NRSG267 - Integrating Practice 4

Year

Credit points

Campus offering

Prerequisites

For Bachelor of Nursing, Bachelor of Nursing/Bachelor of Paramedicine, Bachelor of Nursing/Bachelor of Business Administration: NRSG140 Integrating Practice 2 AND NRSG258 Principles of Nursing: Surgical AND NRSG263 Principles of Nursing Mental Health

For Bachelor of Nursing (Enrolled Nurses): NRSG258 Principles of Nursing: Surgical AND NRSG263 Principles of Nursing Mental Health

Unit rationale, description and aim

Safe practice and safety of the public is paramount within nursing. This second year integrated practice unit scaffolds learning from first year units and semester 1 in second year to prepare nursing students with a further developing level of experience to critical think and link theory to practice. In NRSG267 students build on critical thinking skills, ethics and assessment and management of patients. In the second year IP units, the introduction of reflection in and on practice occurs, with the aim of developing reflective and safe nurses.

In the nursing profession, it is a requirement that the nurse be able to link theory with practice and perform clinical duties which are underpinned by a theoretical understanding. To perform these skills safely and well, the nurse must be able to reflect critically on their practice and appraise their performance to identify best practice. Unit NRSG267 Integrating Practice 4 unit is required by students to support them in further developing their knowledge of theory to further scaffold their learning in professional practice and to reflect on and in practice, guided by a continual process of assessment, diagnosis, planning, implementation and evaluation – skills critical for the nurse to deliver best practice.

Professional Experience Placement (PEP) is an opportunity for students to demonstrate application of theoretical knowledge in practice as well as demonstrate comprehensive and thorough care for individuals.

The aim of this fourth ‘Integrating Practice’ unit is to build on students’ previous and current learning of critical thinking, ethics and assessment and management of individuals in their care and the introduction of reflection in and on practice, to further contextualize their theoretical knowledge through professional experience placement. 

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

LO2 - Implement principles of quality and safety, quality use of medicines and caring when undertaking patient care and/or performing clinical responsibilities at a developed level (GA1, GA2)

LO3 - Apply ethical, legal, cultural and professional principles when undertaking patient care and/or performing clinical responsibilities at a developed level (GA3)

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

LO5 - Examine the principles of teamwork and self-management when planning, implementing and evaluating patient care and/or clinical responsibilities at a developed level (GA7)

LO6 - Reflect on their learning to describe effective learning and self-care strategies for themselves and others at a developed 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 graduates 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-centered practice in the provision of care:
• Providing specific interventions that support people experiencing long term chronic health problems
• Professional & therapeutic communication
• Admission Assessment Interview & referral and discharge summaries
• Clinical handover – ISBAR (e.g. critical communication and recognition of communicating complex needs)
• Communicating with people who are experiencing alterations in emotions and cognition (communicating and advocating with people who cannot express their needs (e.g. person with psychosis/major depression/stroke)
• Therapeutic communication - exploring the use of transference and countertransference
• Communicating with other health disciplines
• The nurse role within interprofessional teams - identification of specific discipline skills and generic discipline skills
• Writing referral and discharge summaries
• Nursing assessment
• Applying the principles of nursing assessment (focused) e.g. medical, ageing, cardiac, renal, GI, respiratory, neurological, infection risk
• Conducting a 12 lead ECG - basic understanding and recognition of sinus rhythm
• Venipuncture
• Blood glucose levels
• Provision, coordination & evaluation of care
• Managing and care of a patient with acute respiratory distress
• Oxygen therapy - Venturi, NRB mask
• Managing (assessment and care of) an UWSD
• Chest physio (deep breathing/incentive spirometry)
• Managing faecal and urinary incontinence including use of devices
• Diabetic foot care
• Recognising and responding to deterioration
• Discharge planning
• Quality use of medicines
• Drug calculations (Oral, Parental & Infusion Rates) - formative
• Managing medication Oral, S/C, IMI, IV, PCAs
• Focus on Bronchodilators, hypoglycaemics, insulin, long acting antipsychotics (depots) and anti-inflammatories (steroid and non-steroid)
• Blood administration
• Medication reconciliation
• Health promotion & education
• Identify health promotion needs and supports e.g. diabetes, stroke, dementia
• Education for individuals and their supports
• Diversity & cultural competence
• Identifying cultural and religious groups and extending knowledge on cultural/religious beliefs and practices
• Professional capabilities
• Debriefing following critical incidents
• Resilience
• Reflecting on practice
• Health care law: addressing adverse events
• Clinical leadership
• Quality and safety
• Clinical risk management and minimizing patient harm
• Clinical reasoning
• Applying critical thinking in practice
• Applying clinical reasoning in practice
• Reflecting on practice - clinical decision making/ judgement

Learning and teaching strategy and rationale

In line with ACU’s constructivist approach to learning, unit NRSG267 aims for students to further develop their knowledge and skills with their individually distinct pre-existing understandings and then apply these new learnings to tasks and problems, demonstrating competence and safe practice.

Multiple modes of delivery are used to strengthen delivery of learning concepts. Modes of delivery in this unit include online lectures, laboratory simulation, 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 further developing their 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 self-reflection are 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 further assist students to link theory with its application in the clinical environment. Located in the second year of the program, this clinical unit includes face-to-face teaching to assist students in linking theory with practice and a 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 professional clinical practice, build self-reflection skills while also providing an opportunity to build community learning skills. The supervised professional experience placement provides a safe environment where students can provide assisted person-centred care, which is essential for successful graduate practice. Components of this unit may also be offered on or off campus in intensive mode for sponsored / special cohorts, with the learning and teaching strategies being equitable with on campus mode offerings.

The aim of this fourth ‘Integrating Practice’ unit is to build on students’ previous and current learning of critical thinking, ethics and assessment and management of individuals in their care and further consolidate their learning.

Assessment strategy and rationale

The assessments are constructively aligned to the 6 learning outcomes of unit NRSG267 and the learning outcomes of the program and graduate attributes.

NRSG267 has 160 hours of professional experience placement that students are required to complete. 

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 during professional 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 (Australian Commission on Safety and Quality in Health Care [ACSQHC], 2020). NRSG267: Integrating Practice 4 includes a mandatory pass on the ANSAT assessment of your professional placement because in nursing, professional competence is a necessary job requirement. Achieving pass as a standard for the 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 to demonstrate their ability to apply clinical reasoning through their learning experiences for NRSG267. To achieve a pass grade for this unit, all three hurdle tasks need to 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. 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’.

Offshore intensive assessment of this unit will be transparently equitable with on campus mode offerings as endorsed by the relevant Course Implementation Committee.

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.

Evans, K., Nizette, D., & O'Brien, A. (2017). Psychiatric & Mental Health Nursing. Chatswood, N.S.W.: Elsevier Health Sciences.

Halter, M. J., (2019). Varcarolis’ Manual of Psychiatric Nursing Care Planning (6th ed.). St Louis, Missouri: Churchill Livingstone/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 (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 (4th ed.). Elsevier Australia.

Tiziani, A., & Havard, M. (2018). Havard’s nursing guide to drugs (10th ed.). Elsevier Australia.

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