Revalidation Forms

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Practice Hours Log Templates

[/cz_title][cz_gap][/vc_column][/vc_row][vc_row][vc_column width=”1/3″][cz_title text_center=”true” id=”cz_62439″]Guide to completing practice hours log:
To record your hours of practice as a registered nurse, midwife and nursing associate, please fill in a page for each of your periods of practice. Please enter your most recent practice first and then any other practice until you reach 450 hours. You can only count practice hours during the three year period since your last registration renewal or initial registration. You do not necessarily need to record individual practice hours. You can describe your practice hours in terms of standard working days or weeks. For example if you work full time, please just make one entry of hours. If you have worked in a range of settings please set these out individually. You may need to print additional pages to add more periods of practice. If you are both a nurse and a midwife or a nursing associate and nurse you will need to provide information to cover 450 hours of practice for each of these registrations.
[/cz_title][cz_gap][cz_gap height=”75px”][/vc_column][vc_column width=”1/3″][cz_title text_center=”true” id=”cz_46803″]Work setting:
• Ambulance service
• Care home sector
• Community setting (including district nursing and community psychiatric nursing)
• Consultancy
• Cosmetic or aesthetic sector
• Governing body or other leadership
• GP practice or other primary care
• Hospital or other secondary care
• Inspectorate or regulator
• Insurance or legal

• Maternity unit or birth center
• Military
• Occupational health
• Police
• Policy organization
• Prison
• Private domestic setting
• Public health organization
• School
• Specialist or other tertiary care including hospice
• Telephone or e-health advice
• Trade union or professional body
• University or another research facility
• Voluntary or charity sector
• Other Scope of practice
• Commissioning
• Consultancy
• Education
• Management
• Policy
• Direct patient care
• Quality assurance or inspection
[/cz_title][/vc_column][vc_column width=”1/3″][cz_title text_center=”true” id=”cz_79907″]Scope of practice:
• Commissioning
• Consultancy
• Education
• Management
• Policy
• Direct patient care
• Quality assurance or inspection
[/cz_title][cz_gap height=”40px”][cz_title text_center=”true” id=”cz_85847″]Registration:
• Nurse
• Midwife
• Nurse/SCPHN
• Midwife/SCPHN
• Nurse and Midwife (including Nurse/SCHPN and Midwife/SCPHN)
[/cz_title][/vc_column][/vc_row][vc_row][vc_column][cz_gap height=”20px”][/vc_column][/vc_row][vc_row][vc_column][cz_contact_form_7 cf7=”Guide to completing practice hours log” id=”cz_25672″ sk_p=”width:33%;”][/vc_column][/vc_row][vc_row][vc_column][cz_gap][/vc_column][/vc_row][vc_row][vc_column][cz_gap height=”75px”][cz_title shape=”image” smart_fs=”true” text_center=”true” id=”cz_14879″ image=”1191″ sk_shape=”top:-80px;” sk_shape_mobile=”font-size:5em;top:-140px;left:20%;”]

Continue Professional Development [CPD]

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Guide to completing practice hours log

[/cz_title][vc_row_inner][vc_column_inner width=”1/3″][cz_title text_center=”true” id=”cz_77889″]Examples of learning method
• Online learning
• Course attendance
• Independent learning
[/cz_title][/vc_column_inner][vc_column_inner width=”1/3″][cz_title text_center=”true” id=”cz_58641″]What was the topic?
Please give a brief outline of the key points of the learning activity, how it is linked to your scope of practice, what you learnt, and how you have applied what you learnt to your practice.
[/cz_title][/vc_column_inner][vc_column_inner width=”1/3″][cz_title text_center=”true” id=”cz_82647″]Link to Code
Please identify the part or parts of the Code relevant to the CPD.
• Prioritise people
• Practise effectively
• Preserve safety
• Promote professionalism and trust
[/cz_title][/vc_column_inner][/vc_row_inner][cz_title text_center=”true” id=”cz_91945″]Please provide the following information for each learning activity, until you reach 35 hours of CPD (of which 20 hours must be participatory). For examples of the types of CPD activities you could undertake, and types of evidence you could retain, refer to our guidance sheet at www.revalidation.nmc.org.uk/download-resources/guidance-and-information[/cz_title][cz_contact_form_7 cf7=”Guide to completing practice hours log” id=”cz_84667″][/vc_column][/vc_row][vc_row][vc_column][cz_gap][/vc_column][/vc_row][vc_row][vc_column][cz_gap height=”75px”][cz_title shape=”image” smart_fs=”true” text_center=”true” id=”cz_94375″ image=”1191″ sk_shape=”top:-80px;” sk_shape_mobile=”font-size:5em;top:-140px;left:20%;”]

FeedBack Log

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Guide to completing completing feedback log

[/cz_title][vc_row_inner][vc_column_inner width=”1/2″][cz_title text_center=”true” id=”cz_104451″]Examples of sources of feedback
Patients or service users
• Colleagues – nurses, midwives, nursing associates, other healthcare professionals
• Students
• Annual appraisal
• Team performance reports
• Serious event reviews
[/cz_title][/vc_column_inner][vc_column_inner width=”1/2″][cz_title text_center=”true” id=”cz_32057″]Examples of types of feedback
Verbal
• letter or card
• Survey
• Report
[/cz_title][/vc_column_inner][/vc_row_inner][cz_gap][cz_title text_center=”true” id=”cz_102106″]Please provide the following information for each of your five pieces of feedback. You should not record any information that might identify an individual, whether that individual is alive or deceased. The section on non-identifiable information in How to revalidate with the NMC provides guidance on how to make sure that your notes do not contain any information that might identify an individual.

You might want to think about how your feedback relates to the Code, and how it could be used in your reflective accounts.[/cz_title][cz_contact_form_7 cf7=”Untitled” id=”cz_37268″][/vc_column][/vc_row][vc_row][vc_column][cz_gap][/vc_column][/vc_row][vc_row][vc_column][cz_gap height=”75px”][cz_title shape=”image” smart_fs=”true” text_center=”true” id=”cz_46563″ image=”1191″ sk_shape=”top:-80px;” sk_shape_mobile=”font-size:5em;top:-140px;left:20%;”]

Reflective Accounts Form

[/cz_title][cz_gap][cz_title text_center=”true” id=”cz_86473″]You must use this form to record five written reflective accounts on your CPD and/or practice-related feedback and/or an event or experience in your practice and how this relates to the Code. Please fill in a page for each of your reflective accounts, making sure you do not include any information that might identify a specific patient, service user, colleague or other individuals. Please refer to our guidance on preserving anonymity in the section on non-identifiable information in How to revalidate with the NMC.[/cz_title][cz_gap][cz_contact_form_7 cf7=”Reflective accounts form” id=”cz_35273″][/vc_column][/vc_row][vc_row][vc_column][cz_gap][/vc_column][/vc_row][vc_row][vc_column][cz_gap height=”75px”][cz_title shape=”image” smart_fs=”true” text_center=”true” id=”cz_105104″ image=”1191″ sk_shape=”top:-80px;” sk_shape_mobile=”font-size:5em;top:-140px;left:20%;”]

Reflective Accounts Form

[/cz_title][cz_gap][cz_title text_center=”true” id=”cz_86473″]You must use this form to record five written reflective accounts on your CPD and/or practice-related feedback and/or an event or experience in your practice and how this relates to the Code. Please fill in a page for each of your reflective accounts, making sure you do not include any information that might identify a specific patient, service user, colleague or other individuals. Please refer to our guidance on preserving anonymity in the section on non-identifiable information in How to revalidate with the NMC.[/cz_title][cz_gap][cz_contact_form_7 cf7=”Reflective accounts form” id=”cz_25547″][/vc_column][/vc_row][vc_row][vc_column][cz_gap][/vc_column][/vc_row][vc_row][vc_column][cz_gap height=”75px”][cz_title shape=”image” smart_fs=”true” text_center=”true” id=”cz_37764″ image=”1191″ sk_shape=”top:-80px;” sk_shape_mobile=”font-size:5em;top:-140px;left:20%;”]

Reflective Accounts Form

[/cz_title][cz_gap][cz_title text_center=”true” id=”cz_86473″]You must use this form to record five written reflective accounts on your CPD and/or practice-related feedback and/or an event or experience in your practice and how this relates to the Code. Please fill in a page for each of your reflective accounts, making sure you do not include any information that might identify a specific patient, service user, colleague or other individuals. Please refer to our guidance on preserving anonymity in the section on non-identifiable information in How to revalidate with the NMC.[/cz_title][cz_gap][cz_contact_form_7 cf7=”Reflective accounts form” id=”cz_103707″][/vc_column][/vc_row][vc_row][vc_column][cz_gap][/vc_column][/vc_row][vc_row][vc_column][cz_gap height=”75px”][cz_title shape=”image” smart_fs=”true” text_center=”true” id=”cz_39885″ image=”1191″ sk_shape=”top:-80px;” sk_shape_mobile=”font-size:5em;top:-140px;left:20%;”]

Reflective Accounts Form

[/cz_title][cz_gap][cz_title text_center=”true” id=”cz_86473″]You must use this form to record five written reflective accounts on your CPD and/or practice-related feedback and/or an event or experience in your practice and how this relates to the Code. Please fill in a page for each of your reflective accounts, making sure you do not include any information that might identify a specific patient, service user, colleague or other individuals. Please refer to our guidance on preserving anonymity in the section on non-identifiable information in How to revalidate with the NMC.[/cz_title][cz_gap][cz_contact_form_7 cf7=”Reflective accounts form” id=”cz_19618″][/vc_column][/vc_row][vc_row][vc_column][cz_gap][/vc_column][/vc_row][vc_row][vc_column][cz_gap height=”75px”][cz_title shape=”image” smart_fs=”true” text_center=”true” id=”cz_25519″ image=”1191″ sk_shape=”top:-80px;” sk_shape_mobile=”font-size:5em;top:-140px;left:20%;”]

Reflective Accounts Form

[/cz_title][cz_gap][cz_title text_center=”true” id=”cz_86473″]You must use this form to record five written reflective accounts on your CPD and/or practice-related feedback and/or an event or experience in your practice and how this relates to the Code. Please fill in a page for each of your reflective accounts, making sure you do not include any information that might identify a specific patient, service user, colleague or other individuals. Please refer to our guidance on preserving anonymity in the section on non-identifiable information in How to revalidate with the NMC.[/cz_title][cz_gap][cz_contact_form_7 cf7=”Reflective accounts form” id=”cz_65395″][/vc_column][/vc_row][vc_row][vc_column][cz_gap][/vc_column][/vc_row][vc_row][vc_column][cz_gap height=”75px”][cz_title shape=”image” smart_fs=”true” text_center=”true” id=”cz_41073″ image=”1191″ sk_shape=”top:-80px;” sk_shape_mobile=”font-size:5em;top:-140px;left:20%;”]

Reflective Discussion Form

[/cz_title][cz_gap][cz_title text_center=”true” id=”cz_109553″]You must use this form to record your reflective discussion with another NMC-registered nurse, midwife or nursing associate about your five written reflective accounts. During your discussion you should not discuss patients, service users, colleagues in a way that could identify them unless they expressly agree, and in the discussion summary section below make sure you do not include any information that might identify an individual. Please refer to the section on non-identifiable information in How to revalidate with the NMC for further information. For more information about reflective discussion, please refer to our guidance sheet on reflective practice for revalidation.[/cz_title][cz_gap][cz_contact_form_7 cf7=”Reflective Discussion Form” id=”cz_12544″][/vc_column][/vc_row][vc_row][vc_column][cz_gap][/vc_column][/vc_row][vc_row][vc_column][cz_gap height=”75px”][cz_title shape=”image” smart_fs=”true” text_center=”true” id=”cz_86068″ image=”1191″ sk_shape=”top:-80px;” sk_shape_mobile=”font-size:5em;top:-140px;left:20%;”]

Confirmation Form

[/cz_title][cz_gap][cz_title text_center=”true” id=”cz_58343″]You must use this form to record your confirmation.

To be completed by the nurse, midwife or nursing associate:[/cz_title][cz_gap][cz_contact_form_7 cf7=”Confirmation form” id=”cz_81418″][/vc_column][/vc_row][vc_row][vc_column][vc_raw_html]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[/vc_raw_html][/vc_column][/vc_row][vc_row][vc_column][vc_raw_html]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[/vc_raw_html][/vc_column][/vc_row]