ASSESSMENT STATION : NMC OSCE 🇬🇧 #nurseniezl #niezl2023

Introduction

This tutorial is designed to help nursing candidates prepare for the UK NMC OSCE exam by providing a clear step-by-step guide on conducting an A to E assessment. This assessment is crucial for evaluating a patient's condition quickly and effectively within a 20-minute timeframe.

Step 1: Understanding the A to E Assessment

The A to E assessment is a systematic approach used in emergency and clinical settings to assess and prioritize patient care. Each letter represents a critical component of patient evaluation:

• A - Airway: Ensure the airway is clear.
• B - Breathing: Assess the effectiveness of breathing.
• C - Circulation: Evaluate circulation and blood pressure.
• D - Disability: Check for any neurological impairment.
• E - Exposure: Expose the patient to assess for any other issues.

Step 2: Sample Scenario Preparation

Before performing the assessment, familiarize yourself with the sample scenario provided in the exam. This will help you anticipate potential issues and understand the context of your assessment.

• Read through the scenario carefully.
• Identify key details about the patient's condition.
• Note any specific instructions or requirements.

Step 3: Conducting the Pre-Assessment

Start your assessment by gathering essential information and preparing yourself:

• Introduce yourself to the patient.
• Confirm the patient's identity.
• Explain the assessment procedure to the patient.
• Gather any available medical history and current medications.

Step 4: Airway Assessment

Evaluate the patient's airway using the following steps:

1. Inspect for any obstructions (e.g., food, blood).
2. Look for signs of respiratory distress (e.g., stridor, wheezing).
3. If the airway is compromised, take immediate action (e.g., reposition the patient, perform suctioning).

Step 5: Breathing Assessment

Assess the patient's breathing by following these steps:

1. Observe the rate, rhythm, and depth of breathing.
2. Listen for abnormal lung sounds using a stethoscope.
3. Check for cyanosis or any signs of hypoxia.
4. Measure oxygen saturation levels using a pulse oximeter.

Step 6: Circulation Assessment

Evaluate the patient’s circulation through these actions:

1. Check the pulse (rate, rhythm, quality).
2. Measure blood pressure using a sphygmomanometer.
3. Assess capillary refill time (should be less than 2 seconds).
4. Look for signs of bleeding or shock.

Step 7: Disability Assessment

Determine the patient's neurological status:

1. Assess the level of consciousness using the AVPU scale (Alert, Voice, Pain, Unresponsive).
2. Check pupil response to light.
3. Evaluate motor response by asking the patient to follow commands.

Step 8: Exposure Assessment

Conduct a full-body assessment:

1. Expose the patient to inspect for any injuries or rashes.
2. Maintain the patient's dignity and warmth during the assessment.
3. Document any findings accurately.

Step 9: NEWS2 Chart Documentation

Document your findings using the NEWS2 (National Early Warning Score) system:

• Record vital signs.
• Assign scores based on the patient's condition.
• Use the chart to guide further action if scores indicate deterioration.

Step 10: Assessing Activities of Daily Living

Evaluate the patient's ability to perform daily activities:

• Ask about the patient's mobility, eating, and personal care.
• Identify any assistance needed and plan appropriate interventions.

Step 11: Post-Assessment Review

After completing the assessment:

• Review your findings and document them thoroughly.
• Discuss any concerns with the healthcare team.
• Plan and prioritize interventions based on your assessment.

Conclusion

Conducting an A to E assessment is a critical skill for nursing candidates preparing for the UK NMC OSCE exam. By following these steps, you will enhance your ability to evaluate patients effectively. Remember to practice these assessments regularly to build confidence and proficiency. Good luck with your preparation, and feel free to reach out for further assistance or clarification!