Advanced Diploma in Preoperative, Operating Room and Surgical Nursing

Purpose

This qualification aims to produce nursing graduates who will be professionally equipped to serve the South African community in the operating room department as specialist health care practitioners. Graduates credited with this qualification will be able to function independently with service-orientated, advanced intellectual and clinical competencies, which are recognised both nationally and internationally, in the preoperative, operating room and surgical environment. They will perform as independent clinical practitioners, leaders, consultants and specialist practitioners in providing, together with other team members, evidence-based care to patients undergoing surgery, in the operating room environment, as determined by the relevant legislative framework.

The qualification will provide a basis for decision-making regarding what is within and beyond the defined scope of practice, as well as an understanding of the referral system in place for anything outside of the scope of practice. Recipients of this qualification will also, in cases of need, be able to deal with specified preoperative, operating room and surgical emergencies beyond their scope of practice. The qualifying student will apply evidence-based nursing practice which is based on research, or established practices that have proven to be effective within the profession, both nationally and internationally.

More specifically, the qualification aims to

• Produce high quality competent nurse practitioners who can function professionally in the preoperative, operating room and surgical environment.
• Provide graduates with a range of skills, knowledge and attitudes that will enable them to make a meaningful and sustained contribution to health services.
• Equip practitioners with a developed sense of equity, justice and service ethics that will ensure accountability, irrespective of their chosen work place.
• Equip practitioners with a wide range of transferable skills for application in other professions, disciplines and general life. These include:

> A methodical, solution-based approach to problem solving.

> An empowering, strengths-based approach to personal development.

> Competence in written and oral communication.

> An ability to plan, implement and manage projects of a varied nature.

> An ability to work both independently and as part of a team.

> An ability to demonstrate knowledge, skills and applied competencies in a field of study that provide opportunities for continued personal and professional growth, gainful economic activity and rewarding contributions to society.

The graduate with this qualification should be eligible for registration with the South African Nursing Council (SANC) as a professional nurse with an additional qualification in Preoperative, Operating Room and Surgical Nursing.

Rationale

This qualification is essential to the health field because there is, at present, limited exposure of pre-registration nurses to the speciality area of preoperative, operating room and surgical nursing. The ongoing complexity of technology and the high acuity level of the patients being cared for demand in-depth knowledge and a specialist level of skills and competencies.

High levels of trauma in the country that necessitate effective levels of service delivery from health professionals, including nurses, lead to complex demands on nurses. Patients undergoing surgery require specialised nursing care while they are acutely ill. This requires a nurse who is familiar with the principles of management for surgical patients in the operating room.

This qualification will address the grave shortage of specialist nurses who are competent to nurse this potentially compromised group of patients.

Students who register for this qualification must be

• Currently registered with the SANC as a Registered Nurse.
• Able to communicate comprehensively what they have learnt in the medium of instruction.
• Able to learn and take responsibility for their own progress.
• Competent in end-user computing at a level to support understanding of technology-based practices prevalent in this specialist area of practice.
• Proficient in reading, speaking and writing in the English language medium, as this is the medium of instruction and in which all learning material is available.

Recognition of Prior Learning

This qualification can be achieved in part through the recognition of prior learning. Evidence may be presented in a variety of forms, including previous international or local qualifications, reports, testimonials, mentoring, portfolios, work records and performance appraisals. Recognition will be granted in accordance with the specific institutional requirements, in agreement with the relevant Quality Council (QC).

The qualification recognises formal and non-formal prior learning (incorporating experiential learning) in nursing or a functional equivalent.

Access to the Qualification

Access is open to nurses who are currently registered with the SANC as Registered Nurses conditional to

• The learning assumed to be in place.
• Student access to an accredited clinical facility that will enable clinical practice to take place under recognised supervision.

In terms of current relevant legislation

• Students entering this qualification are required to be registered with the SANC for the duration of the period of learning.
• Students must have access to clinical facilities of health service providers that are accredited by the relevant QC, in agreement with the SANC, for purposes of the practical component of the qualification.
• Clinical and work-based experiences must comply with the requirements of the current relevant Regulations of the SANC.

In order to be awarded this qualification students are required to complete all the given modules.

Modules at NQF Level 7

• Internal Medicine and Surgery, 15 Credits.
• Ethos and Professional Practice, 4 Credits.
• Nursing Unit Management, 14 Credits.
• Introduction to Research, 11 Credits.
• Operating Room Nursing Science 1, 49 Credits.
• Operating Room Nursing Science 2, 49 Credits.

Total Credits: 142.

1. Maintain the ethical and moral codes of the nursing profession and practice within the regulations and legislation relevant to a registered nurse in a preoperative, operating room and surgical environment.
2. Practice effectively as a leader and member of the operating room health team.
3. Manage an operating room unit, based on an in-depth understanding of the specific contextual variables.
4. Apply specialist, evidence-based knowledge and skills in the care patients before, during and after surgery.
5. Assess, plan, implement, manage and evaluate operating room services within the context of organisational policy at regional, provincial and national levels and facilitate policy change when required.
6. Provide appropriate and expert education to individuals, groups and fellow health care professionals in aspects of preoperative, operating room and surgical nursing.

Critical Cross-Field Outcomes

• Identifying and solving problems using critical and creative thinking within the trauma and emergency environment is demonstrated in the application of advanced knowledge of anatomy, physiology, microbiology, pharmacology and nursing science in the provision of patient care in the preoperative, operating room and surgical environment and using critical thinking in the assessment, planning, implementation and evaluation of surgical patients and their individualised needs.
• Working effectively with others to develop collaboration within the multidisciplinary team, in the treatment of the surgical patient is demonstrated by maintaining professionalism in communication strategies and demonstrating understanding of diversity and cultural sensitivity in the interaction with people within the preoperative, operating room and surgical environment.
• Organising and managing oneself and one's activities responsibly and effectively to ensure optimum care and treatment in a preoperative, operating room and surgical environment is demonstrated by using correct management of self and time to ensure sound implementation of preoperative, operating room and surgical nursing.
• Collecting, analysing, organising and critically evaluating information related to preoperative, operating room and surgical legislation, structures and processes that impact Pre-operative. Operating room and surgical nursing is demonstrated by the application of available information in the management and maintenance of a therapeutic operating room and surgical environment.
• Communicating effectively using visual, mathematical and/or language skills in the modes of oral and/or written presentation to collaborate within the multidisciplinary team and to impact on patient care is demonstrated by the application of total acceptance of diversity in all interactions with personnel and patients within the preoperative, operating room and surgical environment.
• Using science and technology effectively and critically, showing responsibility towards the environment and towards the health of others in order to work effectively in the preoperative, operating room and surgical units is demonstrated in the use of technology in a responsible way in the preoperative, operating room and surgical units.
• Demonstrating an understanding of the world as a set of related systems by recognising that problem-solving in the preoperative, operating room and surgical units context does not exist in isolation but is interlinked with collaborative care within the health context is evidenced in the participation of the provision of the needs of patients and personnel in all areas of the preoperative, operating room and surgical environment and working in harmony with the multidisciplinary team members.

Associated Assessment Criteria for Exit Level Outcome 1

1.1 Patient rights are upheld through effective advocacy and deference to diversity.

1.2 Own values and beliefs indicate congruence with the accepted norms and values pertaining to the preoperative, operating room and surgical environment.

1.3 Knowledge and understanding of legislation and regulations relevant to specialised nursing practice is demonstrated throughout all communication and actions.

Associated Assessment Criteria for Exit Level Outcome 2

2.1 Policies and protocols in the operating room unit are applied effectively and appropriately in terms of occupational health and safety.

2.2 Complex ethical issues in preoperative, operating room and surgical nursing are analysed with a view to developing a balanced personal perspective.

Associated Assessment Criteria for Exit Level Outcome 3

3.1 Management approaches and procedures facilitate the establishment of a therapeutic environment conducive to the achievement of quality patient outcomes.

3.2 Management of personnel ensures that competent staff is available in the unit at all times.

3.3 Management skills indicate in-depth acknowledgement of the specific contextual variables.

Associated Assessment Criteria for Exit Level Outcome 4

4.1 Assessments of surgical patients are conducted accurately.

4.2 Surgical patients of all ages are successfully managed to establish and maintain homeostasis.

4.3 The preoperative, operating room and surgical physical environment is managed to optimise patient and personnel safety.

4.4 Emotional disturbance in the surgical patient is managed effectively within the relevant scope of practice and referred for specialist intervention where required.

Associated Assessment Criteria for Exit Level Outcome 5

5.1 Limitations in legal, ethical and policy guidelines are identified and improvements suggested.

5.2 The population morbidity and mortality profiles for surgical cases at regional, provincial and national levels are accurately analysed and interpreted to establish population-based diagnoses.

5.3 Preoperative, operating room and surgical health services at regional, provincial and national levels are evaluated and influencing factors are analysed to identify alternative strategies to improve services.

5.4 In collaboration with appropriate health-care teams, regional, provincial and national preoperative, operating room and surgical services are planned and implemented according to the outcomes of evidence-based assessments.

Associated Assessment Criteria for Exit Level Outcome 6

6.1 Continuing education is maintained through appropriate identification and utilisation of available learning opportunities.

6.2 Appropriate education for patients and families is provided through structured and unstructured teaching opportunities.

6.3 A consultancy and education service is provided for patients, significant others and personnel.

Integrated Assessment

Assessment and evaluation during the programme takes place through a process of continuous evaluation, based on a comprehensive and integrated approach. Integrated assessment comprises both formative and summative assessment.

Formative assessment may be made by means of, but not limited to

• Case presentations.
• Portfolios of evidence.
• Workbooks.
• Tests.
• Oral presentations by individuals and teams.
• Clinical assessments of individuals.

Summative assessment may be made by means of, but not limited to

• Written examinations.
• Research reports.
• Clinical examinations.