Postgraduate Diploma in Perioperative Nursing

Purpose

The Postgraduate Diploma in Perioperative Nursing qualification aims to produce competent, service-driven perioperative nurses who provide person-centred perioperative care integrating family involvement and acknowledging the patient as part of a community, culture and active society within the interprofessional team.

The demanding and escalating roles of nurses in perioperative nursing and advances in technologies necessitate additional training to prepare them for effective participation as perioperative nurses in various settings and spheres. Trauma is a leading cause of admissions in hospitals in South Africa where surgical interventions are required as a means of treatment.

There is an increase in cancer cases worldwide including South Africa that requires specialist skill and knowledge in caring for those who need diagnostic, medical, and surgical interventions.

Nurses are now expected to have comprehensive and extensive knowledge of their field of expertise to equip the next generation of nurses to address the lack of skills in South Africa, thus the need for this course.

Upon completion of the qualification, a qualified learner will be able to

• Practice as a competent, committed, independent perioperative nursing practitioner in providing scientific, safe comprehensive quality perioperative nursing care in all hospitals and community settings.
• Promote healing, prevent complications, and alleviate suffering based on acquired knowledge, skills, and competencies in perioperative nursing care.
• Be an independent perioperative nurse specialist who conducts safe perioperative nursing care, based on scientific evidence and technology.
• Provide perioperative nursing care through in-depth theoretical knowledge and competency in clinical skills, managerial and leadership skills.
• Establish a research culture that will lead to evidence-based and reflective practice in perioperative nursing.
• Uphold the image of nursing through the application of an ethical, legal, and professional framework in perioperative nursing.

The Postgraduate Diploma in Perioperative Nursing qualification will offer a wide range of transferable skills for application in other professions, disciplines, and general life, which include:

• Capacity to assess, develop, implement, and evaluate health and other policies.
• Ability to plan, commission and manage projects of a varied nature.
• Participation in interprofessional team activities to advocate for evidence-based care.

The needs of the perioperative client will be met through

• A holistic nursing care approach by the delivery of comprehensive, individualised perioperative care based on the patient`s needs within the public and private health care domain.
• Learners progressing into the marketplace as perioperative nurses with advanced knowledge, skills, and competencies.
• The implementation of safety precautions and protocols by the perioperative nurse to ensure that the rights of the surgical patients (clients) are respected.
• Promoting perioperative nursing practice as an essential part of health service delivery to improve quality perioperative patient care.
• Utilising specialised knowledge and skills to provide safe, competent patient-centred care in the perioperative environment.
• Working within the interprofessional health care team and ensuring that patients receive holistic, comprehensive care before, during and after the surgery.
• Providing pre- and post-operative health education to patients and their families to ensure that they are well informed and prepared for the post-operative care that will be provided.

Rationale

The rationale for this qualification is to develop a nurse with advanced knowledge and expert clinical skills in line with the National and Provincial Health Care Plans and Sustainable Goals.

The intention is to promote the health status of the South African population, alleviate the lack of skills and practitioners to address the burden of disease in the healthcare system and practice within a specialised field in hospitals, clinics, industries and communities in both public and private health sectors.

Nurses are required to take responsibility for complex operating room equipment and instrumentation and are challenged regularly with newer specialist technology for better surgical results. In the Western Cape there is currently a shortage of 98 perioperative nurses. The attrition and retirement of skilled perioperative nurses are not included in this data. The backlog of perioperative nurses will not be filled in the foreseeable future. In South Africa, there is no vision to replace the perioperative specialist with a technician.

Nurses are the only category of health workers charged with accountability for patient care in theatre. The perioperative nurse must be equipped with the skill and scientific-based knowledge to render holistic quality nursing care to the patient undergoing surgery.

A constructivist paradigm was chosen as the most appropriate framework according to which the curriculum will be developed. Through the above-mentioned paradigm, a learning environment will be designed with clear learning outcomes, which will allow the qualification to be presented in a classroom or online (blended learning). Blended learning is a learner-centred approach to creating a learning experience whereby the learner interacts with other learners, with the instructor, and with content through the thoughtful integration of online and face-to-face environments (Thompson 2016).

Learners will function within the approved scope of practice as specified by the South African Nursing Council (SANC).

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 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 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

• Bachelor of Nursing, NQF level 7.

Or

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

Or

• Advanced Diploma in Trauma and Emergency Nursing, NQF Level 7.

Or

• Bachelor of Nursing Science, 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.

• Nursing research and professional ethics, 12 Credits.
• Leadership and management in advanced nursing practice, 12 Credits.
• Foundations of perioperative practice, 20 Credits.
• Surgical efficiency one, 28 Credits.
• Surgical efficiency two, 28 Credits.
• Anaesthetic Nursing, 20 Credits.

Exit Level Outcomes

1. Practice and facilitate perioperative nursing, nursing education or health services management within the ethical-legal parameters of the profession.
2. Apply the knowledge of and facilitate evidence-based practice, nursing education or management in the perioperative nursing field to solve contextual problems and develop policies and guidelines.
3. Engage in planning, commissioning, and managing a perioperative nursing unit, an educational entity, or a health service.
4. Engage in scholarly activities to inform evidence-based practice, education, or management related to perioperative nursing.
5. Utilize, manage, and communicate data to support decision-making and research in perioperative nursing.
6. Render and co-ordinate patient-centred perioperative nursing practice within a continuum of care using the scientific approach, integrating biomedical and psychosocial sciences including advanced pharmacology nursing.
7. Mobilize appropriate resources to implement standards of practice relevant to perioperative nursing, to ensure quality patient care and safety.
8. Develop and implement institutional policies, protocols, and guidelines in perioperative nursing, utilising the process of change management in the improvement of quality of care.
9. Facilitate advocacy for the profession and provision of perioperative nursing professional support for personnel, patients, families, and communities.
10. Appraise and develop self, peers, and perioperative nursing learners by facilitating self-directedness/leadership and lifelong learning to maintain competence.
11. Collaborate within the inter-professional team by engaging in health dialogue, shared leadership, decision-making and sound clinical judgment related to perioperative nursing.
12. Participate in the design, development, implementation, and evaluation of perioperative nursing policies, qualifications and projects at provincial or national level.

Associated Assessment Criteria for Exit Level Outcomes 1.

• Integrate relevant legislation and legal framework in perioperative nursing care such as the declaration of Helsinki, Singapore Statement, Bill of Rights, South African Constitution, National Health Act, No. 61 of 2003 as amended, Patients' Right Charter and Batho Pele Principles.
• Apply ethics and ethical frameworks to guide decision-making in perioperative nursing practice.
• Manage moral distress in the perioperative-related interprofessional team and empower perioperative nurses to manage moral distress.
• Conduct and monitor the continuous professional development of the perioperative nursing team.
• Apply ethical principles when conducting clinical research in perioperative nursing.

Associated Assessment Criteria for Exit Level Outcomes 2.

• Evaluate the importance of research and clinical evidence-based guidelines in implementing evidence-based practice in perioperative nursing.
• Reflect on the ways that research literature can be used as evidence for perioperative nursing practice.
• Judge practices of infection control in perioperative nursing against new evidence-based information/research findings made available.

Associated Assessment Criteria for Exit Level Outcomes 3.

• Participate in the entire process of planning, commissioning, and management of a perioperative unit on all levels including all role-players.
• Explore the dynamics that may impact the financial management in a perioperative nursing unit within the healthcare facility.
• Apply knowledge to summarize the role of the operational manager and

submit the perioperative unit's needs for inclusion in the capital budget.

Associated Assessment Criteria for Exit Level Outcomes 4.

• Apply leadership and management skills in the management of the perioperative nursing unit based on evidence from audits.
• Carry out practical patient care procedures by using the given support to learners in the perioperative unit.
• Conduct a needs analysis of the perioperative nursing staff training needs.
• Develop a proposal to nursing management for training activities to be included in the annual institutional CPD plan for the perioperative nursing unit.
• Explore evidence-based research in perioperative nursing care.

Associated Assessment Criteria for Exit Level Outcomes 5.

• Explore how research is used as evidence guiding the practice of perioperative nursing care and communicate these findings to the interprofessional team.
• Interpret qualitative and quantitative data related to perioperative nursing and communicate these findings to the interprofessional team to improve the health of the perioperative patient.
• Employ communication and ethical reasoning skills to address ethical challenges associated with moral distress in the perioperative nursing unit.

Associated Assessment Criteria for Exit Level Outcomes 6.

• Apply psychosocial science and pharmacology to dissect the approach to perioperative nursing care through a scientific approach.
• Explain the surgical pharmacological management of the perioperative patient.
• Dissect the approach to perioperative nursing care through a scientific approach, applying psychosocial science and pharmacology.
• Explain the surgical pharmacological management of the perioperative patient.
• Apply knowledge to perform a comprehensive, individualised preoperative assessment of the patient`s needs based on the following medical history and treatment, physical examination, laboratory results and related investigations.
• Apply vigilance in identifying physical and psychosocial changes in the patient during the perioperative period.
• Liaise with the relevant departments/interprofessional team to ensure comprehensive patient-centred care to the surgical patient.
• Construct comprehensive individualised nursing care plans for surgical patients in all related surgical interventions.
• Design a comprehensive individualised perioperative nursing care plan for the anaesthetic patient.

Associated Assessment Criteria for Exit Level Outcomes 7.

• Review the relevance of perioperative nursing guidelines and standards to remain relevant with current practice nationally and internationally.
• Develop and apply nursing practice standards, guidelines, and policies in perioperative nursing practice.
• Utilise policies to ensure patient safety during surgery such as swab needle and instrument control, bowel technique, handling of specimens, electrocoagulation control and surgical devices related to specific surgical disciplines.
• Apply policies, protocols, and guidelines to ensure patient safety during anaesthesia.
• Debate the implementation of aseptic and sterile techniques during the perioperative period to ensure patient safety.

Associated Assessment Criteria for Exit Level Outcomes 8.

• Provide input on risk management strategies, through participation in local, national, and international perioperative nursing forums to provide.
• Implement safety precautions and protocols to ensure that the rights of surgical patients are respected.
• Evaluate the universal standards and precautions on infection control in the perioperative setting.
• Apply policies and protocols to ensure patient safety before, during and after surgery.

Associated Assessment Criteria for Exit Level Outcomes 9.

• Promote continuous professional development to advance competencies and improve the quality of perioperative nursing care.
• Illustrate practical procedures for perioperative nursing learners in the unit.
• Advocate for the rights of the patient through adherence to surgery-related protocols and policies.
• Participate in interprofessional team activities to advocate for evidence-based care in perioperative nursing.
• Advocate and portray a professional role in patient care, communication with the community and lobbying for change in perioperative nursing care.

Associated Assessment Criteria for Exit Level Outcomes 10.

• Justify the advantages and contributions of continuous professional development to perioperative nursing practice.
• Apply knowledge of and assume responsibility for own professional development and those nursing team members assigned to the perioperative nursing team to promote continuous professional development to advance competencies and improve the quality of perioperative nursing care.
• Promote and monitor CPD attendance for perioperative nursing staff.

Associated Assessment Criteria for Exit Level Outcomes 11.

• Participate in planning committee meetings and monitor adherence to identified needs and standards on all levels related to perioperative nursing care.
• Appraise the contribution of supporting services to the perioperative setting such as the central sterilisation department, facility infection control unit, waste management contractor, maintenance department, environmental cleaning, laboratories and linen management.
• Portray the role of family liaison to the surgical patient and family concerning postoperative care as the perioperative nurse information specialist.
• Manage the integration of the different services rendered during the time of surgery.

Associated Assessment Criteria for Exit Level Outcomes 12.

• Collect and compile data to identify needs and envisage improvement in perioperative service delivery.
• Assess potential environmental sources of injury to patients and personnel in the perioperative environment to improve standards of care.
• Contribute towards planning committee meetings and the monitoring of adherence to identified needs and standards regarding perioperative nursing practices related to all health care levels.

INTEGRATED ASSESSMENT

Assessment consists of a continuous assessment system comprising formative and summative assessments.

Formative Assessments

Assessment tasks such as

• Quiz
• Essay or report in writing
• Test
• Assignment

Summative Assessments

• Assignments
• Case studies
• Tests,
• OSCE
• Portfolios
• Workbooks.

Learners' progress will be assessed at the end of a section of work rather than exclusively by final assessment at the end of the semester/year.

A minimum of two and a maximum of three assessments will be performed for a semester subject.

For year subjects a minimum of three and a maximum of five assessments will be conducted. Assessments (theory and clinical) will contribute equal weight (percentage) towards the final mark.

The theory comprises 40% and Work Integrated Learning comprises 60%. Learners must pass both the theory and Work Integrated Learning components to pass the subject.