NMC OSCE Implementation Station 2024
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- เผยแพร่เมื่อ 2 เม.ย. 2024
- NMC OSCE - Up to date 2024 overview of the NMC OSCE Implementation station. learning the key requirements of the station, how to avoid critical fails, how to read the prescription correctly, dispensing and administering medication.
1:1 or small group tutoring available email hannahlames@outloook.com and get access to example APIE medication charts for all 12 scenarios, detailed information on hospital and community drug charts, and common medication lists. Learn in a supportive small environment with an experienced nurse and OSCE lead.
Facebook Nurse Tutor Tutoring with Hannah
#osce #nmcosce #implemetationstation #internationalnurses #nursetutoring #uknursing #medicationadministration #APIE
These videos are so much better than the very expensive intensive OSCE training course I have attended. I sorely wish I had discovered Hannah earlier. Thank you so much.
@@MultiRols thank you so much my aim was always to provided free, good quality OSCE training resources I do believe many training courses over price and do not deliver good luck with your OSCE exam
Thanks, Hanna, Excellent Video ❤
Thank you hope it helps and good luck with your OSCE study
Brilliant
Thank you
Thank you for the video 🙏🏻
Just a couple of questions
If the patient verbally pain 5 out of 10. And I have administered paracetamol 1g on the ‘regular medicine’ chart. And the ‘as required’ drug chart has oxycodone. what should I do?
1. ask the patient if they need it ? Or give oxycodone directly as the patient already complained of pain
2. what if I am not going to administer oxycodone, and will be escalated if needed? do I need to fill in a code and signature? And if I put a code and signed, what should I write for the last page” reason for the omission” ?
Thank you!
Hi thank you for the question I would always ask the patient first I would suggest to the patient that as their pain is 5 it would be better to take the oxycodone to get on top of the pain but it should be the patient's decision. Unless they have already had a dose and not enough time has passed to give another dose in which case you would need to escalate for an alternative pain medication.
If they do not want it or need it and it is an as required medication you do not need to document or use the codes just leave it blank. If it was a regular medication or a once only you would use the codes and document it on the last page. If you give the as required you need to add the time and your signature. I hope that makes sense
@@HannahAmes24 thank you so so much!! 😊🙏🏻 It's very helpful!
My pleasure good luck with your OSCE study 😊
Hi I passed my exam tq for your answers
well done
Thank you for the video,please can I give anti hypertensive drug in a normal blood pressure reading???
Yes you should give if the BP is "normal" as the medication is maintaining the normal BP.
This video is really helpful.
If I have 3 medications (Amlodipine, Bisoprolol and furosemide) prescribed under once only medications and due at my time 14:00
and I have all three medications prescribed under regular medications same dosage and already given and signed at 8:00
Do I still give all three medications at 14:00 even though all three of them had been given as regular at 8:00?
If yes, do I have to check the BNF for maximum daily dosage so I do not overdose the patient?
Yes you would need to check the dose limit but also the time frame in between doses to make sure you can safely give another dose in the 6 hrs. The normal scenario is there are 3 once-only medications for your time that have not been given and then the same medications as regular medications that have also not been given. Sometimes the prescriber puts an x in the box next to the time to indicate not to give the regular dose in which case you would give the once only and verbalise that the prescriber as marked an x in the regular and you are not to give this. If the prescriber has not put a x in the box and then the regular meds are also due at your time then you would give the once only and then code the regular with a 5 for stat dose and record it on the back omitted drug I hope that makes sense.
Hi Hannah, Can you make a video regarding the GCS chart?
Hi yes I will add this to my list
Hello Hanna! Grateful for the lessons. Please you said we dont need to read out the full prescription for medication not due our time for the sake of time, which part of it does one has to read?
Secondly if the duration and finish date is absent on a prescription, does it still pass for a valid prescription?
Lastly , is every candidate expected to code at least one medication or it should be done as prescription demands?
Hi read out the drug name and time and clearly verbalise that this medication is not due at your time and that you are not going to administer it. If the duration is not there it is still valid, it should have a start date and finish date. Not every implementation chart will have a medication that's needs coding you need to carefully read your drug chart and think about your patients and if there are reasons to code a medication look out for allergies, contraindications and stat doses these are common reasons that need a code. Good luck with your OSCE
Hi Hanna,
Can you make a video for more implementation practice?
Hi I will look at this I am really busy at the moment but hope to make some more videos soon
Please my osce is on monday . I will be grateful if you repky my questions please. Thank You Hanna.
Hi Hannah,
If the patient is allergic to penicillin , can we give Azithromycin?
As they are in different categories
Yes you could give this and if you were unsure the BNF would say if it was penicillin based antibiotic
Hello Hannah.
If a regular medication Ramipril 5mg OD is due at 8:00 but it was marked X indicating it should not be given hence it wasn’t given and I am administering 12:00 medications, can I administer it? Although the only available time is 8:00 since it’s OD medication.
Patient had not had this medication in once only medications either since there was no prescribed medication in that column.
Please help.
@@edithmartinson136 hi Edith if I have understood correctly you should not give this medication at 12 if the only time is 8.00 and the prescriber had indicated not to give it with a cross you should not give a dose at 12 this would be a fail
@@HannahAmes24 Thank you very much.
Hi good morning if the patient is allergic to T Aspirin can we give t clopidrogel
Hi yes clopidogrel is used as an alternative in patients who are allergic to aspirin so you can give it if there are not any other contraindications such as bleeding
Good evening, thanks for your help, what will you do if your patient is having nausea and vomiting and there is metoclopramide prescribed but not due at your time meanwhile is wasn't given by the last nurse at the due time, do I go ahead to give my patient?
Yes you could give it as a delayed dose and make sure you document in the omitted/delayed box on the back or check if there is an as-required metoclopramide as you could also use that prescription
@@HannahAmes24 oh, thanks so much for this explanation.
I hope it helps @@FadekemiArogbokun
@@HannahAmes24 This is the feedback on my exam👇
When checking the prescription chart the patient was not asked if they were experiencing any symptoms, resulting in the 'as required medication' being incorrectly omitted, this could result in the patients care being delayed.
I don't understand this and I need more explanation please
@@FadekemiArogbokun I think this is the end of life scenario you must ask the patient if they are feeling sick and the you need to administer the as required metoclopramide, the as required prescription will not have a time, but you can give if the patient needs it but you must ask the patient first
Hello Hanna,can I put a dot at where i would be signing after the patient accept to take the dispensed medicine in the medication pot? Just to help with easy signing after the patient is done swallowing.
I personally would not do this in the signature box if you want to put a dot do it on the outside of the prescription box or alternatively sign each one after the patient has swallowed them
@@HannahAmes24Thanks so much for your timely response.
Please for ID checks would I be penalized if I seek the patient's consent in holding his/ her wrist to check the band and verbalize the details and confirm allergies? Or do always have to go by asking patients to give full name, date of birth and hospital number (where applicable) before I cross check,which in a way delay like 10-20 seconds of the 15minutes time.
Again,is it alright to go through the prescription chart with the assessor at the medication box with the assessor so I go on to open the med box and dispense them or I have to go through with the patient instead and then on to the med box to open and dispense them?
@@user-cv5gm6ft9o you should always ask the patient first to verbalise their name and DOB and then check this against the name band this is a key marking criteria and also a safety issue as the patient could be wearing the wrong wrist band so you must get them to tell you first.
If subdural haematoma patients is allergic to t Aspirin which medication i should not give
You would not give aspirin or aspirin containing medications if this was prescribed aspirin contains acetylsalicylic acid it, is a nonsteroidal anti-inflammatory drug
Good evening Hannah, please if only the duration is missing but every detail is present can that prescription be classified as invalid and not legible?
Did the other medications have a duration? Did it have a start and finish date in which case you may not need the duration as the start and finish date would cover this. You could potentially appeal it if you felt it was unclear and your other medications had a duration. Personally in practice I don't believe it is unsafe to not give a medication and check with the prescriber if you were unsure about any aspect this is actually safe practice I would always teach that it is best to check if you are ever unsure about a prescription and I would argue this with the NMC if it was failed for just this.
@@HannahAmes24 So the actual prescription in question had both start and end dates it was only the duration that wasn't present so I was kind of confused for safety reasons so I verbalize to the patient that I would be escalating to the rest of the team and also follow up to the GP to review that prescription.
@@user-cv5gm6ft9o personally I think you have done the safe thing and in a real situation you would contact the GP get confirmation and go onto give the medication however we all know how the tests centres mark. If you failed this station for this reason only I would be tempted to appeal based on the fact that the other prescriptions had durations and based on the main point that what you did was safe unless the medication was a time critical life saving medication that the patient needed. Feel free to drop me an email if you need some support hannahlames@outlook.com
@@HannahAmes24 thanks so much
Hi since pt is allergic to aspirin in regular medicine they have prescribed aspirin but in that no prescriber sign and bleep number do we need to code on it ? But the prescription is not valid and since the pt is allergic to aspirin what is the code 7 or 10?
Hi is this a scenario you have had in your 1st attempt or is it from some training resources. If there is no prescriber signature the prescription is not valid and legible which would be a code 6 (prescription incorrect or unclear). But if the patient is allergic this is a code 10 as it is contraindicated and not safe, it would not be a 7. Both codes 6 or 10 would be right as long as you verbalized clearly your reason for admitting personally if the patient was allergic I would be coded it 10 and escalating.
Hi good morning can we give anti coagulants for subdural haematoma patients
Hi no you should not give them if you were to look in the BNF it would say they are contraindicated for at least 48hrs
Tq for your reply and i have one more doubt if i get t Levothyroxine at 14:00 due can I give ? Because usually we should give at before breakfast know
And sorry for inconvenience
You should give it although you are right that it is normally given in the morning it ideally needs 30 minutes before food and on an empty stomach but some people do take it at night. To cover yourself in the exam I would ask the patient actor when they last had anything to eat to be safe, I did have a nurse who had this scenario and did not give it and she was failed for not giving the correct medication so in the retake she administered it and asked when they had last eaten.
Tq so much @@HannahAmes24
Hi mam please help me i had subdural haematoma implementation once only medications frusemide iv t amlodipine ,t bisoprolol,t frusemid its my due time 14:00e in regular medicine i got frusemide amlodipine bisoprolol this medicine they marked as a X and lt had atenolol at 8 o clock
Patient had t atenolol at 8:00 it's not my due time please help me mam which one I need to give
Hi it might be easier to drop me an email hannahlames@outkook.com as it will be easier than on here or book in for an hour session so we can go through this.
you would give the once only. The x means the prescriber has indicated that it should not be given. This is because you have once only medications to give
And also from my last exam I was told I didn’t mention any possible contraindications during implementation
Kindly shed more light
Hi a bit difficult to tell without knowing which medications you had prescribed and the patient's condition. For example, an anticoagulant would be contraindicated in a patient with bleeding, given ibuprofen in a patient with asthma can be contraindicated. The BNF will tell you under contraindications key information you can look it up if you are unsure.
Thank you Hannah
I had a patient with pneumonia and patient was on Ramipril,oxybutynin hydrochloride and statin drug to lower the cholesterol and I failed the station
In my email it was stated I didn’t mention any possible contraindication
Am preparing for my resit and I don’t want to make any further mistake
@@Owoeyebkl I can't think of anything obvious without looking at the past medical history you do need to explain what each medication is for to the patient did you do this.
Feel free to email me your feedback I can have a look hannahlames@outlook.com