original adult nursing marking criteria for nmc osce examMany of the nurses who are preparing for NMC OSCE don’t know about the “Adult Nursing Marking Criteria” prepared together by three universities conducting the exam. The universities participated in making of Adult Nursing Criteria are University of Northampton, Oxford Brookes University and Ulster University. Adult Nursing Marking Criteria was developed to provide uniform assessment of all the stations involved in NMC OSCE across all OSCE facilitation centers. Adult Nursin Marking Criteria was first published on November 30th 2018, revised in May 24 2019 as well as on July 19 2019. Latest revision is as of September 28 2019. Many of the OSCE training centers are still following their own marking criteria instead of following this simple one.

Adult Nursing Marking Criteria developed for OSCE Exam

Adult Nursing Marking Criteria is a set of criteria laid down by universities conducting NMC OSCE exam. These criteria are laid down for all the stations involved in NMC OSCE. In other words these are the key points you should keep in your mind while attempting any of the OSCE stations.

Why these criteria are important?

Each of the osce training centers have developed their own marking criteria before “Adult Nursing Marking Criteria” came to effect in November 2018. The latest revision of Adult Nursing Marking Criteria has come in to effect on September 28th 2019. Sadly they all are still relying on those criteria rather than the original one.

For example in your real osce exam in Assessment/skills stations, it will be written in scenario that privacy is provided, consent is taken etc. Also, it is clearly mentioned in this criteria that there is no need to verbalize seven steps of hand washing. Still training centers are making you to train provide privacy, take consent for procedure, verbalize seven steps of hand washing etc.So in rush of verbalizing all unnecessary things, you will forget the most important ones. So, its important for you to have a look on adult nursing marking criteria before attempting your NMC OSCE exam.

What is added extra in July 19th  2019 Adult Nursing Marking Criteria Update?

Fluid Chart, PHQ9 Questionnaire, MUST Score calculation is the new additions in latest update

What is added extra in May 24th 2019 Adult Nursing Marking Criteria?

A new skill has been added in this marking criteria which is called “Administration of Inhaled Medication”.

What is added extra in September 28th 2019 Adult Nursing Marking Criteria?

A new skill has been added which is called Midstream Collection of Urine or MSU.

Criteria’s laid down for different stations (APIE)

Assessment Station

1 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels
2 May verbalize or make environment safe
3 Introduce self to person
4 Check ID with person (person’s name is essential and either their date of birth or hospital number) : verbally, against wristband (where appropriate) and paperwork
5 Gain consent
6 Sit / stand at an appropriate level and explain the reason for assessment
7 Establish reason for admission
8 Document and provide a score using assessment tool
9 Measures and documents observations accurately
10 May identify risks associated with person’s symptoms
11 May identify poor compliance with medication
12 Use Activities of Living model effectively with clear relevant questioning in a timely manner
13 Identify known allergies
14 Deal with health education sensitively
15 Verbal communication is clear and appropriate
16 Close assessment appropriately and may check findings with person

Planning Station

1 Handwriting is clear and legible for problems one and two
2 Identify two relevant nursing problems / needs
3 Identify aims for both problems
4 Set appropriate evaluation date for both problems
5 Ensure nursing interventions are current / relate to EBP / best practice
6 Self-care opportunities identified and relevant
7 Professional terminology used in care planning
8 Confusing abbreviations avoided
9 Ensure strike-through errors retain legibility
10 Print, sign and date

Implementation Station

1 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels
2 Introduce self to person
3 Seek consent prior to administering medication
4 Check ID with person; verbally, against wristband (where appropriate) and paperwork
5 May refer to previous assessment results
6 Must check allergies on chart and confirm with the person in their care, also note red ID wristband
7 Before administering any prescribed drug, look at the person’s prescription chart and check the following are correct:
 Person
 Drug
 Dose
 Date and time of administration
 Route and method for administration

Ensures:
 Validity of prescription
 Signature of prescriber
 Prescription is legible

8 Identify and administer drugs due for administration correctly and safely
9 Provide a correct explanation of what each drug being administered is for to the person in their care
10 Omit drugs not to be administered and provides verbal rationale (ask candidate reason for non-administration if not verbalised)
11 Accurately record drug administration and non-administration

Evaluation Station

1 Clearly describe reason for initial admission and diagnosis
2 Record date of admission
3 Identify main nursing needs
4 Record approaches and interventions used
5 Outline current ability to self-care based on the person’s care plan
6 List areas identified for health education
7 Documents allergies
8 Ensure strike-through errors retain legibility
9 Print, sign and date

Assessment Criteria laid down for Skill Stations

Administration of Inhaled Medication (New)

1 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels
2 Explain and discuss the procedure with the person
3 Sit the person in an upright position
4 Before administering any prescribed drug, look at the person’s prescription chart and check the following:
Correct:
 Person
 Drug
 Dose
 Date and time administration
 Route and method of administration
 Diluent (as appropriate)
5 Ensures:
 Validity of prescription
 Signature of prescriber
 Prescription is legible
If any of these pieces of information are missing, are unclear or illegible then the nurse should not proceed with administration and should consult the prescriber
6 Remove the mouthpiece cover from inhaler
7 Shake inhaler well for 2-5 seconds
8 With a spacer device: Insert MDI into end of spacer device. Ask the person to
exhale completely and then grasp spacer mouthpiece with teeth and lips while holding inhaler.
9 Ask the person to tip head back slightly, inhale slowly and deeply through the mouth whilst depressing the canister fully
10 Instruct the person to breathe in slowly for 2-3 seconds and hold their breath for approximately 10 seconds, then remove the MDI from mouth before exhaling slowly through pursed lips
11 Instructs the person to wait 20-30 seconds between inhalations (if same
medication) or 2-3 minutes between inhalations (if different medication)
12 Clean any equipment used and discard all disposable equipment in appropriate containers
13 Date and sign drug administration record
14 Reassures the person appropriately
15 Closes interaction professionally and appropriately

For Aseptic Non Touch Technique (ANTT)

1 Check that all the equipment required for the procedure is available and, where applicable, is sterile (i.e. that packaging is undamaged, intact and dry; that sterility indicators are present on any sterilized items and have changed colour where applicable)
2 Explain and discuss the procedure with the person
3 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels
4 Clean trolley with detergent wipes (or equivalent)
5 Place all the equipment required for the procedure on the bottom shelf of the clean dressing trolley (or suitable equivalent)
6 Put on a disposable plastic apron
7 Take the trolley to the person’s bedside disturbing the curtains as little as possible
8 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels
9 Open the outer cover of the sterile pack and, once you have verified that the pack is the correct way up, slide the contents, without touching them, onto the top shelf of the trolley (or suitable equivalent)
10 Open the sterile field using only the corners of the paper
11 Open any other packs, tipping their contents gently onto the centre of the sterile field
12 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels
13 Carry out and complete the relevant procedure using ANTT
14 Dispose of waste appropriately – verbalisation accepted
15 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels

Catheter Sample of Urine (CSU)

1 Explain and discuss the procedure with the person
2 Check that any equipment required for the procedure is available and, where applicable, is sterile (i.e. that packaging is undamaged, intact and dry; that sterility indicators are present on any sterilised items and have changed colour where applicable)
3 If no urine visible in catheter tubing: wash / clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels, don apron and apply non-sterile gloves prior to manipulating the catheter tubing
4 Apply non-traumatic clamp a few centimetres distal to the sampling port
5 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels, don gloves
6 Wipe sampling port with 2% chlorhexidine in 70% isopropyl alcohol and allow drying for 30 seconds
7 If using needle and syringe: using a sterile syringe and needle, insert needle into port at an angle of 45°, using a non-touch technique, and aspirate the required amount of urine, then withdraw needle.

If using needleless system: insert sterile syringe firmly into centre of sampling port (according to manufacturer’s guidelines), using a non-touch technique, aspirate the required amount of urine and remove syringe
8 Transfer an adequate volume of the urine specimen (approx. 10ml) into a sterile container immediately
9 Discard needle and syringe into sharps container (if relevant)
10 Wipe the sampling port with an alcohol wipe and allow to dry
11 Unclamp catheter tubing (if relevant)
12 Dispose of waste, remove apron and gloves and clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels – verbalisation accepted

Basic Life Support (In Hospital Resuscitation – without defibrillation)

1 Ensure personal safety (safe environment)
2 Check the person for a response
3 Shouts for help when the person does not respond (if not already done)
4 Turn the person on to their back
5 Open the airway using head tilt and chin lift (jaw-thrust if risk of cervical spine injury)
6 Keeping the airway open, look, listen, and feel – to determine if the person is breathing normally (less than 10 seconds)
7 May check for carotid pulse at the same time
8 Ensure resuscitation team are called and resuscitation equipment requested (if alone leaves the person to get help and equipment)
9 Commence CPR with ratio of compressions to ventilations of 30:2
10 Uses correct hand position – middle of the lower half of sternum
11 Compression depth of 5-6cm
12 Compression rate of 100-120 compressions per minute
13 Allow the chest to recoil completely after each compression
14 Minimise any interruptions to chest compressions (hands-off time)
15 Use bag-valve mask (ambu-bag / self-inflating bag-mask) to produce a visible rise of the chest wall
16 Avoid rapid or forceful breaths

Midstream Specimen of Urine (MSU) and Urinalysis (New)
1 Discuss the procedure with the person
2 Explain to the person how to perform MSU (part labia and clean meatus with soap and water from front to back)
3 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels
4 Check that all the equipment required for the procedure is available and, where applicable, is sterile (i.e. that packaging is undamaged, intact and dry; that sterility indicators are present on any sterilized items and have changed colour where applicable)
5 Give the person a clean specimen pot
6 Don a disposable plastic apron and non-sterile gloves
7 Dip Reagent strip into the urine for no longer than 1 second
8 Hold strip at an angle at the edge of the container
9 Wait the required time before reading the strip against the colour chart
10 Dispose of waste
11 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels
12 Provide Health Education to Person according to results. Inform of actions to be taken next
13 Document readings according to reagent strip

Intramuscular Injections

1 Explain and discuss the procedure with the person

2 Before administering any prescribed drug, look at the person’s prescription chart and check the following:

Correct:  Person  Drug  Dose  Date and time administration  Route and method of administration  Diluent (as appropriate)

3 Ensures:
 Validity of prescription
 Signature of prescriber
 Prescription is legible
If any of these pieces of information are missing, are unclear or illegible then the nurse should not proceed with administration and should consult the prescriber
4 Prepare medication
5 Don apron and close the curtains / door and assist the person into the required position and wash hands
6 Remove the appropriate garment to expose injection site
7 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels and assess the injection site for signs of inflammation, oedema, infection and skin lesions
8 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels, and apply non-sterile gloves
9 Clean the injection site with a swab saturated with isopropyl alcohol 70% for 30 seconds and allow to dry for 30 seconds
10 Stretch the skin around the injection site
11 Insert the needle at an angle of 90° into the skin until about 1cm of the needle is left showing
12 Pull back on the plunger. If no blood is aspirated, depress the plunger at approximately 1ml every 10 seconds and inject the drug slowly
13 Wait 10 seconds before withdrawing the needle
14 Withdraw the needle rapidly. Apply gentle pressure to any bleeding point but do not massage the site
15 Apply a small plaster over the puncture site
16 Ensure that all sharps and non-sharp waste are disposed of safely (including scooping method of re-sheathing if used and transportation of sharps) and in accordance with locally approved procedures
17 Date and sign drug administration record – verbalisation accepted

Peak Expiratory Flow Rate (Peak Flow Meter)

1 Explain the procedure to the person and obtain their consent
2 Ask the person what their best peak flow measurements have been and what their current peak flow readings are
3 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels
4 Assemble equipment
5 Push needle on the gauge down to zero
6 Ask the person to hold the peak flow meter horizontally, ensuring their fingers do not impede the gauge
7 Ask the person to take a deep breath in through their mouth to full inspiration
8 Ask the person to immediately place their lips tightly around the mouthpiece
9 Ask the person to blow out through the meter in a short sharp ‘huff’ as forcefully as they can
10 Take a note of the reading and return the needle on the gauge to zero. Ask the person to take a moment to rest and then repeat the procedure twice, noting the reading each time
11 Document the highest of the three acceptable readings
12 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels

Removal of Urinary Catheter

1 Explain procedure to the person and inform them of potential post-catheter symptoms, such as urgency, frequency and discomfort, which are often caused by irritation of the urethra by the catheter
2 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels, and put on disposable gloves and don an apron
3 Wearing gloves, use saline soaked gauze to clean the meatus and catheter, always swabbing away from the urethral opening
4 Having checked volume of water in balloon (see patient documentation), use syringe to deflate balloon
5 Ask person to breathe in and then out; as person exhales, gently (but firmly with continuous traction) removes catheter
6 Clean area around the genitalia and make the person comfortable
7 Encourage person to exercise and to drink 2-5 litres of fluid per day
8 Dispose of equipment including apron and gloves in an orange plastic clinical waste bag – verbalisation accepted
9 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels

Subcutaneous Injection

1 Explain and discuss the procedure with the person
2 Before administering any prescribed drug, look at the person’s prescription chart and check the following: Correct: • Person • Date and time of administration • Drug • Route and method of administration • Dose • Diluent (as appropriate)
3 Ensures:
• Validity of prescription
• Signature of prescriber
• Prescription is legible

If any of these pieces of information are missing, are unclear or illegible then the nurse should not proceed with administration and should consult the prescriber
4 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels
5 Prepare medication
6 Don apron
7 Assess the injection site for signs of inflammation, oedema, infection and skin lesions
8 Clean hands with alcohol hand rub, or wash with soap and water, and dry with paper towels and apply non-sterile gloves
9 Pinch the skin and select the correct needle size (this is commonly 25G needle)
10 Where appropriate clean the injection site with a swab saturated with isopropyl alcohol 70%
11 Remove the needle sheath
12 Gently pinch the skin into a fold
13 Hold the needle between thumb and forefinger of dominant hand as if grasping a dart
14 Insert the needle into the skin at an angle of 45° and release the grasped skin (unless administering insulin when an angle of 90° should be used). Inject the drug slowly over 10-30 seconds
15 Withdraw the needle rapidly and apply gentle pressure with sterile gauze. Do not massage the area.
16 Ensure that all sharps and non-sharp waste are disposed of safely (including scooping method of re-sheathing is used) and in accordance with locally approved procedures – verbalisation accepted
17 Sign and date drug administration record – verbalisation accepted

How knowledge of these criterias will help for your OSCE Training?

Information about these marking criterias will help you adjust time for your procedures NMC OSCE and hence practice effectively.

Conclusion

Its very important for nurses attempting NMC OSCE to be aware of these marking criterias. Many candidates are failing in OSCE because of lack of knowledge of these essential criterias.

Hopes this article helps you to make your prepartion for NMC OSCE fruitful, for more article updates on NMC OSCE, please don’t forget to visit this website regularly and like our facebook page ie https://www.facebook.com/nmcosce

PDF Article on September 28th 2019 Update – Adult Nursing Marking Criteria September 2019

PDF article on July 19th  Update – Adult Nursing Marking Criteria July 19 2019 NMC OSCE

PDF article on (May 24 2019) adult nursing marking criteria can be downloaded Adult Nursing Marking Criteria May 24 2019 NMC OSCE.

Full pdf on adult nursing marking criteria (old one) can be downloaded here

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