NSB334 Integrated Nursing Practice 4

Unit Outline: Semester 1 2024, Kelvin Grove, Internal

Overview

This unit is a work integrated learning unit, with you learning predominantly off campus (4 weeks/ 160 hours) within healthcare contexts. This is a third-year unit at the consolidating stage of the course. It builds on all preceding units, with the expectation that previous knowledge and skills will be drawn upon in practice and to enable further development knowledge and skills. This is necessary to prepare for and successfully complete this capstone unit and provide safe and effective care as a beginning -level registered nurse. This unit is a work integrated learning unit with students learning predominantly in off-campus health care contexts. A thorough understanding of the NMBA Registered Nurse Standards for Practice, National Health Priority Areas, Aged Care Standards and Quality Health Service (NSQHS) standards is essential to nursing practice.

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 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 beginner practitioner level.
2. 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.
3. Coordinate and lead provision of care for consumers, families, and the broader community, under supervision.
4. Safely and accurately perform medication calculations and demonstrate safe administration of medicines in both the simulated environment and clinical practice setting

Content

Learning Approaches

Experiential learning is at the forefront of this unit, with you attending an extended period of time in the off-campus healthcare environment. Healthcare environments may include clinics and home-based, community, mental health, 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 application to practice. To provide additional learning support, you will undertake a mandatory face-to-face simulation and online learning modules which will require you to apply problem-solving and clinical decision-making skills. You will also be directed to revisit the safe and quality use of medicines and administration of same.

A peer learning community of practice will be used to encourage active collaboration and provide additional support and engagement during placement off campus. Clinical supervisors will facilitate and support transfer of prior knowledge and skills to the real-world context, in line with the requirements to satisfactorily complete 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 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, student 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. If due to the nature of the 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 on 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 assessments to be completed in this unit. An acute care clinical simulation with pre-briefing and debriefing activities as part of your e-Portfolio, MedSafe examination, a series of module activities with critical essay followed by satisfactory achievement of all criteria in supervised nursing practice assessment (ANSAT) report.

Unit Grading Scheme

S (Satisfactory) / U (Unsatisfactory)

Assessment Tasks

Assessment: Recognising and responding to acute deterioration simulation and completion of a learning activity

You will undertake a simulation scenario in a team of four students. Your performance will be evaluated against performance criteria both as a team and as an individual. If you do not meet the performance criteria you will be offered one further opportunity to demonstrate safe practice performance in a further simulation assessment.

You will engage in face-to-face clinical simulation scenarios that focus on complex problems such as a recognising and responding to the rapidly deteriorating patient and team processes including leadership capabilities. 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 implementation and incorporate experiential learning from real-world practice. Pre-briefing and de-briefing will be included as fundamental components of the learning experience as well as completion of a learning activity/ePortfolio entry directly related to the simulation.

Threshold Assessment:

You are required to achieve a satisfactory grade in each of the assessment items to receive an overall satisfactory grade for the unit. Attending and participating in simulation prepares you to demonstrate safe clinical practice and protect the safety of the public.

Assessment: Online healthcare modules and completion of a learning activity

Online modules: Undertaking a holistic analysis you will complete modules that highlight critical thinking and decision making in diverse and complex healthcare situations across the lifespan. As part of this activity you will develop a critical essay in response to a provided case addressing key elements of nursing practice reflective of the NMBA Registered Nurse Standards for Practice. Foci include communication, collaboration, ethical practice, QUM, cultural safety approaches, interprofessional collaboration. Developmental and chronological age, technological availability, and the contextual elements relevant to particular healthcare settings will also be included.

This is an assignment for the purposes of an extension.

Threshold Assessment:

You are required to achieve a satisfactory grade in each of the assessment items to receive an overall satisfactory grade for the unit. 

If you do not achieve a satisfactory grade for Assessment Item 2, but your achieved mark/grade is within 10% (or 1 grade) of the pass level for the assessment item, you will be eligible to attempt a re-submission of one of these assessment pieces. Failure to reach an initial satisfactory (4 - pass) grade in assessment 2 will result in an unsatisfactory grade for the unit. You are advised to review feedback on your work prior to re-submission.

Assessment: Med+Safe

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 Med+Safe application during the invigilated school-based assessment  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.

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:

Medication calculations are a required element prior to practice to protect the safety of the public. You are required to achieve a satisfactory grade in this assessment item to receive an overall satisfactory grade for the unit.

Assessment: Practice performance – Clinical placement 4 weeks (160 hours) 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:

You are required to achieve a satisfactory grade in each of the assessment items to receive an overall satisfactory grade for the unit. 

Assessment Item 4 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 3 (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

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.

Chang, E; Johnson, A. 2022. Living with Chronic illness & disability: principles for nursing practice. (4th ed). Sydney: Elsevier

Crisp, J., Taylor, C., Douglas, C., & Rebeiro, G. (2020). Potter & Perry's fundamentals of nursing (6th ed.). Mosby, Elsevier: Sydney.

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

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.

Recommended text(s)

Calleja, P., Theobald, K. & Harvey, T. (2020). (3rd ed.). Estes health assessment and physical examination Cengage: South Melbourne.

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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
5. The RN uses ethical frameworks when making decisions
   Relates to: Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
6. The RN maintains accurate, comprehensive and timely documentation of assessments, planning, decision-making, actions and evaluations
   Relates to: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
7. The RN contributes to quality improvement and relevant research.
   Relates to: Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
3. The RN recognises that people are the experts in the experience of their life
   Relates to: Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
4. The RN provides support and directs people to resources to optimise health-related decisions
   Relates to: Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
8. The RN participates in and/or leads collaborative practice
   Relates to: Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
9. The RN reports notifiable conduct of health professionals, health workers and others.
   Relates to: Online healthcare modules and completion of a learning activity

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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
2. The RN provides the information and education required to enhance people's control over health
   Relates to: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
3. The RN uses a lifelong learning approach for continuing professional development of self and others
   Relates to: Online healthcare modules and completion of a learning activity
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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity
5. The RN seeks and responds to practice review and feedback
   Relates to: Online healthcare modules and completion of a learning activity
6. The RN actively engages with the profession
   Relates to: Online healthcare modules and completion of a learning activity
7. The RN identifies and promotes the integral role of nursing practice and the profession in influencing better health outcomes for people.
   Relates to: Online healthcare modules and completion of a learning activity

4: Comprehensively conducts assessments.

1. The RN conducts assessments that are holistic as well as culturally appropriate
   Relates to: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
4. The RN assesses the resources available to inform planning.
   Relates to: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
3. The RN documents, evaluates and modifies plans accordingly to facilitate the agreed outcomes
   Relates to: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
4. The RN plans and negotiates how practice will be evaluated and the time frame of engagement
   Relates to: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
5. The RN coordinates resources effectively and efficiently for planned actions.
   Relates to: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
2. The RN practises within their scope of practice
   Relates to: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
5. The RN practises in accordance with relevant policies, guidelines, standards, regulations and legislation
   Relates to: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
2. The RN revises the plan based on the evaluation
   Relates to: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience
3. The RN determines, documents and communicates further priorities, goals and outcomes with the relevant persons.
   Relates to: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Med+Safe , Practice performance – Clinical placement 4 weeks (160 hours) 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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Med+Safe , Practice performance – Clinical placement 4 weeks (160 hours) 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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) 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: Recognising and responding to acute deterioration simulation and completion of a learning activity , Online healthcare modules and completion of a learning activity, Practice performance – Clinical placement 4 weeks (160 hours) off-campus clinical work experience