Postgraduate Diploma in Occupational Health Nursing

Purpose

The Postgraduate Diploma in Occupational Health Nursing provides a career path for professional nurses who want to stay within the field, but who would like to focus on an area and add to their depth of knowledge and skill. The purpose of the qualification is to produce an accountable expert and competent professional nurse, implementing evidence-based and business practices as a strategic leader in planning, organising, and managing human and financial resources, quality management, and projects within a multidisciplinary team in units of a range of settings, while complying to ethical, legal, and professional frameworks to serve the health needs of the community. Persons in scholarship for this qualification will become experts in occupational health nursing. The public and private industries are legally required to provide for the health and safety needs of their employees and therefore need qualified specialists to provide the service. The focus of the qualification will be to extend theory and its application in the occupational health field. Typical learning activities should include the study of appropriate specialist knowledge, case studies and integrated work-based learning.

More specifically, the qualification aims to

• Produce high-quality and competent specialist nursing practitioners in the occupational health field.
• Provide occupational health specialists with a range of skills, knowledge and attitudes that will enable them to set trends and take leadership roles in a meaningful and sustained contribution to health and safety services.
• Equip specialists with a developed sense of equity, justice and service ethics that will ensure accountability irrespective of their workplace.
• Offer a wide range of transferable skills for application in other professions, disciplines, and general life. These include the ability to influence areas of policy change, development, and implementation; plan, implement and manage projects of a varied nature and work independently and as part of a team.

On completion of the qualification, qualified learners will be able to

• Manage a healthcare facility within the ethical-legal parameters of the speciality.
• Apply principles of knowledge translation to promote evidence-based nursing education to improve the quality of occupational health nursing.
• Render and co-ordinate patient-centred occupational health nursing practice within a continuum of care using the scientific approach, integrating biomedical and psychosocial sciences including advanced pharmacology.
• Apply and understand theoretical frameworks, principles, models and emerging debates and trends to contemporary occupational health nursing practice in conjunction with the inter-professional team.
• Resolve ethical dilemmas by using decision-making and moral reasoning models.
• Apply knowledge and principles of the systematic review and guideline development process to evaluate the standard of guidelines used in a specific speciality in nursing.
• Critically reflect on clinical occupational health nursing practice as part of the cycle of continuous quality improvement.
• Implement Quality Assurance strategies in line with the national as well as other internationally recognised standards.

As qualified specialist occupational health nurses, they have access to more senior practitioners and can affect policy in the local setting. They will act as leaders, consultants, educators, and specialist practitioners in providing evidence-based occupational healthcare to team members. Qualified persons will be able to work as occupational healthcare specialists in public and private industries that have more than 50 employees. The specialist sets the level of and leads professional nurses to execute care. The specialist defines the care of the client.

Rationale

The Occupational Health and Safety legislation has changed since 1994 and internationally accepted management system standards such as ISO 14001 and OHSAS 18001 demand compliance with safety, health, and environmental legal requirements as a minimum performance specification. The National Occupational Health and Safety Policy (23 July 2003), the establishment of Occupational Health Services in the public and private sectors, legalised a very important dimension of nursing in South Africa. The aim of Occupational Health Services is to provide a safe working environment for each employee. These services demand adequately trained healthcare practitioners with the necessary knowledge, skills, and competences to maintain high-quality and comprehensive Occupational Health and Safety services in the workplace or occupational healthcare environment. The Occupational Health Nurse Practitioner plays a key role in the health and safety of employees and employers as the first-line practitioner for the prevention, detection, treatment, and education. The qualification has been developed to address the immediate need for professional development and capacitating in the field of Occupational Health Nursing. Stakeholders were widely consulted at Fundisa and the South African Nursing Council (SANC) to obtain the necessary information on the required learner profile, knowledge and attributes required by hospitals and clinics, the public and private sectors, including primary, secondary, and tertiary levels of care. The competencies for the qualification were issued by SANC. National and provincial policy documents issued by the Department of Health guided the theoretical component of the curriculum.

There is a shortage of Occupational Health Nurses (OHNS) in the field. Regarding the HRH (2011, 44). Occupational Health Nursing is currently not listed under Nursing Specialist Qualifications and very recently, South African Nursing Council (SANC) recognised the need for competencies to define the roles and responsibilities of nurse specialists within their respective fields of specialisation. SANC's consultation on competencies, with occupational health nursing being included as one of these specialisation areas, was posted in February 2013 (SANC, 2013). The South African Nursing Council has now initiated the developed competencies for and designated this qualification as a specialist nursing qualification. The qualification will develop a specialist nurse practitioner with advanced knowledge and expert clinical skills in line with the National and Provincial Healthcare Plans and Sustainable Development Goals as guided by the World Health Organization (WHO). This will promote the health status of the South African population and alleviate the lack of skills and practitioners to address the quadruple burden of disease in the healthcare system.

Based upon its long-standing and respected expertise in training professional nurses, academic capacity, capability, and infra-structure, the institution has the expertise to train nurses who will be able to function as specialists in the field of occupational health. Through the development of the intellectual, practical and research competencies in occupational health settings these nurse experts will function in the capacity of leaders, consultants, educators, advanced practitioners, and researchers in providing evidence-based care in collaboration with multidisciplinary team members. The White Paper for the transformation of the Health System in SA (1997) stated that the development of occupational health services is a key priority area of the Reconstruction and Development Programme and the Department of Health. This White Paper identified five principles to be implemented as, in the past, no special effort was made by the public sector to provide occupational health services (Department of Health, 1997: 147). The National Health Act (No 61 of 2003) Chapter 4, Section 25 (2)(r) clearly states that provincial departments must provide occupational health services.

A strong need exists to bring about alignment to the profession, with nationally recognised qualifications providing for different areas of specialisation. This qualification will be offered to increase the number of qualified nurses who can practice within a specialised field in hospitals, clinics, industries, and communities in both the public and private sectors. The health sector needs qualified specialists both to improve practice and to train other nurses. The focus of the qualification will be to extend theory and its application in practice. Analytical and critical thinkers must be developed to build the scientific knowledge base of nursing related to the health of persons at the workplace. The scope of practice for occupational health nurses in South Africa is inevitably much broader with aspects of care for the employee's families and communities. The knowledge and skills obtained will serve as underpinning elements for the learner to provide safe community-based health care in a variety of settings. The learner will be expected to understand the roles and relationships in healthcare teams, and settings and display the application of these principles in managing the healthcare settings. The lesser number of doctors available means there is a need for a higher ratio of nurse specialists. This is especially relevant to occupational health where the nurse specialist's hours on-site generally far outweigh those of the medical practitioner.

Qualifying candidates will be able to deliver comprehensive care to individuals, and groups in occupational health clinics, units, or facilities. They will therefore perform effectively complex physical, technological and diagnostics assessments, interrogate multiple sources of information and use a range of specialised skills to analyse and address multifaceted problems and perform intricate procedures, taking full responsibility for their decision-making. In addition, they will be able to communicate applicable information to a range of audiences, offering creative insights and solutions to problems and issues appropriate to the context in terms of a valid ethical and professional value system. In addition to professional skills development in the field of Occupational Health, the qualification allows a successful candidate to obtain a nationally recognized qualification that permits access to horizontally and vertically articulated qualifications within the Higher Education Qualifications Sub-Framework (HEQSF), improving the status and employability of candidates working within the field of Nursing and Health Services, as well as providing opportunities for further studies and research in the field. Successful completion of this qualification will entitle the learner to register for an additional nursing qualification with the South African Nursing Council (SANC) as an Occupational Health Nurse Practitioner.

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 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.

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 credits

• 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

• Bachelor of Arts in Nursing Science, NQF Level 7.

Or

• Bachelor of Health Sciences, NQF Level 7.

Or

• Advanced Diploma in Nursing, NQF Level 7

And

• Registration with the South African Nursing Council (SANC) as a registered/professional/general 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

• Professional Ethical-Legal Practice: Occupational Health Nursing, 8 Credits.
• Evidence-based Practice: Occupational Health Nursing, 8 Credits.
• Management and Professional Development: Occupational Health Nursing, 8 Credits.
• Occupational Health Nursing Theory, 40 Credits.
• Occupational Health Nursing Practicum, 40 Credits.
• Quality improvement project: Occupational Health Nursing, 16 Credits.

1. Demonstrate the ability to practice and facilitate occupational health nursing within the ethical-legal parameters of the profession.
2. Apply the knowledge of and facilitate evidence-based practice in occupational health nursing 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 occupational health nursing profession and provision of occupational health nursing specialist professional support for personnel, patient or client, families, and communities.
5. Engage in planning, commissioning, and managing an occupational health nursing specialist unit.
6. Engage in scholarly activities to inform evidence-based occupational health nursing practice.
7. Utilise, manage, and communicate data to support decision-making and research.
8. Render and co-ordinate patient-centred occupational health 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 occupational health nursing, to ensure quality patient care and safety
10. Collaborate within the inter- and intra-professional team by engaging in health dialogue, shared leadership, decision making and sound clinical judgement.
11. Participate in the design, development, implementation and evaluation of nursing policies, programmes, and projects at provincial or national level.
12. Develop and implement institutional policies, protocols, and guidelines in specialisation, utilising the process of change management to improve of quality of care.

Associated Assessment Criteria for Exit Level Outcome 1

• Adhere to and apply the relevant code of ethics in the practice of specialist nursing.
• 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 provided, and continued competence.
• Identify and apply relevant current legislation, policies, regulations, and guidelines pertaining to specialist practice.
• Document accurately, comprehensively, and timeously all care activities considering the legal requirements for record keeping.
• Manage professional misconduct and risks taking into consideration the institutional protocols, protocols, and ethical-legal framework.

Associated Assessment Criteria for Exit Level Outcome 2

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

Associated Assessment Criteria for Exit Level Outcome 3

• Apply leadership skills, appropriate leadership styles, principles, and theories of health services management.
• Effectively facilitate Continuous Professional Development (CPD) for self and others for lifelong learning by creating a positive learning climate in the workplace through the processes of mentorship, preceptorship, supervision, and performance appraisal.
• Conduct performance appraisal according to the purpose and processes of the performance management and development system.
• Use feedback gained from self-reflection, peers, learners, management, and other relevant stakeholders to improve effectiveness in the specialist role.
• Identify and analyse 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 Outcome 4

• Explore and explain the purpose of the advocacy role for a nurse 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/or participate in interest groups to influence legislation and policy affecting the role performance.

Associated Assessment Criteria for Exit Level Outcome 5

• Debate the key levels and/or classification of the respective specialist units.
• Delegate tasks considering the burden of diseases and priority services as determined by current events.
• Evaluate the existing specialist unit and review guidelines for provisioning a specialist unit.
• Plan and delegate roles and responsibilities within the inter and intra-professional team.

Associated Assessment Criteria for Exit Level Outcome 6

• Apply search strategies such as Boolean in conducting searches in different databases in occupational health nursing.
• Conduct literature review in occupational health nursing specialisation to inform evidence-based practice.
• Apply appropriate methods to generate evidence for utilisation in specialist practice (e.g., research, systematic reviews etc.).
• Consult peer reviewed journals and use for sharing of evidence.
• Conduct activities in the specialist practice based 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

• Document all data/information gathered in the context of the specialist practice for utilisation and storage in accordance with the set standards.
• Use comprehensive data, information, and emerging evidence pertinent to the occupational health nursing specialist practice.
• Identify and diagnose the problem and opportunities for improvement based on gathered and critically analyse assessment data from the patients/clients, families, communities, learners, or employees including current scientific evidence.
• Observe intellectual property and minimise and/or avoid plagiarism when presenting documents.

Associated Assessment Criteria for Exit Level Outcome 8

• Critique the position of own specialist service within the health care system.
• Perform a full range of nurse specialist services within the specialist area of practice.
• Render specialist care and integrate promotive, preventive, curative, rehabilitative and palliative care in a healthcare continuum.
• Render specialist care service in accordance with national and international standards and protocols of the specialist field.
• Formulate nursing diagnoses in congruent with the patient's/client's clinical manifestations/data 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.
• Plan and implement individualised nursing interventions considering patient's/client's needs, values, beliefs, preferences, culture, and contextual variables, for example, disease burden, health risks and national priorities.
• Apply specialised knowledge and skills (competencies) including advanced pharmacology in collaboration with the inter and intra-professional team.
• Implement nursing interventions timeously, accurately, safely, and effectively in accordance with set evidenced-based standards, guidelines, protocols, algorithms etc. specific for the specialist field.
• Plan and implement health care interventions in collaboration with the patient or client, family, and relevant members of the health care team.
• Prepare patients/clients, families, and nurses in the lower-level care for continued care in the hospital and community in accordance with the health status and health literacy of the patient/client.
• Document and revise nursing interventions timeously and effectively based on critical analysis of the monitoring and evaluation data and reaching a sound clinical judgement.

Associated Assessment Criteria for Exit Level Outcome 9

• Identify the infrastructure and equipment needed in the specific area of specialisation.
• Render care demonstrates ability to 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 nursing care considering the specialist qualification and 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 specialist area by informed decisions and sound clinical judgement.
• Consult appropriately and timeously in the provision of holistic care in a healthcare continuum through awareness of one's competence.
• Carry out patient referral appropriately and timeously as dictated by the patient's condition and in accordance with the referral guidelines.
• Participate in the inter- and intraprofessional team is promoted, visible and recognised by the members of the team.

Associated Assessment Criteria for Exit Level Outcome 11

• Identify and analyse the steps in the levels of the development of policies, programmes, and projects.
• Discuss own role and responsibilities within the inter and intra-professional policy/project team.
• Advocate for the nursing profession and patients/clients, families, and communities in the specialist area.
• Participate, through appropriate communication (negotiation, bargaining, assertive and persuasive), in the design, implementation and evaluation of project or policy development with the inter-professional project or policy development team and give timeous feedback to own constituency.

Associated Assessment Criteria for Exit Level Outcome 12

• Examine and apply the process and steps of development of policies, standards, guidelines, and protocols.
• Involve the relevant and pre-determined stakeholders in the development of policies, standards, protocols, and guidelines.
• Apply the appropriate methods in the development and evaluation or testing of guidelines and protocols.
• Apply the change process in the implementation of the new policies, protocols, and guidelines to the specialist area.
• Collaboratively revise the developed policies, protocols, and guidelines at appropriate intervals and approved as per the institutional policy for the specialist area.

INTEGRATED ASSESSMENT

Assessment will take place within the context of the quality assurance policies, procedures, and processes of the institution and in a guided and supported learning environment. Baseline assessment will be done during contact sessions by means of introductory questions to determine prior knowledge of learners. Questioning will be used to determine if difficult concepts and information were successfully mastered. Group participation, organisational skills, leadership, cooperation, initiative, and creativity of individual learners will be assessed within group activities.

A combination of different assessment methods allows for testing a wide variety of outcomes and are indicative of learners' progress. An effort is also made to constructively align the assessment methods, assessment tasks, learning opportunities and learning outcomes. The evidence will be compiled in a portfolio.

Formative Assessment

project report Formative assessment will be done by means of completion of workbook activities, group discussion, immersive simulation, and reflection after clinical learning experiences. All modules will use continuous assessment activities which will accumulate into a general portfolio. Constructive feedback will be given following academic interaction with learners. Continuous assessment will be used for the other four modules.

Learning outcomes will be assessed by means of continuous assessment through

• Completion of workbook activities per contact session.
• One individual assignment.
• Two tests.
• Group assignment.

Evidence of attaining the competences for the module on professional development are

• A comprehensive individual report on precepting novices in clinical practice.
• A performance improvement plan and self-evaluation report.

Summative Assessment

A combination of different summative assessment methods allows for testing a wide variety of outcomes. The learning outcomes, learning opportunities and the assessment tasks are constructively aligned. Examples of summative assessment tasks include but not limited to:

• Written tests.
• Written examinations.
• Proficiency tests.
• Case presentations.
• Case studies.
• Project reports.
• Written assignments.
• Portfolio.

Assessment is done by the student, peers, and registered assessors. Evidence of learning are

• Two to three written tests per semester.
• Three to four electronic formative tests.
• Two assignments.
• One three-hour examination per semester.