1. Nursing Competencies Booklet
London HASU
Nursing Competencies Booklet
Elmer Catangui Clinical Nurse Specialist in Stroke/TIA
Imperial College Healthcare NHS Trust

2. Learning Objectives: Scope of the HASU competency workbook
HASU competency document
Assessment
FAQs

3. Why do we need to be
competent in stroke care?

4. HASU Experiences Incident 1 Nurse x gave aspirin 300 mg
& dipyridamole 25 mg within
8 hours to a post thrombolysed
patient.

5. Incident 2
Patient c is admitted with a (L) MCA infarct and requires every one hour monitoring.
Nurse x scores patient’s GCS as 15/15
( Actual: patient is dysphasic, open her eyes by speech)

6. Incident 3 A stroke patient is given normal diet and thin fluid
without a proper swallowing
screening.

7. Incident 4 Intravenous tazocin is given to
a stroke patient who is allergic
to penicillin.

8. Bottom line…….
Training
2. Competence

9. Stroke care? Every 5 minutes someone in the UK suffers a stroke.
2. > 11,000 hospital admissions for stroke each year
3. 1 in 5 people are more likely to survive a stroke
4. Every year over 6,000 Londoners are left with an impairment after stroke

10. Developing competence in stroke care
National Agenda
Stroke care improves patient’s outcome
Clinical guidelines

11. What does the competency booklet look like?

12. Competency Framework:
Stroke Knowledge
Neurological Care
Thrombolysis Care
Respiratory Care
Cardiovascular Care
Complication, Prevention and Detection
Communication
Secondary Prevention
End of Life
The HASU competency covers the 9 critical aspects of stroke care namely… and each competency has statements to demostrate the expected skill, knowledge and attitude.
The stroke knowledge – a nurse will demonstrate competence under this care if a nurse demonstrate un derstanding of 1. anatomy of brain , the vascular territories and symptoms that may occur if blood supply is altered.
Neurological care – is a demonstration of skill and knowledge on how to assess and describe acute neurological deterioration, its causes, and managing patient with seizure post stroke, haemorrhagic stroke, post neurosurgical patients.
Thrombolysis care: it covers the principles and application of thrombolysis in clinical practice, inclusion and exclusion criteria, medication, post thrombolysis complication, detection and monitoring of complications
Respiratory care: it encompasses the anatomy and physiology of respiratory system, assessment of patient with airway and breathing difficulty, the use of oxygen therapy and nebuliser
Cardiovascular care: it involves the relationship of stroke and AF, describing patient with AF and its clinical management, how to prepare ECG and identify cardiac arrhytmia like atrial or ventricular tachycardia.
Complication, Prevention and detection: it includes demonstration of skills and knowledge of identifying and managing common stroke complications such as haemorrhagic transformation, hyperglycaemia/ hypoglycaemia, aspiration pneumonia, subluxation, and pressure sore.
Communication: it covers the assessment of patient with communication and speech disturbance eg. Expressive and receptive dysphasia, understanding the brain structure affected when there is a language problem.

13. “one could gain knowledge and skills ("knowing how")
Benner’s Novice to Expert
“one could gain knowledge and
skills ("knowing how")
without ever learning the theory
("knowing that").”

14. Benner’s Novice to Expert Description

16. Expected Performance
Outcome
Performance Indicators

17. Formative vs Summative Assessment

19. Corner

20. Who can sign the competencies ?
Ward Manager
Band 6 ( Team Leader) Nurses
Clinical Nurse Specialist
Nurse Educator
Highly recommended: Mentors should have a
mentorship qualification.

21. Timeframe for achievement of competency ?
Within 6 months

22. Can I use this competency document when
I move to another HASU hospital?
Yes. In fact, it is a transferable document.
It is an evidence of your professional portfolio.
It is acceptable London HASU document!

23. Once I have completed the HASU competencies?
A certificate of HASU competency will be issued to you.
The original document is to be kept by you within your portfolio

24. If I failed one or two of the HASU competencies?
Local Trust policy
2. Assessor’s discretion
to extend the completion
of the competency and
repeat the failed
competencies

25. Benefits to the staff:
1. Increased knowledge and ability in managing the acute stroke patient
2. Increased awareness and skills in the different aspects of hyper acute stroke care
3. Record of Continuous Professional Development
4. Consistency of skills and delivery of care
5. Recognised standard pan-London which
can support rotation

26. Acknowledgements
James Bitmead, Clinical Practice Facilitator, University College London Hospitals NHS Foundation Trust
Vanessa Brunning, Senior Project Manager, South London Cardiac and Stroke Network
Elmer Catangui, Clinical Nurse Specialist in Stroke/TIA, Imperial College Healthcare NHS Trust
Gill Cluckie, Clinical Lead, Stroke Services, Stroke Specialist Nurse, Guy's and St Thomas' NHS Foundation Trust
Patricia Cossar, Sister, HASU, Princess Royal University Hospital, South London Healthcare NHS Trust
Janelle Devereux, Assistant Director, South London Cardiac and Stroke Network
Beatriz Enriquez-Galilea, Sister, HASU, The Royal London Hospital
Maria Fitzpatrick, Consultant Nurse Stroke Management, Friends Stroke Unit, King’s College NHS Foundation Trust
Patricia Flynn, Ward Manager, HASU, Northwick Park Hospital
Nicola Harding, Clinical Nurse Specialist - Stroke, The National Hospital for Neurology and Neurosurgery
Alison Loosemore, Ward Manager, HASU, St George’s Healthcare NHS Trust
Andrea Marlow, Senior Communications Manager, South London Cardiac and Stroke Network
Jane Paul, Stroke Care Coordinator, South London Healthcare NHS Trust
Angela Roots, Practice Development Nurse, Stroke, Guy's and St Thomas' NHS Foundation Trust
Ann Rush, Matron Trauma and Acute CAU, The Royal London Hospital
Dee Slade, Stroke/TIA Clinical Nurse Specialist, Princess Royal University Hospital, South London Healthcare NHS Trust
Natalie Wilson, Clinical Nurse Specialist in Stroke/TIA, Imperial College Healthcare NHS Trust
Paula Willmore, Teaching Sister, Acute and Trauma, The Royal London Hospital

27. Good Luck!