Registered Nurse Objective Structured Clinical Examination (NMC OSCE) Clinical Skills Stations Syllabus

Clinical Skills Stations syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Clinical Skills Stations in Registered Nurse Objective Structured Clinical Examination (NMC OSCE), not a summary of it.

1. 1

   Aseptic Non-Touch Technique (ANTT)

   4 topics

   • Principles of asepsis and key-part protection
   • Hand hygiene and the WHO five moments
     • Correct handwashing and gel technique
   • Standard precautions and PPE
     • Donning and doffing sequence
   • Worked example: simple wound dressing or device care
     • Maintaining a sterile field
     • Sharps and clinical waste segregation
2. 2

   Medicines Administration and Calculation

   4 topics

   • Safe administration and the rights of medication
     • Checking prescription, allergies and expiry
     • Positive patient identification
   • Drug calculations
     • Tablet, liquid and dosage-by-weight calculations
     • IV infusion rate (mL/hr and drops/min) calculations
   • Routes of administration
     • Oral, subcutaneous and intramuscular technique
   • Documentation and refusal
     • Signing the MAR and recording omitted doses
3. 3

   In-Hospital Resuscitation (BLS)

   4 topics

   • Recognising cardiac arrest and the chain of survival
   • Adult basic life support sequence
     • Chest compression depth, rate and ratio
     • Rescue breaths with a pocket mask or bag-valve-mask
   • Safe use of an AED
   • Calling for help and post-arrest handover
     • Variations for paediatric and field-specific scenarios
4. 4

   Common Clinical Procedures

   6 topics

   • Urinalysis and specimen collection
     • Interpreting dipstick results
   • Blood glucose monitoring (capillary)
   • Inhaler technique and peak flow
   • Subcutaneous injection (e.g. insulin or anticoagulant)
   • Catheter care and removal
     • Catheter-associated infection prevention
   • Fluid balance and intake/output charting

Clinical Skills Stations flashcards for Registered Nurse Objective Structured Clinical Examination (NMC OSCE)

23 of 50 cards from the Clinical Skills Stations deck — real questions with worked answers.

1. What is the definition of asepsis in the context of clinical skills?

   Asepsis is the absence of pathogenic micro-organisms. Aseptic technique is the set of practices used to prevent the transfer of micro-organisms to a susceptible site (e.g. a wound or invasive device) so that contamination and infection are avoided.

2. In the Aseptic Non Touch Technique (ANTT), what is a 'key-part' and what is the core principle of protecting it?

   A key-part is any part of the equipment that, if contaminated, could introduce infection (e.g. syringe tip, needle, the parts of a dressing that touch the wound). The core principle is Key-Part and Key-Site protection: never touch key-parts directly; protect them with caps, covers, sterile gloves or a non-touch technique.

3. What is the difference between 'standard' ANTT and 'surgical' ANTT?

   Standard ANTT is used for short, technically simple procedures with few/small key-parts (e.g. peripheral IV cannulation, simple dressings), typically using non-sterile gloves and a non-touch technique. Surgical ANTT is used for technically complex or long procedures with large open key-sites/many key-parts, requiring a full sterile field and sterile gloves.

4. List the WHO 'Five Moments for Hand Hygiene'.

   1. Before touching a patient. 2. Before a clean/aseptic procedure. 3. After body fluid exposure risk. 4. After touching a patient. 5. After touching patient surroundings.

5. How many distinct steps are in the WHO hand-rubbing/hand-washing technique, and roughly how long should each take?

   There are 6 hand hygiene steps (covering palms, backs of hands, between fingers, backs of fingers, thumbs, and fingertips/nails). Alcohol hand-rub should take about 20-30 seconds; soap-and-water hand washing should take about 40-60 seconds in total.

6. When must soap and water be used for hand hygiene instead of alcohol hand-rub?

   When hands are visibly soiled or contaminated with body fluids, and when caring for patients with spore-forming organisms such as Clostridioides difficile or norovirus, because alcohol gel is not effective against spores.

7. What does 'bare below the elbows' mean and why is it required?

   Short or rolled-up sleeves, no wristwatch, no rings (except a plain band), no bracelets, and no false/gel nails or nail polish. It exposes the wrists and forearms so they can be cleaned and prevents organisms harbouring under jewellery and nails, supporting effective hand hygiene.

8. What are the four main items of standard PPE and the key principle governing their use?

   Gloves, apron/gown, surgical mask/respirator, and eye protection (goggles or visor). The principle is risk assessment: PPE is selected according to the anticipated risk of exposure to blood and body fluids for the specific task, not worn routinely for every contact.

9. Give the correct order for donning and doffing PPE.

   Donning order: apron/gown, then mask/respirator, then eye protection, then gloves. Doffing (removal) order: gloves first, then apron/gown, then eye protection, then mask, performing hand hygiene at the appropriate points and finally after all PPE is removed (gloves are removed first as the most contaminated item).

10. What are 'standard precautions' and to whom do they apply?

    Standard precautions are the basic infection-prevention practices (hand hygiene, PPE, safe sharps handling, respiratory hygiene, safe waste/linen disposal, and environmental cleaning) applied to ALL patients at all times, regardless of known or suspected infection status, because any patient may carry transmissible organisms.

11. Describe the correct steps for a simple wound dressing change using aseptic technique.

    Explain and gain consent; perform hand hygiene; prepare a clean field and equipment; don apron; remove old dressing (often with non-sterile gloves) and dispose; hand hygiene; open sterile pack/dressing protecting key-parts; don clean/sterile gloves as indicated; clean/assess the wound using a non-touch technique; apply the new dressing without touching its key-part; dispose of waste; remove PPE; hand hygiene; document.

12. What solution is generally recommended for cleansing an acute/simple wound, and what should be avoided?

    Sterile normal saline ($\ce{0.9\% NaCl}$) or, for many wounds, clean warm tap water is used to cleanse or irrigate. Routine use of antiseptics such as chlorhexidine or hydrogen peroxide on granulating wounds is avoided because they can be cytotoxic and delay healing.

13. State the classic 'rights' of medication administration (the core five).

    Right patient, right drug (medication), right dose, right route, and right time. Commonly extended with right documentation, right reason/indication, right to refuse, right response, and right (in-date) preparation.

14. Before administering any medication, which three checks against the prescription are essential for safety?

    Check the patient's identity (against ID band and prescription chart), check the drug is correct, in date, and prescribed for that patient, and check the dose, route, and time are correct and not already given. Also check allergies and that the patient consents.

15. State the standard formula for calculating the volume of a liquid medication to draw up.

    $$\text{Volume required} = \frac{\text{Dose required}}{\text{Stock strength}} \times \text{Stock volume}$$ Often summarised as 'what you want over what you've got, times the volume it's in.'

16. A patient is prescribed $750\ \text{mg}$ of a drug available as $250\ \text{mg}$ in $5\ \text{mL}$. What volume is required?

    $$\frac{750}{250} \times 5 = 3 \times 5 = 15\ \text{mL}$$

17. State the formula for calculating tablets required, and work out the dose if $500\ \text{mg}$ is prescribed and tablets are $250\ \text{mg}$ each.

    $$\text{Number of tablets} = \frac{\text{Dose required}}{\text{Strength per tablet}}$$ Here $\frac{500}{250} = 2$ tablets.

18. State the formula for an IV infusion rate in drops per minute (gtt/min).

    $$\text{Drops per minute} = \frac{\text{Volume (mL)} \times \text{Drop factor (gtt/mL)}}{\text{Time (minutes)}}$$ The drop factor is typically $20\ \text{gtt/mL}$ for clear fluids and $15\ \text{gtt/mL}$ for blood giving sets.

19. Calculate the rate in mL/hour to infuse $1000\ \text{mL}$ over $8$ hours.

    $$\frac{1000\ \text{mL}}{8\ \text{h}} = 125\ \text{mL/h}$$

20. What is the weight-based dosing formula, and what is the dose for a $70\ \text{kg}$ adult prescribed $5\ \text{mg/kg}$?

    $$\text{Total dose} = \text{Dose per kg} \times \text{Body weight}$$ For this patient: $5\ \text{mg/kg} \times 70\ \text{kg} = 350\ \text{mg}$.

21. List the common enteral and parenteral routes of medication administration with their abbreviations.

    Enteral: oral (PO/per os), sublingual (SL), buccal, rectal (PR), and via enteral tubes (NG/PEG). Parenteral: intravenous (IV), intramuscular (IM), subcutaneous (SC/SubCut), and intradermal (ID). Other topical/local routes: transdermal, inhaled (INH), nebulised, ophthalmic, otic, nasal, and vaginal (PV).

22. Compare onset and typical use of intravenous (IV) versus subcutaneous (SC) routes.

    IV delivers the drug directly into the bloodstream giving the most rapid onset and 100% bioavailability, used for emergencies and precise control. SC delivers into fatty tissue beneath the skin giving slow, sustained absorption, used for drugs such as insulin, heparin/LMWH, and some vaccines; only small volumes (usually $\leq 1\text{-}2\ \text{mL}$) can be given.

23. At which sites and angles are intramuscular and subcutaneous injections given?

    IM injections are given at $90^{\circ}$ into muscle (e.g. deltoid, vastus lateralis, ventrogluteal). SC injections are given at $45^{\circ}$ to $90^{\circ}$ into a pinched skinfold (e.g. abdomen, outer thigh, upper outer arm), with the angle depending on needle length and the amount of subcutaneous tissue.

See more Clinical Skills Stations flashcards →

Planning Clinical Skills Stations for Registered Nurse Objective Structured Clinical Examination (NMC OSCE)

Clinical Skills Stations (Registered Nurse Objective Structured Clinical Examination (NMC OSCE)) FAQ