Postgraduate Diploma in Nursing

Purpose

This qualification provides a career path for Professional Nurses who want to stay in a clinical context, but who would like to specialise, focus on an area and add to their depth of knowledge and skill. Persons learning towards this qualification become expert in an area.

The focus of the qualification will be to extend theory and its application in practice. Work-integrated learning hours will be spent under the supervision of a unit manager and registered nurse. These are not credit earning hours but are important to become truly skilled as professional practitioners during clinical placement in health services. Work placement allows for the practising of work/professional roles and competencies to a safe level under the supervision of unit managers or registered nurses. The required number of hours and the nature of work-integrated learning are clearly stipulated by the South African Nursing Council (SANC) for each nursing specialisation.

More specifically, the qualification aims to

• Produce competent professional nurse practitioners within a wide range of health service settings.
• Provide graduates with a wide range of skills, knowledge and attitudes that will enable them to make a meaningful and sustained contribution to health services.
• Equip graduates with a developed sense of equity, justice and service ethics that will ensure that they work in a responsible and accountable manner, irrespective of their chosen workplace.
• Offer a wide range of transferable skills for application in other professions, disciplines and general life, including:

> A methodical solution based approach to problem solving.

> An empowerment-based approach to development of self and others.

> Competence in written and oral communication.

> Capacity to assess and implement health and other policy.

> Ability to plan and implement and manage projects of a varied nature.

> Research capacity.

Of the sixteen possible electives within this qualification which are recognised by the South African Nursing Council, this University will offer the following nine:

• Postgraduate Diploma: Operating Theatre Nursing.
• Postgraduate Diploma: Occupational Health Nursing.
• Postgraduate Diploma: Nephrology Nursing.
• Postgraduate Diploma: Critical Care Nursing (Adult).
• Postgraduate Diploma: Psychiatric Nursing.
• Postgraduate Diploma: Midwifery and Neonatal Nursing.
• Postgraduate Diploma: Community Health Nursing.
• Postgraduate Diploma: Nursing and Health Services Management.
• Postgraduate Diploma: Nursing Education.

Rationale

There is rarely any exposure of pre-registration nurses to the complex, and dynamic context of specialised nursing practice. The changing context of health care practice with a growth in debilitating health conditions demands a cadre of clinical nurse specialists who are able to provide nursing care to patients in need of specialised nursing care.

The ongoing complexity of technology and the increasing acuity levels of the patients being cared for demand a capacity to self-evaluate, to exercise personal responsibility and initiative and requires a depth of knowledge and a high level of skill and competence to function in specialised health care units.

High levels of trauma and critical illness in the country lead to complex demands on nurses to utilise rapid meta-cognitive problem solving skills in the resolution of concrete and abstract critical issues.

The decline of students entering the nursing profession has been a matter of great concern to the South African Nursing Council (SANC) and to the Ministry of Health. The problem is discussed in the Human Resources Plan for Health, which the Minister of Health launched in April 2006 and emphasis is given to recruitment of more students into professional nursing.

South Africa requires nurses that are comprehensively trained to provide nursing care in various contexts (Primary health care, institutional/hospitals, midwifery and mental health settings) and in both rural and urban setting. To ensure that these professionals are adequately supported, and that the quality of nursing care delivery is continuously monitored and improved, increasing numbers of specialist nurses are required in clinical practice.

The registration of a Postgraduate Diploma: Nursing is seen as important in providing extended learning pathways, and promoting the uptake of graduate and postgraduate qualifications.

• Current Registration with the South African Nursing Council (SANC) as a Professional Nurse.
• Competence in the following must be equivalent to that of the professional nurse, namely:

> Developing, implementing and evaluating population based health care.

> Planning, implementing and evaluating nursing care for individuals and groups based on thorough assessment.

> Delivering nursing care to sick or disabled individuals and groups.

> Promoting rehabilitation in individual and groups with disabilities.

> Diagnosing and treating minor ailments and common illnesses.

> Maintaining professional nursing in practice.

> Managing a health care unit.

> Delivering safe midwifery care.

> Demonstrating basic understanding of research.

> Integrating and applying knowledge of biomedical sciences, including body functioning, microbiology, pharmacology and socio-psychology in the provision of nursing care within a comprehensive health care system.

For the specialisation of Occupational Health Nursing, competency in the following is required

• Perform an audiometric screening test in the occupational setting.
• Perform a spirometric screening test in the occupational setting.

Recognition of Prior Learning

Students may provide evidence of prior learning for which they may receive credit towards the qualification by means of portfolios, other forms of appropriate evidence and/or challenge examinations, as agreed to between the relevant provider and relevant ETQA.

Recognition of Prior Learning is particularly important, as there are people in the profession with a variety of qualifications of differing quality and scope. It is important that a Recognition of Prior Learning process be available to assist in making maximum use of of existing qualifications and helping to standardise qualifications around a common standard. A related issue is that the nursing profession is facing a new scope of practice, based on the requirements of the Human Resources for Health plan and international standards. It is essential that existing qualifications and all new provisions are aligned to the new scope of practice, and the vision for health care in South Africa.

Access to the Qualification

The University requires that candidates shall be admitted to the study for the Postgraduate Diploma only if they

• Have obtained a Bachelor's degree or a 4 year Diploma in Nursing Science at NQF Level 7 or a qualification deemed by Senate to be equivalent thereto, meet the professional registration requirements of the South African Nursing Council and provide evidence of current registration with South African Nursing Council as a professional nurse.
• Have obtained a mark of at least 60% in the major modules of the degree or diploma; candidates may be required to supplement their knowledge to the satisfaction of the Head of the Department; candidates may be required to write an entrance examination, provide a portfolio of evidence or do an oral examination before being considered for selection.
• Have been approved as candidates for the Postgraduate Diploma by the Health Sciences Faculty Research, Technology and Innovation, on the recommendation of the Head of the Department of Nursing Science.
• Posses at least one year's appropriate clinical and/or work-based experiences which must comply with the regulations of the South African Nursing Council (SANC).
• Provide evidence of NQF Level 3 Computer Literacy skills. If students cannot provide evidence the candidate will be required to enrol for and pass ITCL101 before admission will be granted to the nursing programme of choice.
• Proof of indemnity insurance.
• Proof of current employment in an accredited health care facility in a relevant position and have access to clinical facilities of health service providers that are accredited by the relevant ETQA.

The qualification shall extend over a minimum period of

• One academic year of full-time study.
• Two academic years of part-time study.

The qualification comprises generic Fundamental and Core components and an Elective component that is specific to each specialisation.

In order to be credited with this qualification, students are required to achieve a minimum of 143 Credits, which are made up as follows:

• A Fundamental component of 15 Credits, comprising Exit Level Outcome 1.
• A Core component of 48 Credits, comprising Exit Level Outcomes 2-4.
• An Elective component of 80 Credits, comprising the Exit Level Outcomes specific to the chosen specialisation.

Candidates may choose from 16 Elective options.

All the Exit Level Outcomes for the chosen specialisation must be achieved in order to be awarded the qualification. The Elective Components comprise:

• Operating Theatre Nursing.
• Occupational Health Nursing.
• Nephrology Nursing.
• Critical Care Nursing (Adult).
• Psychiatric Nursing.
• Midwifery and Neonatal Nursing.
• Community Health Nursing.
• Nursing and Health Services Management.
• Nursing Education.

Unlike Work-integrated learning hours, Experiential learning hours are credit earning hours. These hours are spent under the direct supervision of nurse lecturers as supervised practice, laboratory learning and project learning. All qualifications include a minimum of 300 Experiential learning hours which are equivalent to 30 Credits and must be completed to achieve the qualification.

1. Conduct fundamental research appropriate to nursing science.
2. Function effectively as a clinical nurse specialist with other members of the health within the health care system.
3. Analyse of a range of research methods and approaches with regard to their appropriateness for investigating particular research problems in specialised nursing and midwifery.
4. Manage and evaluate specialised nursing services at district, provincial and national level within the constraints of National Health Policy and international guidelines and in different settings.
5. Work as a specialist practitioner with other team members within the operating theatre and surgical environment for the prevention of illness.
6. Demonstrate an informed and critical understanding of the principles, theories and emerging issues and debates in operating theatre nursing.
7. Apply specialist knowledge and skills in peri-operative care of individuals.
8. Work as a specialist practitioner with other team members within the health care system for the promotion of occupational health and the prevention of occupational illness.
9. Demonstrate an informed and critical understanding of the principles, theories and emerging issues and debates in occupational health nursing.
10. Apply specialist knowledge and skills in the occupational health care of individuals and groups.
11. Maintain excellence in practice as a specialist practitioner in a variety of settings (private, employed, self-employed, urban and rural).
12. Work as a specialist practitioner with other team members within the health care system for the promotion of renal health and the prevention of renal dysfunction.
13. Demonstrate an informed and critical understanding of the principles, theories and emerging issues and debates in renal nursing.
14. Apply specialist knowledge and skills in the renal nursing care of individuals, groups and communities with renal health problems.
15. Demonstrate a practice-based understanding and knowledge of bio-medical technologies and nursing skills utilized in support of care of the critically ill person.
16. Apply evidence-based knowledge and skills to understanding, interpreting and mediating the physical and emotional environment of the critical care unit for patients, their families and staff.
17. Demonstrate a coherent understanding of principles, theories, emerging issues nationally and globally in critical care nursing.
18. Interpret and apply information and data correctly to assess the critically ill adult.
19. Apply specialist knowledge and skills in the care and physiological support of critically ill and high-risk adults and their families.
20. Work as a specialist practitioner with other members of health team within the health care system for the promotion of mental health and prevention of mental illness.
21. Demonstrate a coherent and critical understanding of the principles, theories, emerging issues and debates in psychiatric nursing.
22. Apply specialist knowledge and skills in the nursing of individuals, groups and communities with mental health problems.
23. Enhance the functioning of the individual, group and community through expert psycho-education.
24. Work as a specialist practitioner with team members within the health care system for the promotion of maternal and neonatal health and the prevention of maternal and neonatal mortality and morbidity.
25. Demonstrate a coherent and critical understanding of the principles, theories and emerging issues and debates in advanced midwifery and neonatal nursing.
26. Apply specialist knowledge and skills in the provision of advanced reproductive health care for individuals, groups and communities.
27. Work as a specialist practitioner with other members of health team for the promotion of health for groups, communities and populations in striving to resolve public health issues that impact negatively on the attainment of optimal health for the population as a whole.
28. Demonstrate a coherent and critical understanding of the principles, theories, emerging issues and debates in national and global public health.
29. Apply specialist knowledge and skills in population-based care to meet the health needs of groups, communities and populations.
30. Use advanced epidemiological research methods and epistemological thinking to assess needs, determine strategies to meet identified needs and identify best practices in public health and community-based nursing.
31. Demonstrate a comprehensive and systematic knowledge and understanding of the components of the management process in the management of a health service.
32. Demonstrate a coherent and critical understanding of principles and theories of management and leadership.
33. Organize the management of a defined health care unit by identifying, analysing and dealing with complex issues using evidence-based solutions and theory driven arguments.
34. Control the quality of management and performance of health care in the defined service by means of scientific-based solutions.
35. Conduct fair and cost effective human resource management by engaging with current research and scholarly literature pertaining to sound human resource management.
36. Formulate and implement an effective strategic plan for a defined health care service by taking cognisance of internal strengths and weaknesses and external threats and opportunities.
37. Evaluate the effectiveness of the implemented strategic plan for the defined health care service by critical analysis, synthesis and independent evaluation of quantitative and qualitative data.
38. Demonstrate coherent and in-depth understanding of principles of business management pertaining to the private health sector.
39. Demonstrate coherent and critical understanding of the structure and functions of the public health services.
40. Create active learning environments in the teaching of nursing and midwifery both in clinical and classroom settings based on comprehensive and systematic understanding of adult development, learning and motivation theories.
41. Lead curriculum change and/or transformation in the education of nurses and midwives based on critical analysis of educational philosophy, national and global policies and discourses such as managing diversity, RPL, and globalization with regard to their implications for nursing and midwifery education.
42. Design, implement and assess classroom and clinical learning outcomes based on expected learning outcomes and a comprehensive understanding of principles and strategies of assessment of learning outcomes with specific reference to professional education.
43. Develop a coherent curriculum for a particular nursing and/or midwifery programme taking into account the principles of the NQF and the stipulations of the ETQA for nursing and midwifery education (SANC) in collaboration with peers.
44. Demonstrate a comprehensive and critical understanding of theories and approaches of educational management, including quality management systems, with specific reference to managing a nursing education institution (nursing colleges, university and technikon nursing departments).

Critical Cross-Field Outcomes

All the Critical Cross-Field Outcomes are addressed throughout the qualification.

Associated Assessment Criteria for Exit Level Outcome 1

1.1 The specified research area is clearly and unambiguously delineated.

1.2 The specified research problem is accurately described and defined using operational definitions.

1.3 The specific research question/problem to be examined is formulated clearly and conceptualised accurately.

1.4 Research variables are accurately identified.

1.5 Clear hypotheses are provided that are measurable, concise and logically developed with arguments that support the hypotheses.

1.6 The research plan/design and methods are feasible and meet ethical requirements.

1.7 Professional and ethical working relationships with colleagues and participants are maintained.

1.8 Reliable descriptive, quantitative and qualitative information/data gathering methods are identified and used.

1.9 Accurate criteria for selecting information sources are developed and documented.

1.10 Information sources identified are appropriate to the research question/problem.

1.11 Information is gathered that is accurate and appropriate to the question/problem being investigated.

1.12 Research information/data is accurately captured or recorded and documented.

Range of information/data research methods includes: Qualitative, quantitative, descriptive and inferential.

1.13 Research data is correctly described, analysed, interpreted and recorded.

Associated Assessment Criteria for Exit Level Outcome 2

2.1 Specialised health information needs are identified and addressed through structured and unstructured health education.

2.2 Formal and in-service education programmes for specific categories of clinical nurse specialists and other team members are designed and presented to ensure best practice in specialised nursing and health services.

2.3 Programmes for personal and professional growth are designed, implemented and evaluated in collaboration with colleagues and other members of the specialised healthcare team.

2.4 Community development programmes and/or projects are provided through advisory and facilitative processes.

2.5 Consultancy and referral are provided to colleagues through a client, consultative and service-centred process.

Associated Assessment Criteria for Exit Level Outcome 3

3.1 The analysis of research approaches and methods is comprehensive and coherent and includes theoretical and or philosophical orientations about knowledge, reality and truth as well as the implications of these theoretical orientations for selection of techniques and strategies based on particular research problem(s) and questions.

3.2 Analysis and interpretation of research reports (qualitative and quantitative) evidence comprehensive and systematic understanding of data collection techniques, data analysis procedures and principles and the current professional and clinical discourse in a specific area of nursing and midwifery specialisation.

Associated Assessment Criteria for Exit Level Outcome 4

4.1 Specialised health care units, programmes and services at district, provincial and national levels are evaluated and managed in an efficient and effective manner.

4.2 Mentorship to others in the specialised health team is provided by documented short and longer-term relationships and role modelling.

4.3 Team members are developed and supported to cope with the emotional demand of the specialty.

4.4 Professional excellence and competence is maintained through continuing education and life long learning.

4.5 Limitations in ethical, legal and policy guidelines are timeously identified with particular reference to a human rights approach on transforming legislation and civil structures through lobbying and advocacy.

4.6 Patients, families and communities are empowered to access existing appropriate resources.

4.7 The specialised disease profile at district, provincial and national levels and in different settings is correctly determined and interpreted in the formulation of specialised nursing needs of these communities and/or regions.

4.8 Quality assurance activities are conducted to enhance quality in specialised health services.

4.9 Information systems at an aggregate level are developed and maintained.

Associated Assessment Criteria for Exit Level Outcome 5

5.1 Peri-operative factors that threaten health are identified and evaluated through appropriate assessment methods.

5.2 Risk management strategies are developed, implemented and evaluated by assessing the overall health of peri-operative patients.

Associated Assessment Criteria for Exit Level Outcome 6

6.1 Appropriate theoretical frameworks in clinical practice are identified and integrated.

6.2 A substantiated point of view regarding emerging issues and debates relevant to operating theatre nursing is articulated.

6.3 The presentations of the students on issues in the field reflect an understanding of the dynamic and tentative nature of knowledge.

Associated Assessment Criteria for Exit Level Outcome 7

7.1 Assessment of patients is carried out and documented during the pre, intra, post operative phases.

7.2 Procedures associated with the role of a scrub nurse are competently implemented.

Range of procedures includes, but is not limited to: preparing the theatre, instruments and equipment as well as medical and surgical sundries; scrubbing, gowning and gloving; preparing and setting up for the surgical intervention; effective co-ordination of the surgical team; timeous provision of all requirements during surgery through anticipation of needs; transporting and moving of patients.

7.3 Procedures associated with assisting the anaesthetist are competently implemented.

7.4 Cultural sensitivity is demonstrated at all times including during patient assessment, preparation for surgery, disposing of human tissue, preparing and assisting with all methods of anaesthesia, anticipating special needs based on the condition of the patient.

7.5 Procedures associated with the care of the patient in the recovery room are competently implemented and include identifying and managing complications and managing pain.

7.6 The needs of clients are championed by advocacy.

7.7 Quality assurance activities are conducted to enhance the quality of peri-operative services.

Associated Assessment Criteria for Exit Level Outcome 8

8.1 Policies and procedures appropriate for the protection of the health of both employees and the community are analysed, developed and implemented.

8.2 Risk related and disaster management programmes appropriate for a specific industry and hazard are developed in collaboration with essential interdisciplinary team members such as Occupational Hygienists, Toxicologists, Environmentalists, Safety and Ergonomic specialists.

8.3 Management of occupational health issues demonstrates knowledge of legislation applicable to the occupational health environment.

8.4 Health promotion programmes are based on a needs assessment and are relevant to and accepted by both the organisation and employees.

8.5 A realistic health campaign such as aspects of safety or HIV/AIDS prevention, is planned and presented.

Associated Assessment Criteria for Exit Level Outcome 9

9.1 Appropriate theoretical frameworks are identified and integrated in clinical practice.

9.2 A substantiated point of view regarding emerging issues and debates relevant to occupational health nursing is articulated.

9.3 The presentations of the students on issues in the field reflect an understanding of the dynamic and tentative nature of knowledge.

Associated Assessment Criteria for Exit Level Outcome 10

10.1 Advanced specialist assessments relevant to practice are carried out and referred when necessary.

Range of Assessments includes but is not limited to: Audiometry, lung function testing, vision testing, electrocardiography, employee assistance programmes.

10.2 Differentially susceptible groups and individuals vulnerable to risk are identified and their special need in the occupational setting is specified, e.g., reproductive health risks, genetic vulnerability in the presence of identified hazards.

10.3 Relative risk of hazards is identified through workplace risk assessment and priorities in a specific occupational context and/or appropriate management policies are recommended.

10.4 A rehabilitation programme is designed, relevant to the needs of specific clients or groups such as Compensation for Occupational Injury and Diseases (COID) victims and applied in cooperation with the employer and the assistance of the multi-disciplinary healthcare team members.

Associated Assessment Criteria for Exit Level Outcome 11

11.1 A business plan is developed to address occupational health service needs.

11.2 A private practice plan is developed in accordance with ethical and legal guidelines and business registration requirements and presented.

Range of ethical and legal guidelines includes but is not limited to those for Tax, Labour, Equity and Corporate Governance.

Associated Assessment Criteria for Exit Level Outcome 12

12.1 Factors, which promote or threaten renal health are identified, addressed and evaluated by applying appropriate assessment methods.

12.2 Renal health promotion and illness prevention strategies are developed, implemented and evaluated by interrogating the overall renal health care of the community.

12.3 Cultural sensitivity is demonstrated in the assessment of clients, canvassing of organ donors and counselling of organ recipients and their significant others.

Associated Assessment Criteria for Exit Level Outcome 13

13.1 Appropriate theoretical frameworks are identified and integrated in clinical practice.

13.2 A substantiated point of view regarding emerging issues and debates relevant to nephrology nursing is articulated.

13.3 The presentations of the students on issues in the field reflect an understanding of the dynamic and tentative nature of knowledge.

Associated Assessment Criteria for Exit Level Outcome 14

14.1 Detailed assessments of renal function and the effects of renal failure on body systems are carried out.

Range of assessments includes but is not limited to: Initiating specific laboratory tests, History of transplantation and dialysis, Disease progression and Nutritional assessment.

14.2 All types of dialysis for children and adults are initiated timeously and maintained effectively.

Range of Competencies required for effective initiation and maintenance include: Specialist counselling about renal replacement, therapy and rehabilitation; Choosing and preparing apparatus; Initiating, maintaining and terminating dialysis; Pharmacotherapy; Managing complications; Water treatment; Sterilizing and maintenance of apparatus and dialisers; Long term client management; Home-based treatment.

14.3 Paediatric and adult patients preparing for and undergoing kidney transplantations are competently managed.

Range of Competencies include: Donor selection; Pre-transplantation preparation; Organ procurement; Caring for immuno-suppressed patients; Identifying and dealing with post kidney transplant complications; Fluid and electrolyte management; Immediate and maintenance pharmacotherapy; Legal and ethical competence.

14.4 Quality assurance activities are conducted to enhance quality renal care, e.g. infection control.

14.5 Needs of renal patients are championed by advocacy.

Associated Assessment Criteria for Exit Level Outcome 15

15.1 Principles of ventilation are maintained in the application of various modes of ventilation.

15.2 Technologically assisted assessment and support of the various organ systems in critically ill patients (adults and children) is accurately demonstrated.

Range of Assessment includes but is not limited to: Advanced monitoring techniques for all body systems; Evaluation of laboratory tests; Microbiological surveillance; Evaluation of diagnostic tests including electrocardiography and chest X-rays; Evaluation of pain.

15.3 Specialised skill and knowledge in advanced life support and resuscitation techniques of both adult and child are demonstrated.

15.4 Principles of renal replacement therapies are applied in the provision of nursing care to individuals with severe and life threatening renal health problems.

15.5 Knowledge of the causes and pathophysiology of shock is demonstrated during life support and resuscitation interventions.

Associated Assessment Criteria for Exit Level Outcome 16

16.1 The risks of the technological environment are effectively controlled to ensure a safe environment.

Range of Control Measures includes but is not limited to: correct use of equipment, noise management, sensory overload and/or deprivation.

16.2 Implementation of infection control measures is promoted in order to enhance the safety of the critical care environment.

16.3 The psychosocial, cultural and emotional needs of the critically ill patient and their significant others, including patient rights and advocacy, are anticipated identified and managed.

16.4 Ability to contribute to a cohesive multi-disciplinary critical care team is clearly demonstrated.

16.5 Knowledge and skills for effective management of death, dying, and complex ethical issues, (e.g. withdrawal of therapy), within a high stress environment are continuously developed.

16.6 The importance of effective coaching, support and mentorship of the critical care team is explained and demonstrated.

Associated Assessment Criteria for Exit Level Outcome 17

17.1 Theoretical frameworks that underpin critical care nursing practice are described and integrated into clinical practice.

17.2 Articulated points of view regarding emerging national and global issues and policies demonstrate in-depth and critical understanding of relevant discourses in critical care nurses.

17.3 Contributions on complex and controversial debates on critical care nursing issues reflect an appreciation of the dynamic and tentative nature of most human knowledge.

Associated Assessment Criteria for Exit Level Outcome 18

18.1 Advanced knowledge of anatomy and physiology of the adult, including metabolic and biochemical processes of all body systems is displayed during all patient interventions.

18.2 Assessment of the critically ill and high-risk patient is conducted in an integrated manner and includes measures of physical, psychosocial emotional and spiritual needs.

18.3 Specialist nurse competences are utilized effectively in the assessment of the functioning of specific body systems in critically ill patients:

Range of Specific Body Systems must include: Cardiovascular System, including haemodynamic and cardiac monitoring; Respiratory System, including arterial blood gas analysis; Neurological System, including invasive intracranial pressure monitoring, general pain and anxiety; Renal System, including acid-base balance; Metabolic/Endocrine System, including glycaemic control, sleep/rest cycles; Gastro-intestinal System, including nutritional assessment and elimination; Integumentary System, including the assessment of wounds; Haematological system, including coagulation studies; Immune system.

18.4 Laboratory results and special investigations and procedures are interpreted with the clinical interface, recorded and acted on.

Associated Assessment Criteria for Exit Level Outcome 19

19.1 Advanced knowledge of the pathophysiological basis for compromised organ systems in critical illness is applied in the care of critically ill adults.

19.2 Advanced knowledge of the required care of the critically ill adult, using evidence-based interventions, is demonstrated.

Range of Interventions must include: Airway management and respiratory support; Cardiac support, including pacemakers and intra-aortic balloon pumps (IABP); Haemodynamic support; Fluid therapy; Electrolyte imbalance; Acid base imbalance; Nutritional support; Endocrine and metabolic derangements; Pain management and sedation; Thermoregulation; Sepsis surveillance; Basic hygiene and comfort needs.

19.3 Competence in the nursing management of patients who require critical care, including promotive, preventative and rehabilitative measures, is demonstrated.

Range of Compromised Functions must include: Cardiovascular system (CVS) function e.g. acute coronary syndrome, valvular disease, cardiothoracic surgery, and vascular surgery; Respiratory function e.g. acute respiratory failure, ventilator dependency, obstructive and restrictive disorders, and adult respiratory distress syndrome; Neurological function e.g. head and spinal cord injuries, cerebrovascular accidents, neuromuscular disorders; Renal function e.g. acute renal failure: Endocrine function e.g. diabetic keto-acidosis; Gastro-intestinal (GIT) and hepatic function e.g. abdominal trauma, acute pancreatitis, severe GIT haemorrhage, and liver failure; Haematological function e.g. disseminated intra-vascular coagulopathy (DIC); Obstetric related illness including haemolysis-elevated liver enzymes-low platelets (HELLP) syndrome; Immune system e.g. immunosuppressive therapy, infectious diseases, and HIV/AIDS related illnesses.

Range of Multisystem Disorders must include: Multiple organ dysfunction syndrome; Severe sepsis and related syndromes, such as Systemic Inflammatory Response Syndrome, Polytrauma; Physiological shock-all types; Acute Intoxications, including accidental poisoning, recreational drug abuse, intentional drug overdose and Burns.

19.4 Comprehensive knowledge of the pharmacotherapy (including pharmacodynamics and pharmacokinetics) of the various drugs used in the management of the critically ill adult is exhibited during all nursing interventions.

Associated Assessment Criteria for Exit Level Outcome 20

20.1 Factors, which promote or threaten mental health are identified, addressed and evaluated by conducting appropriate methods.

20.2 Mental health promotion and illness prevention strategies are developed implemented and evaluated e.g. stigma prevention.

20.3 The psycho-social well being of the community is facilitated, promoted and maintained through community upliftment programmes.

20.4 Cultural sensitivity is demonstrated in the assessment, process and documentation of psychiatric nursing and mental health care by utilizing, understanding and comparing the various cultural customs pertaining to the practice of psychiatric nursing and mental health care.

Associated Assessment Criteria for Exit Level Outcome 21

21.1 Appropriate theoretical frameworks are identified and integrated in theoretical and practical work.

21.2 A substantiated point of view regarding emerging issues and debates relevant to psychiatric nursing is articulated.

21.3 The presentation of the students on issues in the field reflects an understanding of the dynamic and tentative nature of knowledge.

Associated Assessment Criteria for Exit Level Outcome 22

22.1 Specialised mental health assessment instruments and techniques are utilised during assessment of patient with mental health or psychiatric illnesses.

22.2 Complicated cases are referred and/or competently managed using various competencies.

Range of competencies include but are not limited to: Developing, testing and implementing evidence-based high risk protocols; Personality disorders; Dual diagnosis and Uncommon conditions.

22.3 Specialist psychiatric nursing therapy is carried out using specific therapeutic methods.

Range of Methods include but are not limited to: Individual therapy, Play therapy (if specialising in child psychiatric nursing), Group therapy and Family/marital therapy.

22.4 Referrals from primary health care practitioners of patients with mental health problems or illnesses are accepted and effectively managed.

22.5 Quality assurance activities are conducted to enhance quality mental health practice and psychiatric nursing.

22.6 Needs of mental health clients and their significant others are championed by advocacy.

Associated Assessment Criteria for Exit Level Outcome 23

23.1 Complex health education needs are identified and addressed by structured and unstructured mental health education.

23.2 Formal and in-service education programmes for psychiatric nurses and other team members are designed and presented to ensure best practice in mental health services.

23.3 Programmes for personal and professional growth of psychiatric nurses are presented on a continuous basis.

23.4 Evaluation of students is done in a valid and reliable manner to ensure competent mental health practitioners.

Associated Assessment Criteria for Exit Level Outcome 24

24.1 Factors, which promote or threaten maternal and neonatal health are identified and evaluated by conducting appropriate assessment methods.

24.2 Maternal and neonatal health promotion and illness prevention strategies are developed, implemented and evaluated by interrogating the overall reproductive health of the community.

24.3 Cultural sensitivity is demonstrated in the assessment, processing and documentation of maternal and neonatal health care by comparing and utilizing the various cultural customs pertaining to the practice of midwifery nursing and maternal health care.

Associated Assessment Criteria for Exit Level Outcome 25

25.1 Appropriate theoretical frameworks are identified and integrated in theoretical and practical work.

25.2 A substantiated point of view regarding emerging issues and debates relevant to midwifery care is articulated.

25.3 The presentation of the students on issues in the field reflects an understanding of the dynamic and tentative nature of knowledge.

Associated Assessment Criteria for Exit Level Outcome 26

26.1 Assessments of mothers and neonates complicated by psychosocial, physical, service related or other factors are carried out.

26.2 Advanced procedures of reproductive health are competently implemented.

Range of Procedures must include: Sexually transmitted diseases (STD) management; Family planning; Prescription and/or administration of specific medication and Internal foetal monitoring.

26.3 Complicated cases at ante-, intra- and postnatal stage are referred or competently managed.

Range of Competencies must include: Developing, testing and implementing evidence-based high risk protocols; Assisted delivery; Resuscitating the neonate and Assisting with operating theatre procedures.

26.4 Referrals from primary health care practitioners of patients with midwifery problems or illnesses are accepted and effectively managed.

26.5 Quality assurance activities are conducted to enhance reproductive services.

26.6 Needs of mothers and neonates in high risk pregnancy and/or delivery are championed by advocacy.

Associated Assessment Criteria for Exit Level Outcome 27

27.1 Factors, which promote or threaten public health are identified and evaluated by means of epidemiological surveys, population based studies and participatory research.

27.2 Public prevention strategies are developed, implemented and monitored against specific indicators and factors.

27.3 Cultural sensitivity is demonstrated during interaction with team members and communities.

Associated Assessment Criteria for Exit Level Outcome 28

28.1 Appropriate theoretical frameworks are identified and integrated in theoretical and practical work.

28.2 A substantiated point of view regarding emerging issues and debates relevant to public health nursing is articulated.

28.3 The presentation by the students on issues in the field reflects an understanding of the dynamic and tentative nature of knowledge.

Associated Assessment Criteria for Exit Level Outcome 29

29.1 Complex public health issues are referred and/or effectively managed, within the multidisciplinary healthcare team approach.

Range of Competencies utilised must include: Developing, testing and implementing evidence based protocols; Environmentally focused strategies; Health behaviour strategies; Project/programme planning, implementing and evaluating, according to specific population group needs; Human resource analyses and plans and Promoting supportive environments through targeted strategies addressing specific needs.

29.2 Quality assurance activities are conducted to enhance quality public health service.

29.3 Public health needs are made visible by advocacy.

29.4 Epidemiological principles are applied in developing strategies to meet those needs.

Associated Assessment Criteria for Exit Level Outcome 30

30.1 Principles and theories of causal analysis, conditional, individual and collective relationships, genetic and environmental factors and their inter-relationships are identified and analysed in order to establish a population-based diagnosis of health status and disease burden.

30.2 Epidemiological principles and methods of the natural history (course and outcome) of identified problems are applied, in order to support preventative and clinical strategies and influence behaviour and lifestyle changes in population wellness promotion.

30.3 Appropriate and implementable control strategies for the management and prioritisation of identified chronic, communicable diseases and social pathologies are developed.

Range of diseases and pathologies must include: HIV/AIDS, Tuberculosis, Carcinoma, Heart Disease, Violence of all types and in all situations.

Associated Assessment Criteria for Exit Level Outcome 31

31.1 Management of a health care system reflects the application of the management process.

31.2 Evidence based practice indicates that work related behaviour is grounded in the management processes.

Associated Assessment Criteria for Exit Level Outcome 32

32.1 Management and leadership theories/models are critically analysed and compared.

32.2 The choice of appropriate management and leadership theories relevant to a particular context are identified, implemented and combined with an understanding of the clinical realities.

32.3 Analysis and interpretation of management research reports (quantitative and qualitative) evidences comprehensive and systematic understanding of data collection techniques, data analysis procedures and principles and the current scholarly discourse in management.

Associated Assessment Criteria for Exit Level Outcome 33

33.1 The principles of organising are applied to ensure the achievement of objectives in the defined health care service.

33.2 Essential resources to implement managerial plans or programmes are mobilised within and outside the health care system through effective networking and utilization of grants.

33.3 Critical thinking, problem solving and decision-making skills are applied to optimise the organisation and functioning of the defined health care service.

Associated Assessment Criteria for Exit Level Outcome 34

34.1 The quality control criteria for management and performance applicable to the service are selected and applied to improve the quality of the management and service delivery of the defined service.

34.2 Professional excellence and competence is maintained through continuing education and life long learning.

Associated Assessment Criteria for Exit Level Outcome 35

35.1 Planning for and providing human resources are executed within the relevant legislation and policy guidelines.

35.2 Maintenance of human resources is undertaken by taking cognisance of personal and professional needs.

35.3 Effective utilisation of human resources is ensured by means of correct placement and appropriate skill application.

35.4 Assessment and development of human resources is undertaken on continuous bases.

Associated Assessment Criteria for Exit Level Outcome 36

36.1 On the basis of an assessment, the vision, mission, generally accepted protocols (GAP) analysis, objectives and action plans are developed.

36.2 A strategic plan is developed and implemented to ensure organisational goal achievement.

36.3 An organisational structure for the defined service is designed and the implementation explained.

36.4 Applicable policies and procedures are formulated to address the implementation of the action plan.

36.5 The human resource plan includes task analyses, job descriptions, personal and professional development and a skills development plan.

36.6 A customer care plan incorporates all the relevant stake holders.

36.7 Information and quality management programmes, consistent with identified needs, are developed, explained to stakeholders and implemented.

36.8 An industrial relations policy and plan is developed and implemented for the health care service.

36.9 A financial plan is developed and includes capital, operational and human resource budgets to facilitate cost effective and quality patient care.

Associated Assessment Criteria for Exit Level Outcome 37

37.1 A performance appraisal system to determine productivity is developed and implemented.

37.2 Productivity is determined through appropriate measures, handled effectively and rectified where necessary.

37.3 Customer and stakeholder satisfaction is determined through appropriate measures and rectified where necessary.

37.4 Trends identified by means of the information system accurately reflect the performance within the defined service.

37.5 A meta-assessment of the evaluation process is performed.

Associated Assessment Criteria for Exit Level Outcome 38

38.1 Knowledge and understanding of a health care organisation as a business and the implementation of general management principles are demonstrated.

38.2 The functional management of marketing and public relations within a health care service context is applied.

38.3 The financial function of a health care unit as a business, in terms of asset management, financial decisions, operations management, purchasing functions and activities, and the provision of human resources, are applied.

38.4 Contemporary health care management issues such as absenteeism and high turnover rates, extreme staff shortages, private practice, diverse health environments and commissioning of a health service are critically analysed.

Associated Assessment Criteria for Exit Level Outcome 39

39.1 An understanding of the nature, content, and scope of public administration is demonstrated.

39.2 The typical clients of public health, welfare and housing services in South Africa and the available resources are described.

39.3 The provision and organisation of public services are critically analysed.

39.4 The interrelationship between management of public service provision, power and public functions are argued.

Associated Assessment Criteria for Exit Level Outcome 40

40.1 Critical analysis of adult development, learning (cognitive, behavioural, social, transformative and experiential) and motivation theories shows comprehensive understanding of a range of aspects including, conceptualisations of knowledge, teaching, learning, basic assumptions, and andragogical implications for nursing and midwifery education and is valid in accordance with current discourses about teaching/learning in professional education.

40.2 Teaching practice in nursing and midwifery is based on understanding of adult development, learning and motivation theories as evidenced by the creation and maintenance of an active learning environment, thus allowing students space to question their meaning perspectives about health and illness.

Associated Assessment Criteria for Exit Level Outcome 41

41.1 Critical analysis and synthesis of the philosophical basis of nursing is based on recognised contemporary nursing theories and models which are relevant to the current sociopolitical context of nursing practice.

41.2 Analysis of nursing and midwifery decisions is supported by particular models or theories of nursing and takes into consideration the legal and ethical frameworks of nursing practice as well as the socio-political, economic and cultural contexts in which such decisions have to be made.

41.3 Critical analysis of educational philosophy with regard to its implications for nursing and midwifery education is in accordance with rules of consensual validation.

41.4 Inferences on the implications of educational theory on teaching nursing and midwifery are based on comprehensive analysis of the current discourses on the nature and purpose of professional education.

41.5 Critical analysis, synthesis and independent evaluation of global policies and issues impacting on nursing and midwifery education is supported by an extensive and integrated review of literature and current research on issues such as managing diversity in the learning environment, globalisation and the nursing workforce, global health, Recognition of Prior Learning (RPL).

Associated Assessment Criteria for Exit Level Outcome 42

42.1 A coherent and critical understanding of the importance of congruency between expected learning outcomes and the teaching/learning process supports evaluation of various teaching strategies with regard to their effectiveness in facilitating deep and self-directed learning in clinical and classroom settings.

42.2 Teaching plans and implementation thereof, place emphasis on collaborative learning, student needs and differences, development of self-directed learning, inquiring minds, as well as the complexity and unpredictability of clinical learning environments.

42.3 Identification, selection and combinations of assessment approaches and strategies are based on a coherent and logical understanding of the requirements of applied competence and integrated assessment and meet the criteria for credible, trustworthy, feasible, and valid assessment.

42.4 Assessment of clinical learning in particular is largely undertaken in a real-world practice environment where appropriate, and/or simulated clinical learning environments are utilised.

42.5 Competence in assessment is compliant with the Higher education and Training requirements for learner assessment.

42.6 Teaching scholarship is evident in the identified areas of research as well as application of best-practice evidence in nursing and midwifery education.

Associated Assessment Criteria for Exit Level Outcome 43

43.1 Critical analysis of curriculum development theory and models includes philosophical underpinning and implications thereof for the curriculum development process in nursing and midwifery education.

43.2 The designed curriculum is comprehensive and includes all the steps of curriculum development as verifiable with any standard curriculum development text in nursing and midwifery education and is a collaborative piece of work involving peers.

43.3 The designed curriculum is appropriate in terms of the relevant Statutory Council's guidelines and regulations for a particular programme of nursing and/or midwifery and current national health policies on human resource development for health.

Associated Assessment Criteria for Exit Level Outcome 44

44.1 Approaches and theories of educational management are interrogated and critically analysed in terms of their applicability and relevance to managing nursing education institutions within the context of the current situation in nursing education in South Africa with regard to governance, programmes, financing and provision.

44.2 Analysis of the current situation in nursing and midwifery education evidences a comprehensive and reflective understanding of the implications of the dual systems of governance and provision of nursing education for coherent programming and financing of nursing education.

44.3 Evaluation of the nursing education institution's quality management systems shows a broad understanding of principles and aims of institutional quality management systems in Higher Education in South Africa and globally, with specific reference to the requirements of the relevant Quality Control bodies for quality improvement and assurance.

Integrated Assessment

Formative Assessment is carried out throughout the duration of learning. It may take the form of a variety of assessment strategies, including, but not limited to:

• Clinical case studies and reports.
• Literature reviews.
• Assignments.
• Projects.
• Portfolios.
• Tests.
• Peer group assessment.
• Clinical assessments.
• Panel interviews.
• Discussion Papers.

Summative Assessment is carried out at the end of the duration of learning and may include, but is not limited to

• Written examinations.
• Clinical examinations.
• Treatise.