Postgraduate Diploma in Emergency Nursing

Purpose

The primary purpose of the Postgraduate Diploma in Emergency Nursing is to develop, reconstruct and revitalize the profession which enables the emergency nurse specialist to achieve a recognisable level of expertise within the area of specialisation. This will be done using a systematic survey of current thinking, practice, and research methods in the discipline of emergency nursing. The qualification will equip emergency nurse specialists with critical, analytical evaluation, creative thinking innovation, problem-solving, and communication skills and abilities as well as psychomotor competencies to address the quadruple disease burden and population health needs within a revitalized healthcare system in South Africa.

The emergency nurse specialist will be able to establish a research culture that will lead to evidence-based and reflective practice as well as lead and manage themself and others within the multi-disciplinary team. The image of emergency nursing will be upheld through the application of an ethical, legal, and professional framework.

The qualification further aims to

• Develop an emergency nurse specialist who is a competent, independent critical thinker who will provide scientific, safe, comprehensive, and quality nursing care to address the health needs of the public and private patients, families, and communities within the legal-ethical framework of emergency nursing.
• Enhance and maintain professionalism and professional ethos amongst members of the emergency nursing and midwifery profession.
• Promote and enhance evidence-based nursing practice and reflective thinking.
• Equip emergency nurse specialists to address the population's health care needs within the parameters of the Health Care Plan 2030, the disease burden, and Millennium Development Goals.
• Provide direct access to a Master's degree.

On successful completion of this qualification, the nurse specialist will be eligible for registration with the South African Nursing Council (SANC) as an Emergency Nurse Specialist. This qualification provides a career path for professional nurses who want to stay in the clinical context but who would also like to specialize. The emergency nurse specialist will practice as a competent, independent, critical thinker who will provide scientific, safe, comprehensive, and quality nursing care, aiming to promote healing, prevent complications and alleviate suffering based on acquired knowledge, skills, and competencies. The nurse specialist will progress in the marketplace with advanced knowledge, skills, and specific competencies.

Rationale

Emergency Nursing is an area of specialized nursing care. It is frequently the first point of contact for patients in the emergency and/or critical phase of their illness or injury, focusing on the level of severity and critical interventions. The demanding and escalating roles of nurses and advances in technologies necessitate additional training to prepare them for effective participation in emergency and/or critical illness and disaster situations. Emergency nurses require a broad scope of knowledge and skills to care for patients with a variety of health problems.

The rationale behind the qualification is to develop an emergency specialist nurse practitioner with expert and advanced knowledge and clinical skills in line with the National and Provincial Healthcare Plans and Sustainable Development Goals as guided by the World Health Organisation (WHO). The aim is to promote the health status of the South African population; alleviate the lack of skilled practitioners to address the quadruple burden of disease in the health care system and increase the number of qualified nurses who practice within an emergency nursing department/field in hospitals, clinics, industries, and communities in both public and private sectors.

Emergency Nursing specialization is a sought-after skill for nurse practitioners and offers a career path according to the National Scarce Skills List. There is an ever-increasing demand for applicants to complete the Emergency Nurse qualifications. South Africa needs qualified specialists to both improve practice and train other people. The qualification will alleviate the deficit or gap of emergency nurse specialists in the country. The needs of the client will be met through a holistic approach by addressing the physical, psychological, and social dimensions of the healthcare user within the public and private healthcare domain.

The healthcare state of South Africa, including the standing of emergency nursing, was described by, Brysiewicz and Bruce (2008). The brain drain has resulted in South Africa facing a critical shortage of emergency nurses. This situation is multi-factorial: includes inadequate salaries, limited career opportunities, poor nursing leadership, poor working conditions and a lack of safety and security in the workplace. Due to the shortage of emergency nurses, it has become the norm to employ agency nurses, to manage the demands of workload. Agency staff often displays a lack of commitment, and their work is not up to the standards of quality of patient care (de Beer, Brysiewicz and Bhengu, 2011). This phenomenon leads to medical-legal risks.

Emergency nursing in South Africa was born out of the need for dedicated trauma and emergency care because of escalating military invasion and political unrest between the early 1970s and 1990s (Brysiewicz and Bruce, 2008). Trauma and Emergency nursing was established as a post-registration qualification in South Africa registered with the South African Nursing Council as Trauma and Emergency Nursing. The Emergency Nurse Specialist must function with advanced intellectual and practical competencies in specialized emergency nursing settings as a leader, consultant, educator, and specialist practitioner in providing evidence-based care to other team members.

A constructivist paradigm was chosen as the most appropriate framework according to which the curriculum will be developed. Through the above paradigm, a learning environment will be designed with clear learning outcomes, which will allow the qualification to be presented in a classroom or online (blended learning). Blended learning is a learner-centred approach to creating a learning experience whereby the learner interacts with other learners, with the instructor, and with content through the thoughtful integration of online and face-to-face environments (Thompson 2016). The South African Nursing Council endorsed this qualification in Emergency Nursing to be designated as a specialist nursing qualification.

Recognition of Prior Learning (RPL)

The institution has an approved Recognition of Prior Learning (RPL) policy which is 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 may be applied for access, credits from modules and credits for or towards the qualification.

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 should they be allowed entrance into the qualification.

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 Emergency Medical Care, NQF Level 7.

Or

• Bachelor of Nursing, NQF Level 7.

And

• Registered Professional Nurse with SANC for two years (community service year included) as a General Nurse and Midwife or Professional Nurse and Midwife.

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

Compulsory Modules, Level 8, 120 Credits

• Nursing Research and Professional Ethics, 12 Credits.
• Leadership in Advanced Nursing Practice, 12 Credits.
• Foundations of Emergency Nursing, 20 Credits.
• Trauma Emergency Nursing, 20 Credits.
• Medical Emergency Nursing, 20 Credits.
• Advanced Technology and Skills, 20 Credits.
• Unique Patient Population in Emergency Nursing, 16 Credits.

1. Demonstrate the ability to practice and facilitate specialist nursing, nursing education or health services management within the ethical-legal parameters of the profession.
2. Apply the knowledge of and facilitate evidence-based practice, nursing education or management in the specialist field to solve contextual problems and develop policies and guidelines.
3. Demonstrate the ability to appraise and develop self, peers and nurse specialist or midwife specialist learners by facilitating self-directedness/leadership and lifelong learning to maintain competence.
4. Demonstrate the ability to facilitate advocacy for the profession and provision of specialist professional support for personnel, patients, families, and communities.
5. Demonstrate the ability to engage in planning, commissioning, and managing a specialist unit, an educational entity, or a health service.
6. Demonstrate the ability to engage in scholarly activities to inform evidence-based practice, education, or management.
7. Utilize, manage, and communicate data to support decision-making and research.

Associated Assessment Criteria for Exit Level Outcome 1

• Conform to the relevant code of ethics in the practice of specialist nursing or midwifery, nursing education and health services management.
• Use critical decision-making, and moral reasoning models and principles to make clinical judgments and resolve ethical dilemmas within the specialist practice.
• Accept accountability for own professional judgment, actions, outcomes of specialist care, nursing education or health services management, and continued competence.
• Analyse and apply the relevant current legislation, policies, regulations, and guidelines pertaining to specialist practice or nursing education or health services management.
• Record all care activities accurately, comprehensively, and timeously considering the legal requirements for record keeping.
• Manage a trauma and emergency unit, based on an in-depth understanding of the specific contextual variables.
• Apply knowledge of the nurse specialist or midwife specialist to manage professional misconduct and risks considering the institutional protocols and ethical-legal framework.

Associated Assessment Criteria for Exit Level Outcome 2

• Identify the infrastructure and equipment needed in the emergency nursing specialization.
• Render care, operate and monitor the equipment used in the specialist area.
• Employ sound asset management principles to ensure appropriate, adequate, well-maintained, and up-to-date equipment.
• Assign staff to nurse care considering the specialist qualification and competencies, experience, standard nurse-patient ratios for the area of specialization, job description and skill mix.

Associated Assessment Criteria for Exit Level Outcome 3

• Identify and collaboratively solve practice problems in the specialist area by making informed decisions and sound clinical judgment.
• Consult and provide holistic care in a healthcare continuum through awareness of one's competence.
• Carry out appropriate and timeous 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 as recognized by the members of the team.

Associated Assessment Criteria for Exit Level Outcome 4

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

Associated Assessment Criteria for Exit Level Outcome 5

• Explain the levels and/or classification of the respective specialist units, health services or educational entities.
• Commission task considering 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 and apply the guidelines for provisioning a specialist unit/health service or an educational entity.
• Engage in the planning and commissioning of roles and responsibilities within the inter and intra-professional team.

Associated Assessment Criteria for Exit Level Outcome 6

• Use appropriate search engines and databases for the literature review to inform evidence-based practice, nursing education and health services management.
• Use the appropriate methods to generate evidence for utilization in specialist practice (e.g., research, systematic reviews etc.) education and health services management.
• Consult the peer-reviewed journals for sharing of evidence.
• Conduct the activities in the specialist practice, education and health services management based on scientifically proven evidence.
• Participate in inter and intra-professional dialogues, debates, or discourses in quality improvement.

Associated Assessment Criteria for Exit Level Outcome 7

• Collect documents and all data/information in the context of the specialist practice, education and health services for utilization and storage in accordance with the set standards.
• Collect and analyse comprehensive data, information, and emerging evidence pertinent to the respective specialist practice.
• Diagnose and analyse the problem and identify opportunities for improvement based on gathered assessment data from the patients/clients, families, communities, learners, or employees including current scientific evidence.
• Demonstrate respect for intellectual property and avoid plagiarism in the documentation.

INTEGRATED ASSESSMENT

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

Formative assessment includes but is not limited to

• Case presentations.
• Portfolios of evidence.
• Workbooks.
• Tests.
• Oral presentations by individuals and teams.
• Written test.
• Critiquing article.
• Literature review.
• Research proposal.
• Clinical assessments of individuals.

Summative assessment includes but is not limited to

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

The assessment policy determines the theory and clinical learning requirements that learners must meet. Learners receive feedback regarding the outcome after each formative and summative assessment. Learners must see their scripts and the memorandum to improve performance.

The qualification consists of a large component of clinical learning which occurs according to a placement schedule/programme. Lecturers are responsible for the learners in terms of the following: orientation to the clinical facilities, clinical accompaniment, identifying and guiding learners in a variety of learning opportunities available, conducting formative and summative clinical assessments, providing feedback on the assessment outcome, acting as advocate and counsel learners who experience traumatic events of a personal or professional nature. Lecturers monitor the actual clinical hours worked against the actual hours required and put remedial plans in place to assist the learner to achieve this requirement.