NRSG258 - Principles of Nursing: Surgical

Year

Credit points

Campus offering

Prerequisites

NRSG140 Integrating Practice 2

For Bachelor of Nursing (Enrolled Nurses) students: Nil

Unit rationale, description and aim

The registered nurse plays a central role in the provision of health care for people who experience health alterations. Health alterations occur across a range of settings and it is a requirement that the nurse is able to provide effective and holistic care for people experiencing these alterations.  This unit is required by students to assist their ongoing development of theoretical knowledge, specifically in relation to nursing practice in the surgical environment.  As part of an integrated curriculum this unit builds on previously acquired knowledge. In later units you will develop stronger clinical reasoning skills and a comprehension of nursing management of the complex surgical patient.  

The principles of surgical nursing that underpin best practice will be demonstrated by the use of evidence-based case studies. Students will explore the roles of the surgical nurse across a variety of health settings, and within the context of the patient journey and the delivery of interprofessional health care. The content contained within this unit will inform nursing students’ future clinical practice across a variety of settings.

This aim of NRSG258 Principles of Nursing: Surgical is to support students in development of knowledge and skills for person-centred, evidence-based nursing care of individuals experiencing episodic health alterations or illnesses that require surgery.

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 - Outline the biopsychosocial, spiritual and cultural factors that impact on the person’s surgical experience (GA1, GA4, GA5)

LO2 - Describe knowledge of pathophysiology to manage common issues in surgical nursing (GA4, GA5)

LO3 - Apply the models of nursing across the lifespan, to the principles of surgical nursing across the care continuum (GA1, GA4, GA5, GA9)

LO4 - Implement critical thinking and clinical reasoning across a range of settings, to plan safe, evidence-based, culturally sensitive, person-centred nursing care for common health alterations in surgical nursing (GA3, GA4, GA5, GA8, GA9)

LO5 - Analyse quality use of medicines, non-pharmacological therapeutic interventions and complementary therapies in the surgical context (GA1, GA3, GA4, GA5, GA8)

LO6 - Appraise legal and ethical principles related to the surgical experience (GA3)

Graduate attributes

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

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 

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

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

NMBA Registered Nurse 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:

Surgical nursing care

• Principles
• Alterations to health resulting in surgery (e.g. acute neurological problems)
• Risk factors and comorbidities – impact on surgical experience
• Biopsychosocial, spiritual and cultural considerations
• Promoting independence and working collaboratively
• Safety and risk assessments
• Assessing for and managing deterioration
• Patient education
• Quality use of medicines (anaesthetic agents, intravenous fluids, antiemetics, analgesia, antipyretics and antibiotics)
• Continuity of care
• Discharge planning
• Tools for planning care (e.g. care pathways)
• Legal and ethical issues
• Preoperative
• Types of surgery and settings
• Pathways for surgical admission 
• Role of the nurse and the interprofessional team
• Admission and preparation for surgery
• Intraoperative
• Role of the nurse and the interprofessional team
• Postoperative
• Role of the nurse and the interprofessional team
• Identifying and managing post-operative complications. 
• Acute pain management

Learning and teaching strategy and rationale

Modes of delivery in this unit include lectures, tutorials, online activities and self-directed study. Consistent with adult learning principles, the teaching and learning methods used within these modes of delivery will provide students with foundational knowledge and skills relevant to professional nursing practice. These approaches 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 methods 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. Located in the second year of the program, this theory unit includes opportunities to assist students to link nursing theory with practice.

Online lectures are utilised to convey core content and its central principles, lectures provide opportunities for student to begin the exploration of content and scaffold their learning in follow up tutorials. Consolidation of content in tutorials is promoted through collaboration and discussion with student peers. In addition, Tutorials deliver interactive learning sessions which include formative feedback to build foundational tertiary study skills while also providing an opportunity to establish group-work and community learning skills. Online materials are introduced to provide students with a foundation for ongoing, self-directed, self-motivated, off-campus study.

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.

A formative online quiz for this unit will be made available to students in week 4 of semester to provide feedback on their progress and guide their unit learning. The formative quiz follows the same format as the online quizzes used in first year. First year quizzes were summative; second year quizzes are formative and will not contribute to the final unit grade – they are designed to assist students in the transition toward independent study and life-long learning.

In this unit, students transition from three low weighted assessments (in previous units) to two heavily weighted assessments: a written assignment and examination. The written assignment will allow students to prepare their submission progressively while also providing an opportunity for early feedback. The written assessment will use a case study to engage students with the application of theory into practice. The examination is a focussed assessment requiring steady, progressive learning over the course of the semester. The examination requires a sound knowledge base to answer content questions and an understanding of this content to address the process related questions. 

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

Brown, D., Edwards, H., Buckley, S., Aitken, R. (2020). Lewis’s medical-surgical nursing. Assessment and management of clinical problems (5th. Ed). Elsevier.

Bullock, S. & Hales, M. (2019). Principles of pathophysiology (2nd ed.). Pearson.

Bullock, S., & Manias, E. (2017). Fundamentals of pharmacology. (8th ed.). Pearson. 

Forbes, H., & Watt, E. (2020). Jarvis’s physical examination and health assessment (3rd ed.). Elsevier.

Holland, K., Jenkins, J., Solomon, J., & Whittam, S. (2019). Applying the Roper-Logan-Tierney Model in practice-E-Book. Elsevier. 

Levett-Jones, T. (2017). Clinical Reasoning: Learning to think like a nurse. Pearson.

Tiziani, A. P.(2021).Havard’s nursing guide to drugs(11th ed). Elsevier.

Tortora, G.T., Derrickson, B.H., Burkett, B., Peoples, G., Dye, D., Cooke, J., Diversi, T., McKean, M., Samalia, L., & Mellifont, R. (2019). Principles of anatomy and physiology (2nd Asia-Pacific ed.) John Wiley & Sons.