Nursing-Associates-Proficiency-Standards 2

Standards of
proficiency for
nursing associates
Published 10 October 2018
www.nmc.org.uk Standards of proficiency for nursing associates 1

Contents
Introduction 2
Platform 1
Being an accountable professional 4
Platform 2
Promoting health and preventing ill health 7
Platform 3
Provide and monitor care 9
Platform 4
Working in teams 12
Platform 5
Improving safety and quality of care 14
Platform 6
Contributing to integrated care 16
Annexe A:
Communication and relationship management skills 18
Annexe B:
Procedures to be undertaken by the nursing associate 22
Glossary 27

Introduction The proficiencies serve a number of purposes:
• They set out for patients and the public what nursing associates
know and can do when they join the NMC register.
The standards of proficiency presented here represent
the standards of knowledge and skills that a nursing • The standards help nursing associates by providing clarity about
associate will need to meet in order to be considered their role. Read alongside the nursing standards of proficiency,
they demonstrate the synergies and differences between the
by the NMC as capable of safe and effective nursing two roles.
associate practice. These standards have been
designed to apply across all health and care settings. • For nurses and other health and care professionals, the
standards provide clarity on the knowledge and skills they can
reasonably expect all nursing associates to have and this will help
inform safe decisions about delegation.
• Employers understand what nursing associates can contribute

to the health and wellbeing of patients and service users, and
can make effective decisions about whether and how to use
the role.
• Educators must develop and deliver programmes that equip

nursing associates with the skills, knowledge and behaviours
needed to meet these standards of proficiency when they qualify.
Nursing associate is a new role being introduced into the health

and care workforce in England from 20191 . It is a generic role (not
defined by a field of nursing) but within the discipline of nursing.
Nursing associates are intended to bridge a gap between health
and care assistants, and registered nurses.
While the nursing associate role is new, it is particularly important

that the public, health and care professionals, and employers can
develop an understanding of what nursing associates know and
can do.
1
The nursing associate role is being introduced and regulated in England from 2019. If other
countries of the UK decide to use and regulate the role in future it will require a change to our
legislation, and the updating of our standards www.nmc.org.uk Standards of proficiency for nursing associates 2
Nursing associates are members of the nursing team, who We have designed these proficiencies to align with the latest
have gained a Foundation Degree, typically involving two years standards of proficiency for nurses:
of higher education. They are not nurses; nursing is a graduate
entry profession and those joining the nursing part of the NMC • To allow people to understand the differences between the
register require a degree. Nurses also develop additional skills and two roles
knowledge within a specific field of nursing.
• To enable education providers to facilitate educational
Nursing associates are a new profession, accountable for their progression from nursing associate to nurse
practice. These proficiencies set out what pre-registration
training will equip nursing associates to know, and do. Once they are • To demonstrate how the nursing associate role can support the
practising, nursing associates can undertake further education and registered nurse, to allow registered nurses to deliver the NMC’s
training and demonstrate additional knowledge and skills, enhancing enhanced ‘Future Nurse’ standards of proficiency.
their competence as other registered professionals routinely do.
The roles played by nursing associates will vary from setting to The outcome statements for each platform have been designed
setting, depending on local clinical frameworks, and it may also be to apply across all health and care settings. At the point of
shaped by national guidance. registration, nursing associates are required to meet all
outcome statements and to demonstrate an awareness of how
Nursing associates provide care for people of all ages and from requirements vary across different health and care settings. As
different backgrounds, cultures and beliefs. They provide care for the nursing associate role is generic, students may demonstrate
people who have mental, physical, cognitive and behavioural care proficiencies in any appropriate context, and there is no
needs, those living with dementia, the elderly and for people at the expectation that they must be demonstrated in every health and
end of their life. They must be able to care for people in their own care setting.
home, in the community or hospital or in any health care settings
where their needs are supported and managed. They work in the In common with all of our regulatory standards and guidance, these
context of continual change, challenging environments, different proficiencies will be subject to periodic review. The current version
models of care delivery, shifting demographics, innovation and of our proficiencies can always be found on our website.
rapidly evolving technologies. Increasing integration of health
and social care services will require nursing associates to play a
proactive role in multidisciplinary teams.

Annexe A:
Being an Promoting
Provide and Working Improving safety Contributing to Communication Annexe B:
accountable health and preventing Glossary
monitor care in teams and quality of care integrated care and relationship Procedures
professional ill health
management skills
Platform 1
Being an accountable
professional
Nursing associates act in the best interests of people,
putting them first and providing nursing care that is
person-centred, safe and compassionate. They act
professionally at all times and use their knowledge and
experience to make evidence based decisions and solve
problems. They recognise and work within the limits of
their competence and are responsible for their actions.

Annexe A:
Being an Promoting
management skills
1. Outcomes: 1.6 understand the professional responsibility to adopt a healthy

lifestyle to maintain the level of personal fitness and wellbeing
The outcomes set out below reflect the proficiencies for
required to meet people’s needs for mental and physical care
accountable practice that must be applied across all standards of
proficiency for nursing associates, as described in platforms 2-6. 1.7 describe the principles of research and how research findings
are used to inform evidence-based practice
At the point of registration, the nursing associate will be able to:
1.8 understand and explain the meaning of resilience and
1.1 understand and act in accordance with the Code: Professional
emotional intelligence, and their influence on an individual’s
standards of practice and behaviour for nurses, midwives and
ability to provide care
nursing associates, and fulfil all registration requirements
1.9 communicate effectively using a range of skills and strategies
1.2 understand and apply relevant legal, regulatory and governance
with colleagues and people at all stages of life and with a range
requirements, policies, and ethical frameworks, including any
of mental, physical, cognitive and behavioural health challenges
mandatory reporting duties, to all areas of practice
1.10 demonstrate the skills and abilities required to develop,
1.3 understand the importance of courage and transparency
manage and maintain appropriate relationships with people,
and apply the Duty of Candour, recognising and reporting any
their families, carers and colleagues
situations, behaviours or errors that could result in poor
care outcomes 1.11 provide, promote, and where appropriate advocate for, non-
discriminatory, person-centred and sensitive care at all times.
1.4 demonstrate an understanding of, and the ability to, challenge
Reflect on people’s values and beliefs, diverse backgrounds,
or report discriminatory behaviour
cultural characteristics, language requirements, needs and
1.5 understand the demands of professional practice and preferences, taking account of any need for adjustments
demonstrate how to recognise signs of vulnerability in
1.12 recognise and report any factors that may adversely impact
themselves or their colleagues and the action required to
safe and effective care provision
minimise risks to health
1.13 demonstrate the numeracy, literacy, digital and technological
skills required to meet the needs of people in their care to
ensure safe and effective practice

Annexe A:
Being an
Being an Promoting
accountable
professional
management skills
1.14 demonstrate the ability to keep complete, clear, accurate and

timely records
1.15 take responsibility for continuous self-reflection, seeking and
responding to support and feedback to develop professional
knowledge and skills
1.16 act as an ambassador for their profession and promote public
confidence in health and care services
1.17 safely demonstrate evidence based practice in all skills and
procedures stated in Annexes A and B.

Annexe A:
Being an Promoting
management skills
Platform 2
Promoting health and
preventing ill health
Nursing associates play a role in supporting people to
improve and maintain their mental, physical, behavioural
health and wellbeing. They are actively involved in
the prevention of and protection against disease
and ill health, and engage in public health, community
development, and in the reduction of health inequalities.

Annexe A:
Being an Promoting
management skills
2. Outcomes: 2.7 explain why health screening is important and identify those
who are eligible for screening
The proficiencies identified below will equip the newly registered
nursing associate with the underpinning knowledge and skills 2.8 promote health and prevent ill health by understanding the
required for their role in health promotion and protection and evidence base for immunisation, vaccination and herd immunity
prevention of ill health.
2.9 protect health through understanding and applying the
At the point of registration, the nursing associate will be able to: principles of infection prevention and control, including
communicable disease surveillance and antimicrobial
2.1 understand and apply the aims and principles of health
stewardship and resistance.
promotion, protection and improvement and the prevention of
ill health when engaging with people
2.2 promote preventive health behaviours and provide information
to support people to make informed choices to improve their
mental, physical, behavioural health and wellbeing
2.3 describe the principles of epidemiology, demography, and
genomics and how these may influence health and
wellbeing outcomes
2.4 understand the factors that may lead to inequalities in
health outcomes
2.5 understand the importance of early years and childhood
experiences and the possible impact on life choices, mental,
physical and behavioural health and wellbeing
2.6 understand and explain the contribution of social influences,
health literacy, individual circumstances, behaviours and
lifestyle choices to mental, physical and behavioural
health outcomes

Annexe A:
Being an Promoting
management skills
Platform 3
Provide and
monitor care
Nursing associates provide compassionate, safe
and effective care and support to people in a range
of care settings. They monitor the condition and
health needs of people within their care on a continual
basis in partnership with people, families, and carers.
They contribute to ongoing assessment and can
recognise when it is necessary to refer to others
for reassessment.

Annexe A:
Being an Promoting
management skills
3. Outcomes: 3.6 demonstrate the knowledge, skills and ability to perform a

range of nursing procedures and manage devices, to meet
people’s need for safe, effective and person-centred care
nursing associate with the underpinning knowledge and skills
required for their role in providing and monitoring care. 3.7 demonstrate and apply an understanding of how and when to
escalate to the appropriate professional for expert help
At the point of registration, the nursing associate will be able to: and advice
3.1 demonstrate an understanding of human development from
3.8 demonstrate and apply an understanding of how people’s
conception to death, to enable delivery of person-centred safe
needs for safety, dignity, privacy, comfort and sleep can be met
and effective care
3.9 demonstrate the knowledge, skills and ability required to meet
3.2 demonstrate and apply knowledge of body systems and
people’s needs related to nutrition, hydration and bladder and
homeostasis, human anatomy and physiology, biology, genomics,
bowel health
pharmacology, social and behavioural sciences when
delivering care 3.10 demonstrate the knowledge, skills and ability to act as required
to meet people’s needs related to mobility, hygiene, oral care,
3.3 recognise and apply knowledge of commonly encountered
wound care and skin integrity
mental, physical, behavioural and cognitive health conditions
when delivering care 3.11 demonstrate the ability to recognise when a person’s
condition has improved or deteriorated by undertaking health
3.4 demonstrate the knowledge, communication and relationship
monitoring. Interpret, promptly respond, share findings, and
management skills required to provide people, families and
escalate as needed
carers with accurate information that meets their needs
before, during and after a range of interventions 3.12 demonstrate the knowledge and skills required to support
people with commonly encountered symptoms including anxiety,
3.5 work in partnership with people, to encourage shared decision
confusion, discomfort and pain
making, in order to support individuals, their families and
carers to manage their own care when appropriate

Annexe A:
Being an Promoting
management skills
3.13 demonstrate an understanding of how to deliver sensitive and 3.20 understand and apply the principles and processes for making
compassionate end of life care to support people to plan for reasonable adjustments
their end of life, giving information and support to people who
3.21 recognise how a person’s capacity affects their ability to make
are dying, their families and the bereaved. Provide care to
decisions about their own care and to give or withhold consent
the deceased
3.22 recognise when capacity has changed and understand where
3.14 understand and act in line with any end of life decisions
and how to seek guidance and support from others to ensure
and orders, organ and tissue donation protocols, infection
that the best interests of those receiving care are upheld
protocols, advanced planning decisions, living wills and lasting
powers of attorney for health 3.23 recognise people at risk of abuse, self-harm and/or suicidal
ideation and the situations that may put them and others
3.15 understand the principles of safe and effective administration
at risk
and optimisation of medicines in accordance with local and
national policies 3.24 take personal responsibility to ensure that relevant
information is shared according to local policy and appropriate
3.16 demonstrate the ability to recognise the effects of medicines,
immediate action is taken to provide adequate safeguarding
allergies, drug sensitivity, side effects, contraindications and
and that concerns are escalated.
adverse reactions
3.17 recognise the different ways by which medicines can
be prescribed
3.18 demonstrate the ability to monitor the effectiveness of care
in partnership with people, families and carers. Document
progress and report outcomes
3.19 demonstrate an understanding of co-morbidities and
the demands of meeting people’s holistic needs when
prioritising care

Annexe A:
Being an Promoting
management skills
Platform 4
Working in teams
Nursing associates play an active role as members
of interdisciplinary teams, collaborating and
communicating effectively with nurses, a range of
other health and care professionals and lay carers.

Annexe A:
Being an Promoting
management skills
4. Outcomes: 4.6 demonstrate the ability to monitor and review the quality of
care delivered, providing challenge and constructive feedback,
when an aspect of care has been delegated to others
required to understand and apply their role to work effectively as 4.7 support, supervise and act as a role model to nursing
part of an interdisciplinary team. associate students, health care support workers and those
At the point of registration, the nursing associate will be able to: new to care roles, review the quality of the care they provide,
promoting reflection and providing constructive feedback
4.1 demonstrate an awareness of the roles, responsibilities and
scope of practice of different members of the nursing and 4.8 contribute to team reflection activities, to promote
interdisciplinary team, and their own role within it improvements in practice and services
4.2 demonstrate an ability to support and motivate other 4.9 discuss the influence of policy and political drivers that impact
members of the care team and interact confidently with them health and care provision.
4.3 understand and apply the principles of human factors and

environmental factors when working in teams
4.4 demonstrate the ability to effectively and responsibly access,

input, and apply information and data using a range of methods
including digital technologies, and share appropriately within
interdisciplinary teams
4.5 demonstrate an ability to prioritise and manage their own

workload, and recognise where elements of care can safely be
delegated to other colleagues, carers and family members

Annexe A:
Being an Promoting
management skills
Platform 5
Improving safety and
quality of care
Nursing associates improve the quality of care by
contributing to the continuous monitoring of people’s
experience of care. They identify risks to safety or
experience and take appropriate action, putting the
best interests, needs and preferences of people first.

Annexe A:
Being an Promoting
management skills
5. Outcomes: 5.7 understand what constitutes a near miss, a serious adverse

event, a critical incident and a major incident
nursing associate with the underpinning knowledge and skills 5.8 understand when to seek appropriate advice to manage a risk
required for their role in contributing to risk monitoring and and avoid compromising quality of care and health outcomes
quality of care.
5.9 recognise uncertainty, and demonstrate an awareness of
strategies to develop resilience in themselves. Know how to
5.1 understand and apply the principles of health and safety seek support to help deal with uncertain situations
legislation and regulations and maintain safe work and
care environments 5.10 understand their own role and the roles of all other staff at
different levels of experience and seniority in the event of a
5.2 participate in data collection to support audit activity, major incident.
and contribute to the implementation of quality
improvement strategies
5.3 accurately undertake risk assessments, using contemporary

assessment tools
5.4 respond to and escalate potential hazards that may affect the
safety of people
5.5 recognise when inadequate staffing levels impact on the ability

to provide safe care and escalate concerns appropriately
5.6 understand and act in line with local and national

organisational frameworks, legislation and regulations to
report risks, and implement actions as instructed, following up
and escalating as required

Annexe A:
Being an Promoting
management skills
Platform 6
Contributing to
integrated care
Nursing associates contribute to the provision of care
for people, including those with complex needs. They
understand the roles of a range of professionals and
carers from other organisations and settings who may
be participating in the care of a person and their family,
and their responsibilities in relation to communication
and collaboration.

Annexe A:
Being an Promoting
management skills
6. Outcomes: 6.6 demonstrate an understanding of their own role and

contribution when involved in the care of a person who
is undergoing discharge or a transition of care between
professionals, settings or services.
required for their role in contributing to integrated care to meet
the needs of people across organisations and settings.
6.1 understand the roles of the different providers of health

and care. Demonstrate the ability to work collaboratively and
in partnership with professionals from different agencies in
interdisciplinary teams
6.2 understand and explore the challenges of providing safe

nursing care for people with complex co-morbidities and
complex care needs
6.3 demonstrate an understanding of the complexities of

providing mental, cognitive, behavioural and physical care
needs across a wide range of integrated care settings
6.4 understand the principles and processes involved in supporting

people and families with a range of care needs to maintain
optimal independence and avoid unnecessary interventions
and disruptions to their lives
6.5 identify when people need help to facilitate equitable access to

care, support and escalate concerns appropriately

Annexe A:
Being an Promoting
management skills
Annexe A: It will be important for nursing associates to demonstrate cultural

awareness when caring for people and to ensure that the needs,
priorities, expertise and preferences of people are always valued
Communication and taken into account.
and relationship Where people have special communication needs or a disability, it

is essential that nursing associates make reasonable adjustments.
management skills This means they’ll be able to provide and share information in a
way that promotes good health and health outcomes and does not
prevent people from having equal access to the highest quality
of care.
Introduction
The skills listed below are those that all nursing associates are
In order to meet the proficiency outcomes outlined in the main body
expected to demonstrate at the point of registration.
of this document, nursing associates must be able to demonstrate
the communication and relationship management skills described in
this annexe at the point of registration.
The ability to communicate effectively, with sensitivity and

compassion, and to manage relationships with people is central
to the provision of high quality person-centred care. These
competencies must be demonstrated in practice settings and
adapted to meet the needs of people across their lifespan.
Nursing associates need a diverse range of communication skills
and strategies to ensure that individuals, their families and carers
are supported to be actively involved in their own care wherever
appropriate, and that they are kept informed and well prepared.

Annexe A:
Being an Promoting
management skills
At the point of registration, the nursing associate will be able to 1.12 recognise the need for translator services and material
safely demonstrate the following skills:
1.13 use age appropriate communication techniques.
1. Underpinning communication skills for providing and
monitoring care: 2. Communication skills for supporting people to prevent ill
health and manage their health challenges:
1.1 actively listen, recognise and respond to verbal and
non-verbal cues 2.1 effectively share information and check
understanding about:
1.2 use prompts and positive verbal and non-verbal
-- preventative health behaviours that help people to
reinforcement make lifestyle choices and improve their own health
1.3 use appropriate non-verbal communication including and wellbeing
touch, eye contact and personal space -- a range of common conditions including: anxiety,
depression, memory loss, diabetes, dementia,
1.4 make appropriate use of open and closed questioning respiratory disease, cardiac disease, neurological
disease, cancer, skin problems, immune deficiencies,
1.5 speak clearly and accurately psychosis, stroke and arthritis in accordance with
1.6 use caring conversation techniques care plans
2.2 clearly and confidently explain to the individual and family
1.7 check understanding and use clarification techniques
how their lifestyle choices may influence their health. This
1.8 be aware of the possibility of own unconscious bias in includes the impact of common health risk behaviours
communication encounters including smoking, diet, sexual practice, alcohol and
substance use
1.9 write accurate, clear, legible records and documentation
2.3 use appropriate materials, making reasonable
1.10 clearly record digital information and data adjustments where appropriate to support people’s
understanding of what may have caused their
1.11 provide clear verbal, digital or written information and
health condition and the implications of their care
instructions when sharing information, delegating or
and treatment
handing over responsibility for care

Annexe A:
Being an Promoting
management skills
2.4 use repetition and positive reinforcement strategies 3. Communication skills and approaches for providing
therapeutic interventions:
2.5 recognise and accommodate sensory impairments during
all communications 3.1 identify the need for and use appropriate approaches to
develop therapeutic relationships with people
2.6 support and monitor the use of personal
communication aids 3.2 demonstrate the use of a variety of effective
communication strategies:
2.7 address and respond to people’s questions, recognising
when to refer to others in order to provide -- reassurance and affirmation
accurate responses -- de-escalation strategies and techniques
2.8 identify the need for and manage a range of alternative -- distraction and diversion strategies
communication techniques -- positive behaviour support approaches.
2.9 engage in difficult conversations with support from 4. Communication skills for working in professional teams:
others, helping people who are feeling emotionally or
physically vulnerable or in distress, conveying compassion Demonstrate effective skills when working in teams through:
and sensitivity.
4.1 active listening when receiving feedback and when dealing
with team members’ concerns and anxieties
4.2 timely and appropriate escalation
4.3 being a calm presence when exposed to situations

involving conflict
4.4 being assertive when required
4.5 using de-escalation strategies and techniques when

dealing with conflict.

Annexe A:
Being an Promoting
management skills
5. Demonstrate effective supervision skills by providing:
5.1 clear instructions and explanations when

supervising others
5.2 clear instructions and checking understanding when

delegating care responsibilities to others
5.3 clear constructive feedback in relation to care delivered

by others
5.4 encouragement to colleagues that helps them to reflect

on their practice.

Annexe A:
Being an Promoting
management skills
Annexe B: management skills described in Annexe A) is crucial to the provision

of person-centred care. These procedures must be demonstrated
with an awareness of variations required for different practice
Procedures to be settings and for people across their lifespan. They must be carried
out in a way that reflects cultural awareness and ensures that the
undertaken by the needs, priorities, expertise and preferences of people are always
valued and taken into account.
nursing associate
Introduction
In order to meet the proficiency outcomes outlined in the main
body of this document, nursing associates must be able to carry
out the procedures described in this annexe at the point of their
registration. Nursing associates are required to demonstrate an
awareness of how requirements for procedures may vary across
different health and care settings. As the nursing associate role
is generic, students may demonstrate the ability to carry out
procedures in any appropriate context, and there is no expectation
that this must be demonstrated in every health and care setting.
Ideally students will demonstrate skills in a practice setting,
but where necessary some procedures may be demonstrated
through simulation.
Nursing associates are expected to apply evidence based best

practice across all procedures. The ability to carry out these
procedures, safely, effectively, with sensitivity and compassion
(while demonstrating the communication and relationship

Annexe A:
Being an Promoting
management skills
At the point of registration, the nursing associate will be able to 1.7 recognise and escalate signs of self-harm and/or
safely demonstrate the following procedures: suicidal ideation
1.8 undertake and interpret neurological observations
Part 1: Procedures to enable effective monitoring of a
person’s condition 1.9 recognise signs of mental and emotional distress
including agitation, or vulnerability
1. Demonstrate effective approaches to monitoring signs and
symptoms of physical, mental, cognitive, behavioural and 1.10 administer basic mental health first aid
emotional distress, deterioration and improvement: 1.11 recognise emergency situations and administer basic
1.1 accurately measure weight and height, calculate body physical first aid, including basic life support.
mass index and recognise healthy ranges and clinically
significant low/high readings Part 2: Procedures for provision of person-centred
1.2 use manual techniques and devices to take, record
nursing care
and interpret vital signs including temperature, pulse, 2. Provide support in meeting the needs of people in relation to
respiration (TPR), blood pressure (BP) and pulse oximetry rest, sleep, comfort and the maintenance of dignity:
in order to identify signs of improvement, deterioration
or concern 2.1 observe and monitor comfort and pain levels and rest and
sleep patterns
1.3 undertake venepuncture and routine ECG recording
2.2 use appropriate bed-making techniques, including those
1.4 measure and interpret blood glucose levels required for people who are unconscious or who have
1.5 collect and observe sputum, urine, stool and vomit limited mobility
specimens, interpreting findings and reporting 2.3 use appropriate positioning and pressure
as appropriate relieving techniques
1.6 recognise and escalate signs of all forms of abuse 2.4 take appropriate action to ensure privacy and dignity at
all times

Annexe A:
Being an Promoting
management skills
2.5 appropriate action to reduce or minimise pain 4. Provide support with nutrition and hydration:
or discomfort
4.1 use contemporary nutritional assessment tools
2.6 support people to reduce fatigue, minimise insomnia and
4.2 assist with feeding and drinking and use appropriate
take appropriate rest.
feeding and drinking aids
3. Provide care and support with hygiene and the maintenance of 4.3 record fluid intake and output to identify signs of
skin integrity: dehydration or fluid retention and escalate as necessary
3.1 observe and reassess skin and hygiene status using 4.4 support the delivery of artificial nutrition and hydration
contemporary approaches to determine the need for using oral and enteral routes.
support and ongoing intervention.
3.2 identify the need for and provide appropriate assistance
with washing, bathing, shaving and dressing
3.3 identify the need for and provide appropriate oral, dental,
eye and nail care and suggest to others when an onward
referral is needed
3.4 prevent and manage skin breakdown through appropriate
use of products
3.5 Identify and manage skin irritations and rashes
3.6 monitor wounds and undertake wound care using
appropriate evidence-based techniques.

Annexe A:
Being an Promoting
management skills
5. Provide support with maintaining bladder and bowel health: 7. Provide support with respiratory care:
5.1 observe and monitor the level of urinary and bowel 7.1 manage the administration of oxygen using a range of
continence to determine the need for ongoing support routes and approaches
and intervention, the level of independence and self-
7.2 take and be able to identify normal peak flow and
management of care that an individual can manage
oximetry measurements
5.2 assist with toileting, maintaining dignity and privacy and
7.3 use appropriate nasal and oral suctioning techniques
use appropriate continence products
7.4 manage inhalation, humidifier and nebuliser devices.
5.3 care for and manage catheters for all genders
5.4 recognise bladder and bowel patterns to identify and 8. Preventing and managing infection:
respond to incontinence, constipation, diarrhoea and
urinary and faecal retention. 8.1 observe and respond rapidly to potential infection risks
using best practice guidelines
6. Provide support with mobility and safety: 8.2 use standard precautions protocols
6.1 use appropriate risk assessment tools to determine the 8.3 use aseptic, non-touch techniques
ongoing need for support and intervention, the level of
independence and self-care that an individual can manage 8.4 use appropriate personal protection equipment
6.2 use appropriate assessment tools to determine, manage 8.5 implement isolation procedures
and escalate the ongoing risk of falls 8.6 use hand hygiene techniques
6.3 use a range of contemporary moving and handling 8.7 safely decontaminate equipment and environment
techniques and mobility aids
8.8 safely handle waste, laundry and sharps.
6.4 use appropriate moving and handling equipment to
support people with impaired mobility.

Annexe A:
Being an Promoting
management skills
9. Meeting needs for care and support at the end of life: 10.5 administer injections using subcutaneous and
intramuscular routes and manage injection equipment
9.1 recognise and take immediate steps to respond
appropriately to uncontrolled symptoms and signs of 10.6 administer and monitor medications using
distress including pain, nausea, thirst, constipation, enteral equipment
restlessness, agitation, anxiety and depression
10.7 administer enemas and suppositories
9.2 review preferences and care priorities of the dying
10.8 manage and monitor effectiveness of symptom
person and their family and carers, and ensure changes
relief medication
are communicated as appropriate
10.9 recognise and respond to adverse or abnormal
9.3 provide care for the deceased person and the bereaved
reactions to medications, and when and how to
respecting cultural requirements and protocols.
escalate any concerns
10. Procedural competencies required for administering 10.10 undertake safe storage, transportation and disposal
medicines safely: of medicinal products.
10.1 continually assess people receiving care and their ongoing
ability to self-administer their own medications. Know
when and how to escalate any concerns
10.2 undertake accurate drug calculations for a range
of medications
10.3 exercise professional accountability in ensuring the safe
administration of medicines to those receiving care
10.4 administer medication via oral, topical and
inhalation routes

Annexe A:
Being an Promoting
management skills
Glossary
Abuse: is something that Co-morbidities: the presence Evidence based person- Health literacy: the degree to
may harm another person, or of one or more additional centred care/nursing care: which individuals can obtain,
endanger their life, or violate diseases or disorders that making sure that any care and process, and understand basic
their rights. The person occur with a primary disease or treatment is given to people, by health information and services
responsible for the abuse may disorder. looking at what research has needed to make appropriate
be doing this on purpose or may shown to be most effective. health decisions.
not realise the harm that they Contraindications: a condition The judgment and experience of
are doing. The type of abuse or factor that serves as a the nurse and the views of the Human factors: environmental,
may be emotional, physical, reason to withhold a certain person should also be taken into organisational and job factors,
sexual, psychological, material medical treatment due to the account when choosing which and human and individual
or financial, or may be due to harm that it would cause the treatment is most likely to be characteristics, which influence
neglect. patient. successful for an individual behaviour at work in a way which
patient. can affect health and safety.
Candour: being open and Demography: the study of
honest with patients when statistics such as births, Genomics: branch of molecular
things go wrong. deaths, income, or the incidence biology concerned with the
of disease, which illustrate the structure, function, evolution,
Cognitive: The mental changing structure of human and mapping of genomes.
processes of perception, populations.
memory, judgment and
reasoning.

Annexe A:
Being an Promoting
management skills
Intervention: any investigations, People: individuals or groups Person-centred: an approach Vulnerable people: those who
procedures, or treatments who receive services from where the person is at the at any age are at a higher
given to a person. nurses, midwives and centre of the decision making risk of harm than others.
nursing associates, healthy processes and the design of Vulnerability might be in relation
and sick people, parents, their care needs, their nursing to a personal characteristic or
children, families, carers, care and treatment plan. a situation. The type of harm
representatives, also including may be emotional, physical,
educators and students and Reflection: to carefully sexual, psychological, material
other within and outside the consider actions or decisions or financial, or may be due to
learning environment. and learn from them. neglect.

The role of the
Nursing and
Midwifery Council
What we do
We regulate nurses, midwives and nursing associates in the
UK. We exist to protect the public. We set standards of
education, training, conduct and performance so that nurses,
midwives and nursing associates can deliver high quality care
throughout their careers. We maintain a register of nurses
and midwives allowed to practise in the UK.
We make sure nurses, midwives and nursing associates

keep their skills and knowledge up to date and uphold our
professional standards.
We have clear and transparent processes to investigate

people who fall short of our standards.
These standards were approved by Council at their

meeting on 26 September 2018.

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Standards of

Published 10 October 2018

www.nmc.org.uk Standards of proficiency for nursing associates 1

www.nmc.org.uk Standards of proficiency for nursing associates 1

• Employers understand what nursing associates can contribute

• Educators must develop and deliver programmes that equip

Nursing associate is a new role being introduced into the health

While the nursing associate role is new, it is particularly important

www.nmc.org.uk Standards of proficiency for nursing associates 3

www.nmc.org.uk Standards of proficiency for nursing associates 4

1. Outcomes: 1.6 understand the professional responsibility to adopt a healthy

www.nmc.org.uk Standards of proficiency for nursing associates 5

1.14 demonstrate the ability to keep complete, clear, accurate and

www.nmc.org.uk Standards of proficiency for nursing associates 6

www.nmc.org.uk Standards of proficiency for nursing associates 7

www.nmc.org.uk Standards of proficiency for nursing associates 8

www.nmc.org.uk Standards of proficiency for nursing associates 9

3. Outcomes: 3.6 demonstrate the knowledge, skills and ability to perform a

www.nmc.org.uk Standards of proficiency for nursing associates 10

www.nmc.org.uk Standards of proficiency for nursing associates 11

www.nmc.org.uk Standards of proficiency for nursing associates 12

4.3 understand and apply the principles of human factors and

4.4 demonstrate the ability to effectively and responsibly access,

4.5 demonstrate an ability to prioritise and manage their own

www.nmc.org.uk Standards of proficiency for nursing associates 13

www.nmc.org.uk Standards of proficiency for nursing associates 14

5. Outcomes: 5.7 understand what constitutes a near miss, a serious adverse

5.3 accurately undertake risk assessments, using contemporary

5.5 recognise when inadequate staffing levels impact on the ability

5.6 understand and act in line with local and national

www.nmc.org.uk Standards of proficiency for nursing associates 15

www.nmc.org.uk Standards of proficiency for nursing associates 16

6. Outcomes: 6.6 demonstrate an understanding of their own role and

At the point of registration, the nursing associate will be able to:

6.1 understand the roles of the different providers of health

6.2 understand and explore the challenges of providing safe

6.3 demonstrate an understanding of the complexities of

6.4 understand the principles and processes involved in supporting

6.5 identify when people need help to facilitate equitable access to

www.nmc.org.uk Standards of proficiency for nursing associates 17

Annexe A: It will be important for nursing associates to demonstrate cultural

and relationship Where people have special communication needs or a disability, it

The ability to communicate effectively, with sensitivity and

www.nmc.org.uk Standards of proficiency for nursing associates 18

www.nmc.org.uk Standards of proficiency for nursing associates 19

4.2 timely and appropriate escalation

4.3 being a calm presence when exposed to situations

4.4 being assertive when required

4.5 using de-escalation strategies and techniques when

www.nmc.org.uk Standards of proficiency for nursing associates 20

5. Demonstrate effective supervision skills by providing:

5.1 clear instructions and explanations when

5.2 clear instructions and checking understanding when

5.3 clear constructive feedback in relation to care delivered

5.4 encouragement to colleagues that helps them to reflect

www.nmc.org.uk Standards of proficiency for nursing associates 21

Annexe B: management skills described in Annexe A) is crucial to the provision

Nursing associates are expected to apply evidence based best