NRSG376 - Integrating Practice 6

Year

Credit points

Campus offering

Prerequisites

NRSG373 Integrating Practice 5

Unit rationale, description and aim

Safe practice and safety of the public is paramount within nursing. This final third year integrated practice unit scaffolds learning from previous years, and first semester in third year, to prepare nursing students at a mastery level to be safe nurses. Unit NRSG373 is a prerequisite for NRSG376 and in NRSG376 students consolidate 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. In preparation for practice as a registered nurse, application of critical reasoning to promote safe practice is paramount. The clinical reasoning skills of assessment, planning, implementation, evaluation and reflection at a mastery level are consolidated in NRSG376. This unit also introduces students to foundational skills in counselling, that can be applied to therapeutic interactions with individuals.

This unit enables students to draw on previous learning in all subjects and integrate theoretical and practical knowledge gained in the course to date. NRSG376 is a capstone unit which uses simulation classes so that students establish mastery in nursing practice skills with advanced theoretical knowledge during scenario based learning in the simulation practical class.

The aim of this final Integrated Practice unit is to consolidate skills and knowledge through to application in practice at a mastery level. The integrated practice units in third year aim for students to be work ready, critically 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 - Appraise 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 - Appraise ethical, legal, cultural and professional principles when undertaking patient care and/or performing clinical responsibilities at a mastery level (GA3)

LO4 - Demonstrate introductory level counselling skills and therapeutic use of self in establishing, maintaining and terminating therapeutic relationships across the lifespan (GA9)

LO5 - Critique 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 to enable sound graduate practice at a mastery 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 nursing program graduates. 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:

Content

Topics will include:

• Person-centred practice
• Application of person-centred practice in the provision of care:
• Providing the person with opportunities for choice and decision making in relationship to their care and treatment and respect for those choices and decisions
• Professional & therapeutic communication
• Negotiation and challenges and conflict resolution
• De-escalation techniques - management of clinical aggression/establishment of a safe environment.
• Participation in difficult conversations including death and dying
• Oppressed group behaviour
• Collaborative practice and communication within interprofessional teams
• Nursing assessment
• The Deteriorating patient
• Emergency situations (Escalation & De-escalation)
• Initiating appropriate assessments during clinical deterioration including haemodynamic instability
• Provision, coordination & evaluation of care
• Managing cognitive impairment and challenging behaviors
• Goal setting and recovery and wellness planning
• Prioritising care and time management
• Initiation of nursing care
• Nursing care of the palliative patient including specific hygiene cares
• Quality use of medicines
• Managing medication Oral, S/C, IMI, IV, PCAs, PICCs (CVAD), Syringe Drivers
• Use of drugs in Palliation 
• Health promotion & education
• Teaching a colleague
• Health promotion and community education
• Diversity & cultural competence
• Identifying cultural and religious groups and extending knowledge of cultural/religious beliefs and practices
• Professional capabilities
• Prioritising care in a changing environment 
• Time management in a changing environment
• Delegation
• Resilience
• Reflective practice
• Developing a professional identity
• Professional development
• Clinical leadership
• Managing change
• Clinical reasoning
• Applying clinical reasoning and judgement in advanced practice
• Reflecting on practice - clinical decision making and judgement 

Learning and teaching strategy and rationale

Modes of delivery in NRSG376 include lectures, simulation, practical classes, online activities, professional practice and self-directed study. Consistent with adult learning principles, the teaching and learning approaches 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 strategy also supports students in meeting the aim, learning outcomes and graduate attributes of the unit, and the broader course learning outcomes. The learning and teaching strategy also reflects 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 to manage their ongoing individual learning. Therefore, feedback and critical self-reflection are required to identify what is being done well, what requires additional work, to identify progress toward the required learning outcomes. The professional practice experience assists students to link theory with clinical practice. Located in the third year of the program, NRSG376 includes face-to-face teaching and learning activities, and a self-directed learning component that aims to affirm life-long learning skills. Lectures are used to convey content and central principles, and simulation classes aim to deliver interactive learning sessions which will assist students to apply theory to clinical practice and build critical reflective skills. Simulation classes also provide an opportunity to continue to build community learning skills. Supervised professional practice provides a safe environment to provide the assisted, person-centred care that is essential for successful graduate practice. 

Assessment strategy and rationale

The assessments are constructively aligned to the six learning outcomes of unit NRSG376 and the learning outcomes of the program and graduate attributes. NRSG376 has 240 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 that students achieve the unit learning outcomes and attain the graduate attributes. Competence during professional practice will be assessed using the ANSAT.

In real-world practice, it is a requirement that the registered nurse has the ability to complete accurate medication administration. This requirement exists because errors in the calculations of drug dosages, or errors in drug administration can have severe, adverse health consequences for patients. NRSG376 requires a mandatory pass grade for the ANSAT assessment component of professional practice because, in nursing, professional competence is a necessary job requirement. Achieving a pass grade 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 NRSG376, 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 program, will enable the student to graduate as a safe and effective nurse. For these assessments:

• Drug Calculation 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’. 
• The Clinical Portfolio assessment 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 the third and final 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’.
• 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.

Overview of assessments

Representative texts and references

This reference list was finalised in 2016 for internal curriculum approval; it will be revised prior to unit delivery to ensure the most current representative text and reference list for students.

Crisp, J., Taylor, C., Douglas, C., & Rebeiro, G., & Waters, D. (202016). Potter & Perry’s fundamentals of nursing (65e; Australia and New Zealandth ed.). Chatswood, N.S.W: Sydney, N.S.W.: Mosby/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. 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. (2019). Applying the Roper-Logan-Tierney model in practice (3rd; ed.). Edinburgh: Elsevier.Holland, K., Jenkins, J., Solomon, J.,& Whittam, S. (2008). Applying the Roper-Logan-Tierney Model in practice, London: Churchill Livingston. (2017 edition will replace this).

Levett-Jones, T. (2018). Clinical reasoning : Learning to think like a nurse (2nd; ed.). Melbourne, Vic: Pearson Australia.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.