NRSG373 - Integrating Practice 5

Year

Credit points

Campus offering

Prerequisites

NRSG264 Integrating Practice 3 AND NRSG267 Integrating Practice 4

Unit rationale, description and aim

Safe practice and safety of the public is paramount within nursing. This third year integrated practice unit scaffolds learning from previous years to prepare nursing students at a mastery level to be safe nurses. In NRSG373 students build on skills and knowledge and move towards mastery in examining, critiquing and applying theory to practice. Reflection in and on practice is scaffolded from second year units and students are encouraged to become autonomous and accountable in their practice.. Leadership qualities including delegation, skills that are required of a nurse are reviewed in this unit.

Students demonstrate having met the learning outcomes of this unit through their practice during the professional experience placement.

The aim of this fifth Integrated Practice unit is to build on from a second year developed level to a mastery level.  The integrated practice units in third year aim for students to be work ready, critical reflective learners who are  safe in 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 - Use critical thinking and clinical reasoning to the care of individuals or groups utilising an advanced knowledge of pathophysiology (GA4, GA5, GA6, GA8)

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

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

LO4 - Demonstrate advanced oral, electronic and written communication capabilities to provide safe patient care and/or clinical responsibilities during simulation, OSCE's and professional experience placement at a mastery 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 mastery level (GA7)

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

Graduate attributes

Expectations of student performance during Professional Practice experiences, and the real-world practice of nursing program graduates, requires developmental progression toward all graduate attributes across every clinical placement experience. The Australian Nursing Standards Assessment Tool (ANSAT) reflects the Graduate Attributes and so students are required to demonstrate these qualities during professional practice. Following successful completion of NRSG373, 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: 

Content

Topics will include: 

• Person-centred practice 
• Application of person-centered practice in the provision of care: 
• Respect for the person's choices for their treatment and care  
• Supported decision making within mental health context.  
• Understanding personal recovery & support personal recovery goals & collaborative care. 
•  Professional & therapeutic communication 
• Identifying and communicating in complex family or relationship dynamics and roles) 
• Therapeutic use of self - advanced communication of working with a person who has altered cognitive, emotional and behavioural thinking) 
• Promoting and advocating and the principles of open disclosure 
• Communication within interprofessional teams (e.g. clinical review processes - leadership and advocacy)  
• Nursing assessment 
• Applying principles of nursing assessment - focused and integrated  
• Complete health assessment - Head to toe, complexity and multi-system 
• Family and Social Assessment  
•  Provision, coordination & evaluation of care 
• Principles of Advance Life Support  
• Advanced airway management (e.g. tracheostomy; oxygenation LMA and ETT and CPAP) 
• Managing aggression and domestic violence (includes de-escalation techniques and therapeutic communication focus) 
• Emotional pain 
• Dealing with complexity - psychiatric illness & substance use.  
• Management of metabolic syndrome  
• Management of chronic/complex wounds 
•  Quality use of medicines 
• Drug Calculations (Oral, Parental & Infusion Rates) - Summative  
• Managing medication Oral, S/C, IMI, IV, PCAs, PICCs (CVAD) 
• Focus on beta blockers, antihypertensives, diuretics, cytotoxics  
• Polypharmacy  
• Health promotion & education  
• Patient education (teaching a patient) 
•  Diversity & cultural competence 
• Identifying cultural and religious groups and extending knowledge on cultural/religious beliefs and practices  
•  Professional capabilities 
• Prioritising care in a changing environment   
• Time Management in a changing environment  
• Resilience  
• Reflective Practice  
• Professional Development  
• Clinical leadership  
• Change Management  
•  Clinical reasoning  
• Applying clinical reasoning and judgement 
• Reflecting on practice - clinical decision making/ judgement  

Learning and teaching strategy and rationale

Modes of delivery in NRSG373 include online lectures recordings, laboratory simulation, online activities, clinical placement experience, and self-directed study. Consistent with adult learning principles, the teaching and learning strategy used within these modes of delivery will provide students with the foundational knowledge and skills that are relevant to professional nursing practice. The teaching and learning approaches will also support students to meet the aims, learning outcomes and the graduate attributes of the unit and the broader course learning outcomes. The teaching and learning strategy also reflects respect for the student 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 to manage their ongoing individual learning. Feedback and critical self-reflection are required to identify what is being done well, what requires additional work and to identify progress toward required learning outcomes. The clinical placement experience will assist students to link theory with clinical practice. Located in the third year of the program, NRSG373 comprises face-to-face teaching and learning activities, and additionally, a large self-directed learning component that aims to affirm life-long learning skills. On-line lectures are used to convey content and central principles and simulation practical classes aim to deliver interactive learning sessions which assist students to apply theory to clinical practice and build critical reflective skills. Simulation practical classes also provide an opportunity for students to continue building their community learning skills. The supervised clinical placement experience provides a safe environment for students to provide assisted person-centred care that is essential for successful graduate practice.

Assessment strategy and rationale

The assessments are constructively aligned to the 6 learning outcomes of unit NRSG373 and the learning outcomes of the program and graduate attributes.

NRSG373 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 clinical placement experience will be assessed using the Australian Nursing Standards Assessment Tool (ANSAT).

In real world 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. NRSG373 requires a mandatory pass grade for the ANSAT assessment component of clinical placement experience because, in nursing, professional competence is a necessary job requirement. Achieving pass grade as a standard for the clinical skills portfolio is also mandatory. The clinical skills portfolio will support student employment applications as well as the continuing professional development required for registration as a nurse. To achieve a pass grade for NRSG373, 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, noting a Pass for this task requires 100% for the exam) with three attempts permitted. This assessment is conducted as an invigilated exam. If the student is unsuccessful on the first attempt, remediation is given prior to a second and third examination attempt. Successful achievement of 100% is required for eligibility to attend professional experience placement. 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 prior to the published due date, when students must submit a completed Clinical Portfolio in order to receive a pass. The National Assessment Review Committee may, in exceptional circumstances, grant one further attempt ‘only’.

Overview of assessments

Representative texts and references

Crisp, J., Douglas, C., & Rebeiro, G., & Waters, D. (2020). Potter & Perry’s fundamentals of nursing (6e; Australia and New Zealand ed.). Chatswood, N.S.W: Elsevier Australia.

Jarvis, C., Forbes, H., Watt, E., Thomas, P., & Strandberg, K. (2016). Jarvis's physical examination & health assessment (2nd; Australian and New Zealand ed.). Chatswood, N.S.W.: Elsevier Australia.

Holland, K., & Jenkins, J. (2019). Applying the Roper-Logan-Tierney model in practice (3rd; ed.). Edinburgh: Elsevier.

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

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.