Postgraduate Diploma in Oncology and Palliative Nursing

Purpose

The Postgraduate Diploma in Oncology and Palliative Care Nursing has been designed to promote a deeper engagement with knowledge and professional practice at the forefront of the nursing profession. The qualification includes fundamentals in research to enable an understanding of the theoretical and ethical underpinning knowledge of various methodologies and designs of research to inform practice as well as encourage the development of critical and reflective nurse practitioners. Qualifying learners will enhance their professional practice and career development by gaining leadership and management knowledge and skills as well as develop an advanced level of knowledge and critical thinking skills that will prepare them as specialists, to manage patients, their families, and communities, admitted to any oncology and palliative facility. This qualification provides a career path for professional nurses nationally who want to stay in a clinical context, but who would like to specialise, with a focus on oncology and palliative nursing, and add to their depth of knowledge and skills.

The qualification aims to broaden the range of the learner's abilities and prepare them to be at the forefront of healthcare management and professional practice in general health services, midwifery, and specialty units empowered to demonstrate ethical and socially responsible behaviours and effective teamwork, communication, and presentation skills. Qualifying learners will establish a research culture that will lead to evidence-based and reflective practice, ensuring holistic quality patient-focused care for individuals, groups, and communities within the health care system.

The purpose of this qualification is to offer a professional nursing specialisation that combines conceptual and contextual knowledge, skill, and the resultant necessary applied competencies, to enable the oncology and palliative nurse specialist to competently apply scientifically based oncological and palliative health strategies and technologies geared towards the promotion of healing of the cancer patient, prevent complications and to alleviate suffering in the palliative patient.

Upon completion of this qualification, qualifying learners will be able to

• Demonstrate foundational and conditional knowledge of inter-professional people-centred oncology and palliative nursing care of people in a variety of settings to promote positive health outcomes.
• Render and coordinate comprehensive inter-professional people-centred oncology and palliative nursing care to patients in a variety of institutes to promote positive health outcomes.
• Understand and apply theoretical frameworks, principles, models, and emerging debates and trends to contemporary oncology and palliative nursing practice in conjunction with the inter-professional team.
• Demonstrate knowledge of and rendering and coordination of comprehensive inter-professional people-centred risk and resource management within oncology and palliative nursing settings.
• Participate in the design of and development, implementation, and evaluation of oncology and palliative nursing policies, standards, protocols, and guidelines
• Apply knowledge of basic research methodology in the appraisal of research articles in oncology and palliative nursing.
• Manage a healthcare facility within the ethical-legal parameters of oncology and palliative nursing.
• 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 oncology and palliative nursing.
• Work as a specialist practitioner with other team members within the health care system for the promotion of oncology and palliative nursing and the prevention of cancer-related diseases.
• Demonstrate an informed and critical understanding of the principles, theories, and emerging issues and debates in oncology and palliative nursing.
• Apply specialist knowledge and skills in the oncology and palliative management and care of individuals and groups.
• Maintain excellence in practice as an Oncology and Palliative specialist practitioner in a variety of settings.

Rationale

The rationale of the qualification is to develop a specialist nurse practitioner with advanced knowledge and expertise in clinical skills in line with the National and Provincial Healthcare Plans and Sustainable Development Goals as guided by the WHO (2015). This will promote the health status of the South African population and alleviate the lack of skills and practitioners in order to address the quadruple burden of disease in the healthcare system.

The South African Nursing Council (SANC) has developed competencies for and designated this qualification as a specialist clinical nursing qualification. Nursing specialisations such as oncology and palliative nursing are a direct articulation from the undergraduate nursing qualification to the Postgraduate Diploma which offers a career path for oncology and palliative nurses.

This specialist nurse works within a multidisciplinary team in facilities in a range of settings complying and aligning with ethical, legal, and professional frameworks that prescribe their scope of practice according to the South African Nursing Council (SANC) to serve the health needs of patients, their families, and the communities.

The Gazette (2018) made the National Scarce Skills list available. The background of the list has shown that the provision of education and training must be coordinated with the needs of society and the skills required to provide for these needs. South Africa has identified the current and future occupational demands to ensure that the goals of the National Development Plan, New Growth Path, and the Industrial Policy Action Plan are achieved. The primary purpose of the National Scarce Skill list was to improve the responsiveness of the Post-School Education and Training System (PSET). The list is important for enrolment planning, decision-making on how to prioritise resource allocation, qualification development, and career information and advice. The 2020 list of National Scarce Skills confirms the fact that Healthcare Professionals and related clinical science are third on the list, with the Clinical Nurse Specialist as a priority (Critical Skills Occupational List, 2020).

The National Cancer Strategic Framework 2017 - 2022 is outlined in the National Development Plan (2015) to demonstrate how the country is committed to reducing the burden of cancer amongst South Africans, through training, this strategy was developed to ensure that all people have access to health services to control and prevent cancer, being treated by competent oncology nurses.

Cancer incidence and prevalence have been increasing internationally and in South Africa. Global cancer statistics have shown that cancer kills more people each year than AIDS, tuberculosis, and malaria together (CANSA, 2020). As reported by Bray, Ferlay, Soerjomataram, Siegel, Torre, and Jemal (2018), the 2018 GLOBOCAN statistics indicate that in 2018, there were over 18 million new cases of cancer.

The need to train more oncology and palliative clinical specialists is related to the increasing number of cancer cases and the number of private oncology units and practices that need to deliver care to cancer patients. Legislation at SANC and ethical issues in the field of oncology require nurses to specialize before embarking on employment in this field of practice. At the World Health Assembly in Geneva (2017), the current WHO Global Action Plan on Non-Communicable Diseases (NCDs) and the ambitious targets of the United Nations (UN) Sustainable Development Goals (SDGs) 2030, including SDG 3 (Good health and well-being) were highlighted, which creates a timely imperative to invest in cancer, a leading NCD killer. With 1 in 3 people directly affected by cancer and 8.8 million annual deaths, this disease is one of the world's most pressing health concerns worldwide (CANSA, 2020).

The South African Nursing Council has issued a Regulation on the new Scope of Practice for the clinical specialist (SANC, 2020)) emphasising the promotion of the health of the communities throughout the lifespan (Government Gazette no 43305, 2020). The oncology and palliative nurse practitioner will function independently within the scope of practice of the specialist nurse, as formulated by the South African Nursing Council. The draft of the Scope of practice (2020) emphasises the importance of the specialist. The oncology and palliative nurse practitioner will function independently within the Scope of Practice of the Specialist Nurse (Regulation of June 2020), as formulated by the South African Nursing Council.

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 Occupational Health Nursing, NQF Level 7

Or

• Bachelor of Nursing Science, NQF Level 7

Or

• A relevant qualification in the related field, NQF Level 7.

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

Compulsory Modules, Level 8, 120 Credits

• Fundamentals in Research, 8 Credits.
• Professional Practice, 8 Credits.
• Research Methodology, 8 Credits.
• Research Project in Oncology and Palliative Nursing, 16 Credits.
• Professional Development, 8 Credits.
• Management and Leadership, 8 Credits.
• Theoretical foundations in Oncology and Palliative nursing, 16 Credits.
• Biomedical assessment of the cancer patient, 16 Credits.
• Scientific nursing care of the cancer patient, 16 Credits.
• Quality assurance in Oncology and Palliative Nursing, 16 Credits.

1. 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.
2. Facilitate advocacy for the profession and provision of specialist professional support for personnel, patient, client, families, and communities.
3. Conduct services in a legal, ethical, and professional environment, resolving and reflecting on ethical dilemmas by using decision-making and moral reasoning models suitable for different ethical value systems.
4. Demonstrate critical decision-making and moral reasoning models and principles to resolve ethical dilemmas within the specialty practice.
5. Communicate and manage data to support decision-making and research.
6. Appraise and develop self, peers, and nurse specialists by facilitating self-directedness, leadership, and lifelong learning to maintain competence.
7. Demonstrate understanding of the process of commissioning at different levels and classifications of the specialist units, health services, or educational entities.
8. Collaborate within the inter-and intra-professional team by engaging in health dialogue, shared leadership, decision-making, and sound clinical judgement.
9. Render and co-ordinate patient-centred oncology and palliative nursing practice within a continuum of care.
10. Mobilise appropriate resources to implement standards of practice relevant to the area of Specialisation, to ensure quality patient care and safety.
11. Participate in the design, development, implementation, and evaluation of nursing policies, programmes, and projects at a provincial or national level.

Associated Assessment Criteria for Exit Level Outcome 1

• Differentiate the different research approaches and designs.
• Engage in specialist practice, demonstrating an understanding of the process of evidence-based practice as applied in research.
• Apply evidence-based specialist practice in the field of specialisation, taking into consideration the appropriate methodology of gathering research evidence for example, systematic or scoping reviews, appraisal of articles, practice based-research and publication.
• Use of evidence-based practice, in the field of specialisation demonstrating knowledge of and critical analysis of the various levels of evidence for nursing.

Associated Assessment Criteria for Exit Level Outcome 2

• Adhere to the relevant code of ethics in the practice of specialist nursing or midwifery, nursing education and health services management.
• Demonstrate accountability for own professional judgement, actions, outcomes of specialist nursing care and management provided, and continued competence.

Associated Assessment Criteria for Exit Level Outcome 3

• Identify and apply legislative and regulatory requirements pertaining to specialist nursing practice.
• Manage professional misconduct according to institutional and legal protocol and an ethical-legal framework.
• Document all care activities accurately, comprehensively, and timeously considering the legal requirements for record keeping.
• Use critical decision-making and moral reasoning models and principles to resolve ethical dilemmas within the specialty practice.
• Use advocacy principles to advocate for safe and quality care in various nursing practice settings.
• Demonstrate understanding and the purpose of the advocacy role for a specialist nurse and midwife.
• Use appropriate communication channels and skills of communication in facilitating advocacy.

Associated Assessment Criteria for Exit Level Outcome 4

• Practice in the respective specialisations demonstrates knowledge of appropriate search engines and databases for review of the literature to inform evidence-based practice, nursing education and health services management.
• Use appropriate methods to generate evidence for utilisation in specialist practice education and health services management.
• Demonstrates awareness of the peer-reviewed journals and use for sharing of evidence.
• Base activities in specialist practice, education, and health services management on scientifically proven evidence.
• Actively participates in inter and intra-professional dialogues, debates, or discourses in quality improvement.

Associated Assessment Criteria for Exit Level Outcome 5

• Apply all data and information gathered in the context of oncology and palliative nursing practice for utilisation and storage in accordance with the set standards.
• Utilise comprehensive data, information, and emerging evidence pertinent to oncology and palliative nursing practice.
• Gather and analyse problem identification, diagnoses, and opportunities for improvement based on assessment data from the patients/clients, families, and communities, including current scientific evidence.
• Practice problems in the specialist area are identified, shared, and collaboratively solved by informed decisions and sound clinical judgement.
• Revise and approve developed policies, protocols, and guidelines collaboratively at appropriate intervals as per the institutional policy for the specialist area.
• Implement new policies, protocols, and guidelines in the specialist area to demonstrate understanding and application of the change process.

Associated Assessment Criteria for Exit Level Outcome 6

• Demonstrate mindfulness of the principles and theories of management and leadership.
• Create a positive learning climate in the workplace through the processes of mentorship, preceptorship, supervision, and performance appraisal.
• Debate the key concepts of self-responsibility, self-ownership, self-leadership, and self-development.
• Assess the degree of self-ownership in developing professionally to stay a competent practitioner.
• Develop a framework to demonstrate the process of self-development in the professional career.
• Utilise feedback gained from self-reflection, peers, learners, management, and other relevant stakeholders to improve the effectiveness as a nurse specialist.
• Create a plan to establish academic and professional relationships to sustain lifelong learning amongst nurses.
• Use performance appraisal principles to monitor own development within the context of the programme.
• Engage in performance appraisal and demonstrate an understanding of the purpose and processes of the performance management and development system.
• Demonstrate leadership skills through the application of appropriate leadership styles, principles, and theories of health services management as a nurse specialist.
• Demonstrates understanding of the various risk factors that impact health and wellness within the workplace and applies strategies to care for self, peers, employees, and learners.
• Apply a model for implementing mentorship in a unit for novices.

Associated Assessment Criteria for Exit Level Outcome 7

• Engage in planning, commissioning, and managing a specialist unit, an educational entity, or a health service.
• Take into consideration the burden of disease and priority services as determined by current trends of disease profiles, in the management or commissioning of a health service or educational entity.
• Participate in the evaluation of the unit to demonstrate knowledge of guidelines for the provisioning of a health service or educational entity.
• Engage in planning and commissioning demonstrating an understanding of the role and responsibilities within these tasks in conjunction with the intra and inter-professional team.
• Demonstrate a comprehensive understanding of the components of the management processes of planning, organising, staffing, directing, and control.
• Implement the components, principles, and theories of leadership in the health service or educational unit.
• Demonstrate team functioning and team leadership with the available best evidence on collaborative group work.

Associated Assessment Criteria for Exit Level Outcome 8

• Identify, share, and solve practice problems in oncology and palliative nursing through informed decisions and sound clinical judgement.
• Seek and provide consultation appropriately and timeously in the provision of holistic care in a healthcare continuum through awareness of one's competence.

Associated Assessment Criteria for Exit Level Outcome 9

• Plan 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 in the provision of oncology and palliative nursing interventions include.
• Demonstrate understanding of the position of oncology and palliative nursing service within the health care system.
• Use the full range of services within oncology and palliative nursing practice in the provision of oncology and palliative care.
• Render integrated promotive, preventative, curative, rehabilitative and palliative care in a healthcare continuum in the field of oncology and palliative nursing.
• Demonstrate knowledge, skill and attitudes involved in rendering oncology and palliative care in accordance with national and international standards and protocols of the oncology and palliative nursing field.
• Plan oncology and palliative nursing interventions that are individualised considering patient's/client's needs, values, beliefs, preferences, culture, and contextual variables, for example, disease burden, health risks, and national priorities.
• Plan and implement oncology and palliative nursing interventions timeously, accurately, safely, and effectively in accordance with set evidenced-based standards, guidelines, protocols, and algorithms.
• Document and revise oncology and palliative 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 10

• Demonstrate understanding of the infrastructure and equipment needed in the specific area of specialisation.
• Render care demonstrating the 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 nurse care taking into consideration the oncology and palliative nursing practice and its competencies, experience, and standard nurse-patient ratios.

Associated Assessment Criteria for Exit Level Outcome 11

• Participate in the development of oncology and palliative nursing policies, programmes, and projects demonstrating an understanding of the steps in and levels of the development of policies, programmes, and projects.
• Participate in project and policy development demonstrating knowledge of own role and responsibilities within the inter and intra-professional policy/project team in the provision of oncology and palliative care.
• Participate in policy, programme, and project development, and demonstrate advocacy for the nursing profession and patients/clients, families, and communities in the oncology and palliative nursing practice.
• Participate in project development including appropriate communication (negotiation, bargaining, assertiveness, persuasion,).
• Provide timely and adequate feedback to relevant stakeholders is provided as necessary.
• Demonstrate knowledge of the process and or steps of development of policies, standards, guidelines, and protocols.
• Apply the process of development of policies, standards, protocols, and guidelines involving the relevant and pre-determined stakeholders.
• Utilise the process of development and evaluation or testing of guidelines and protocols using the appropriate methods.
• Implement the new policies, protocols, and guidelines to the specialist area demonstrating understanding and application of the change process.
• Participate in the revision of developed policies, protocols, and guidelines which are collaboratively revised at appropriate intervals and approved as per the institutional policy for the Oncology and palliative nursing practice.

INTEGRATED ASSESSMENT

Integrated assessment forms part of continuous assessment at the institution and takes the form of an appropriate mix of both formative and summative assessment methods.

Assessments are aligned with the learning outcomes as indicated in the oncology and palliative nursing-specific subject guides. Assessment dates are collectively discussed by the academic staff to ensure no overlap of due dates of assessments.

Assessment policy and practices at the institution promote constructive alignment of the curriculum, student centred-learning and assessment, and the importance of feedback to enhance student engagement. Assessment practices should be fair, reliable, and valid. It should also be in keeping with academic disciplinary and professional field norms and standards.

Formative assessment is aimed at enhancing learning and provides learners with an opportunity to reflect critically on their own learning and to improve their own levels of personal accountability and time management. Formative assessments will consist of a variety of assessment tasks relevant to oncology and palliative nursing services management.

The formative assessments may be conducted as individual or group work. Peer and self-assessment tools may also be used in conjunction with tutor-centred methods for some units to enhance learner feedback.

The qualification will include a variety of tasks such as problem-solving individual and/or group assignments and projects, case studies, portfolio development, class discussions, quizzes, field trip reports, and digital story presentations.

Summative assessment will take place at the end of a section of work and is aimed at assessing learners' attainment against the learning outcomes of the programme and subject(s). Summative assessments are internally and externally moderated based on institutional policy and requirements.

Summative assessments usually consist of a variety of formal assessment tasks relevant to oncology and palliative nursing, including written assessments and assignments, reports, and a Work Integrated Learning (WIL) portfolio. This qualification will consist of written assessments in the form of written class tests and assignments (oral, and written), and portfolios conducted during and at the end of the academic semester.

Integrated assessment is aimed at holistic development and contributes to learners' personal and professional development in Oncology and Palliative Nursing in terms of foundational, practical, and reflexive competence. Integrated assessment in this qualification will take place continuously and learners will be assessed holistically by means of project reports. Integrated assessments in this qualification will take place through research projects conducted across different subject fields and also in community engagement projects that make use of the different knowledge and skills from different subject areas.