NRSG140 - Integrating Practice 2

Year

Credit points

Campus offering

Prerequisites

NRSG139 Integrating Practice 1: Assessment in Health

Unit rationale, description and aim

NRSG139 is a pre-requisite unit for NRSG140. The aim of NRSG140 is to enhance skills and knowledge that students were introduced in NRSG139, and to develop these further to strengthen foundational learning of critical thinking, reflection and safe practice within the integrated practice units.

NRSG140 is the second integrated practice unit within the BN program and associated degrees.

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 safe and best practice.

NRSG140 Integrating Practice 2 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.

This unit enables students to draw on their learning in previous subjects to extend and integrate theoretical and practical knowledge gained in the course to date. NRSG140 Integrating Practice 2 uses scenario based teaching and simulation learning activities in practical classes so that students integrate foundational nursing practice skills with theoretical knowledge. Students will consolidate their theoretical knowledge through clinical experience comprising 80 hours. Professional Experience Placement (PEP) is required to enable students to apply theoretical knowledge and demonstrate comprehensive and thorough safe 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 - Identify principles of quality and safety, quality use of medicines and caring when undertaking patient care and/or performing clinical responsibilities at an introductory level (GA1, GA2)

LO2 - Describe critical thinking and clinical reasoning to the care of individuals or groups utilising a foundational knowledge of pathophysiology (GA4, GA5, GA6, GA8)

LO3 - Describe the principles of teamwork, self-management when planning, implementing and evaluating patient care and/or clinical responsibilities at an introductory level (GA7)

LO4 - Demonstrate effective oral and written communication (including electronic) capabilities when undertaking patient care and/or performing clinical responsibilities during simulation, OSCE's and professional experience placement at an introductory level (GA9, GA10)

LO5 - Practice ethical, legal, cultural and professional principles when undertaking patient care and/or performing clinical responsibilities at an introductory level (GA3)

LO6 - Reflect on their learning to identify effective learning and self-care strategies for themselves and others at an introductory level (GA4, GA10)

Graduate attributes

Developmental progression toward all graduate attributes across every professional practice experience is required for students to meet expectations of student performance during professional practice and the real-world practice of graduate nurses. Additionally, the Australian Nursing Standards Assessment Tool (ANSAT) reflects the Graduate Attributes and so students are required to demonstrate these qualities during professional practice. On successful completion of this unit, students should have developed their ability to:

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 Registered Nurse Standards for Practice

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

National Safety and Quality Health Service Standards (2nd edition)

The Australian Commission on Safety and Quality in Health Care standards developed in this unit are:

Content

Topics will include:

• Person-centred practice
• Application of person-centred practice in the provision of care:
• Reducing anxiety & distress related to assessment and investigations
• Recognising anxiety for all individuals in all illness contexts.
• Professional & therapeutic communication
• The assessment Interview
• Documentation principles of documentation clinical files/ electronic records/statutory requirements
• Charting (e.g. FBC, vital signs)
• Writing nursing notes
• Clinical handover (ISBAR) demonstration of a clinical handover process using the ISBAR - identification, situation, background, assessment & recommendation)
• Nursing assessment
• Applying the principles of a nursing assessment
• Introduction to conducting a focused assessment
• Investigations and diagnostics (e.g. urinalysis & specimens)
• Demonstrating psychological vital signs
• Risk assessments: falls, pressure injury, nutrition
• Provision, coordination & evaluation of care
• Activities of living (provision and coordination of care – application of models of nursing and recording and documentation)
• Basic oxygen delivery
• Hygiene
• Elimination
• Infection control
• Hand hygiene
• Asepsis (inc. ANTT simple wound dressing)
• Standard and Transmission-based precautions
• Introduction to wound management (simple wounds)
• Manual handling & assisting with mobility
• Pressure intervention (including patient positioning)
• Venous thrombo embolism (movement and prevention of in ADL)
• Quality use of medicines
• Drug scheduling & storage
• Drug administration (10 rights and 3 Checks)
• National prescribing chart
• Over the counter medications
• Introduction to drug calculations (oral tablets and syrups) – formative
• Managing medications (oral/ophthalmic/topical)
• Focus on ophthalmic & oral analgesics
• Health promotion & education
• Identifying opportunities for education, health promotion and behaviour change
• Diversity and cultural culture in healthcare
• Applying cultural competence and safety in practice
• Professional capabilities
• Receiving and providing feedback
• Self care & resilience
• Health care law: privacy and confidentiality
• Clinical leadership
• Introduction to management and leadership
• Clinical reasoning
• Applying critical thinking in practice
• Applying clinical reasoning 

Learning and teaching strategy and rationale

Modes of delivery in this unit include online lectures, laboratory simulation, practical class (theory), online activities, professional practice 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 entering university need significant support to transition into a learning and teaching environment where they are required to drive their own learning. To guide students in their learning, feedback is required to identify what is being done well, what requires additional work and to identify progress toward required learning outcomes. The professional practice experience will assist students to link theory with practice in the clinical environment. Located in the first year of the programme, NRSG140 includes significant face-to-face teaching hours to assist students in linking theory with practice. Lectures are utilised to convey content and central principles while laboratories and simulations deliver interactive learning sessions which assist students to apply theory to clinical practice while also providing an opportunity to establish community learning skills. The supervised professional placement provides a safe environment where students can provide assisted person-centred care, which is essential for successful graduate practice.  

Assessment strategy and rationale

The assessments are structured to support students meeting the learning outcomes of the unit.

NRSG140 has 80 hours of professional experience placement that students are required to complete.

To show a trajectory of learning, the three assessments though similar to assessments in NRSG139, build on concepts and further contribute to students learning.

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 ANSAT (Australian Nursing Standards Assessment Tool).

In practice, it is a requirement that the registered nurse has the ability to complete error-free medication calculations. This requirement exists because errors in the calculations of drug dosages can have severe adverse health consequences for patients (Australian Commission on Safety and Quality in Health Care [ACSQHC], 2020). NRSG140 Integrating Practice 2 requires a mandatory pass grade for the ANSAT assessment of professional placement because in nursing professional competence is a necessary job requirement. Achieving a pass grade as a standard for the clinical skills portfolio is also mandatory. The clinical skills portfolio supports consolidation of the theory and simulation components of the unit and enables the student to demonstrate their ability to apply clinical reasoning through their learning experiences for NRSG140. To achieve a pass grade for NRS140, all three (3) of the above hurdle tasks must be completed successfully.

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

• Australian Nursing Standard Assessment Tool (ANSAT) is an “Ungraded Hurdle” (PASS/FAIL) with only one attempt. The rationale for only one attempt is that students are not able to be granted multiple clinical placements.
• Drug Calculation is an “Ungraded Hurdle” (PASS/FAIL) with multiple attempts prior to the published due date, when students must submit a certificate of 100% achievement in order to receive a pass. The National Assessment Review Committee may, in exceptional circumstances, grant one further attempt ‘only’.
• Clinical Portfolio is an “Ungraded Hurdle” (PASS/FAIL) with multiple attempts permitted prior to the published due date, when students must pass all components of the Clinical Portfolio to be eligible to attend professional experience placement. The National Assessment Review Committee may, in exceptional circumstances, grant one further attempt ‘only’.

Overview of assessments

Representative texts and references

Australian Commission on Safety and Quality in Health Care [ACSQHC]. (2021). National Safety and Quality Health Service standards (NSQHS): Sydney: https://www.safetyandquality.gov.au/standards/nsqhs-standards

Brown, D., Edwards, H., Buckley, T. C. T., Aitken, R. L., Lewis, S. M., Bucher, L., Heitkemper, M. M., Harding, M., Kwong, J., & Roberts, D. (2020). Lewis’s medical-surgical nursing: assessment and management of clinical problems (5th ANZ ed.). Elsevier Australia 

Crisp, J., Crisp, J., Douglas, C., Rebeiro, G., & Waters, D. (2021). Potter & Perry’s fundamentals of nursing  (6th ANZ ed.). Elsevier.

Jarvis, C., Eckhardt, A., Watt, E., & Forbes, H. (2021). Jarvis’s health assessment & physical examination (3rd ANZ ed.). Elsevier Australia

Jenkins, J., & Holland, K. (2019). Applying the Roper-Logan-Tierney model in practice - Library search (exlibrisgroup.com) (3rd ed.). Elsevier.

Levett-Jones, T. (2017). Clinical reasoning : Learning to think like a nurse  (2nd ed.). Pearson Australia.

O’Toole, G. (2020). Communication : core interpersonal skills for healthcare professionals - Library search (exlibrisgroup.com) (4th ed.). Elsevier Australia.

Tiziani, A., & Havard, M. (2018). Havard’s nursing guide to drugs (10th ed.). Elsevier Australia Havard's nursing guide to drugs - Library search (exlibrisgroup.com)

Tollefson, J., & Hillman, E. (2018). Clinical psychomotor skills (5-point bondy) : assessment tools for nurses (7th ed.). Cengage Australia.