Core Advanced Pharmacist e-portfolio

DOPS

Title *

Respiratory examination of a patient with Chronic Obstructive Pulmonary Disease

Date of assessment *

30/8/2022

Collaborator Details

Collaborator name *

A M

Collaborator email

Only required for sending ticketed invitations

[email protected]

Collaborator position *

Consultant Pharmacist - Respiratory

Collaborator profession *

Pharmacist

Collaborator declaration *

I can confirm I have read the RPS collaborator guidance and have the appropriate experience to complete this assessment. I confirm I have completed the assessment objectively and independently.

Yes ☒

Details of Procedure

Procedure being observed*

Respiratory examination of a patient with Chronic Obstructive Pulmonary Disease

Clinical setting*

Outpatient clinic setting (20min – COPD review)

Level of complexity*

Low  ☐   Medium   ☒     High ☐

Collaborator Assessment

Professional approach (to include communication, consent, consideration of the patient, seeks help if appropriate) *

Satisfactory

Needs improvement

Comments *

All appropriate and no concerns identified. Communication with patient was excellent.

Knowledge (indication, anatomy, technique) *

Satisfactory

Needs improvement

Comments *

All appropriate, and no concerns identified. Indication for examination was discussed, and technique stages were described in advance of examination.

Demonstrates appropriate preparation pre-procedure*

Satisfactory

Needs improvement

Comments *

All appropriate and no concerns identified. All personal hygiene and infection control processes followed.

Technical ability *

Satisfactory

Needs improvement

Comments *

• General inspection of patient & general examination (e.g. hands/fingers etc.) all performed perfectly
• Respiratory rate/pattern and radial pulse/BP all taken perfectly.
• Certain aspects not performed (e.g. those needed when assessing acutely presenting patient), as not needed for this patient.
• Performing well with the stethoscope when auscultating on both the front and back of the chest, and when jointly listening with a double training stethoscope.

Post-procedure management *

Satisfactory

Needs improvement

Comments *

Not assessed.

Summary of Assessment 

Overall rating *

Based on your observation of this procedure, rate the overall ability to perform the procedure

Unable to perform the procedure

Able to perform the procedure under direct supervision/assistance

Able to perform the procedure with limited supervision/assistance

Competent to perform the procedure unsupervised and deal with complications 

What aspects were done well? *

• Able to perform the necessary steps for the normal examination of a patient attending for a chronic disease review and is now competent and confident to perform these independently.
• Performing well with the stethoscope when auscultating on both the front and back of the chest. Understands normal breath sounds and can identify additional sounds (e.g. wheezing, fine crackles, and course crackles, etc.).

Suggested areas for development *

• Could perhaps ask patients to take deeper breaths at times, as some patients need clearer instruction and COPD patients can be quiet.
• Over time we can build in concepts and techniques of how to perform a more in-depth examination (e.g. more in-depth palpation, percussion, etc.), and identification of less common additional sounds.

Agreed action(s)

• Organise experiential learning in area with acutely unwell adults.
• Practice, and develop, palpation and percussion.
• Take opportunities to listen to and identify additional noises such as rubs.

Learner’s reflection

Describe what you have learned. How will it change your practice in the future?

I have really gained confidence on chest auscultation and I can see the significant progress that I’ve made. This skill is already helping me make better clinical decisions and I am able to deliver care more autonomously. I’m looking forward to the next stage of learning but understand the assessment/examination of acutely unwell adults will potentially be harder and more ‘high risk’. Despite this challenge, I am looking forward to progressing into this space. My supportive mentor is vital to this, and I really value their feedback.

Attachments

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None

Mappings

Consider what learning outcome(s) this record provides evidence for and map to all that apply

• 2.1 Delivers care using advanced pharmaceutical knowledge and skills for individuals and/or groups with highly complex needs, including where evidence is limited or ambiguous.
• 2.2 Undertakes a holistic clinical review of individuals with complex needs, using a range of assessment methods, appropriately adapting assessments and communication style based on the individual.

Linked Evidence

Consider if this records links to any other pieces of evidence within your portfolio.

None