Practical Guide – Nurses Online Discussion

PRACTICAL GUIDE FOR NURSES AND MIDWIVES

Nurses and midwives have a professional responsibility to know and understand practical knowledge since it is the backbone of nursing and it highly impacts the clinical practice.

OSPE/OSCE PRACTICAL GUIDE

STATION

SCENARIO: TAKING OBSERVATIONS

At this station, there is patient on four (4) hourly observations.

INSTRUCTIONS:

Prepare the tray.
Take the temperature, pulse, respiration and blood pressure.
Record the findings on the observation chart.
Move to the next station when the bell rings.

STATION: CHECKLIST FOR TAKING VITAL OBSERVATIONS

STUDENT’S NSIN: ________________________

EXAMINER: ___________________________

DATE :____________________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Wash hands	2
2.	Identify each instrument by naming
	Cusco’s vaginal speculum	1
	Dressing forceps	1
	Sponge holing forceps	1
	Uterine sound	1
	Mouth gag	1
	Airway piece	1
	Cord scissor	1
	Straight artery forceps	1
3.	Explain the use of each of the instruments
	Used during vaginal examination to view the cervix and walls of the vagina	1
	Used for dressing wounds	1
	Holding sponge/cotton swabs during mopping of blood	1
	Measure the length of the uterus	1
	Open mouth wide during oral care	1
	Keep airway open	1
	Cutting the umbilical cord	1
	Arresting haemorrhage	1
4.	Wash hands	2
TOTAL		20

Examiners’ comment: ……………………………………………………………………………………………………………………………………………………………….

SCENARIO: MAKING ADMISSION BED

At this station, there is a need to make an admission bed.

INSTRUCTIONS

The trolley is already set
Make an admission bed.
Move to the next station when the bell rings.

STATION: MAKING ADMISSION BED

STUDENT’S NSIN _____________________

EXAMINER_______________________

DATE__________________________

S/No	Areas to be Assessed	Score
1.	Places 2 chairs at the foot of the bed and arranges linen on the chairs.	½
2.	Checks the springs	½
3.	Turns the mattress systematically	½
4.	Puts on long mackintosh	1
5.	Puts on bottom sheet and metres corners	1
6.	Puts draw mackintosh and draw sheet	1
7.	Places admission sheet over draw sheet	1½
8.	Another admission sheet is put before the top sheet	1½
9.	Puts the top sheet, metres corners at the bottom and folds the top.	1
10.	Puts the blanket, metres cornes and bed cover, tucks the bottom, metres corners but does not tuck in the sides	1
11.	Clears away	½
Total		10

SCENARIO: MAKING POST OPERATIVE BED

At this station you are to prepare a trolley for making post-operative bed, and make the bed.

INSTRUCTIONS:

Prepare a trolley for post operative bed.
Make the post operative bed.
Move to the next station when the bell rings.

STATION: CHECKLIST FOR MAKING A POST OPERATIVE BED

CANDIDATES NUMBER __________________________

EXAMINER____________________________

DATE_______________________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Wash hands	1
2.	Put chairs at the foot of the bed with the back of chairs opposite to each other	1
3.	Move locker from the bed	1
4.	Pull the bed away from the wall	1
5.	Turn the mattress, check the springs	1
6.	Straighten the mattress cover	1
7.	Place the long mackintosh	1
8.	Place the bottom sheet	1
9.	Tack the sheet well	1
10.	Put on the draw mackintosh and the draw sheet	2
11.	Put on top sheet	1
12.	Put on blankets and bed covers	2
13.	Fold both sides of the bed linen into a neat pack which can easily be removed when lifting the patient on to the bed	4
14.	Place a small mackintosh and draw sheet across the top of the bed and tack it in	1
15.	Clear away	1
TOTAL		20

SCENARIO: GIVING A BED PAN

At this station, there is abed ridden patient who needs to empty the bowel.

INSTRUCTIONS

Give a bed pan.
Move to the next station when the bell rings.

STATION: GIVING A BED PAN

STUDENT’S NSIN ______________________________

EXAMINER___________________________

DATE_____________________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Explains the procedure to the patient	1
2.	Screens the bed	1
3.	Warms the bed pan using warm water	½
4.	Gently slips the bed pan under the patient’s buttocks while the second nurse helps lift the patient	2
5.	Give a toilet paper to the patient to clean herself if she can or helps the patient to clean	1½
6.	Carefully remove the bed pan and cover it	1½
7.	Offer the patient water to wash hands	1
8.	Leave the patient comfortable	½
9.	Clear the trolley and sluice the bed pan	1
TOTAL		10

SCENARIO: PREPARATION OF A TROLLEY FOR BED BATH

At this station, there is abed ridden patient who needs to bed bathed.

INSTRUCTIONS

Prepare the trolley and present it to the examiner.
Move to the next station when the bell rings.

STATION: PREPARATION OF A TROLLEY FOR BED BATH

STUDENT’S NSIN_________________________

EXAMINER_______________________

DATE__________________________

S/No	Areas to be Assessed	Score
1.	Washes hands and cleans the trolley	½
2.	Top shelf	½
	Bath basin	½
	Jug with hot water	½
	Jug with cold water	½
	2 flannel Tray containing	½
	Soap in a soap dish	½
	Nail brush and nail cutter	½
	Tooth brush and paste	½
	Comb	½
	Roll of toilet paper	½
	Glove	½
3.	Bottom shelf	½
	2 bath towels	½
	1 pair of sheet	½
	1 bucket for used water	½
	1 receiver	½
4.	Bed side	½
	Dirty linen container	½
	Screen	½
	Two chairs	½
	Hand washing equipment	½
	Bed pan and urinal	½
TOTAL		10

SCENARIO: BED BATH

At this station, there is a dependent patient in bed and needs to be bed bathed.

INSTRUCTIONS:

The equipments are ready prepared.
Carry out bed bath as the examiner observes and scores you.
Move to the next station when the bell rings.

STATION: CHECKLIST FOR BED BATH

CANDIDATE NUMBER:_______________________

EXAMINER:____________________________

DATE:________________________

S/No	KEY AREAS TO ASSESS	SCORE
1.	Explain the procedure to the patient and provide privacy	1
2.	Offer a bed pan or urinal if required	1
3.	Strip the bed to the top sheet and remove the patient’s gown	1
4.	Wash and dry each part of the body separately uncovering only the part to be washed in the order of face, neck, arm, chest and abdomen and change water whenever necessary.	4
5.	Wash each leg separately and wash the feet with water over the basin, dry them and cut the nails.	2
6.	Turn the patient to the sides and wash the back starting from the neck to the buttocks and dry, paying special attention in between the folds.	2
7.	Treat pressure areas	2
8.	Turn the patient on the back, change the water and wash genitalia with another flannel.	2
9.	Make up the bed with a clean linen	1
10.	Dress up the patient	1
11.	Clean the patient’s mouth	1
12.	Comb the hair and make the patient comfortable	1
13.	Clear away the equipments and report any abnormality observed	1
TOTAL		20

SCENARIO: PREPARATION OF A TRAY FOR ORAL CARE

At this station, there is a patient who is on routine oral care.

INSTRUCTIONS

Prepare the tray for oral care and present it to the examiner.
Speak loudly for the examiner to hear you.
Move to the next station when the bell rings.

STATION: PREPARATION OF A TRAY FOR ORAL CARE

STUDENT’S NSIN _____________________________

EXAMINER:________________________

DATE:_________________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Washes hands and cleans the trolley	½
2.	Top shelf Bath basin Jug with hot water Jug with cold water 2 flannel Tray containing Soap in a soap dish Nail brush and nail cutter Tooth brush and paste Comb Roll of toilet paper Glove	½ ½ ½ ½ ½ ½
3.	Bottom shelf 2 bath towels 1 pair of sheet 1 bucket for used water 1 receiver	½ ½ ½ ½
4.	Bed side Dirty linen container Screen Two chairs Hand washing equipment Bed pan and urinal	½ ½ ½ ½ ½
TOTAL		10

SCENARIO: ORAL CARE OF AN UNCONSCIOUS PATIENT

At this station, there is an unconscious patient for oral or mouth care

INSTRUCTIONS

Prepare a tray for mouth care.
Carry out the procedure of mouth wash on the patient.
Move to the next station when the bell rings.

STATION: CHECKLIST FOR ORAL CARE AN UNCONSCIOUS PATIENT

STUDENT’S NSIN:________________________________

EXAMINER:_____________________________

DATE____________________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Prepare a tray for mouth care	2
2.	Screen the bed and wash hands	1
3.	Position the patient in a lateral position and protect the clothes with towel	1
4.	Remove the dentures if he/she has them	1
5.	Insert the mouth gag, leave in position to keep mouth open	2
6.	Inspect the mouth, note and report any abnormality	2
7.	Grip a swab firmly with artery forceps, dip in cleaning solution, press against the gallipot to prevent dripping	2
8.	Clean inner and outer surface of the teeth from the root to the crown. Clean the gums, inside the cheeks and tongue. Change swabs as often as needed. Avoid touching the soft palate.	4
9.	Rinse the mouth with mouth wash	2
10.	Wipe the lips with dabbing movement and apply lubricant	2
11.	Leave the patient comfortable	1
TOTAL		20

SCENARIO: TREATING PRESSURE AREAS

At this station, there is a bed ridden patient awaiting treatment of pressure areas.

INSTRUCTIONS:

Prepare the requirements.
Treat all the pressure areas.
Move to the next station when the bell rings.

STATION: CHECKLIST FOR TREATMENT OF PRESSURE AREAS

STUDENT’S NSIN:_______________________

EXAMINER________________________

DATE:_______________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Explain the procedure to the patient	2
2.	Screen the bed	1
3.	Pour warm water in the basin	1
4.	Protect the bed linen from soiling with mackintosh and towel	1
5.	Carefully assess the condition of the skin. If it is not broken wash it with soap and water using a flannel	4
6.	Massage the area with soapy hand	2
7.	Using flannel, rinse each and pant it dry	2
8.	Apply a little Vaseline and massage onto the skin	2
9.	Change or straighten the bed linen and live the patient comfortable	2
10.	Thank the patient and clear away	1
11.	Record the procedure and observation in patient’s chart	2
TOTAL		20

SCENARIO: TEPID SPONGING

At this station, there is a patient in bed with hyperpyrexia, and needs tepid sponging.

INSTRUCTIONS:

The equipments are ready prepared.
Carry out tepid sponging as the examiner observes and scores you.
Move to the next station when the bell rings.

STATION: CHECKLIST FOR TEPID SPONGING

CANDIDATE NUMBER:______________________

EXAMINER:_________________________

DATE:_______________________

S/No	KEY AREAS TO ASSESS	SCORE
1.	Follow the general rules	1
2.	Take the temperature and chart	1
3.	Strip the bed to the top sheet	1
4.	Sponge the face and dry. Apply cold compress on the forehead	1
5.	Place the face flannel wrung out in cold water in the axilla, and the groin and change when necessary	2
6.	Expose the arms and sponge, using long slow sweeping movements, pour water over the hands and change compress over the forehead.	3
7.	Expose the chest and abdomen, and with a face flannel in each hand sponge the chest and abdomen together using long slow sweeping movements. Cover the patient before starting the next part.	3
8.	Change the water in the bowl, sponge the legs and pour water over the feet	2
9.	Remove the compress from the forehead and face flannels from the axilla and groins	1
10.	Turn the patient gently the side, sponge the back using face flannels, long sweeping movements and then dry.	2
11.	Remake the bed using clean linen and leave the patient comfortable	1
12.	Give the patient a cold drink	1
13.	Clear away the equipments	1
TOTAL		20

SCENARIO: MANAGEMENT OF SECOND STAGE OF LABOUR

At this station there is a model representing a mother in 2nd stage of labour.

Requirements are already prepared.

INSTRUCTIONS:

Prepare yourself for the delivery
Conduct the delivery of the baby
Move to the next station when the bell rings.

STATION: CHECKLIST FOR MANAGEMENT OF SECOND STAGE OF LABOUR

STUDENT’S NSIN:______________________

EXAMINER:_______________________

DATE:___________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Ensure privacy and explain to the mother that she is ready to push	1
2.	Empty the bladder	1
3.	Position the mother in a dorsal position with legs flexed and confirm second (2^nd) stage	1
4.	Check fetal heart every after contraction	1
5.	Wash hands and put on sterile gloves	1
6.	Drape the mother	1
7.	Encourage mother to push with every contraction	1
8.	Maintain flexion of the head	1
9.	At crowning perform a episiotomy	1
10.	Deliver the head by aiding extension	1
11.	Clear the airway by use of bulb syringe	1
12.	Feel for the cord around the neck. If loose slip it over the head, if tight clamp and cut it	1
13.	Deliver the anterior shoulder by downward traction	1
14.	Deliver the posterior shoulder by upward traction	1
15.	Deliver the body by lateral flexion towards mother’s abdomen	1
16.	Note time, score the baby, clamp and cut the cord, congratulate the mother	1
17.	Show the baby’s face and sex to the mother	1
18.	Wrap the baby in sterile towel, put on mother’s breast if condition is good and no contraindication	1
19.	Put an identification band on the baby’s hand	1
20.	Put end of cord in a receiver between mother’s legs	1
TOTAL		20

SCENARIO: ADMINSTRATION OF ORAL MEDICINE

At this station there is a mentally sick patient who is to receive Haloperidol tablet 5mgs three times a day.

INSTRUCTIONS:

Prepare a tray for drug administration.
Administer the prescribed medicine to the patient.
Move to the next station when the bell rings.

STATION: CHECKLIST FOR ADMINISTRATION OF ORAL MEDICINE

CANDIDATES NUMBER:_____________________________

EXAMINER:______________________________

DATE:______________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Explain the procedure to the patient	2
2.	Wash hands and dry	1
3.	Verify the order from the patients chart	2
4.	Confirm the identity of the patient by calling the patients name	2
5.	Check the room or bed number before giving the drug	2
6.	Assess the patient’s condition including the level of consciousness	2
7.	Check the label, expiry date on the bottle/container	2
8.	Check the dose on the prescription, get the dose on a spoon, and administer with water or milk to aid swallowing. Confirm that the drug has been swallowed	4
9.	Sign the medicine list and leave the patient comfortable	2
10.	Wash the medicine cups and return to their proper place	1
TOTAL		20

SCENARIO: ADMINISTRATION OF A DRUG BY I.M

At this station, there is a patient in bed on P.P.F 0.8mg o.d.

INSTRUCTIONS:

The tray is already set.
Administer the injection.

Move to the next station when the bell rings.

STATION: CHECKLIST FOR ADMINISTRATION OF A DRUG BY I.M

CANDIDATE NUMBER : _______________________________

EXAMINER : ____________________________

DATE :______________

S/No	KEY AREAS TO ASSESS	SCORE
1.	Follow the general rules	1
2.	Wash hands	1
3.	Read the prescription carefully and check the drug with the other Nurse including the amount to be given.	1
4.	Assemble syringe and needle	1
5.	Check the drug for label and expiry date	1
6.	Break open or remove the top of the rubber cup	1
7.	Reconstitute powdered drug according to the instructions on the bottle.	2
8.	Draw up the prescribed dose of the drug	2
9.	Expel the air	1
10.	Choose the site for injection, clean the skin and draw it tightly and introduce the needle at an angle of 90^o.	2
11.	Withdraw the piston to make sure that the needle is not in the blood vessel	2
12.	If no blood is seen in the syringe, continue to give the injection.	2
13.	Withdraw the needle while pressing firmly round it with a swab.	1
14.	Thank the patient and leave him/her comfortable	1
15.	Record the drug and clear away.	1
TOTAL		20

SCENARIO: URINE TESTING

At this station there is urine sample for testing. Requirements needed are prepared.

INSTRUCTIONS:

Test the urine for colour, deposits, smell, specific gravity, glucose and proteins.
Record your findings on the piece of paper provided.
Move to the next station when the bell rings.

STATION: CHECKLIST FOR URINE TESTING

CANDIDATES NUMBER:______________________________

EXAMINER : ____________________________

DATE ; ___________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Note the appearance	2
2.	Note the amount	1
3.	Note the colour	1
4.	Put enough urine in the glass container	2
5.	Float the urinometer in the urine in the glass container	4
6.	Dip the uristix in the urine compare the colour change with the one on the scale on the container	6
7.	Record your findings on the paper	2
8.	Wash hands	2
TOTAL		20

SCENARIO: DRESSING A CLEAN WOUND

At this station, there is a patient with a clean wound which has to be dressed.

INSTRUCTIONS:

The requirements are already prepared.
Dress the wound.
Move to the next station when the bell rings.

STATION: CHECKLIST FOR DRESSING A CLEAN WOUND

STUDENT’S NSIN : _________________________________

EXAMINER : _______________________________

DATE :____________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Explain the procedure to the patient	1
2.	Position the part, put on dressing mackintosh and towel	1
3.	Loosen the strapping	½
4.	Wash hands	½
5.	Open the dressing pack and arrange the instruments	1
6.	Pour the lotion and add other missing requirements like swabs	1
7.	Using clean gloves and dissecting forceps remove the loosened dressing and discard the gloves in a receiver and put used instruments in a receiver	4
8.	Wash hands with soap and water and dry them using sterile hand towel	1
9.	Put on sterile gloves and spread the dressing towel	1
10.	Using dressing forceps, clean the wound from inside out, until clean	4
11.	Place used instruments in a receiver	½
12.	Apply the dressing	11/2
13.	Apply strapping or bandage	1
14.	Make patient comfortable, clear away and wash hands	2
TOTAL		20

SCENARIO: HEALTH EDUCATION

At this station, there is a group of mothers who have come to ante natal clinic.

INSTRUCTIONS:

Give a health education talk about prevention of HIV/AIDS.
Talk loudly for examiner to hear and score you.
Move to the next station when the bell rings.

STATION: CHECKLIST FOR HEALTH EDUCATION ON PREVENTION ON HIV/AIDS

STUDENT’S NSIN : ___________________________

EXAMINER : _______________________

DATE : _______________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Great the client	1
2.	Introduce your self	1
3.	Introduce the topic	2
4.	Checks participants’ knowledge about the topic	2
5.	Give the health education on the topic	4
6.	Ask the client to ask question	2
7.	Answer the question	2
8.	Ask question to evaluate the understanding of the clients	2
9.	Give summary of the talk	2
10.	Give the topic for the next health education, time and venue	2
TOTAL		20

SCENARIO: ASSESSING FOR DEHYDRATION

At this station, there is a one year old child in the bed with diarrhea and severe vomiting.

INSTRUCTIONS:

Assess the child for signs of dehydration, and speak loudly for the examiner to score you.

Move to the next station when the bell rings.

STATION: ASSESSING A ONE YEAR OLD CHILD FOR DEHYDRATION

CANDIDATE NUMBER:______________________________

EXAMINER : _______________________________

DATE : _______________

S/No	KEY AREAS TO ASSESS	SCORE
1.	Create a rapport	1
2.	Explain the procedure to the mother	1
3.	Wash and dry hands	2
4.	Examine the child looking for signs of dehydration:- The eyes- if sunken	2
	Mouth- lips if dry	2
	Tongue if dry and coated white	2
	Fontanelle- if sunken	2
	Skin- skin pinch if it goes back very slowly (>2s) or slowly (<2s) or immediately	2
5.	General condition	2
	Lithergic/Unconscious	2
	Restless and irritable	2
	Eagerness to drink i.e does not drink or drinks poorly or drinks eagerly and thirsty	2
6.	Give feed back to the mother and reassure and advise her	2
TOTAL		20

SCENARIO: EXAMINATION OF A PREGNANT ABDOMEN

At this station, a pregnant mother has come for Ante natal clinic (ANC).

INSTRUCTIONS:

Examine the abdomen.
Talk loudly for the examiner to hear and score you.
Move to the next station when the bell rings.

OSPE/OSCE PRACTICAL GUIDE

STATION: CHECKLIST FOR EXAMINATION OF A PREGNANT ABDOMEN

CANDIDATE NUMBER: _________________________

EXAMINER:____________________________

DATE:____________

S/No	KEY AREAS TO ASSESS	SCORE
1.	Follow the general rules	1
2.	Put the mother in a recumbent position	1
3.	Expose the abdomen from the sternum to the level of symphysis pubis	2
4.	Take position at the foot of the bed and observe for signs of pregnancy:- Size and shape of abdomen Enlargement of the abdomen Striae gravidarum, fetal movements Linea nigra Hyper pigmentation	2
5.	Palpation of the abdomen Light palpation for tenderness Deep palpation for organomegally	2
6.	Fundal height estimation	2
7.	Deep pelvic palpation Turn and face the foot of the mother. Palpate the lower pole to determine presentation, size of the presenting part and attitude	2
8.	Fundal palpation Turn and face the mother’s face, palpate the abdomen what is in the fundus and the lie	2
9.	Lateral palpation Support the right hand side of the abdomen with the left hand. Palpate left side of the abdomen from the lower pole towards the upper pole to determine what is on the side of the abdomen Palpate the right side of the abdomen in the same way	2
10.	Note the irregular nodules which indicate the fetal limbs, and the long continuous curved mass which indicates the fetal back	2
11.	Auscultation – listen	1
12.	Share the findings with the mother	1
TOTAL		20

SCENARIO: HEALTH EDUCATION ON DANGERS OF DRUG ABUSE

At this station, a group of community members have gathered for Health Education.

INSTRUCTIONS:

Give Health Education on the dangers of drug abuse.
Talk loudly for the examiner to hear and score you.
Move to the next station when the bell rings.

STATION: CHECKLIST FOR HEALTH EDUCATION ON DANGERS OF DRUG ABUSE

CANDIDATE NUMBER: __________________________________

EXAMINER:_________________________

DATE________________

S/No	KEY AREAS TO ASSESS	SCORE
1.	Follow the general rules	1
2.	Introduce yourself to the community members	2
3.	Introduce the topic and asses clients knowledge	2
4.	Define drug abuse	1
5.	State the dangers of drug abuse Loss of respect Loss of job theft suicidal tendency crime etc	4
6.	Ask the community members to ask questions.	2
7.	Answer the question.	2
8.	Ask the members questions to evaluate the understanding of the community members	2
9.	Summary of the talk	2
10.	Thank the community members, give the date of the next Health Education talk	2
TOTAL		20

SCENARIO: HEALTH EDUCATION ABOUT PREVENTIVE MEASURES FOR HIV INFECTION

At this station, there are mother who have come for antenatal care and needs to be health educated about preventive measures for HIV infection.

INSTRUCTIONS

Health educate the mothers and talk loudly as the examiner scores you.
Move to the next station when the bell rings.

STATION: HEALTH EDUCATION ABOUT PREVENTIVE MEASURES FOR HIV INFECTION

STUDENT’S NSIN: ___________________________

EXAMINER:_______________________

DATE:_____________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Arranges room and teaching charts	½
2.	Introduces self	½
3.	Introduces topic correctly	½
4.	Asks mother what they know about HIV/AIDs and preventive measures	½
5.	Explains content to mothers correctly e.g:- Definition Causes Information about voluntary HIV testing Preventive measures Do not share sharp instruments Abstinence Faithfulness Avoid unscreened blood transfusion For infected mothers, use of the PMTCT	½ ½ 1 1 ½ ½ ½ ½ ½
6.	Ask mothers for any question	½
7.	Checks understanding by asking mothers questions about the topic	½
8.	Summarizes the topic	½
9.	Thanks mothers for attending and makes another appointment day and a topic	½
TOTAL		10

SCENARIO: COLOSTOMY CARE

At this station, there is a patient in bed.

INSTRUCTIONS:

The equipments are ready prepared.
Carry out colostomy care as the examiner observes and scores you.
Move to the next station when the bell rings.

OSPE/OSCE PRACTICAL GUIDE

STATION: CHECKLIST FOR COLOSTOMY CARE

CANDIDATE NUMBER : ___________________________

EXAMINER :_____________________________

DATE :_________________

S/No	KEY AREAS TO ASSESS	SCORE
1.	Explain the procedure to the patient	1
2.	Provide privacy	1
3.	Position the patient and turn down the bed clothes to expose the stoma	2
4.	Wash hands and put on gloves	1
5.	Remove the soiled bag gently taking care not to pull the skin	3
6.	Wash the area around the stoma with soapy water and dry well	3
7.	Apply a barrier cream	1
8.	Re measure the stoma to make sure that the bag fits correctly and cut the correct size of circle in the stoma adhesive, using measuring guide.	3
9.	Apply a clean bag as instructed	3
10.	Clear away and leave the patient comfortable	1
11.	Wash and dry hands	1
TOTAL		20

SCENARIO: VULVA SWABBING/TOILET

At this station, there is a patient in bed who needs vulva swabbing.

INSTRUCTIONS:

The equipments are ready prepared.
Carry out vulva swabbing as the examiner observes and scores you.
Move to the next station when the bell rings.

Candidate’s name : ____________________________________

Examiner: _______________________

Date : ______________________

S/No	KEY AREAS TO ASSESS	SCORE
1.	Explain the procedure and provide privacy	1
2.	Strip the bed to the top sheet	1
3.	Place the draw mackintosh and towel under the patient’s buttocks	1
4.	Place the patient in a dorsal position with the knees flexed and then abducted apart and fold back the top sheet	2
5.	Wash, dry hands and put on sterile gloves	1
6.	Drape the patient to protect the abdomen and thighs	2
7.	Using the left hand, swab the vulva using a fresh swab for each part in the following order:- Left labia majora Right labia majora Left labia minora Right labia minora Vagina introitius using right hand	1 1 1 1 2
8.	Dry the vulva, put in position vulva pad if required	2
9.	Turn the patient on the side, swab and dry the perineum	2
10.	Clear away and leave the patient comfortable	1
11.	Thank the patient and report any abnormality	1
TOTAL		20

SCENARIO: EXAMINATION OF ANAEMIA

At this station, there is a patient in bed who needs to be assessed for anaemia

INSTRUCTIONS:

Examine the patient for anaemia, speak loudly as the examiner scores you.
Move to the next station when the bell rings.

S/No	KEY AREAS TO ASSESS	SCORE
1.	Explain the procedure and provide privacy	1
2.	Position the patient	1
3.	Wash hands	1
4.	Ask the patient to look up, open the lower eyelid and check for the:- Paleness of the conjunctiva	2
5.	Ask the patient to open the mouth and check for the paleness of the:- Tongue Gums	2 2
6.	Straighten the arms and check for:- Palmer paller Capillary refill time (>3s is very slow) of the finger nails	1 2
7.	on the lower limbs, check for Paleness of the sole Capillary refill time of the toes at the nail bed	1 2
8.	Check the mucus membranes of the vagina (if female)	2
9.	Give appropriate feedback and share the finding with the patient.	1
10.	Advise the patient appropriately	1
11.	Documents and thank the patient	1
TOTAL		20

SCENARIO: CARE OF THE CORD

At this station, there is a newly born baby (doll) whose cord requires to be cared for.

INSTRUCTIONS

Carry out the care of the cord while examiner scores you.
Move to the next station when the bell rings.

S/No	KEY AREAS TO ASSESS	SCORE
1.	Explain the procedure to the mother	½
2.	Position the baby (lying flat on the back)	½
3.	puts on sterile gloves	½
4.	Inspects the cord for any sign of infection or bleeding	1
5.	Holds the cord with the swabs and clean the base of the cord in a single circular movement using the once and discard	2½
6.	Cleans the cord from the base upward with swab, discard and leave the cord to dry	1
7.	Leave the baby comfortable and show the mother how to care for the cord.	1
8.	Gives the baby to the mother and thank her	½
9.	Clears away and record the findings and any abnormalities	1
TOTAL		10

SCENARIO: BANDAGING THE RIGHT EYE

At this station, there is a patient with an injury on the right eye and needs bandaging. The tray is ready.

INSTRUCTIONS

Bandage the right eye
Move to the next station when the bell rings.

S/No	AREAS TO BE ASSESSED	SCORE
1.	Explain the procedure to the patient and ensure privacy	1
2.	Stands facing the patient who has asked to hold the eye pad in place till it is bandaged	1
3.	Begins from the right side to the normal across the forehead and around the head in a fixing turn	2
4.	From the back of the head the bandage comes under the ear, across the eye, covering the nasal side of the pad and straight over the lead and down the back.	2
5.	The next turn comes under the ear, overlaps as it crosses the head and comes round to the front.	1
6.	The pin should be in the centre of the forehead	1
7.	Thanks, then leaves the patient comfortable and records the procedure.	1
8.	Another admission sheet is put before the top sheet	1½
TOTAL		10

SCENARIO: ADMINISTRATION OF ORAL DRUG

At this station, there is a patient suffering from schizophrenic illness, put on tablet Trifluoperazine 15mg b.d.

INSTRUCTIONS

Give the drug as prescribed.
Speak loudly for the examiner to hear you.
Move to the next station when the bell rings.

OSPE/OSCE PRACTICAL GUIDE

STATION: CHECKLIST FOR ADMINISTRATION OF A DRUG ORALLY

STUDENT’S NSIN: ______________________________

EXAMINER:__________________________

DATE: ________________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Greet s the patient and explains the procedure	½
2.	Washes hands and brings medicine tray at the patient’s bedside	½
3.	Reads the prescription and checks with the label on the medicine bottle	1
4.	Reads the label again to check name of the drug, strength and expiry date.	1
5.	Uses spoon to pick the required dose and put them into a medicine cup	1
6.	Re-reads the label before placing the bottle back to the trolley/tray and covers it	1
7.	Asks for the patient’s name again, checks with prescription and assess the general condition before giving the drug.	2
8.	Stays with the patient until patient swallows the drug and notes any immediate reactions.	1
9.	Thank the patient	1
10.	Document	1
TOTAL		10

SCENARIO: PREPARATION OF A TRAY FOR PASSING A NASOGASTRIC TUBE

At this station, there is a patient who needs a Nasogastric tube for feeding.

INSTRUCTIONS

Prepare the tray for passing a nasogastric tube and present it to the examiner.
Move to the next station when the bell rings.

OSPE/OSCE PRACTICAL GUIDE

STATION: CHECKLIST FOR PREPARATION OF A TRAY FOR PASSING A NG TUBE

STUDENT’S NSIN: _____________________________

EXAMINER:_____________________________

DATE:_________________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Greet s the patient and explains the procedure	½
2.	Prepares the equipment necessary onto the tray
	Ryles tube (Nasogastric tube) in a bowl with spigot	1
	2 kidney dishes	1
	Lubricant	1
	Gauze pieces or cotton in a gallipot	1
	Adhensive plaster and scissors	1
	10-20ml syringe and 5ml syringe	1
	Gallipot with clean water (warm)	½
	Glass of water and a jar of feed	1
	Mackintosh cap and towel	1
	Pair of disposable gloves	½
TOTAL		10

SCENARIO: TAKING PATIENT’S PARTICULARS

At this station, there is an out-patient whose particulars are to be taken.

INSTRUCTIONS

Take the patient’s particulars
Speak loudly as the examiner scores you
Move to the next station when the bell rings.

STATION: CHECKLIST FOR TAKING PATIENT’S PARTICULARS

STUDENT’S NSIN: ________________________________

EXAMINER:__________________________________

DATE____________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Explain the procedure to the mother	½
2.	Washes hands and brings medicine tray at the patient’s bedside	½
3.	Reads the prescription and checks with the label on the medicine bottle	1
4.	Reads the label again to check name of the drug, strength and expiry date.	1
5.	Uses spoon to pick the required dose and put them into a medicine cup	1
6.	Re-reads the label before placing the bottle back to the trolley/tray and covers it	1
7.	Asks for the patient’s name again, checks with prescription and assess the general condition before giving the drug.	2
8.	Stays with the patient until patient swallows the drug and notes any immediate reactions.	1
9.	Thank the patient	1
10.	Document	1

SCENARIO: APPLICATION OF TETRACYCLINE EYE OINTMENT

At this station, there is an out-patient seated on a chair with an eye problem, apply tetracycline eye ointment.

INSTRUCTIONS

Apply tetracycline eye ointment
Move to the next station when the bell rings.

STATION: CHECKLIST FOR APPLICATION OF TETRACYCLINE EYE OITMENT

STUDENT’S NSIN: _______________________________

EXAMINER: _____________________________

DATE:__________________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Explains the procedure to the patient and provides privacy	1
2.	Prepares the tray and brings it to the bed side	1
3.	Position the patient in a sitting up position	1
4.	Washes hands and puts on glove	1
5.	Places a folded swab on the lower lid	1
6.	Draws up the upper lid	1
7.	Places the nosal of the eye ointment 1cm away from the lower lid	1
8.	Presses eye ointment horizontally from within outward on a lower lid	1
9.	Wipes off any surplus ointment gently using a sterile swab	½
10.	Thanks the patient and clear away	½
11.	Records the findings	1
TOTAL		10

SCENARIO: CHANGING BOTTOM SHEET FROM SIDE TO SIDE

At this station, there is a patient in the bed with a soiled bottom sheet which needs to be changed.

INSTRUCTIONS

Change the bottom sheet from side to side.
Move to the next station when the bell rings.

STATION: CHECKLIST FOR CHANGING BOTTOM SHEET FROM SIDE TO SIDE

STUDENT’S NSIN: _________________________________

EXAMINER: ____________________________

DATE: __________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Creates a Rapport and explains the procedure	½
2.	Provides privacy	½
3.	Places two chairs at the foot of the bed	½
4.	Gently loosens the beddings off the patient’s bed with the help of the assistant	½
5.	Removes the bed cover and blanket and places them on the chairs at the foot of the bed	1
6.	Removes the pillows and places them on the chairs	1
7.	Gently positions the patient for turning Places one hand over the chest Places one leg over the other	½ ½
8.	Gently rolls the patient to the side	1
9.	Rolls the dirty linen towards the patient	½
10.	Rolls the clean linen (sheet, draw mackintosh and sheet) from one side to the other i.e towards the patient and completely makes that side	1½
11.	Turns back the patient to the other side and gently removes the dirty lines	1
12.	Straighten and remakes the bed, leaves the patient comfortable and thanks the patient	1
TOTAL		10

SCENARIO: COUNSELING AND INITIATING HIV POSTIVE PREGNANT MOTHER ON ARVS.

At this station a pregnant mother has reported to ANC in Apac main hospital for her first visit, HIV test reveals TRR.

Instructions:

Counsel the client.
Start her on treatment of ARVS.
Speak loud for examiner to hear.
Move to the next station when the bell rings.

EXAMINER’S CHECKLIST.

STATION: CHECKLIST FOR COUNSELLING AND INITIATING THE HIV POSTIVE PREGNANT MOTHER ON ARVS

Candidate’s No: ___________________________

School code: _________________________

Examiner’s name:________________

Date: _________________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Creates a Rapport and explains the procedure	½
2.	Provides privacy	½
3.	Places two chairs at the foot of the bed	½
4.	Gently loosens the beddings off the patient’s bed with the help of the assistant	½
5.	Removes the bed cover and blanket and places them on the chairs at the foot of the bed	1
6.	Removes the pillows and places them on the chairs	1
7.	Gently positions the patient for turning Places one hand over the chest Places one leg over the other	½ ½
8.	Gently rolls the patient to the side	1
9.	Rolls the dirty linen towards the patient	½
10.	Rolls the clean linen (sheet, draw mackintosh and sheet) from one side to the other i.e towards the patient and completely makes that side	1½
11.	Turns back the patient to the other side and gently removes the dirty lines	1
12.	Straighten and remakes the bed, leaves the patient comfortable and thanks the patient	1
TOTAL		10

SCENARIO: IDENTIFICATION OF INSTRUMENTS

INSTRUCTIONS:

Identify the instruments with their uses.
Speak loud for the examiner to hear.
Move to the next station when the bell rings.

OSPE/OSCE PRACTICAL GUIDE

EXAMINER’S CHECKLIST.

Station:

CHECKLIST FOR IDENTIFICATION OF INSTRUMENTS

Candidate’s No: ______________________

School code: ___________________

Examiner’s name: ______________

Date:___________

S/No	AREAS TO BE ASSESSED	SCORE
1.	Creates a Rapport and explains the procedure	½
2.	Prepares the equipment necessary onto the tray
	Episiotomy scissor- performing episiotomy	1
	Straight long artery forcep or cord clamp- clamping the cord	1
	Cord scissor- cutting the cord.	1
	Uterine sound-for measuring the length of the uterus.	1
	Sponge holding forcep- holding the swabs	1
	Protoscope-for examining the rectum	1
	Suture- for stitching	1
	Skin retractor- retracting the skin during operation	1
	Cervical dilator- dilating the cervix	1
	Uterine curette- used during evacuation	1
TOTAL		10

SCENARIO: MANAGEMENT OF THIRD STAGE OF LABOUR USING CONTROLLED CORT TRACTION.

At this station there is a model representing a mother who has just delivered the baby, assist to deliver the placenta.

Instructions:

Carry out delivery of the placenta, all requirements are already set.
Speak loud for examiner to hear
Move to the next station when the bell rings.

Scenario: ACTIVE MANAGEMENT OF THIRD STAGE OF LABOUR

Candidate’s No: ______________________

School code:___________________

Examiner’s name: _______________

Date: _______________

NO.	AREAS TO BE ASSESSED	SCORE
1	Defines third stage of labor correctly	½
2	Palpates the abdomen to exclude second twin	½
3	Gives Oxytocin 10 IU intramuscularly.	½
4	Extends the cord clamp to the vulva for easy holding.	½
5	Changes the gloves or rinses in the lotion	1
6	Puts the left hand on the funds of the uterus.	½
7	With the first contraction, turns the palm of the left hand facing the fundus applying counter traction over the pubic bone.	1
8	Right hand grasps the cord clamp, then applies a steady downward and outward traction until the placenta is seen at the vulva, then applies upward traction to receive the placenta in cupped hands.	1
9	Rolls the membranes, prevent from breaking then deliver the membranes using up ward and down ward movement.	½
	Notes the time of delivery of the placenta	½
10	Rub the fundus to promote contraction of the uterus.	½
11	Carry out quick look for completeness of the membranes and puts in the receiver.	½
12	Cleans the vulva at the same time inspecting for tears, lacerations or extension of episiotomy, cervix and vaginal as well.	1
13	Puts a sterile pad in position, leaves the mother comfortable.	½
14	Clears away and documents the findings	1
	TOTAL	10

SCENARIO: FEMALE CATHETERIZATION.

At this station there is a model of a mother who is due for caesarean section you are required to pass the urinary catheter. The requirements are all set.

INSTRCTIONS:

Perform the procedure aseptically.
Speak loud for examiner to hear.
When the bell rings move to the next station.

Station:

Scenario: FEMALE CATHETERISATION.

Examiner’s name: _________________________

School code: _________________________

Candidate’s No: _____________________

Date: _________________

NO.	AREAS TO BE ASSESSED	SCORE
1	Creates rapport with the patient.	½
2	Explains the procedure	½
3	Screens the bed and extends the trolley to the bed side.	½
4	Puts the small mackintosh and towel to protect the linens	½
5	Washes hands methodically and puts on surgical gloves.	1
6	Inspects and cleans the vulva in a methodical way.	1
7	Drapes the mother	½
8	Selects the appropriate catheter and lubricates the tip with k.y jelly.	½
9	Place the receiver in between the thighs and puts the catheter, inserts slowly until urine is seen emptying into the receiver	1
10	Injects into the catheter to balloon it and aid it remain in situ.	1
11	Connects the catheter to the urinary bag and Fastens it on the thigh	1
12	Removes the receiver, drape, and small mackintosh.	½
13	Measures the urine collected and records in the fluid balance chart.	½
14	Clears away, leaves the mother comfortable and thanks her.	½
15	Washes hands and documents the findings.	½
	TOTAL	10

SCENARIO: SETTING REQUIREMENTS FOR VULVA SWABBING

At this station there is a mother who is in first stage of labour, you are asked to set all the requirements needed for vulva swabbing and present to the examiner.

Instructions:

Perform the task
Speak loud for the examiner to hear
When the bell rings move to the next station.

Examiner’s name: ________________________

School code: _________________________

Candidate’s No: ___________________

Date: ______________________

NO.	AREAS TO BE ASSESSED	SCORE
1.	Disinfects the trolley and puts a sterile towel.	1
2	TOP SHELF
	Sterile swabs in a Gallipot- for vulva swabbing Sterile pad- to be put after the procedure Antiseptic lotion in a Gallipot- for vulva swabbing A pair of sterile gloves- for protection Sterile drape and towel-for providing sterile surface Receiver for used swabs Sterile hand towel- for drying hands	1 1 ½ 1 1 1 ½
3	BOTTOM SHELF
	Small mackintosh and towel- for protecting the linens	1
	Antiseptic lotion in a bottle- for vulva swabbing.	½
	Apron – for protection	½
4	BED SIDE
	Hand washing facilities	½
	Screen for privacy	½
	TOTAL	10

SCENARIO: CORD CARE.

At this station mother Irene is a zero day after delivery of her first born baby boy, demonstrate to her how to clean the cord.

Instructions:

Prepare a tray and present to the examiner.
Speak loud for examiner to hear.
Move to the next station when the bell rings.
EXAMINER’S CHECKLIST.

Station:

CHECKLIST FOR CORD CARE.

Examiner’s name:______________________________

School code: ________________________

Candidate’s No: ____________________

Date: ____________

NO.	AREAS TO BE ASSESSED	SCORE
1	Creates rapport with the mother	½
2	Explains the procedure to the mother and reason for doing it.	1
3	Positions the baby	½
4	Washes hands and puts on surgical gloves	1
5	Inspects the cord for any bleeding or signs of infection.	1
6	Holds the cord with the swab and cleans the base using a single circular motion and single swab and discards it.	1
7	Cleans the cord from base upward with a swab once until the cord is clean.	1
8	Leaves the cord dry.	1
9	Gives the baby back to the mother.	½
10	Thanks the mother and educates her on the cord care.	1
11	Documents the findings	½
12	Clears away and washes hands.	1
	TOTAL	10

SCENARIO: BOUNDARIES OF THE PELVIC BRIM AND DIAMETERS OF THE BRIM.

Instructions:

Identify the boundaries of the pelvic brim in order and the diameters of the brim with their measurements.
speak loud for the examiner to hear
move to the next station when the bell rings

OSPE/OSCE PRACTICAL GUIDE

CHECKLIST FOR IDNTIFYING BOUNDARIES OF THE PELVIC BRIM AND DIAMETERS OF THE BRIM.

Examiner’s name:____________________________

School code: __________________________

Candidate’s No: _____________________

Date:__________________________

NO.	AREAS TO BE ASSESSED	SCORE
1	Washes the hands	½
2	Defines the pelvis correctly	½
3	BOUNDARIES OF THE BRIM IN ORDER :
	1. Sacral promontory	1
	2. Ala/ wing of the sacrum	½
	3. Sacral iliac joint	½
	4. Iliopectineal line	½
	5. Iliopectineal eminence	½
	6. Superior ramus of the pubic bone	1
	7. Upper inner border of the body of the pubic bone	1
	8. Upper inner border of the symphysis pubis	1
4	DIAMETERS OF THE BRIM:
	Transverse diameter extends across the greater width of the brim. Average measurers 13 cm	1
	Oblique diameter extends from Iliopectineal eminence of one side to the sacral iliac joint of the opposite side. Average measurers 12 cm	1
	Anteroposterior / conjugate diameter extends from the sacral promontory to the symphysis pubis average measures 11 cm (obstetrical conjugate).	1
	TOTAL	10

SCENARIO: VAGINAL EXAMINATION.

At this station there is a mother admitted in maternity ward in first stage of labour ward and senior midwife has ordered you to carry out vaginal examination to confirm the cervical dilatation.

Instructions:

Carry out vaginal examination, the requirements are already set.
Speak loud for examiner to hear.
Move to the next station when the bell rings

OSPE/OSCE PRACTICAL GUIDE

Scenario: VAGINAL EXAMINATION.

Examiner’s name: ________________________________

School code: __________________________________

Candidate’s No: ___________________________

Date: ____________________

NO.	AREAS TO BE ASSESSED	SCORE
1.	Creates rapport and explains the procedure to the mother	½
2.	Asks the mother to empty the bladder if full.	½
3.	Provides privacy	½
4.	Brings the requirements near the bed side	½
5.	Washes hands and puts on sterile gloves.	½
6.	Carries out vulva swabbing in the following order using each swab at a time.
	Labia majora left and right Labia minora left and right Vestibules	½ ½ ½
7.	Inspects the vulva and reports about; Presence of any discharge Any previous scar Oedema Varicose veins Sores or warts	½
		½
		½
		½
		½
		½
8.	Inserts two fingers and examines the vagina and reports about: Nature of the vagina whether hot and moist /dry . Nature of the cervix whether thin or soft. Dilatation of the cervix Nature of the membranes if rupture or intact Moulding and caput formation if present	½
		½
		½
		½ ½
		½
9.	Gives feedback to the mother and thanks her.	½
10.	Records down the findings.	½
	TOTAL	10

SCENARIO: ANTENANTAL HISTORY TAKING AT THE FIRST VISIT.

At this station, the mother has reported to antenatal clinic on 7th / June/ 2016 for her first visit with LNMP 15th / FEB/ 2016

Instructions:

Take all the histories required and calculate the EDD and weeks of amenorrhea (WOA)
Speak loud for examiner to hear.
Move to the next station when the bell rings.

OSPE/OSCE PRACTICAL GUIDE

Station: 9

Scenario: ANTENANTAL HISTORY TAKING

Examiner’s name: ___________________________

School code: _________________________

Candidate’s No: ________________

Date: ____________________

NO.	AREAS TO BE ASSESSED	SCORE
1	Creates rapport	½
2	Offers sits to the mother	½
3	Takes the following histories:
	Demographic data	1
	Family history	1
	Medical history	1
	Past obstetric history	1
	Present obstetric history	1
4	Calculates the EDD using LNMP as 15/Feb./2016 and reporting day as 7/June /2016	1 ½
5	Calculates the weeks of amenorrhea	2
6	Gives feedback to the mother	½
	TOTAL	10

SCENARIO: URINE TESTING FOR GLUCOSE AND ALBUMINS.

At this station there are two specimens labeled as specimen A and specimen B.

Instructions:

Identify the specimens A and B
Test specimen B for the presence of glucose and albumins.
Speak loud for examiner to hear.
Move to the next station when the bell rings

OSPE/OSCE PRACTICAL GUIDE.

Station:

Scenario: URINE TESTING FOR GLUCOSE AND PROTEINS

Examiner’s name: _____________________________________

School code:___________________________

Candidate’s No: _____________________

Date: _______________________

NO.	AREAS TO BE ASSESSED	SCORE
1	Washes hands	½
2	Puts on clean gloves	½
3	Identifies the specimen A as savlon / chlorhexidine disinfectant and specimen B as urine	½
4	Examines the urine and reports the about the following: Colour as yellow or amber Amount normal is between 1000 to 1500mls in a day Specific gravity using urinometer normal one is between 1010 to 1025 Deposits Odour or smell normal presents with smell of ammonia Reaction by using the litmus paper whether acidic or alkaline	½ ½ ½ ½ ½ ½
5	Pours some urine in the test tube and tests for glucose using the uristix	½
6	Holds the uristix without touching its top part and inserts in the test tube of urine.	1
7	Removes the uristix and allows excess urine to flow off then puts if against the colour codlings correctly.	1
8	Reports the presence of glucose and proteins in the urine.	2
9	Documents the findings and reports to the examiner.	½
	TOTAL	10

SCENARIO: ASSESSMENT FOR ANAEMIA.

At this station there is a mother admitted with history of per vaginal bleeding following incomplete abortion.

Instructions:

Carry out assessment for anaemia.
Speak loud for examiner to hear.
Move to the next station when the bell rings

OSPE/OSCE PRACTICAL GUIDE

EXAMINER’S CHECKLIST.

Station:

Scenario: ASSESSMENT FOR ANAEMIA.

Candidate’s No: ____________________________________

Date: ____________________________

School code: ____________________________

Examiner’s name: ____________________________

NO.	AREAS TO BE ASSESSED	SCORE
1	Creates rapport with the patient	½
2	Explains the procedure to the patient and washes hands	1
3	Screens for privacy and positions the patient in a sitting up position	½
4	Examines the patient from head to toe systematically	½
5	Reports about the following:
	Conjunctiva and the mucus membranes of the eyes whether pink or pale	1
	Instructs the patient to open the mouth and reports about the lips, the gum and the tongue whether pink or pale	1
	Checks the patients palms for paleness	1
	Checks for venous return whether slow or fast by pressing the nail bed of the thumb.	1
	Mentions about the vulva	½
	Checks the soles of the feet for paleness and also finds out the venous return by pressing the nail beds of the toes	1
6	Gives findings to the patient and advice accordingly and thanks the patient	1
7	Documents the findings and washes hands.	1
	TOTAL	10

SCENARIO: HEALTH EDUCATION ON REPORT WRITING

At this station there is a group of junior students allocated on the surgical ward.

INSTRUCTIONS:

Health educate the junior students on the ward about report writing.
Speak Loud As The Examiner Scores You
Move To The Next Station When The Bell Ring.

OSPE/OSCE PRACTICAL GUIDE

EXAMINER’S CHECKLIST.

Scenario: HEALTH EDUCATION TALK ON REPORT WRITING

Examiner’s name: ……………………………………………………………

Date: ………………………………..

School code:………………………………………………………………….

Candidate’s No: …………………………………………..

NO.	AREAS TO BE ASSESSED	SCORE
1.	Total number of patients and new admissions, escapees etc	2
2.	Post operative patients and their conditions and treatments	2
3.	Very ill patients and doctors prescription individually	2
4.	Pre- operative patients and time of operation	2
5.	Number of death and report individually on each if more than one.	2
	TOTAL	10

SCENARIO: ARRESTING BLEEDING.

At this station there is a patient presented in the health center two with severe bleeding on the left lower limb after having a serious cut during a fight.

Instructions:

Prepare and arrest the bleeding.
Move to the next station when the bell rings.

EXAMINER’S CHECKLIST.

Scenario: HAEMORRHAGE ARRESTING.

Examiner’s name: …………………………………………………………………..…

Date: …………..………………………………..

School code: …………………………………………………..

Candidate’s No…………………………………………..

NO.	AREAS TO BE ASSESSED	SCORE
1.	Prepare a tray containing tourniquet, gauze pads and bandage.	3
2.	Re assure the patient and position the affected limb	1
3.	Apply pressure with a thumb just above the site.	1
4.	Apply a tourniquet for seconds and release	1
5.	Apply a gauze pad and bandage it	1
6.	Elevates the limb using a pillow	1
7.	Ensure that the patient is comfortable and ask whether the bandage is tight	1
8.	Thanks the patient	½
9.	Documents the procedure done.	½
	TOTAL	10

SCENARIO: ASSESSMENT OF DEHYDRATION.

At this station there is a mother with a one year old child who has reported in health center two with history of severe diarrhorea and vomiting for two days.

Instructions:

As an in charge of health center two assess this child for signs of dehydration and report to the examiner your findings.
Move to the next station when the bell rings.

EXAMINER’S CHECKLIST.

Scenario: ASSESSMENT OF DEHYDRATION

Examiner’s name: _______________________________

School Code: ___________________________

Candidate’s No: _____________________

Date: __________________________

NO.	AREAS TO BE ASSESSED	SCORE
1.	Creates rapport and explains the procedure	1
2.	Requests the mother and inspects the child’s general condition	½
3.	Assess for the following signs from head to toe:- Depressed fontanelles Sunken eyes and absence of ears on crying Irritability. Dry lips and mucus membrane Dry skin Slow return of the skin on pinching Thirsty as the child wants to grasp the cup and also drinks eagerly.
		½ ½
		½ ½ ½ ½ ½
4.	Gives feedback to the mother	1
5.	Advices the mother appropriately	2
6.	Documents the findings	1
7.	Refer the child for better management.	1
	TOTAL	10

SCENARIO: PREPAPARTION OF ATROLLEY FOR WOUND DRESSING.

At this station, doctor has ordered a trolley to be set for dressing a deep cut wound.

Instructions:

Prepare a complete sterile trolley for carrying out sterile wound dressing and present to the examiner.
Speak loud for the examiner to hear.
Move to the next station when the bell rings.

EXAMINER’S CHECKLIST.

Station:

Scenario: PREPARING A COMPLETE TROLLEY FOR WOUND DRESSING.

Examiner’s name: __________________________

School Code: ________________

Candidate’s No: _______________________

Date: _______________________

NO.	AREAS TO BE ASSESSED	SCORE
1.	Disinfects the trolley and lays a sterile towel	1
2.	Picks sterile instruments methodically and puts on the top shelf.	½
3.	TOP SHELF
4.	Gallipot of sterile cotton swabs Gallipot of sterile gauze swabs Gallipot containing a dressing lotion Dressing towels Sterile drape Sterile hand towels Receiver containing 2 dissecting forceps, 1 dressing forcep, sinus, forcep, probe and 1 artery forcep. Receiver for used swabs and for instruments.	½ ½ ½
		½ ½ ½ 1 ½
		½
5.	BOTTOM SHELF
6.	Pair of sterile gloves	½ ½ ½ ½ ½
	Apron
	Small mackintosh and towel
	Pair of scissor and strapping.
	Pair of clean gloves.
7.	BED SIDE.
	Screen Hand washing towel	½ ½
3.	TOTAL	10

SCENARIO: GIVING AN INTRAMUSCULAR INJECTION.

At this station there is a patient with a diagnosis of pneumonia and doctor has ordered intramuscular injection of benzyl penicillin 1 MU to be given.

Instructions:

Prepare the medication and give to the patient.
Move to the next station when the bell rings

EXAMINER’S CHECKLIST.

Scenario: GIVING INTRAMUSCULAR INJECTION.

Examiner’s name: ____________________________

School code: ________________________

Candidate’s No: _______________________

Date: _____________________

NO.	AREAS TO BE ASSESSED	SCORE
1.	Creates rapport and explains the procedure	½
	Requests for medical form to confirm the patient’s identity and prescribed medication.	½
2.	Washes hands and prepares the medication to be given	½
3.	Picks correct medication and checks for correct name, expiry date and check for the prescribed dosage	1
4.	Assemble the medication tray near the patient and explains to the patient	½
5.	Screens the bed and washes hands	½
6.	Opens the ampoule methodically and reconstitute the medication without touching the top of the vial.	½
7.	Positions the patients and exposes the site to be injected.	½
8.	Puts on the gloves.	½
9.	Withdraws the medication and expels the air while handling the needle at an angle of 90°	1
10.	Cleans the selected site using one swab at a time and discards.	½
11.	Holds the muscle and injects the medication while handling the needle at an angle of 90°	½
12.	Withdraws the needle and applies the swab at the injected site without massaging.	½
13.	Records down the medication given and explains to the patient the time of next treatment.	1
14.	Clears away and confirms the medication being given to the patient when returning back to the shelf.	1
15.	Thanks the patient and washes the hands.	½
	TOTAL	10

SCENARIO: VAGINAL EXAMINATION.

At this station there is a mother admitted in a gynecological ward and doctor has ordered vaginal examination to be done.

Instructions:

Carry out vaginal examination, the requirements are already set.
Speak loud for examiner to hear.
Move to the next station when the bell rings

NO.	AREAS TO BE ASSESSED	SCORE
1.	Creates rapport and explains the procedure	1
2.	Requests the mother and inspects the child’s general condition	½
3.	Assess for the following signs from head to toe: Depressed fontanelles Sunken eyes and absence of ears on crying Irritability. Dry lips and mucus membrane Dry skin Slow return of the skin on pinching Thirsty as the child wants to grasp the cup and also drinks eagerly.
		½ ½
		½ ½ ½ ½ ½
4.	Gives feedback to the mother	1
5.	Advices the mother appropriately	2
6.	Documents the findings	1
7.	Refer the child for better management.	1
	TOTAL	10

SCENARIO: IDENFICATION OF PARTS OF OXYGEN CYLINDER WITH THEIR FUNCTIONS.

INSTRUCTIONS:

At this station there is an oxygen cylinder, identify all its part with their functions.
Speak loud for examiner to hear
Move to the next station when the bell rings

NO.	AREAS TO BE ASSESSED	SCORE
	Washes the hands
1	Identifies the following parts with their functions.
2	Main tap/ valve for allowing air flow out.	2
3	Flow meter for measuring the amount of oxygen to be given.	2
4	Regulator for regulating the required amount prescribed	1
5	Wolfe’s bottle for moistening and cleaning the air before reaching the patient.	2
6	Pressure gauge for indicating the amount of oxygen present in the cylinder	2
7	Oxygen catheter for administering oxygen to the patient.	1
	TOTAL	10

SCENARIO: GROWTH MONITORING

At this station there is a mother with a six (6) month year old baby boy who haS reported in the young child clinic (Y C C) for check up.

INSTRUCTIONS:

Carry out baby weighing, the requirements are already set.
Speak loud for examiner to hear.
Move to the next station when the bell rings.

Scenario: BABY WEIGHING.

Examiner’s name: _______________________________

School Code:_____________________________

Candidate’s No: _____________________________

Date: _______________________________

NO.	AREAS TO BE ASSESSED	SCORE
1.	Creates rapport and explains the procedure to the mother.	1
2.	Washes hands	½
3.	Prepares and checks the weighing scale to see that its in good working conditions	½
4.	Records the initial values of the weighing pan.	1
5.	Requests the mother and together they undress the baby and puts the baby’s clothes on the mother’s shoulder.	1
6.	Dresses the baby in a weighing pan correctly.	½
7.	Holds the baby gently and puts up on the weighing scale.	1
8.	Notes the reading on scale.	½
9.	Removes the baby from the weighing and requests the mother to dress back the baby	1
10.	Plots the weight correctly in the child growth monitoring chart by subtracting the weight of the weighing pan from the final readings	1 ½
11.	Gives feed back to the mother and advices her accordingly	1
12.	Thanks the mother and washes the hands.	½
	TOTAL	10

SCENARIO: IDENTIFICATION OF INSTRUMENTS WITH THEIR USES.

Instructions

Identify the instruments with their uses
Speak loud for examiner to hear.
Move to the next station when the bell rings.

Scenario: IDENTIFICATION OF INSTRUMENTS.

Examiner’s name: ___________________________

School code: _______________________________

Candidate’s No: ______________________

Date: ______________

NO.	AREAS TO BE ASSESSED	SCORE
	Washes the hands
1.	Non retained abdominal retractor/ doyen’s retractor- for opening the abdomen during operation.	1
2.	Sinus forcep – for packing swabs in the orifices and dressing deep wounds	1
3.	Plastic air way tube- for opening the airway and keeping it patent.	1
4.	3 way urethral catheter- for irrigation of the bladder	1
5.	Otoscope- for examining the air.	1
6.	Blade holder for holding surgical blades.	1
7.	Towel clip for fastening dressing towels during the procedure./ clamping towels on the trolley when setting for sterile procedure.	1
8.	Auvard’s vaginal speculum- for evacuation	1
9.	Uterine tenaculum- for holding the uterus in place.	1
10.	Alice tissue forcep- for holding tissues during operation.	1
	TOTAL	10

SCENARIO: IDENTIFICATION OF THE DIAMETERS OF THE FETAL SKULL

Instructions:

Identify the diameters of the fetal skull correctly.
Speak loud for the examiner to hear.
Move to the next station when the bell ring

Scenario: IDENTIFYING DIAMETERS OF THE FETAL SKULL

Examiner’s name: ____________________________

School Code: _________________________

Candidate’s No: __________________________

Date: ___________________________

NO.	AREAS TO BE ASSESSED		SCORE
1	Washes hands		1
2	Defines fetal skull		1
	Identifies the diameters correctly as:
3	2 TRANSVERSE DIAMETER:
	Bi parietal diameter	9.5 cm	1
	Bi temporal diameter	8.2 cm	1
4	6 LONGITUDINAL DIAMETERS
	Sub-occipito bregmatic	9.5cm	1
	Sub occipito frontal	11.5 cm	1
	Occipital frontal	10 cm	1
	Sub mentol vertex	11.5 cm	1
	Sub mentol bregmatic	9.5 cm	1
	Mental vertex	13 cm	1
	TOTAL		10

SCENARIO: MAKING A HOSPITAL BED

At this station, all the requirements for bed making are already set for you. Make an un occupied bed (hospital bed) while observing the rules of bed making.

Instructions:

Perform the task.
Move to the next station when the bell rings.

EXAMINER’S CHECKLIST.

Station:

Scenario: MAKING A HOSPITAL BED

Examiner’s name: _____________________________

School code: ___________________________

Candidate’s No: ________________

Date : ________________

NO.	AREAS TO BE ASSESSED	SCORE
1.	Washes hands and requests for an assistant.	½
2.	Brings the trolley near the bed side and puts two chairs at the bottom of the bed.	½
3.	Screens and extend the bed away from the wall	½
4.	Turns the mattress to check for firmness of the spring and straightens the mattress cover working from top to bottom of the bed.	½
5.	Puts the long mackintosh and meters the corners to make an envelope then tucks in from top to bottom	1
6.	Puts the bottom bed sheet and meters the corners to make an envelope then tucks in from top to bottom	1
7.	Puts a draw mackintosh across the bed at the level of the buttocks and tucks on both sides	½
8.	Puts a draw sheet on the draw mackintosh and also tucks in on both sides.	½
9.	Puts the top bed sheet and meters the corners of the bottom to make an envelope then tucks in	1
10.	Puts the blanket and meters the corners of the bottom to make an envelope then tucks in from top to bottom	1
11.	Puts the counter pane and meters the bottom, the folds together with the blanket and top sheet up to the middle way and tucks in on both sides	1
12.	Puts a pillow in a pillow case and places at the top ensuring that the open part doesn’t face the door.	1
13.	Takes the bed back to the wall, clears away and washes hands.	1
	TOTAL	10

SCENARIO: DUMP DUSTING A LOCKER

At this station, all the requirements for dump dusting are already set for you.

Instructions:

Carry out dump dusting.
Speak loud for examiner to hear
Move to the next station when the bell rings.

EXAMINER’S CHECKLIST.

Station: 3

Scenario: DUMP DUSTING

Examiner’s name: _________________________

School code: _______________________

Candidate’s No: _____________________

Date: ____________________

NO.	AREAS TO BE ASSESSED	SCORE
1	Puts on an apron and Washes hands and	1
2	Puts on clean gloves	1
3	Pours water in one basin and mix with soap to make soapy water and another basin with clean water.	1
4	Using a flannel ,dumps it in soapy water and dusts the top surface of the locker from far to nearby side	1
5	Rinses the towel and again dusts using clean water and dries up using a dry flannel.	1
6	Moves to the inner part following the same steps like in 2 and 3 above	1
7	Move to the lower parts and follow the same steps like in 2 and 3 above	1
8	Changes water whenever dirty	1
9	Clears away and washes hands	1
	TOTAL	10

SCENARIO: SURGICAL HAND WASHING

At this station, all the requirements for hand washing are already set for you.

Instructions:

Carry out surgical hand washing methodically.
Move to the next station when the bell rings.

EXAMINER’S CHECKLIST.

Station: 4

Scenario: SURGICAL HAND WASHING

Examiner’s name: ___________________________

School code: ______________________________

Candidate’s No: ___________________

Date: __________________

NO.	AREAS TO BE ASSESSED	SCORE
1.	Wets the hands and applies soap thoroughly to form foam.	1
2.	Scrubs the left palm over the right palm down- up movement at least five times.	1
3.	Scrubs the left dorsum over the right palm in the same manner like in 2 above and vice versa	1
4.	Scrubs the left dorsum over the right palm with fingers interlocked and vice versa	1
5.	Scrubs the left palm over the right with the fingers interlaced	1
6.	Does the rotational rubbing of the left thumb and vice versa.	1
7.	Scrubs the tips of the left fingers over the right palm and vice versa.	1
8.	Rinses the hands thoroughly up to the point below the elbow joint methodically	1
9.	Turns off the tap using the elbow but not the hand	1
10.	Using a sterile hand towel, dries the hands methodically and discards it in a right place then remains with the hands up.	1
	TOTAL	10

SCENARIO: IDENTIFICATION OF BED APPLIANCES WITH THEIR USES

At this station you are provided with some of the bed

appliances necessary for providing patient’s comfort.

Instructions:

Identify the appliances with their uses.
Speak loud for examiner to hear.
Move to the next station when the bell rings.

EXAMINER’S CHECKLIST.

Station:

Scenario: IDENTIFICATION OF BED APPLIANCES WITH THEIR USES

Examiner’s name: __________________________

School code:_____________________________

Candidate’s No: ___________________________

Date________________________

NO.	AREAS TO BE ASSESSED	SCORE
1	Long mackintosh- for protecting the mattress.	1
2	Bed cradle- for lifting off the linens over the wound.	1
3	Cardiac table- for the patient to lean forward and feeding purposes in patients with difficulties in breathing	1
4	Back rest- to support the patient in sitting up position	1
5	Foot rest- to prevent foot drop	1
6	Fracture board- to provide firm support of the mattress.	1
7	Bed blocks/elevator- to elevate the top or bottom of the bed.	1
8	An air ring- to reduce pressure to the sacrum and coccyx	1
9	Hot water bottle- for providing additional warmth to the patient.	1
10	Sand bags- to prevent movement of the lower limbs when the patient is in bed	1
	TOTAL	10

SCENARIO: NAMING THE PELVIC BONES AND JOINTS.

At this station you are provided with a model of the pelvis.

Instructions:

Name all its bones and joints correctly.

Speak loud for examiner to hear.

Move to the next station when the bell rings.

EXAMINER’S CHECKLIST.

Station:

Scenario: NAMING PELVIC BONES AND JOINTS

Examiner’s name : ______________________________

School code: _____________________________

Candidate’s No: ______________________

Date: _______________________

NO.	AREAS TO BE ASSESSED	SCORE
1	Moves the trolley near the examiner and washes hands.	1
2	Holds the pelvis properly and defines it.	1
3	Identifies two innominate bones as right and left. Each innominate bone consists of the Ilium, ischium and the pubic bone	2
4	Identifies sacrum made of five fused bones	1
5	Identifies the coccyx made up of four fused bones.	1
6	Mentions the pelvic joints as: 2 sacro iliac joints left and right. 1 sacro coccygeal joint joining the sacrum and coccyx Symphysis pubis joining two pubic bones.	1 1 1
7	Washes the hands	1
	TOTAL	10

SCENARIO: PUTTING ON STERILE GLOVES

At this station you are provided with the requirements for surgical gloving.

Instructions:

Put on the gloves while observing sterility.
Move to the next station when the bell rings.

EXAMINER’S CHECKLIST.

Station:

Scenario: PUTTING ON SURGICAL GLOVES.

Examiner’s name: _______________________

School code: ____________________________

Candidate’s No.: __________________

Date: ___________________

NO.	AREAS TO BE ASSESSED	SCORE
1.	Washes hands and requests for an assistant.	½
2.	Brings the trolley near the bed side and puts two chairs at the bottom of the bed.	½
3.	Screens and extend the bed away from the wall	½
4.	Turns the mattress to check for firmness of the spring and straightens the mattress cover working from top to bottom of the bed.	½
5.	Puts the long mackintosh and meters the corners to make an envelope then tucks in from top to bottom	1
6.	Puts the bottom bed sheet and meters the corners to make an envelope then tucks in from top to bottom	1
7.	Puts a draw mackintosh across the bed at the level of the buttocks and tucks on both sides	½
8.	Puts a draw sheet on the draw mackintosh and also tucks in on both sides.	½
9.	Puts the top bed sheet and meters the corners of the bottom to make an envelope then tucks in	1
10.	Puts the blanket and meters the corners of the bottom to make an envelope then tucks in from top to bottom	1
11.	Puts the counter pane and meters the bottom, the folds together with the blanket and top sheet up to the middle way and tucks in on both sides	1
12.	Puts a pillow in a pillow case and places at the top ensuring that the open part doesn’t face the door.	1
13.	Takes the bed back to the wall, clears away and washes hands.	1
	TOTAL	10

SCENARIO: TAKING TEMPERATURE.

At this station, there is a patient admitted in bed, you are asked to take his temperature.

Instructions:

Set and carry out temperature.
Move to the next station when the bell rings.

EXAMINER’S CHECKLIST.

Station:

Scenario: TEMPERATURE TAKING.

Examiner’s name: __________________________

School code: ___________________________

Candidate’s No: ______________________

Date: ____________________

NO.	AREAS TO BE ASSESSED	SCORE
1	Creates rapport and explains the procedure to the patient	1
2	Washes hands and sets the following: Thermometer in its jar of lotion Gallipot of cotton swabs Receiver for used swabs Watch with ticker timer Temperature chart and a pencil/ a pen.	3
3	Screens the bed for privacy.	1
4	Inspects the thermometer for cracks, and cleans it with a swab.	1
5	Cleans the axilla with a dry swab and inserts the thermometer, correctly.	1
6	Removes the thermometer, after three minutes and takes the readings at an eye level.	1
7	Gives the findings to the patient	1
8	Records the findings and clears away.	1
	TOTAL	10

SCENARIO: POSITIONING A PATIENT IN PRONE POSITION.

At this station, there is a patient admitted in bed, you are asked to position him in a prone position.

Instructions:

Set and position the patient.
Speak loud for examiner to hear.
Move to the next station when the bell rings.

Scenario: PRONE POSITION.

Examiner’s name: ______________________

School code: ________________________

Candidate’s No: ____________________

Date: _______________________

NO.	AREAS TO BE ASSESSED	SCORE
1	Creates rapport with the patient	1
2	Explains the procedure to the patient Asks for the an assistant	1
3	Washes the hands together with the assistant	1
4	Moves trolley at the bed side	1
5	Asks the patient to allow to be positioned	1
6	Patient lies on the abdomen with the head on a pillow turned one side	1
7	Small soft pillow placed under the abdomen	1
8	Pelvis and the lower legs are supported on a pillow under the ankles to prevent discomfort of toes pressing the bed.	1
9	Thanks the patient and laves him comfortable	1
10	Washes hands	1
	TOTAL	10

SCENARIO: HEALTH EDUCATION ON PATIENT’S RIGHTS

At this station, there is a group of patients who have reported

in the OPD, health educate them on the patient’s rights

Instructions:

Conduct health education.
Speak loud for examiner to hear.
Move to the next station when the bell rings.

Scenario: HEALTH EDUCATION ON PATIENTS RIGHTS.

Examiner’s name: …………………………..…………..

School Code: …………………………………………………

Candidate’s No: …………………………………………..

Date: ………………………………..

NO.	AREAS TO BE ASSESSED	SCORE
1	Requests for attention and introduces self.	½
2	Introduces the topic	½
3	Assess their understanding on the topic	½
4	Defines the topic and gives the rights of patient as: Right to participation in treatment decision Right to respect and non- discrimination Right to choice of providers and plans Right to complains and appeals Right to hospital policy Right to information disclosure Right to confidentiality of health information	1 1 1 1 1 1 1
5	Acknowledges patient’s understanding about the topic	½
6	Allows them to ask questions and answers them correctly	½
7	Summarizes the topic	½
8	Enquires about the next topic, time and place	½
9	Thanks the patients	½
	TOTAL	10