday 2 February 
Thestudio Conference Centre, Birmingham

Midwife Appraisal and Revalidation
Tuesday 9 February 
Hallam Conference Centre, London

Download: Dr Carolyn Middleton full presentation

19 October 2015


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