Postgraduate Diploma in Perioperative Nursing

Purpose

The purpose of this qualification is to strengthen and deepen the learners' knowledge and expertise in nursing as a speciality. It will enable the Nurse Specialist to undertake advanced reflection and development by means of a systematic survey of current thinking, practice and research methods in their field or discipline. The qualification aims to develop a Nurse Specialist who will use expert knowledge to enhance patient care. This includes preventing disease, injury, complications, screening, appropriate management, and prompt referral of patients with specific and complex problems in all clinical settings.

The qualification will provide a high level of theoretical engagement, sound clinical judgement and intellectual independence, as well as the ability to relate knowledge to a range of contexts to render professional and competent nursing care highly skilled work. The qualification was designed to equip candidates with relevant knowledge and skills combined with the required attitude and values to enter the field of nursing education as a career, either in the public or private sector. It includes research and high demand on theoretical engagement as well as independent learning with the emphasis on higher-order meta-cognitive skills such as analysis, synthesis and evaluation. Reflective practice and critical thinking will be developed across all modules as much as possible.

Learners will function within the approved scope of practice as specified by the South African Nursing Council (SANC), complemented by the policies and procedures of the institution of employment. The Perioperative Nurse is found in hospital perioperative settings/services, which include but are not limited to, public and private hospital settings. The Perioperative Nurse collaborates with General Medical Practitioners, Medical Specialist, and other nurses and at any level of health establishment.

Upon completion of the qualification, the qualifying learner achieves the following competencies

• Professional, Ethical and Legal Practice
• Clinical Practice, care provision and management
• Quality of Practice
• Management and leadership
• Research

This qualification will provide graduates with the opportunity to access a Master's Degree directly.

The Perioperative Nurse Specialist who has completed this qualification will be able to

• Provide clinical leadership in the care of patient/s throughout the lifespan in a specialist nursing field.
• Provide comprehensive evidence-based nursing/midwifery care including technology for patients in a specialist nursing field.
• Practise within an ethical-legal framework.
• Evaluate health care outcomes and make innovative suggestions to improve quality care and safety.
• Provide professional support for personnel, patients, families and groups to promote independence and behavioural change.
• Explore and improve current practices to meet the changing needs of patients and communities.
• Make recommendations to improve the cost-effectiveness of care.
• Demonstrate accountability and moral reasoning for independent clinical decisions made regarding patient care.
• Participate in research activities such as fieldwork and publication of clinical findings.
• Collaborate with multi-disciplinary team members and refer patients to relevant organizations/services.

Rationale

This qualification addresses the human resource development needs of the country for specialist nurses. A Specialist Nurse Practitioner is a registered nurse clinician who has acquired the expert clinical knowledge and skills that include complex decision-making abilities and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which she/he has the credentials to practice.

Qualifying learners will be able to perform the following functions and/or competencies

• Care for the patient in a pre-operative, intra-operative or post-operative unit.
• Scrub-, circulating-, recovery room nurse.
• Assist the Anaesthetist during the induction, maintenance, and reversal stages of Anaesthesiology.
• A leader who is clinically focused, service-orientated; autonomous, innovative Nurse Specialist.
• Render comprehensive, scientific nursing care, as determined by the appropriate legislative framework.
• Incorporate procedural knowledge and skills whilst maintaining professional and ethical standards and behaviour.

Perioperative specialist nurses demonstrate a unique knowledge, grounded in the early anticipation and prevention of risks, distinct from bedside nursing. The care of the surgical patient takes place primarily in a fast-paced and high-risk environment that requires situational awareness and an ability to make assertive decisions promptly. Perioperative specialist nurses must therefore be adaptable in rapidly changing situations and emergency surgical interventions.

The qualification is aligned to the exit level outcomes and competencies published by the South African Nursing Council and place a unique emphasis on person-centred care, ethics, leadership, and evidence-based practice. The Department of Health held a nursing summit on the theme "Reconstruction and Revitalizing the Nursing Profession" in April 2011 which resulted in six core priority areas, namely:

• Nursing Education and Training.
• Leadership.
• Governance
• Policy and Legislation.
• Ethical matters.
• Nursing practice.

Recognition of Prior Learning (RPL)

This qualification can be achieved in part through the recognition of prior learning. Prior learning is recognised according to the RPL policy and procedures of the institution. The previous learning and experience of an applicant will be compared with the Exit Level Outcomes required for a specified qualification as well as any prior learning that meets the requirements in respect of the qualification will be accepted.

Provision is made for prior learning to be recognized so that candidates can gain access to the qualification, obtain advanced standing in the prescribed learning qualification, exemption from the modules and credit recognition towards a qualification.

All learners who wish to enrol should adhere to the admission requirements which include the opportunity for a portfolio of evidence to be considered. RPL candidates should demonstrate competence in respect of certain specified knowledge, skills and/or attitudes pertaining to this qualification.

In addition, there are gaps between old qualifications and the requirements of the new scope of practice, and a consequent need to upgrade qualifications. RPL is seen as vitally important in every case to give recognition to learning already in place, make sense of the plethora of different levels and standards in the field, and provide a means for all to gain access to, and progress within, a common learning pathway for the profession.

RPL for access to the Qualification

• Access is open to nurses who are currently registered with the SANC as Registered Nurses as well as professional nurses qualified under the new Professional Degree.
• Two years' experience as a Registered/Professional Nurse which includes experience in the field of the speciality within the last five years. In specific circumstances, where the requirements are not fully met, a portfolio of evidence may be considered.

RPL for credits

The qualification also allows potential learners who have other primary care nursing qualifications to apply for exemption of modules for credits towards the qualification. All applications will be judged against the conditions and rules as specified in the RPL regulations of the institution. This includes the following:

• A maximum of 50% credits of a completed (previous) qualification may be transferred to another qualification.
• Admission of learners through the RPL route should not constitute more than 10% of the learner intake for the qualification.

Entry Requirements

The minimum entry requirement for this qualification is

• Bachelor of Nursing, NQF level 7.

Or

• Advanced Diploma in Preoperative, Operating Room and Surgical Nursing, NQF Level 7.

Or

• Registered Professional Nurse with the South African Nursing Council (SANC).

Or

• Bachelor of Nursing Science, NQF Level 7.

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

Compulsory Modules, Level 8,120 Credits

• Praxis of Specialist Practice, 8 Credits.
• Applied Research, 8 Credits.
• Leadership and Development in Specialist Practice, 8 Credits.
• Evidence-based Nursing practice, 8 Credits.
• Perioperative Nursing in context, 32 Credits.
• Specialist Perioperative practice, 56 Credits.

1. Demonstrate advanced knowledge of Perioperative Nursing care of patients in a variety of clinical settings, to promote health outcomes.
2. Analyse and apply knowledge of basic research methodology in the appraisal of articles in the field of perioperative care.
3. Assess, plan, implement, manage and evaluate operating room services within the context of organisational policy at regional, provincial and national levels and facilitate policy change when required.
4. Perform and coordinate comprehensive Perioperative health care to patients in a variety of health care settings, to promote health outcomes.
5. Identify and solve professional-ethical dilemmas by using decision making and moral reasoning models within the ethical-legal parameters of the nursing profession.
6. Examine and apply principles of evidence-based care to ensure quality in perioperative nursing care.
7. Apply scientific knowledge and principles of the systematic review and guideline development process to evaluate and review the standard of guidelines used in Perioperative nursing.
8. Manage Perioperative nursing services by implementing effective medico-legal norms, practices, and standards within an inter-professional team.
9. Implement strategies to develop self and peers by promoting self-directedness through a process of perception and monitoring.
10. Analyse complex ethical issues in preoperative, operating room and surgical nursing to develop a balanced personal perspective.

Associated Assessment Criteria for Exit Level Outcome 1

• Explore and critique Perioperative nursing care processes.
• Debate and evaluate principles underlying perioperative nursing.
• Critically analyse and apply individualised care of the preoperative, intraoperative, and postoperative patient.

Associated Assessment Criteria for Exit Level Outcome 2

• Appraise research articles in the field of perioperative nursing through the application of basic knowledge of research methodology.
• Compare and contrast qualitative, quantitative and mixed-method research designs.

Associated Assessment Criteria for Exit Level Outcome 3

• Review and apply national, professional, and institutional standards used to evaluate Perioperative nursing care.
• Mobilize and utilize resources to optimize perioperative nursing.
• Apply evidence-based practice to inform decision making about improving the quality of Perioperative nursing.
• Debate and recommend the influence of global trends; social, political, and economic factors; as well as disease profiles on Perioperative care.
• Evaluate Preoperative, operating room and surgical health services at regional, provincial, and national levels and analyse influencing factors to identify alternative strategies to improve services.
• Evaluate and implement collaborative leadership styles.
• Practice effectively as a leader and member of the operating room health team.

Associated Assessment Criteria for Exit Level Outcome 4

• Evaluate and implement mentoring and precepting models to develop self and others.
• Identify and apply mentoring and precepting techniques in practice to promote theory and practice integration.
• Establish and maintain academic/professional relationships to sustain lifelong learning.
• Create a positive learning climate by establishing positive relationships.
• Develop and implement activities towards enhancing Continuous Professional Development (CPD).
• Apply performance appraisal principles to monitor own development.
• Evaluate and apply learning theories in own development and the development of others.

Associated Assessment Criteria for Exit Level Outcome 5

• Apply critical decision making and moral reasoning models to guide clinical practice and resolve professional-ethical dilemmas within the Perioperative environment.
• Identify and debate the relevant latest legislation, policies, protocols, regulations, guidelines, directives, and applicable ethics pertaining to Perioperative nursing.
• Apply advocacy principles to advocate for Perioperative patients.
• Manage clinical misconduct according to institutional protocol.

Associated Assessment Criteria for Exit Level Outcome 6

• Use Boolean and other information search strategies to search for relevant databases.
• Analyse and implement problem-based learning to identify problems and recommend changes through evidence in current literature.

Associated Assessment Criteria for Exit Level Outcome 7

• Use academic writing in reports and guidelines.
• Apply academic writing skills in assignments, patient reports, case studies and reflective practice.
• Formulate research questions according to the patient/population, intervention, comparison and outcomes (PICO) format and any other frameworks.

Associated Assessment Criteria for Exit Level Outcome 8

• Evaluate standard guidelines used in perioperative nursing by applying knowledge of the systematic review and guideline development process.

Associated Assessment Criteria for Exit Level Outcome 9

• Design and execute a plan for learning facilitation sessions that promote the metacognition and clinical judgment processes in nursing learners.
• Differentiate between teaching and learning paradigms.
• Align teaching and learning approaches with learning theories.
• Compare different knowledge taxonomies and align with teaching and learning approaches.
• Explain and analyse thinking operations.
• Formulate learning outcomes and align with a selected knowledge taxonomy.
• Develop and implement teaching and learning activities to attain a set learning outcome.
• Facilitate learning in the classroom, online, and in the clinical setting.
• Develop and execute an integrated assessment plan.
• Develop assessment tasks and tools and test for reliability.
• Provide feedback on assessment and use it as a learning opportunity.
• Compile a moderator's report that addresses all the assessment criteria.
• Use technology within the educational domain to effectively communicate and facilitate learning.

Associated Assessment Criteria for Exit Level Outcome 10

• Identify and address ethical issues based on critical reflection on the suitability of different ethical value systems to perioperative nursing contexts.
• Implement evidence-based nursing to promote quality perioperative nursing.
• Use systematic reviews to improve perioperative nursing education.
• Conduct quality audits at predetermined times to improve Perioperative Nursing Education.
• Critique, develop and implement education standards.
• Monitor the quality of Perioperative Nursing Education continuously.