Bachelor of Nursing

Purpose

The Bachelor of Nursing qualification will provide learners with a well-rounded, broad education. This qualification will also equip them with the knowledge base, theory and methodology. Thus, learners will be able to demonstrate initiative and responsibility in a professional nursing context.

This qualification aims to

• Produce competent professional nurses and midwife practitioners who will be able to provide comprehensive evidence based care to healthcare users in various healthcare settings.
• Equip learners with a thorough foundational knowledge of basic and social sciences that underpins nursing science.
• Develop learners with a sense of equity, justice and moral ethics that will result in them being accountable and responsible for their actions.
• Produce nurses who can improve quality of care through applying governance principles and implementing best practices.
• Develop graduate attributes such as:

> Academic competence through active engagement with the profession specific content and lifelong learning,

> Critical thinking to comprehensively explore issues, ideas and nursing care problems before accepting or formulating an opinion or care plan,

> Problem solving skills based on the nursing care process of assessing, interpreting, planning, implementation and reassessment,

> Oral and written communication skills that foster understanding and eloquence,

> Cultural sensitivity for our cultural and socially diverse communities through reciprocal community engagement,

> Ethical self-identity through practicing ethical decision-making skills on ethical dilemmas encountered during work integrated learning,

> Entrepreneurship and employability that will make them desirable for the healthcare sector.

Rationale

The newly proposed National Health Insurance (NHI) Bill highlighted the shortage of qualified nurses in South Africa. The Bachelor of Nursing (BNurs) aims to deliver qualified learners to render the necessary services required to provide quality healthcare. In consultation with the South African Nursing Council (SANC) and based on their requirements, learners will be able to function as an independent professional nurse and midwife practitioners. They will be able to make a sound clinical judgment and render people-centred healthcare at all levels of healthcare services.

According to the scope of practice, as published by the SANC, learners should initiate quality measures and take full responsibility for all nursing and midwifery practices. The qualification has a research component. This component will enable learners to understand and implement research findings in practice and lift the quality of healthcare by the development and incorporation of best practice guidelines and clinical pathways. Professional nurses and midwives will act as professional team leaders. They will provide and manage healthcare and develop the capacity of other team members. In doing so, they will provide a much needed service to society and help promote the economy of South Africa.

Learners will be able to work as professional nurses and midwife practitioners in private and public hospitals, clinics or provide individual care to patients.

South Africa has a nurse based healthcare system that is similar to Thailand and Brazil (South Africa, 2011). According to the Human Resources strategic plan of the Department of Health 2013-2016 (2011), the number of nurses declined by 10 000 and is more or less similar to the numbers in 2006. The high burden of disease and the constraints and bottlenecks in human resources contribute to the inability of the health services to deliver quality healthcare. Only 4% of the total registered nurses are younger than 30 years while 48% are older than 50 years. There is a dire need for young highly qualified nurses to enter the profession (SANC 2013). There is a need for competent professional nurses and midwives who can demonstrate critical thinking, analytical, and problem-solving skills to improve the quality of healthcare in the country.

The qualification will replace the Bachelor of Social Science in Nursing qualification. Successful completion of the qualification would enable both horizontal and vertical articulation with relevant cognate qualifications, provided that they meet the minimum admission requirements. Learners may progress vertically to Masters at NQF Level 9 qualifications in related cognate study areas, such as the Master of Nursing. In addition, learners may articulate horizontally to other relevant cognate qualifications at NQF Level 8. Learners can also enrol for a number of Postgraduate Diplomas that offer them the opportunity to become specialists within the field of nursing.

Recognition of Prior Learning (RPL)

Learners not meeting the minimum admission requirements may be allowed entry to the qualification through RPL, in accordance with the RPL policy, where sufficient industry-related experience can be proven through the processes applied by the RPL office of the institution. RPL will be applied according to the Recognition of Prior Learning, Credit Accumulation and Transfer and Assessment and the institution's RPL policy. This will relate to both access to the qualification as well as for credit recognition or exemption towards achieving the qualification. The process for access to the qualification will be managed by the central RPL Office.

Entry Requirements

The minimum entry requirement for this qualification is

• National Senior Certificate, NQF Level 4, granting access to Bachelor's studies.

Or

• National Certificate (Vocational), NQF Level 4, granting access to Bachelor's studies.

This qualification consists of the following compulsory and elective modules at NQF Levels 5, 6, 7 and 8 totalling 512 Credits.

Compulsory Modules, Level 5, 92 Credits

• Sociology (SOSI1512), 8 Credits;
• Nursing Theory (NUGT1514), 16 Credits;
• Nursing Practicum (NUGP1512), 8 Credits;
• Ethics (NUET1512), 8 Credits;
• General Nursing Theory (NUGT1524), 16 Credits;
• General Nursing Practicum (NUGP1522), 8 Credits;
• Human Anatomy and Physiology Theory (BMNT1524), 16 Credits;
• Human Anatomy and Physiology Practicum (BMNP1523), 12 Credits.

Compulsory Modules, Level 6, 156 Credits

• Microbiology (MCBH2614), 16 Credits;
• Microbiology (MCBH2624), 16 Credits;
• Maternal and Child Health Nursing Theory (NUMT2614), 16 Credits;
• Maternal and Child Health Nursing Practicum (NUMP2614), 16 Credits;
• Pharmacology (FRMB2612), 8 Credits;
• Human Anatomy and Physiology Theory (BMNT2614), 16, Credits;
• Human Anatomy and Physiology Practicum (BMNP2613), 12 Credits;
• General Nursing Theory (NUGT2624), 16 Credits;
• General Nursing Practicum (NUGP2624), 16 Credits;
• Pharmacology (FRMB2622), 8 Credits;
• Mental Health Nursing Theory (NUPT2624), 16 Credits.

Compulsory Modules, Level 7, 120 Credits

• General Nursing Theory (NUGT3714), 16 Credits;
• General Nursing Practicum (NUGP3712) 8 Credits;
• Nursing Research Methodology (NURT3714), 16 Credits;
• Mental Health Theory (NUPT3714), 16 Credits;
• Mental Health Practicum (NUPP3712), 8 Credits;
• General Nursing Theory (NUGT3724), 16 Credits;
• General Nursing Practicum (NUGP3724), 16 Credits;
• Midwifery Theory (NUMT3724), 16 Credits;
• Midwifery Practicum (NUMP3722), 8 Credits.

Compulsory Modules, Level 8, 144 Credits

• General Nursing Theory NUG (T4814), 16 Credits;
• General Nursing Practicum (NUGP4814), 16 Credits;
• Midwifery Theory (NUMT4814), 16 Credits;
• Nursing Research Methodology (NRES4814), 16 Credits;
• Midwifery Practicum (delivering a research report) (NUMP4808), 32 Credits;
• Midwifery Theory (NUMT4824), 16 Credits;
• Nursing Management (NUAT4814), 16 Credits;
• Organisational Sociology (SOSI4824), 16 Credits.

1. Apply knowledge of biological and natural sciences, psycho-social sciences and pharmacology in the provision of safe nursing and midwifery care, throughout the life span, in a variety of health care settings and communities in response to population needs.
2. Identify and address ethical and legal issues based on critical reflection on the suitability of different ethical value (and legal) systems to the nursing and midwifery practice within the legal framework.
3. Effectively manage a health care unit and health facility based on the understanding of the roles and relationships within the multidisciplinary team.
4. Access, produce and manage information effectively in order to creatively solve problems or issues.
5. Conduct research in investigating nursing and health-related problems in order to improve quality of care.
6. Apply learning strategies effectively to address own and other's professional and personal ongoing learning needs in a self-critical manner.
7. Apply knowledge of theories, methods and techniques in the practice safe clinical nursing that is responsive to the needs of the individual, the family and the community, in accordance with national legislative and policy frameworks at all levels of health care.
8. Sustain optimal health of a woman, her family and baby, pre-partum, post-partum and intra-partum.

Associated Assessment Criteria for Exit Level Outcome 1

• Demonstrate knowledge of psychology and sociology is applied in nursing and midwifery practice in ways which benefit the level and quality of health care delivery to patients.
• Demonstrate knowledge of bio-natural sciences meets requirements for professional health care, and promotes effective nursing and midwifery care delivery.
• Provide assistance to the client and identify indicators of relapse or complications and ways of preventing such.
• Use technology in the practice of nursing and midwifery in ways that facilitate the effective diagnosis and treatment of illnesses and conditions.
• Initiate treatment to manage common conditions (including prescribing and dispensing medication) in accordance with relevant legislation and protocols.
• Demonstrate an understanding of pharmacokinetics and pharmacodynamics, as well as standard treatment protocols/guidelines are evident in prescribing and administering drugs to women peri-natally.
• Pharmacological principles are applied in the care and control of drugs used for neonates.

Associated Assessment Criteria for Exit Level Outcome 2

• Advocate activities to promote individual, group and community rights with respect to law and health care provision.
• Apply practice consistently in a manner that reflects a clear understanding and interpretation of the requirements of SA Nursing and Health Care legislation, including a Primary Health Care approach.
• Interpret and apply ethical codes, professional accountability and responsibility, and standards for the practice of nursing and midwifery consistently in line with their spirit and intent.

Associated Assessment Criteria for Exit Level Outcome 3

• Plan and provide health care based on sound assessment, and informed decision making to ensure planning is inclusive of the patient and other key stakeholders.
• Ensure unit philosophy, vision, mission, goals, policy and procedures developed for nursing and midwifery care provision and personnel management within a health care unit comply with current legislation, SANC requirements and international best practice for the profession.
• Establish systems to promote cost effective and efficient service delivery within a health care unit.
• Direct management and leadership activities towards the establishment of a team approach to health care, and the effective delivery of services within a physically safe and emotionally supportive environment.
• Manage pharmacological preparations and treatment in ways that ensure the correct storage of drugs and the correct preparation and administration of pharmacological treatment.
• Apply management processes strategically and systematically to manage resources effectively within a health care unit.
• Implement and monitor quality management systems effectively.

Associated Assessment Criteria for Exit Level Outcome 4

• Ensure organisation, presentation and communication of professional information is accurate and consistent with professional expectations.
• Promote community involvement in health care through information sharing and contact, which promotes ongoing collaboration with the community or group.
• Document assessment, planning, implementation and evaluation accurately and timeously, and promotes effective service delivery as well as security and confidentiality of information.
• Monitor standards set for unit health care delivery regularly and gather information to identify areas for improvement on an ongoing basis.
• Communicate effectively using a variety of media and technology, including computers.
• Use interpersonal skills effectively to establish supportive and therapeutic relationships.

Associated Assessment Criteria for Exit Level Outcome 5

• Base research of limited scope conducted on identified needs and take into consideration the steps of the research process, as per standard research text.
• Base research conducted on ethically sound research principles and methods.
• Develop strategies and/or programmes appropriately to the findings of comprehensive health assessments, and based on sound epidemiological principles.
• Provide care based on scientific evidence.

Associated Assessment Criteria for Exit Level Outcome 6

• Ensure wwn personal development and management maintains emotional balance, and promotes effective and professional service delivery of self and the health care unit as a whole.
• Engage in professional development activities that contributes significantly to the professional growth of nurses in sphere of influence, and to the standing of the nursing profession.
• Research activities, develop own professional knowledge and expertise and contribute to the development of nursing practice and the profession as a whole.
• Direct learning activities towards positive health outcomes and use relevant teaching strategies.
• Direct mentoring activities towards the development of others, according to their needs and their scope of practice.

Associated Assessment Criteria for Exit Level Outcome 7

• Provide health care that is appropriate to the particular context and based on comprehensive health assessment.
• Implement nursing care in an integrated manner, according to plans for the health care status of individuals, groups and/or communities, identify changes in general status in time to implement preventive or corrective measures in the interests of general wellbeing.
• Diagnose and manage conditions accurately according to generally accepted treatment guidelines.
• Base nursing interventions on individualised plans that reflect comprehensive and integrated assessment of mentally ill persons and understand common emotional and behavioural disorders, as well as major psychiatric disorders (perceptual and severe mood disorders).
• Ensure interventions with mentally ill persons are consistent with generally accepted psycho-social techniques and contribute to the therapeutic management of these patients.
• Provide support to patients recovering from illness and prepare them for discharge in ways that enable the patient, family and significant others to cope with the management of the patient at home.
• Deliver nursing care that provides the necessary physical and psychological care and support for long term and/or terminally ill patients, in line with the accepted scope of practice for nursing.
• Ensure interventions with patients contribute to identification and management of conditions, maintenance of homeostasis, the comfort of patient and significant others and the prevention and/or management of complications.
• Demonstrate competent clinical skills at all times.
• Make clinical decisions/judgements in accordance with principles of clinical governance.
• Use strategies in problem-solving that are scientific, systematic and appropriate to addressing identified problems.

Associated Assessment Criteria for Exit Level Outcome 8

• Ensure the preparation of a woman and family for pregnancy, childbirth and family changes is appropriate, takes into consideration the woman's context/background and is facilitated by means of antenatal classes and appropriate health education.
• Conduct obstetric history-taking and physical examination of the mother in a comprehensive manner, using a variety of available technology.
• Observe significant changes and laboratory results and accurately interpret and refer appropriately where potential risk to mother and/or foetus exists.
• Monitor the wellbeing of the foetus by monitoring foetal movement, heart rates and growth.
• Monitor and manage the mother during labour and delivery and demonstrate comprehensive, evidences by understanding of the physiology of labour, technology used to monitor the mother and wellbeing of the foetus.
• Demonstrate an understanding of changes taking place in a new-born baby.
• Identify potential and actual emergencies of the mother and/or foetus are timeously and accurately manage.
• Deliver intra-labour care to the mother and baby and ensure it complies with generally accepted treatment guidelines, manages potential and actual emergencies and promotes the safety of both.
• Deliver care post-natally which is integrated and provides for the long-term wellbeing of mother and child, in line with the accepted scope of practice for midwives.

Integrated Assessment

The number and types of tests vary per module but on average, the learners will write two to three formative tests that will be used to calculate their semester mark. Assignments may either be part of the theoretical or clinical component as the aim of the assignment determines where it falls. There is usually one assignment or case study per semester per module. Learners at each level has one major project per year for example during the first year they implement a community engagement project, second year they have to develop teaching material to promote self-care of the client at primary healthcare level, in the third year, learners will do an extensive wound care project while in the fourth year midwifery learners do home visits.

The qualification will comply with the institutional and faculty assessment policy. Formative assessment in the nursing modules happens through two to three semester tests, case studies, assignments, skills assessment, immersive simulation, peer assessment and informal assessment by preceptors. Clinical competences are summatively assessed by means of an Objective Structured Clinical Evaluation (OSCE) or integrated assessments strategies for example the triple jump exercise.

Continuous assessment is done in the mental health practicum and research modules. In all other modules the learners write examinations at the end of the semester. Summative assessment of practicum modules, except mental health and research, is assessed by means of an OSCE or integrated assessment in the clinical setting. Theoretical and/or practical nursing module(s) must be successfully completed before a learner may register for theoretical and/or practical nursing module(s) in any successive academic years. In addition, the required clinical hours per year must be met in order to pass the relevant practical module.

The module mark of a practical module contributes 50% and the examination mark 50% to the combined mark.