Test of Competence

Test of competence
Part 1
Nursing test
blueprint
Page 1
- Generic Nursing Domains

o Domain 1: Professional values
o Domain 2: Communication and interpersonal skills
o Domain 3: Nursing practice and decision-making
o Domain 4: Leadership, management and team working
- Field Specific competencies
o Adult Nursing
o Mental Health Nursing
o Learning Disabilities Nursing
o Children's Nursing
Test of competence blueprint: Part one - nursing

Domain 1: Professional values
Competency
Point of entry: Essential knowledge, understanding and skill application required

Essential skills cluster number and point
Articulates the underpinning values of the code, (NMC.2008). Care, Compassion and
Competency 1. All nurses must
practise with confidence according Communication (CCC)1 ,1.
to The code: Standards of conduct,
performance and ethics for nurses
and midwives (NMC,2008), and
within other recognised ethical and
legal frameworks. They must be
able to recognise and address
ethical challenges relating to
people's choices and decisionmaking about their care, and act
within the law to help them and
their families and carers find
acceptable solutions.
Generic Multichoice Exam: (E*

= Critical item
when related to
patient and
public safety and
if tested in MCQ
must be passed)
(50Qs)
Suitable items for

Multi-choice Exam:
Generic applied to
nursing field
Suitable items for testing within
specific (E* =
OSCE's E* = Critical item when
Critical item when
related to patient or public safety and
related to patient
if tested in scenario/skill must be
and public safety
passed
and if tested in
MCQ must be
passed) (50Qs).
Below are some useful on-line links which can

be used to support preparation for the NMC's
Test of Competence. These on-line links are
not exhaustive, and many other useful sources
will exist, the links are designed to help
candidates identify gaps as they explore each
domain and competence. Candidates should
consider the need for revision and
consolidation of knowledge before taking the
test of competence.
http://www.nmc-uk.org/Publications/Standards/
http://www.rcn.org.uk/development/practice/princip
les/
Adopts a principled approach to care underpinned by the code,( NMC,2008) CCC4, 3.
Y
http://www.nhs.uk/CarersDirect/moneyandlegal/leg
al/Pages/MentalCapacityAct.aspx
http://www.equalityhumanrights.com/yourrights/human-rights/what-are-human-rights/humanrights-act
http://www.advancedpractice.scot.nhs.uk/legaland-ethics-guidance.aspx
http://www.rcn.org.uk/development/learning/transc
ultural_health/transcultural
http://www.euromedinfo.eu/a-model-of-care-forcultural-competence.html/
http://rcnpublishing.com/page/ns/students/reflectiv
e-practice/developing-reflective-practice
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-in-practice/Regulation-inPractice-Topics/Confidentiality/
Upholds peoples legal rights and speaks out when these are at risk of being compromised
CCC4,4.
Is acceptant of differing cultural traditions, beliefs, UK legal frameworks and professional

ethics when planning care with people and their families and their carers CCC4, 5.
Y
Through reflection and evaluation demonstrates commitment to personal and professional

development and lifelong learning CCC5,13.
Acts professionally and autonomously in situations where there may be limits to

confidentiality, for example, public interest and protection from harm CCC7,5.
Works within legal frameworks for data protection including access to and storage of records
CCC7,8.
http://ico.org.uk/for_organisations/data_protection/t
he_guide/the_principles
Works within legal frameworks when seeking consent CCC8, 5.

Assesses and responds to the needs and wishes of carers and relatives in relation to
information and consent. CCC8,6
Shares information safely with colleagues and across agency boundaries for the protection of
individuals and the public. OAC11, 6.
Works within ethical and legal frameworks and local policies to deal with complaints and
concerns. OAC12,9.
Challenges the practice of self and others across the multi-professional team OAC 14, 7
Works within the requirements of the code (NMC, 2008) in delegating care and when care is
delegated to them. OAC15, 2.
Recognises and addresses deficits in knowledge and skill in self and others and takes
appropriate action OAC15,5.
http://www.nhs.uk/conditions/consent-totreatment/Pages/Introduction.aspx
http://www.mind.org.uk/information-support/legalrights/mental-capacity-act-2005/
http://www.wales.nhs.uk/sites3/page.cfm?orgid=46
5&pid=11930.
http://www.advancedpractice.scot.nhs.uk/legaland-ethics-guidance/consent/defininghttp://www.rcn.org.uk/development/research_and_
innovation/rs/publications_and_position_statement
s/informed_consent
http://www.cqc.org.uk/search/site/documents/com
plaints?location=&sort=default&distance=15&mod
e=html
http://www.cqc.org.uk/sites/default/files/documents
/20140210_6642_cqc_how_to_complain_leaflet_fi
nal_web.pdf
http://www.rcn.org.uk/development/health_care_s
upport_workers/professional_issues/
Takes decisions and is able to answer for these decisions when required OAC 16,2
Y
Appropriately reports concerns regarding staffing and skill-mix and acts to resolve issues that
may impact on the safety of service users within local policy frameworks OAC 17,9.
https://www.evidence.nhs.uk/search?q=delegation
%20in%20nursing
http://www.nmc-uk.org/Publications/Guidance/
Works within legal and ethical frameworks that support promoting safety and positive risk
taking. OAC18, 13.
Y
Applies research based evidence to practice OAC 9,14

E
Works within the limitations of the role and recognises own level of comptence.CCC1, 2
Applies legislation that relates to the management of specific infection risk at a local and
national level. Infection Preventions and Control (IPC), 22,8.
Y
Assists people to make safe and informed choices about their medicines. MM.40,5.
Applies legislation to practice in safe and effective ordering, receiving, storing, administering
and disposal of drugs, including controlled drugs in both primary and secondary care settings
and ensures others do the same Medicine Management (MM), 34,4.
E
http://www.nmc-uk.org/Publications/Standards/Thecode/Provide-a-high-standard-of-practice-and-careat-all-times-/
http://www.rcn.org.uk/development/practice/clinical
_governance/quality_and_safety
http://www.wales.nhs.uk/sites3/documents/739/rcn
%20infection%20control.doc.pdf
http://www.evidence.nhs.uk/search?q=legislation%
20for%20infection%20control
http://www.rcn.org.uk/development/practice/infecti
on_control
https://www.evidence.nhs.uk/topic/infection-control
http://www.mhra.gov.uk/Howweregulate/Medicines
/Overviewofmedicineslegislationandguidance/Proj
ecttoconsolidateandreviewUKmedicineslegislation/
index.htm
http://www.mhra.gov.uk/ConferencesLearningCent
re/LearningCentre/Medicineslearningmodules/inde
x.htm
Assesses the persons ability to safely self-administer their medicines.MM 40,4
http://www.legislation.gov.uk/ukpga/1971/38/conte
nts
http://www.cpa.org.uk/information/reviews/Managi
ng_and_Administering_Medication_in_Care_Hom
es.pdf
Gives clear instructions and explanation and checks that a person understands the use of
medicines and treatment options MM40,3.
Fully understands all methods of supplying medicines, for example Medicines Act
exemptions, patient group directions(PGDs), clinical management plans and other forms of
prescribing MM,34,6
Is sensitive and empowers people to meet their own needs and make choices and considers
Competency 2 All nurses must
with the person and their carer(s) their capability to care. CCC2, 8.
practice in a holistic, nonjudgemental, caring and sensitive
manner that avoids assumptions,
supports social inclusion;
recognises and respects individual
choice; and acknowledges
diversity. Where necessary, they
must challenge inequality,
discrimination and exclusion from
access to care
Ensures access to independent advocacy.CCC2, 9.
Acts autonomously and proactively in promoting care environments that are culturally
sensitive and free from discrimination, harassment and exploitation. CCC,4,6
Makes effective referrals to safeguard and protect children and adults requiring support and
protection. OAC11,7.
http://www.nice.org.uk/nicemedia/live/11766/4304
2/43042.pdf http://www.nmc-uk.org/Nurses-andmidwives/Regulation-in-practice/Regulation-inPractice-Topics/Patient-Group-Directions-PGDs/
http://www.cpa.org.uk/information/reviews/Managi
ng_and_Administering_Medication_in_Care_Hom
es.pdf
http://www.nice.org.uk/Search?area=NICE.Search
&q=self+administration+of+medicines
http://www.nmc-uk.org/publications/standards
http://www.nmc-uk.org/publications/guidance
http://www.nhslothian.scot.nhs.uk/HealthInformatio
n/Advocacy/Pages/default.aspx
http://www.kingsfund.org.uk/blog/2012/10/developi
ng-culture-compassionate-care
http://www.culturediversity.org/index.html
http://www.nmc-uk.org/Documents/Standards/
http://www.rcn.org.uk/development/practice/social
_inclusion
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-in-practice/SafeguardingNew/
http://www.rcn.org.uk/development/practice/safegu
arding
http://www.nhs.uk/CarersDirect/guide/vulnerablepeople/Pages/vulnerable-adults.aspx
http://www.nmc-uk.org/Publications/Supportinginformation/
http://www.cqc.org.uk/public/what-arestandards/safeguarding-people
https://www.gov.uk/childrensservices/safeguarding-children
Supports people in asserting their human rights. OAC,11,9
Challenges practices which do not safeguard those in need of support and protection.
OAC,11,10
http://www.nmc-uk.org/Documents/Standards/f
http://www.equalityhumanrights.com/humanrights/what-are-human-rights/the-human-rightsact/
http://www.equalityhumanrights.com/humanrights/human-rights-practical-guidance/areahealth/
http://www.rcn.org.uk/__data/assets/pdf_file/0007/
157723/003208.pdf
http://www.cqc.org.uk/_db/_documents/restraint%
5B1%5D.pdf
Acts with dignity and respect to ensure that people who are unable to meet their activities of
living have choices about how these are met and feel empowered to do as much as possible
support and promote the health,
for themselves.CCC,2,12
wellbeing, rights and dignity of
people, groups, communities and
populations. These include people
whose lives are affected by ill
health, disability, ageing, death and
dying. Nurses must understand
how these activities influence
public health.
http://www.rcn.org.uk/development/practice/dignity
Is proactive in promoting and maintaining dignity.CCC3, 5.

E
Acts autonomously to challenges situations or others when someone's dignity may be

compromised. CCC,3,6
Works within the context of a multi-professional team and works collaboratively with other
agencies when needed to enhance the care of people, communities and populations.
OAC9,15.
http://www.nmcuk.org/Documents/Safeguarding/England/1/Dignity
%20Ward.pdf http://www.nmcuk.org/Publications/Information-for-the-public/
http://www.rcn.org.uk/development/practice/spiritu
ality
%20Ward.pdf http://www.nmc-uk.org/Nurses-andmidwives/Raising-and-escalating-concerns/
http://www.who.int/patientsafety/education/en/
Promotes health and well-being, self care and independence by teaching and empowering
people and carers to make choices in coping with the effects of treatment and the ongoing
nature and likely consequences of a condition including death and dying. OAC 9,16
Discusses sensitive issues in relation to public health and provide appropriate advice and
guidance to individuals, communities and populations for example, contraception, substance
misuse, smoking, obesity.OAC,9,18
https://www.gov.uk/government/uploads/system/u
ploads/attachment_data/file/212450/Liverpool_Car
e_Pathway.pdf http://www.who.int/cancer/en/
https://www.gov.uk/government/topics/publichealth
https://www.gov.uk/government/organisations/publ
ic-health-england
www.publichealthwales.wales.nhs.uk/
http://www.healthscotland.com/resources/network
s/scotphn/about.aspx
http://www.publichealth.hscni.net/
http://www.rcn.org.uk/development/practice/public
_health
Works within a public health framework to assess needs and plan care for individuals,
communities and populations.OAC9, 22.
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-in-practice/Specialistcommunity-public-health-nursing/
http://www.rcn.org.uk/development/practice/public
_health
http://www.scotland.gov.uk/Publications/2011/01/1
1133654/5
http://www.wales.nhs.uk/sitesplus/888/home
http://www.publichealth.hscni.net/directoratenursing-and-allied-health-professions/nursing
http://www.who.int/topics/health_promotion/en/
with the person and their carer(s) their capability to care. CCC2, 8.
Y
http://www.nmc-uk.org/patients-public/Olderpeople-and-their-carers/Care-and-respect-everytime-new-guidance-for-the-care-of-older-people/
Actively helps people to identify and use their strengths to achieves their goals and
aspirations. CCC2,14
work in partnership with service
users, carers, families, groups,
communities and organisations.
They must manage risk, and
promote health and wellbeing while
aiming to empower choices that
promote self -care and safety.
www.nmc-uk.org/Nurses-and-midwives/Regulationin-practice/Regulation-in-Practice
y
Uses appropriate strategies to empower and support their choice. CC3,7.
http://www.nmc-uk.org/publications/guidance
Recognises situations and acts appropriately when a person's choice may compromise their
safety or the safety of others. CCC2,10.
Uses strategies to manage situations where a person's wishes conflict with nursing
interventions necessary for the person's safety. CCC,2, 11
Works autonomously, confidently and in partnership with people, their families and carers to
actively empower people to be involved in their care planning and delivery including strategies
for self care and peer support. CCC2,13.
Assesses and implements measures to manage, reduce or remove risk that could be
detrimental to people, self and others. OAC18,11.
Works within legal and ethical frameworks to promote safety and positive risk taking.
OAC18,13.
Takes steps not to cross professional boundaries and put self or colleagues at risk.
OAC18,15.
Explains risks to people, relatives, carers and colleagues and educates them in prevention
and control of infection. IPC21,10.
Adheres to infection prevention and control policies and procedures at all times and ensures
that colleagues work according to good practice guidelines. IPC22,9.
Acts as a role model to others and ensure colleagues work within local policy IPC24,4
http://www.nhs.uk/conditions/consent-totreatment/Pages/Introduction.aspx
http://www.mind.org.uk/information-support/legalrights/mental-capacity-act-2005/
http://www.ageuk.org.uk/health-wellbeing/yourhealthcare-rights/
Acts appropriately in sharing information to enable and enhance care (carers, MDT and
across agency boundaries). CCC7, 7.
Y
http://www.dhsspsni.gov.uk/index/hss/governance.
htm http://www.nmc-uk.org/publications/
http://www.knowledge.scot.nhs.uk/ig.aspx
http://www.connectingforhealth.nhs.uk/systemsan
dservices/infogov/codes
http://www.england.nhs.uk/ourwork/tsd/ig/
http://www.wales.nhs.uk/nwis/page/52618
http://www.hse.gov.uk/healthservices/sensible-riskassessment-care-settings.htm
http://www.scie.org.uk/publications/adultsafeguardi
nglondon/riskassessment/
http://www.nrls.npsa.nhs.uk/resources/patientsafety-topics/
http://www.rcn.org.uk/development/practice/clinical
_governance http://www.nmc-uk.org/Nurses-andmidwives/Regulation-in-practice/Regulation-inPractice-Topics/consent/
http://www.nrls.npsa.nhs.uk/resources/patientsafety-topics/
http://www.nrls.npsa.nhs.uk/ http://www.nmcuk.org/Nurses-and-midwives/Regulation-inpractice/Regulation-in-Practice-Topics/consent/
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-in-practice/Regulation-inPractice-Topics/Advice-for-nurses-and-midwivesworking-with-young-people/ http://www.nmcuk.org/Nurses-and-midwives/Regulation-inpractice/Regulation-in-Practice-Topics/MaintainingBoundaries-/
on_control/resources
http://www.who.int/topics/infection_control/en/
Able to communicate potential risks to others and advise people on their device, site or
wound to prevent and control infection and to promote healing. IPC25, 5.
Takes effective role within a team adopting the leadership role when appropriate. OAC14, 8.
fully understand the nurse's various
role, responsibilities and functions,
and adapt their practice to meet the
changing needs of people, groups
communities and populations.
les/principle_h
Y
Prioritise own workload and manages competing and conflicting priorities. OAC17,8.
Y
Acts appropriately in sharing information to enable and enhance care (carers, MDT and
across agency boundaries). CCC,7,7
Seeks specialist advice as required in order to formulate an appropriate care plan. NFM28,6.
Competency 6All nurses must
understand the roles and
responsibilities of other health and
social care professionals, and seek
to work with them collaboratively
for the benefit of all who need care.
les/principle_h
http://www.knowledge.scot.nhs.uk/ig.aspx
http://www.connectingforhealth.nhs.uk/systemsan
dservices/infogov/codes
http://www.england.nhs.uk/ourwork/tsd/ig/
http://www.wales.nhs.uk/nwis/page/52618
http://www.nrls.npsa.nhs.uk/resources/patientsafety-topics/consent-communicationconfidentiality/
les/principle_g
http://www.rcn.org.uk/development/practice/nutritio
n
Discusses progress and changes in condition with the person, carers and multi- disciplinary
team NFM28,9
Y
Works collaboratively with the person their carers and the multi-disciplinary team to ensure
and adequate fluid intake and output. NFM.29.7
Actively consults and explores solutions and ideas with others to enhance care. OAC14, 6.
y
Y
Values others' roles and responsibilities within the team and interacts appropriately OAC,14,3
Works interprofessionally and autonomously as a means of achieving optimum outcomes for

people. OAC,14,10
%20Ward.pdf
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-in-practice/Regulation-inPractice-Topics/Scope-of-practice-/

development and life long learning.CCC5, 13.
Y
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-in-practice/Regulation-inPractice-Topics/
Competency 7 All nurses must be Uses supervision and other forms of reflective learning to make effective use of feedback.
OAC12, 3.
responsible and accountable for
keeping their knowledge and skills
up to date through continuing
professional development. They
must aim to improve their
performance and enhance the
safety and quality of care through
evaluation, supervision and
appraisal.
Is self-aware and self confident, knows own limitations and is able to take appropriate action.
practice independently, recognising CCC1, 9.
the limits of their competence and
knowledge. They must reflect on
these limits and seek advice from,
or refer to other professionals
where necessary.
Applies research based evidence to practice.OAC9,14.

appreciate the value of evidence in
practice, be able to understand and
appraise research findings to their
work, and identify areas for further
investigation.
Questions, critically appraises, takes into account ethical considerations and the preferences
of the person receiving care and uses evidence to support and argument in determining when
medicines may or may not be an appropriate choice of treatment. MM.35,10
http://www.nmc-uk.org/Nurses-andmidwives/Revalidation/Revalidationprofessionalism-and-the-Code/
les/principle_f
Y
Y
https://www.rcn.org.uk/__data/assets/pdf_file/0005
/422276/RCN__Nursing_Research_In_Scotland.pdf
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-in-practice/Medicinesmanagement-and-prescribing/
http://www.nrls.npsa.nhs.uk/resources/patientsafety-topics/risk-assessment-management/
http://www.nice.org.uk/guidance/CG76
Domain 2: Communication and interpersonal skills
Competency
Point of entry: Essential knowledge, understanding and skill

application required Essential skills cluster number and point
Suitable items
for Multi-choice Suitable items
Generic MultiExam: Generic
for testing
choice Exam:
applied to
within OSCE's
(E* = Critical
nursing field
E* = Critical
item when
specific (E* =
item when
related to
Critical item
related to
patient and
when related to
patient or
public safety
patient and
public safety
and if tested in
public safety and if tested in
MCQ must be
and if tested in scenario/skill
passed)
MCQ must be
must be
(50Qs)
passed) (50Qs).
passed
Below are some useful on-line links which can

be used to support preparation for the NMC's
Test of Competence. These on-line links are
not exhaustive, and many other useful sources
will exist, the links are designed to help
candidates identify gaps as they explore each
domain and competence. Candidates should
consolidation of knowledge before taking the
test of competence.
les http://www.nmc-uk.org/Nurses-andmidwives/Standards-and-guidance1/
1
Competency 1. All nurses must Has insight into own values and how these may impact on interaction with
others. CCC5,10.
build partnerships and
therapeutic relationships through
safe, effective and nondiscriminatory communication.
They must take account of
individual differences, capabilities
and needs.
Works with people and carers to provide clear and accurate information
MM40,2.
Recognises and acts to overcome barriers in developing effective
relationships with service uses and carers. CCC1, 12.
Acts autonomously to reduce and challenge barriers to effective

communication and understanding. CCC6,10.
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-in-practice/Regulation-inPractice-Topics/Maintaining-Boundaries-/
http://www.rcn.org.uk/development/professional_st
andards
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-in-practice/Medicinesmanagement-and-prescribing/
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-in-practice/Regulation-inPractice-Topics/Advice-for-nurses-and-midwivesworking-with-young-people/ http://www.nmc-
http://www.nmc-uk.org/Documents/NMCPublications/NMC-Guidance-for-the-care-of-olderpeople.pdf
Competency 2. All nurses must Engages with people in the planning and provision of care which
recognises the importance of personal needs and providing both practical
use a range of communication
skills and technologies to support and emotional support.CCC5, 9.
person-centred care and enhance
quality and safety. They must
ensure people receive all the
information they need in a
language and manner that allows
them to make informed choices
and share decision making. They
must recognise when language
interpretation or other
communication support is needed
and know how to obtain it.
Listens to, watches for and responds to verbal and non verbal cues.
CCC5,8.
Uses skills of active listening, questioning, paraphrasing and reflection to

support therapeutic intervention. CCC6,12.
http://www.nhs.uk/Planners/Yourhealth/Pages/Car
eplan.aspx
http://www.england.nhs.uk/2013/09/25/tim-kelsey2/ http://www.nmc-uk.org/Documents/NMCPublications/NMC-Guidance-for-the-care-of-olderpeople.pdf
les/principle_e
http://www.helpguide.org/mental/eq6_nonverbal_c
ommunication.htm
les/principle_e
Competency 3. All nurses must Communicates effectively and sensitively in different settings, using a
range of methods and skills CCC6, 8.
use the full range of
communication methods,
including verbal, non-verbal and
written, to acquire, interpret and
record their knowledge and
understanding of people's needs.
They must be aware of their own
values and beliefs and the impact
this may have on their
communication with others. They
must take account of the many
different ways in which people
communicate and how thee may
be influenced by ill health,
disability and other factors, and
be able to recognise and respond
effectively when a person finds it
hard to communicate.
Consistently shows ability to communicate safely and effectively with

people providing guidance for others.CCC6,7
7
Provides accurate and comprehensive written and verbal reports based on

sound evidence. CCC6, 9.
Provides information to people and their carers. NFM.28,7.
Uses strategies to enhance communication and remove barriers to

effective communication minimising the risk to people from lack of or poor
communication.CCC6, 6.
https://www.rcn.org.uk/__data/assets/pdf_file/0005
/380795/Nursing_Standard_Principle_E_April11_5
63KB.pdf
http://www.nursinginpractice.com/article/communic
ation-how-can-we-improve-our-skills
http://www.nmc-uk.org/Documents/NMCPublications/NMC-Record-Keeping-Guidance.pdf
http://www.nursinginpractice.com/article/communic
ation-how-can-we-improve-our-skills
http://www.actiononhearingloss.org.uk/yourhearing/ways-of-communicating.aspx
http://www.alzheimers.org.uk/site/scripts/document
s_info.php?documentID=1211&pageNumber=2
http://www.alzheimers.org.uk/site/scripts/document
s_info.php?documentID=130
http://www.nhs.uk/Conditions/dementiaguide/Pages/dementia-and-communication.aspx
http://www.actiononhearingloss.org.uk/yourhearing/ways-of-communicating/communicationtips/tips-for-hearing-people.aspx
http://www.mencap.org.uk/all-about-learningdisability/informationprofessionals/communication/communicatingpeople-learning- http://www.gmcuk.org/learningdisabilities/25.aspx
10
Competency 4. All nurses must Anticipates how people might feel in a given situation and respond with
kindness and empathy to provide physical and emotional comfort. CCC5,
recognise when people are
6.
anxious or in distress and
respond effectively, using
therapeutic principles, to promote
wellbeing, manage personal
safety and resolve conflict. They
must use effective
communication strategies and
negotiation techniques to achieve
best outcomes, respecting the
dignity and human right of all
concerned. They must know
when to consult a third party and
how to make referrals for
advocacy, mediation or
arbitration.
Is proactive and creative in enhancing communication and understanding.

CCC6,11
11
Makes appropriate use of touch. CCC5, 7.

Y
Manages and diffuses challenging situations effectively.CCC4,7.

y
12
Recognises circumstances that trigger personal negative response and

takes action to prevent this compromising care. CCC5,11.
http://www.nmc-uk.org/Documents/NMCPublications/NMC-Guidance-for-the-care-of-olderpeople.pdf http://www.england.nhs.uk/wpcontent/uploads/2012/12/compassion-inpractice.pdf
http://www.nhs.uk/CarersDirect/yourself/help-foryou/Pages/Advocacy.aspx
http://www.nhs.uk/carersdirect/moneyandlegal/lega
l/pages/applying-the-mental-capacity-act.aspx
http://www.nhs.uk/CarersDirect/guide/practicalsup
port/Pages/Challenging-behaviour.aspx
http://www.headway.ie/resources/publications/nchallenging-behaviour-and-abi/
13
14
Competency 5. All nurses must Initiates, maintains and closes professional relationships with service
users and carers. CCC1,13.
use therapeutic principles to
engage maintain and, where
appropriate, disengage from
professional caring relationships,
and must always respect
professional boundaries.
Competency 6. All nurses must
take every opportunity to
encourage health promoting
behaviour through education, role
modelling and effective
communication.
Discusses sensitive issues in relation to public health and provides

appropriate and guidance to individuals, communities and populations in
health promoting behaviours such as contraception, cessation of smoking,
addressing obesity and substance misuse. OAC9,18.
http://www.professionalstandards.org.uk/library/do
cument-detail?id=35f0ef3a-e42d-49e0-8be007f340d5f51b
https://www.gov.uk/government/publications/frame
work-for-personalised-care-and-population-health
http://www.patient.co.uk/health/health-promotion1321
Uses negotiating and other skills to encourage people who might be

reluctant to drink to take adequate fluids. NFM.29,5
15
16
17
Discusses the benefits of health promotion within the concept of public

health to prevent and control infection to improve and maintain the health
of the population. IPC21, 6.
Competency 7. All nurses must Provides accurate and comprehensive written reports based on best
possible evidence. CCC6,9.
maintain accurate, clear and
complete records, including the
use of electronic formats, using
appropriate and plain language.
Works within legal frameworks for data protection including access to and
storage of records. CCC7,8.
Effectively keep records of medication administered and omitted, in a
variety of setting, including controlled drugs and ensures others do the
same MM 39,2
n
http://www.who.int/topics/health_promotion/en/
E
Keeps appropriate records in relation to the use and maintenance of

medical devices and the decontamination process required as per local
and national guidelines. OAC. 20,4.
Y
Makes a comprehensive assessment of people's needs in relation to

nutrition identifying, documenting and communicating level of risk. NFM.
28,5.
18
20
http://www.mhra.gov.uk/ConferencesLearningCent
re/LearningCentre/Deviceslearningmodules/Devic
esinpractice/index.htm
http://www.mhra.gov.uk/Howweregulate/Devices/
http://www.mhra.gov.uk/Safetyinformation/Reportin
gsafetyproblems/Devices/index.htm
n
Monitors and records progress against the plan. NFM. 28,8.
Competency 8. All nurses must Recognises the significance of information and acts in relation to who does
or does not need to know.CCC7,6.
respect individual rights to
confidentiality and keep
information secure and
confidential in accordance with
the law and relevant regulatory
frameworks, taking account of
local protocols. They must
actively share personal
information with others when the
interests of safety and protection
override the need for
confidentiality.
n
Acts within the law when confidential information has to be shared with
others. CCC7,9.
Domain 3: Nursing practice and decision-making
Competency
Point of entry: Essential knowledge, understanding and skill application

required Essential skills cluster number and point
Demonstrates clinical confidence through sound knowledge, skills and understanding

Competency 1. All nurses
relevant to field. CCC1,8.
must use up-to-date
knowledge and evidence to
assess, plan, deliver and
evaluate care, communicate
findings, influence change and
promote health and best
practice. They must make
person-centred, evidence
based judgements and
decisions in partnership with
others involved in the care
process, to ensure high quality
care. they must be able to
recognise when the complexity
of clinical decisions requires
specialist knowledge and
expertise and, consult or refer
accordingly.
Recognises the significance of information and acts in relation to who does or does
not need to know. CCC,7,6
Refers to specialists when required. OAC9, 19
Generic Multichoice Exam:

(E* = Critical
item when
related to
patient and
public safety
and if tested
in MCQ must
be passed)
(50Qs)
Suitable items
for Multichoice Exam:
Generic
applied to
Suitable items for
nursing field
testing within OSCE's
specific (E* =
E* = Critical item when
Critical item
related to patient or
when related
public safety and if
to patient and
tested in scenario/skill
public safety
must be passed
and if tested
in MCQ must
be passed)(
50Qs).
Below are some useful on-line links

which can be used to support
preparation for the NMC's Test of
Competence. These on-line links
are not exhaustive, and many other
useful sources will exist, the links
are designed to help candidates
identify gaps as they explore each
domain and competence.
Candidates should consider the
need for revision and consolidation
of knowledge before taking the test
of competence.
http://www.nmcuk.org/Documents/Standards/
http://www.rcn.org.uk/development/pra
ctice/principles
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Regulation-in-PracticeTopics/Confidentiality/
ctice/principles/principle_g
Works within the code(NMC,2008) and in keeping with guidance on professional

conduct for nursing and midwifery students (NMC,2010) and in collaboration with
people and their carer's to meet responsibilities for prevention and control of infection.
IPC.21,7.
y
Recognises and acts upon the need to refer to specialist advisors as appropriate.
IPC23, 5.
ctice/infection_control/resources
ctice/nutrition
http://www.patientsafetyfirst.nhs.uk/Co
ntent.aspx?path=/Campaignnews/nutrition-and-hydration-week2013/
Refers to specialist members of the multi- disciplinary team for additional or specialist advice.
NFM27, 8.
Acts appropriately in sharing information to enable and enhance care with carers,
multi-disciplinary teams and across agency boundaries. CCC7, 7.

must possess a broad
knowledge of the structure
and functions of the human
body, and other relevant
knowledge from the life,
behavioural and social
sciences as applied to health,
ill health, disability, aging and
death. They must have an indepth knowledge of common
physical and mental health
problems and treatments,
including co-morbidity and
physiological and
psychological vulnerability.
http://www.nice.org.uk/guidance/cg139
https://www.gov.uk/government/public
ations/infection-prevention-and-controlin-care-homes-information-resourcepublished
http://www.hpa.org.uk/Publications/Inf
ectiousDiseases/InfectionControl/
Uses appropriate and relevant communication skills to deal with difficult and
challenging circumstances, for example, responding to emergencies, unexpected
occurrences, saying no, dealing with complaints, resolving disputes, de-escalating
aggression, conveying unwelcome news CCC6,13.
Anticipates how people may feel in a given situation and responds with kindness and
empathy to provide physical and emotional comfort. CCC5, 6.
Recognise and acts autonomously to respond to own emotional discomfort or distress

in self and others. CCC5,12.
Recognises circumstances that trigger personal negative responses and takes action
to prevent this compromising care. CCC5,11.
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Regulation-in-PracticeTopics/Confidentiality/
https://www.rcplondon.ac.uk/resource
s/national-early-warning-score-news
http://www.nice.org.uk/guidance/Cg50
http://www.institute.nhs.uk/quality_and
_service_improvement_tools/quality_a
nd_service_improvement_tools/sbar__situation_-_background__assessment_-_recommendation.html
https://www.resus.org.uk/pages/guide.
htm
http://www.nhs.uk/choiceintheNHS/Rig
htsandpledges/complaints/Pages/NHS
complaints.aspx
http://www.rcn.org.uk/__data/assets/p
df_file/0018/109800/003017.pdf
ctice/principles/principle_a
df_file/0004/377356/Nursing_Standard
_Principle_A_March11_563KB.pdf
https://www.rcn.org.uk/__data/assets/
pdf_file/0011/445817/Research2012M
o16.pdf
http://www.leadershipacademy.nhs.uk/
discover/leadershipframework/demonstrating-personalqualities/developing-self-awareness/
http://rcnpublishing.com/doi/pdfplus/10
Recognises stress in others and provide appropriate support or guidance ensuring

safety to people at all times. OAC17,10.
Safely manages drug administration and monitors effects. MM 36,4.
Where relevant, applies knowledge of age and condition related anatomy, physiology
and development when interacting with people. OAC9,11.
Uses knowledge of dietary, physical, social and psychological factors to inform
practice being aware of those that can contribute to poor diet, cause or be caused by
ill health. NFM27, 6.
df_file/0008/78515/001484.pdf
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Medicines-management-andprescribing/
http://www.innerbody.com/
http://www.who.int/topics/ageing/en/
http://www.indiana.edu/~anat550/embr
http://www.nhs.uk/Tools/Pages/Toolsli
brary.aspx?Tag=Healthy+eating
http://www.nhs.uk/Tools/Pages/Toolsli
brary.aspx?Tag=Fitness
http://www.nhs.uk/Tools/Pages/Wellbe
ing-self-assessment.aspx
Evaluates the effect of interventions, taking account of peoples and carers

interpretation of physical, emotional, and behavioural changes. OAC 10,9.
Y
Applies knowledge of basic pharmacology, drug pathways and how medicines act and
interact in the systems of the body and their therapeutic action, MM 36,2.
Understands common routes and techniques of medicine administration including

absorption, metabolism, adverse reactions and interaction. MM 36,3.
Y
Reports adverse incidents and near misses. MM36, 5.
Safely manages anaphylaxis MM36,6.

Actively empowers people to be involved in the assessment and care planning
process. CCC2,2.
must carry out
comprehensive, systematic
nursing assessments that take
account of relevant physical,
social, cultural, psychological,
spiritual, genetic and
environmental factors, in
partnership with service users
and others through interaction,
observation and
measurement.
http://www.rcn.org.uk/development/lea
rning/transcultural_health/transcultural
/adulthealth/sectionthree
http://www.mhra.gov.uk/ConferencesL
earningCentre/LearningCentre/Medicin
eslearningmodules/Reducingmediciner
isk/index.htm
eslearningmodules/FAQsforthelearnin
gmodules/index.htm
http://www.nice.org.uk/Guidance/Servi
eslearningmodules/index.htm
http://www.nmc-uk.org/Nurses-andhttp://resus.org.uk/pages/reaction.htm
df_file/0010/78616/002310.pdf
Accurately undertakes and records base line assessments of weight, height,

temperature, pulse, respiration and blood pressure using manual and electronic
devices. OAC9,2
Takes and records accurate measurements of weight, height, length, body mass index
and other appropriate measures of nutritional status. NFM28,1
Y
Measures documents and interprets vital signs and acts autonomously and
appropriately on findings OAC 9,21
Acts autonomously and appropriately when faced with sudden deterioration in

people's physical or psychological condition or emergency situation, abnormal vital
signs, collapse, cardiac arrest, dehydration, self harm, extremely challenging
behaviour, attempted suicide.OAC9,20.
earningCentre/LearningCentre/Device
slearningmodules/Basicobservations/i
ndex.htm#l4
p
g
yweightcalculator.aspx
http://www.patient.co.uk/health/bmicalculator
http://www.bapen.org.uk/screening-formalnutrition/must/introducing-must
slearningmodules/Basicobservations/i
ndex.htm#l4
ntent.aspx?path=/interventions/Deterio
ration/
htm
https://www.resus.org.uk/pages/Public
.htm
http://www.nhs.uk/conditions/Selfinjury/Pages/Introduction.aspx
http://www.nhs.uk/conditions/Suicide/
Pages/Introduction.aspxhttp://www.ns
hn.co.uk/resources.htmlhttp://www.nic
e.org.uk/guidance/CG133
Performs routine diagnostic tests, for example urinalysis, under supervision as part of
the assessment process (near client testing). OAC9,7.
Y
In partnership with the person, their carers and their families, makes a holistic, person
centred and systematic assessment of physical, emotional, psychological, social,
cultural and spiritual needs, including risk, and together, develops a comprehensive
personalised plan of nursing care.OAC9, 12.
http://www.nmc-uk.org/media/Latestnews/How-to-achieve-person-centredwriting-style-in-care-plans/
http://www.nhs.uk/Planners/Yourhealt
h/Pages/Careplan.aspx
Acts autonomously and takes responsibility for collaborative assessment and planning
of care delivery with the person, their cares and their family. OAC9,13.
ctice/principles/principle_d
http://www.nmc-uk.org/Publications/
Provides accurate and comprehensive written reports based on best possible

evidence. CCC6,9.
Y
http://www.nmcuk.org/Publications/Guidance/
Works within a public health framework when assessing the needs of people,
communities and populations within the UK. OAC9,22.
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Specialist-community-publichealth-nursing/
ctice/public_health
http://www.scotland.gov.uk/Publication
s/2011/01/11133654/5
http://www.wales.nhs.uk/sitesplus/888/
news/30702
http://www.publichealth.hscni.net/direc
torate-nursing-and-allied-healthprofessions/nursing
Detects, records and reports if necessary, deterioration or improvement and takes

must ascertain and respond to appropriate action autonomously. OAC 10,8
the physical, social and
psychological needs of people,
groups and communities.
They must then plan, deliver
and evaluate safe, competent,
person centred care in
partnership with them, paying
special attention to changing
health needs during different
life stages, including
progressive illness and death,
loss and bereavement.
In partnership with people and their carers, plans, delivers and documents care that
demonstrates effective risk assessment, infection prevention and control. IPC21,8.
Initiates and maintains appropriate measure to prevent and control infection according
to route of transmission of micro-organism, in order to protect service users, members
of the public and other staff. IPC.22,7
y
ntent.aspx?path=/interventions/
htm
.htm
e.org.uk/guidance/CG133
ations/infection-prevention-and-controlin-care-homes-information-resourcepublished http://www.hpa.org.uk/
http://www.wales.nhs.uk/documents/In
fections-English.pdf
ations/infection-prevention-and-controlin-care-homes-information-resourcepublished
http://www.hpa.org.uk/Publications/Inf
Demonstrates effective hand hygiene and the appropriate use of standard infection
control precautions when caring for people. IPC,22,1
Y
http://www.who.int/gpsc/en/
ctice/infection_control/publications
http://www.nric.org.uk/IntegratedCRD.
nsf/NRIC_Home1?OpenForm
Works within legal and ethical frameworks taking account of personal choice.
NFM31.6
y
ctice/nutrition
Ensure provision is made for replacement meals for anyone who is unable to eat at
the usual time, or unable to prepare their own meals. FNM30,7.
ctice/nutrition
http://www.nrls.npsa.nhs.uk/resources
/?entryid45=59806&char=P
ctice/cpd_online_learning/supporting_
peoples_nutritional_needs/supporting_
and_assisting_people
http://www.rcn.org.uk/newsevents/cam
paigns/nutritionnow/tools_and_resourc
es/national_guidance
Uses knowledge of dietary, physical, social and psychological factors to inform

practice being aware of those that can contribute to poor diet, cause or be caused by
ill health.NFM27,6
Y
Promotes health and well-being, self care and independence by teaching and
empowering people and carers to make choices in coping with the effects of treatment
and the ongoing nature and likely consequences of a condition including death and
dying.OAC9,16.
Provides safe and effective care in partnership with people and their carers within the
context of people's ages, conditions and developmental stages.OAC,10,6
ctice/nutrition
ntent.aspx?path=/Campaignnews/nutrition-and-hydration-week2013/
http://www.nuffieldtrust.org.uk/publicati
ons/integrated-care-patientspopulations-improvingoutcomes?gclid=COfJy5uYyr8CFQ2W
tAodZwgA-w
http://www.pointofcarefoundation.org.u
k/Home/
http://www.institute.nhs.uk/qipp/joined
_up_care/patient_centred_care.html
ctice/clinical_governance/patient_focu
s
ctice/
Discusses in a non-judgemental way how diet can improve health and the risks
associated with not eating appropriately. NFM27,9.
ctice/nutrition
http://www.ageuk.org.uk/healthwellbeing/doctors-hospitals/campaignagainst-malnutrition-in-hospital/
http://www.bapen.org.uk/screening-formalnutrition/must/must-app
df_file/0006/187989/003284.pdf
Provides support and advice to carers when the person they are caring for has
specific dietary needs.NFM27,11.
Y
In liaison with a registered midwife provides essential advice and support to mothers
who are breast feeding. NFM27,10
Y
Explains medical devices to people and checks understanding.OAC20,5.
Acts autonomously and proactively in promoting care environments that are culturally
must understand public health sensitive and free from discrimination, harassment and exploitation.CCC4,6.
principles, prioritise in order to
recognise and respond to the
major causes and
determinants, of health, illness
and health inequalities. They
must use a range of
information and data to assess
the needs of people, groups,
communities and populations,
and work to improve health,
wellbeing and experience of
healthcare; secure equal
access to health screening,
health promotion and
healthcare; and promote
social inclusion.
/?entryid45=59823
peoples_nutritional_needs/understandi
ng_nutrition
http://www.nhs.uk/Conditions/pregnan
cy-and-baby/pages/whybreastfeed.aspx#close
http://www.breastfeedingnetwork.org.u
k/
http://www.unicef.org.uk/babyfriendly/a
bout-baby-friendly/breastfeeding-in-theuk/
slearningmodules/Devicesinpractice/in
dex.htm
http://www.nmcuk.org/Documents/Standards/
http://www.rcn.org.uk/development/lea
rning/transcultural_health/transcultural
/adulthealth/sectionone
http://www.equalityhumanrights.com/y
our-rights/human-rights/what-arehuman-rights/human-rights-act
https://www.nice.org.uk/Search?area=
NICE.Search&q=infection+control
http://www.hpa.org.uk/Topics/Infectiou
sDiseases/InfectionsAZ/NotificationsO
fInfectiousDiseases/ListOfNotifiableDis
eases/
https://www.gov.uk/government/collect
ions/notifiable-diseases
Recognise infection risk and reports and acts in situations where there is need for
health promotion and protection and public health strategies IPC.21,11.
Understands the concept of public health and the benefits of healthy lifestyles and the
potential risks involved with various lifestyles or behaviours, for example, substance
misuse, smoking, obesity.OAC,9,3
Works within a public health framework to assess needs and plan care for individuals,
communities and populations.OAC9, 22.
Supports people in asserting their human rights. OAC11, 9.

Y
Safely uses and maintains a range of medical devices appropriate to the area of work,
must practise safely by being including ensuring regular servicing, maintenance and calibration including reporting
adverse incidents relating to medical devices.OAC20,3
aware of the correct use,
limitations and hazards of
common interventions,
including nursing activities,
treatments, and the use of
medical devices and
equipment. The nurse must be
able to evaluate their use,
report any concerns promptly
through appropriate channels
and modify care where
necessary to maintain safety.
They must contribute to the
collection of local and national
data and formulation of policy
on risks, hazards and adverse
outcomes.
Works within legal frameworks and applies evidence based practice in the safe
selection and use of medical devices.OAC20,2
https://www.gov.uk/government/organi
sations/public-health-england
https://www.gov.uk/government/collect
ions/public-health-outcomesframework
http://www.equalityhumanrights.com/y
our-rights/human-rights/what-arehuman-rights/human-rights-act
dex.htm
Administers enteral feeds safely and maintains equipment in accordance with local
policy.NFM31, 4.
dex.htm
http://www.bsg.org.uk/clinicalguidelines/small-bowelnutrition/guidelines-for-enteral-feedingin-adult-hospital-patients.html
https://www.evidence.nhs.uk/evidenceupdate-46
/?EntryId45=133441
https://www.evidence.nhs.uk/search?..
.Nasogastric%20tube%20insertion..htt
p://www.patient.co.uk/doctor/pegfeeding-tubes-indications-andmanagement.
www.nice.org.uk/guidance/CG174
http://www.nhs.uk/news/2013/12December/Pa
ges/NICE-issues-warning-over-dangerous-IVdrip-use.aspx http://www.vipscore.net/
Safely, maintains and uses naso-gastric, PEG and other feeding devices. NFM31,5
Monitors infusion sites for signs of abnormality and takes the required action reporting
and documenting signs and actions taken NFM32, 4.
Understands and applies knowledge of intravenous fluids and how they are prescribed
and administered within local administration of medicines policy. FM. 32,1
Safely performs wound care, applying non-touch or aseptic techniques in a variety of

settings. IPC25,4.
E
Manages hazardous waste and spillages in accordance with local health and safety
policies.IPC26,4.
Y
Instruct others to do the same IPC.26,5.

Adheres to health and safety at work legislation and infection control policies
regarding the safe disposal of all waste, soiled linen, blood and other body fluids and
disposing of sharps including in the home setting. IPC. 26,1
Is competent in the process of medication-related calculation in nursing field involving:

tablets and capsules, liquid, injections and IV infusions including; unit dose, sub and
multiple doses, complex calculations and SI units, for all ages. MM33,2.
E
Safely manages drug administration and monitors effects MM 36,4 .
Safely and effectively administers and, where necessary, prepares medicines via
routes and methods commonly used and maintains accurate records. MM38,4.
http://www.nmcuk.org/Publications/Standards/
http://www.nes.scot.nhs.uk/educationand-training/by-themeinitiative/healthcare-associatedinfections/trainingresources/preventing-infection-in-carehttp://www.rcn.org.uk/__data/assets/p
df_file/0008/571427/004187.pdf
http://www.hse.gov.uk/biosafety/bloodborne-viruses/index.htm
www.nes.scot.nhs.uk/.../script_management_of_blood_and_body_flui
d...
ctice/principles/principle_h
df_file/0008/571427/004187.pdf
https://www.gov.uk/healthcare-waste
http://www.hse.gov.uk/biosafety/inform
ation.htm
http://www.npc.co.uk/
http://www.nice.org.uk/Guidance/InDe
velopment/GID-CGWAVE0676
http://www.baxterhealthcare.co.uk/do
wnloads/healthcare_professionals/ther
apies/pharmacy_services/ps_calc_gui
de.pdf
eslearningmodules/index.htm
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Medicines-management-andprescribing/ http://www.nmcuk.org/Nurses-andmidwives/Regulation-inpractice/Regulation-in-Practice-Topics/
Supervises and teaches others to do the same.MM.38,5,

Understands the legal requirements MM 38,6
Orders, receives, stores and disposes of medicines safely (including controlled drugs)
MM,37,2.
Demonstrates knowledge of what a patient group directive is and who can use
them.MM 42,1
y
Understands all methods of supplying medicines, for example, Medicines Act

exemptions, patient group directions, clinical management plans and other forms of
prescribing. MM,34,5
http://www.legislation.gov.uk/ukpga/19
68/67/section/10
http://www.mhra.gov.uk/Howweregulat
e/Medicines/Availabilityprescribingselli
ngandsupplyingofmedicines/Exemptio
nsfromMedicinesActrestrictions/
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Regulation-in-PracticeTopics/Patient-Group-DirectionsPGDs/ http://www.nmc-uk.org/Nursesand-midwives/Regulation-inpractice/Regulation-in-PracticeTopics/Supplementary-Prescribingand-Clinical-Management-PlansCMPs/
Through simulation and coursework demonstrates knowledge and application of

principles required for safe and effective supply and administration via a patient group
direction including an understanding of role and accountability. MM42,2
Demonstrates awareness of a range of commonly recognised approaches to

managing symptoms, for example, relaxation, distraction and lifestyle advice. MM 35,
7
Through simulation and course work demonstrates how to supply and administer via a
patient group direction. MM42,3.
http://www.nhs.uk/chq/Pages/1391.as
px?CategoryID=73
ations/controlled-drugs-list
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Medicines-management-andprescribing/Controlled-drugs-/
http://www.cqc.org.uk/content/controll
ed-drugs
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Regulation-in-PracticeTopics/Patient-Group-DirectionsPGDs/
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Regulation-in-PracticeTopics/Patient-Group-DirectionsPGDs/
http://pathways.nice.org.uk/pathways/
diet/lifestyle-advice-on-diet-andphysical-activity
p
uk.org/Publications/Standards/
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Medicines-management-and-
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Medicines-management-andprescribing/ http://www.nmcuk.org/Nurses-andmidwives/Regulation-inpractice/Regulation-in-Practice-Topics/
Fully understands the different types of prescribing including supplementary

prescribing, community practitioner nurse prescribing, and independent nurse
prescribing MM,34,6
Y
Accesses commonly used evidence based sources relating to the safe and effective
management of medicine. MM40,1
Anticipates how people might feel in a given situation and responds with kindness and
must be able to recognise and empathy to provide physical and emotional comfort. CCC5,6.
interpret signs of normal and
deteriorating mental and
physical health and respond
promptly to maintain or
improve the health and
comfort of the service user,
acting to keep them and
others safe.
Listens to, watches for, and responds to verbal and non-verbal cues. CCC5, 8.

peoples physical or psychological condition or emergency situations, abnormal vital
signs, collapse, cardiac arrest, self-harm, extremely challenging behaviour, attempted
suicide.OAC,9,20
Recognises stress in others and provides appropriate support or guidance ensuring

safety to people at all times. OAC 17,10
Y
Refers to specialists when required. OAC9,19
http://www.npc.co.uk/
http://www.nice.org.uk/guidance
http://www.nursinginpractice.com/articl
e/compassion-practice-6-cs
http://www.kingsfund.org.uk/blog/2012
/10/developing-culture-compassionatecare http://www.england.nhs.uk/wpcontent/uploads/2012/12/6c-a5leaflet.pdf
http://www.rcn.org.uk/development/he
alth_care_support_workers/resources/
RCN_Library_resources/communicatin
g_with_patients,_relatives_and_collea
gues http://rcnhca.org.uk/
ctice/principles/principle_e
ntent.aspx?path=/interventions/Deterio
ration/
htm
.htm
ctice/principles/principle_c
Acts autonomously to initiate appropriate action when malnutrition is identified or

where a persons nutritional status worsens, and report this as an adverse event. NFM
28,10
Identifies signs of dehydration and acts to correct these. NFM,29,6

Y
peoples_nutritional_needs/nutritional_
screening
http://www.europeanhydrationinstitute.
org/dehydration.html?gclid=CMHLpcK
Qx8ACFdLKtAodWlIAkg
Recognises, responds appropriately and reports when people have difficulty eating or
swallowing.NFM. 31,1.
E
Takes action to ensure that, where there are problems with eating and swallowing,
nutritional status is not compromised.NFM31,3.
Reports adverse incidents and near misses. MM 36,5

must provide educational
support, facilitation skills and
therapeutic nursing
interventions to optimise
health and wellbeing. They
must promote self- care and
management whenever
possible, helping people to
make choices about their
needs involving families and
carers where appropriate, to
maximise their ability to care
for themselves.
Is sensitive and empowers people to meet their own needs and make choices and
considers with the person and their carer(s) their capability to care.CCC,2,8
Acts with dignity and respect to ensure that people who are unable to meet their
activities of living have choices about how these are met and feel empowered to do as
much as possible for themselves.CCC2,12.
Actively helps people to identify and use their strengths to achieve their goals and
aspirations.CCC. 2,14
Uses helpful and therapeutic strategies to enable people to understand treatments

and other interventions in order to give informed consent. CCC,8,4
Y
/?entryid45=59823
ctice/nutrition
http://www.rcslt.org/speech_and_lang
uage_therapy/what_is_an_slt
http://www.mhra.gov.uk/Safetyinforma
tion/index.htm http://www.nmcuk.org/Publications/Standards/
https://yellowcard.mhra.gov.uk/
http://www.nhs.uk/Planners/Yourhealt
h/Pages/Whatisselfcare.aspx
http://www.nursingtimes.net/coreprinciples-on-self-care-increasepatient-responsibility/1328256.article
https://www.gov.uk/government/policie
s/improving-quality-of-life-for-peoplewith-long-term-conditions
ctice/older_people/uk_wide_resources
/standards_and_guidance
www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Regulation-in-PracticeTopics/consent/
Demonstrates respect for the autonomy and rights of people to withhold consent in
relation to treatment within legal frameworks and in relation to people's safety.
CCC,8,7
E
Assess the person's ability to safely self-administer their medicines MM40,4.
Supports people to make appropriate the choices and changes to eating patterns,
taking account of dietary preferences, religious and cultural requirements, treatments
and special diets needed for health reasons. NFM.27,7.
empowering people and carers to make choices in coping with the effects of treatment
and the ongoing nature and likely consequences of a condition including death and
dying.OAC9,16.
Recognises and responds when people are in vulnerable situations and at risk, or in
need of support and protection. OAC 11,5
must be able to recognise
when a person is at risk and in
need of extra support and
protection and take
reasonable steps to protect
them from abuse.
Makes effective referrals to safeguard and protect children and adults requiring
support and protection. OAC,11,7
Works collaboratively with other agencies to develop, implement and monitor

strategies to safeguard and protect individuals and groups who are in vulnerable
situations.OAC 11,8
Supports people in asserting their human rights. OAC 11,9

Y
www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Regulation-in-PracticeTopics/consent/
http://www.nutrition.org.uk
http://www.nhscareers.nhs.uk/exploreby-career/allied-healthprofessions/careers-in-the-alliedhealth-professions/dietitian/
http://www.leeds.ac.uk/yawya/scienceandnutrition/Religion%20and%20food.html
http://www.foodafactoflife.org.uk/sheet
.aspx?siteId=19&sectionId=81&conten
tId=275
ctice/nutrition/nutrition
ctice/nutrition/nutrition_for_specific_gr
oups
http://www.nice.org.uk/guidance/PH49
http://www.nice.org.uk/guidance/PH6
http://pathways.nice.org.uk/pathways/
behaviourchange?fno=1#content=view-infocategory%3Aview-about-menu
http://www.nmc-uk.org/Nurses-andmidwives/Raising-and-escalatingconcerns/ http://www.nmcuk.org/Nurses-andmidwives/Regulation-inpractice/Safeguarding-New/
Challenges practises which do not safeguard those in need of support and protection.
OAC,11,10
Recognises stress in others and provides appropriate support or guidance ensuring

safety to people at all times.OAC17,10.
Y
Selects and applies appropriate strategies and techniques for conflict resolution, deescalation and physical intervention in the management of potential violence and
aggression. OAC 19,3.
Competency 10. All nurses Acts appropriately in sharing information to enable and enhance care (carers, MDT
and across agency boundaries.CCC,7,7
must evaluate their care to
improve clinical decisionmaking, quality and outcomes,
using a range of methods,
amending the plan of care,
where necessary, and
communicating change to
others.
Evaluates the effect of interventions, taking account of peoples and carers
interpretation of physical, emotional, and behavioural changes. OAC10,9.
Involves the person in review and adjustments to their care, communicating changes
to colleagues. OAC 10,10
Assesses and implements measures to manage, reduce or remove risk that could be
detrimental to people, self and others. OAC 18,11.
http://www.nmc-uk.org/Nurses-andmidwives/Raising-and-escalatingconcerns/ http://www.nmcuk.org/Nurses-andmidwives/Regulation-inpractice/Safeguarding-New/
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-in-practice/
https://www.evidence.nhs.uk/search?q
=deescalation%20of%20violence%20and
%20aggression
http://www.nmc-uk.org/nurses-andmidwives/advice-bytopic/a/advice/confidentiality/
http://www.hscic.gov.uk/confguideorg
ctice/principles/
=nursing%20process%20assessment
8/chapter/introduction http://www.nmcuk.org/media/Latest-news/NMC-andGMC-release-joint-statement-onprofessional-values/ http://www.nmcuk.org/Publications/Standards/
=standard%20nursing%20risk%20ass
essments
ctice/patient_safety http://www.nmcuk.org/Publications/Standards/
Domain 4: Leadership, management and team working
Competency
Suitable items
for Multi-choice
Generic MultiExam: Generic
choice Exam:
applied to
(E* = Critical
nursing field
item when
specific (E* =
related to
Critical item
Point of entry: Essential knowledge, understanding and skill application required
patient and
Essential skills cluster number and point
when related to
public safety
patient and
and if tested
public safety
in MCQ must
and if tested in
be passed)
MCQ must be
(50Qs)
passed) 50Qs).
Responds appropriately when people want to complain, providing assistance and

support.OAC 12,2
must act as change agents
and provide leadership
through quality improvement
and service development to
enhance people's wellbeing
and experience of healthcare.
Shares complaints, compliments and comments with the team in order to improve care.
OAC 12,5.
Below are some useful on-line

links which can be used to
Suitable support preparation for the NMC's
items for
Test of Competence. These ontesting
line links are not exhaustive, and
within
many other useful sources will
exist, the links are designed to
OSCE's E*
if tested in help candidates identify gaps as
they explore each domain and
scenario
competence. Candidates should
must be
passed consider the need for revision and
consolidation of knowledge before
taking the test of competence.
http://www.rcn.org.uk/development/pr
actice/clinical_governance/
https://www.rcn.org.uk/development/
practice/clinical_governance/leaders
E*
hip
http://www.flyingstart.scot.nhs.uk/lear
ning-programmes/safepractice/clinical-governance/
As an individual team member and team leader, actively seeks and learns from feedback
to enhance care and own and others professional development.OAC 12,8
Y
Actively consults and explores solutions and ideas with others to enhance care.
OAC14,6.
Challenges the practice of self and others across the multi-professional team.OAC,14,7
Y
Appropriately reports concerns regarding staffing and skill mix and acts to resolve issues
that may impact on the safety of service users.OAC,17,9
Y
http://www.nmc-uk.org/Nurses-andmidwives/Raising-and-escalatingconcerns/
Reflects on and learns from safety incidents as an individual and as a team member and
contributes to team learning.OAC,18,9
Y
Challenges others who do not follow procedures. NFM.30,5.

Y
Participates in clinical audit to improve the safety of service users.OAC,18,10
Evaluates the effect of interventions taking account of people's and carers' interpretation
must systematically evaluate of physical, emotional and behavioural changes. OAC,10,9
care and ensure that they and
others use the findings to help
improve peoples' experience
and care outcomes and to
shape future services.
Acts autonomously and takes responsibility for collaborative assessment and planning of
care delivery with the person, their carers and their family. OAC9,13.
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Regulation-in-PracticeTopics/
http://www.england.nhs.uk/ourwork/q
ual-clin-lead/clinaudit/
http://www.patientsafetyfirst.nhs.uk/c
ontent.aspx?path=/
http://patientsafety.health.org.uk/
http://www.hscic.gov.uk/clinicalaudits
http://www.england.nhs.uk/ourwork/q
ual-clin-lead/clinaudit/
actice/
Y
Involves the person in review and adjustments to care, communicating changes to

colleagues. OAC10,10.
Prioritises the needs of groups of people and individuals in order to provide care
effectively and efficiently.OAC10,7.
must be able to identify
priorities and mange time and
resources effectively to ensure
the quality of care is
maintained.
Actively responds to feedback. OAC12,6
Demonstrates effective time management. OAC17,7
actice/principles
Y
Y
Y
Manages time effectively.OAC 16,5

Negotiates with others in relation to balancing competing and conflicting priorities.
OAC16,6.
actice/
Y
Y
Ensures that appropriate food and fluids are available as required. NFM.30,8.
Y
actice/nutrition
Ensure appropriate assistance and support is available to enable people to eat. NFM30,6.
actice/nutrition http://www.nmcuk.org/Nurses-andmidwives/Regulation-inpractice/Regulation-in-PracticeTopics/
Manages overall environment to minimise risk.IPC 22,11.

Competency 4 . All nurses
must be self-aware and
recognise how their own
values, principles and
assumptions may affect their
practice. They must maintain
their own personal and
professional development,
learning from experience,
through supervision,
feedback, reflection and
Acts professionally to ensure that personal judgements, prejudices, values, attitudes and
beliefs do not compromise care.CCC3, 4.
Is acceptant of differing cultural traditions, beliefs, UK legal frameworks and professional

ethics when planning care with people and their families and carers.CCC4, 5.
Has insight into own values and how these may impact on interactions with others.CCC5,
10.
Y
appropriate action.OAC15, 5.
Y
Bases decisions on evidence and uses experience to guide decision-making.OAC16, 3.

E
must facilitate nursing
students and others to
develop their competence,
using a range of professional
and personal development
Acts as a positive role model in promoting a professional image.CCC1,10.
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Regulation-in-Practice-Topics/
http://www.nmc-uk.org/Nurses-andmidwives/Revalidation/
Acts as an effective role model in decision making, taking action and supporting
others.OAC14, 9.
actice/principles
Prepares, supports and supervises those to whom care has been delegated.OAC15, 4.
Y
Takes responsibility and accountability for delegating care to others. OAC15,3
Y
Acts as a positive role model for others. OAC16,4
Inspires confidence and provides clear direction to others.OAC16, 1.
must work independently as
well as in teams. They must
be able to take the lead in
coordinating, delegating and
supervising care safely,
managing risk and remaining
accountable for the care
Works autonomously, confidently and in partnership with people, their families and carers
to ensure that needs are met through care planning and delivery, including strategies for
self care and peer support.CCC2, 13.
Acts as a role model in developing trusting relationships, within professional boundaries.

CCC1,11
Actively consults and explores solutions and ideas with others to enhance care.OAC14,
6.
Works inter-professionally and autonomously as a means of achieving optimum

outcomes for people.OAC14, 10.
Safeguards the safety of self and others, and adheres to lone working policies when
working in the community setting and in peoples homes.OAC14, 11.
Y
actice/principles/principle_b
http://personcentredcare.health.org.u
k/?gclid=CKGZhcq_x8ACFZMRtAodxoAbQ
https://www.rcn.org.uk/__data/assets
/pdf_file/0004/377365/Nursing_Stand
ard_Principle_D_April11_560KB.pdf
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-inpractice/Regulation-in-PracticeTopics
http://www.nhsbsa.nhs.uk/Document
s/SecurityManagement/Lone_Workin
g_Guidance_final.pdf
http://patientsafety.health.org.uk/reso
urces http://www.nmc-uk.org/Nursesand-midwives/Regulation-inpractice/Safeguarding-New/
Works within local policies when working in the community setting including people's
homes and ensures the safety of others. OAC17,12
Y
Identifies suitable alternatives when isolation facilities are unavailable and principles have
to be applied in unplanned circumstances. IPC23,8.
Y
9
http://www.who.int/topics/infection_co
ntrol/en/
https://www.gov.uk/government/orga
nisations/public-health-england
Ensures that people including colleagues are aware of and adhere to local policies in
relating to isolation and infection control procedures. IPC,23,7
actice/infection_control
https://www.gov.uk/government/orga
nisations/public-health-england
Works within national and local policies and ensures others do the same.MM40,2
http://www.legislation.gov.uk/uksi/200
1/3998/contents/made
Y
Works confidently as part of the team and, where relevant, as leader of the team to
develop treatment options and choices with the person receiving care and their
carers.MM.35,9
Works within the requirements of the code (NMC 2008) in delegating care and when care
is delegated to them.OAC15, 2.
Assists in preparing people and carers for transfer and transition through effective
must work effectively across dialogue and accurate information.OAC13,1.
professional and agency
boundaries, actively involving
and respecting others'
contributions to integrated
person-centred care. They
must know when and how to
communicate with and refer to
other professionals and
agencies in order to respect
the choices of service users
and others, promoting shared
decision making, to deliver
positive outcomes and to
coordinate smooth, effective
transition within and between
services and agencies.
Reports issues and people's concerns regarding transfer and transition.OAC13,2.
https://www.evidence.nhs.uk/search?
q=patient%20transfer%20between%
20hospitals
Y
Assists in the preparation of records and reports to facilitate safe and effective
transfer.OAC13,3.
Adult Nursing: Field Specific competencies
Competency (Adult nurses) and

application
Domain and ESC
Suitable items
for Multi-choice
Exam: Nursing
Field specific
(E* = Critical
item when
related to patient
and public
safety and if
tested in MCQ
must be passed)
(20Qs)
Suitable items
Below are some useful on-line links which
for testing
can be used to support preparation for the
within OSCE's
NMC's Test of Competence. These on-line
E* = Critical
links are not exhaustive, and many other
item when
useful sources will exist, the links are
related to
designed to help candidates identify gaps
patient or
as they explore each domain and
public safety
competence. Candidates should consider
and if tested in
the need for revision and consolidation of
scenario/skill
knowledge before taking the test of
must be
competence.
passed
1.1 Adult nurses must understand and apply D1 Professional values Competency 1.
current legislation to all service users, paying
special attention to the protection of
vulnerable people, including those with
complex needs arising from ageing, cognitive
impairment, long-term conditions and those
approaching the end of life.
https://www.gov.uk/government/publications/th
e-health-and-care-system-explained/the-healthand-care-system-explained
http://dementiachallenge.dh.gov.uk/
http://www.kingsfund.org.uk/publications/provid
ing-integrated-care-older-people-complexneeds
http://wales.gov.uk/topics/health/publications/s
ocialcare/strategies/integration/?lang=en
http://www.scotland.gov.uk/Topics/Health/Supp
ort-Social-Care/Support/OlderPeople/ReshapingCare
http://www.dhsspsni.gov.uk/older_people
http://www.scie.org.uk/
Apply current legal, ethical and professional

requirements to older people with complex
needs
www.legislation.gov.uk/ukpga/2005/9/contents
E*
Communication (CCC)1 ,1.
E*
http://www.cqc.org.uk/
Y
www.nmc-uk.org/
Y
CCC4,4.
Y
http://restraintreductionnetwork.org/conferenceresources/
Is acceptant of differing cultural traditions, beliefs, UK legal frameworks and professional ethics
when planning care with people and their families and their carers CCC4, 5.
Y

http://www.kingsfund.org.uk/sites/files/kf/field/fi
eld_pdf/Library-reading-list-bme-olderpeople.pdf A K based reading list concerning
health and social care for black minority older
persons in the UK).
Acts professionally and autonomously in situations where there may be limits to confidentiality,
for example, public interest and protection from harm CCC7,5.
http://dementiachallenge.dh.gov.uk/
http://www.rcn.org.uk/development/practice/de
mentia
http://www.alzheimers.org.uk/site/scripts/docu
ments_info.php?documentID=117
CCC7,8.
http://www.sageusa.org/resources/publications.
cfm?ID=107 (This is an American resource but
offer some useful information about caring for
older people who are lesbian gay or
transgender).
https://www.gov.uk/government/publications/qu
ality-standards-for-supporting-people-with-longterm-conditions
https://www.gov.uk/government/policies/improv
ing-quality-of-life-for-people-with-long-termconditions http://www.kingsfund.org.uk/time-tothink-differently/trends/disease-anddisability/long-term-conditions-multi-morbidity
http://www.dhsspsni.gov.uk/living-longtermconditions.pdf
http://scotland.gov.uk/Topics/Health/Services/L
ong-Term-Conditions
http://www.wao.gov.uk/publication/managemen
t-chronic-conditions-wales-%E2%80%93update
http://www.kingsfund.org.uk/sites/files/kf/field/fi
eld_document/managing-people-long-termconditions-gp-inquiry-research-papermar11.pdf practice/Safeguarding-New/
Children young people and women

Y
Y
concerns. OAC12,9.
Y
http://www.nhs.uk/planners/end-of-lifecare/pages/end-of-life-care.aspx
http://www.ncpc.org.uk/palliative-careexplained http://www.endoflifecareintelligence.org.uk/home
https://www.gov.uk/government/publications?k
eywords=end+of+lifer&publication_filter_option
=all&topics%5B%5D=national-healthservice&departments%5B%5D=department-ofhealth&official_document_status=all&world_loc
ations%5B%5D=all&from_date=&to_date=
http://www.nice.org.uk/guidance/qs13
http://www.rcn.org.uk/development/practice/de
mentia/supporting_people_with_dementia/end_
of_life_care
https://www.spottingthesickchild.com/
http://www.nice.org.uk/Guidance/CG84
http://www.nice.org.uk/Guidance/Populationgroups/Children-and-young-people
http://www.nice.org.uk/Guidance/Populationgroups/Children-and-young-people
http://www.nmc-uk.org/Nurses-andmidwives/Regulation-in-practice/Regulation-inPractice-Topics/Advice-for-nurses-andmidwives-working-with-young-people/
http://www.unfpa.org/emergencies/motherhood
.htm
People with mental health problems/learning

disability or physical health problems
Y
Y
http://www.mentalhealthcare.org.uk/mental_he
alth_act http://www.mind.org.uk/informationsupport/legal-rights/mental-health-act-the-mindguide/ http://www.mwcscot.org.uk/thelaw/mental-health-act/
Y
http://www.learningdisabilities.org.uk/helpinformation/learning-disability-a-z/
http://www.rcn.org.uk/development/practice/so
cial_inclusion/learning_disabilities
taking. OAC18, 13.
https://www.mencap.org.uk/about-learningdisability/about-learning-disability
http://www.scie.org.uk/publications/elearning/in
dex.asp

http://www.mhra.gov.uk/
Y
http://www.mhra.gov.uk/Safetyinformation/Heal
thcareproviders/index.htm
http://www.mhra.gov.uk/Safetyinformation/How
wemonitorthesafetyofproducts/index.htm
https://www.gov.uk/rights-disabledperson/overview http://www.npsa.nhs.uk/
https://www.rcplondon.ac.uk/resources/nationalearly-warning-score-news
http://www.palliativecareguidelines.scot.nhs.uk/
http://www.nice.org.uk/resources/Servicedelivery--organisation-and-staffing/End-of-lifecare
https://www.resus.org.uk/
Y
Fully understands all methods of supplying medicines, for example Medicines Act exemptions,
patient group directions(PGDs), clinical management plans and other forms of prescribing
MM,34,6

requirements to people with complex needs
and cognitive impairment
E*
E*
CCC4,4.

CCC7,8.
concerns. OAC12,9.
Y
taking. OAC18, 13.
E*
E*

MM,34,6
and Long term conditions.
CCC4,4.

CCC7,8.
concerns. OAC12,9.
Y
Y
Y
Y
taking. OAC18, 13.

MM,34,6
Apply current legal, ethical and professional Articulates the underpinning values of the code, (NMC.2008). Care, Compassion and
requirements to people with complex needs Communication (CCC)1 ,1.
as they near end of life
CCC4,4.
E*
E*

CCC7,8.
concerns. OAC12,9.
Y
Y
Y
Y
taking. OAC18, 13.
Communicates effectively and sensitively in different settings, using a range of methods and
skills CCC6, 8.
Consistently shows ability to communicate safely and effectively with people providing
guidance for others.CCC6,7

MM,34,6
3.1 Adult nurses must promote the concept,
knowledge and practice of self- care with
people with acute and long-term conditions,
using a range of communication skills and
strategies.
D2 Communication and Interpersonal skills Competency 3
Acute medical and surgical conditions
Provides accurate and comprehensive written and verbal reports based on sound evidence.
CCC6, 9.
E*
E*
Communicates effectively and sensitively in different settings, using a range of methods and
skills CCC6, 8.
Consistently shows ability to communicate safely and effectively with people providing
guidance for others.CCC6,7
Uses strategies to enhance communication and remove barriers to effective communication

minimising the risk to people from lack of or poor communication.CCC6, 6.
Long term conditions
Provides accurate and comprehensive written and verbal reports based on sound evidence.
CCC6, 9.
Uses strategies to enhance communication and remove barriers to effective communication
minimising the risk to people from lack of or poor communication.CCC6, 6.
1.1 Adult nurses must be able to recognise D3 Nursing practice and decision making competency 1.
and respond to the needs of all people who
come into their care including babies,
children and young people, pregnant and
postnatal women, people with mental health
problems, people with physical disabilities,
people with learning disabilities, older
people, and people with long term problems
such as cognitive impairment.
Responding to the needs of babies and

children
E*
Demonstrates clinical confidence through sound knowledge, skills and understanding relevant
to field. CCC1,8.
Recognises the significance of information and acts in relation to who does or does not need to
know. CCC,7,6
Works within the code(NMC,2008) and in keeping with guidance on professional conduct for
nursing and midwifery students (NMC,2010) and in collaboration with people and their carer's
to meet responsibilities for prevention and control of infection. IPC.21,7.
Recognises and acts upon the need to refer to specialist advisors as appropriate. IPC23, 5.
Refers to specialist members of the multi- disciplinary team for additional or specialist advice. NFM27,
8.
Acts appropriately in sharing information to enable and enhance care with carers, multidisciplinary teams and across agency boundaries. CCC7, 7.
Y
Y
Y
Y
Y
Y
Responding to the needs of young people
Y
to field. CCC1,8.
know. CCC,7,6
8.
Responding to the needs of pregnant women
Y
Y
Y
Y
Y
Y
Y
to field. CCC1,8.
know. CCC,7,6
8.
Responding to the needs of postnatal
Y
Y
Y
Y
Y
Y
Y
to field. CCC1,8.
know. CCC,7,6
8.
Y
Y
Y
Y
Responding to the needs of people with
mental health problems
Y
to field. CCC1,8.
know. CCC,7,6
8.
physical disability
to field. CCC1,8.
know. CCC,7,6
8.
learning disabilities
to field. CCC1,8.
know. CCC,7,6
Y
Y
Y
Y
Y
Y
E*
E*

8.
Responding to the needs of older people
to field. CCC1,8.
know. CCC,7,6
8.
Responding to people with long term
problems
to field. CCC1,8.
know. CCC,7,6
8.
E*
E*
3.1 Adult nurses must safely use a range of D3 Nursing practice and decision making Competency 3
diagnostic skills, employing appropriate
technology, to assess the needs of service
users.
A range of diagnostic skills using technology
Actively empowers people to be involved in the assessment and care planning process.
CCC2,2.
Accurately undertakes and records base line assessments of weight, height, temperature,
pulse, respiration and blood pressure using manual and electronic devices. OAC9,2
E*
E*
Y
Y
Takes and records accurate measurements of weight, height, length, body mass index and
other appropriate measures of nutritional status. NFM28,1
Measures documents and interprets vital signs and acts autonomously and appropriately on
findings OAC 9,21
Acts autonomously and appropriately when faced with sudden deterioration in people's
physical or psychological condition or emergency situation, abnormal vital signs, collapse,
cardiac arrest, dehydration, self harm, extremely challenging behaviour, attempted
suicide.OAC9,20.
Y
Y
Performs routine diagnostic tests, for example urinalysis, under supervision as part of the
assessment process (near client testing). OAC9,7.
In partnership with the person, their carers and their families, makes a holistic, person centred
and systematic assessment of physical, emotional, psychological, social, cultural and spiritual
needs, including risk, and together, develops a comprehensive personalised plan of nursing
care.OAC9, 12.
Acts autonomously and takes responsibility for collaborative assessment and planning of care
delivery with the person, their cares and their family. OAC9,13.
E*
Provides accurate and comprehensive written reports based on best possible evidence.
CCC6,9.
Works within a public health framework when assessing the needs of people, communities and
populations within the UK. OAC9,22.
4.1 Adult nurses must safely use invasive
D3 Nursing practice and decision making Competency 4
and non-invasive procedures, medical
devices, and current technological and
pharmacological interventions, where
relevant, in medical and surgical nursing
practice, providing information and taking
account of individual needs and preferences.
Invasive and non-invasive procedures

Detects, records and reports if necessary, deterioration or improvement and takes appropriate
action autonomously. OAC 10,8
Initiates and maintains appropriate measure to prevent and control infection according to route
of transmission of micro-organism, in order to protect service users, members of the public and
other staff. IPC.22,7
Demonstrates effective hand hygiene and the appropriate use of standard infection control
precautions when caring for people. IPC,22,1
Works within legal and ethical frameworks taking account of personal choice. NFM31.6
Y
Y
nature and likely consequences of a condition including death and dying.OAC9,16.
Provides safe and effective care in partnership with people and their carers within the context
of people's ages, conditions and developmental stages.OAC,10,6
Discusses in a non-judgemental way how diet can improve health and the risks associated with
not eating appropriately. NFM27,9.
Ensure provision is made for replacement meals for anyone who is unable to eat at the usual
time, or unable to prepare their own meals. FNM30,7.
Uses knowledge of dietary, physical, social and psychological factors to inform practice being
aware of those that can contribute to poor diet, cause or be caused by ill health.NFM27,6
Provides support and advice to carers when the person they are caring for has specific dietary
needs.NFM27,11.
In liaison with a registered midwife provides essential advice and support to mothers who are
breast feeding. NFM27,10
Y
Y
Demonstrates awareness of a range of commonly recognised approaches to managing

symptoms, for example, relaxation, distraction and lifestyle advice. MM 35, 7
E*
Safely and effectively administers and, where necessary, prepares medicines via routes and
methods commonly used and maintains accurate records. MM38,4.
Safe use of medical devices

Y
Y
needs.NFM27,11.
E*

safe use of current technology

Y
Y
needs.NFM27,11.
Y
Y
E*
E*

Pharmacological interventions
Y
Y
needs.NFM27,11.
E*
E*

Medical nursing context
Y
Y
needs.NFM27,11.
E*
E*

Surgical nursing context
Y
Y
needs.NFM27,11.
Y
Y

4.2 Adult nurses must recognise and

respond to the changing needs of adults,
families and carers during terminal illness.
They must be aware of how treatment goals
and service users choices may change at
different stages of progressive illness, loss
and bereavement.
Understand changing needs of adults,

families and carers during terminal illness
Y
Y
needs.NFM27,11.
Y
Y
E*
E*
7.1Adult nurses must recognise the early

signs of illness in people of all ages. They
must make accurate assessments and start
appropriate and timely management of those
who are acutely ill, at risk of clinical
deterioration, or require emergency care.
Recognise early signs of illness in people of

all ages
empathy to provide physical and emotional comfort. CCC5,6.
Acts autonomously and appropriately when faced with sudden deterioration in peoples
physical or psychological condition or emergency situations, abnormal vital signs, collapse,
cardiac arrest, self-harm, extremely challenging behaviour, attempted suicide.OAC,9,20
Recognises stress in others and provides appropriate support or guidance ensuring safety to
people at all times. OAC 17,10
Takes action to ensure that, where there are problems with eating and swallowing, nutritional
status is not compromised.NFM31,3.
Y
E*
Y
E*
Acts autonomously to initiate appropriate action when malnutrition is identified or where a

persons nutritional status worsens, and report this as an adverse event. NFM 28,10

Make accurate initial assessment

Manage acute illness
Y
E*
Y
E*
Y


Manage clinical deterioration
E*
E*
E*
E*


Emergency care
Y


7.2 Adult nurses must understand the
normal physiological and psychological
processes of pregnancy and childbirth. They
must work with the midwife and other
professionals and agencies to provide basic
nursing care to pregnant women and families
during pregnancy and after childbirth. They
must be able to respond safely and
effectively in an emergency to safeguard the
health of mother and baby.
Recognise specific risks to health and

wellbeing of pregnant women and babies
and respond effectively in an emergency to
safeguard the health of mother and baby.
E*
Y


Y
8.1 Adult nurses must work in partnership

with people who have long-term conditions
that require medical or surgical nursing, and
their families and carers, to provide
therapeutic nursing interventions, optimise
health and wellbeing, facilitate choice and
maximise self-care and self-management.
Partnership working with people, families
and carers with long term conditions
requiring medical or surgical interventions
with the person and their carer(s) their capability to care.CCC,2,8
Acts with dignity and respect to ensure that people who are unable to meet their activities of
living have choices about how these are met and feel empowered to do as much as possible
for themselves.CCC2,12.
Uses helpful and therapeutic strategies to enable people to understand treatments and other
interventions in order to give informed consent. CCC,8,4
Demonstrates respect for the autonomy and rights of people to withhold consent in relation to
treatment within legal frameworks and in relation to people's safety. CCC,8,7
Supports people to make appropriate the choices and changes to eating patterns, taking
account of dietary preferences, religious and cultural requirements, treatments and special
diets needed for health reasons. NFM.27,7.
E*
E*
Y
Mental Health Nursing: Field Specific Competencies
Competency (Mental Health Nurses) and

application
1.1 Mental health nurses must understand

and apply current legislation to all service
users, paying special attention to the
protection of vulnerable people, including
those with complex needs arising from
ageing, cognitive impairment, long-term
conditions and those approaching the end of
life.
requirements to older people with complex
needs
Domain
Suitable items
for Multi-choice
Exam: Nursing
Field specific
(E* = Critical
item when
related to
patient and
public safety
and if tested in
MCQ must be
passed) (20Qs)
Suitable items
for testing
within OSCE's
E* = Critical
item when
related to
patient or
public safety
and if tested in
scenario/skill
must be passed
Below are some useful on-line links

which can be used to support
preparation for the NMC's Test of
Competence. These on-line links are
not exhaustive, and many other useful
sources will exist, the links are
designed to help candidates identify
gaps as they explore each domain and
competence. Candidates should
consolidation of knowledge before
taking the test of competence.
D1 Professional values Competency 1
Articulates the underpinning values of the code, (NMC.2008). Care,

Compassion and Communication (CCC)1 ,1.
Adopts a principled approach to care underpinned by the code,( NMC,2008)
CCC4, 3.
Upholds peoples legal rights and speaks out when these are at risk of being
compromised CCC4,4.
Is acceptant of differing cultural traditions, beliefs, UK legal frameworks and
professional ethics when planning care with people and their families and their
carers CCC4, 5.
Through reflection and evaluation demonstrates commitment to personal and
professional development and lifelong learning CCC5,13.
Acts professionally and autonomously in situations where there may be limits
to confidentiality, for example, public interest and protection from harm
CCC7,5.
storage of records CCC7,8.
E*
E*
http://www.mentalhealthcare.org.uk/ment
al_health_act
http://www.legislation.gov.uk/ukpga/2005/
9/contents
http://www.mentalhealthcare.org.uk/ment
al_health_language
http://www.mentalhealthcare.org.uk/home
http://www.rcn.org.uk/development/menta
l_health_virtual_ward
l_health_virtual_ward/triangle_of_care
Assesses and responds to the needs and wishes of carers and relatives in
relation to information and consent. CCC8,6
l_health_virtual_ward/admission
l_health_virtual_ward/care_plans2
l_health_virtual_ward/carers_and_familie
s
Shares information safely with colleagues and across agency boundaries for
the protection of individuals and the public. OAC11, 6.
Works within ethical and legal frameworks and local policies to deal with
complaints and concerns. OAC12,9.
Challenges the practice of self and others across the multi-professional team
OAC 14, 7
Works within the requirements of the code (NMC, 2008) in delegating care
and when care is delegated to them. OAC15, 2.
Recognises and addresses deficits in knowledge and skill in self and others
and takes appropriate action OAC15,5.
Takes decisions and is able to answer for these decisions when required OAC
16,2
Appropriately reports concerns regarding staffing and skill-mix and acts to
resolve issues that may impact on the safety of service users within local
policy frameworks OAC 17,9.
Works within legal and ethical frameworks that support promoting safety and
positive risk taking. OAC18, 13.
Works within the limitations of the role and recognises own level of
comptence.CCC1, 2
Applies legislation that relates to the management of specific infection risk at a
local and national level. Infection Preventions and Control (IPC), 22,8.
Assists people to make safe and informed choices about their medicines.
MM.40,5.
Applies legislation to practice in safe and effective ordering, receiving, storing,
administering and disposal of drugs, including controlled drugs in both primary
and secondary care settings and ensures others do the same Medicine
Management (MM), 34,4.
Assesses the persons ability to safely self-administer their medicines.MM
40,4
Gives clear instructions and explanation and checks that a person
understands the use of medicines and treatment options MM40,3.
Fully understands all methods of supplying medicines, for example Medicines
Act exemptions, patient group directions(PGDs), clinical management plans
and other forms of prescribing MM,34,6
and cognitive impairment
CCC4, 3.
compromised CCC4,4.
Y
Y
Y
l_health_virtual_ward/dual_diagnosis
l_health_virtual_ward/patient_safety
l_health_virtual_ward/race_equality
l_health_virtual_ward/research_and_audi
l_health_virtual_ward/treatments
http://www.mind.org.uk/
http://www.mind.org.uk/informationsupport/drugs-and-treatments/
Y
Y
E*
E*

carers CCC4, 5.
CCC7,5.
Y
Y
OAC 14, 7
16,2
comptence.CCC1, 2
MM.40,5.
Y
Y

40,4
and Long term conditions
CCC4, 3.
compromised CCC4,4.
carers CCC4, 5.
CCC7,5.
OAC 14, 7
E*
E*
Y
Y
16,2
comptence.CCC1, 2
MM.40,5.
40,4
as they near end of life
CCC4, 3.
compromised CCC4,4.
Y
Y
E*
E*

carers CCC4, 5.
CCC7,5.
OAC 14, 7
16,2
comptence.CCC1, 2
MM.40,5.
Y
Y
Y
Y
Y

40,4

E*
E*

2.1 Mental health nurses must practise in a
D1Professional values competency 2
way that addresses the potential power
imbalances between professionals and people
experiencing mental health problems,
including situations when compulsory
measures are used, by helping people
exercise their rights, upholding safeguards
and ensuring minimal restrictions on their
lives. They must have an in depth
understanding of mental health legislation and
how it relates to care and treatment of people
Mental Health Act and its application
Is sensitive and empowers people to meet their own needs and make choices
and considers with the person and their carer(s) their capability to care.
CCC2, 8.
Acts autonomously and proactively in promoting care environments that are
culturally sensitive and free from discrimination, harassment and exploitation.
CCC,4,6
Makes effective referrals to safeguard and protect children and adults
requiring support and protection. OAC11,7.
Challenges practices which do not safeguard those in need of support and
protection. OAC,11,10
Compulsory measures and their application
Y
Y
E*
E*
and considers with the person and their carer(s) their capability to care.
CCC2, 8.
CCC,4,6
requiring support and protection. OAC11,7.
Y
Y
3.1 Mental health nurses must promote

mental health and wellbeing, while challenging
the inequalities and discrimination that may
arise from or contribute to mental health
problems.
Challenging inequalities

D2 Professional values Competency 3.1
E*
E*
Communicates effectively and sensitively in different settings, using a range of

methods and skills CCC6, 8.
Consistently shows ability to communicate safely and effectively with people
providing guidance for others.CCC6,7

Uses strategies to enhance communication and remove barriers to effective
communication minimising the risk to people from lack of or poor
Challenging discrimination
4.1 Mental health nurses must work with

people in a way that values, respects and
explores the meaning of their individual lived
experiences of mental health problems, to
provide person-centred and recovery-focused
practice.

D2 Professional values Competency 3.1
Working in a recovery focussed way

Actively helps people to identify and use their strengths to achieves their goals
and aspirations. CCC2,14
Y
Y
E*
E*
Y
Y
Y
E*
E*
Y
Y

Recognises situations and acts appropriately when a person's choice may
compromise their safety or the safety of others. CCC2,10.
Uses strategies to manage situations where a person's wishes conflict with

nursing interventions necessary for the person's safety. CCC,2, 11
Works autonomously, confidently and in partnership with people, their families

and carers to actively empower people to be involved in their care planning
and delivery including strategies for self care and peer support. CCC2,13.
Acts appropriately in sharing information to enable and enhance care (carers,

MDT and across agency boundaries). CCC7, 7.
Assesses and implements measures to manage, reduce or remove risk that
could be detrimental to people, self and others. OAC18,11.
Works within legal and ethical frameworks to promote safety and positive risk
taking. OAC18,13.
Takes steps not to cross professional boundaries and put self or colleagues at
risk. OAC18,15.
Explains risks to people, relatives, carers and colleagues and educates them
in prevention and control of infection. IPC21,10.
Adheres to infection prevention and control policies and procedures at all
times and ensures that colleagues work according to good practice
guidelines. IPC22,9.
Acts as a role model to others and ensure colleagues work within local policy
IPC24,4
Able to communicate potential risks to others and advise people on their
device, site or wound to prevent and control infection and to promote healing.
IPC25, 5.
8.1 Mental health nurses must have and value D1 Professional values Competency 4.1
an awareness of their own mental health and
wellbeing. They must also engage in reflection
and supervision to explore the emotional
impact on self of working in mental health;
how personal values, beliefs and emotions
impact on practice and how their own
Self awareness
Is self-aware and self confident, knows own limitations and is able to take
appropriate action. CCC1, 9.
Supervision
Is self-aware and self confident, knows own limitations and is able to take
appropriate action. CCC1, 9.
1.1 Mental health nurses must use skills of
D1 Professional values Competency1.1
relationship-building and communication to
engage with and support people distressed by
hearing voices, experiencing distressing
thoughts or experiencing other perceptual
problems.
Relationship building with people experiencing
psychotic symptoms
Has insight into own values and how these may impact on interaction with
others. CCC5,10.
Works with people and carers to provide clear and accurate information
MM40,2.
Y
Y
Y
E*
E*
Recognises and acts to overcome barriers in developing effective

relationships with service uses and carers. CCC1, 12.
1.2 Mental health nurses must use skills and

knowledge to facilitate therapeutic groups with
people experiencing mental health problems
and their families and carers.
Acts autonomously to reduce and challenge barriers to effective

communication and understanding. CCC6,10.
D1 Professional values Competency1.2
Facilitating groups
Engages with people in the planning and provision of care which recognises
the importance of personal needs and providing both practical and emotional
support.CCC5, 9.
Listens to, watches for and responds to verbal and non verbal cues. CCC5,8.
Uses skills of active listening, questioning, paraphrasing and reflection to
support therapeutic intervention. CCC6,12.
4.1 Mental health nurses must be sensitive to, D2 Communication and interpersonal skills Competency 4.1
and take account of, the impact of abuse and
trauma on peoples wellbeing and the
development of mental health problems. They
must use interpersonal skills and make
interventions that help people disclose and
discuss their experiences as part of their
recovery.
Helping people to recover from abuse and
Anticipates how people might feel in a given situation and respond with
kindness and empathy to provide physical and emotional comfort. CCC5, 6.
CCC6,11
Recognises circumstances that trigger personal negative response and takes

action to prevent this compromising care. CCC5,11.
5.1 Mental health nurses must use their
D2 Communication and interpersonal skills Competency5.1
personal qualities, experiences and
interpersonal skills to develop and maintain
therapeutic, recovery-focused relationships
with people and therapeutic groups. They
must be aware of their own mental health, and
know when to share aspects of their own life
to inspire hope while maintaining professional
Self disclosure in therapeutic relationships
Y
Y
Y
Y
Initiates, maintains and closes professional relationships with service users

and carers. CCC1,13.
6.1 Mental health nurses must foster helpful D2 Communication and interpersonal skills Competency 4.1
and enabling relationships with families,
carers and other people important to the
person experiencing mental health problems.
They must use communication skills that
enable psychosocial education, problemsolving and other interventions to help people
cope and to safeguard those who are
Helping people cope with a family
member/person experiencing mental health
Discusses sensitive issues in relation to public health and provides
appropriate and guidance to individuals, communities and populations
in health promoting behaviours such as contraception, cessation of
smoking, addressing obesity and substance misuse. OAC9,18.
Uses negotiating and other skills to encourage people who might be

reluctant to drink to take adequate fluids. NFM.29,5
Discusses the benefits of health promotion within the concept of public
health to prevent and control infection to improve and maintain the
health of the population. IPC21, 6.
1.1 Mental health nurses must be able to

recognise and respond to the needs of all
people who come into their care including
babies, children and young people, pregnant
and postnatal women, people with physical
health problems, people with physical
disabilities, people with learning disabilities,
older people, and people with long term
problems such as cognitive impairment.
Responds to the needs of babies and children
Y
Demonstrates clinical confidence through sound knowledge, skills and
understanding relevant to field. CCC1,8.
Recognises the significance of information and acts in relation to who does or

does not need to know. CCC,7,6
Y
Y
Works within the code(NMC,2008) and in keeping with guidance on

professional conduct for nursing and midwifery students (NMC,2010) and in
collaboration with people and their carer's to meet responsibilities for
prevention and control of infection. IPC.21,7.
Recognises and acts upon the need to refer to specialist advisors as
appropriate. IPC23, 5.
Refers to specialist members of the multi- disciplinary team for additional or

specialist advice. NFM27, 8.
Acts appropriately in sharing information to enable and enhance care with

carers, multi-disciplinary teams and across agency boundaries. CCC7, 7.
Responds to the needs of young people

Y
Y
Y
Y
Y


Responds to the needs of pregnant women
Y
Y
Y
Y



Responds to the needs of post-natal women
Y
Y


Y
Y



Responds to the needs of people with
physical health problems
Y
Y
Y
Y



Responds to the needs of people with learning
disabilities
Y
Y
Y
Y




Responds to the needs of older people
Y
Y
Y
Y



Responds to the needs of people with long
term conditions
Y
Y
Y
Y




apply their knowledge and skills in a range of
evidence-based individual and group
psychological and psychosocial interventions,
to carry out systematic needs assessments,
develop case formulations and negotiate
Planning care for individuals and groups in a
variety of settings
Actively empowers people to be involved in the assessment and care
planning process. CCC2,2.
temperature, pulse, respiration and blood pressure using manual and
electronic devices. OAC9,2
Takes and records accurate measurements of weight, height, length, body
mass index and other appropriate measures of nutritional status. NFM28,1
people's physical or psychological condition or emergency situation, abnormal
vital signs, collapse, cardiac arrest, dehydration, self harm, extremely
challenging behaviour, attempted suicide.OAC9,20.
E*
E*
Y
Y
Y
Y
Performs routine diagnostic tests, for example urinalysis, under supervision as

part of the assessment process (near client testing). OAC9,7.
In partnership with the person, their carers and their families, makes a holistic,
person centred and systematic assessment of physical, emotional,
psychological, social, cultural and spiritual needs, including risk, and together,
develops a comprehensive personalised plan of nursing care.OAC9, 12.
Acts autonomously and takes responsibility for collaborative assessment and
planning of care delivery with the person, their cares and their family.
OAC9,13.
evidence. CCC6,9.
apply their knowledge and skills in a range of
evidence-based psychological and
psychosocial individual and group
interventions to develop and implement care
plans and evaluate outcomes, in partnership
with service users and others.
Psychological and psychosocial theories and

their application
Y
Detects, records and reports if necessary, deterioration or improvement and
takes appropriate action autonomously. OAC 10,8
In partnership with people and their carers, plans, delivers and documents
care that demonstrates effective risk assessment, infection prevention and
control. IPC21,8.
Initiates and maintains appropriate measure to prevent and control infection
according to route of transmission of micro-organism, in order to protect
service users, members of the public and other staff. IPC.22,7
Demonstrates effective hand hygiene and the appropriate use of standard
infection control precautions when caring for people. IPC,22,1
Works within legal and ethical frameworks taking account of personal choice.
NFM31.6
Ensure provision is made for replacement meals for anyone who is unable to
eat at the usual time, or unable to prepare their own meals. FNM30,7.
Uses knowledge of dietary, physical, social and psychological factors to
inform practice being aware of those that can contribute to poor diet, cause or
be caused by ill health.NFM27,6
empowering people and carers to make choices in coping with the effects of
treatment and the ongoing nature and likely consequences of a condition
including death and dying.OAC9,16.
Provides safe and effective care in partnership with people and their carers
within the context of people's ages, conditions and developmental
stages.OAC,10,6
Discusses in a non-judgemental way how diet can improve health and the
risks associated with not eating appropriately. NFM27,9.
Provides support and advice to carers when the person they are caring for
has specific dietary needs.NFM27,11.
In liaison with a registered midwife provides essential advice and support to
mothers who are breast feeding. NFM27,10
Y
Y
Y
Y
Y
5.1 Mental health nurses must work to

promote mental health, help prevent mental
health problems in at-risk groups, and
enhance the health and wellbeing of people
with mental health problems.
Health promotion
culturally sensitive and free from discrimination, harassment and
exploitation.CCC4,6.
Recognise infection risk and reports and acts in situations where there is need
for health promotion and protection and public health strategies IPC.21,11.
Understands the concept of public health and the benefits of healthy lifestyles
and the potential risks involved with various lifestyles or behaviours, for
example, substance misuse, smoking, obesity.OAC,9,3
Works within a public health framework to assess needs and plan care for
individuals, communities and populations.OAC9, 22.
6.1 Mental health nurses must help people

experiencing mental health problems to make
informed choices about pharmacological and
physical treatments, by providing education
and information on the benefits and unwanted
effects, choices and alternatives. They must
support people to identify actions that promote
health and help to balance benefits and
unwanted effects.

Pharmacological and physical treatments and

their use including education and information
for people undergoing treatment
Safely uses and maintains a range of medical devices appropriate to the area
of work, including ensuring regular servicing, maintenance and calibration
including reporting adverse incidents relating to medical devices.OAC20,3
E*
E*
E*
E*
Works within legal frameworks and applies evidence based practice in the
safe selection and use of medical devices.OAC20,2
Administers enteral feeds safely and maintains equipment in accordance with
local policy.NFM31, 4.
Safely, maintains and uses naso-gastric, PEG and other feeding devices.
NFM31,5
Monitors infusion sites for signs of abnormality and takes the required action
reporting and documenting signs and actions taken NFM32, 4.
Y
Y
Understands and applies knowledge of intravenous fluids and how they are
prescribed and administered within local administration of medicines policy.
FM. 32,1
Safely performs wound care, applying non-touch or aseptic techniques in a
variety of settings. IPC25,4.
Manages hazardous waste and spillages in accordance with local health and
safety policies.IPC26,4.
Adheres to health and safety at work legislation and infection control policies
regarding the safe disposal of all waste, soiled linen, blood and other body
fluids and disposing of sharps including in the home setting. IPC. 26,1
Is competent in the process of medication-related calculation in nursing field
involving: tablets and capsules, liquid, injections and IV infusions including;
unit dose, sub and multiple doses, complex calculations and SI units, for all
ages. MM33,2.
Y
Y
Y
Y
Y
Safely manages drug administration and monitors effects MM 36,4 .

Safely and effectively administers and, where necessary, prepares medicines
via routes and methods commonly used and maintains accurate records.
MM38,4.
Orders, receives, stores and disposes of medicines safely (including
controlled drugs) MM,37,2.
Demonstrates knowledge of what a patient group directive is and who can use
them.MM 42,1
Understands all methods of supplying medicines, for example, Medicines Act
exemptions, patient group directions, clinical management plans and other
forms of prescribing. MM,34,5
Through simulation and coursework demonstrates knowledge and application
of principles required for safe and effective supply and administration via a
patient group direction including an understanding of role and accountability.
MM42,2
Demonstrates awareness of a range of commonly recognised approaches to
managing symptoms, for example, relaxation, distraction and lifestyle advice.
MM 35, 7
Through simulation and course work demonstrates how to supply and
administer via a patient group direction. MM42,3.
Fully understands the different types of prescribing including supplementary
prescribing, community practitioner nurse prescribing, and independent nurse
prescribing MM,34,6
Y
Y
Y
Y
Accesses commonly used evidence based sources relating to the safe and
effective management of medicine. MM40,1
E*
E*
7.1 Mental health nurses must provide

support and therapeutic interventions for
people experiencing critical and acute mental
health problems. They must recognise the
health and social factors that can contribute to
crisis and relapse and use skills in early
intervention, crisis resolution and relapse
management in a way that ensures safety and
security and promotes recovery.
Critical and acute mental health problems
Anticipates how people might feel in a given situation and responds with
kindness and empathy to provide physical and emotional comfort. CCC5,6.
Listens to, watches for, and responds to verbal and non-verbal cues. CCC5,
8.
peoples physical or psychological condition or emergency situations,
abnormal vital signs, collapse, cardiac arrest, self-harm, extremely
challenging behaviour, attempted suicide.OAC,9,20
Recognises stress in others and provides appropriate support or guidance
ensuring safety to people at all times. OAC 17,10
Acts autonomously to initiate appropriate action when malnutrition is identified
or where a persons nutritional status worsens, and report this as an adverse
event. NFM 28,10
Recognises, responds appropriately and reports when people have difficulty
eating or swallowing.NFM. 31,1.
Takes action to ensure that, where there are problems with eating and
swallowing, nutritional status is not compromised.NFM31,3.
Contributory health and social factors to crisis
and relapse
8.
Y
Y


event. NFM 28,10

Relapse management
8.

event. NFM 28,10
Y
Y
Y
Y

E*
E*

7.2 Mental health nurses must work positively D3 Nursing practice and decision making Competency 7
and proactively with people who are at risk of
suicide or self-harm, and use evidence-based
models of suicide prevention, intervention and
harm reduction to minimise risk.
Prevention, intervention and harm reduction in

suicide and self harm
8.



event. NFM 28,10
8.1 Mental health nurses must practise in a

way that promotes the self- determination and
expertise of people with mental health
problems, using a range of approaches and
tools that aid wellness and recovery and
enable self-care and self-management.
Patient centred care
and considers with the person and their carer(s) their capability to
care.CCC,2,8
Acts with dignity and respect to ensure that people who are unable to meet
their activities of living have choices about how these are met and feel
empowered to do as much as possible for themselves.CCC2,12.
Actively helps people to identify and use their strengths to achieve their goals
and aspirations.CCC. 2,14
Uses helpful and therapeutic strategies to enable people to understand
treatments and other interventions in order to give informed consent. CCC,8,4
Demonstrates respect for the autonomy and rights of people to withhold
consent in relation to treatment within legal frameworks and in relation to
people's safety. CCC,8,7
Supports people to make appropriate the choices and changes to eating
patterns, taking account of dietary preferences, religious and cultural
requirements, treatments and special diets needed for health reasons.
NFM.27,7.
E*
E*
E*
E*
9.1 Mental health nurses must use recovery- D3 Nursing practice and decision making Competency 9
focused approaches to care in situations that
are potentially challenging, such as times of
acute distress; when compulsory measures
are used; and in forensic mental health
settings. They must seek to maximise service
user involvement and therapeutic
engagement, using interventions that balance
the need for safety with positive risk-taking.
Recovery focussed approaches to challenging

situations and risk assessment
Recognises and responds when people are in vulnerable situations and at

risk, or in need of support and protection. OAC 11,5
requiring support and protection. OAC,11,7
Works collaboratively with other agencies to develop, implement and monitor
strategies to safeguard and protect individuals and groups who are in
vulnerable situations.OAC 11,8
Supports people in asserting their human rights. OAC 11,9
Challenges practises which do not safeguard those in need of support and
ensuring safety to people at all times.OAC17,10.
Selects and applies appropriate strategies and techniques for conflict
resolution, de-escalation and physical intervention in the management of
potential violence and aggression. OAC 19,3.
4.1 Mental health nurses must actively
D4 Leadership, management and team working Competency 4
promote and participate in clinical supervision
and reflection, within a values-based mental
health framework, to explore how their values,
beliefs and emotions affect their leadership,
management and practice.
Supervision and reflection
Acts professionally to ensure that personal judgements, prejudices, values,
attitudes and beliefs do not compromise care.CCC3, 4.
5.1 Mental health nurses must help raise

awareness of mental health, and provide
advice and support in best practice in mental
health care and treatment to members of the
multi-professional team and others working in
health, social care and other services and
settings.
Educating and informing others

professional ethics when planning care with people and their families and
carers.CCC4, 5.
Has insight into own values and how these may impact on interactions with
others.CCC5, 10.
and takes appropriate action.OAC15, 5.
Bases decisions on evidence and uses experience to guide decisionmaking.OAC16, 3.
Acts as a positive role model in promoting a professional image.CCC1,10.
Y
Y
E*
E*
Y
Y
Y
Y
Acts as an effective role model in decision making, taking action and

supporting others.OAC14, 9.
Prepares, supports and supervises those to whom care has been
delegated.OAC15, 4.
Takes responsibility and accountability for delegating care to others. OAC15,3
Acts as a positive role model for others. OAC16,4
Inspires confidence and provides clear direction to others.OAC16, 1.
6.1 Mental health nurses must contribute to
the management of mental health care
environments by giving priority to actions that
enhance people's safety, psychological
security and therapeutic outcomes, and by
ensuring effective communication, positive
risk management and continuity of care
across service boundaries.
Risk management and transition
E*
E*

and carers to ensure that needs are met through care planning and delivery,
including strategies for self care and peer support.CCC2, 13.
Acts as a role model in developing trusting relationships, within professional

boundaries. CCC1,11
Actively consults and explores solutions and ideas with others to enhance
care.OAC14, 6.
Works inter-professionally and autonomously as a means of achieving
optimum outcomes for people.OAC14, 10.
Safeguards the safety of self and others, and adheres to lone working policies
when working in the community setting and in peoples homes.OAC14, 11.
Works within local policies when working in the community setting including
people's homes and ensures the safety of others. OAC17,12
Identifies suitable alternatives when isolation facilities are unavailable and

principles have to be applied in unplanned circumstances. IPC23,8.
Ensures that people including colleagues are aware of and adhere to local
policies in relating to isolation and infection control procedures. IPC,23,7
Works within national and local policies and ensures others do the
same.MM40,2
Works confidently as part of the team and, where relevant, as leader of the
team to develop treatment options and choices with the person receiving care
and their carers.MM.35,9
Works within the requirements of the code (NMC 2008) in delegating care and
when care is delegated to them.OAC15, 2.
Learning Disabilities Nursing: Field Specific Competencies
Competency (Learning Disabilities

Nursing) and Application
Domain
1.1 Learning disabilities nurses must D1 Professional values Competency 1

understand and apply current
legislation to all service users, paying
special attention to the protection of
vulnerable people, including those
with complex needs arising from
ageing, cognitive impairment, longterm conditions and those
approaching the end of life.
Complex needs
Articulates the underpinning values of the code, (NMC.2008). Care, Compassion
and Communication (CCC)1 ,1.
Suitable items
for Multichoice Exam:
Nursing Field
specific (E* =
Critical item
when related
to patient and
public safety
and if tested
in MCQ must
be passed)
(20Qs)
Suitable items
for testing
within OSCE's
E* = Critical
item when
related to
patient or
public safety
and if tested
in
scenario/skill
must be
passed
https://www.mencap.org.uk/
about-learningdisability/informationprofessionals
about-learningdisability/resources-centre
E*
E*

CCC4, 3.
compromised CCC4,4.
Below are some useful online links which can be

used to support
preparation for the NMC's
Test of Competence.
These on-line links are not
exhaustive, and many
other useful sources will
exist, the links are
designed to help
candidates identify gaps
as they explore each
domain and competence.
Candidates should
consider the need for
revision and consolidation
of knowledge before
taking the test of
competence.
about-learninghttps://www.mencap.org.uk/
about-learningdisability/informationprofessionals/health/legislati
about-learningdisability/informationprofessionals/health/healthtools-and-resources-usefullinks

carers CCC4, 5.
Y
Y

Shares information safely with colleagues and across agency boundaries for the
protection of individuals and the public. OAC11, 6.
Y
Y
OAC 14, 7
Works within the requirements of the code (NMC, 2008) in delegating care and
when care is delegated to them. OAC15, 2.
Recognises and addresses deficits in knowledge and skill in self and others and
takes appropriate action OAC15,5.
16,2
Appropriately reports concerns regarding staffing and skill-mix and acts to resolve
issues that may impact on the safety of service users within local policy
frameworks OAC 17,9.
comptence.CCC1, 2

MM.40,5.

Y
Gives clear instructions and explanation and checks that a person understands
the use of medicines and treatment options MM40,3.
exemptions, patient group directions(PGDs), clinical management plans and
other forms of prescribing MM,34,6
E*
E*


CCC4, 3.
compromised CCC4,4.

carers CCC4, 5.
Older people


Y
Y
OAC 14, 7
Y
Y
16,2

comptence.CCC1, 2
MM.40,5.

Y
Dementia
CCC4, 3.
compromised CCC4,4.
carers CCC4, 5.
E*
E*

OAC 14, 7
16,2
comptence.CCC1, 2
MM.40,5.
3
4
5
6
7
10
11
Long term conditions

Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
E*
E*

CCC4, 3.
compromised CCC4,4.
carers CCC4, 5.
OAC 14, 7
16,2
comptence.CCC1, 2
MM.40,5.
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Dying
CCC4, 3.
compromised CCC4,4.
carers CCC4, 5.
OAC 14, 7
16,2
comptence.CCC1, 2
E*
E*
Y
Y
Y
Y
y
Y
Y
Y
Y
Y
Y
Y
Y
Y
MM.40,5.
2.1 Learning disabilities nurses must

always promote the autonomy, rights
and choices of people with learning
disabilities and support and involve
their families and carers, ensuring
that each persons rights are upheld
according to policy and the law.
Upholding rights according to UK law

and considers with the person and their carer(s) their capability to care. CCC2, 8.

use their knowledge and skills to
exercise professional advocacy, and
recognise when it is appropriate to
refer to independent advocacy
services to safeguard dignity and
human rights.
Advocacy

CCC,4,6
Makes effective referrals to safeguard and protect children and adults requiring
support and protection. OAC11,7.
Y
Y
E*
E*
E*
E*
activities of living have choices about how these are met and feel empowered to
do as much as possible for themselves.CCC,2,12
Is proactive in promoting and maintaining dignity.CCC3, 5.
Acts autonomously to challenges situations or others when someone's dignity
may be compromised. CCC,3,6
Works within the context of a multi-professional team and works collaboratively
with other agencies when needed to enhance the care of people, communities
and populations. OAC9,15.
including death and dying. OAC 9,16
Discusses sensitive issues in relation to public health and provide appropriate
advice and guidance to individuals, communities and populations for example,
contraception, substance misuse, smoking, obesity.OAC,9,18
and considers with the person and their carer(s) their capability to care. CCC2, 8.
Y
Y
4.1 Learning disabilities nurses must D1 Professional values Competency 4

recognise that people with learning
disabilities are full and equal citizens,
and must promote their health and
wellbeing by focusing on and
developing their strengths and
abilities.
Supporting equality
Actively helps people to identify and use their strengths to achieves their goals
and aspirations. CCC2,14
Recognises situations and acts appropriately when a person's choice may
compromise their safety or the safety of others. CCC2,10.
Uses strategies to manage situations where a person's wishes conflict with
nursing interventions necessary for the person's safety. CCC,2, 11
and carers to actively empower people to be involved in their care planning and
delivery including strategies for self care and peer support. CCC2,13.
Acts appropriately in sharing information to enable and enhance care (carers,
MDT and across agency boundaries). CCC7, 7.
Assesses and implements measures to manage, reduce or remove risk that
could be detrimental to people, self and others. OAC18,11.
Y
Y
Works within legal and ethical frameworks to promote safety and positive risk
taking. OAC18,13.
Takes steps not to cross professional boundaries and put self or colleagues at
risk. OAC18,15.
Explains risks to people, relatives, carers and colleagues and educates them in
prevention and control of infection. IPC21,10.
Adheres to infection prevention and control policies and procedures at all times
and ensures that colleagues work according to good practice guidelines.
IPC22,9.
Acts as a role model to others and ensure colleagues work within local policy
IPC24,4

use the full range of person-centred
alternative and augmentative
communication strategies and skills to
build partnerships and therapeutic
relationships with people with learning
disabilities.
Augmentative communication
Able to communicate potential risks to others and advise people on their device,
site or wound to prevent and control infection and to promote healing. IPC25, 5.
D2 Communication and interpersonal skills Competency 1
Has insight into own values and how these may impact on interaction with others.
CCC5,10.
Works with people and carers to provide clear and accurate information MM40,2.

be able to make all relevant
information accessible to and
understandable by people with
learning disabilities, including
adaptation of format, presentation
and delivery.
Recognises and acts to overcome barriers in developing effective relationships

with service uses and carers. CCC1, 12.
Acts autonomously to reduce and challenge barriers to effective communication
and understanding. CCC6,10.
Making information understandable

by and accessible to people with a
learning disability
Engages with people in the planning and provision of care which recognises the
importance of personal needs and providing both practical and emotional
support.CCC5, 9.
Listens to, watches for and responds to verbal and non verbal cues. CCC5,8.
Y
Y
Y
Y
Y
Y
Y
E*
E*
Y
Y
Uses skills of active listening, questioning, paraphrasing and reflection to support

therapeutic intervention. CCC6,12.
Acts autonomously to reduce and challenge barriers to effective communication
and understanding. CCC6,10.
E*
E*
3.1 Learning disabilities nurses must D2 Communication and interpersonal skills Competency 3
use a structured approach to assess,
communicate with, interpret and
respond therapeutically to people with
learning disabilities who have
complex physical and psychological
health needs or those in behavioural
distress.
Assess, communicate, interpret and

respond to complex physical and
psychological health needs or those
in behavioural distress

recognise and respond therapeutically
to the complex behaviour that people
with learning disabilities may use as a
means of communication.
Responding to complex behaviours

Provides accurate and comprehensive written and verbal reports based on sound
evidence. CCC6, 9.
Anticipates how people might feel in a given situation and respond with kindness
and empathy to provide physical and emotional comfort. CCC5, 6.
CCC6,11
Recognises circumstances that trigger personal negative response and takes
action to prevent this compromising care. CCC5,11.
Y
Y
Y
Y
Y
Y
Y
1.1 Learning disabilities nurses must D3 Nursing practice and decision making Competency 1 and associated
be able to recognise and respond to ESCs
the needs of all people who come into
their care including babies, children
and young people, pregnant and
postnatal women, people with mental
health problems, people with physical
health problems and disabilities, older
people, and people with long term
problems such as cognitive
impairment.
Respond to the needs of babies and

children
people and their carer's to meet responsibilities for prevention and control of
infection. IPC.21,7.
IPC23, 5.
Refers to specialist members of the multi- disciplinary team for additional or specialist
advice. NFM27, 8.
E*
E*
Y
Y
Y
Y
Y
Y
Responds to the needs of young
people
IPC23, 5.
advice. NFM27, 8.
Y
E*
E*
Y
Y
Y
Y
Y
Y
Y
Responds to the needs of pregnant

women
IPC23, 5.
advice. NFM27, 8.
E*
E*
Y
Y
Y
Y
Y
Y
Responds to the needs of post-natal
women
IPC23, 5.
advice. NFM27, 8.
Y
E*
E*
Y
Y
Y
Y
Y
Y
mental health problems
IPC23, 5.
Y
E*
E*
Y
Y
Y
Y
advice. NFM27, 8.
physical health problems and
disabilities
IPC23, 5.
advice. NFM27, 8.
Y
E*
E*
Y
Y
Y
Y
Y
Y
Responds to the needs of older
people
IPC23, 5.
advice. NFM27, 8.
Y
E*
E*
Y
Y
Y
Y
Y
Y
long term problems
Y
E*
E*
Y
Y

IPC23, 5.
advice. NFM27, 8.
Y
Y
dementia
IPC23, 5.
advice. NFM27, 8.

use a structured, person-centred
approach to assess, interpret and
respond therapeutically to people with
learning disabilities, and their often
complex, pre-existing physical and
psychological health needs. They
must work in partnership with service
users, carers and other professionals,
services and agencies to agree and
implement individual care plans and
ensure continuity of care.
Y
E*
E*
Y
Y
Y
Y
Y
Y
D3 Nursing practice and decision making Competency 3 and associated
ESCs.
Response to complex, pre-existing

physical and psychological health
needs
process. CCC2,2.
E*
E*

devices. OAC9,2
Takes and records accurate measurements of weight, height, length, body mass
index and other appropriate measures of nutritional status. NFM28,1
vital signs, collapse, cardiac arrest, dehydration, self harm, extremely challenging
person centred and systematic assessment of physical, emotional, psychological,
social, cultural and spiritual needs, including risk, and together, develops a
comprehensive personalised plan of nursing care.OAC9, 12.
planning of care delivery with the person, their cares and their family. OAC9,13.
evidence. CCC6,9.
Collaborative care planning and
transition between services
process. CCC2,2.
devices. OAC9,2
Takes and records accurate measurements of weight, height, length, body mass
index and other appropriate measures of nutritional status. NFM28,1
vital signs, collapse, cardiac arrest, dehydration, self harm, extremely challenging
person centred and systematic assessment of physical, emotional, psychological,
social, cultural and spiritual needs, including risk, and together, develops a
comprehensive personalised plan of nursing care.OAC9, 12.
Y
Y
Y
Y
Y
Y
Y
Y

planning of care delivery with the person, their cares and their family. OAC9,13.

lead the development,
implementation and review of
individual plans for all people with
learning disabilities, to promote their
optimum health and wellbeing and
facilitate their equal access to all
health, social care and specialist
services.

evidence. CCC6,9.
Promote equal access to health,

social and specialist services

work in partnership with people with
learning disabilities and their families
and carers to facilitate choice and
maximise self-care and selfd and di
t th
Maximise selft care
co-ordinate

culturally sensitive and free from discrimination, harassment and
exploitation.CCC4,6.
Recognise infection risk and reports and acts in situations where there is need for
health promotion and protection and public health strategies IPC.21,11.
Understands the concept of public health and the benefits of healthy lifestyles
and the potential risks involved with various lifestyles or behaviours, for example,
substance misuse, smoking, obesity.OAC,9,3
D3 Nursing practice and decision making Competency 8.
the transition between different

services and agencies
and considers with the person and their carer(s) their capability to care.CCC,2,8
activities of living have choices about how these are met and feel empowered to
do as much as possible for themselves.CCC2,12.
Y
Y
Y
Y
Y
Y
Y
E*
E*
Y
Y
Uses helpful and therapeutic strategies to enable people to understand

treatments and other interventions in order to give informed consent. CCC,8,4
Demonstrates respect for the autonomy and rights of people to withhold consent
in relation to treatment within legal frameworks and in relation to people's safety.
CCC,8,7
Supports people to make appropriate the choices and changes to eating patterns,
taking account of dietary preferences, religious and cultural requirements,
treatments and special diets needed for health reasons. NFM.27,7.
12
13
14
15
16
17
18
19
20
21
22
23
24
25

take the lead in ensuring that people
with learning disabilities receive
support that creatively addresses their
physical, social, economic,
psychological, spiritual and other
needs, when assessing, planning and
delivering care.
Creatively addresses the needs of a

person with leaning disabilities
support.OAC 12,2
Shares complaints, compliments and comments with the team in order to improve
care. OAC 12,5.
As an individual team member and team leader, actively seeks and learns from
feedback to enhance care and own and others professional development.OAC
12,8
OAC14,6.
Challenges the practice of self and others across the multi-professional
team.OAC,14,7
Appropriately reports concerns regarding staffing and skill mix and acts to resolve
issues that may impact on the safety of service users.OAC,17,9
Reflects on and learns from safety incidents as an individual and as a team
member and contributes to team learning.OAC,18,9
Y
Y
Y
Y
E*
E*
Y
Y
Y
Y
Y
Y
27

provide direction through leadership
and education to ensure that their
unique contribution is recognised in
service design and provision.
Educating others about service needs

and design

use data and research findings on the
health of people with learning
disabilities to help improve peoples
experiences and care outcomes, and
shape of future services.

support.OAC 12,2
Shares complaints, compliments and comments with the team in order to improve
care. OAC 12,5.
As an individual team member and team leader, actively seeks and learns from
feedback to enhance care and own and others professional development.OAC
12,8
OAC14,6.
Challenges the practice of self and others across the multi-professional
team.OAC,14,7
Appropriately reports concerns regarding staffing and skill mix and acts to resolve
issues that may impact on the safety of service users.OAC,17,9
Reflects on and learns from safety incidents as an individual and as a team
member and contributes to team learning.OAC,18,9
Using data and research findings

Evaluates the effect of interventions taking account of people's and carers'
interpretation of physical, emotional and behavioural changes. OAC,10,9
planning of care delivery with the person, their carers and their family. OAC9,13.
Involves the person in review and adjustments to care, communicating changes
to colleagues. OAC10,10.
Y
Y
Y
Y
Y
Y
Y
E*
E*
29
6.1 Learning disabilities nurses must D4 Leadership, management and team working Competency 6
use leadership, influencing and
decision-making skills to engage
effectively with a range of agencies
and professionals. They must also be
able, when needed, to represent the
health needs and protect the rights of
people with learning disabilities and
challenge negative stereotypes.
Engaging with other agencies and

professionals
boundaries. CCC1,11
care.OAC14, 6.
Works confidently as part of the team and, where relevant, as leader of the team
to develop treatment options and choices with the person receiving care and their
carers.MM.35,9
Challenge negative stereotypes
boundaries. CCC1,11
care.OAC14, 6.
E*
E*
Y
Y
Y
Y
carers.MM.35,9
31
32
Represent and protect the rights of

people with learning difficulties
boundaries. CCC1,11
care.OAC14, 6.
carers.MM.35,9
Y
Y
Y
Y
Y
Y
Y
Y

work closely with stakeholders to
enable people with learning
disabilities to exercise choice and
challenge discrimination.
Working with stakeholders

boundaries. CCC1,11
care.OAC14, 6.
carers.MM.35,9
Challenges discrimination
boundaries. CCC1,11
care.OAC14, 6.
Y
Y
Y
Y
Y
Y
carers.MM.35,9
Y
Y
Children's nursing: Field specific competencies
Competency (Children's Nurses) and

application
1.1 Childrens nurses must understand the

laws relating to child and parental consent,
including giving and refusing consent,
withdrawal of treatment and legal capacity.
Domain
Suitable items
for Multi-choice
Exam: Nursing
Field specific
(E* = Critical
item when
related to patient
and public
safety and if
tested in MCQ
must be passed)
(20Qs)
Suitable items
for testing
within OSCE's
E* = Critical
item when
related to
patient or
public safety
and if tested in
scenario/skill
must be passed
http://www.nmc-uk.org/
http://rcnpublishing.com/journal/ncyp
Consent
Articulates the underpinning values of the code,
(NMC.2008). Care, Compassion and Communication
(CCC)1 ,1.
Adopts a principled approach to care underpinned by the
code,( NMC,2008) CCC4, 3.
Upholds peoples legal rights and speaks out when these
are at risk of being compromised CCC4,4.
Is acceptant of differing cultural traditions, beliefs, UK
legal frameworks and professional ethics when planning
care with people and their families and their carers
Through reflection and evaluation demonstrates
commitment to personal and professional development
and lifelong learning CCC5,13.
Acts professionally and autonomously in situations where
there may be limits to confidentiality, for example, public
interest and protection from harm CCC7,5.
Works within legal frameworks for data protection
including access to and storage of records CCC7,8.
Below are some useful on-line links which

can be used to support preparation for the
NMC's Test of Competence. These on-line
links are not exhaustive, and many other
useful sources will exist, the links are
designed to help candidates identify gaps as
they explore each domain and competence.
Candidates should consider the need for
revision and consolidation of knowledge
before taking the test of competence.
E*
E*
Y
Y
Y
Y
http://www.rcn.org.uk/__data/assets/pdf_file/000
3/78573/002012.pdf
http://www.rcn.org.uk/development/practice/safe
guarding/children_and_young_people
http://www.rcn.org.uk/development/practice/pain
http://www.nhs.uk/NHSEngland/AboutNHSservi
ces/Documents/Consent_%20aguideforparents
DH_4117353.pdf
http://www.nspcc.org.uk/Inform/research/briefing
s/definition_of_a_child_wda59396.html
http://www.nspcc.org.uk/help-and-advice/fororganisations-and-professionals/adviceinformation-support/child-protection-advicesupport_wda101366.html
https://www.gov.uk/government/uploads/system/
uploads/attachment_data/file/216695/dh_11997
3.pdf
http://www.nursingtimes.net/296359.article
Works within legal frameworks when seeking consent

CCC8, 5.
Assesses and responds to the needs and wishes of
carers and relatives in relation to information and
consent. CCC8,6
Shares information safely with colleagues and across
agency boundaries for the protection of individuals and
the public. OAC11, 6.
Works within ethical and legal frameworks and local

policies to deal with complaints and concerns. OAC12,9.
Challenges the practice of self and others across the

multi-professional team OAC 14, 7
Works within the requirements of the code (NMC, 2008)
in delegating care and when care is delegated to them.
OAC15, 2.
Recognises and addresses deficits in knowledge and skill
in self and others and takes appropriate action OAC15,5.
Takes decisions and is able to answer for these
decisions when required OAC 16,2
Appropriately reports concerns regarding staffing and
skill-mix and acts to resolve issues that may impact on
the safety of service users within local policy frameworks
OAC 17,9.
Works within legal and ethical frameworks that support
promoting safety and positive risk taking. OAC18, 13.
Works within the limitations of the role and recognises
own level of comptence.CCC1, 2
Applies legislation that relates to the management of
specific infection risk at a local and national level.
Infection Preventions and Control (IPC), 22,8.
Assists people to make safe and informed choices about
their medicines. MM.40,5.
Y
Y
http://www.patient.co.uk/doctor/denverdevelopmental-screening-test
https://www.spottingthesickchild.com/?
http://www.medicalprotection.org/mps-factsheetparental-responsibility.pdf
https://www.gov.uk/government/collections/imm
unisation
https://www.evidence.nhs.uk/search?q=paediatri
c%20assessment%20triangle
https://www.evidence.nhs.uk/search?q=patient
%20transfer%20between%20hospitals
https://www.gov.uk/government/uploads/system/
uploads/attachment_data/file/281368/Working_t
ogether_to_safeguard_children.pdf
www.nice.org.uk
http://www.nice.org.uk/GuidanceMenu/Populatio
n-groups.
Applies legislation to practice in safe and effective

ordering, receiving, storing, administering and disposal of
drugs, including controlled drugs in both primary and
secondary care settings and ensures others do the same
Medicine Management (MM), 34,4.
Assesses the persons ability to safely self-administer
their medicines.MM 40,4
Gives clear instructions and explanation and checks that
a person understands the use of medicines and
treatment options MM40,3.
Fully understands all methods of supplying medicines, for
example Medicines Act exemptions, patient group
directions(PGDs), clinical management plans and other
forms of prescribing MM,34,6
Y
Y
E*
E*
2.1 Childrens nurses must recognise that all

children and young people have the right to be
safe, enjoy life and reach their potential. They
must practise in a way that recognises,
respects and responds to the individuality of
every child and young person.
Responds to the individuality of each child and
young person
Is sensitive and empowers people to meet their own
needs and make choices and considers with the person
and their carer(s) their capability to care. CCC2, 8.
3.1 Childrens nurses must act as advocates

for the right of all children and young people to
lead full and independent lives.
Advocacy for children and young people

Acts autonomously and proactively in promoting care
environments that are culturally sensitive and free from
discrimination, harassment and exploitation. CCC,4,6
Makes effective referrals to safeguard and protect
children and adults requiring support and protection.
Supports people in asserting their human rights.
OAC,11,9
Challenges practices which do not safeguard those in
need of support and protection. OAC,11,10
Y
Y
E*
E*
Acts with dignity and respect to ensure that people who

are unable to meet their activities of living have choices
about how these are met and feel empowered to do as
much as possible for themselves.CCC,2,12
Is proactive in promoting and maintaining dignity.CCC3,
5.
Acts autonomously to challenges situations or others
when someone's dignity may be compromised. CCC,3,6
Works within the context of a multi-professional team and
works collaboratively with other agencies when needed to
enhance the care of people, communities and
populations. OAC9,15.
Promotes health and well-being, self care and
independence by teaching and empowering people and
carers to make choices in coping with the effects of
treatment and the ongoing nature and likely
consequences of a condition including death and dying.
Discusses sensitive issues in relation to public health and
provide appropriate advice and guidance to individuals,
communities and populations for example, contraception,
substance misuse, smoking, obesity.OAC,9,18
Works within a public health framework to assess needs
and plan care for individuals, communities and
populations.OAC9, 22.
and their carer(s) their capability to care. CCC2, 8.
4.1 Childrens nurses must work in partnership D1 Professional values Competency4
with children, young people and their families
to negotiate, plan and deliver child and familycentred care, education and support. They
must recognise the parents or carers primary
role in achieving and maintaining the childs or
young persons health and wellbeing, and offer
advice and support on parenting in health and
illness.
Education and support for children, young
people and their parents or carers
Actively helps people to identify and use their strengths to
achieves their goals and aspirations. CCC2,14
Uses appropriate strategies to empower and support their
choice. CC3,7.
Y
Y
E*
E*
Y
Y
Recognises situations and acts appropriately when a

person's choice may compromise their safety or the
safety of others. CCC2,10.
Uses strategies to manage situations where a person's
wishes conflict with nursing interventions necessary for
the person's safety. CCC,2, 11
Works autonomously, confidently and in partnership with
people, their families and carers to actively empower
people to be involved in their care planning and delivery
including strategies for self care and peer support.
CCC2,13.
Acts appropriately in sharing information to enable and
enhance care (carers, MDT and across agency
boundaries). CCC7, 7.
Assesses and implements measures to manage, reduce
or remove risk that could be detrimental to people, self
and others. OAC18,11.
Works within legal and ethical frameworks to promote
safety and positive risk taking. OAC18,13.
Takes steps not to cross professional boundaries and put
self or colleagues at risk. OAC18,15.
Explains risks to people, relatives, carers and colleagues
and educates them in prevention and control of infection.
IPC21,10.
Adheres to infection prevention and control policies and
procedures at all times and ensures that colleagues work
according to good practice guidelines. IPC22,9.
Acts as a role model to others and ensure colleagues
work within local policy IPC24,4
Able to communicate potential risks to others and advise
people on their device, site or wound to prevent and
control infection and to promote healing. IPC25, 5.
1.1 Childrens nurses must work with the child, D2 Communication and interpersonal skills
young person and others to ensure that they
Competency 1
are actively involved in decision-making, in
order to maintain their independence and take
account of their ongoing intellectual, physical
and emotional needs.
Ensure the child or young person is actively
involved in decision- making, and maintains
their independence
Has insight into own values and how these may impact
on interaction with others. CCC5,10.
Works with people and carers to provide clear and
accurate information MM40,2.
Y
Y
Y
Y
Y
E*
E*
Y
Y
Recognises and acts to overcome barriers in developing

effective relationships with service uses and carers.
CCC1, 12.
Acts autonomously to reduce and challenge barriers to
effective communication and understanding. CCC6,10.
2.1
D2 Communication and interpersonal skills
Childrens nurses must understand all aspects Competency 2
of development from infancy to young
adulthood, and identify each child or young
persons developmental stage, in order to
communicate effectively with them. They must
use play, distraction and communication tools
appropriate to the childs or young persons
stage of development, including for those with
sensory or cognitive impairment.
Child development, play, distraction
techniques, sensory and cognitive impairment
Engages with people in the planning and provision of
care which recognises the importance of personal needs
and providing both practical and emotional
Listens to, watches for and responds to verbal and non
verbal cues. CCC5,8.
Uses skills of active listening, questioning, paraphrasing
and reflection to support therapeutic intervention.
CCC6,12.
3.1 Childrens nurses must ensure that, where D2 Communication and interpersonal skills
possible, children and young people
Competency 3
understand their healthcare needs and can
make or contribute to informed choices about
all aspects of their care.
Informed choice
Communicates effectively and sensitively in different
settings, using a range of methods and skills CCC6, 8.
Consistently shows ability to communicate safely and
effectively with people providing guidance for
others.CCC6,7
Provides accurate and comprehensive written and verbal
reports based on sound evidence. CCC6, 9.
Provides information to people and their carers.
NFM.28,7.
Uses strategies to enhance communication and remove
barriers to effective communication minimising the risk to
people from lack of or poor communication.CCC6, 6.
Y
Y
E*
E*
1.1 Childrens nurses must be able to

D3 Nursing practice and decision making
recognise and respond to the essential needs Competency 1
of all people who come into their care including
babies, pregnant and postnatal women, adults,
people with mental health problems, people
with physical disabilities, people with learning
disabilities, and people with long term
problems such as cognitive impairment.
Respond to the needs of pregnant and
postnatal women
Y
Demonstrates clinical confidence through sound
knowledge, skills and understanding relevant to field.
CCC1,8.
Recognises the significance of information and acts in
relation to who does or does not need to know. CCC,7,6
Works within the code(NMC,2008) and in keeping with
guidance on professional conduct for nursing and
midwifery students (NMC,2010) and in collaboration with
people and their carer's to meet responsibilities for
Recognises and acts upon the need to refer to specialist
advisors as appropriate. IPC23, 5.
Y
Y
Y
Refers to specialist members of the multi- disciplinary team for

additional or specialist advice. NFM27, 8.

enhance care with carers, multi-disciplinary teams and
across agency boundaries. CCC7, 7.
Respond to the needs of adults
Y
CCC1,8.
Y
Y
Y
Y
Y

Respond to the needs of people with mental

health problems
CCC1,8.
Y
Y


Respond to the needs of people with physical

disabilities
Y
CCC1,8.
Y
Y
Y


10
Respond to the needs of people with learning

disabilities

CCC1,8.
11
Y
Y


Respond to the needs of people with dementia
Y
CCC1,8.
1.2 Childrens nurses must use recognised,

evidence-based, child-centred frameworks to
assess, plan, implement, evaluate and record
care, and to underpin clinical judgments and
decision-making. Care planning and delivery
must be informed by knowledge of
pharmacology, anatomy and physiology,
pathology, psychology and sociology, from
infancy to young adulthood.

Competency 1
Y
Y
Y
Y
Y
Y
Evidence based, child-centred framework for

planning care
CCC1,8.
Y
Y


E*
E*

CCC1,8.
13
E*
Clinical judgement and decision making
12
E*
Y
Y
14

15

E*
E*
Pharmacology
CCC1,8.
Y
Y



Anatomy and physiology

CCC1,8.
Y
Y
Y


Pathology
16
Y
CCC1,8.
Y
Y
Y
Y
Y

Psychology and sociology
Y
CCC1,8.
17
18

3.1 Childrens nurses must carry out

comprehensive nursing assessments of
children and young people, recognising the
particular vulnerability of infants and young
children to rapid physiological deterioration.

Competency 3
Recognise and act on rapid physiological

deterioration
19
Actively empowers people to be involved in the

assessment and care planning process. CCC2,2.
Accurately undertakes and records base line
assessments of weight, height, temperature, pulse,
respiration and blood pressure using manual and
electronic devices. OAC9,2
Takes and records accurate measurements of weight,
height, length, body mass index and other appropriate
measures of nutritional status. NFM28,1
Measures documents and interprets vital signs and acts
autonomously and appropriately on findings OAC 9,21
Acts autonomously and appropriately when faced with
sudden deterioration in people's physical or psychological
condition or emergency situation, abnormal vital signs,
collapse, cardiac arrest, dehydration, self harm,
extremely challenging behaviour, attempted
Y
Y
Y
Y
Y
Y
E*
E*
Y
Y
Performs routine diagnostic tests, for example urinalysis,

under supervision as part of the assessment process
(near client testing). OAC9,7.
In partnership with the person, their carers and their
families, makes a holistic, person centred and systematic
assessment of physical, emotional, psychological, social,
cultural and spiritual needs, including risk, and together,
develops a comprehensive personalised plan of nursing
care.OAC9, 12.
Acts autonomously and takes responsibility for
collaborative assessment and planning of care delivery
with the person, their cares and their family. OAC9,13.
Provides accurate and comprehensive written reports
based on best possible evidence. CCC6,9.
Works within a public health framework when assessing
the needs of people, communities and populations within
the UK. OAC9,22.
5.1 Childrens nurses must include health
promotion, and illness and injury prevention, in Competency 5
their nursing practice. They must promote early
intervention to address the links between early
life adversity and adult ill health, and the
risks to the current and future physical, mental,
emotional and sexual health of children and
young people.
Health promotion
discrimination, harassment and exploitation.CCC4,6.
Recognise infection risk and reports and acts in
situations where there is need for health promotion and
protection and public health strategies IPC.21,11.
Understands the concept of public health and the
benefits of healthy lifestyles and the potential risks
involved with various lifestyles or behaviours, for
Supports people in asserting their human rights. OAC11,
9.
Risk assessment
Y
Y
Y
Y

9.
20
21
Physical, mental, emotional and sexual health

9.
6.1 Childrens nurses must have numeracy
skills for medicines management, assessment, Competency 6 and associated ESCs
measuring, monitoring and recording which
recognise the particular vulnerability of infants
and young children in relation accurate
medicines calculation.
Application of Number
Safely uses and maintains a range of medical devices
appropriate to the area of work, including ensuring
regular servicing, maintenance and calibration including
reporting adverse incidents relating to medical
Works within legal frameworks and applies evidence
based practice in the safe selection and use of medical
devices.OAC20,2
Administers enteral feeds safely and maintains
equipment in accordance with local policy.NFM31, 4.
Safely, maintains and uses naso-gastric, PEG and other
feeding devices. NFM31,5
Y
Y
Y
Y
E*
E*
Monitors infusion sites for signs of abnormality and takes

the required action reporting and documenting signs and
actions taken NFM32, 4.
Understands and applies knowledge of intravenous fluids
and how they are prescribed and administered within
local administration of medicines policy. FM. 32,1
Safely performs wound care, applying non-touch or
aseptic techniques in a variety of settings. IPC25,4.
Manages hazardous waste and spillages in accordance
with local health and safety policies.IPC26,4.
Adheres to health and safety at work legislation and
infection control policies regarding the safe disposal of all
waste, soiled linen, blood and other body fluids and
disposing of sharps including in the home setting. IPC.
26,1
Is competent in the process of medication-related
calculation in nursing field involving: tablets and
capsules, liquid, injections and IV infusions including; unit
dose, sub and multiple doses, complex calculations and
SI units, for all ages. MM33,2.
Safely manages drug administration and monitors effects
MM 36,4 .
Safely and effectively administers and, where necessary,
prepares medicines via routes and methods commonly
used and maintains accurate records. MM38,4.
Orders, receives, stores and disposes of medicines
safely (including controlled drugs) MM,37,2.
Demonstrates knowledge of what a patient group
directive is and who can use them.MM 42,1
Understands all methods of supplying medicines, for
example, Medicines Act exemptions, patient group
directions, clinical management plans and other forms of
Through simulation and coursework demonstrates
knowledge and application of principles required for safe
and effective supply and administration via a patient
group direction including an understanding of role and
accountability. MM42,2
Demonstrates awareness of a range of commonly
recognised approaches to managing symptoms, for
example, relaxation, distraction and lifestyle advice. MM
35, 7
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Through simulation and course work demonstrates how

to supply and administer via a patient group direction.
MM42,3.
Fully understands the different types of prescribing
including supplementary prescribing, community
practitioner nurse prescribing, and independent nurse
prescribing MM,34,6
Accesses commonly used evidence based sources
relating to the safe and effective management of
medicine. MM40,1
Medicines management
22
23
Safely uses and maintains a range of medical devices

appropriate to the area of work, including ensuring
regular servicing, maintenance and calibration including
reporting adverse incidents relating to medical
Works within legal frameworks and applies evidence
based practice in the safe selection and use of medical
devices.OAC20,2
Administers enteral feeds safely and maintains
equipment in accordance with local policy.NFM31, 4.
Safely, maintains and uses naso-gastric, PEG and other
feeding devices. NFM31,5
Monitors infusion sites for signs of abnormality and takes
the required action reporting and documenting signs and
actions taken NFM32, 4.
Understands and applies knowledge of intravenous fluids
and how they are prescribed and administered within
local administration of medicines policy. FM. 32,1
Safely performs wound care, applying non-touch or
aseptic techniques in a variety of settings. IPC25,4.
Manages hazardous waste and spillages in accordance
with local health and safety policies.IPC26,4.
Adheres to health and safety at work legislation and
infection control policies regarding the safe disposal of all
waste, soiled linen, blood and other body fluids and
disposing of sharps including in the home setting. IPC.
26,1
Is competent in the process of medication-related
calculation in nursing field involving: tablets and
capsules, liquid, injections and IV infusions including; unit
dose, sub and multiple doses, complex calculations and
SI units, for all ages. MM33,2.
Safely manages drug administration and monitors effects
MM 36,4 .
Y
E*
E*
Y
Y
Y
Y
8.1 Childrens nurses must use negotiation

skills to ensure the best interests of children
and young people in all decisions, including the
continuation or withdrawal of care. Negotiation
must include the child or young person, their
family and members of the multidisciplinary
and interagency team where appropriate.
Safely and effectively administers and, where necessary,

prepares medicines via routes and methods commonly
used and maintains accurate records. MM38,4.
Orders, receives, stores and disposes of medicines
safely (including controlled drugs) MM,37,2.
Demonstrates knowledge of what a patient group
directive is and who can use them.MM 42,1
Understands all methods of supplying medicines, for
example, Medicines Act exemptions, patient group
directions, clinical management plans and other forms of
Through simulation and coursework demonstrates
knowledge and application of principles required for safe
and effective supply and administration via a patient
group direction including an understanding of role and
accountability. MM42,2
Demonstrates awareness of a range of commonly
recognised approaches to managing symptoms, for
example, relaxation, distraction and lifestyle advice. MM
35, 7
Through simulation and course work demonstrates how
to supply and administer via a patient group direction.
MM42,3.
Fully understands the different types of prescribing
including supplementary prescribing, community
practitioner nurse prescribing, and independent nurse
prescribing MM,34,6
Accesses commonly used evidence based sources
relating to the safe and effective management of
medicine. MM40,1
Competency 8
Negotiation skills
and their carer(s) their capability to care.CCC,2,8
Y
Y
Y
Y
E*
E*

achieve their goals and aspirations.CCC. 2,14
Uses helpful and therapeutic strategies to enable people
to understand treatments and other interventions in order
to give informed consent. CCC,8,4
Demonstrates respect for the autonomy and rights of
people to withhold consent in relation to treatment within
legal frameworks and in relation to people's safety.
CCC,8,7
Assess the person's ability to safely self-administer their
medicines MM40,4.
Supports people to make appropriate the choices and
changes to eating patterns, taking account of dietary
preferences, religious and cultural requirements,
treatments and special diets needed for health reasons.
NFM.27,7.
consequences of a condition including death and
24
25
Withdrawal of care
and their carer(s) their capability to care.CCC,2,8
achieve their goals and aspirations.CCC. 2,14
Uses helpful and therapeutic strategies to enable people
to understand treatments and other interventions in order
to give informed consent. CCC,8,4
Demonstrates respect for the autonomy and rights of
people to withhold consent in relation to treatment within
legal frameworks and in relation to people's safety.
CCC,8,7
Assess the person's ability to safely self-administer their
medicines MM40,4.
E*
E*
9.1 Childrens nurses must understand their

central role in preventing maltreatment, and
safeguarding children and young people. They
must work closely with relevant agencies and
professionals, and know when and how to
identify and refer those at risk or experiencing
harm.
Safeguarding children
Supports people to make appropriate the choices and

changes to eating patterns, taking account of dietary
preferences, religious and cultural requirements,
treatments and special diets needed for health reasons.
NFM.27,7.
consequences of a condition including death and
Competency 9
Recognises and responds when people are in vulnerable

situations and at risk, or in need of support and
protection. OAC 11,5
Works collaboratively with other agencies to develop,
implement and monitor strategies to safeguard and
protect individuals and groups who are in vulnerable
situations.OAC 11,8
Supports people in asserting their human rights. OAC
Challenges practises which do not safeguard those in
Recognises stress in others and provides appropriate
support or guidance ensuring safety to people at all
times.OAC17,10.
Selects and applies appropriate strategies and
techniques for conflict resolution, de-escalation and
physical intervention in the management of potential
violence and aggression. OAC 19,3.
Referral to other agencies
E*
E*
Y
Recognises and responds when people are in vulnerable
situations and at risk, or in need of support and
protection. OAC 11,5
Works collaboratively with other agencies to develop,
implement and monitor strategies to safeguard and
protect individuals and groups who are in vulnerable
situations.OAC 11,8
26
27
1.1 Childrens nurses must understand health

and social care policies relating to the health
and wellbeing of children and young people.
They must, where possible, empower and
enable children, young people, parents and
carers to influence the quality of care and
develop future policies and strategies.
Supports people in asserting their human rights. OAC

11,9
Challenges practises which do not safeguard those in
Recognises stress in others and provides appropriate
support or guidance ensuring safety to people at all
times.OAC17,10.
Selects and applies appropriate strategies and
techniques for conflict resolution, de-escalation and
physical intervention in the management of potential
violence and aggression. OAC 19,3.
D4 Leadership, management and team working
Competency 1
Health and social policies

Responds appropriately when people want to complain,
providing assistance and support.OAC 12,2
Shares complaints, compliments and comments with the
team in order to improve care. OAC 12,5.
As an individual team member and team leader, actively
seeks and learns from feedback to enhance care and
own and others professional development.OAC 12,8
Actively consults and explores solutions and ideas with
others to enhance care. OAC14,6.
multi-professional team.OAC,14,7
skill mix and acts to resolve issues that may impact on
the safety of service users.OAC,17,9
Reflects on and learns from safety incidents as an
individual and as a team member and contributes to team
learning.OAC,18,9
Challenges others who do not follow procedures.
NFM.30,5.
Participates in clinical audit to improve the safety of
service users.OAC,18,10
28
29
Empowering children, young people, parents

and carers to influence change
E*
E*
Y
Y
Y
Y
Y
Y
Y
E*
E*
30
31

learning.OAC,18,9
NFM.30,5.
1.2 Childrens nurses must ensure that,
wherever possible, care is delivered in the child
or young persons home, or in another
environment that suits their age, needs and
preferences.
Home nursing
learning.OAC,18,9
NFM.30,5.
Nursing in other environments
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y

learning.OAC,18,9
NFM.30,5.
6.1 Childrens nurses must use effective
D4 Leadership, management and team working
clinical decision-making skills when managing Competency 6
complex and unpredictable situations,
especially where the views of children or young
people and their parents and carers differ.
They must recognise when to seek extra help
or advice to manage the situation safely
Complex care
people, their families and carers to ensure that needs are
met through care planning and delivery, including
strategies for self care and peer support.CCC2, 13.
Acts as a role model in developing trusting relationships,
within professional boundaries. CCC1,11
others to enhance care.OAC14, 6.
Works inter-professionally and autonomously as a means
of achieving optimum outcomes for people.OAC14, 10.
Safeguards the safety of self and others, and adheres to
lone working policies when working in the community
setting and in peoples homes.OAC14, 11.
Works within local policies when working in the
community setting including people's homes and ensures
the safety of others. OAC17,12
Identifies suitable alternatives when isolation facilities are
unavailable and principles have to be applied in
unplanned circumstances. IPC23,8.
Y
Y
Y
Y
Y
Y
Y
E*
E*
Y
Y
Ensures that people including colleagues are aware of

and adhere to local policies in relating to isolation and
infection control procedures. IPC,23,7
Works within national and local policies and ensures
others do the same.MM40,2
Works confidently as part of the team and, where
relevant, as leader of the team to develop treatment
options and choices with the person receiving care and
their carers.MM.35,9
Works within the requirements of the code (NMC 2008) in
delegating care and when care is delegated to
them.OAC15, 2.
32
33
34
35
Unpredictable situations
them.OAC15, 2.
Seeking extra help and advice
Y
Y
Y
Y
Y
Y
E*
E*

them.OAC15, 2.
7.1 Childrens nurses must work effectively with D4 Leadership, management and team working
young people who have continuing health
Competency 7
needs, their families, the multidisciplinary team
and other agencies to manage smooth and
effective transition from childrens services to
adult services, taking account of individual
needs and preferences.
Continuing health needs

Assists in preparing people and carers for transfer and
transition through effective dialogue and accurate
information.OAC13,1.
Reports issues and people's concerns regarding transfer
and transition.OAC13,2.
Assists in the preparation of records and reports to
facilitate safe and effective transfer.OAC13,3.
Y
Y
Y
Y
Y
Y
Managing transition of care

Assists in preparing people and carers for transfer and
transition through effective dialogue and accurate
information.OAC13,1.
Reports issues and people's concerns regarding transfer
and transition.OAC13,2.
Assists in the preparation of records and reports to
facilitate safe and effective transfer.OAC13,3.
38
Y
Y

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Adopts a principled approach to care underpinned by the code,( NMC,2008) CCC4, 3.

Is acceptant of differing cultural traditions, beliefs, UK legal frameworks and professional

Through reflection and evaluation demonstrates commitment to personal and professional

Acts professionally and autonomously in situations where there may be limits to

Works within legal frameworks when seeking consent CCC8, 5.

Applies research based evidence to practice OAC 9,14

Assesses the persons ability to safely self-administer their medicines.MM 40,4

Ensures access to independent advocacy.CCC2, 9.

Supports people in asserting their human rights. OAC,11,9

Is proactive in promoting and maintaining dignity.CCC3, 5.

Acts autonomously to challenges situations or others when someone's dignity may be

Uses appropriate strategies to empower and support their choice. CC3,7.

Works interprofessionally and autonomously as a means of achieving optimum outcomes for

Through reflection and evaluation demonstrates commitment to personal and professional

Applies research based evidence to practice.OAC9,14.

Domain 2: Communication and interpersonal skills

Point of entry: Essential knowledge, understanding and skill

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Acts autonomously to reduce and challenge barriers to effective

Uses skills of active listening, questioning, paraphrasing and reflection to

Consistently shows ability to communicate safely and effectively with

Provides accurate and comprehensive written and verbal reports based on

Uses strategies to enhance communication and remove barriers to

Is proactive and creative in enhancing communication and understanding.

Makes appropriate use of touch. CCC5, 7.

Manages and diffuses challenging situations effectively.CCC4,7.

Recognises circumstances that trigger personal negative response and

Discusses sensitive issues in relation to public health and provides

Uses negotiating and other skills to encourage people who might be

Discusses the benefits of health promotion within the concept of public

Keeps appropriate records in relation to the use and maintenance of

Makes a comprehensive assessment of people's needs in relation to

Monitors and records progress against the plan. NFM. 28,8.

Domain 3: Nursing practice and decision-making

Point of entry: Essential knowledge, understanding and skill application

Demonstrates clinical confidence through sound knowledge, skills and understanding

Refers to specialists when required. OAC9, 19

Generic Multichoice Exam:

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Works within the code(NMC,2008) and in keeping with guidance on professional

Competency 2. All nurses

Recognise and acts autonomously to respond to own emotional discomfort or distress

Recognises stress in others and provide appropriate support or guidance ensuring

Safely manages drug administration and monitors effects. MM 36,4.

Evaluates the effect of interventions, taking account of peoples and carers

Understands common routes and techniques of medicine administration including

Reports adverse incidents and near misses. MM36, 5.

Safely manages anaphylaxis MM36,6.

Accurately undertakes and records base line assessments of weight, height,

Acts autonomously and appropriately when faced with sudden deterioration in

Provides accurate and comprehensive written reports based on best possible

Detects, records and reports if necessary, deterioration or improvement and takes

Uses knowledge of dietary, physical, social and psychological factors to inform

Explains medical devices to people and checks understanding.OAC20,5.

Supports people in asserting their human rights. OAC11, 9.

Safely performs wound care, applying non-touch or aseptic techniques in a variety of

Instruct others to do the same IPC.26,5.