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 experience placement 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.

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), Anticoagulation Therapy (Heparin), 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 experience placement, 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 experience placement 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. Completing 100% of professional experience shifts is a requirement to pass this unit.

Students are required to submit a medical certificate or statutory declaration for any professional experience placement hours missed. Instructions on submitting this documentation is available in the Student Placement Experience Manual. All hours missed due to non-attendance at professional experience placement must be completed prior to successfully completing the unit. An interim grade of “IP” will be made if 100% attendance at professional experience placement is not achieved. Successful completion of your nursing degree requires a minimum amount of 800 hours of professional experience placement, and this must be completed incrementally throughout your program of study.

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 demonstrate their ability to apply clinical reasoning through their learning experiences for NRSG267. To achieve a pass grade for this unit, all four 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:

• 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’.
• 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.
• Attendance at 100% of professional experience placement hours is an “Ungraded Hurdle” (PASS/FAIL). Completion of professional experience placement hours are an important step towards completion of the minimum amount of 800 hours of professional experience placement that is required within your degree. Make-up may be granted if a medical certificate(s) or Statutory Declaration (maximum of one day absence) is submitted and approved for any professional experience placement hours missed. The requirements and procedures for applying for make-up are available in the Student Placement Experience Manual. Strict timelines and procedures apply.

Attendance at laboratory simulation classes in IP units

You are required to attend a minimum of 8 of 10 laboratory simulation classes in NRSG267. This 80% minimum attendance requirement for laboratory simulation classes is mandated because attendance at these classes is integral to achievement of the learning outcomes in NRSG267. Attendance and active participation at laboratory simulation classes are also an essential component of preparation for your professional experience placement in NRSG267.

If you have an illness, and/or personal circumstance beyond your control that leads to your non-attendance at laboratory simulation classes you will be expected to provide a medical certificate or Statutory Declaration to support your absence for each class missed. The procedure for uploading this documentation will be provided on Canvas. Make-up will only be provided for students with appropriate supporting documentation, and in exceptional circumstances, as determined by the Lecturer-in-Charge. The procedure for lodging the Practical Class Absenteeism form is provided on Canvas.

As part of Standard 1: Safety of the public in The Registered Nurse Accreditation Standards (ANMAC, 2019), standard 1.7 stipulates that “only students who have demonstrated the requisite knowledge and skills required for safe practice are eligible for PEP [professional experience placement]”. It is an expectation therefore that students attend their laboratory simulation classes to demonstrate they have obtained the required knowledge and skills to attend their professional experience placements.

If you do not meet the minimum attendance requirement for laboratory simulation classes in NRSG267 then you will be ineligible to undertake the pre-placement assessment and will therefore be unable to attend professional experience placement. This will lead to a NU grade for NRSG267 as you will be unable to successfully complete the required assessment tasks and demonstrate achievement of the Unit learning outcomes.

If you think you will not be able to meet the mandatory attendance requirements in NRSG267 please contact your Lecturer-in-Charge as soon as possible to discuss.

Pre-placement Requirements

NRSG267 requires students to meet pre-placement requirements by the compliance due date specified within InPlace. The Faculty of Health Sciences require students to meet pre-placement compliance to ensure that students hold the essential checks, immunisations, and training for placement eligibility. All students must meet mandatory State or Territory legal and industry policy requirements prior to being allocated a placement. Students must fulfill a standard set of pre-placement requirements as set out by the Faculty of Health Sciences in the ACU Work Integrated Learning site to be eligible to go on professional experience placements. Failure to meet these pre-placement requirements by the specified compliance due date means students are ineligible for professional experience placement allocation and will receive an NU (Fail) grade for NRSG267.

Fitness to Practice

Prior to attending professional experience placement, all students are required to meet the inherent and mandatory documentation requirements including ‘fitness to practice.’ It is imperative that students are fit for professional practice, without physical or mental health impairments which could affect their own safety or the safety of the public, for whom they will be providing health care. This is in alignment with The Health Practitioner Regulation National Law Act (2009). Students are required to complete an online Fitness for Practice Declaration via InPlace within the first three weeks of any semester where they are enrolled into an Integrating Practice unit with professional experience placement. The Fitness for Practice Declaration is part of the student’s preplacement requirements, and it is an expectation that this declaration will be completed prior to every professional experience placement the student attends. It is essential for students to disclose any condition/s they are aware of that would make them unfit for practice. Failure to complete the Fitness to Practice Declaration means students are ineligible for professional experience placement allocation and will receive an NU (Fail) grade for NRSG267.

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): 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. Elsevier Health Sciences.

Halter, M. J., (2019). Varcarolis’ Manual of Psychiatric Nursing Care Planning (6th ed.). 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.