NRSG264 - Integrating Practice 3

Year

Credit points

Campus offering

Prerequisites

NRSG140 Integrating Practice 2

For Bachelor of Nursing (Enrolled Nurses) students: Nil

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 prepares nursing students with a developing level of experience to critical think and link theory to practice. NRSG140 is a prerequisite for NRSG264 and in NRSG264, 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.

NRSG264 Integrating Practice 3 is required by students to assist them to further develop their knowledge of theoretical concepts to inform their clinical practice and to describe how practice is guided by a continual process of assessment, diagnosis, planning, implementation and evaluation - skills critical for the nurse to deliver best practice.

This unit enables students to draw on their learning in previous subjects to extend and integrate theoretical and practical knowledge gained in the course to date. NRSG264 Integrating Practice 3 uses scenario based teaching and simulation learning activities in practical classes so that students integrate foundational nursing practice skills with theoretical knowledge. Students will consolidate their theoretical knowledge through clinical experience comprising 160 hours. Placement for professional practice is required to enable students to apply theoretical knowledge and demonstrate comprehensive and thorough care for individuals for whom they are caring.

The aim of this third ‘Integrating Practice’ unit is to build on students’ previous and current learning to further contextualize their theoretical knowledge through professional clinical 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.

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 undergoing surgery or in emotional distress
• Professional & therapeutic communication
• Admission assessment interview & referral and discharge summaries
• Clinical handover (ISBAR) demonstration of a clinical handover process using the ISBAR - identification, situation, background, assessment & recommendation)
• Accurate charting & documentation
• Communicating with people who are experiencing alterations in emotions and cognition- establishing a therapeutic relationship & with altered communication processes.
• Communicating with families, partners or significant others
• Interprofessional teams and interprofessional practice
• Nursing assessment
• Admission assessment
• Pre & post operative and emergency assessment
• Pain assessment
• Infection risk
• Completing a mental health assessment including Mental State Examination (MSE) and physical health assessment
• Risk assessments (e.g. suicidal, homicidal, self-harm)
• Alcohol and other drug screening assessments / scales
• Charting & documentation.
• Assessment of delirium, dementia & depression
• Provision, coordination & evaluation of care
• Basic life support
• Surgical wounds and devices (inc. ANTT, stiches, staples, drains, stomas)
• Enteral feeding and nasogastric tubes
• Pain–intervention (including PCA)
• Identification, prevention and management of a patient with postoperative complications
• Fluid & electrolyte imbalance
• Management of pyrexia
• Discharge planning
• Clinical risk management
• Managing a person with altered cognitive, emotional and behavioural thinking.
• Mental health nursing interventions
• Quality use of medicines
• Drug calculations (oral, parental & infusion rates) - formative
• Managing medication Oral, S/C, IMI( focus on depot injections in mental health context), IV
• Focus on antibiotics, anticoagulants, psychotropics
• Medication compliance (adherence)
• Health promotion & education
• Identify health promotion needs and supports (e.g. postoperative care, SANE, support groups, mental health promotion, suicide prevention strategies)
• Promotion of effective partnerships through education for individuals and their supports 
• Diversity & cultural competence
• Identifying cultural and religious groups and extending knowledge on cultural/religious beliefs and practices
• Cultural and spiritual assessment in mental health
• Professional capabilities
• Debriefing following critical incidents    
• Principles for debriefing and self-care for nurses in mental health context
• Resilience
• Reflecting on practice - clinical decision making/ judgement
• Health care law: dealing with emergency situations in health care practice
• Clinical leadership
• Clinical governance
• Scope of practice relating to the practice of; student registered nurses, registered nurses and nursing teams.
• Clinical reasoning
• Applying critical thinking in practice      
• Applying clinical reasoning
• Reflecting on practice - clinical decision making/ judgement

Learning and teaching strategy and rationale

Modes of delivery in this unit include online lectures, laboratory simulations, 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 a further developed 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 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 effective 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 assists students to link theory with its application inthe clinical environment. Located in the second year of the programme, this clinical unit includes face-to-face teaching to assist students in linking theory with practice and an increasing 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 placement provides a safe environment where students can provide assisted person-centred care essential for successful graduate practice.  

Assessment strategy and rationale

The assessments are constructively aligned to meet the 6 learning outcomes of unit NRSG264 and the learning outcomes of the program and graduate attributes. In order to pass the unit, students must demonstrate achievement of all learning outcomes.

NRSG264 has 160 hours of professional experience placement that students are required to complete. 

Demonstration of safe practice whilst on professional experience placement will be assessed using the Australian Nursing Standards Assessment Tool (ANSAT).

In clinical 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). NRSG264: Integrating Practice 3 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 NRSG264. To achieve a pass grade for this unit, all three 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) 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’.

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 - Library search (exlibrisgroup.com) (4th ed.). Elsevier Australia.

Tiziani, A., & Havard, M. (2018). Havard's nursing guide to drugs - Library search (exlibrisgroup.com) (10th ed.). Elsevier Australia.

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