Postgraduate Diploma in Adult Critical Care Nursing

Purpose

The Postgraduate Diploma in Adult Critical Care Nursing aims to produce independent postgraduate Critical Care Nurse Specialists who can demonstrate competencies in critical, analytical thinking, autonomy, and advocacy, who can also apply clinical judgment and reasoning skills to enable rendering of comprehensive critical care which includes both preventative, curative, and reactive care within the interprofessional team in various critical care settings.

The competencies acquired by this specialist nurse include being clinically focused and service-orientated, delivering specialized care, including preventative, promotive, curative, emergency, and rehabilitative care, depending on the scope of the speciality, using a wide range of skills such as accountability, service ethics and effective decision-making.

The specialist nurse's important role is to form a strong basis for referral from health care professionals. Their role in consultancy is crucial and, in this way, they contribute to expanding the theoretical base. The expected skills for these specialist nurses are of higher order, they will do higher-level functions for individuals, families, and communities. They are required to work with and care for critically ill, highly unstable patients and provide leadership in the health care team.

An outcomes-based approach is used whereby learners are placed for Work Integrated Learning (WIL) in a variety of specialized healthcare settings to learn and apply the required competencies. A collaborative teaching and learning approach is embodied that promotes the use of evidence-based practice.

On completion of the qualification, the learner will be registered as a Critical Care Nurse (Adult) Specialist with the South African Nursing Council (SANC) to practice as defined by the Nursing Act No 33 of 2005.

A qualified learner will be able to

• Practice and facilitate specialised critical care nursing within ethical and legal parameters of the profession.
• Apply the knowledge of and facilitate evidence-based practice in the specialised critical care field to solve contextual problems and develop policies and guidelines.
• Mobilize appropriate resources to implement standards of practice relevant to critical care specialisation, to ensure quality patient care and safety.
• Develop and implement policies, protocols, and guidelines in the critical care practice, utilising the process of change management in the improvement of quality of care.
• Engage in planning, commissioning, and managing specialised critical care units.

Rationale

Positioning nursing education within the higher education band is a legislative mandate responding to both transformation in the education system of the country and the health care system agenda.

In compliance with the provisions of the Higher Education Act (Act 101 of 1997 as amended in 2008), the change in the educational landscape of the country mandates the alignment of the nursing qualifications to the National Qualification Framework (NQF), whereas the Nursing Act No. 33 of 2005 provides for training, leading to registration as a Specialist Nurse in Critical Care Nursing (Adult).

In the South African context, there is a need for the right skills at the point of service. The specialist nurses contribute to policy changes; they work at regional, provincial, and even national levels, and are drawn into planning. The specialist nurse helps to maintain and improve the expertise in practice.

This qualification is aimed at producing an Adult Critical Care Specialist Nurse with competencies to respond to the complexities within diverse healthcare settings. The learning and teaching process incorporates government qualifications in addressing the burden of life-threatening diseases, injuries, emergencies, and complications through the primary health care approach displaying an understanding of theories, methodologies, and techniques to provide effective and accessible health care services.

The qualified learners will do higher-level functions for individuals, families, and communities. They are required to work with and care for critically ill, highly unstable patients and provide leadership in the health care team.

SANC Regulation No. 635 of 2020 prescribes the requirements for registration in the category of Critical Care Nurse Specialist (Adult).

Both public and private healthcare facilities need specialised and trained critical care nurses.

Recognition of Prior Learning (RPL)

The institution has an approved Recognition of Prior Learning (RPL) policy applicable to equivalent qualifications for admission into the qualification. RPL will be applied to accommodate applicants who qualify. RPL thus provides alternative access and admission to qualifications, as well as advancement within qualifications.

RPL for access

• Learners who do not meet the minimum entrance requirements or the required qualification that is at the same NQF level as the qualification required for admission may be considered for admission through RPL.
• To be considered for admission in the qualification based on RPL, applicants should provide evidence in the form of a portfolio that demonstrates that they have acquired the relevant knowledge, skills, and competencies through formal, non-formal and/or informal learning to cope with the qualification expectations.

RPL for exemption of modules

• Learners may apply for RPL to be exempted from modules that form part of the qualification. For a learner to be exempted from a module, the learner needs to provide sufficient evidence in the form of a portfolio that demonstrates that competency was achieved for the learning outcomes that are equivalent to the learning outcomes of the module.

RPL for credit

• Learners may also apply for RPL for credit for or towards the qualification, in which they must provide evidence in the form of a portfolio that demonstrates prior learning through formal, non-formal and/or informal learning to obtain credits towards the qualification.
• Credit shall be appropriate to the context in which it is awarded and accepted.

Entry Requirements

The minimum entry requirement for this qualification is

Advanced Diploma in Critical Care Nursing, NQF Level 7.

Or

Advanced Diploma in Trauma and Emergency Nursing, NQF Level 7.

Or

Bachelor of Arts in Health Care Studies, NQF Level 7.

And

Proof of current SANC registration as a Professional Nurse and Midwife.

This qualification consists of the following compulsory modules at NQF Level 8 totalling 144 Credits.

Compulsory modules, Level 8, 144 Credits.

• Health Service Dynamics, 16 Credits.
• Health Science Research, 12 Credits.
• Critical Care Nursing Adult Specialty 1, 30 Credits.
• Critical Care Nursing Adult Specialty 2, 16 Credits.
• Critical Care Nursing WIL, 70 Credits.

Exit Level Outcomes

1. Practice and facilitate specialised critical care nursing within the ethical-legal parameters of the profession.
2. Apply the knowledge of and facilitate evidence-based practice in the specialised critical care field to solve contextual problems and develop policies and guidelines.
3. Appraise and develop self, peers, and critical care specialist learners by facilitating self-directedness/leadership and lifelong learning to maintain competence.
4. Facilitate advocacy for the profession and provision of specialised critical care professional support for personnel, patients, families, and communities.
5. Engage in planning, commissioning and managing specialised critical care units.
6. Engage in scholarly activities to inform evidenced-based practice in specialised critical care units.
7. Utilize, manage, and communicate data to support decision-making and research.
8. Mobilize appropriate resources to implement standards of practice relevant to critical care specialisation, to ensure quality patient care and safety.
9. Collaborate within the inter-professional team by engaging in health dialogue, shared leadership, decision-making and sound clinical judgment.
10. Develop and implement policies, protocols, and guidelines in critical care practice, utilising the process of change management in the improvement of quality of care.

Associated Assessment Criteria for Exit Level Outcomes 1.

• Illustrate conformity to the relevant code of ethics in the practice of specialised critical care through personal attributes and behaviour.
• Appy critical decision-making and moral reasoning models and principles to make clinical judgements and resolve ethical dilemmas within the specialised critical care practice.
• Take accountability of own professional judgement, actions, and outcomes of specialised critical care and provide continued competence.
• Identify and apply relevant current legislation, policies, regulations, and guidelines pertaining to specialized critical care practice.
• Accurately document comprehensive specialised critical care activities and timeously consider the legal requirements for record keeping.
• Apply knowledge of the critical care nurse specialist role in the management of professional misconduct and risks taking into consideration the institutional protocols and protocols and ethical-legal framework.

Associated Assessment Criteria for Exit Level Outcomes 2.

• Engage in specialized critical care practice and show an understanding of the process of evidence-based practice.
• Apply evidence-based and specialized critical care practice, taking into consideration the appropriate methodology of gathering evidence for the practice, for example, systematic or scoping reviews, appraisal of articles, practice-based research and publication.
• Apply knowledge of and use evidence-based specialized critical care practice, and critical analysis of the various levels of evidence.

Associated Assessment Criteria for Exit Level Outcomes 3.

• Illustrate leadership skills through the application of appropriate leadership styles, principles, and theories.
• Facilitate Continuous Professional Development (CPD) for self and others effectively for lifelong learning by creating a positive learning climate in the workplace through the processes of mentorship, preceptorship, supervision, performance appraisal, etc.
• Engage in performance appraisal and demonstrate an understanding of the purpose and processes of the performance management and development system.
• Utilise feedback gained from self-reflection, peers, learners, management, and other relevant stakeholders to improve effectiveness in the critical care nurse specialist's role.
• Illustrate understanding of the various risk factors that impact health and wellness within the workplace and apply strategies to care for self, peers, employees and learners.

Associated Assessment Criteria for Exit Level Outcomes 4.

• Illustrate understanding of the purpose of the advocacy role for a critical care nurse specialist.
• Apply advocacy principles to ensure safe and quality care in various critical care settings.
• Apply appropriate use of communication skills and channels in facilitating advocacy.
• Illustrate ability to lobby and/or participate in interest groups to influence legislation and policy affecting the role performance.

Associated Assessment Criteria for Exit Level Outcomes 5.

• Apply knowledge to show understanding of levels and/or classification of the respective specialized critical care units.
• Command tasks taking into consideration the burden of diseases and priority services as determined by current events.
• Participate in the evaluation of the existing specialized critical care unit and demonstrate knowledge of guidelines for provisioning a specialized critical care unit.
• Engage in planning and commissioning to show understanding of the role and responsibilities in the task within inter and intra-professional teams.

Associated Assessment Criteria for Exit Level Outcomes 6.

• Apply specialized critical care setting; show knowledge of appropriate search engines and databases for review of literature to inform evidence-based practice in specialized critical care.
• Apply appropriate methods to generate evidence for utilization in specialized critical care practice such as research, systematic reviews, etc.
• Illustrate awareness of peer-reviewed journals and use them for sharing of evidence.
• Utilise activities based on scientifically proven evidence in the specialized critical care practice.
• Actively participate in inter and intra-professional dialogues, debates or discourses in quality improvement.

Associated Assessment Criteria for Exit Level Outcomes 7.

• Document all data or information gathered in the context of the specialized critical care practice, for utilization and storage in accordance with the set standards.
• Utilise data, information and emerging evidence pertinent to the respective specialized critical care practice.
• Identify problems, diagnoses and opportunities for improvement based on gathered and critically analyzed assessment data from the patients/clients, families, communities, learners or employees including current scientific evidence.
• Document data and apply skills that show respect for intellectual property and recorded information is without plagiarism.

Associated Assessment Criteria for Exit Level Outcomes 8.

• Apply knowledge and show understanding of the infrastructure and equipment needed in the specific area of critical care specialization.
• Render care ability to operate and monitor the equipment used in the critical care specialist area.
• Employ sound asset management principles to ensure appropriate, adequate, well maintained and up-to-date equipment.
• Assign staff to critical care nursing taking into consideration the critical care specialist's qualification and competencies, experience, standard nurse-patient ratios for the area of critical care specialization, job description and skill mix.

Associated Assessment Criteria for Exit Level Outcomes 9.

• Identify practice problems in the specialized critical care area, share and collaboratively solve them by informed decisions and sound clinical judgement.
• Provide appropriate and timely consultation in the provision of holistic care in a healthcare continuum through awareness of one's competence.
• Carry out appropriately and timeously patient referrals as dictated by the patient's condition and in accordance with the referral guidelines.
• Promote participation in the inter- and intra-professional team, and ensure its visibility and recognition by the members of the team.

Associated Assessment Criteria for Exit Level Outcomes 10.

• Participate in the development of policies, programmes, and projects to show understanding of the steps followed in the process of change management in the improvement of quality of care.
• Illustrate knowledge of own role and responsibilities within inter and intra-professional policy/project team by participating in project and policy development.
• Apply knowledge and participate in policy and project development to show advocacy for the critical care profession and patients, families, and communities in the critical care specialist area.
• Apply knowledge in the process of developing policies, standards, guidelines, and protocols.
• Use appropriate methods in the process of development and evaluation or testing of guidelines and protocols.
• Implement the new policies, protocols and guidelines to the specialist area showing understanding and application of the change process.
• Collaboratively revise developed policies, protocols and guidelines at appropriate intervals approved as per the institutional policy for the critical care specialist area.