Postgraduate Diploma in Primary Care Nursing

Purpose

The purpose of the Postgraduate Diploma in Primary Care Nursing is to produce high-quality professionals who can function with advanced intellectual and practical competencies, in complex specialised areas, as specialist practitioners in providing evidence-based primary care with other team members. In addition, qualifying learners will contribute to the continuous development of Primary Care Nursing, as well as the associated healthcare services through the development of scientific and professional knowledge for the advancement of Primary Care Nursing practice, and its research, management and education. Qualifying learners will work as clinical nurse specialists in Primary Care Nursing in the health sector. They are independent practitioners in their own right in their speciality.

This qualification aims to produce competent Primary Care Nurse Specialists in a range of health service settings. It will provide learners with a range of skills, knowledge, values and attitudes that will enable them to set trends and fulfil leadership roles in a meaningful and sustained contribution to health services. The qualification will also equip learners with a developed sense of equity, justice and service ethics that will ensure that they work in an accountable manner irrespective of their chosen workplace. Learners will be exposed to a wide range of transferable skills for application in other professions, disciplines, and general life, including; the capacity to assess and implement health and other policies, an ability to affect areas of policy change, development, and implementation, the ability to plan, implement and manage projects of a varied nature, the ability to work independently and as part of a team.

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

• Practice and facilitate specialist Primary Care Nursing within ethical-legal parameters of the profession.
• Apply knowledge of evidence-based Primary Care Nursing practice in the specialist field to solve contextual problems and develop policies and guidelines.
• Appraise and develop self, peers, and nurse/midwife specialist learners by facilitating self-directedness/leadership and lifelong learning to maintain competence.
• Facilitate advocacy for the profession and provide specialist professional support for personnel, patients, clients, families, and communities.
• Engage in planning, commissioning, and managing a primary health care facility.
• Engage in scholarly activities to inform evidence-based Primary Care Nursing practice.
• Utilise, manage, and communicate data to support decision-making and research.
• Render and coordinate patient-centred specialist Primary Care Nursing practice within a continuum of care using the scientific approach, integrating biomedical and psychosocial sciences, including advanced pharmacology.
• Mobilise appropriate resources to implement standards of practice relevant to Primary Care Nursing, to ensure quality patient care and safety.
• Collaborate within the inter-professional team by engaging in health dialogue, shared leadership, decision-making and sound clinical judgement.
• Participate in the design, development, implementation and evaluation of nursing policies, programmes, and projects at the provincial or national level.
• Develop and implement institutional policies, protocols, and guidelines in the area of Primary Care Nursing specialisation, utilising the process of change management to improve the quality of care.

Rationale

The State of the World's Nursing Report (2020) provides a compelling case for investing in nursing education to strengthen the nursing workforce to deliver the Sustainable Development Goals, improve health for all, and strengthen the primary health care workforce on our journey towards universal health coverage. Primary Care Nurses should therefore work in their full scope of practice, and nurse-led models should be expanded to improve healthcare access.

This qualification is aligned with the World Health Organization's Global Strategy on Human Resources for Health: Workforce 2030 and the Human Resource Development Strategy for South Africa 2030 goals. The National Health Act, Number 33 of 2003, Section 48(2) Development Strategies mandate the government to provide appropriately trained staff at all levels of the national health system to meet the population's health care needs. The National Department of Health Strategic Plan 2015-2021, The National Development Plan 2030, and National Health Insurance (NHI) all support the universal, equitable access to medical care by strengthening primary health care (PHC) for individuals and communities. It includes PHC re-engineering, hospital services, and Emergency Medical Services (EMS), and improving leadership and governance in the health system through reforms to the education of qualified personnel, management, and governance in all healthcare facilities. All of this is only achievable by enabling the education of the professionals needed to render the services.

Primary Health Care is the initial or first level of healthcare given to individuals seeking care in the public health sector and is the cornerstone of universal health coverage. The world needs primary health care to attain, retain, or regain health. The focus of South African healthcare has changed from hospital-centred to primary healthcare due to population and financial constraints in the healthcare sector. Health services have been decentralised to district and local levels to deliver more affordable, accessible, and acceptable basic healthcare to as large a sector of the population as possible. The nursing fraternity forms the largest component of healthcare workers and thus plays a crucial role in nurse-led primary healthcare delivery in South Africa.

It is essential to ensure that nurses are trained with the requisite knowledge and competency to address the basic health needs of the communities they serve. The role of Primary Care Nursing Specialists involves integrating the promotion of health, prevention of disease, curative skills, effective communication, and public health skills. Nurses in primary care nursing settings need to combine knowledge, skills, and proficiency to provide comprehensive PHC services, particularly in rural areas. Accordingly, profound rethinking of curricular approaches is necessary as education and training of PHC nurses are grounded in a community-based model, problem-based learning, and a person/people-centred approach.

Recognition of Prior Learning (RPL)

According to the SANC Postgraduate Diploma guidelines, recognition of prior learning for access and credit transfer is applicable as per the institutional and national guidelines or policies.

Currently, recognition of prior learning for the postgraduate programme will be for credits / advanced standing only. Discussions between the South African Nursing Council (SANC) and the Council on Higher Education (CHE) are underway to explore RPL for professional nurses who exited the legacy diplomas at NQF level 6.

RPL for access

The institution's current RPL policy for postgraduate study allows RPL for advanced standing on a case-by-case basis. Each application is considered and approved in collaboration with the relevant Faculty, supervisor (content specialist/academic), RPL Unit, and the Quality Assurance office. Relevant research experience, formal and non-formal learning are evaluated. The RPL Policy recommends that 10% of the learner's cohort can be admitted through the RPL process. Prospective learners who wish to be admitted to the programme using the RPL process must demonstrate knowledge, skills, competence, and academic readiness.

Access to postgraduate studies through Senate discretion is a common practice at many institutions. It entails candidates producing evidence of relevant learning achievement through work and/or other experience. Advanced standing entails the consideration of evidence of learning achievement through work and/or experience. Relevant research experience, formal and non-formal learning, current research, and conferences attended are evaluated. The final decision rests with the Senate Higher Degrees Committee in terms of its standing Orders on recommendation of the Faculty Higher Degrees Committee.

Entry Requirements

The minimum entry requirement for this qualification is

• Advanced Diploma in Critical Care Nursing, NQF Level 7

Or

• Advanced Diploma in Midwifery NQF Level 7.

Or

Advanced Diploma in Trauma and Emergency Nursing, NQF level 7

Or

• Bachelor of Nursing Science in Education, Management and Community, NQF Level 7

And

• Proof of current SANC registration as a Professional Nurse and Midwife for General Nurse with Midwifery.

AND

• Two (2) years' experience as a professional nurse or general nurse and midwife.

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

Compulsory Modules, Level 8, 120 Credits

• Paradigms of Primary Care Nursing, 16 Credits.
• Advanced Clinical Practice in Primary Care Nursing, 20 Credits.
• Adult Primary Care Nursing, 20 Credits.
• Child Primary Care Nursing, 20 Credits.
• Primary Care Emergency Nursing, 20 Credits.
• Evidence-Based Practice and Dynamics, 24 Credits.

1. Practice and facilitate specialist Primary Care Nursing within ethical-legal parameters of the profession.
2. Apply the knowledge of and facilitate evidence-based Primary Care Nursing practice in the specialist field to solve contextual problems and develop policies and guidelines.
3. Appraise and develop self, peers, and nurse/midwife specialist learners by facilitating self-directedness/leadership and lifelong learning to maintain competence.
4. Facilitate advocacy for the profession and provision of specialist professional support for personnel, patients, clients, families, and communities.
5. Engage in planning, commissioning, and managing a primary health care facility.
6. Engage in scholarly activities to inform evidence-based Primary Care Nursing practice.
7. Utilise, manage, and communicate data to support decision-making and research.
8. Render and co-ordinate patient-centred specialist Primary Care Nursing practice within a continuum of care using the scientific approach, integrating biomedical and psychosocial sciences, including advanced pharmacology.
9. Mobilise appropriate resources to implement standards of practice relevant to Primary Care Nursing, 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 judgement.
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 area of Primary Care Nursing specialisation, utilising the process of change management to improve the quality of care.

Associated Assessment Criteria for Exit Level Outcome 1

• Adhere to the relevant code of ethics in the practice of specialist Primary Care Nursing.
• Apply critical decision making, moral reasoning models and principles to make clinical judgements and resolve ethical dilemmas within Primary Care Nursing practice.
• Demonstrate accountability for professional judgement, actions, outcomes of specialist Primary Care Nursing care provided, and continued competence.
• Identify and apply the relevant current legislation, policies, regulations, and guidelines about specialist Primary Care Nursing practice.
• Accurately, comprehensively, and timeously document all care activities considering the legal requirements for record keeping.
• Discuss the Primary Care Nurse specialist role in managing professional misconduct and risks, considering the institutional protocols, protocols, and ethical-legal framework.

Associated Assessment Criteria for Exit Level Outcome 2

• Discuss the process of evidence-based practice in specialist Primary Care Nursing practice.
• Apply evidence-based Primary Care Nursing practice, considering the appropriate methodology of gathering evidence for practice, education, and management, for example, systematic or scoping reviews, appraisal of articles, practice-based research, and publication.
• Critically analyse various levels of evidence in evidence-based Primary Care Nursing practice.

Associated Assessment Criteria for Exit Level Outcome 3

• Apply appropriate leadership styles, principles, and theories of health services management.
• 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.
• Discuss the purpose and processes of the performance management and development system in performance appraisal.
• Use feedback gained from self-reflection, peers, learners, management, and other relevant stakeholders to improve effectiveness in the specialist Primary Care Nursing role.
• Identify the 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 nurse specialist or midwife specialist practice.
• Apply advocacy principles in various healthcare settings to ensure safe and quality care.
• Use appropriate communication skills and channels to facilitate advocacy.
• Lobby and or participate in interest groups to influence legislation and policy affecting role performance.

Associated Assessment Criteria for Exit Level Outcome 5

• Discuss levels and classification of the respective primary health care services.
• Commission task considering the burden of diseases and priority services as determined by current events.
• Apply guidelines for provisioning a specialist unit/ health service or educational entity in the evaluation of the existing primary health care services.
• Discuss the role and responsibilities within the inter- and intra-professional team in planning and commissioning.

Associated Assessment Criteria for Exit Level Outcome 6

• Conduct appropriate search engines and databases for review of the literature to inform evidence-based Primary Care Nursing practice.
• Use methods to generate evidence for utilisation in specialist Primary Care Nursing practice.
• Use peer-reviewed journals for sharing evidence.
• Base activities on scientifically proven evidence in specialist Primary Care Nursing practice.
• Actively participate in inter-professional dialogues/debates/discourses in quality improvement.

Associated Assessment Criteria for Exit Level Outcome 7

• Document all data/information gathered in the context of the specialist Primary Care Nursing practice for utilisation and storage per the set standards.
• Utilise comprehensive data, information, and emerging evidence pertinent to specialist Primary Care Nursing practice.
• Identify and diagnose problems and base opportunities for improvement on gathered and critically analyse assessment data from the patients/clients, families, communities, learners, or employees, including current scientific evidence.
• Respect intellectual property and minimise plagiarism.

Associated Assessment Criteria for Exit Level Outcome 8

• Discuss the position of Primary Care Nursing specialist service within the healthcare system.
• Describe the full range of services of a nurse specialist within Primary Care Nursing practice.
• Render specialised Primary Care Nursing that is integrated, promotive, preventive, curative, rehabilitative in a continuum.
• Render specialised Primary Care following standards and protocols of Primary Care Nursing.
• Formulate nursing diagnoses congruent with the patient's/client's clinical manifestations/data and are 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 individualised primary care nursing interventions considering the patient's/client's needs.

Associated Assessment Criteria for Exit Level Outcome 9

• Identify and analyse the infrastructure and equipment needs in the Primary Care Nursing specialisation.
• Operate and monitor the equipment used to render care in the specialist Primary Care Nursing area.
• Employ sound asset management principles to ensure appropriate, adequate, well-maintained and up-to-date equipment.
• Assign staff to primary nursing care considering the specialist qualification and competencies, experience, standard nurse patient ratios for the area of Primary Care Nursing specialisation, job description and skill mix.

Associated Assessment Criteria for Exit Level Outcome 10

• Identify, share and collaboratively solve practice problems in the specialist Primary Care Nursing by applying informed decisions and sound clinical judgement.
• Consult and appropriately and timeously provide holistic care in a continuum through awareness of one's competence.
• Appropriately and timeously carry out patient referral as dictated by the patient's condition and in accordance with the referral guidelines.
• Promote and participate in the inter-professional team recognised by the members of the team.

Associated Assessment Criteria for Exit Level Outcome 11

• Discuss the steps and/or levels involved in the development of policies, programmes, and projects.
• Discuss own role and responsibilities within the inter- and intra-professional policy/project team in project and policy development.
• Participate in advocacy for the specialised Primary Care nursing profession and patients/clients, families and communities in policy development, programme and project development.
• Apply appropriate communication (negotiation, bargaining, assertiveness, persuasion, etc.) techniques in project development.
• Provide on-time, adequate feedback to relevant stakeholders as necessary.

Associated Assessment Criteria for Exit Level Outcome 12

• Analyse the process and/or steps involved in the development of policies, standards, guidelines, and protocols.
• Engage the relevant and pre-determined stakeholders in the development of policies, standards, protocols, and guidelines.
• Use the appropriate methods in the development, evaluation, or testing of guidelines and protocols.
• Apply the change process in the implementation of new policies, protocols, and guidelines to the specialist Primary Care Nursing area.
• Collaboratively revise the developed policies, protocols, and guidelines at appropriate intervals and sign as per the institutional policy for the specialist Primary Care Nursing area.