NRSG264 - Integrating Practice 3

Year

Credit points

Campus offering

Prerequisites

For BN, BN/BBA and BN/BP students: NRSG140 Integrating Practice 2 ; For BN(EN) Students: Nil

Unit rationale, description and aim

In the nursing profession, it is a requirement that the nurse is able to link theory with practice and perform clinical duties which are underpinned by a theoretical understanding. To perform these skills well, the nurse must be able to reflect critically on their practice and appraise their performance to identify best practice moving forward. This unit is required by students to assist them to use theory to drive their clinical practice and to understand how practice is guided by a continual process of assessment, diagnosis, planning, implementation and evaluation - skills critical for the nurse to deliver best practice. Foundational nursing practice skills will be developed and extended through scenario based learning in the laboratory. Students will be required to apply their theoretical knowledge during their clinical placement comprising 160 hours.

The aim of this third 'Integrating Practice' unit is to build on students' previous and current learning to further contextualize their theoretical knowledge through clinical practice.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - apply the clinical reasoning cycle to the care of individuals or groups utilising a sound knowledge of pathophysiology; (GA4, GA5, GA6, GA8)

LO2 - practice principles of quality and safety, quality use of medicines and caring when undertaking patient care and/or performing clinical responsibilities; (GA1, GA2)

LO3 - practice ethical, legal, cultural and professional principles when undertaking patient care and/or performing clinical responsibilities; (GA3)

LO4 - demonstrate effective communication capabilities (oral, electronic and written) when undertaking patient care and/or clinical responsibilities; (GA9, GA10)

LO5 - apply the principles of teamwork and self-management when planning, implementing and evaluating patient care and/or clinical responsibilities; (GA7)

LO6 - reflect on their learning within a professional portfolio to evaluate effective learning and self-care strategies for themselves and others. (GA4, GA10)

Graduate attributes

GA1 - demonstrate respect for the dignity of each individual and for human diversity

GA2 - recognise their responsibility to the common good, the environment and society 

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

GA7 - work both autonomously and collaboratively 

GA8 - locate, organise, analyse, synthesise and evaluate information 

GA9 - demonstrate effective communication in oral and written English language and visual media 

GA10 - utilise information and communication and other relevant technologies effectively.

NMBA Standards for Practice

The Nursing and Midwifery Board of Australia’s Registered Nurse Standards for Practice developed in this unit are:

Content

Topics will include:

• Person-centred practice
• Application of person-centered practice in the provision of care:
• Providing specific interventions that support people undergoing surgery or in emotional distress

• Professional & therapeutic communication
• Admission assessment interview & referral and discharge summaries
• Clinical handover (ISBAR) Demonstration of a clinical handover process using the ISBAR - identification, situation, background, assessment & recommendation)
• Accurate Charting & Documentation
• Communicating with people who are experiencing alterations in emotions and cognition- establishing a therapeutic relationship & with altered communication processes.
• Communicating with families, partners or significant others
• Multidisciplinary teams and Interprofessional practice

• Nursing assessment
• Admission Assessment
• Pre- & postoperative and emergency assessment
• Pain Assessment
• Completing a Mental Health Assessment including Mental State Examination (MSE), including physical health assessment
• Risk Assessments (e.g. suicidal, homicidal, self-harm)
• Alcohol and other drug screening assessments / Scales
• Charting & Documentation.
• Assessing the 3 D's (Delirium, Dementia & Depression)

• Provision, coordination & evaluation of care
• Basic Life Support
• Surgical wounds and devices (e.g. stiches, staples, drains, stomas)
• Enteral feeding and nasogastric tubes
• Pain–intervention (including PCA)
• Identification, prevention and management of a patient with postoperative complications
• Fluid & electrolyte imbalance
• Management of pyrexia
• Group process as therapy
• Mental health management (e.g. dealing with silence, depression)
• Discharge Planning
• Clinical risk management
• Cognitive Behavioral Therapy
• Managing a person with altered cognitive, emotional and behavioral thinking.

• Quality use of medicines
• Drug Calculations (Oral, Parental & Infusion Rates) - Formative
• Managing medication Oral, S/C, IMI( focus on depot injections in mental health context), IV
• Focus on antibiotics, anticoagulants, psychotropics
• Medication Compliance (adherence)

• Health promotion & education
• Identify health promotion needs and supports (e.g. postoperative care, SANE, support groups, mental health promotion, suicide prevention strategies)
• Education for individuals and their supports

• Diversity & cultural competence
• Identifying cultural and religious groups and extending knowledge on cultural/religious beliefs and practices
• Cultural and spiritual assessment in mental health

• Professional capabilities
• Debriefing following critical incidents     
• Principles for debriefing and self-care for nurses in mental health context
• Resilience
• Reflecting on practice - clinical decision making/ judgement
• Health care law: dealing with emergency situations in health care practice
• Clinical leadership
• Clinical Governance

• Clinical reasoning
• Applying Critical Thinking in practice      
• Applying Clinical Reasoning

Reflecting on practice - clinical decision making/ judgement

Learning and teaching strategy and rationale

Modes of delivery in this unit include lectures, laboratories, simulations, clinical placement, online activies and self-directed study. Consistent with adult learning principles, the teaching and learning strategies used within these modes of delivery will provide students with foundational knowledge and skills relevant to professional nursing practice. These strategies will also support students in meeting the aim, learning outcomes and graduate attributes of the unit and the broader course learning outcomes. Learning and teaching strategies will reflect respect for the individual as an independent learner. Students will be expected to take responsibility for their learning and to participate actively with peers.

Students undertaking a tertiary qualification need skills to assist them in managing their individual learning. Feedback and effective self-reflection are required to identify what is being done well, what requires additional work and to identify progress toward required learning outcomes. Practicum assists students to link theory with its application. Located in the second year of the programme, this clinical unit includes face-to-face teaching to assist students in linking theory with practice and an increasing self-directed component of learning to build life-long learning skills. Lectures are utilised to convey content and central principles while laboratories and simulation deliver interactive learning sessions which assist students to apply theory to clinical practice, build self-reflection  skills while also providing an opportunity to build community learning skills. The supervised clinical placement provides a safe environment where students can provide assisted person-centred care essential for successful graduate practice.  

Assessment strategy and rationale

A range of assessment items consistent with University assessment requirements and policy will be used to ensure students achieve the unit learning outcomes and attain the graduate attributes. Competence whilst on clinical placement will be assessed with the Australian Nursing Standards Assessment Tool (ANSAT).

In real world practice, it is a requirement that the registered nurse have the ability to complete medication calculations with no errors. This requirement exists because errors in the calculations of drug dosages can have severe adverse health consequences for patients. This unit includes a mandatory pass on the ANSAT assessment of your clinical placement because in nursing, your professional competence is a necessary job requirement. Achieving pass as a standard for the skills portfolio is also mandatory. The skills portfolio will help with your employment as well as your continuing professional development which is an ongoing requirement for registration as a Registered Nurse. In order to gain a pass in this unit, all three hurdle tasks must be completed successfully.

These assessments are required to build student knowledge and skills which, by the conclusion of this programme, will enable the student to graduate as a safe and effective nurse. 

Overview of assessments

Representative texts and references

Crisp, J., Taylor, C., Douglas, C., & Rebeiro, G. (2016). Potter & Perry’s fundamentals of

nursing (5th ed.). Sydney, N.S.W.: Mosby/Elsevier Australia.

Forbes, H., & Watt, E. (2016). Jarvis’s physical examination and health assessment (2nd Australian and New Zealand ed.). Chatswood, N.S.W.: Churchill Livingstone/Elsevier.

Holland, K., Jenkins, J., Solomon, J. & Whittam, S. (2008). Applying the Roper-Logan-TierneyModel in practice, London: Churchill Livingston. (2017 edition will replace this).

Levett-Jones, T. (2013) Clinical reasoning: Learning to think like a nurse. Frenchs Forest, N.S.W.: Pearson.

McCabe, C., & Timmons, F. (2013) Communication skills for nursing practice (2nd ed.). London: Palgrave McMillan.

Rebeiro, G., Jack, L., Scully, N., & Wilson, D. (2016). Fundamentals of nursing clinical skills workbook (3rd ed.). Sydney, N.S.W.: Mosby/Elsevier Australia.