Postgraduate Diploma in Ophthalmic Nursing

Purpose

The purpose of the Postgraduate Diploma in Ophthalmic Nursing is to develop a specialist nurse who can demonstrate advanced knowledge, expertise, and skills in eye health promotion and prevention of eye diseases, injuries, visual impairment, and blindness. The qualification will enable the ophthalmic nurse specialist to utilize the advanced technology in eye care appropriately and safely in the comprehensive assessment, diagnosis, planning, and management of ophthalmology patients of all age groups, including ocular emergencies.

The qualification will enable the Ophthalmic Nurse specialist to undertake advanced reflection and development through engaging in research and evidence-based practice in their field of specialization. This qualification will provide a high level of theoretical engagement, sound clinical judgement, intellectual independence, and the ability to apply knowledge to a range of contexts to render professional and competent eye care. The qualification will contribute towards strengthening healthcare systems through the delivery of comprehensive, high-quality, and safe Ophthalmology Nursing services.

The qualification will enable the Ophthalmic Nurse specialists to play a central role in the planning and delivery of people-centred eye care services, delivery of comprehensive eye care programmes, systems, and policy development in collaboration with other health care specialists at primary, secondary, and tertiary levels, including follow-up, referral, and rehabilitation of ophthalmology patients.

The qualification will enable Ophthalmic Nurse Specialists to function as members of the inter-professional health team, including Primary Health Care Outreach Teams, for the promotion of eye health and prevention of visual impairment and blindness within the District health system using a Primary Health Care Approach. The qualification will develop ophthalmic nurse specialists who will use expert knowledge and skills to provide universal eye health coverage, thus eliminating avoidable blindness beyond 2030 (In Sight initiative).

The curriculum is competency-based and has a strong component of work-integrated learning. Learners will be placed in a variety of ophthalmic care clinical learning sites throughout the qualification, as part of work-integrated learning to facilitate the integration of theory to practice and development of the required competencies in line with the requirements of the relevant statutory professional bodies within the ophthalmic nurse specialist competencies. The ophthalmic nurse specialist will be able to implement individual, family, and community awareness strategies to ensure that the human rights of visually impaired and blind persons are protected.

The curriculum content is structured in a manner that will equip the ophthalmic nurse to demonstrate critical understanding of the principles, theories and emerging issues and debates in this field and also apply specialist knowledge, skills and attitudes in the ophthalmological care of individuals, groups and communities at primary, secondary and tertiary levels of care in response to current and future health care needs of the population.

The qualification utilizes a learner-centred approach in teaching and learning, aimed at providing the ophthalmic specialist nurse with a wide range of skills, knowledge, and attitudes which will promote the culture of lifelong learning and continuing professional development.

Rationale

The qualification is aligned to the Higher Education Qualification Sub-Framework (HEQSF), new nursing qualifications, and the new competencies for ophthalmic nurse specialists as envisaged by the South African Nursing Council (SANC). This qualification will produce an Ophthalmic Nurse Specialist who will function as a leader, who is clinically focused, service-oriented, autonomous, innovative, and able to render comprehensive, scientific Ophthalmic nursing care, as determined by the appropriate legislative framework.

The burden of eye disease is a major challenge for the South African health care system and highlights the need to increase resource allocation to meet the eye health care needs of the South African population. According to the World Health Organization (WHO), an estimated 253 million people globally live with vision impairment, 36million are blind, and 217 million have moderate to severe vision impairment. The top three causes of blindness worldwide are cataracts, which account for 39.1% of global blindness, uncorrected refractive errors, which account for 18.2% and glaucoma, which accounts for 10.1% of global blindness (WHO Vision Report 2019). The prevalence of vision impairment in South Africa is the highest of all disabilities (32%), and it is estimated that 97% of all blind and partially sighted people in the country are unemployed. The qualification is therefore responding to the healthcare needs by preparing Ophthalmic nurse specialists with the knowledge, skills, and professional values in advocating for the prevention of eye disease and promotion of eye health, including meeting the eye health care needs of the population across the lifespan from birth to age.

In South Africa, nurses are essential in the expansion of access to health care services across the continuum of care to rural and remote populations. The qualification will address. human resources needs and bridge skills gap in line with provincial and national health priorities and scarce skills. According to the SANC 2021 Statistics, there are currently only 748 professional nurses with an additional qualification in Ophthalmological Nursing. The qualification will thus increase the production and distribution of Ophthalmic Nurse Specialists both in urban and rural communities, especially in Primary Health Care settings where there is the greatest need, for the purposes of developing strategies for eye health promotion, disease prevention, diagnosis, treatment, and rehabilitation. According to the National Health Department Human Resource Strategy, South Africa has an 80% nurse-based health system. Given the central role nurses play in the South African health system, the qualification will equip ophthalmic nurse specialists with specialised knowledge and skills to alleviate the current burden of eye disease.

According to the World Health Organization World Report on Vision (2019), there is a need to upscale training of ophthalmic nurse specialists to achieve the Sustainable Development Goals, Universal Health Coverage, and prevent avoidable blindness, as health worker density is used as an indicator of service capacity and access with positive health outcomes.

The qualification is designed to prepare an ophthalmic nurse specialist with a depth of knowledge and high level of skill and competence in dealing with and combating the burden of eye disease in individuals, groups and communities, under the SANC competencies of an ophthalmic nurse, and within the parameters of the ethical, professional and legal framework and Council on Higher Education prescripts. The qualification will produce an ophthalmic nurse specialist who is competent to serve in a dynamic health care system, which requires health care professionals who can promote and provide excellence in eye care for individuals, families, and communities through a comprehensive, multidisciplinary, evidence-based approach to ophthalmic nursing practice.

Graduates will assess and identify individuals at risk of developing eye diseases using appropriate technology as well as expert knowledge, skills, and attitude in the health promotion, screening, diagnosis, prompt referral, and treatment of such patients, thus preventing complications that may lead to blindness. An Ophthalmic nurse specialist will be an asset to function at a consultancy level to coordinate and manage ophthalmology services across the continuum of health care and between role players within the health care system.

Recognition of Prior Learning (RPL)

RPL for access

• There is no RPL for access to the Postgraduate Diploma in Ophthalmic Nursing.
• Applicants must meet the minimum entry requirements, which are a basic or undergraduate nursing qualification and Midwifery, as it forms the basis upon which to build specialization.

Entry Requirements

• Advanced Diploma in Medical and Surgical Nursing Science, NQF Level 7.

Or

• Advanced Diploma in Midwifery, NQF Level 7.

Or

• Bachelor of Nursing Science, NQF Level 7.

Or

• A four-year Diploma or Degree according to the South African Nursing Council (SANC) regulation R425

And

• Registration with SANC as a Nurse and Midwife/General Nurse with Midwifery/Professional Nurse and Midwife.

This qualification consists of the following compulsory modules at National Qualifications Framework Level 8, totalling 128 credits.

Compulsory Modules, NQF Level 8, 128 Credits

• Foundations of Ophthalmic Nursing 1, 16 Credits.
• Community-Oriented Ophthalmic Nursing Practice 1, 24 Credits.
• Ophthalmic Nursing Practice 1, 24 Credits.
• Nursing Research, 16 Credits.
• Contemporary Issues in Ophthalmic Nursing, 8 Credits.
• Clinical Nurse Specialist Practice, 16 Credits.
• Ophthalmic Nursing Practice 2, 24 Credits.

1. Practice and facilitate Ophthalmic Nursing within ethical-legal parameters of the profession.
2. Apply the knowledge of and facilitate evidence-based practice in ophthalmic nursing to solve contextual problems and develop policies and guidelines.
3. Appraise and develop self, peers, and ophthalmic nurse specialist learners by facilitating self-directedness/leadership and lifelong learning to maintain competence
4. Facilitate advocacy for the profession and provision of ophthalmic specialist professional support for personnel, patients, or clients, families, and communities.
5. Engage in planning, commissioning, and managing a specialist unit.
6. Engage in scholarly activities to inform evidence-based practice, education, and management.
7. Utilize, manage, and communicate data to support decision-making and research.
8. Render and co-ordinate patient-centred ophthalmic nursing within a continuum of care using the scientific approach, integrating biomedical and psychosocial sciences, including advanced pharmacology.
9. Mobilize appropriate resources to implement standards of practice relevant to ophthalmic nursing practice to ensure 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 judgment
11. Participate in the design, development, implementation, and evaluation of nursing policies, programmes, and projects at the provincial or national level.
12. Develop and implement institutional policies, protocols, and guidelines in the ophthalmic nursing area of specialization, utilizing the process of change management in the improvement of quality of care.

Associated Assessment Criteria for Exit Level Outcome 1

• Conform to the relevant code of ethics in the practice of ophthalmic specialist nursing.
• Use critical decision-making and moral reasoning models and principles to make clinical judgments and resolve ethical dilemmas within the specialist practice.
• Demonstrate accountability for own professional judgment, actions, outcomes of specialist care provided, and continued competence.
• Identify and apply relevant current legislation, policies, regulations, and guidelines about specialist practice
• Document all care activities accurately, comprehensively, and timeously, all care activities are documented considering the legal requirements for record keeping.
• Apply knowledge of the ophthalmic nurse specialist role in the management of professional misconduct and risk-taking, taking into consideration the institutional protocols, protocols, and ethical-legal framework.

Associated Assessment Criteria for Exit Level Outcome 2

• Discuss the evidence-based practice process in the ophthalmic specialist practice, demonstrating understanding of the process.
• Apply the evidence-gathering methodology appropriate for evidence-based practice.
• Critically analyse various levels of evidence using evidence-based practice

Associated Assessment Criteria for Exit Level Outcome 3

• Apply leadership skills appropriate to leadership styles, principles, and theories of health services management.
• Effectively facilitate Continuous Professional Development (CPD) for self and others and lifelong learning by creating a positive learning climate in the workplace through the processes of mentorship, preceptorship, supervision, performance appraisal, etc.
• Explore the purpose of performance management processes and the development system in performance appraisal.
• Utilise feedback gained from self-reflection, peers, learners, management, and other relevant stakeholders to improve effectiveness in the specialist role.
• Assess the impact of various risk factors on health and wellness within the workplace and apply strategies to care for self, peers, employees, and learners.

Associated Assessment Criteria for Exit Level Outcome 4

• Discuss the purpose of the advocacy role for an ophthalmic nurse specialist practice.
• Apply advocacy principles to ensure safe and quality care in various healthcare settings.
• Apply appropriate communication skills and channels in facilitating advocacy.

Associated Assessment Criteria for Exit Level Outcome 5

• Analyse levels and/or classification of the respective ophthalmic nurse specialist units.
• Commission task considering the burden of diseases and priority services as determined by current events.
• Develop the evaluation guidelines for the provisioning of the existing ophthalmic nurse specialist unit.
• Discuss the role and responsibilities in planning and commissioning tasks within inter- and intra-professional teams.

Associated Assessment Criteria for Exit Level Outcome 6

• Use appropriate search engines and databases for literature review to inform evidence-based practice.
• Apply appropriate methods to generate evidence for utilisation in ophthalmic nurse specialist practice (e.g., research, systematic reviews, etc.)
• Use peer-reviewed journals for sharing of evidence.
• Base activities on scientifically proven evidence in the ophthalmic nurse specialist practice.
• 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 for utilization and storage by the set standards in the context of the ophthalmic nurse specialist.
• Utilize the comprehensive data, information, and emerging evidence pertinent to the respective ophthalmic nurse specialist practice.
• Base problem identification, diagnoses, and opportunities for improvement on gathered and critically analyse assessment data from the patients/clients, families, communities, including current scientific evidence.
• Demonstrate respect for intellectual property and observe plagiarism in all documentation

Associated Assessment Criteria for Exit Level Outcome 8

• Evaluate the position of the ophthalmology nursing specialist service within the health care system.
• Discuss the full range of services within the ophthalmology nursing specialist area of practice.
• Render integrated promotive, preventive, curative, rehabilitative, and palliative care in an Ophthalmology nursing specialist care healthcare continuum.
• Render ophthalmology nursing specialist care per national and international standards and protocols of the ophthalmology nursing specialist field.
• Formulate nursing diagnoses in line with the patient's/client's clinical manifestations/data, and accurate analysis and interpretation of data obtained from scientific, laboratory, diagnostic, technological, and psycho-sociocultural assessment, including consultation of relevant/current literature/evidence.
• Plan individualized ophthalmology nursing interventions considering patients'/clients' needs, values, beliefs, preferences, culture, and contextual variables, for example, disease burden, health risks, national priorities, etc.
• Plan ophthalmology nursing interventions based on formulated nursing diagnoses and apply ophthalmology specialized knowledge and skills (competencies), including advanced pharmacology, in collaboration with the inter- and intra-professional team.
• Implement the planned ophthalmology nursing interventions timeously, accurately, safely, and effectively per set evidence-based standards, guidelines, protocols, algorithms, etc., specific to the ophthalmology nursing specialist field.
• Plan Health care interventions in collaboration with the patient or client, family, and relevant members of the health care team
• Include preparation of patients/clients, families, and nurses in the lower-level care in the nursing interventions for continued care in the hospital and community, following the health status and health literacy of the patient/client.
• Timeously and effectively document and revise ophthalmology nursing interventions 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 ophthalmology nursing practice area of specialisation.
• Operate and monitor the equipment to render care in the ophthalmology nursing 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 ophthalmology nursing specialist qualification and competencies, experience, standard nurse patient ratios for the ophthalmology nursing specialisation, job description, and skill mix.

Associated Assessment Criteria for Exit Level Outcome 10

• Identify, share, and collaboratively solve practice problems by informed decisions and sound clinical judgement in the ophthalmology nursing specialist area.
• Consult and appropriately and timeously provide holistic care in a healthcare continuum through awareness of one's competence.
• Appropriately and timeously conduct patient referral as dictated by the patient's condition and in accordance with the referral guidelines.
• Participate in the inter- and intra-professional team is promoted, visible, and recognized by the members of the team

Associated Assessment Criteria for Exit Level Outcome 11

• Discuss the steps in and/or levels of the development of policies, programmes, and projects
• Examine own role and responsibilities within the inter- and intra-professional policy/project team in project and policy development
• Advocate for the nursing profession and patients/clients, families, and communities in the specialist area in policy development, programme, and project development.
• Include appropriate communication (negotiation, bargaining, assertiveness, persuasion, etc.).
• Provide timely and adequate feedback to relevant stakeholders as necessary.

Associated Assessment Criteria for Exit Level Outcome 12

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

Integrated Assessment

The assessment strategy for the Postgraduate Diploma in Ophthalmic Nursing comprises formal and informal assessments. Informal assessments are used during facilitation and as part of the consolidation of what the learners may have learnt on their own. They provide an opportunity for lecturers to establish learners' understanding of the subject matter. This includes the following strategies, which serve as both teaching and assessment strategies:

Lectures

• The lecture method will be used to present common and complex content, allowing interactive learning.
• The lecture is also used to introduce & clarify information in foundational modules, which promotes deductive reasoning.
• Modes of delivery include face-to-face contact, formal lecture, provocative lecture, interactive lectures, PowerPoint presentations, smart boards, charts and models, videos, and textbooks.

Case Studies

• Case studies are used in case presentations based on module outcomes and will be allocated to Ophthalmic Nurse specialists to research, prepare, and present.
• Case-based teaching is used to promote integration of theory and practice. It helps Ophthalmic Nurse specialists in developing skills to collect data/history taking, data analysis, data interpretation, and consolidation, as well as presentation of findings.
• Modes of delivery include individual and group presentations, assignments, projects, and researchable cases.
• Allows for active participation in acquiring information, problem solving, decision making, and development of public speaking, and improves other communication skills.

Group discussions

• Group discussion involves allocation of tasks to groups of Ophthalmic Nurse specialists to research, prepare, and present.
• It promotes collaborative and cooperative learning (teamwork), communication skills, and peer-to-peer feedback, and develops self-awareness.
• It uses evidence-based practice examples and online literature searches to facilitate discussions

Assignments

• Assignments can be allocated to groups and or individual learners for the collection of information, consolidation, analysis, and interpretation of findings, and reporting.
• It enhances basic academic writing skills, teamwork, and promotes contextual and inquiry-based learning.
• Mode of delivery in the form of literature search, review, and critique to stimulate deep learning.

Simulation

It is an attempt to replicate nearly all of aspect clinical situation to make it more understandable.

• Simulation takes place as individualized clinical practice in a simulated skills laboratory.
• Develops competencies in a protected environment for ongoing acquisition of knowledge and skills.
• Modes of delivery include role play, demonstration, and simulation.

Tutorials

• Tutorials are utilized to provide additional support and or individual attention to a group of learners, which are usually smaller groups to promote understanding of learning content.

Reflective Learning Diaries

• Reflective learning diaries are logs or journals of work-based learning of what the learners have learnt, tried, and critically reflected upon.
• The use of experiential learning diaries promotes the development of self-awareness through reflection on practice.
• It provides evidence of acquired skills over time.

Web-based learning

• Allows accessing information at own pace/time, which promotes self-directed learning and peer and facilitator support.

Methods include Online literature search

• This method shall be progressively phased in accordance progressive development of IT-based administrative and academic activities and processes of the College.

Flipped classroom

• The flipped classroom is a pedagogical model where lecture and homework elements are reversed.
• Mode of delivery- recording of a lecture is viewed by Ophthalmic Nurse specialists at home before coming to the lecture, and then the contact time itself is devoted to discussion and activities.
• Learners have done background work on a topic before coming into a teaching session, so the lecturer has more time during the session to go into more depth, or to help Learners with aspects they don't understand.
• Learners can identify which areas they are challenged by, from watching the recording beforehand, and then work on these during contact time.

Problem-based learning

- Mode of delivery

Problem-based learning. The lecturer presents learners with a problem rather than a solution.

• This allows learners to become more active in their learning as they work out which information they need to find out to solve a particular problem.
• advantages to learners: it allows them to:
• Improve communication and teamwork
• Practice research and information processing
• Develop debating and analytical skills

Work-based learning

• This mode of delivery provides Ophthalmic Nurse specialists with real-life work experiences to aid their learning and improve their knowledge base.
• Workplace learning is integrated into the curriculum to allow Ophthalmic Nurse specialists to experience theories in practice. This could be done through accompaniment, mentoring, or field trips.

Blended learning

• Blended learning (also known as hybrid learning) is when traditional classroom teaching is combined with online learning and independent study, allowing the Ophthalmic Nurse specialists to have more control over the time, pace, and style of their learning.

Formal assessments will be in the form of formative and summative assessments. Formal assessments will determine learners' progression between semesters and completion of training.

Formative Assessments

• Formative assessments will contribute 30% towards the final mark in the module.
• Assessment content will be commensurate with the percentage contributed by the formal assessment.

Theory

• The following strategies will be used to assess learners' cognitive grasp of the subject matter: written tests, assignments, case studies, projects (quality improvement, community projects), and clinical assessments in real-life situations.
• Integration of theory and practice approach will be applied in all assessments; however, theory and work-integrated learning will be assessed separately, and marks will be published separately.
• Formative clinical assessments are conducted in the clinical areas their average percentage contributes 30% towards the final clinical nursing result.

Summative assessments

• Summative assessments will be conducted at the end of each semester.
• They contribute 70% towards the final examination result.
• Theory examination papers will be set for each module.

Work-integrated learning (WIL)

• Work-integrated learning will be assessed in the form of a comprehensive clinical examination in each semester.
• This comprehensive examination will embrace all the modules that have a clinical component in a semester.
• Work-integrated learning is assessed separately and must be passed for the learner to complete training.