NSB335 Integrated Nursing Practice 5

Unit Outline: Semester 1 2024, Kelvin Grove, Internal

Overview

Clinical practice and evidence-based theory are integrated and critically applied at the completion of this unit (8 weeks / 320 hours of clinical practice) by demonstration of safe and effective person-centred care consistent with the NMBA Registered Nurse Standards of Practice. All Nursing and Midwifery Board of Australia (NMBA) and National Safety, Aged Care Standards and Quality Health Service (NSQHS) standards, as they apply to nursing practice, are further explored in this unit. This unit complements other third-year units and consolidates learning to date. This unit is a work integrated learning unit with you learning predominantly in off-campus health care contexts.

Mandatory elements may start in Orientation week. Please check the published unit timetable.

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 beginner practitioner level nursing care that is consistent with the principles of the NMBA Registered Nurse Standards of Practice and the National Safety and Quality Health Service Standards at a beginner practitioner level.
2. Safely and accurately perform medication calculations and demonstrate safe administration of medicines in both the simulated environment and the clinical practice setting.
3. Demonstrate critical thinking and clinical reasoning in diverse and complex healthcare settings consistent with the provision of safe, quality person-centred care across the lifespan.
4. Coordinate and lead the provision of care for consumers, families, and the broader community, under supervision.

Content

Learning Approaches

Experiential learning is at the forefront of this unit, with you attending an extended period in the off-campus healthcare environment. Health care environments may include clinics and home-based, community, and acute-care facilities. Within these contexts, you will be expected to take on advanced responsibilities with respect to the coordination and leadership of care for consumers, families, and the wider community.

Preparation for this unit involves review of theoretical concepts explored in previous units to facilitate their application in practice. You will undertake a mandatory interprofessional education learning module which will require you to apply problem-solving and clinical decision-making skills. You will also be directed to revisit concepts relating to safe and quality use of medicines and the administration of same.

A peer learning community of practice will be used to encourage active collaboration and provide additional support and social engagement during placement off campus. Clinical supervisors will facilitate transfer of prior knowledge and skills to the real-world context, to enable you to demonstrate satisfactory achievement of criteria in the Australian Nursing Standards Assessment Tool (ANSAT) at the level of a beginning registered nurse. 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 an 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 placements. 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.

Where absence is due to special or unforeseeable circumstances independently supported by documentation (e.g. medical certificate), every effort will be made to accommodate you in an alternate placement within the same semester or clinical completion hours in the future. If due to the nature of your special circumstances and/or limited placement availability an alternate placement cannot be negotiated, you 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.

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.

You will receive further additional information and explanation consistent with this statement on 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 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 three assessments to be completed in this unit. You must attend 100% of the clinical practice sessions, achieve 100% in the medication calculations (within Med+Safe). You must also satisfactorily complete an interprofessional education learning module and achieve all criteria on the clinical performance (ANSAT) assessment tool to achieve an overall pass grade for this unit.

To receive a satisfactory grade in the unit, 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

The exam consists of multiple choice questions regarding safe practice in MedSafe. 

MedSafe: Evidence of 100% successful completion of the required test in the Med+Safe application during the invigilated school-based exam time period. Test questions focus on calculations and the development of knowledge and skills associated with medication administration and quality use of medicines.

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.

Failure to complete this assessment within the specified timeframes and invigilated conditions will result in an unsatisfactory grade in this unit and withdrawal from 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.

Second attempt / resit: Evidence of 100% successful completion of the required test in the Med+Safe application during the invigilated school-based exam time period is required.

Assessment: Interprofessional education learning module

You will be provided with a link to the Faculty of Health Interprofessional Education (IPE) Canvas site where you need to undertake Module 3: Interprofessional Conflict and Collaboration, the relevant quiz and generate a certificate of completion.    

This learning activity extends your understanding of effective teamwork, collaboration and conflict resolution within the IPE context. The module uses scenarios and focuses on complex problems and team processes including leadership capabilities.

This assignment is eligible for the 48 hour late submission period and assignment extensions.

Threshold Assessment:

For the purpose of professional accreditation IPE activities need to be completed by the end of semester.

Assessment: Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience

In your assigned clinical placements, you will be assessed on the demonstration of a range of skills 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 and the Australian Nursing Standards Assessment Tool (ANSAT). You are required to demonstrate satisfactory achievement of the 7 standards (and related criteria) for this level. You will receive formative verbal and written feedback on your progress during the clinical placement. Each standard and criteria of the ANSAT must be achieved satisfactorily and 100% attendance is required for off-campus clinical placement experiences.

Threshold Assessment:

For the purpose of professional accreditation, demonstration of safe practice and performance consistent with the National Minimum Standards for Registration (NMBA) is required.

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

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)

Brown, D., Edwards, H., Buckley, T. C. T., & Aitken, R. L. (2020). Lewis’s medical-surgical nursing : assessment and management of clinical problems (5th Australia and New Zealand Edition.). Elsevier.

Crisp, J., Douglas, C., Rebeiro, G., & Waters, D. (2021). Potter & Perry’s fundamentals of nursing (6th edition ; Australia and New Zealand). Elsevier Australia a division of Reed International Books Australia Pty Ltd.

Rebeiro, G., Wilson, D., & Fuller, S. (2021). Fundamentals of nursing : clinical skills workbook (4th edition.). Elsevier Australia a division of Reed International Books Australia Pty Ltd.

Software

Medsafe

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: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
2. The RN develops practice through reflection on experiences, knowledge, actions, feelings and beliefs to identify how these shape practice
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
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: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
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 , Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
5. The RN uses ethical frameworks when making decisions
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
6. The RN maintains accurate, comprehensive and timely documentation of assessments, planning, decision-making, actions and evaluations
   Relates to: Med+Safe , Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
7. The RN contributes to quality improvement and relevant research.
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience

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: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
2. The RN communicates effectively, and is respectful of a person’s dignity, culture, values, beliefs and rights
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
3. The RN recognises that people are the experts in the experience of their life
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
4. The RN provides support and directs people to resources to optimise health-related decisions
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
5. The RN advocates on behalf of people in a manner that respects the person’s autonomy and legal capacity
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
6. The RN uses delegation, supervision, coordination, consultation and referrals in professional relationships to achieve improved health outcomes
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
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: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
8. The RN participates in and/or leads collaborative practice
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
9. The RN reports notifiable conduct of health professionals, health workers and others.
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience

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: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
2. The RN provides the information and education required to enhance people's control over health
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
3. The RN uses a lifelong learning approach for continuing professional development of self and others
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
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: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
5. The RN seeks and responds to practice review and feedback
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
6. The RN actively engages with the profession
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
7. The RN identifies and promotes the integral role of nursing practice and the profession in influencing better health outcomes for people.
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience

4: Comprehensively conducts assessments.

1. The RN conducts assessments that are holistic as well as culturally appropriate
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
2. The RN uses a range of assessment techniques to systematically collect relevant and accurate information and data to inform practice
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
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: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
4. The RN assesses the resources available to inform planning.
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience

5: Develops a plan for nursing practice.

1. The RN uses assessment data and best available evidence to develop a plan
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
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: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
3. The RN documents, evaluates and modifies plans accordingly to facilitate the agreed outcomes
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
4. The RN plans and negotiates how practice will be evaluated and the time frame of engagement
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
5. The RN coordinates resources effectively and efficiently for planned actions.
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience

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 , Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
2. The RN practises within their scope of practice
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
3. The RN appropriately delegates aspects of practice to enrolled nurses and others, according to enrolled nurse’s scope of practice or others’ clinical or non-clinical roles
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
4. The RN provides effective timely direction and supervision to ensure that delegated practice is safe and correct
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
5. The RN practises in accordance with relevant policies, guidelines, standards, regulations and legislation
   Relates to: Med+Safe , Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
6. 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 , Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience

7: Evaluates outcomes to inform nursing practice.

1. The RN evaluates and monitors progress towards the expected goals and outcomes
   Relates to: Med+Safe , Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
2. The RN revises the plan based on the evaluation
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
3. The RN determines, documents and communicates further priorities, goals and outcomes with the relevant persons.
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience

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 , Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
2. Apply critical thinking, clinical reasoning, and digital literacy skills to make evidence- based decisions and evaluate outcomes
   Relates to: Med+Safe , Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
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: Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
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: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience
5. Demonstrate developing socially informed leadership capabilities to achieve positive individual and community outcomes in dynamic healthcare contexts.
   Relates to: Interprofessional education learning module, Practice performance – Clinical placement 8 weeks /320 hours in total) off-campus clinical work experience