Forms and Templates

​​​​​​​​​​​​PDRP Application Guidelines (for all PDRP applications, CDHB & partners)

These guidelines integrate the newly updated national framework and evidential requirements that were released in April 2017.

You will need to read and complete the necessary requirements within these workbooks for the appropriate level you are applying for, when submitting via a hard copy portfolio.  When submitting via ePortfolio please use these guidelines as a guide only, for requirements at the level you are applying for.  Please see ePortfolio section on the PDRP website. 

You will need the Guidelines and the organisational Performance Appraisal to begin your Portfolio.

(Note: to download your own copy right click on the form > select 'save target as' > save document to your PC)

​​RN Competent Guidelines updated Sept19.docx

RN Proficient Guidelines updated March21.docx

RN Expert Guidelines Updated Sept19.docx

Designated Senior Nurse Guidelines updated Sept19.docx

EN Competent Guidelines updated Sept19.docx

EN Proficient Guidelines updated May19.docx

EN Accomplished Guidelines updated Sept 2019.docx


This Applicant Example Phrases form may be useful to assist you in writing practice examples for a performance appraisal or peer review. You are required to write an action and/or example of practice, to help you think about "HOW​" the competency and/or indicator is met within the Performance Appraisal.

Applicants Example Phrases 2018.pdf
 


PDRP level indicators and levels of practice definitions

(Note: to download your own copy, right click on the form > select 'save target as' > save document to your PC)

PDRP Level Indicators for ENs 2023.pdf

PDRP Level Indicators for RNs 2023.pdf

PDRP levels of Practice Definitions RN and EN Nurses 2018.pdf​ 

       (previously national indicators)

 

Performance Review/Appraisal for CDHB staff only

(Also includes Interim Performance Review/Appraisal)

Performance review forms provide the core evidence within a portfolio. The CDHB Performance Appraisal document is below and for CDHB staff only.  For all external organisations, please contact your PDRP Coordinator for relevant forms.

CDHB STAFF ONLY

For CDHB Performance Review/Appraisal forms please see link below 

Performance Review/Appraisal CDHB Only

 

EXTERNAL ORGANISATIONS

Please contact your PDRP Coordinator within your own organisation for relevant Performance Appraisal documents. 

 

Peer Review Forms 

Applicants from external Organisations should contact their PDRP Coordinator for their specific documents.

The CDHB nurse performance appraisal/reviews which are aligned to Nursing Council competencies are sufficient for submission to the PDRP without an additional peer review necessary.

The only time peer reviews might be necessary is if there is insufficient evidence within the performance appraisal and you believe the peer could provide extra information.

If you do not have a nursing line manager then a peer review by another nurse is necessary along with your self assessment to meet Nursing Council's requirements. The performance appraisal by your manager will be required as well. 

Please note that peer reviews are only valid for a year after completion to ensure currency of practice is assessed.

 

(Note: to download your own copy right click on the form > select 'save target as' > save document to your PC)

Peer Review Designated Senior Nurse March 2021.doc 

Peer Review RN Competent -Proficient -Expert March 2021.doc

Peer Review EN Competent -Proficient - Accomplished March 2021.doc

 

Evidence of Professional Development 

Nursing Council of New Zealand requires that your portfolio include an explanation of what you have learnt from three key learning activities OR a short reflection for each course/activity attended. 

Please refer to Frequently Asked Questions (FAQ) link below for Nursing Council requirements:   FAQ 

(Note: to download your own copy right click on the form > select 'save target as' > save document to your PC)

​​ 

Practice Reflection Guidelines 2018

Reflection on professional development 2018.doc

Journal Article Review 2020.doc

 

Contribution to Clinical Practice (Including Quality Forms) 

In health a quality activity is a systematic evaluation of an aspect of service or care against measurable quality indicators which has resulted in improvement. This improvement may be related to clinical practice or a service process and may be done as either a group or individual project.

Examples of quality improvement activity are audits, incident reports, data analysis, surveys, etc.

(Note: to download your own copy right click on the form > select 'save target as' > save document to your PC)

Clinical Specialty Resource Role 2023.doc

Membership of Professional Organisations 2018

Quality Improvement Change of Practice Initiative Form 2023 (6).doc

Quality Policy Protocol and Procedure Guidelines 2018

Role Overview updated Sept 2019.doc

Work Projects 2018

 

Evidence of Teaching/Preceptoring or Supporting Skill Development of Colleagues

Nurses contribute to education, preceptorship, buddying and skill development in a variety of ways within the clinical setting. These forms help articulate the different ways in which education occurs.

Preceptorship is a formal role undertaken by the RN. You should include a reflection on the role and feedback from the preceptee.

Buddying is a more informal process that is used to buddy a nurse who is working on a temporary basis in the area.

Teaching is a planned teaching session to a number of staff, using a teaching plan, set venue, available resources and an evaluation procedure.

Informal teaching is an unplanned opportunity to teach one or more staff in an informal environment e.g. a procedure at the bedside, equipment set up, etc.

Below you find the forms required for any of the above sessions. 

(Note: to download your own copy right click on the form > select 'save target as' > save document to your PC)

Case Study Presentation Feedback Form 2018

Case Study Presentation Guidelines 2018

Evaluation Reflection of Preceptee by Preceptor 2018.doc

Evaluation of Preceptor by Preceptee 2018

Personal Record of Presented Education 2018

Record of supporting skill development 2020.doc

Teaching Evaluation - Formal 2018

Teaching Evalution - Informal 2018

Teaching Plan 2018

 

PDRP Transfer Application Forms

(Note: to download your own copy right click on the form > select 'save target as' > save document to your PC)

Please go to the Transfer page for the latest form.

 

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Page last reviewed: 06 March 2024