Postgraduate Diploma in Child Nursing

Purpose

The purpose of this qualification is to prepare professional nurses to function as Child Nurse Specialists and to register as such with the South African Nursing Council (SANC). The Nursing Act No 33 of 2005 defines a Nurse Specialist with a "specialisation" means the acquisition of in-depth knowledge and expertise in a specific field of practice.

Children's Nursing is a specialist field that focuses on the comprehensive care of children, which includes children across the whole age range, from infants to adolescents, within a whole-child and person-centred framework. This care requires professional competence in nursing ill children to decrease morbidity and mortality by providing quality and safe healthcare to newborns, children and adolescents in the context of their families, communities in health care facilities and other settings.

This care includes the promotion of child health and well-being and the prevention of illness and injury. A Child Nurse Specialist is a Professional Nurse with an additional qualification in Children's Nursing and is registered with the SANC. The qualification will prepare the Child Nurse Specialist with evidence-based knowledge to demonstrate clinical leadership, deep reflection and ethical, clinical decision-making by regularly reviewing current thinking, practice and research methods relevant to this discipline.

A Child Nurse Specialist is found in the following workplace settings

• Community healthcare settings where they work with teams of community and lay healthcare workers.
• Nurses and specialist teams who work with children, including clinics and school health services.
• Children's units/wards in district, regional, tertiary and quaternary (academic) hospitals.
• Facilities of care and specialist services for children.

Rationale

South Africa was unable to meet the target of Millennium Development Goal 4 by reducing the high level of infant and child mortality by 2015. While child health indicators have started to improve, this remains a national, regional and global priority and is now articulated in sub-goal 3.2 of the United Nations Agenda 2030 for Sustainable Development Goals (SDGs). The SDGs aim to end preventable deaths of newborn babies and children under five years by 2030. Along with all other countries, South Africa is also aiming to reduce neonatal mortality to at least 12 deaths per 1000 live births and under-five mortality to no more than 25 deaths per 1000 live births.

The SDGs also commit member states to substantially increase recruitment, development, training and retention of the health workforce in developing countries. The Mortality and Morbidity in Children Under Five (5) Ministerial Committee recommended the strengthening of children's nursing training as a primary strategy to reduce the under-five mortality rate in South Africa. The Postgraduate Diploma in Child Nursing will qualify successful candidates for registration with the South African Nursing Council (SANC) as specialist child nurses.

Both public and private healthcare facilities need specialised and trained critical care nurses with a strong basis for referral from staff and professional nurses. Their consultancy role is important, and in this way, they contribute to expanding the theory base.

The South African context needs the right skills at the point of service; the specialist contributes to policy changes by determining the needs and initiating policy and procedures. This qualification will equip child nurse specialists in partnership with others in the Nursing and Midwifery profession and other health professions to offer a creative, caring and goal-directed service to individuals, families and communities, based on a sound body of knowledge. The focus of Nursing and Midwifery is to care for people across the lifespan from before birth to death in a whole person-centred manner; to create an environment conducive to the promotion, maintenance, and restoration of health and to protect those who are vulnerable.

Nurses and midwives encounter people in various age ranges, stages of health and illness, and individuals and families or larger groups of people. Therefore, central to their practice is a commitment to interpersonal relationships and partnership. Although the focus is on preventive and promotive health care, nurses are required to meet the health care needs of people in all stages of health and illness. It is, therefore, imperative that those neonates and children who require nursing care interventions are nursed by child nurse specialists to improve their health outcomes. This group of children have a constitutional right to good health and must be afforded the opportunities to survive, thrive and make a meaningful contribution to society and to the economy.

The Postgraduate Diploma in Child Nursing is recognised and regulated by the South African Nursing Council (SANC). The qualification was designed in line with the revised SANC's regulations for specialist nurses. The registered nurses would work at regional, provincial, and national healthcare levels. The clinical sites for workplace-based learning are managed through a bilateral agreement with the Western Cape Provincial Health Department.

Recognition of Prior Learning (RPL)

RPL will be applied to accommodate applicants who qualify. RPL thus provides alternative access and admission to qualifications, as well as advanced standing within qualifications. RPL may be applied for access, credits from modules and credits for or towards the qualification. Access via RPL will be applied in accordance with the SANC 2013 guidelines.

RPL for access

• Learners who do not meet the minimum entrance requirements or the required qualification 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 should they be allowed entrance into the qualification.

Entry Requirements

The minimum entry requirement for this qualification is

• An appropriate bachelor's degree in nursing and Midwifery (R174), NQF Level 7.

Or

• Advanced Diploma in Midwifery, NQF level 7.

Or

• Four-year Diploma in Nursing and Midwifery, NQF Level 7.

Or

• Four-year Bachelor's Degree offered under Regulation R425 of 22 February 1985 as amended

and

• Proof of registration with the SANC as a professional nurse and midwife.
• Two years' post-registration experience as a Professional Nurse, which includes at least two years of experience in the field of the speciality within the last five years, excluding the Community Service year.
• Evidence of professional indemnity/insurance.

This qualification consists of the following compulsory modules at National Qualifications Framework Level 8, totalling 120 credits.

Compulsory Modules, Level 8, 120 Credits

• Foundations of Specialist Practice, 24 Credits.
• Leading Quality and Safety in Children's Nursing,16 Credits.
• Principles of Children's Nursing, 40 Credits.
• Children's Nursing Practice, 40 Credits.

1. Practice and facilitate specialist nursing within ethical-legal parameters of the profession.
2. Apply the knowledge of and facilitate evidence-based practice in the specialist field to solve contextual problems and develop policies and guidelines.
3. Appraise and develop self, peers and nurse specialist learners by facilitating self-directedness / leadership and lifelong learning to maintain competence
4. Facilitate advocacy for the profession and provision of specialist professional support for personnel, patients, families and communities.
5. Engage in planning, commissioning and managing a specialist unit.
6. Engage in scholarly activities to inform evidenced-based practice
7. Utilise, manage and communicate data to support decision-making and research
8. Render and coordinate patient-centred specialist nursing practice within a continuum of care using the scientific approach, integrating biomedical and psychosocial sciences including advanced pharmacology.
9. Mobilise appropriate resources to implement standards of practice relevant to the area of specialisation to ensure quality patient care/safety.
10. Collaborate within the inter-professional team by engaging in health dialogue, shared leadership, decision-making and sound clinical judgment
11. Participate in the design, development, implementation and evaluation of nursing policies, programmes and projects.
12. Develop and implement policies, protocols, and guidelines in specialisation, utilising the process of change management in the improvement of quality of care.

Associated Assessment Criteria for Exit Level Outcome 1

• Conform to the specialist nursing or midwifery practice code of ethics.
• Use critical decision-making and moral reasoning models and principles to make clinical judgements and resolve ethical dilemmas within the specialist practice.
• Demonstrate accountability for own professional judgement, actions, outcomes of specialist care, nursing education or health services management and competence.
• Identify and apply relevant current legislation, policies, regulations and guidelines pertaining to specialist practice.
• Accurately, comprehensively and timeously document all specialised care activities according to the legal requirements for record keeping.
• Apply knowledge of the nurse specialist or midwife specialist role in the management of professional misconduct and risks, taking into account the institutional protocols, protocols and ethical-legal framework.

Associated Assessment Criteria for Exit Level Outcome 2

• Engage in childcare specialist practice, demonstrate understanding of the process of evidence-based practice primary care specialist practice
• Apply evidence-based specialist practice, nursing education and health services management, taking into account the appropriate methodology of gathering evidence for practice, education and management, for example, systematic or scoping reviews, and appraisal of articles, practice-based research and publication.
• Use evidence-based primary care nursing specialist practice, nursing education, and health service management to demonstrate knowledge of and critical analysis of the various levels of evidence.

Associated Assessment Criteria for Exit Level Outcome 3

• Effectively facilitate continuous professional development (CPD) for self, others and 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 examine 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 specialist role.
• Assess 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 Outcome 4

• Discuss the purpose of the advocacy role for a nurse specialist or midwife specialist practice.
• Apply advocacy principles to ensure safe and quality care/ in various healthcare settings.
• Use appropriate communication skills and channels in facilitating advocacy.
• Lobby and participate in interest groups to influence legislation and policy affecting the role performance.

Associated Assessment Criteria for Exit Level Outcome 5

• Discuss the levels and or classification of the respective specialist units.
• Commission tasks taking into account the burden of diseases and priority services as determined by current events.
• Participate in the evaluation of the existing specialist unit, health or education entity demonstrates knowledge of guidelines for provisioning a specialist unit.
• Describe the role and responsibilities within the inter and intra-professional team in planning and commissioning tasks.

Associated Assessment Criteria for Exit Level Outcome 6

• Use appropriate search engines and databases for the review of literature to inform evidence-based primary care nursing speciality practice.
• Apply appropriate methods to generate evidence for utilisation in specialist practice (e.g. research, systematic reviews, etc).
• Demonstrate awareness of the peer-reviewed journals and use for sharing of evidence.
• Base education and health services management specialist practice activities on scientifically proven evidence.
• Actively participate in inter and intra-professional dialogues, debates or discourses in quality improvement.

Associated Assessment Criteria for Exit Level Outcome 7

• Gather all data/information for utilisation and storage in accordance with the set standards in the primary care specialist practice.
• Utilise comprehensive data, information and emerging evidence pertinent to the primary care specialist practice.
• Critically analyse all gathered assessment data from the patients/clients, families, communities, learners or employees, including current scientific evidence to identify, diagnose problems and opportunities for improvement.
• Demonstrate respect for intellectual property and avoid plagiarism in all documents.

Associated Assessment Criteria for Exit Level Outcome 8

• Discuss primary care nursing specialist service within the health care system.
• Describe the full range of services within the primary health care specialist area of practice.
• Integrate promotive, preventive, curative, rehabilitative and palliative care to render primary care nursing specialist care in a healthcare continuum.
• Render specialist care in accordance with national and international standards and protocols of the primary health care nursing specialist field.
• Formulate primary care nursing diagnoses based on accurate analysis and interpretation of data obtained from scientific, laboratory, diagnostic, technological and psycho-sociocultural assessment, including consultation of relevant/current literature/evidence that are congruent with the patient's/client's clinical manifestations/data
• Plan individualised nursing interventions based on patient's/client's needs, values, beliefs, preferences, culture and contextual variables, for example, disease burden, health risks, national priorities, etc.
• Plan nursing interventions based on formulated nursing diagnoses and application of specialised knowledge and skills (competencies) including advanced pharmacology in collaboration with the inter and intra-professional team.
• Timeously, accurately, safely and effectively implement the planned nursing interventions in accordance with set evidenced-based standards, guidelines, protocols, algorithms, etc., specific to the primary care nursing specialist field.
• Collaboratively plan health care interventions with the patient or client, family and relevant members of the health care team.

Associated Assessment Criteria for Exit Level Outcome 9

• Identify infrastructure and equipment needed in the primary care nursing specialisation.
• Operate and monitor the equipment used to render care in the primary care nursing specialist area.
• Employ sound asset management principles to ensure appropriate, adequate, well maintained and up-to-date equipment.
• Assign staff to nursing care taking into account the specialist qualification and its competencies, experience, standard nurse patient ratios for the area of specialisation, job description and skill mix.

Associated Assessment Criteria for Exit Level Outcome 10

• Identify, share and collaboratively solve practice problems in the child specialist area using informed decisions and sound clinical judgement.
• Consult and provide appropriate and timeous holistic care in a healthcare continuum through awareness of one's competence.
• Carry out appropriate and timeous patient referral as dictated by the patient's condition and in accordance with the referral guidelines.
• Advocate and promote the team's participation in the inter- and intra-professional team.

Associated Assessment Criteria for Exit Level Outcome 11

• Critically participate and identify the steps in and or levels of the development of policies, programmes and projects.
• Explore own role and responsibilities in project and policy development within the inter and intra-professional policy/project team.
• Apply advocacy principles for the nursing profession and patients/clients, families and communities in the specialist area in policy development, programme and project development
• Use appropriate communication channels and/or strategies such as negotiation, bargaining, assertive, persuasive, etc, in projects and development.
• Provide feedback timeously where necessary to own constituency.

Associated Assessment Criteria for Exit Level Outcome 12

• Discuss the process and or steps of development of policies, standards, guidelines and protocols.
• Identify and engage relevant and pre-determined stakeholders in the development of policies, standards, protocols and guidelines.
• Apply appropriate methods in the development and evaluation or testing of guidelines and protocols
• Implement the new policies, protocols and guidelines of the change process to the primary child health care specialist area.
• Collaboratively revise and approve developed policies, protocols and guidelines at appropriate intervals as per the institutional policy for the specialist area.

INTEGRATED ASSESSMENT

All assessments are aligned with the institution's Assessment Policy, which strives to

• Provide a safe and effective learning environment, free from harassment, intimidation and discrimination
• Provide support and developmental opportunities for teaching
• Provide all reasonable facilities and structures to support learners' success.
• Provide secure and reliable processes with respect to assessment and certification procedures.

Continuous (formative) assessment during the year contributes 40% of the final year mark for three modules and 50% for the Practice module; summative evaluation at the end of the year contributes 50-60% of the final year mark depending on the course and as approved by the Health Sciences' Faculty Board. Assessment weightings and strategies, as specified for each course, are published in the Faculty of Health Sciences Postgraduate Handbook annually. A minimum of 80% of the summative assessment for the clinical courses will be conducted in real-life situations.

Integrated Assessment

There is continuous integration of theory and practice throughout the period of the programme. The assessment approach is to use formative, continuous and summative assessments of learning in the form of written and clinical examinations, assignments, individual and group projects, portfolios and teaching practice for integrated learning. An ability to apply theory to practice is tested.