NSN903 Development of Safe Clinical Practice

Unit Outline: Semester 2 2024, Kelvin Grove, Internal

Overview

This unit is a work integrated learning unit where you learn predominantly in off-campus health care contexts undertaking clinical placement for four weeks (160hours). Prior to placement you will attend clinical practice labs to further develop nursing skills with self-directed and peer led opportunities for practice of skills. The unit is at the developing stage of your course and builds on all preceding units. You will actively draw upon and apply knowledge and skills gained in previous units to develop your learning and practice.  A thorough understanding of the NMBA Registered Nurse Standards for Practice, National Health Priority Areas, Aged Care Quality Standards, and National Safety and Quality Health Service Standards is 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 high-fidelity simulation and engage critical thinking, clinical reasoning and professional communication skills in diverse and complex healthcare settings consistent with safe, quality 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, with you attending 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 clinical units including NSN902 Foundations of Safe Clinical Practice. 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 labs 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 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 the student in an alternate placement within the same semester. 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. 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.

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 receive feedback on your learning and assessment through:
• Ongoing formative feedback via self-check exercises, clinical facilitator and peer feedback in labs, and through whole of class feedback in online communities
• 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 assessments to be completed in this unit. You must achieve 100% in the medication calculations (within Med+Safe); attend 100% of the clinical practice sessions and demonstrate safe practice and satisfactorily perform in an OSCE.  Lastly you must achieve all criteria on the clinical performance assessment tool (ANSAT) during work integrated learning to achieve an overall satisfactory grade for this unit. The Med+Safe application has many in-built practice tests for you to practise 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

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

Evidence of 100% successful completion of the required test in the MedSafe 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 the invigilated test, including the your name exactly as it appears in your 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 of your off-campus clinical work experience.

Threshold Assessment:

You must achieve 100% in the medication calculations assessment to demonstrate you are safe to practice in the clinical area, under supervision.

Assessment: Simulation and Completion of ePortfolio activity

You will engage in face-to-face clinical simulation scenarios and complete a reflection regarding your individual contribution to the simulation outcome. 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. 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 satisfactory completion of a learning activity directly related to the simulation.

Assessment: Objective Structured Clinical Examination

Students 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.

Students will be assessed on their performance of the skill according to relevant best practice guidelines and performance criteria. The OSCE will be undertaken using exam conditions and students will not be prompted during the assessment. Students 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 coloured text in rubric) must be effectively demonstrated to achieve a satisfactory grade. All assessment rubrics are available on the Canvas unit site.

Students who are not successful in achieving ALL essential performance criteria in the OSCE will be offered one (1) further attempt to repeat the assessment and demonstrate satisfactory performance.

Threshold Assessment:

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

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:

You are required to demonstrate satisfactory achievement of the 7 standards (and related criteria) for this level to pass this unit. Each criterion of the ANSAT must be achieved satisfactorily and 100% attendance is required at off-campus clinical placement.

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)

Crisp, J., Douglas, C., Rebeiro, G., & Waters, D. (Eds.). (2016). Potter and Perry's fundamentals of nursing (5th ed.). Elsevier.

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

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.

Course Learning Outcomes

NS89 Master of Nursing - Entry to Practice

1. Analyse and apply scientific knowledge and skills in context of nursing and related disciplines to the provision of holistic, person-centred, evidence-based nursing across the life span
   Relates to: Med+Safe Exam, Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement
2. Evaluate practice outcomes drawing upon critical thinking and clinical reasoning skills to examine person-centred nursing care and make evidence-based decisions
   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 intraprofessional 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 of self and others to achieve positive individual and community outcomes in dynamic health care contexts
   Relates to: Simulation and Completion of ePortfolio activity , Placement performance – 4 weeks/160 hours of clinical placement