Postgraduate Diploma in Perioperative Nursing

Purpose

The purpose of the Postgraduate Diploma in Perioperative Nursing is to strengthen and deepen the learners' knowledge and practice in Perioperative Nursing as a speciality. It will enable the Perioperative Nurse Specialist to engage in the specialized areas of practice with in-depth knowledge, skills, attitudes and values to enhance professional independence and health outcomes. This will include prevention of adverse events and complications.

The qualification will produce graduates who are autonomous and competent Perioperative Nurse Specialist with a focus on collaborative, critical analytic and reasoning skills, sound ethical decision making and clinical judgment that will display advocacy, confidentiality and leadership skills to enable the Perioperative Nurse Specialist to render evidenced-based specialized perioperative care within the inter and intra- professional team in various perioperative care settings.

Upon completion of the qualification, the qualifying learner will be able to

• Practice and facilitate specialised Perioperative Nursing within the ethical-legal parameters of the profession.
• Apply the knowledge of and facilitate evidence-based practice in specialised perioperative nursing care to solve contextual problems and develop policies and guidelines.
• Appraise and develop self, peers and perioperative nursing learners by facilitating self-directedness/leadership and lifelong learning to maintain competence.
• Facilitate advocacy for the profession and provision of specialises perioperative professional support for personnel, patients, families and communities.
• Engage in planning, commissioning and managing a specialist perioperative nursing unit.
• Engage in scholarly activities to inform evidenced-based Perioperative Nursing practice.
• Utilize, manage and communicate data to support decision-making and research.
• Render and coordinate patient-centred specialist nursing or perioperative practice within a continuum of care using the scientific approach, integrating biomedical and psychosocial sciences including advanced pharmacology.

Rationale

Positioning of Nursing Education within Higher Education is a response to the transformation of the Education and Health Care system agenda of the country as indicated in the following legislative frameworks.

• In compliance with the provisions of the Higher Education Act (Act 101 of 1997 as amended in 2008) the change in the educational landscape of the country mandates the alignment of the nursing qualifications to the National Qualification Framework (NQF).
• The Nursing Act No. 33 of 2005 provides for training, leading to registration as a Perioperative Nurse Specialist.
• The Government Notice No. 801 of 2016, stipulates information regarding the phasing out of legacy nursing qualifications and the implementation of nursing qualifications to be aligned to the Higher Education Qualification Sub-Framework (HEQSF).
• The South African Nursing Council Regulation No 635. (05 June 2020) prescribes the requirements for registration in the category of Perioperative Nurse Specialist.

This qualification is aimed at producing a Perioperative Nurse Specialist with competencies to respond to the reduction of morbidity and mortality rates in surgical patients. The learning and teaching process incorporates government programmes addressing infection prevention and control measures to promote quality patient care through evidence-based practice.

The qualification is responding to the National Development Plan Vision 2030 chapter 10 and the National Strategic Plan 2020/2021, one of the priorities is the prevention of diseases. World Health Organization (WHO) guidelines put emphasis on the decrease of morbidity and mortality rates in surgical patients. The Association of Operating Room Nurses and Association of Perioperative Practitioners of South Africa guidelines for perioperative nurses are the golden standards in evidence-based recommendations to deliver safe perioperative patient care. National Infection Prevention and Control Strategic Framework and Practical Manual and Centers for Disease Control and Prevention (CDC): Guidelines for Environmental Infection Control in Health-Care Facilities to ensure infection policies and guidelines are adhered to.

The competencies acquired from the qualification will enable the graduates to be autonomous, critical analytical thinkers and apply reasoning skills with sound ethical decision-making that will display advocacy, confidentiality and leadership skills to enable them to render evidenced-based specialized perioperative care within the multidisciplinary team in the various perioperative care settings.

Community engagement will be integrated with the curriculum to enable the learners to interact and involve their communities when matters of health related to their issues are discussed and when decisions pertaining to their needs are made.

On successful completion of the qualification, the graduate will be registered as a Perioperative Nurse Specialist with the South African Nursing Council (SANC) to practice as defined by the Nursing Act No. 33 of 2005.

Recognition of Prior Learning (RPL)

The institution admits candidates with various qualifications, some of which have been acquired from other institutions and are in line with the content of the courses offered by the college. Assessment of informal and non-formal learning for the purpose of access to qualifications or exemption from modules.

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.
• Only 10% of candidates per intake will be admitted through RPL.

RPL for credits

• A candidate who does meet the formal entrance criteria for a qualification could follow the RPL for credit route towards the qualification, in which he/she 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.
• Credits may be awarded to a maximum of 50% of a 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.

Entry Requirements

The minimum entry requirement for this qualification is

• Advanced Diploma in Midwifery, 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, NQF level 7.

Or

• Bachelor of Nursing Science, NQF Level 7.

And

• Proof of current SANC registration as a Professional Nurse and Midwife or General Nurse with Midwifery
• At least two (2) years experience after registration as a Professional Nurse or General Nurse and Midwife, which includes a year of community service.

This qualification consists of the following compulsory modules at National Qualifications Framework Level 8 totalling 144 credits.

Compulsory Modules, Level 8, 144 Credits

• Health Service Dynamics, 16 Credits.
• Health Science Research, 12 Credits.
• Advanced Perioperative Care, 16 Credits.
• Intra and Postoperative Nursing, 30 Credits.
• Perioperative Work Integrated Learning, 70 Credits.

1. Demonstrate the ability to practice and facilitate specialised Perioperative Nursing within the ethical-legal parameters of the profession.
2. Apply the knowledge of and facilitate evidence-based practice in specialised perioperative nursing care to solve contextual problems and develop policies and guidelines.
3. Appraise and develop self, peers and perioperative nursing learners by facilitating self-directedness/leadership and lifelong learning to maintain competence.
4. Facilitate advocacy for the profession and provision of specialises perioperative professional support for personnel, patients, families and communities.
5. Engage in planning, commissioning and managing a specialist perioperative nursing unit.
6. Engage in scholarly activities to inform evidenced-based Perioperative Nursing practice.
7. Utilize, manage and communicate data to support decision-making and research.
8. Render and coordinate patient-centred specialist nursing or perioperative practice 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 the area of specialization, to ensure quality patient care and safety.
10. Collaborate within the inter-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.
12. Develop and implement policies, protocols, and guidelines around 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 perioperative nursing specialist practice.
• Use critical decision-making and moral reasoning models and principles to make clinical judgments and resolve ethical dilemmas within the perioperative nursing specialist practice.
• Be accountable for own professional judgment, actions, and outcomes of specialist care, provided and continued competence.
• Identify and apply relevant current legislation, policies, regulations and guidelines pertaining to perioperative nursing specialist practice.
• Accurately, comprehensively and timeously document all care activities considering the legal requirements for record keeping.
• Discuss the perioperative nursing specialist role in the management of professional misconduct and risks taking into consideration the institutional protocols, other protocols and ethical-legal framework.

Associated Assessment Criteria for Exit Level Outcome 2

• Engage in the perioperative nursing specialist practice and the process of evidence-based practice,
• Apply evidence-based perioperative nursing specialist practice, taking into consideration the appropriate methodology of gathering evidence for the practice, for example, systematic or scoping reviews, appraisal of articles, practice-based research and publication.
• Use evidence-based practice, and perioperative nursing specialist practice and critically analyse the various levels of evidence.

Associated Assessment Criteria for Exit Level Outcome 3

• Apply leadership skills through the application of appropriate leadership styles, principles and theories.
• 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, performance appraisal, etc.
• Engage in performance appraisal demonstrates an understanding of the purpose and processes of the Performance Management and Development System.
• Utilise feedback gained from self-reflection, peers, learners, management and other relevant stakeholders to improve effectiveness in the perioperative nursing specialist role.
• Examine 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

• Discuss the purpose of the advocacy role for a perioperative nursing specialist practice.
• Apply advocacy principles to ensure safe and quality care in various perioperative nursing healthcare settings.
• Use appropriate communication skills and channels in facilitating advocacy.
• Lobby and/or participate in interest groups to influence legislation and policy affecting role performance.

Associated Assessment Criteria for Exit Level Outcome 5

• Explain the levels and/or classification of the specialized perioperative nursing units.
• Commission task considering the burden of diseases and priority services as determined by current events.
• Participate in the evaluation of the existing specialized perioperative nursing unit and demonstrate knowledge of guidelines for provisioning a specialized unit.
• Discuss the role and responsibilities in planning and commissioning within inter and intra-professional teams.

Associated Assessment Criteria for Exit Level Outcome 6

• Practice in the specialized perioperative nursing health setting to demonstrate knowledge of appropriate search engines and databases for review of the literature to inform evidence-based practice.
• Use appropriate methods to generate evidence for utilization in specialized perioperative nursing practice (e.g. research, systematic reviews etc.).
• Use peer-reviewed journals for sharing of evidence.
• Base the specialized perioperative nursing practice activities 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

• Gather documents all data/information in the context of the specialized perioperative nursing practice, for utilization and storage in accordance with the set standards.
• Utilise comprehensive data, information and emerging evidence pertinent to the specialized perioperative nursing practice.
• Identify and diagnose problems and critically analyse opportunities for improvement of assessment data from the patients/clients, families, communities, learners or employees including current scientific evidence.
• Respect for intellectual property and minimize plagiarism.

Associated Assessment Criteria for Exit Level Outcome 8

• Examine the position of specialized perioperative nursing service within the health care system.
• Discuss the full range of services within the specialized perioperative area of practice.
• Render and integrate promotive, preventive, curative and rehabilitative care in the specialized perioperative nursing healthcare continuum.
• Render specialist perioperative nursing care in accordance with institutional, national and international standards and protocols of the perioperative nursing field.
• Formulate perioperative nursing diagnoses congruent with the patient'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 individualized perioperative nursing interventions considering patient's/client's needs, values, beliefs, preferences, culture and contextual variables, for example, disease burden, health risks, national priorities, etc.
• Plan perioperative nursing interventions based on formulated nursing diagnoses and apply specialized knowledge and skills (competencies) including advanced pharmacology in collaboration with inter and intra-professional teams.
• Timeously, accurately, safely and effectively plan and implement perioperative nursing in accordance with set evidenced-based standards, guidelines, protocols, algorithms etc. specific to the specialized perioperative nursing field.
• Plan healthcare interventions in collaboration with the patient/client, family and relevant members of the healthcare team.
• Prepare patients/clients, families, and nurses in the lower-level care in nursing interventions for continued care in the hospital and community in accordance with the health status and health literacy of the patient/client.
• Document and revise timeously and effectively Perioperative nursing interventions based on critical analysis, monitoring and evaluation of data in order to reach a clinical judgement.

Associated Assessment Criteria for Exit Level Outcome 9

• Identify the infrastructure and equipment needed in the specialized perioperative area.
• Render care, operate and monitor the equipment used in the specialized perioperative area of practice.
• Employ sound asset management principles to ensure appropriate, adequate, well maintained and up-to-date equipment.
• Assign staff to nursing care considering the Perioperative Nursing Specialist's qualification and competencies, experience, standard nurse-patient ratios for the area of perioperative nursing specialization, job description and skill mix.

Associated Assessment Criteria for Exit Level Outcome 10

• Identify, share and collaboratively solve practical problems informed by decisions and sound clinical judgment in the specialized perioperative nursing area.
• Appropriately and timeously consult and provide holistic care in a healthcare continuum through awareness of one's competence.
• Appropriately and timeously carry out patient referrals as dictated by the patient's condition and in accordance with the referral guidelines.
• Recognize the members of the team in the inter- and intra-professional team participation

Associated Assessment Criteria for Exit Level Outcome 11

• Discuss the steps in and or levels of the development of policies, programmes and projects in the development of policies, programmes and projects.
• Examine own role and responsibilities within inter and intra-professional teams in project and policy development.
• Advocate for the perioperative nursing profession and patients/clients, families and communities in the specialized perioperative nursing area in policy development, programme and project development.

Associated Assessment Criteria for Exit Level Outcome 12

• Discuss the process and or steps of development of policies, standards, guidelines and protocols.
• Involve relevant and pre-determined stakeholders in the process of development of policies, standards, protocols and guidelines.
• Use the appropriate methods in the process of development and evaluation or testing of guidelines and protocols.
• Implement new policies, protocols and guidelines to the specialized perioperative nursing area demonstrates understanding and application of the change process.
• Develop and collaboratively revise policies, protocols and guidelines at appropriate intervals and approve as per the institutional policy for the specialized perioperative nursing area.

INTEGRATED ASSESSMENT

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

Health Science Research

Continuous Formative Assessment (100%)

• Test 1 100%.

Summative assessment 100%.

Work Integrated Learning (WIL)

Portfolio of evidence 100%.

Final Assessment

• Evidence-based poster presentation (project) 100%

Health Service Dynamics

Continuous Formative Assessment

• Test 1 60%.
• Assignment 1 40%.

Work Integrated Learning (WIL)

• Situational analysis 70%.
• Conducting a meeting 30%.

Summative assessment

• Portfolio of Evidence (Written Assessment) 100%.

Advanced Perioperative Care.

Continuous Formative Assessment (100%).

Formative Assessments.

• Test 1 35%.
• Test 2 45%.
• Assignment 1 20%.

Summative Assessment.

• Clinical.
• Written Assessment 100%.

Intra And Postoperative Nursing

Continuous Formative Assessment (50%).

Formative Assessments.

• Test 1 35%.
• Test 2 45%.
• Case study 20%.

Summative Assessment

• Clinical.
• Written examination 100%.

Perioperative Work Integrated Learning

Formative Assessments.

• Comprehensive patient assessment 35%.
• Clinical workbook. 10%.
• Case study. 20%.
• Anaesthetic machine video 35%.

Summative Assessments

• Final assessment: summative. 100%.