Postgraduate Diploma in Adult Critical Care Nursing

Purpose

The purpose of the Postgraduate Diploma in Adult Critical Care Nursing is to strengthen and deepen the learners' knowledge and expertise as a speciality of the nursing profession. It is designed to develop the learner's skills based on current thinking, practice and research methods in the field of critical care nursing. A high level of theoretical engagement and intellectual independence is needed to acquire the ability to relate knowledge to a range of contexts, to undertake professional and highly skilled workers, and to conduct a research project under supervision. This includes prevention of disease, injury, complications, screening, appropriate management, and prompt referral of patients with specific and complex health problems in the critical care settings.

Upon completion of this qualification, qualifying learners will be able to

• Practice within the ethical-legal parameters of the nursing profession and resolve professional-ethical dilemmas by using decision-making and moral reasoning models.
• Apply knowledge of basic research methodology in the appraisal of articles in the field of Critical Care.
• Demonstrate advanced knowledge of people-centred critical care of patients in a variety of Critical Care units, to promote health outcomes.
• Render and coordinate comprehensive Critical Care nursing care to patients in a variety of critical care units, to promote health outcomes.
• Apply scientific knowledge and principles of the systematic review and guideline development process, to evaluate and review the standard of guidelines used in Critical Care clinical practice
• Apply principles of evidence-based care to ensure quality patient care and safety in Critical Care nursing.
• Implement strategies to develop self and peers by promoting self-directedness through a process of precepting and mentoring.
• Manage Critical Care nursing services by implementing effective medico-legal norms, practices, and standards within an inter-professional team.

Rationale

The increase in patient demand for critical care is primarily caused by the ageing population, the high burden of violence and vehicle accidents, and advances in medicine that extend life expectancy. The long-standing shortage of nurses, especially nurses trained in critical care, compound the problem of adequate service provision. There is a need for critical care nursing specialists in the country as determined by the National Department of Health and the South African Nursing Council (SANC). The qualification will strengthen and deepen the learner's knowledge in the field of adult critical care nursing. It will enable the critical care specialist to undertake advanced reflection and development by means of a systematic survey of current thinking, practice, and research methods in critical care.

The Postgraduate Diploma in Adult Critical Care Nursing is recognised and regulated by the SANC and is competency-based to achieve clinical competency. Both public and private healthcare facilities need specialised and trained critical care nurses. This qualification aims to meet this need, as it offers the opportunity for general nurses and midwives to become nurse specialists in critical care. Registered nurses with an interest in critical care nursing and those recommended by the healthcare facilities register for the qualification and mostly work in critical care settings on successful completion. By training critical care nurses this qualification benefits society as it provides trained professionals to care for critically ill patients, and in doing so benefits the economy. This qualification benefits the individual, community, society, and country through promotive, preventive, curative, and rehabilitative health services.

Recognition of Prior Learning (RPL)

This qualification may be achieved in part or completely through the Recognition of Prior Learning, which includes formal, informal, and non-formal learning and work experience. The Recognition of Prior Learning (RPL) assessment process involves the identification, mediation, assessment and acknowledgement of knowledge and skills obtained through informal and non-formal learning. RPL is applied in terms of the policy and criteria of the institution. The necessary documentary evidence will have to be provided and a formal RPL process will be followed. The institution will apply in this qualification the RPL for both access and credits in line with the National Policy and Criteria for the Implementation of RPL (Amended in March 2019).

RPL for Access

Learners who do not meet the minimum entry requirements of the required qualification may be considered for RPL. There are two options:

• Advanced Standing, in which case the minimum entry requirements are waived by the admitting institution based on evidence of prior learning, work experience or any other relevant circumstances that may apply to an individual learner. No portfolio is required.

OR

• Applicants may provide evidence in the form of a portfolio that demonstrates that the applicant has acquired sufficient relevant knowledge, skills, and competencies to be able to reasonably meet the expectations for learning demanded by the qualification for which they are seeking access.
• In instances where RPL is applied for the purposes of access, no credits will be awarded for any previous learning. However, the candidate may choose the option of being assessed for credit.

RPL for credits

Learners who do meet the necessary entry requirements for admission to a qualification may be awarded some or all the credits towards the qualification. There are two possibilities:

• Learners may apply for RPL to be exempted from a module or some modules by providing sufficient evidence in the form of a portfolio that demonstrates that a level of competency, equivalent to the learning outcomes of the module or modules, has been achieved. Credits will be awarded for such modules.

OR

• Learners may apply for RPL to be awarded all the credits required for the qualification. Sufficient evidence must be provided that demonstrates a level of competency equivalent to all the learning outcomes of the qualification.

Entry Requirements

The minimum entry requirement for this qualification is

• Advanced Diploma in Midwifery, NQF Level 7.

Or

• A relevant qualification in the related field, NQF Level 7.

This qualification consists of the following compulsory modules at National Qualifications Framework Level 8 totalling 130 Credits.

Compulsory Modules, Level 8,130 Credits

• Ethical-legal-professional Framework in Adult Critical Care, 8 Credits.
• Research in Adult Critical Care, 10 Credits.
• Cardiology and Cardiothoracic surgery, 8 Credits.
• Pulmonology and Specific Pulmonary Conditions, 8 Credits.
• Clinical Practice in Adult Critical Care 1, 40 Credits.
• Nephrology, 8 Credits.
• Neurology and Neurosurgery, 8 Credits.
• General Surgery, Sepsis and Endocrinology, 8 Credits.
• Clinical Practice in Adult Critical Care 2, 32 Credits.

1. Practice within the ethical-legal parameters of the nursing profession and resolve professional-ethical dilemmas by using decision-making and moral reasoning models.
2. Apply knowledge of basic research methodology in the appraisal of articles in the field of Critical Care.
3. Demonstrate advanced knowledge of people-centred critical care of patients in a variety of Critical Care units, to promote health outcomes.
4. Render and coordinate comprehensive Critical Care nursing care to patients in a variety of critical care units, to promote health outcomes.
5. Apply scientific knowledge and principles of the systematic review and guideline development process, to evaluate and review the standard of guidelines used in Critical Care clinical practice
6. Apply principles of evidence-based care to ensure quality patient care and safety in Critical Care nursing.
7. Implement strategies to develop self and peers by promoting self-directedness through a process of precepting and mentoring.
8. Manage Critical Care nursing services by implementing effective medico-legal norms, practices, and standards within an inter-professional team.

Associated Assessment Criteria for Exit Level Outcome 2

• Use critical decision making, and moral reasoning models to guide clinical practice and resolve professional-ethical dilemmas within critical care settings.
• Apply the relevant latest legislation, policies, protocols, regulations, guidelines, directives, and applicable ethics regarding critical care in practice.
• Adhere to the professional-ethical and legal frameworks that guide the critical care specialist practice.
• Practice and facilitate advocacy for the rights and best interests of the critically ill patient.
• Interpret and apply ethical codes, professional accountability, responsibility, confidentiality, and standards for the practice of critical care nursing consistently and correctly.

Associated Assessment Criteria for Exit Level Outcome 3

• Demonstrate academic writing skills in research reports.
• Appraise research articles in the field of critical care and healthcare through the application of basic knowledge of research methodology.
• Differentiate qualitative, quantitative, and mixed methods research designs accurately.
• Integrate evidence-based practice of research findings for safe, effective, and efficient practice
• Demonstrate and apply knowledge of research in a research project.

Associated Assessment Criteria for Exit Level Outcome 4

• Promote health outcomes through the demonstration of people-centred critical care nursing in a variety of critical care units.
• Interpret and use epidemiological data pertaining to critical care to plan a community awareness programme/campaign.
• Identify and debate legislation, policies and guidelines relevant to critical care and communicate recommendations to authorities.
• Identify strategies to ensure that the human rights of vulnerable populations in critical care units are respected.
• Use best available evidence is used to plan a healthy environment in critical care units.
• Debate the influence of the psychosocial, political, cultural and economic developments within the country on the provision of critical care, and communicate recommendations to authorities with the ultimate goal of improving critical care nursing.
• Explore and debate suitable injury/ condition-specific assessment techniques to improve health outcomes of critically ill patients.
• Use biomedical, pharmacology and social sciences to explain interpretations of health assessment findings and management of conditions affecting critically ill patients.
• Interpret and explain subjective and objective assessment findings in order to make nursing diagnoses.
• Base comprehensive individual, family-centred treatment plans on assessment findings and standardised national and contextually appropriate guidelines in the critical care setting.

Associated Assessment Criteria for Exit Level Outcome 5

• Promote health outcomes through rendering and coordinating specialist critical care nursing in a variety of critical care units.
• Base community awareness campaigns on epidemiological data pertaining to critical care.
• Create and sustain a healthy critical care environment that is based on the best available evidence.
• Perform, analyse and interpret subjective and objective assessments.
• Execute and coordinate comprehensive individual, person-centred treatment plans competently within an inter-professional team.
• Calculate and classify the severity of a patient's condition according to standardised tools and execute optimal interventions within the limitations of the system and practice.
• Monitor and interpret the health status of the patient continuously and ensure that appropriate interventions are implemented in collaboration with the inter-professional team.

Associated Assessment Criteria for Exit Level Outcome 6

• Evaluate and report current evidence-based guidelines used in critical care practice at predetermined times to improve health care.
• Demonstrate academic and professional writing skills in reports and guidelines.
• Formulate research questions according to the PICO and other formats.
• Critically appraise evidence-based practice, theories, or models on critical care nursing and adopt best practice guidelines to improve health care service delivery.
• Search databases by using Boolean and other information search strategies.

Associated Assessment Criteria for Exit Level Outcome 7

• Promote quality of patient care and safety in critical care settings by implementing evidence-based practice.
• Use systematic reviews to improve client experience and outcomes in critical care health services.
• Perform quality audits aimed at improving patient services at predetermined times.
• Critique, develop and implement clinical standards for critically ill patients.
• Monitor patient outcomes in the critical healthcare services, including quality patient care and safety continuously.

Associated Assessment Criteria for Exit Level Outcome 6

• Apply precepting and mentoring processes to develop self and peers.
• Develop thinking/reasoning processes of self and others through facilitation of learning.
• Apply learning theories in own development and the development of others.
• Create a positive learning environment by supporting peers and novices.

Associated Assessment Criteria for Exit Level Outcome 7

• Manage critical care health services according to medico-legal norms, practices, and standards within an inter-professional team.
• Access and use benchmarks and best practices are to develop indicators for quality and cost-effectiveness in critical care nursing.
• Demonstrate appropriate leadership styles within the critical care inter-professional team.
• Create and document shared decision-making opportunities regarding critical care health services.
• Mobilize and utilize resources to optimise the critical care health environment.
• Analyse and optimize care pathways and referral systems.
• Coordinate the activities of the inter-professional team within the critical care unit.
• Use morbidity and mortality data of critical care nursing to guide decision-making.