NSB233 Integrated Nursing Practice 3 Off Campus

Unit Outline: Semester 2 2024, Kelvin Grove, Internal

Overview

This unit is a work integrated learning unit in which you learn predominantly in off-campus health care contexts (4 weeks/160 hours). The unit is at the developing stage of your course and builds on all preceding units. You are expected to draw on knowledge and skills gained in previous units to develop your practice and will be actively encouraged to apply learning and skills from earlier units. The unit is a concurrent requisite of NSB236 Integrated Nursing Practice 3 – On campus to facilitate application of theory to practice. You will require knowledge of and ability to apply the NMBA Registered Nurse Standards for Practice, National Health Priority Areas, Aged Care Quality Standards, and National Safety and Quality Health Service Standards essential to nursing practice.

This is a designated unit which is essential to your course progression. Designated units include professional experience units, units requiring the development of particular skills, and units requiring demonstration of certain personal qualities. If you fail to achieve a satisfactory level of performance in a designated unit, you may be excluded from enrolment or will be put on academic probation. If you fail a designated unit twice within your course, you may be excluded. Supplementary assessment is not available on designated units.

Learning Outcomes

On successful completion of this unit you will be able to:

1. Demonstrate evidence-based practice, clinical reasoning and decision making to provide culturally safe, quality, person-centred care consistent with the NMBA Registered Nurse Standards for Practice and the National Safety and Quality Health Service Standards at a developing level of practice.
2. Safely and accurately perform medication calculations and demonstrate safe administration of medicines in both the simulated environment and the clinical practice setting.
3. Satisfactorily complete hi-fidelity simulation and engage with critical thinking and clinical reasoning in diverse and complex healthcare settings consistent with safe person-centred care across the lifespan.
4. Demonstrate developing level provision of safe, appropriate, and responsive quality nursing care for consumers, families, and the broader community.

Content

Learning Approaches

Experiential learning is at the forefront of this unit, where you attend for a continuous period of time in the off-campus healthcare environment. Healthcare environments may include clinics and home-based, community, mental health, and acute-care facilities. Preparation for this unit involves review of theoretical concepts explored in previous units to facilitate application to practice. You will prepare for this off-campus experience through simulated clinical situations and small group clinical skills and practice activities incorporating the use of a range of health care technologies.

You will also be directed to revisit the safe and quality use of medicines and administration of same, drawing on the learning activities and resources from your previous integrated on-campus units and including NSB236 Integrated Nursing Practice 3 – On campus. A peer-learning community of practice will be used as a means of encouraging active collaboration and to provide additional support and engagement during placement off campus. Clinical supervisors will facilitate and support transfer of knowledge and skills to the real-world context in line with the requirements to satisfactorily complete the Australian Nursing Standards Assessment Tool (ANSAT). Learning experiences will include a focus on promoting implementation of evidence-based, scientific knowledge, communication, critical inquiry, digital literacy, and intra and interprofessional collaboration as an ethical, socially inclusive, and culturally safe practitioner.

This unit requires attendance at mandatory clinical practice sessions and off-campus clinical placement. Placement opportunities are negotiated by QUT with hospitals and health care facilities and are finite in number. You cannot organise your own placement. You must be available for shift-work rostering which enables patient care to be delivered 24 hours a day, 7 days a week. Travel may be involved, and clinical placements can occur during semester breaks. Any absence from an off-campus clinical placement will reduce the opportunity for competence development, your performance may not be assessed and a grade of 'Unsatisfactory' may be awarded. If a student is absent due to illness during their clinical placement they are required to complete additional hours at a future time to meet the mandatory clinical completion hours for the unit, and cumulatively meet eligibility for graduation.  

Any clinical completion hours needed are calculated at the end of placement in individual units and if required, the grade will remain unfinalised until completion of the required number of clinical placement hours for the unit. There are limited opportunities to offer clinical completion hours. 

Where absence is due to special or unforeseeable circumstances independently supported by documentation (e.g. medical certificate), every effort will be made to accommodate the student in an alternate placement within the same semester or provide clinical completion hours at a later time. If due to the nature of the student's special circumstances and/or limited placement availability an alternate placement cannot be negotiated, the student will be advised to seek withdrawal from the unit without academic or financial penalty. Standard course progression cannot be guaranteed following an Unsuccessful grade or withdrawal from a clinical placement unit.

You will receive further additional information and explanation consistent with this statement in lectures and information will be added to the unit Canvas site.

Feedback on Learning and Assessment

You will be provided with feedback and guidance to assist your learning throughout the semester through:

• Formative feedback online and in class interactions throughout semester, individually and/or as a group
• Peer and clinical facilitator feedback on skills acquisition within clinical practice sessions
• Feedback on clinical performance will be provided by the clinical facilitator using the ANSAT tool at an interim timepoint halfway through your clinical placement and formally at the end of clinical placement

Assessment

Overview

There are four authentic assessments to be completed in this unit. You must attend 100% of the clinical practice sessions and demonstrate safe practice and satisfactorily perform in an OSCE and achieve 100% in the medication calculations (within Med+Safe).  Lastly you must achieve all criteria on the clinical performance assessment tool (ANSAT) to achieve an overall pass grade for this unit. The Med+Safe application has many practice tests in-built for you to practice achieving 100%. These are requirements for you (and QUT) to ensure you can safely practice and act appropriately in an emergency as required by the National Health and Safety standards and ANMAC safety of the public standards. 

To receive a satisfactory grade in the unit you must complete mandatory clinical hours; all hours that a student is absent from clinical placement require attendance at a clinical completion option. There is no capacity to offer unlimited opportunities for clinical completion hours. Failure to self-select clinical completion hours when invited (through the Work Integrated Learning team) and/or attend agreed clinical completion hours will cause delays to course progression. Failure to complete agreed clinical completion hours will result in the unit grade being finalised as unsatisfactory

Unit Grading Scheme

S (Satisfactory) / U (Unsatisfactory)

Assessment Tasks

Assessment: Med+Safe Exam

Evidence of 100% successful completion of the required test in the Med+Safe application during the invigilated school-based exam time period.

MedSafe certificates are awarded once you have achieved 100% for the designated test. The MedSafe certificate uploaded must reflect the date and time of your invigilated test, including your name exactly as it appears in the student's enrolment.

You may be eligible for one further opportunity to undertake this assessment if you do not achieve 100%. The same assessment conditions of invigilated exam apply.

Test questions focus on calculations and the development of knowledge and skills associated with medication administration and quality use of medicines.

Failure to complete this assessment within the specified timeframes will result in an unsatisfactory grade in this unit and withdrawal of your off-campus clinical work experience.

Threshold Assessment:

Professional accreditation mandates demonstration of safe practice in both skills performance and medication safety prior to work integrated learning.

Assessment: Simulation and Completion of ePortfolio activity

You will engage in face-to-face clinical simulation scenarios. This will require a collaborative approach in responding to problems and challenges of the given situation. The scenarios are designed to assist you to integrate concepts and principles that are needed for practice as a beginning-level registered nurse, providing person-centred care in various clinical settings. Focus is on developing team skills and communicating for safety. You will critically analyse and address ongoing nursing care provision and incorporate experiential learning from real-world practice. The scenarios will be focused on complex patient problems and team processes including small team leadership capabilities. Pre-briefing and de-briefing will be included as fundamental components of the learning experience as well as completion of a learning activity directly related to the simulation.

Threshold Assessment:

Professional accreditation mandates demonstration of safe practice in both skills performance and medication safety prior to work integrated learning.

Assessment: Objective Structured Clinical Examination

You will attend a series of mandatory lab sessions to learn safe medication practice and nursing skills to enable safe person-centred care, concluding with an OSCE assessment. Attendance at lab sessions is mandatory to be eligible for OSCE assessment. Options to make up a lab session due to legitimate illness or other absence are limited. You will be expected to use your current knowledge, skills and attributes developed from mandatory attendance at clinical laboratory sessions to apply principles of safe practice and demonstrate satisfactory performance of one (1) selected skill in an OSCE context.

In the OSCE you will be assessed on your performance of the skill according to relevant best practice guidelines and performance criteria. The OSCE will be undertaken using exam conditions and you will not be prompted during the assessment. You will not be permitted to bring or review resources external to those supplied at the OSCE station during the assessment.

All essential performance criteria (indicated by red text in rubric) must be effectively demonstrated to achieve a satisfactory grade. All assessment rubrics are available on the Canvas unit site.

Threshold Assessment:

For the purpose of professional accreditation and demonstration of safe practice prior to work integrated learning a satisfactory performance in OSCA task is required (threshold assessment conditions apply).

Assessment: Placement performance – 4 weeks/160 hours of clinical placement

In your assigned clinical placement, you will be assessed on your ability to demonstrate a range of knowledge, skills, and attributes in relation to the provision of safe, quality, person-centred care. Assessment performance is determined in line with the NMBA Registered Nurse Standards for Practice using the Australian Nursing Standards Assessment Tool (ANSAT). You are required to demonstrate satisfactory achievement of the 7 standards (and related criteria) for this level. Each criterion of the ANSAT must be achieved satisfactorily and 100% attendance is required at off-campus clinical placement.

Threshold Assessment:

Assessment Item requires 100% attendance at an off-campus clinical placement and a satisfactory pass on the clinical placement assessment tool, to pass the unit. Re-submission is not available for an unsatisfactory result for Assessment Item (placement performance).

Academic Integrity

Students are expected to engage in learning and assessment at QUT with honesty, transparency and fairness. Maintaining academic integrity means upholding these principles and demonstrating valuable professional capabilities based on ethical foundations.

Failure to maintain academic integrity can take many forms. It includes cheating in examinations, plagiarism, self-plagiarism, collusion, and submitting an assessment item completed by another person (e.g. contract cheating). It can also include providing your assessment to another entity, such as to a person or website.

You are encouraged to make use of QUT’s learning support services, resources and tools to assure the academic integrity of your assessment. This includes the use of text matching software that may be available to assist with self-assessing your academic integrity as part of the assessment submission process.

Further details of QUT’s approach to academic integrity are outlined in the Academic integrity policy and the Student Code of Conduct. Breaching QUT’s Academic integrity policy is regarded as student misconduct and can lead to the imposition of penalties ranging from a grade reduction to exclusion from QUT.

Requirements to Study

Requirements

A blue card is required to complete this unit. A blue card confirms that you have passed a screening of your criminal history (the Working with Children Check) and have been approved to work with children and young people. For more information on the blue card and how to apply please visit the QUT website.

Blue Card

A blue card is required to complete this unit. A blue card confirms that you have passed a screening of your criminal history (the Working with Children Check) and have been approved to work with children and young people. For more information on the blue card and how to apply please visit the QUT website.

Resources

Resource Materials

Prescribed text(s)

Med+Safe application (https://medsafe.com.au)

Crisp, J., Douglas, C., Rebeiro, G., & Waters, D. (Eds.). (2021). Potter and Perry's fundamentals of nursing (5th ed.). Elsevier.

Rebeiro, G., Jack. L, Scully, N., & Wilson, D. (2016). Fundamentals of nursing clinical skills workbook (3rd ed.). Elsevier.

Recommended text(s)

Calleja, P., Theobald, K., & Harvey, T. (2024). Estes health assessment and physical examination (4th ed.).  Cengage Learning Australia.

Risk Assessment Statement

During clinical work experience, you are exposed to a range of risks and hazards that are normally encountered by nurses practising in a variety of health care settings. When undertaking clinical work experience, you are automatically subject to the workplace health and safety policies, procedures, and regulations of the healthcare facility. You are required, by law, to comply with these policies and procedures at all times. To minimise risks in this unit, it is essential that you:

• Participate in the healthcare facility orientation session
• Act in accordance with organisational workplace health and safety policies
• Are appropriately supervised by a registered nurse at all times
• Undertake the required theoretical and practical preparation prior to commencement of the placement
• Are aware of specific risks and hazards associated with the particular clinical area to which you have been assigned
• Act within your scope of practice and the requirements of this unit
• Maintain your personal health and immunisation status.

Standards/Competencies

This unit is designed to support your development of the following standards\competencies.

Registered Nurse Standards for Practice

1: Thinks critically and analyses nursing practice.

1. The RN accesses, analyses, and uses the best available evidence, that includes research findings, for safe, quality practice
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
2. The RN develops practice through reflection on experiences, knowledge, actions, feelings and beliefs to identify how these shape practice
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
3. The RN respects all cultures and experiences, which includes responding to the role of family and community that underpin the health of Aboriginal and Torres Strait Islander peoples and people of other cultures
   Relates to: Placement performance – 4 weeks/160 hours of clinical placement
4. The RN complies with legislation, regulations, policies, guidelines and other standards or requirements relevant to the context of practice when making decisions
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
5. The RN maintains accurate, comprehensive and timely documentation of assessments, planning, decision-making, actions and evaluations
   Relates to: Med+Safe Exam, Placement performance – 4 weeks/160 hours of clinical placement

2: Engages in therapeutic and professional relationships.

1. The RN establishes, sustains and concludes relationships in a way that differentiates the boundaries between professional and personal relationships
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
2. The RN communicates effectively, and is respectful of a person’s dignity, culture, values, beliefs and rights
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
3. The RN recognises that people are the experts in the experience of their life
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
4. The RN provides support and directs people to resources to optimise health-related decisions
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
5. The RN advocates on behalf of people in a manner that respects the person’s autonomy and legal capacity
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
6. The RN uses delegation, supervision, coordination, consultation and referrals in professional relationships to achieve improved health outcomes
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
7. The RN actively fosters a culture of safety and learning that includes engaging with health professionals and others, to share knowledge and practice that supports person-centred care
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
8. The RN participates in and/or leads collaborative practice
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement

3: Maintains the capability for practice.

1. The RN considers and responds in a timely manner to the health and wellbeing of self and others in relation to the capability for practice
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
2. The RN provides the information and education required to enhance people's control over health
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
3. The RN uses a lifelong learning approach for continuing professional development of self and others
   Relates to: Placement performance – 4 weeks/160 hours of clinical placement
4. The RN accepts accountability for decisions, actions, behaviours and responsibilities inherent in their role, and for the actions of others to whom they have delegated responsibilities
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement

4: Comprehensively conducts assessments.

1. The RN conducts assessments that are holistic as well as culturally appropriate
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
2. The RN uses a range of assessment techniques to systematically collect relevant and accurate information and data to inform practice
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
3. The RN works in partnership to determine factors that affect, or potentially affect, the health and wellbeing of people and populations to determine priorities for action and/ or for referral
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
4. The RN assesses the resources available to inform planning.
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement

5: Develops a plan for nursing practice.

1. The RN uses assessment data and best available evidence to develop a plan
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
2. The RN collaboratively constructs nursing practice plans until contingencies, options priorities, goals, actions, outcomes and timeframes are agreed with the relevant persons
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
3. The RN documents, evaluates and modifies plans accordingly to facilitate the agreed outcomes
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
4. The RN plans and negotiates how practice will be evaluated and the time frame of engagement
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
5. The RN coordinates resources effectively and efficiently for planned actions.
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement

6: Provides safe, appropriate and responsive quality nursing practice.

1. The RN provides comprehensive safe, quality practice to achieve agreed goals and outcomes that are responsive to the nursing needs of people
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
2. The RN practises within their scope of practice
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
3. The RN practises in accordance with relevant policies, guidelines, standards, regulations and legislation
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
4. The RN uses the appropriate processes to identify and report potential and actual risk related system issues and where practice may be below the expected standards.
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement

7: Evaluates outcomes to inform nursing practice.

1. The RN evaluates and monitors progress towards the expected goals and outcomes
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
2. The RN revises the plan based on the evaluation
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
3. The RN determines, documents and communicates further priorities, goals and outcomes with the relevant persons.
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement

Course Learning Outcomes

NS42 Bachelor of Nursing

1. Apply scientific knowledge and skills from nursing and related disciplines to the provision of safe, person-centred, evidence-based nursing care across the lifespan
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
2. Apply critical thinking, clinical reasoning, and digital literacy skills to make evidence- based decisions and evaluate outcomes
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
3. Practice as an ethical, socially inclusive, and culturally safe practitioner, reflective of your professional nursing identity across a range of health service settings.
   Relates to: Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
4. Enact and sustain effective communication skills, therapeutic relationships, and professional capabilities to practice independently and in inter and intra professional teams, to ensure safe, person-centred care
   Relates to: Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
5. Demonstrate developing socially informed leadership capabilities to achieve positive individual and community outcomes in dynamic healthcare contexts.
   Relates to: Placement performance – 4 weeks/160 hours of clinical placement